Dr. Neil Verma

Definitely a candidate.  Good donor bank.  Needs approx 4.5K grafts to fill the crown and restore the anterior hairline.  

You can wear a loose fitting surgical scrub cap immediately post op.  

Depends on your age and expected ongoing loss in the upcoming years. 1500 seems reasonable though an extra 250 grafts would help density and finasteride can help to avoid further native crown hair loss.  

Dutasteride is also an option to minimize chance of permanent miniaturized hair loss. From the photos provided 2500 grafts seems appropriate to restore the hairline and match the surrounding density. From the pics rough estimate of grafts that can be harvested safely from the donor region is >6500 grafts so plenty of capacity for a repeat procedure in the future. 

1 hour ago, H.K said:

I mean isn't shock loss more possible when hair is transplanted in area where there's still existing weak/miniaturized follicles ?

 Anyway of minimizing risk of permanent shock loss "not including using finasteride"  , does having multiple smaller sessions which some surgeons do increase or decrease shock loss possibility ? 

Not really.  There is always going to be some amount of miniaturized follicles.  Shock loss is temporary and doesn’t occur in everyone.  Multiple sessions need to be spaced out by many months 6+ to allow the scalp to have adequate time to heal from the previous procedure.  So in summary very large sessions >3500 grafts and frequent sessions within a short time of one another increase risk of shock loss, which is still temporary.  

Correct.  For 2000 grafts would typically need a strip that would be approx 18-20 cm in length depending on donor density.  This strip would start in the center (where donor quality is highest) and work its way out laterally.  

On 4/23/2021 at 4:17 PM, gillenator said:

Aloe Vera use can be started after the crusts are gone.

Officially added to our post op hair care instructions.  Thank you

Thank you Gillenator....I've officially added Aloe Vera to our post op hair care instructions.  

Risk of Shockloss is present whether you do a hair transplant procedure now or in the future.  The greater the number of grafts needed for harvesting the higher the chance of shock loss as it means a longer procedure, more micro trauma to the scalp, greater stress on the body etc. 

It's variable.  When our patients are edging towards being a slow grower (though at 5 months is a not considered slow...typically at the 6 month mark) we recommend they trial a PRP session to to enhance the scalp tissue environment and promote growth.  

The channelling seen is a normal occurrence post op and does not reflect a poorly performed hair transplant procedure.  

Sometimes if the graft size is small ie. eyebrow transplant procedure the strip is only taken from one side.  For eyebrows the strip length is typically just 4-5cm length x 1 cm width and taken from one side to obtain 400-800 grafts.  Otherwise for beard and hair we want to take the strip where we can obtain the maximum high quality grafts.  

By 6-9 months should definitely be seeing results.  Finished product with ideal before and afters are taken at 12-18 months post op.  

This question came up yesterday with a patient that was a Norwood 5 and had let his hair grow quite long to conceal his crown loss.  As he did not want to shave his hair and it was his first procedure that would not go near his crown loss he opted to go for FUT to repair his anterior hairline and midscalp.  Understanding patient goals is important to deciding what is best for the individual. 

 We recommend that after day 3.

See pic for FUE minimal scarring (hypopigmentation) on a fully shaved scalp.  This patient is undergoing a second procedure for crown repair.  His first FUE was 1 year ago so has fully healed.  With excellent technique FUT scars are minimal as well just linear instead of dots.

Baby oil will help soften the scabs and gentle massage will help lift them off the scalp. 

I can’t advise you on taking medication.  Ice packs are helpful.  The swelling will settle down with time and is normal to experience after hair transplant.  Any local doctor should be able to offer you advice on taking those medications. 

Derm fibers will help conceal it until it grows in. Anterior hairline first several rows should just be singles.  You could probably count the grafts if you took the time to do so based on the pictures provided.  Be patient as it may turn out just fine once it grows in though touch up for density to anterior hairline may be needed.

First 3 days no shower/shampoo to the grafts.  Saline spray (salt water) every 30 minutes to keep the scabs moist and soft.

To minimize scabs and crusts altogether saline soaks every 30 minutes for the first few days. 

Removing fresh transplants will likely involve scarring and costly.  Better to let them settle in and have a good post op care ie. Baby shampoo, aloe vera, etc.  Density does look thin which could be addressed in the future with medication, topical creams, concealers, touch up procedure.  It’s going to take 1 year for results so need to be patient.  

We try to predict the future hair loss during the consultation.  Medication does help slow further progress but understandable when patients don’t want to take it.  It’s important to explain well to patients so they can make an informed decision.

When resuming topical minoxidil post op 2 weeks better to start with 2% as it may be less irritating to the skin as it’s still healing

Would need to see photos as it varies individual to individual