Dr Blake Bloxham

Hello everyone. Bluebird, I'm not sure what more I can say or add at this point. As I have been explaining and demonstrating to you for the past 3 months, your belief that you only received 1,700 grafts is simply untrue. You did, in fact, receive 2,700 grafts and I even went back in and extended the original length of the strip to ensure we achieved -- and even exceeded -- the quoted number of grafts. All of the other comments about things you believe may have been "off" or untoward about your procedure are, again, simply untrue. I have invited you back to the office many times so we can review all of this in-person; I still not only strongly recommend and encourage you to come in, but I will also (with that patient's permission) allow you to observe a live procedure and interact with the technicians and any observing doctors so you can see exactly what happens during an FUT case just like your own. You have declined these offers so far, but it stands in perpetuity. I will make myself and everything related to your case available at any time. I know you have now posted your concerns throughout the internet for other patients to review as well, but I further invite you to visit other reputable hair transplant doctors for a professional review of your case. You are more than welcome to put me on speaker phone during that visit should the doctor have any questions. I think you will find they agree with our assessment. Should you change your mind or find some time in your schedule and come to visit, you are more than welcome to video record the entire follow-up and put that online as well. I did just finish reviewing everything related to your case a final time and put all my thoughts in a letter for your records. Thank you, Dr. Blake Bloxham Feller & Bloxham Medical, PC

Drew, So, if I am understanding correctly, the doctor is afraid that weight training will shunt blood to the muscles being strained and, therefore, steal blood from the scalp and negatively impact the follicles? To combat this, he/she provided a blood thinner? Somewhat novel theory. I have not heard of this before.

Hi JJ, No, I do not believe psoriasis or seborrheic dermatitis would cause this. I have had several patients experience flare-ups of both in the post-op, and it did not affect final yield. What I was referring to was specific types of inflammatory or immune-mediated types of alopecia like LPP, areata, etc.

Pre-Screened, In theory, your logic makes sense; the longer you leave them in, the longer the wound has to heal without tension, and the better the scar. In reality, there will be diminishing returns for leaving them in past the recommended period. Eventually any benefit you may -- and may is the operative word there -- achieve by removing tension on the wound would likely be nullified by the increased inflammation caused by leaving a foreign body in for so long. I close the vast majority of my strips with staples, and 14 days is the longest I recommend leaving them in. I have had a few patients go as long as 20 days or so for various reasons, and I have not noticed any better scarring from leaving them in for a few extra days. I have, however, noticed increased inflammation and a greater difficulty taking them out at 20 days versus 14. Hope this helps!

The "tagging" feature is neat. Thank you for bringing this thread to my attention, Melvin! AKC, I think you have received good advice thus far. Pustules like this seem to indicate some type of infection. The level of involvement (multiple follicles, skin, deeper tissues, etc) and proper course of treatment is difficult to estimate based on images alone. One question I do have, however, is how long ago you had the hair transplant? I was not clear on this. If I had to fathom a guess, I would say that you had the transplant within the last 3-4 months and the pustules are related to "ingrown" hairs penetrating through the scalp. If these were manipulated enough or things like oil were placed around them and created a nice environment for bacteria to grow, infectious agents absolutely could have infiltrated through the surface of the scalp and settled in various layers of the tissue. Depending on how deep the bacteria penetrated and how wide it spread, oral antibiotics may be a good option. This will all need to be determined by a knowledgeable doctor in person. It would be nice to get your HT doctor's input, but I would probably see your GP as well. Hope this helps.

Every clinic has different requirements. I recommend speaking with your clinic and following their instructions as closely as possible. For what it is worth, we allow patients to return to full activity (both FUT and FUE) 10-14 days post-op without restriction. Always seems to go well.

Good topic. Altogether, I think the stigma is decreasing. Doctors have told me that 25 years or so ago, patients would try to set up consultations during weird hours of the day and nearly run in and out of the office as to not be spotted anywhere near a hair transplant clinic. I think the fact that the surgery itself has improved so dramatically and people are becoming more open about discussing it online is really breaking down walls. I am always impressed when a patient allows us to use their full face in presentations or even refers acquaintances and colleagues to the office. I find it happening more frequently each year, and it seems to indicate that the stigma is decreasing.

Hi Jerry, Sorry to hear about this. I second the suggestion to have a scalp biopsy and determine whether or not this may be caused to an underlying immune-mediated process. You may have an underlying condition that is causing the body to inappropriately attack the follicles and cause them to fall out. Are you having any other symptoms? Redness or inflammation of the scalp? Any patches of hair missing from the donor region or any other hair-bearing areas of the body like your beard or chest?

MrZ, If the doctor is recommending that you split it up, I highly recommend splitting it up into two days. This is not uncommon at all. And, in my opinion, it is a good thing. Speed is not a virtue in FUE. Typically taking a slower, careful, more considered approach pays dividends. This also equates to less graft "out of body time." Good things all around.

Very good replies thus far. It absolutely comes down to skin type, how the patient heals, punch size, and the distribution of the extraction sites. For what it is worth, I tell all my FUE patients they can safely go down to a #2. There are obviously exceptions to all rules, but I think it's a safe generalization to keep expectations realistic.

Thank you for the kind words. I am very big on comb-through video. Particularly wet comb-through video. As you said before, there is simply no way to "fake it." It is honestly not the most flattering way to present a hair transplant, but I do believe it is the most honest. Potential patients need to know what they are getting themselves into if they chose the transplant route. If they watch a video where the transplants are soaking wet and being combed back and they like what they see, pretty good chance they will be happy with the outcome of a good transplant. If they do not, then maybe it is not for them and they just saved themselves time, money, and stress. Yes, we trim the grafts under microscopes. The same scopes we use in all of our FUT procedures and by the same technicians (the members of the staff cross-trained for FUE specifically). The grafts are reviewed to make sure they grossly look okay (twice, actually), properly identified, and trimmed up. And yes, we absolutely trim all the grafts in FUT as well.

I am always up for it. I have done a few little TV interviews and things like that, and they are always fun. So many misconceptions still exist about hair transplants specifically, and I love to set the record straight.

Genes, Good luck with the upcoming procedure. You may want to research saw palmetto if you can't tolerate finasteride. I have seen a number of patients do well on it. I am not convinced it is as effective, but a lot of patients want to throw everything they can at the hair loss; especially if they are having a procedure.

Thank you for watching and commenting. Thank you for the kind words as well. Absolutely. I actually try to include a scar comb-through in all of my FUT videos. I did not film this one myself, so it looks like I did not get scar footage. I will share some if he comes back, and do look out for pictures and video in future presentations.

Good observation. Sometimes these little "tweaks" can make such a difference. And framing the face with hairline work is always key.