Janna

I too have never heard of this (1 & 2's growing before 3 & 4's). Nor the idea that the first planted grafts grows before the last planted grafts. Feel free to correct me if my understanding is incorrect. Follicles have different cycle patterns of resting and growing phases. That is a given for everyone (surgery or no surgery). Now, you add surgery, and the stress placed on the follicles. After surgery, the shedding phase does not occur immediately or all at once. The speed of shedding varies, correct? Thus, the re-growth varies as well. There are many factors and variances that determine the viability of a follicle (stress, damage, blood supply, natural cycle, etc.). I believe there was a good explanation above about predetermined stages of a follicle before surgery. I guess it's good that the follicles are on different cycles instead of just one cycle, or we would all be bald while the follicles were resting.

Moris, I'm perplexed as to why you had to quit your job? From your pics, I agree with others that your donor scar looks pretty normal. And, I do not see from the shaved recipient area where you had the grafts put in. It sounds like there were miscommunications as to the expectations and results of your transplant. Right now, it's hard to determine where your hard feelings come from except for the misleading info on what you needed for the number of grafts. I hope you are able to get back on your feet and not let MHR ruin your life. Good luck!

There are Dr. Duncan Simmons with MHR and Dr. Robert Reese. Dr. Reese used to be with MHR until couple years ago. PAI also had a floating physician here in town, though I think they closed shop last year. I'm not positive on that.

B-Spot, I hope you bought the "premier package" to get the right end up.

No offense taken Troy. The website is subpar cuz I'm not in charge of it (ha, ha, ha). The good doc is too preoccupied with perfecting the HT technique to concentrate on the website. I've been hearing for years that the website is being worked on. I'm pretty sure we will get it updated soon. I'll keep bugging him.

We are aware we need to update our website. Sorry it's so slow going. 1000-2000gr session is definately considered a light day now. B-Spot, we're looking forward to seeing you. Numb up your rear b4 you get here, it'll be a long day. Of course it'll be all worth it!!!

What I gather from our patients who used every type of system out there, it is much more expensive in the long run than a transplant. Not because the hair system is so expensive but the cost of maintaining one is so costly. If you find you're interested because it looks natural enough, make sure you get every detail of the cost for a year and see if it is worth it. I know too many who regret the time and money spent on their old hair systems.

Vargman, You should consider a HT if your hair loss really bothers YOU to a point where you feel you need to do something to improve. You will get different opinions when you take a survey. From the pic, your hair loss is minimal in comparison to many patients we treat. We have done wide range of hairline cases on patients simply because they felt their hair loss caused them undue stress.

I'm very glad for Mark to have found the right clinic for him. I found it odd that Mark issued a challenge of getting a consult done over the Forum as well when he initally said he had a phone consult with SMG. If he had, he would have had the answers to his "challenge" already. When I asked for the date and his last name to find his info, he simply stated he was going to call the next morning. He failed to follow through on his part and claims we failed him. I don't get where we failed, but I am truly happy that he found H & W. Best of luck to you from all of us at SMG!!!

If anyone comes across a person with 60cm wide hairline, you better take some pictures. I think you'll be able to demand top dollars on the Enquirer. I had to measure today's patient's hairline to compare, it's 16cm across. Shane's pictures and numbers do not add up...IMO. I'd love to talk to the techs who planted 3000 grafts at the hairline. I can't fathom 90-100 incisions in a cm2 for 30cm2. Wow, the potential for bleeding and popping, not to mention the time it takes to extract 3000 grafts. The immediate post-op picture does not indicate such density, nor a 30cm2 coverage...again,IMO.

Alec, Take heart that the swelling typically last only 3 days. We advise our patients to start icing immedately after surgery for three days to minimize their chances of swelling (along with medications). If a patient swells, it shows up 72 hours (3 days) after surgery. It starts at the top of the forehead, then just above the eyes the next day, and finally it reaches below your eyes the third day. The visibility is minimal as the swelling drains down to your cheeks on the fourth day. If you don't have post-op instructions, you need to call your HT doctor's office for their specific instructions. I'd advise you to calmly research what you can to to get optimal growth at this point. I hope you find comfort and gain useful knowledge from all the caring posters above who are here to lend support to all those who seek it. Best of luck to you.

"That had to be the nicest way anyone ever told me...gee, your really bald! Only kidding--appreciate the reply. I do not have the measurements but will make a note of getting them. I do have pics prior to removal and to me it looks a little like the grand canyon". Ha, ha, ha. I knew i liked your sense of humor. I wasn't very delicate, was I? Sorry about that. Whenever you get the dimensions is fine, no hurry. It's nice to get all the pertinent data to follow your progress better. Best of luck to you. You have a lot of support here.

Hi Glock08, Congrats on taking the plunge. Not having to contend with the hair systems has to be sheer joy. You inject a nice sense of humor in your hair loss blog, I enjoyed reading it. I also appreciate the fact that you included the technicians when you wrote about your overall experience as I think the techs/assistants' care can make a difference. Of course it comes from the top, if you feel comfortable with the doctor, then it's reasonable to expect the staff to provide the same quality of care. From your pre-op picture, it looked like you had fairly big open area to work with. From your immediate post-op pic, it shows you got coverage just about everywhere, thus needing as many grafts as possible spread out rather than concentrating on frontal half or two thirds for density. This is merely a preference by the doctor and patient rather than a right or wrong way of approaching hair restoration. Thanks for providing the graft and hair count, it will give us a better understanding of what to expect when your hairs start growing in. Do you by chance have the dimensions of your donor strip?

Your blog is very nicely done. I'm sure it would have taken me few days as opposed to few hours for you. I'm looking forward to seeing your results. Generally, I see the results if the patient comes back for another procedure. I appreciate your time and effort of keeping a journal of your experience as it benefits so many others. Here's to abundant growth!

Even though I'm rather new to this forum, or any HT site for that matter, I'd like to put my two cents worth regarding Pat's site. I first met Pat about 8 years ago as we were walking into the same clinic in Minesota. If my memory serves me correctly, Pat was first hired to take videos of our procedures. Taking videos for a few days was the extent of his HT research. I remember the mild mannered Pat having high anxiety about the whole process as he was about to go through his first HT procedure. There really wasn't much of a support system availble which were deemed a patient advocate site. After his procedure, he was a new man who wanted to share his experience to the world. I'd safely say he's reached at least one of his goals. Through the years, I've found our patients to be more and more knowledgable with realistic expectations, which makes our job easier. The knowledge, in part, comes from this site with many regular members willing to help others by sharing their opinions and experiences. I know it's helped me get a better understanding of the goals and expectations of our patients. So, THANK YOU to Pat and to all those who have contributed on this site.

Yes, it's certainly possible to get hair transplanted in front of an existing hairline whether one has hair loss or not. If I understand your concerns correctly, you want to soften the widow's peak by bringing down your temporal peaks into a soft curve. Right now you have a V shape hairline. Your picture is a little blurry to give an accurate assessment of how many grafts you might need. My best guess is you probably won't need as many grafts as you might think for a natural aesthetic look. In my opinion, the traditional linear strip is still a good option since you will most likely have ample density in the donor region, it will only take a small strip to provide enough grafts. This means just a pencil line width by approx. one to two inch long scar will remain in the donor area when all is said and done. In fact, you will have a hard time finding the scar with the new type of donor closure, which produces minimal scar lines (tricophytic closure). You'll save yourself money and surgery time. With the small strip excision, there should be plenty donor left for future loss(if any).

While there are no guarantees, most of the hairs lost due to shock loss will return. We have patients who go through the same anxiety as you're experiencing right now. At 3-4 months post-op, your transplanted hairs and the shock loss hairs start growing in. Are you on Propecia? It seems to help a great deal of patients retain not only the transplanted hairs, but also help keep the existing hairs from shock loss. Cutting your three inch long hairs should not matter one way or the other. It's probably better to get a hair style you'd like to try at this point, not just a short hair cut to curb shock loss. Good luck to you.

Hi Bushy, I absolutely agree with you that 9000 or 9200 hairs won't be much of a factor in the long run. It's really in cases where a patient receives 6000 hairs rather than 9000 hairs. One of my concerns in my original comment is when patients see results like Bobman's, they feel that is the norm when Bobman obviously had great density with the optimal hair characteristics for a HT. I'm also sure he had great hair count. It's really for the patients who have lower density that hair count becomes a bigger factor. This helps everyone in reaching a realistic goal.

Joe, I don't know if this explanation will ease your concerns, but the fact that you provide the hair count and every other aspect of the surgery only gives the patient a broader understanding of what to expect. Hair count is only one piece of the puzzle. Certainly the characteristics of a given hair play a major role as this will dictate in many cases whether they have average density or not. When a patient comes into a clinic or has a remote consult, one of the first things you do is ascertain the type of hair they possess. Let's say the patient is Asian, most (not all) Asian hair, from my experience, have very strong hair caliber, but the density tends to be on the low side, which means the follicles mostly come in groupings of two's and one's. At completion of surgery if you state he received 3,000 grafts and leave it at that, it stands to reason he may expect similar results to someone else receiving 3,000 grafts. In instances such as this where the hair count plays a key role. Now, I believe you and your clinic educate your patients so the patient understands what they should realistically expect, but the hair count can only help in the explanation. I've never come across a case where the hair count became a negative factor. In the past, most patients didn't care about the hair count; it was indeed just about the results. However, with the new era of mega sessions and dense packing, the hair count and hair characteristic seems to have become a bigger piece of the puzzle.

Pat, I believe you know my vote on this. I don't see this as a tedious task for the clinic as the clinics all have the graft count already. It's just one more column of numbers with basic math thrown in.

You will soon get many different advice on what you can do to optimize your transplant results shortly. The only advice I'd like to give at this point is to not stress and look for growth in the mirror everyday. I realize its easier said than done, however, stress is not good for your body or hair. Try to keep yourself healthy, happy and occupy your thoughts with anything other than HAIR. Your next 6 months will go by much faster and your hair will start going before you know it. This is an advice I give to our patients quite often.

We do not encourage anyone with a recent HT to wear a hair system. However, from past patients who find it difficult to let go of a system until the hairs start going in, they have worn it minimally as possible (ie, just for work, not more than 8 hrs each day). I have not heard any negative feedback regarding growth from these patients. If you have any existing natural hair coverage on top, you could use Dermatch or Toppiks to help disguise the surgery. The redness from surgery typically fades away around 10 days after surgery. The redness discussed on this thread is something different. Not everyone gets folliculitis, and it's red spots rather than general redness on the recipient area.

As I write this an alert came up on my screen with B-spot's latest posting, which has a very valid point, and I'd like to thank him for his calm, well thought out input. Mainly, I want to apologize to the H&W Group for any offense taken by my comments and concerns to Pat's posting. Given the data I saw on the forum, I questioned their technique and made certain assumptions to their graft and hair count. I should not have jumped into the assumptions without asking the questions first. It's human nature to question or assume when you don't have the answers. We've come to rely much on the internet for answers. I used to wonder how H&W were able to accomplish such a large session in one day. By visiting their clinic I was able to see that it just took the old fashion hard work and long hours. In reference to the "two piles", which still has me stumped has a simple remedy to this concern by providing the hair count. One cannot get too upset by the thirsty man wanting a glass of water. B-Spot, I'm not sure about the waste percentage being a factor. It would be hard to calculate if it increases as session size increases. It's also hard to measure exactly what the percentage might be as this data would be provided by the individual tech cutting the grafts, and no tech wants to believe there are any waste. Realistically, I believe you are right to estimate 3-5% percent waste per session.

Spoon, Basically, a patient's one hair grafts are going to be the same size with a certain percentage of them being finer in caliber. Despite the two different size of ones, they are inserted into the same size incisions. We purposely pick out the finest ones to place at the very front points. The regular size ones are then place just behind the fine 1 hair grafts. Here's a break down of the blade sizes based on average caliber hairs: 1 hair grafts-.7mm, 2 hair grafts-.8mm, 3 hair grafts-.9mm, 4 hair grafts-1.0mm. There's slight variation to these sizes depending on how strong, curly, or fine the hairs are. We've gone as small as .65mm for ones on one patient, and as high as .8mm in another patient. As the doctor begin making incisions, we test by inserting a graft into the appropriate size incisions to make sure the grafts fit. Experienced techs can tell the different size incisions and know where differnt size grafts should be placed. More importantly, the doctor directs us to where he wants the grafts placed.

Since my posting has caused such a heated debate, I thought this thread warranted another posting. One thing I did not mention before, when I visited H&W I only viewed Dr. Wong's surgery. His grafts were put into three piles. It was from Pat's posting which stated Dr. Hasson's case of 5100+gr. with just two piles of 1's and "others", and that there were past concerns brought up on the Forum that raised some concerns for me. I don't think anyone is purposely splitting FU's, or suggest that the doctors are dictating this. From an assistants point of view, there is some individual judgment when looking at 3 and 4 hair groupings as to whether they can be kept as 3's and 4's, or safely made into 1's and 2's. There is a natural tendency for assistants who will later plant into all the small, close incisions to cut the grafts to fit those microscopic size incisions unless the doctor makes the appropriate size incisions for the corresponding size of the grafts. I stated exactly why we keep a cutting log in my "comments". We also know what the hair count is and know right away if the patient has below average, average, or above average density. On occasion when a patient has very low density, we've restructured our fee to coincide with the hair count rather than the graft count. I don't agree that H&W are "ripping" patients off. Nor are we ripping patients off if we opt to do two sessions instead of one. Either way, I believe both fee structures are moderate considering the caliber of work. Whatever H&W comfort level may be, and whether they are equipped to handle such large session is up to the individual physician. My contention is if Dr. Shapiro has concerns he has not been able to put to rest at this juncture in regards to mega sessions that exceed 4500grafts on a routine basis, our clinic should not be viewed as less than stellar. Also, the misconception on the Forum that everyone is an ideal candidate for a mega session bothers me as there's bound to be disappointed patients. Even the patients who get exceptional work of 2000-3000 grafts feel insecure. It's perfectly fine to have different techniques and beliefs as voiced by many on this Forum. I've gotten to know Dr. Wong in the last couple years from Conferences and my visit to his clinic, and I personally trust and respect him. I'm sure I'd say the same for Dr. Hasson if I got to know him as I know he has many happy and satisfied patients. The two clinic doctors get along very well and have mutual respect for one another.