Dr. Sethi & Dr. Bansal

On 11/26/2018 at 11:37 AM, Melvin-Moderator said:

Very nice hairline great work!

Thank you dear Melvin for your appreciation.

On 11/26/2018 at 9:11 AM, Spanker said:

There is not reason to believe that the scalp folds are from weight or the turban. Tons of people wear turbans that do not have this. 

 

The folds are from a condition called cutis verticis grata.

 

Nice case tho. 

I think the folds are not enough in the dimensions of sulci and gyri to be called as CVG (Cutis Verticis Gyrata). 

(Attached are few pics of CVG. It can be more read in PUBMED.)

You are right all who wear turbans don’t develop this necessarily. 

In this case, there were no internal cranial complains or problems. So was not traced deep. It has also improved. 

I will try to capture the pic when he returns back. (Though it will be difficult to do that with long hair!)

Thank you for appreciating the case.

2 hours ago, BjornBorg said:

Didn't hear of them until they started putting up a lot of results the last few weeks. I was impressed with pretty much every one of those.

Thank you for your appreciation. We just started posting our cases.

We have been doing hair transplants since 2010, and doing exclusively only hair restoration since 2013. We have documented most of our cases well and there are many who are very interesting. We will keep posting the cases.

On 11/22/2018 at 2:31 PM, BjornBorg said:

Those folds on his scalp, are they also due to constantly wearing a turban?

Splendid result.

Yes. They are due to the constant wearing of the turban for many years. He was also overweight which augmented to the pressure.

Presenting a successful hair restoration story in a Scarring Alopecia (Lichen Plano Pilaris, LPP). The lady patient of 26 years old presented to us with a childhood history of Scarring Alopecia which was non progressive for more than last 10 years. She was socially conscious and regressive. As expected, she always wanted hair on her head and was hiding her big hairless patch of scar with regular use of a cap. When we saw her, took a detailed history and wanted to be 100% sure of the non progressiveness of the condition before taking her up for the procedure. So, we did a test patching of 200 grafts to see any remnant of activities of the disease. After near to 6 months, most of the 200 grafts grew. This gave us the confidence to go ahead and do the bigger chunk of the scarring patch. We did 2000 grafts (the patient allowed us to do a complete trimming of the donor area as she was expecting the best possible result to her by us). We kept on following her. She came after four months with some visible growth and by the end of 1 year, most of her hair had grown and she could cover most of her bald patch and is extremely happy. We are following her since then and till today her hair is doing well and there is no sign of disease activity. 

Note: Lichen Plano Pilaris (LPP) is a very rare and unpredictable disease condition which causes Scarring Alopecia in patches in the central scalp and occasionally on the occipital scalp, more often in ladies than males. Usually LPP does not affect the hairline. Also very rarely affects the beard in males. But in many cases, after doing the procedure, the disease which seems silent, gets activated and damages the planted roots. So it is difficult clinically to ascertain the timing of a hair transplantation in LPP. Many physicians consider a silent period of more than 2 years is adequate to do a procedure upon the scarring. But many are proven wrong by the disease reactivation! Also, scarred tissue has altered vasculature and is not the same as the normal skin for transplanting hair. The thickness of the different layers of the skin are also altered so an experienced surgeon only should attempt to do a procedure in a Scarring Alopecia.

So there are two unpredictabilities in LPP: 

1. Uncertainty of the disease activity, &

2. Unfavourable dermal tissue. 

Other than doing a biopsy, trusting the history by the patient about the disease activity, a test grafting is essential to predict the future course after transplantation. 

2 hours ago, Mick50 said:

Hi Bill does the clinic have any cases they could show of patients with less favourable hair characteristics?  i.e more contrast skin to hair colour and finer hair as most if not all of the examples shown are of guys with thick hair caliber and good skin to hair contrast ,this is in no way  takes away form the results presented as they are very good transformations  ,just be nice to see their work on different hair -skin  types 

Dear Mick50,

Thank you for reviewing our cases. As told by Bill, we get mostly patients from India or Indian origins from other countries. However, the Indians who stay abroad and have received results from us had started referring their friends from their country of work and stay. We keep getting patients having lighter skin and hair colour and also patients with Negroid origin. (Here to mention that we get most of our patients referred by our old patients from all across the world and doctors sending their patients to us). So, we will be keeping on posting some western results time to time. Please go through the following link of a case of 1 year after transplantation.

Mr. Park from Australia referred by one of his friends who indeed was our old patient, came to us in 2016 with near Grade IV baldness. He had a decent density on the donor scalp. We did close to 3800 grafts spread over 2 days (1st day: 3000 grafts; 2nd day: 800 grafts). Carefully single follicles were chosen and planted on the hairline and a density of 35 to 40 grafts per sqcm were planted. The patient was sensitised about the importance of medicines like Finasteride and minoxidil to prevent the future baldness, as we do to all our patients. 

I got the opportunity to meet him after 1 year in Sydney and the patient was happy to share his story. 

26 minutes ago, Raker said:

Brilliant, looks like a different person. Keep up the great work. 

Thank you Raker for your encouragement.

1 minute ago, Raker said:

Great result, impressed. Keep up the good work. 

Dear Raker,

Thank you for your encouragement.

3 minutes ago, BjornBorg said:

And to think the crown is only at 6 months. That is already a knockout result considering where he started.

Dear BjornBorg,

Thank you for your kind words. Indeed, he has a fabulous growth.

1 hour ago, Bill - Managing Publisher said:

Wow, that's a very impressive result considering this guy was essentially a full Norwood 7 and now he looks like has just about a full head of hair again.

Nice work Dr. Sethi and Dr. Bansal.

Best wishes,

Bill

Dear Bill,

Thank you for your generous appreciation. Indeed this is one of those cases who gave us the impetus to keep going. 

On 11/20/2018 at 12:06 AM, VicTNYC said:

Thanks for the clarification.

Results look very good.

You are most welcome.

38 minutes ago, BjornBorg said:

Great characteristics on that guy. And what a result he got. Applause!

Yes, he has got a great result and has become a dear friend to us and he keeps sending his friends to us.

13 hours ago, literalno said:

unbelievable result!!! huge congrats

Dear Literalno,

Thank you for your kind words.

This 31 year old male having a strong family history of baldness approached us in 2014 and we did his case in two sittings, as below. 

1st Sitting: 3216 grafts (singles: 410)

Keeping in mind his strong family history of baldness, we kept the hairline up at 8 cm from the mid eyebrow point (glabella). And he developed a great result within 5 months of his transplant. And his temple point was untouched. Encouraged with the results, the patient insisted about lowering the hairline.

2nd Sitting: 1784 grafts

We did lower the hairline by 1.5 cm and blunted a bit in the fronto temporal area and also did the temple point. As expected, he got an amazing result after 6 to 7 months. We have also primed the patient about the importance of taking the medicines to prevent the future baldness in the mid scalp and the crown. 

Mr. Gary used to wear a turban since his childhood till the age of 30. As expected, he developed traction alopecia on the frontal scalp as well as the side locks and the temple points. He wanted to remove the turban and have a natural hairline. He had a bigger size of head and the surface area to be covered was surprisingly larger. In this type of turban induced traction alopecia cases, the difficult area is to do the temple and side locks going up to above the ear. Since these cases are not graded baldness cases, there is a sharp border of high density on the front. So, during transplantation if the transplanted hair does not attain matching density, then the result will not be considered great. So, providing an optimum density in the transplanted area is very important. In this case, we planted 2500 grafts, all extracted from the scalp and the results presented here are after 1 year.  

Mr. Ram was very conscious about his hair loss and he used to keep the hair on the side of his head longer and used to cover the balding area with it. He had curlier side of hair and the donor density was very good and he wanted to cover the total area in one go. With our rich experience of BHT, we took up the case and judiciously kept the hairline at the optimum point (not too hight neither too low) keeping in mind the ultimate coverage of his total bald area. 

Breakup of the grafts:

Scalp: 4000 (Singles: 530, rest were multiples)

Beard: 3000

Since he had curlier side of scalp hair, his beard hair blended well with the transplanted scalp hair. We provided the graded density from front to crown keeping in mind that the front is the aesthetic importance to the person. After 9 months most of his hair were grown and the crown was as expected, had a little lower density in comparison to the front. And his scalp donor is still adequate to be harvested again to do the crown.

The index patient had a big head. He was Grade VI bald on the Norwood Scale of Baldness. The patient wanted a natural hairline and therefore, we decided to concentrate on the frontal part of the patient's scalp. 

Total grafts: 4105 (Singles: 430)

Temple points: 300 each

His donor was average. His fronto - temporal angle and his temple pionts are corresponding to the sharpness of his nose. According to us the right kind of alignment of hairline, temple point corresponding to the nose, chin and mandible is required for a nearly natural look. 

He started to experience the growth spurt after 4 months and within 8 months he has extremely good results. He is planning for his second sitting on the crown. We have not exhausted his scalp donor and his beard donor is untouched. 

17 hours ago, Melvin-Moderator said:

Excellent results congratulations to the patient he must be thrilled.

Thank you Melvin. Yes the patient is extremely thrilled! He lost weight, became a fitness freak!

9 hours ago, AnalogFeel said:

would this be considered a norwood 6 or a norwood 7?

His sides still look decently high. I thought norwood 7 was very low sides?

Though traditionally Norwood 7 should have lower sides, we have considered the occipital area as the reference point. And in this case 6 or 7 does not make much difference in the treatment plan!

8 hours ago, harin said:

1. It is always good to have healthy dose of skepticism. But it is evident that DHT from what I have experienced and seen, results in much higher percentage of grafts to take in than traditional FUE. (least out of the body time for grafts)

2. It is clearly written that patient was also prescribed Minoxidil and Finasteride to strengthen existing hairs and prevent further hair loss. Which as anyone with experience would know leads to improvements in crown, and reduces further hair loss!,...though in most cases Dr. Sethi's patients' whom I have seen..... would not be on any meds. This including me as well.

Exceptional results.

Thank you for the scinetific explanations.

If there is no pre existing hair at the time of transplantation then there is no need of medicines. 

18 hours ago, VicTNYC said:

I’m a bit skeptical of this result....how did the crown area get such good coverage of hair growth (after photo) without any grafts placed there at all according to the level of thinning in his crown in the pre-op photos?

Were any concealers used on his scalp to improve the look of  results?

Dear VicTNYC,

Thank you for seeing some of our results that we have posted here.  As mentioed by Mr Harin, this patient is upon Finasteride and Minoxidil. 

We treat all our patients holistically. If some one has got still  some pre existing hair at the time of transplantation, then we insist that they should take medicines to prevent the ongoing baldness. Finasteride and minoxidil work very well in the crown area than the front and mid scalp. We keep a track of all our patients for many years and ensure that they keep taking the medical treatment to ensure the prevention of the baldness, as much and as long as possible.

Note: There is no use of any concealer in any of our cases ever!   

( However, in cases where there is no pre exisiting hair, the newly transplanted hair doesnot require any support in the form of Minoxidil or Finasteride.)

We encourage, rather insist, all our patients who have any existing hair during transplantation of new hair regarding taking medicines for preventing the ongoing hairloss. 

Hair restoration means: 1) prevent the ongoing hairloss and 2) get new hair on the bald areas by transplantation. Ultimately there should be holistic approach in hair restoration.

Explanation of density after 6 months in the non planted area:

At the time of transplantation, he had kept short hair. When hair is short, whatever great  the density might be, that looks less. And when they grow to 3-5 cm long, the area looks dense and covered well. 

In the index case, since he had an ongoing Androgenetic Alopecia (baldness), in addition to planting hair on the front he was alos given Finasteride 1mg daily and regular Minoxidil to apply. So, due to the combination of growth of the thinning hair due to medical therapy and plantation of hair, which grows faster due to the DHT concept of graft placement.

Thank you Mr Harin for your continued trust and encouragements. 

Thank you Bill for your appreciation.

As mentioned by Mr Harin, in DHT we try to minimise the out of the body time for the grafts which are living tissue and are supposed to grow back in a new area. In our experience of now more than 4500 cases, in DHT there is an early growth of the planted hair and that proves that there is maximum survival of the planted hair.