ArochaHair

Runerrr, Thank you for taking the time to do the research and for your kind comments regarding our work!

Hi Bald36, Sorry for not seeing this before. No, we don't shave. In fact, Dr. Arocha has never shaved the recipient area and he can still perform surgeries of 4000 or more grafts in one procedure (strip). The trend over the past several years has been to require shaving of the recipient area but Dr. Arocha never subscribed to this approach. He feels that the patient should have as little downtime as possible and by not shaving, the patient is usually fit for work only a few days later with no worries about obvious redness in the recipient zone and sutures or staples being visible in the donor area.

Thanks mrkellymac!

Some good points have been made, particularly by Gillenator. 2200 grafts is fine for some designs but unfortunately we have no idea how low the hairline will be lowered nor how strongly the temples will be filled or closed. The number estimated could be far too low or even too high so until we see the plan. Do you have any photos showing this?

We agree, Ontop. The problem is most clinics haven't standardized on HD video because it isn't in the best interest for their business;)

mania1, Wwiizzkkiidd24, Pete-from-Farjo, and David - Moderator: Thank you all for taking the time to view our patient results and for commenting. Hope you all are having a fantastic weekend!

The video...

Happy Friday everyone! Today we want to share a result from a few years ago. In 2011 this patient came to see Dr Arocha to address the frontal zone. Dr. Arocha and the team at Arocha Hair Restoration performed one procedure of follicular unit strip surgery which allowed for a harvest of 3000 grafts. Dr. Arocha addressed the temples and the central tuft. The result shown is 15 months post-op.

The emotional side of the process dominates over any rationality every time, at least in the beginning. I don't think anyone comes into the idea of a hair transplant from a rational position because if they did they would most likely rule out the idea of a hair transplant due to the cost and potential downsides. It is up to the doctor and his/her staff to help bring rational thought back into the frame of mind for the patient because far too often the emotions of the patient dominate. We've seen patients that seem perfectly rational wind up being surprised by the reality of the options before them and it is then that rational thought begins to play a stronger role. This doesn't happen every time but it the case more often than not. When you introduce rational thought into the process after the emotions having driven you then a more even perspective can be achieved where one may think to themselves "ok, this makes a lot more sense" and then they can make the best decisions for themselves. The idea that you won't care about your image in your 40's and 50's as much as you do in your 20's is untrue, btw. The motivation may be different where a 25 year old may be thinking about being able to get more girls and wanting to look their age where a 60 year old may be thinking about trying to look as young as possible or just healthier overall, which as one gets older, can be just as powerful of a motivator. We all want to look our best and that doesn't change with age. The reasons why are what change but it doesn't make the reasons any less powerful.

Yesterday we shared the photos representing a follicular unit strip surgery result of 3005 grafts after two years post-op. Today we have an HD video to show more of the result with a detailed comb through. If you have any questions or comments about this result do not hesitate to share.

This patient came to see Dr. Arocha to discuss his receding temples and thinning frontal forelock. Dr. Arocha determined that a higher density would be necessary in order to properly blend with the forelock and because finer hair, such as found on this patient, usually requires higher density for naturalness. 3005 grafts were moved via FUSS (follicular unit strip surgery) in one procedure with the results shared representing two years post-op. The patient has been on medical therapy since before his procedure.

Hi aWidowsPeek, Our pricing is on our website. If you have any further questions please let us know. Hair Restoration and Hair Loss Specials in Houston and Dallas, TX

If you are seeing new hairs every day then that is all you can ask for at this point. I would not say you are having delayed growth as it is still within the acceptable time frame for the resting phase to be winding down. You should continue to see more new hairs coming in and those that have already started growing will get longer and stronger and the pigment will fill in as well. Patience is key.

This patient came to see Dr. Arocha regarding his receding hairline and thinning frontal tuft. Dr. Arocha discussed the options available to the patient and after considering these options the patient decided that FUSS (follicular unit strip surgery) would be the better option. Dr. Arocha and the team performed one procedure where 3000 grafts were moved to lower the frontal hairline, strengthen the temples and to add density into the forelock. The results seen at 36 months after the procedure. The patient is still very happy with his result and we feel fortunate that he returned to allow us to document his result. If you have any questions regarding this result or any other hair transplant result by Dr. Arocha do not hesitate to ask.

Hi HTSoon, I've followed your case for a while and it is good to see your great result. Regarding your current dilemma, I think that your crown needs more attention than some would argue. Consider that the top of your crown has a nice blending down toward the central whorl pattern. There is not "wall" or dramatic drop in density as it is more of a gradual progression. I think that one possible approach would be to add roughly 1000 grafts to the top of the crown and then roughly 750 into the central whorl pattern. This area has the highest degree of angulation change in order to create a natural result and the placement needs to be fairly tight in your case. The difference will be dramatic where the top of the crown, while not quite as dramatic, will have an appealing bump in density. The reason why the central whorl will have a more dramatic improvement is because it is a smaller area but with almost no hair compared to the top of the crown. It is more difficult to have visually positive improvements in areas where hair already exists and the end result will be a transition that looks natural while giving you the coverage and density necessary for a much fuller overall appearance. You'll also have more hair for concealers to grab onto, if that is your thing, and the groundwork will have been laid for density sessions in the future if you want to get aggressive (beard, strip, SMP, etc.).

Today we'd like to present a very straightforward case for your review. This mid-forties Caucasian male presented with NW5 androgenic alopecia. The assessment was that he was likely to progress to a NW6 as evidenced by the diffused loss in the "bridge" of his vertex and parietal humps. Dr. Arocha and the patient discussed the options available and the patient decided on follicular unit strip surgery. Dr. Arocha and the team harvested 3200 follicular units in one procedure with the goal being facial framing and general coverage for the front of the scalp. The majority of the grafts were placed in the frontal 1/3 and then extended into the vertex for proper and natural blending. The results shown are at 13 months after the procedure.

Yesterday we presented photos showing the transformation achieved by our patient with 2400 grafts from one strip surgery. His photos are in this this thread... http://www.hairrestorationnetwork.com/eve/184392-dr-arocha-slam-dunk-2400-fuss-result.html Now we have edited together an HD video that better illustrates the quality of the result.

This patient came to see Dr. Arocha about his thinning and receded frontal hairline. Being in his mid-twenties it was of particular concern for him as he felt he looked far older than his actual age. Dr. Arocha mapped out a plan that included a 2400 graft FUSS procedure. Dr. Arocha was able to place the new grafts in between his existing hairs with no perceivable shock loss and he also strengthened the temples. The patient had already been taking Propecia for a number of years with observed stabilization and the follow up at three years post-op verifies that his loss is still stable.

To address the percentage question, he has more than 8000 grafts. Dr. Arocha assessed a 9000 graft availability via strip and a 2000 to 2500 graft availability via FUE so with the assessed 11,500 grafts available in total we used approximately 25.4% of his available donor hair. Even if you were correct with his remaining donor hair being 38% less, if he were to proceed to a NW6 we'd still have 5000 grafts to fill the mid-scalp and blend into the crown. With his actual assessed donor at 11,500 he's got 8500 grafts left for such an unlikely outcome. I don't think in either case his future surgical prospects are at risk of a low donor supply.

Thank you again for your comments and your opinions. You do bring up good points but in the end, this is not a case of us showing a result nine months after his surgery where your points would have stronger legs. You originally said 2000 grafts would have been enough for the hairline, which is what it wound up receiving, and the latest point was that 1500 grafts would have been enough, which is only a 500 graft variance. In the end, we and the patient feel it was an appropriate number of grafts because he's dealing with actual density, not an illusion of density. He's six years post-op and he has no plans on stopping Propecia so it looks like the approach and overall plan was as good as the actual result. Thanks again or your comments.

Dr. Arocha shares your opinion of posting results and thank you again for your comments. Your reiterating of your position is confusing. You first said that 2000 grafts would have been better (assuming you meant for the hairline) than the assumed 3010. I then clarified that roughly 2000 grafts were used for the hairline with the remainder in the crown but now you're saying that you still think less grafts would have sufficed. With you feeling 2000 grafts were necessary for the front, and my confirmation that 2000 grafts were used for the front, why would you still say that too many grafts were used? We have no problem with critical commentary but I don't see why you'd have the same criticism after the basis for your criticism is shown to be false and the reality of the case aligns with your opinion of how it should have been addressed.

Thank you all for your comments.

Hi BadBeat, I agree, there wasn't anything "wrong" but the patient had in fact experienced recession and thinning in the frontal zone and he wanted to rectify this issue. He's very happy now and has been for six years. Interesting observation, Andy. I'm not sure how he would "be hooped" if he moves into NW4 or NW5 territory. First, he's in his forties now, and since he's not lost any hair in the past six years, it's unlikely this scenario will unfold. However, if he does, why would he be hooped? The placement went a bit further back than one inch but it was isolated to the frontal zone and also the crown, as has been stated, so your observation that about 2000 would be best for the front is pretty much how this unfolded. The rest were placed into the crown so based on your assessment of how it should have been addressed, which is was, it doesn't appear that he'd be hooped if he progresses to a NW4 or NW5:)

This is the HD video result showing a comb through of the patient previously presented in another thread. You can see that thread here... http://www.hairrestorationnetwork.com/eve/184303-dr-arocha-long-term-result-6-years.html The patient had 3010 grafts via FUSS in one procedure six years ago and has been on finasteride ever since with no further need for hair transplant surgery. This video will give a stronger presentation of the degree of diffused loss the patient was suffering from as well as give a more realistic presentation of the results with a proper comb through. http://www.youtube.com/watch?v=AXjBpNdv5cg&feature

Not everyone sheds after their hair transplant but it is something to be expected. If it doesn't happen then consider yourself among the lucky few but it does not mean that something is wrong. The exception to this is if you are too careful with the grafts. Sometimes patients can be so paranoid that they will cause damage to their new grafts that they will refuse to touch them, or when they do, they do so with the slightest touch. This can in some cases cause problems down the road. When a transplant is performed the hair typically goes through an unexpected interruption to the natural hair growth cycle. The hairs that we see are in the anagen phase but the surgery induces catagen, where the follicle separates from the blood supply and then the telogen phase begins which is the shed and eventual dormancy. Hairs shed through normal everyday physical activity. The hair moves up out of the follicular canal and eventually falls out. But patients that are too careful, sometimes, will see these hairs remaining but they are still separated from the blood supply so the hair just sits there in the skin. Eventually the body can see these hairs as a foreign body and start the rejection process. The skin will remain pink and even start to look slightly inflamed and mild infections can manifest. This eventually causes micro-scarring as the body continues to try and expel the foreign body. The above is very rare but it can happen which is why we always encourage out patients to wash their hair and to be thorough with cleansing. This helps to knock the hairs out that are supposed to come out and the scalp remains healthy. I hope this helps.