Dr. James Vogel

56 year old 8 months following 2500 grafts to forelock and posterior forelock

This man has undergone a single session of 2200 ultra refined follicular unit hair transplants. His results are seen at 8 months. Note the influence of the patients own natural wave on the appearance of perceived hair density. When the hair turns back on itself, it appears extra dense where the hair shingles or layers on on other transplanted hair. It is less dense appearing at the part. These influences are important for the patient to appreciate pre operatively.

This patient has had 3500 grafts to restore his hairline and frontal forelock.

This patient underwent three sessions of plug reduction and recycling. A total of approximately 2000 grafts with plug removal were performed. There are two important principles illustrated by this repair case. The first is to recreate the soft natural hairline by directly removing and reducing the offending plugs. Camouflage alone (without plug reduction) using small grafts in front of the plugs does not do enough. The second principle is to develop a very irregular hair line, and when possible a widows peak, to completely change the previous unnatural oval hairline. Obviously a very pleased patient who no longer needs to be self conscious about his hair line!

This is an example of 2500 grafts packed tightly within existing hair. The existing hair was not trimmed before the operation. This is his result at 8 months.

This man has had previous plug grafts that required removal and recycling as well as additional grafting. He received 3700 grafts to soften his look. He had a red hue to the base of the plugs which is not too unusual in patients with some red hues to their hair color. Because of this discoloration he needed to have his hair line lowered a bit more than usual. Note the location of the red mole in his left temporal area before and after to assess the amount of hair line lowering.

These results are of a 44yo approximately 8 months following a 3200 graft session to the forelock and temporal bulge.

The readers of this discussion must be aware that different hair transplant surgeons have different practice policies and techniques. The overwhelming number do larger sessions seperated by 6-8 months and use skilled technicians. There are a variety of reasons for this. Obviously though, in some practices no technicians are required.

Dr. Vogel

Baltimore

Thor:

This term really refers to the appearance of the old 4mm plugs that healed as do all circular scars, in a circular manner, with a pincushion look and were somewhat elevated like cobblestones on the street. You do not have this problem. At 2 days post op you have swelling, edema, inflammation etc, etc. It really does not look too bad actually. Give it some time and you will be relieved I am sure.

Dr. James Vogel

Baltimore, Md

The issue of the number staffers needed to perform an excellent HT is a crutial one. The procedures today are easier and better for the patient but more labor intensive for the doctor. The average to good tech can cut or plant about 250 grafts in one hour. The average 1200 graft session should take about 4 hours from start to finish with one doc and 3 techs. The issue of how many grafts can or should be placed on the scalp should not really be judged in terms of the required time for the procedure but rather the question should be asked like this...How many grafts can be placed safely in a given area so that they will give me the fullest appearance and have the maximum blood supply to grow succesfully ? It is a mistake to be limiting the number of grafts because of time issues. A well honed HT team should be able to provide the maximum number of grafts to do the job in a reasonable time period. After all, as a patient you will be waiting 8 or so months to see the result, and paying a considerable price, and we know it takes a lot of hair to make a difference...so do not ask for smaller numbers and more frequent sessions...ask for large safe sessions performed expediciously.

Dr. James Vogel