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DrTBarghouthi

Elite Coalition Physician
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Everything posted by DrTBarghouthi

  1. DrTBarghouthi
    Probably around 3000 imo.
  2. DrTBarghouthi
    Pimples can occur after a transplant in both donor and recipient areas. Usually Sporadic and non painful.
  3. DrTBarghouthi
    Thank you for the mention. I agree that it doesn’t look like 5000 grafts- which I hope is the case as this means there is some donor left. 5000 in 7 or 8 hours is quite difficult. Might be possible but certainly will be quite rushed and hasty and that will affect quality. Also 5000 grafts will mean grafts staying out of body for longer hours and that can affect overall survival too. I personally cap our day at 2000-2500 grafts maximum.
  4. DrTBarghouthi
    Epinephrine is present in all anesthesia that we inject. It is possibly one of the contributors of shock loss among other mentioned factors.
  5. DrTBarghouthi
    Thank you for your message. Ofcourse you need to be cautious with the amount of anesthesia and epinephrine used. We have to use enough to numb the area but not to over do it. Also the use of tumescent fluids helps with being able to use anesthesia and epinephrine in diluted amounts. I personally use triamcinolone (steroids) in my tumescent solution which has a potential effect in reducing swelling and shock loss in some studies presented by colleagues.
  6. DrTBarghouthi
    I’d say around 500-800 depending on how it looks in real life. Maybe a bit more on your right side since you seem to comb it slightly right to left.
  7. DrTBarghouthi
    Use some olive oil and leave it to soak overnight. I usually ask patients to start that at day 8 for 2 days and then come in for a wash at day 10 if they can. If not, a normal shower will flake most of these out. I find olive oil very helpful in getting most of them out from the first proper scrub.
  8. DrTBarghouthi
    I think there is always a small chance of it happening. It depends on several factors but seems epinephrine plays a major role. I find it happening in 2-5% of patients in the donor area and the majority happening in the area behind the ears.
  9. DrTBarghouthi
    Hello and thanks for tagging. A double crown is not considerably different than a single whirl. The main thing is to recognize it and mimic the directions. Yes the directional change might make more the scalp showing rather than the typical cross linking effect. Might need a bit more grafts but if a surgeon is used to crown work, there is not much difference except for the planning part and maybe a bit of more work getting to work with the various directions.
  10. DrTBarghouthi
    Thanks for your message. Given the existing weakness in the donor and the progressive thinning following FUT - I don’t recommend undergoing surgery. I would however suggest SMP or a hair systems (combined with some transplam ) for you.
  11. DrTBarghouthi
    Thanks for pointing it out. I’ll act on it.
  12. DrTBarghouthi
    Hello. Just a quick update on the 1 year progress:
  13. DrTBarghouthi
    Thanks! Yes I tend to premake all temple point incisions using a small sapphire blade. Might add in between at the end as a “stick and place” As for systems, I use my customized motor device which is a modification on the PCID system. I use all the other systems, but I am leaning towards this custom made one.
  14. DrTBarghouthi
    Flew by I know!
  15. DrTBarghouthi
    Thanks for sharing. My number one recommended treatment is finasteride and it doesn’t have to be on a daily dose. You can try topical fin too as I’m sure it would work better than not using anything. This helps preserve as much existing hairs as possible given your age.
  16. DrTBarghouthi
    Yes I do at the clinic. These I just shared the ones I kept on my pc unfortunately.
  17. DrTBarghouthi
    Hello again, just saw this gentleman for his yearly check up. Here is his almost one year update. He remains on finasteride on alternate days.
  18. DrTBarghouthi
    May I ask you about your age? It seems reasonable in many cases to delay the crown work for various reasons: shock loss of existing hairs, ongoing outward loss, limited donor etc. I also agree that PRP is not the ideal maintenance regimen. I use it during surgery but not to do with the result itself.
  19. DrTBarghouthi
    @SD1984by the looks like of it, your donor would probably yield around 5000 grafts if not more with FUE. Ofcourse not all should be done in one go. Depending on actual examination, it might yield more based on head size and hair density. But I dont think it will yield anything less than that to be honest.
  20. DrTBarghouthi
    @solooplease share some photos if possible in order to give you further feedback if needed.
  21. DrTBarghouthi
    Hi @Berxedan7Are you on any maintenance medications? and what is your family history like? Can you post some photos of your current state? It is important at your age to be cautious and probably conservative. Please feel free to share some photos here or through a DM.
  22. DrTBarghouthi
    Yes the donor looks patchy and rather depleted. How many grafts were extracted ? Can you share some more photos of the result and also the beard?
  23. DrTBarghouthi
    It can be applied using different tapes or adhesives depending on preference, allergy testing and hair presence (or not). I find tape to be really good if no hair is present at all. For other cases I use a sort of a foam or liquid adhesive.
  24. DrTBarghouthi
    I agree that you do have favorable conditions including that of hair color. I do believe 4500-5000 grafts for the entire area is manageable and would give you the results needed. I’m not sure if I missed whether you’re on any maintenance meds?
  25. DrTBarghouthi
    Go for whatever your doctor is consistently getting good results with. In many cases several techniques may be used in the same setting. I, for example, like the Sapphire blades and have been using them for more than 5 years. However, I do a stick and place in almost most procedures. I leave around 50-100 grafts at the end for “icing the cake” and going into areas that I feel may need more emphasis. This is usually made through visual inspection but also based on what the techs would also see during the implantation process. in some cases I do all sites before extracting even.
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