Dr. Alan Feller

I agree with Dr. Beehner. I don't see a problem with a patient golfing after 48 hours. By then the grafts are well scabbed in and secured. I've even let my patients go swimming in the ocean by the third day for years and never had a problem. GD, the only concern I have for you is that you may increase the amount of swelling around your eyes because you necessarily have to look down to address the ball. If you are willing to deal with this, then good luck in your tournament. Dr. Feller

This is turning into some thread. Perhaps a "spool" of thread. WW, in the tome you posted above it was mentioned that in dense packing 50 grafts per sq cm the expected hair yield should have been 115 hairs, but was actually found to only be 106 when counted. Remember that the remaining hairs may well be in telogen, and thus resting comofortably beneath the surface waiting for their turn to grow. This highly probable possiblility should not be omitted. Even the non-transplanted scalp cycles it's hair on a regular basis such that a percentage is asleep at any given time. Dr. Feller

Ten square centimeters. About the length of a Twix bar (a single twix bar) Use those grafts judiciously. Dr Feller

Yalao, Your question is far to general for me to answer fully, but I'll do my best. In another thread called "success" you can see the results of a patient upon whom I placed thousands of grafts using most of her donor area in the process. She certainly felt it was worth it, but I wouldn't really know how to classify her now. I don't classify POST OP patients in terms of Norwood scale. I don't think it is a valid method, and it can be quite confusing. For example, let's say that I had a Norwood 4 patient in for surgery and I filled in ALL the bald areas at 20 grafts per square cm. Is he still a Norwood 4 with more coverage? Or is he a Norwood 1 with thin coverage? Get the point? Dr. Feller

My guess is there is a confusion in language. I doubt that an FU practitioner is punching recipient sites. Easiest thing to do is call them and ask them to clarify. Dr. Feller

Below you can see different types of hair transplant scars. I don't think that these scars should be the cause of such concern. After all, they are the normal result of elective (or any) surgery. Most of my patients have normal scars, although you absolutely will get someone who will stretch or have some unique complicaiton. By and large, however, the strip method is excellent and doesn't deserve the "villification" it has been receiving. With respect to FUE, I am not studying, researching, and performing this procedure simply to avoid the strip method. I am doing this because it may ultimately offer HIGHER follicular yields than a disected strip. In fact I have already proven this in my office and have documented this in photos and video. I suspect other less vocal practitioners of this technique have also noticed this and may attribute their excellent results to this phenomenon.

I won't front load a patient unless I know he is coming back for round 2, and am sure he has enough donor area for it. With this in mind, front loading is, in my opinion, the way to go. I agree that having thick hair in the front 1/3 and being relatively empty in the back 2/3 is strange looking. In fact you just hit on THE major disadvantage of "flaps" (which I despise. I've seen them and bend over backwards for these patients). But this is not the case for my version of front loading. My distribution is over an area significantly larger than a flap. I just don't want to go back into an area on a second surgery if I can avoid it. It is well known by now that the best transplant is the FIRST transplant. By doing it my way (which I picked up from Dr Seager by the way) I can perform a "first" transplant on the same patient multiple times! A change in paradigm, but a very effective and powerful one in my view. Check out this patient of mine who just visited for his seven month postop followup. He came to discuss surgery number 2. A glance at these photos will show that he doesn't need to go back ito the front at all. We will focus on the middle third and stop there. To me, this was the most responsible way to perform HIS transplant. Dr. Feller ]http://www.fellermedical.com/images/frontload/close.jpg' alt='close.jpg'> Dr. Feller www.fellermedical.com

I didn't shave this patient's hair, this is how he has kept it for years to minimize the impact of his baldness. You know the idea, keep the rest of the hair buzzed and people won't notice the balding area. Fortunately for me and my staff, this patient didn't have any long terminal hairs in the "work zone" so I wouldn't have had to cut any hair even if he did choose to wear his sides and back long. Cutting the hair in the recipient area has many advantages. Aside from making the work "easier" for me and my staff, it definietely allows for a denser pack, more hair, a more accurate and less traumatic slit incision, decreased bleeding, decreased need for injected medication, and a decreased surgical time. I assure you the greatest advantage is to the patient. Before you begin to think I attack every patient with a buzzer, realize that I am very selective with the hair I buzz. In most cases I leave enough hair to "cover up" the baldness. Understand also that if you have so much hair in the recipient area that cutting it would make a significant cosmetic difference, then maybe you shouldn't be placing transplants into that spot! Dense packing allows me to decrease the amount of hair buzzed because I am usually working in one tight spot. This method, I feel, makes the first few weeks after surgery far easier to conceal. Dr Feller

Thought you all might like to see another example of a fresh dense pack. 1,750 grafts packed into the front third of the scalp (average of 38 grafts per sq cm). Patient has a thick, coarse, curly hair. All slits oriented laterally. Custom made blades utilized. Dr. Feller Dr. Feller

Thought you all might like to see another example of a fresh dense pack. 1,750 grafts packed into the front third of the scalp (average of 38 grafts per sq cm). Patient has a thick, coarse, curly hair. All slits oriented laterally. Custom made blades utilized. Dr. Feller Dr. Feller

I really thought this issue was asked and answered a long time ago. There is no advantage, let me repeat, there is NO ADVANTAGE to inserting minigrafts. You can achieve MAXIMUM density using FUs just fine. Period. Why mix? If you are already cutting FUs why bother to stop and switch to minigrafts??? You can't pack minigrafts as tight as FUs, therefore your density will simply go down. Dr. Feller

Noreaster, I will try to dig through my archives and pull out examples of each. Dr Feller

Actually, there is something that can be done to speed up the growth, start using Rogaine. This is a total reversal of my prior position, but a study presented at the International Society of Hair Restration Surgery (ISHRS) showed that not only does Rogaine accelerate growth, but enhances thickness as well. I was very impressed with the photos shown during the lecture and now advise all my patients to start using over the counter Rogaine the week after surgery. Dr. Feller

Microprose, You probably are a bit young to be looking at transplantation now. However, you do bring up an excellent point...that where and when transplants are to be placed is completely subjective. In the end it is up to the individual to decide what is right for them and when. Take tatoos for instance. If I had my way nobody would have them. To me, tatooing is the voluntary permanent mutilation of one's body, however, every other person seems to have one. Why should hair be any different? On the other hand, 90% of those people with tatoos also wish they had never gotten them in the first place. So, bearing this in mind, I would not take you for hair transplantation just yet. While I see YOU are not concerned about the future now, you eventually will be. I'd rather not do something I am fairly sure you will regret up the road. Hang in there. Dr. Feller

Sorry to read about your plight Lauz. Looks like drug therapy worked well for you, at least for a while. Remember, Propecia is a treatment, not a cure. As far as what to do. If you are thin enough, then you may be ready for transplants. I would recommend that you focus in the front third of your scalp. An area no bigger than the palm of your hand. Fill that area, let it grow, and then decide if and when to do more going back. Good luck, Dr Feller

That is a correct evaluation. The presence of hair in the transplanted area three weeks after surgery is not an accurate indication of what lies beneath. Most of the hairs have probably shed by now. Don't worry about it. Dr Feller

If you had follicular transplantation the only way you are going to get those grafts out is with a knife. So rub your head vigorously and get on with your life. The grafts know what to do. Dr Feller

Yalao, He is 28 and is a norwood class 5-6. He WILL progress to a Norwood 6, although the use of Propecia may stay that inevitablility for a few years longer. Understand please that I did not put him on that drug, his GP did. His progression to stage six was factored into my plan from the beginning. He will not need another surgery in the frontal area. It is finished as it has been densely packed by me and my staff and he is indeed very happy (he has sent me a number of referrals). The top and crown have not been touched, only the areas I've outlined in the before photo. I will try to find a pic of him from the top view, or ask him to come in for a new round of pictures and then post them on this site. I would recommend he go for another 2400 grafts in the top and crown at his convenience. A tight pack into the remaining areas ought to do it. If his sides receed significantly he has plenty of donor area to chase it. This patient owes alot of his results to the thick caliber of his hair and abundance of donor area. All hair docs love to get a guy like this. Dr. Feller www.fellermedical.com

2,400

I received many positive emails from around the world from both hairloss patients and doctors alike who viewed the intra-op and post-op photos I posted on this site to demonstrate that dense packing of grafts in a small area of baldness is not only viable, but preferable. I thank you for your comments and compliments. Most of you expressed curiosity as to how it will look when grown out and asked me to post the after results in about a year. Rather than wait until then, I am posting a virtually identical patient I performed the same procedure on over a year ago. Note the tight area I and my staff squeezed the grafts into and the wonderful results he achieved. I didn't waste any grafts in his crown, but chose to pack them in the front third of the scalp. Dr. Feller Feller Medical, P.C. 287 Northern Blvd, Suite 200 Great Neck, NY 1-800-HAIRS-2-U 1-516-487-3797 www.fellermedical.com

I received many positive emails from around the world from both hairloss patients and doctors alike who viewed the intra-op and post-op photos I posted on this site to demonstrate that dense packing of grafts in a small area of baldness is not only viable, but preferable. I thank you for your comments and compliments. Most of you expressed curiosity as to how it will look when grown out and asked me to post the after results in about a year. Rather than wait until then, I am posting a virtually identical patient I performed the same procedure on over a year ago. Note the tight area I and my staff squeezed the grafts into and the wonderful results he achieved. I didn't waste any grafts in his crown, but chose to pack them in the front third of the scalp. Dr. Feller Feller Medical, P.C. 287 Northern Blvd, Suite 200 Great Neck, NY 1-800-HAIRS-2-U 1-516-487-3797 www.fellermedical.com

Kilimanjaro, To answer your questions: Harnessing the hair was not difficult as she was born with an overabundance in the back. I have not found that females grow any better than men. As was discussed during our first consultation I informed her that I would remove approximately 75% of her donor hair, leaving just enough to cover the area when styled properly. It was the stratigic placement of the grafts that allowed me to acheive this result. Moreover, it was her absolute commitment to follow through with the plan. Once the last round of transplants grew Ms. S figured out on her own how to best style her hair to make it as full as possible. Her temples are still thin, but she styles the hair to compensate. She is a master at this. She simply maximized what I gave her. Dr. Feller