Dr. Alan Feller

Ms. S has been a patient of mine for the past three years. When she came to me she was completely bald on the top of the head. Worse, she had had an unsuccessful hair transplant perfomed years ago by another clinic that left her scalp virtually one big mass of scar. No one could look at this woman and not feel sorry for her, although she seemed to take it in stride. In spite of her extensive baldness, and the donor area depletion of her first "surgery", she still had an impressive amount of donor hair left. Under normal circumstances, I probably would have turned her down. Women tend to thin everywhere by the time they become this advanced. It is rare to see a woman this bald on the top, but so relatively thick in the donor area. I told her that I could improve her, but that I could never match the wig she was wearing at the time. She understood. I also told her it would take a long time and as many as five procedures, and that even then it might not make a significant cosmetic difference. She said she understood. I proceded to do four surgeries on her over 3 years. She walked into my office seven months after her last surgery this afternoon and told me she got rid of the wig. That's my definition of SUCCESS. Dr. Feller Feller Medical, PC 1-800-HAIRS-2-U 1-516-487-3797 www.fellermedical.com

Ms. S has been a patient of mine for the past three years. When she came to me she was completely bald on the top of the head. Worse, she had had an unsuccessful hair transplant perfomed years ago by another clinic that left her scalp virtually one big mass of scar. No one could look at this woman and not feel sorry for her, although she seemed to take it in stride. In spite of her extensive baldness, and the donor area depletion of her first "surgery", she still had an impressive amount of donor hair left. Under normal circumstances, I probably would have turned her down. Women tend to thin everywhere by the time they become this advanced. It is rare to see a woman this bald on the top, but so relatively thick in the donor area. I told her that I could improve her, but that I could never match the wig she was wearing at the time. She understood. I also told her it would take a long time and as many as five procedures, and that even then it might not make a significant cosmetic difference. She said she understood. I proceded to do four surgeries on her over 3 years. She walked into my office seven months after her last surgery this afternoon and told me she got rid of the wig. That's my definition of SUCCESS. Dr. Feller Feller Medical, PC 1-800-HAIRS-2-U 1-516-487-3797 www.fellermedical.com

Thank you Noreaster, it was my pleasure. You are an encyclopedia of hair transplant information. Good luck to you, Dr. Feller

Just give a call at 516-487-3797 before you come to make sure I'm not in surgery. Dr Feller Feller Medical, PC www.fellermedical.com

Dr Parsley is right. I assumed your scar was above the nuchal ridge. If it isn't, the chances are indeed a bit greater.

Yes Midnite, you are correct. It usually takes me longer, alot longer, to place sites in the second go around, especially if there is considerable leakage of blood from the newly created sites (don't get frightened though, the bleeding can be as small as a few thimbles worth to obscure the field enough to slow me down) This is another reason why I like to hit one area with high density and get it over with. This way I don't have to go back into the first area on the second surgery. I might hit the front part of the hairline to touch it up on a second go around, but I don't have to dance too much in between the last group of grafts. My usual M.O. is to hit the front with everything I've got, and then when I do the second surgery, usually in the top or crown, I can work in a virgin area obviating the need for me to be careful about transecting grafts. In the end it is faster and safer. If your 2800 was placed over a fairly large area, then I would imagine the slit placement may take two to three times as long on the second procedure. To give you an idea, under ideal conditions, it takes me an hour and 15 minutes to numb the skin and place 1800 slits on a virgin scalp in the front. Good luck Dr. Feller www.fellermedical.com

Tom I do not believe that flexing your head forward will make any difference. It's not as if your scalp at the level of the donor wound is directly connected to your lower neck. It is attached to the skull the whole way down so the force of pull is very slight by the time it reaches that level. I've heard other people, including doctors, claim that bending the head can make a difference, but the anatomy and physiology just don't allow for this to be a problem in any significant way. If your scar streches significantly over the next few months you can rest assured that it wasn't because of anything you did. Strech is primarily a function of skin physiology, and not your activity. So feel free to bend your head in thanks to your top of the line hair transplant clinic in Chicago that gave you 2,000 grafts. Best of luck Dr. Alan S. Feller Feller Medical, PC Great Neck, NY www.fellermedical.com

To "The Victim" and everyone else, If you were able to read my thread about Density a few weeks ago, you might have been able to avoid the problem you ran into. To me, density is everything. Unfortunately there are too many doctors out there who claim hair just won't grow in a scalp that has a high density procedure. This is simply not true and has been disproven by clinics like mine and just about every other doctor in the IAHRS. If you look below you will see photos of one of my typical patients I very recently performed surgery on. He had only ONE procedure. I gave him 1800 (plus) grafts in just the front portion of the scalp. In 2 of the photographs I include a ruler to be used for scale. Count for yourself and see that the density is over 35 follicular units per sq cm. Note how you can see the hairs growing about 2-3 mm in just 8 days, which is when he came to have his sutures removed. If dense packing should have killed the follicles, then how can the hairs still be growing? The answer is that they are very much alive, even at this density. Sorry to read of your woes The victim, but you really should check out your docs closely before hand. That consent you signed would of had me in the car on the way home after reading that you can't go to another clinic to confirm the count. Dr. Feller Feller Medical, PC www.fellermedical.com

I think it has been pretty well established by now that grafts grow most successfully after the first transplant. This is why I advocate the "one pass" method described by Dr Seager, and push for high density over a smaller area. Read my Density thread for a more detailed explanation. Dr. Feller

I've noticed that the transplanted hairs will actually grow faster for the first week or so before it falls out. This may represent some sort of protective mechanism as the follicle prepares to enter the sleep phase. After 3 months you may have no growth yet. So don't panic. I've had patients that have taken 4 1/2 months just to begin growing. By and large, however, I agree with Arfy that 1/2 inch is a reasonable expectation after 3 months or so.

This area is still somewhat of a mystery. You can do the same exact procedure on five different people and get five varying degrees of swelling. I believe most swelling is simply a function of skull shape and head position. I doubt very much that post-op swelling had anything to do with popped grafts as suggested above. There are two sources of fluid lending themselves to post-op swelling. The first is the amount of local pain killer and saline injected into the scalp to facilitate graft implantation. The second is the natural swelling you would experience after any trauma to the scalp (in this case thousands of punctures). This volume has to go somewhere, and the easiest route down is through the face. Here the skin is quite thin and there are alot of boney projections. As the fluid travels down it gets hung up and accumulates in the soft tissue of areas above the brow and the bridge of the nose giving the "Alien" appearance. The use of ice is probably counter productive as it simply compresses the skin causing an actual decrease in drainage. To me, there is no question that 95% of swelling is positional. That is, the position of your head during surgery and after surgery. If you were sitting up in the chair while being transplanted you will probably swell more than the patient who was lying further back.

I am looking for several candidates who are willing to volunteer for Follicular Unit Extraction. It is not necessary for candidates to have had hair transplant surgery in the past, although that would be a plus. Candidates should reside within 30 minutes of my office in Great Neck, NY. That is on the borderline of Nassau County and Queens. Please leave your information at info@fellermedical.com Thank you, Dr. Alan S. Feller

I am looking for several candidates who are willing to volunteer for Follicular Unit Extraction. It is not necessary for candidates to have had hair transplant surgery in the past, although that would be a plus. Candidates should reside within 30 minutes of my office in Great Neck, NY. That is on the borderline of Nassau County and Queens. Please leave your information at info@fellermedical.com Thank you, Dr. Alan S. Feller

I think you should re-read the thread.

Until now I beleived websites like this one were beneficial to patients and doctors alike. Now I'm not so sure. The problem is that what is written in these chat areas are not only taken as gospel, but are presented with authority as well. ie: "the best surgeons in NYC are...". This is ridiculous. I've been in the field for almost 9 years and I don't even know who the "best" surgeon is. I certainly have my own opininon based on what I've seen, but I would not profer this to anyone, especially on a site like this where readers are already super sensitized by the pain of losing hair. How is "best" defined anyway? By virtue of results? Number of procedures required? Pain? Density? Price? What!!? The truth is that it is impossible to rank surgeons who are experienced at FUs and really care about their work and their patients. It is unfair to lead the public into thinking hair transplant doctors can only be catagorized as honest vs. evil, or super-doctor vs. negligent bungler, as I have seen time and time again. Here is a tip for the multitudes out there who have followed this site and many others like it hoping to be told how to pick a doctor... if your doctor is: 1.performing Follicular Grafting and 2.taking care to pack them at a minimum 25 grafts per sq Cm (with some exceptions like blacks) and 3. he/she has been practicing for more than 5 years on their own without the benefit of multimillion dollar ad campaigns, or being part of a group that can carry him... then he will produce results, on average, as good as ANYBODY else in the field. If you want proof of this, just look at the photographs on this site presented by the different doctors. Most look the same!!! Why do you think this is? Because most doctors of equal experience and any empathy for their patients perform surgery basically the same way. I am in a unique position as a veteran full time hair transplant doctor, and patient to gauge accurately who is the "best surgeon" in New York and can promise you that ALL of the surgeons listed on this website will not leave you with a regret. And ALL of the surgeons (yes I've met them all) are empathetic toward their patients and passionate about their work. It is now up to you to pick 2 or 3 and find which variation of method you like best, and with whom you are most comfortable. Simple as that.

I haven't read of anyone providing a detailed or authorative reason for kinky hair post transplant. I don't think it is due to the lack of sebacious gland, as was suggested, because even larger minigrafts display kinking. These larger grafts no doubt contain multiple glands,so this is probably not the right direction. In my practice I notice that hair will be kinky mostly through to the ninth month. After this time the hair "normalizes" as I call it. It begins to take on the smooth appearence it had in the back of the head, along with the shine. I suspect that the reason for the kinky and unnatural look is the transplanted follicle itself. Imagine the individual follicle as a vase. Now imagine the inside of the vase lined with cells. These cells contribute "liquid pre-hair" to the center after which chemical cross linking causes the production of a hair which is then continuously extruded. When a follicle is transplanted, these cells go to sleep for about 3 months. It is reasonable to assume that not all the cells composing the follicle wake up at one time. Perhaps a majority of cells will wake up on only one side of the follicle. If this is the case, then the resulting hair would be denser on one side than the other. When it reaches the surface of scalp and is extruded from the hair channel, the denser side will cause the hair to "bow over" and thus you have a kink. As more cells of the individual follicle awake, the more evenly the hair will be formed, and the kinking will eventually go away. It is reasonable to also suggest that if the kinking does not go away, it is probably because all the cells of the follicle never awoke.