Dr. James Vogel

This gentleman underwent 1256 FUE's as donor harvest. We have been recommending a stealth shaving of the donor or having the patient come in with a "military" haircut. In the later example, at about 10 days post op, the patients usually get a haircut to even out the hair length between the non harvested area and the grown hairs next to the healed FUE sites. 0.8m FUE punch size is used and this patient's appearance is seen two weeks following the HT.

This result is seen 8 months following 2600 grafts. This illustrates an excellent result without over-harvesting and diminishing his donor supply.

This is a man who is in this mid 60's and has always had a low AHL . This case shows that not all men require an AHL HT at an elevated level. In this well selected case he received 1850 grafts to the restore the AHL with the lowest point at 6.5 cm from the brow. Temporal recession also filled in and he remains on Finasteride.

This result is shown 8 months following 1800 grafts to the anterior hairline and forelock. This results illustrates a conservative technique for blending a mature hairline and existing low hairline that will eventually recede leaving behind only the transplants.

This patient received 2500 grafts to the crown vertex area - Note the reestablishment of the natural whorl pattern. He is a very stable pattern of hair loss/maintenance in the frontal forelock area and has already had hair transplants there as well so an aggressive HT session to the crown area linking this region to the forelock was appropriate in this 45 year old man.

Results seen 8 months following a single session of 2200 grafts to anterior hairline and temporal area

This patient had a pluggy transplant years ago by another surgeon using older techniques. He is seen here following 2 sessions to correct the pluggy appearance.

FUE is a terrific option for selected patients. One short term disadvantage is the need to shave the entire donor scalp. By shaving a discrete and relative narrow portion of scalp, the hair above the harvested area can be used to hide the donor region. This technique does take more time and detailed planning but can be performed for up to 1200 FUE grafts and more in dense donor scalps. This 'stealth' FUE donor technique is popular for obvious reasons and I thought the HT Network Community would find it interesting. Pictured here are approximately 1000, 0.8mm FUE harvest sites.

The photos shown are after 2 plug reduction and recycling sessions and approximately 3000 grafts. Note the freckle on his left side to obtain perspective on how much his hair line was lowered.

Photos shown are the final result after 2700 grafts, linear excision of anterior hairline, and approximately 46 plug reductions.

Results 8 months following 3300 grafts to hair line and forelock. Note left temporal freckle as verification of same patient.

Result 8 months following transplant. This result is an excellent example of poor quality, narrow hair and the importance of appropriate design of the transplant using this limited, low quality resource.

Results 8 months following 2700 grafts

Often we write about how a natural hairline is created but do not show the process. The irregularity of the front distribution of grafts is illustrated. In the front zone are single hair grafts. Behind that are grafts that contain 2 hairs/follicular unit and behind that, larger ones. In the temporal bulge area grafts containing 1-2 hairs are placed. The angulation of grafts in the temporal areas are toward the ear and the hairline grafts are placed 45 degrees toward the nose. This is a single pass hair transplant of 2200 grafts to the anterior forelock and hairline. Results are seen at about 9 months post operatively.

Results seen 8 months following 2000 grafts. He now colors his hair however you can match up the freckles on his forehead to tell it is the same person!

Results 8 months following transplant of 1850 grafts

The majority of photos on the web show excellent HT results or poor donor scars. This example shows the typical excellent result following a trichophytic closure in the donor site following strip excision 8 months earlier - The trichophytic closure technique allows hair to grow through the scar to camouflage it as much as possible. Re-excision in the same area and re-closure with the same technique is possible to minimize scarring.

Photos seen before, intra-op, and 8 months following the procedure

Thank you so much for your kind words and confidence. I look forward to serving the needs of the Hair Transplant Network Community for years to come. James Vogel, MD

Results seen 8 months following 2400 grafts

Results seen 8 months following 2400 grafts. The wavy texture of his hair helps to camouflage the scalp.

Thank you all for the comments. This case illustrates my philosophy to do the best work with using the least amount of the valuable and limited resources (i.e. donor hair). Often people push for large sessions with lots of grafts but each case should be evaluated with this concept in mind. On the other hand, certain low density donor situations and other donor hair characteristics will require much larger sessions. Key is to individualize for every patient. James E. Vogel, M.D.

Results seen 8 months following 1500 graft session

This case was done by FUE with a total of 250 grafts. Thank you for your kind words, I certainly enjoyed this case.

Results 8 months following transplant to cleft lip scar