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Cam Simmons MD ABHRS

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    264
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About Cam Simmons MD ABHRS

  • Rank
    Senior Member

Basic Information

  • Gender
    Male

Hair Transplant Clinic Information

  • Hair Transplant Surgeon
    Cam Simmons MD ABHRS
  • Hair Transplant Network Recommendation Profile
  • Hair Transplant Clinic Name
    Seager Medical Group
  • Primary Clinic Address
    2863 Ellesmere Road, Suite 418
  • Country
    Canada
  • State
    AL
  • City
    Toronto
  • Zip Code
    M1E5E9
  • Phone Number
    416-924-2482
  • Fax Number
    416-924-2484
  • Website
    http://www.chtc.ca
  • Email Address
    info@chtc.ca
  • Provides
    Follicular Unit Hair Transplantation (FUT)
    Follicular Unit Extraction (FUE)
    Eyebrow Transplantation
    Prescriptions for Propecia
    Free In-depth Consults
  1. Thanks for posting this video David. It is clearly a different technique. I'll take my foot out of my mouth now! I hope that Dr. Rassman will present this at the Annual Meeting in October. This method might be quite good for eyebrow transplants where a few hundred single-haired grafts are needed and longer hair helps control the curl during placement.
  2. Hi AGL77 Here is the explanation: http://www.hairrestorationnetwork.com/eve/167059-dr-cam-simmons-has-reunited-seager-medical-group.html Spencer invited me to apply to join the IAHRS a couple of years ago but I had already joined the hair transplant network and didn't have time to be involved with both. My return to Seager has given me more time and more support staff. We had to submit photos to be vetted by the IAHRS.
  3. Thanks everyone. AGL77, Many doctors use a 2-layered trichophytic closure. The deep layer of (dissolving) sutures go under the hair follicles in the fat layer to close the gap and to reduce tension on the surface. After that layer, I test to make sure the the edges will come together easily then remove a 1 mm wide and 1 mm deep ledge from an edge of the incision. That trims just the surface of the skin and the tips of the hairs. Finally, I use fine sutures to bring the edges of the skin together without tension. I remove the surface sutures after 7 days so they don't leave suture marks. The trimmed hair will later grow back through the narrow scar. For the first 6 months, I suggest that patients keep their hair at least 1 inch long but after that most can hide the scar with hair cut with a #4 clipper (1/2 inch long.) Some can go shorter but I can't promise that up front. Scoring-blunt dissection is a method I developed to preserve as much hair as possible along the edges of the incision.
  4. jrbiz 1. Did you mean subcuticular or subcutaneous? Like Dr. Charles, I routinely offer a 2-layer trichophytic closure. The deep layer is subcutaneous in the fat below the hair follicles. It provides strength and takes the tension away from the surface. Those sutures eventually dissolve. For the surface layer I use sutures that should be removed after 7 days to bring the edges together without tension. Before closing the surface, we remove a ledge from one edge of the incision so hair will later grow back through the scar. Subcuticular sutures are usually dissolving sutures that replace the surface sutures. They are placed just under the surface of the skin and can be used as the top layer of a 2-layer closure. The advantage is that you don't have to return for suture removal. The disadvantage is that the dissolving time is variable and the sutures may get pushed to the surface before they dissolve and that could make the final recovery take a bit longer. I haven't used subcuticular sutures much but have seen some photos of nice trichophytic scars where subcuticular sutures were used. 2. Do you mean facial closure or fascial closure? I haven't heard of a specific "facial closure". May be the doctor was talking about using a similar technique to what he or she uses when doing facial cosmetic surgery. Fascia is a thick, strong band of (connective) tissue. In the scalp it is called the Galea Aponeurotica. Some surgeons use the strength of the Galea to reduce tension on the surface by either anchoring subcutaneous sutures to the Galea or by suturing the Galea itself. When scalp reductions were done, the Galea was cut then sutured together. I am not a plastic surgeon and have never done a scalp reduction. I avoid cutting the Galea. I limit the depth of my incisions to just below the hair follicles in the subcutaneous layer. When I first started doing this newer 2-layer closure, I did anchor the sutures in the Galea as recommended by the author. However, I found that patients had more post-op pain. Since I kept the sutures only in the subcutaneous layer, my patients were much more comfortable and the scars were just as narrow. It makes sense that the Fascia could give strength to the wound but there could also be more complications. What limited experience I had with using the fascia was negative but there may be doctors who know better how to use the strength of the fascia for revisions. Dr. Lindsey may have more to say about using the Galea (Fascia) in closures. 3. I am watching the debate about Acell and PRP with interest but haven't been compelled to try either yet.
  5. P.S. Today's patient had 4396 grafts. He had a 33.6 cm long donor strip that averaged 14 mm wide and he had densities from 80 on the sides to 120 in back. By sampling, he had about 748 ones, 1913 twos, 1289 threes, and 446 fours with ratios of 17% ones, 44% twos, 29% threes, and 10% fours.
  6. Starr It was good to meet you in our consultation. (Your story makes it clear who you are but nothing that I say here will disclose any private information.) Doctor-patient communication is never perfect. Back in my family practice residency, we watched videos of consultations then heard what the doctor thought was said and then what the patient thought was said. Neither the doctor not the patient had perfect recall! (That is why I take notes.) I would like to clarify some points. 1. We are not limited by staffing. We are doing a 4300 graft session today with 8 experienced staff and had more available if we needed them. 2. You have not met Dr. Rahal yet, as you said, so you aren't comparing final recommendations. 3. The number of grafts available at a session is determined by the length of the donor strip, the width of the donor strip, and the density of the grafts within the donor strip. a) Your density is fixed and is a bit better than average. I estimated your donor density to vary between 80 grafts per sq cm above your ears, 100 grafts per sq. cm in your mastoid areas, to 120 grafts per sq cm in your mid-occiput. b) Staying within your safe zone, I felt that your donor strip could be 32 cm long. If we started higher above your ears and dropped lower in the back, the strip would be longer but you are young enough that we can't be sure that you will keep the hair at the top of your lateral fringes. I don't want your grafts to disappear and your scar to show later in life. c) Your scalp laxity is less than average. I measured your vertical scalp laxity at 10 mm above your ears and in your mastoid areas and at 12 mm in your occiput. Scalp stretching exercises can sometimes improve your laxity but only if you actually do them consistantly for 4 to 6 weeks. The most important factor to prevent wide scars is to avoid having tight closures. 4. Splitting 3-haired grafts into 1-haired and 2-haired grafts would artificially increase the number of grafts but would not increase the amount of hair transplanted. We transplant hairs in their natural groupings. Different patients have different graft ratios but a caucasian man with average diameter, dark hair should usually have about 50 - 55% 2s, 30- 35% 3s, and 10-15% 1s. Rarely, patients have very few natural 1-haired grafts and we need to create more to get a soft hairline. When that happens, we plant more grafts than originally recommended. Follicular units aren't always obvious. Sometimes a collection of 4 hairs may appear under the microscope to be a 4-haired follicular unit or 2 close 2-haired follicular units. Because we tend to use chubby grafts with a stick-and-place technique, we would be more inclined to keep that as a 4-haired graft. Doctors who use slimmer grafts in lateral slits may be more inclined to dissect that group into 2-haired grafts. Each doctor would choose to do what would give the best results for their patient. 5. I usually recommend that patients wait at least 9 months before having another session so there is more time for the scalp to loosen up and so that any hairs that are shed around the donor incision have time to grow back. I have chatted with Dr. Rahal a few times at conferences and by phone and have seen some of his patients. I am sure that Dr. Rahal has his patients' best interests in mind and that he does high quality work. His donor strips may be a bit wider than mine but stay within the safe zone. I would be the first to admit that I am a cautious and more conservative guy. I would rather take a safe approach for the long-term and give my patients the best results that I can without risking a wider scar or getting into trouble if hair loss progresses later. I am happy to offer larger sessions when someone has dense donor hair and a flexible scalp. I don't want to push the envelope when thay don't. In your case, Starr, I will stick with my recommendation of 3400 grafts as a safe target based on your scalp laxity and density estimates. I would rather understimate and give more grafts than planned than overestimate and give fewer. Let us know what Dr. Rahal says.
  7. Thanks sparky That's life in the Great White North. HT in early May (no tan) and follow-up in mid-June the next year (tan). Also the new blue background helps people pop!
  8. Mick This was a big canvas and Dr. Farjo spread the paint wisely. Nice graded plan to balance density and coverage. He already looks much better and it has only been 5 months.
  9. While this approach may be helpful for some patients, I am not sure that this would be called a breakthrough. It has already been done. Anyone who does FUE, could tape up hair in the donor area and trim one follicular unit then extract it before moving on to the next follicular unit to be extracted. It is slow and tedious but it is certainly possible ... especially for a small number of grafts. For a moderate number of grafts, patients can keep their hair longer and narrow "ribbons" can be trimmed with long hair left between the ribbons. I believe I heard Dr. Martinick proposed this idea to Dr. Harris at a meeting a few years ago. At least so far, if somone wants a larger number of grafts, shaving the donor area is most efficient. If Dr. Rassman has figured out a way to reliably extract follicular units without having to trim the hair to see the angle, that would be interesting. I believe that Dr. Bauman also tried this in the past though.
  10. This 29 year-old man had a Norwood 5 to 6 thinning pattern. He was balding in front with a thinning midfrontal forelock and he had thinning in his midscalp. He had coarser than average, black, wavy hair and average scalp laxity and donor density. He kept his hair short to de-emphasize the balding in front. 3500 grafts were available from the safest part of his donor area in one session without risking a tight closure. He opted to focus on the front and to start Finasteride to stabilize his hair loss. We transplanted 3557 grafts. He had about 8% 1s, 50% 2s, 33% 3s, 8% 4s, and 1% 5s, by sampling. He had scoring-blunt donor dissection and a 2-layer trichophytic closure. These photos are taken after 8 months so he doesn’t quite have his final results. He has seen a moderate improvement in his hair in his midscalp because of the Finasteride and because his hair is longer.
  11. This woman in her mid-40's had hair loss for 15 years. She had a Ludwig 2 pattern and had straight, highlighted, dark brown hair. She had thinning over a large area on top but her hair was thinnest in the midfrontal forelock. She parted her hair on the left to partially conceal the thinning. We transplanted 2135 grafts and concentrated them in her midfrontal forelock and left part. Typically with female pattern hair loss, we concentrate the grafts in key areas to improve the appearance of the hair in that area and to allow that hair to be styled to cover other areas. Transplanted hair will never be as thick as a teenager’s but should allow for better and easier styling. She is very happy with her hair and her only regret was that she didn’t do it sooner.
  12. Thanks aaron1234 I use the hair from the sides of the head for temporal points and the front of the hairline. In his before photos, his hair was grey in his natural temporal hairlines but not as grey above his ears. Men often grey in their temples first then progress to the sides and hairline but there is a salt-and-pepper effect. There are a few grey hairs in his temporal points now but not as many as before. His hair direction also lets the transplanted hair drape over the grey hair that was there before. As his hair continues to grey, his temporal points will grey again before the hair on the back of his head ... unless he likes brown temporal points and chooses to dye them!
  13. The circle is now complete. I worked with Dr. David Seager from 1999 to 2005 then founded the Canadian Hair Transplant Centre in 2006. As we got busier, it became too much for me to both look after patients and run the practice. (Patients always came first!) Since November 2011, I moved my practice and shared office space and administration with Seager Hair Transplant Centre but we maintained two separate practices. Now we have officially merged. This move will not affect patient care. Ben now looks after administration but leaves all medical decisions to me. I still see every consultation patient, review email consultations, and decide with my patients how best to help them. My dedicated and experienced staff moved with me and we still aim to provide world-class hair restoration to every patient. In fact, divesting my business responsibilities allows me to focus on what I enjoy most: doing hair transplants and looking after patients. I will continue to follow the forum and will post occasionally but you will likely hear more from Ben and Stephanie in the months ahead. I hope that you will welcome them as you have welcomed me and Louise. I have had a number of patients ask about why I moved my office and I hope that this explains it. The Canadian Hair Transplant Centre will gradually disappear but Dr. Simmons and staff will carry on as part of the Seager Medical Group. I will keep my contact info up-to-date. Feel free to contact me with any questions.
  14. Aggressive and frequent colouring can make hair break more easily but should not affect long-term growth. Cant decide is right. People get used to the lighter colour of their miniaturizing hair in the recipient area. Transplanted hair is healthier and darker. Also, in the summer, longer hair on the sides and back of the head doesn't get bleached out by the sun as much as the hair on top.
  15. hairloss89 You need to see a hair specialist or dermatologist in person. The most common causes of flaky dry skin are seborrhea and psoriasis but they don't usually cause hair loss. Finasteride and Minoxidil are great for slowing AGA (genetic hair loss) but AGA involves shrinking hairs not shedding hairs. You need to get an accurate assessment and diagnosis before anyone can recommend the best treatment.
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