Dr. Ricardo Mejia

You may be referring to PRP and stem cell stimulation with a product called A cell. This a study we are currently undergoing. There are several case reports and presentations regarding the benefits. However there is no clear study proving any stem cell stimulation. It is a theoretical benefit based on the growth factors that are injected. We are hoping to get good results in men and women with androgenetic alopecia. We are also experimenting with scarring alopecias such as lichen Plano Pilaris.

Have you tried cutting a 5 mg tablet? some of my patients have difficulty cutting it into quarters, and it depends on the manufacturer. I usually advise patients to take a 1/4 tablet a day. There is evidence that even smaller dosages are helpful and even if you alternate therapy. My patients have experienced good results with a quarter tablet a day.

I personally use the flat blades. They are precise and cut well. However , I tend to use a variety of blades depending on the type of tissue the patient presents with and which one will end up giving the best result with the size of grafts we are using.

Sorry... flutter kicks for abs minimizes tension in the neck area as long as you isolate the muscles.

Flutter kicks

Your welcome

Be careful of anything that causes tension or stress in the area

I'm an agreement with Dr.Glenn Charles.

A: It is the doctor’s responsibility to properly educate you on the number of grafts that are needed to achieve the expectations of your hair transplantation surgery. The most important aspect of the education process is to properly understand what a follicular unit is and what a graft is and to understand the proper terminology that the physician is speaking. Typically in modern day hair transplantation, a follicular unit is a group of hairs that are held together by a piece of skin. This follicular unit may contain one hair, two hairs, three hairs, or even four hairs. A follicular unit that is dissected is also called a graft. A graft is nothing more than a piece of tissue holding hairs similar to a follicular unit. In modern day hair transplantation most physicians refer to a follicular unit as equivalent to a graft. However, there are some physicians that may use the terminology called graft hairs, which is confusing because they are referring to the total number of hairs and not grafts. So if you have four grafts and they have three hairs per graft, they may say 12 graft hairs as opposed to 4 grafts. Consequently it is important to understand the proper terminology. The next issue in understanding how much is needed for your surgery is the area that is being transplanted. The area will determine the approximate number of grafts. Are you transplanting in an area of 50 sq cm, 100 sq cm or 200 sq cm. If an individual is completely bald with 100 sq. cm. and there is absolutely no hair then one can transplant anywhere from 20-50 follicular units per cm sq and consequently can achieve a total of 2,000 to 5,000 follicular units. Obviously the more follicular units per cm sq you are transplanting, you are also transplanting finer two hair or single hair grafts. The next issue to determine the proper number of grafts that is obtainable is to understand your donor density. Donor density can range anywhere from 50-100 follicular units per cm sq depending upon your age and donor density. The average distance on the scalp from ear to ear is approximately 30 cm and an average width of strip taken from ear to ear is 1 cm. Consequently the total width of a strip can be 30 cm sq. If your average follicular unit density is only 70 grafts per cm sq then the total number of grafts obtainable is 2100 grafts or 70 x 30. However if a surgeon extends the surgical line more anteriorly in front of the ear and is able to obtain a larger length and width and can remove twice as much area then it is possible that 4200 grafts can be obtained. However, to uniformly remove a 2 cm strip in many patients can produce significant tension and is generally not advised. Consequently, it is up to each individual physician to properly evaluate each patient carefully, understanding their donor density and area that is to be transplanted. They also need to understand patient expectations to arrive at a proper estimate of the total number of follicular units to achieve your expectations as well as what can be physically obtained from the back of your scalp. Keep in mind that there are differences in how physicians dissect follicular units and some may keep chubby follicular unit grafts with more hairs per grafts and others may subdivide or keep very fine follicular units with smaller numbers per graft. To illustrate this, assume that two strips of equal sq cm area are taken out by two individual hair surgeons. Assume that you count the exact number of hairs from each strip and assume that they both contain 8,000 hairs. What is the difference between the physician that states that he will give you 2,000 grafts and the physician that states that he will give you 4,000 grafts? Who gave you more hair? The answer is, neither. Both gave you a total of 8,000 hairs. Surgeon A gave you an average of four hairs per graft or 2,000 grafts and surgeon B gave you smaller grafts of two hairs per graft or 4,000 grafts but in total the number of hairs is the same. This may account for some of the differences in numbers that you may be receiving or it may be based on the estimations of your donor density and the amount that they can take out and the amount of sq cm areas that they are transplanting into. Hope this helps, but each case and consult is different.

Only your surgeon can advise you properly. Only he or she knows whether it s a single or double layered closure and whether there ws significant tension or not during the closure. Generally speaking some surgeons remove sutures at 7 days. We do not know whether you are on medications that affect wound healing or a smoker. Consequently, you should take your advise from your surgeon based on his her closure technique etc etc.

YOur hair looks great. More than alot of people.

As in any surgery there are risks of scars. FUE does have its risk of scars even in caucasians. If every patient that had FUE done, shaved their head, you would likely see some hypopigmentation. It is only more prominet because of the ethnicity and contrast with the skin color. The less contrast the less noticeable.

If you have limited funds and can only affor one transplant, I would think twice before getting started surgically. I typically advise my patients to start medical therapy and give it a try. The side effect profile is a small percentage but hair saving onthe back end. No pun intended. Remember if in 5 years your hair loss advances significantly and you thin out, you are going to need another hair transplant to bring you back where you where. So in reality it is a catch up game tranpslanting what you are losing. I have had young patients which much more advanced hair loss try actually going the opposite direction. They shaved their heads. At first it was hard but now they are totally happy. Get good consultations from doctors in your local area who can sit down and clearly go over your history and your expectations

no, except for what has been called bubble hair from overblow drying and causing fragility or fracture of the hair shaft but not real loss of the follicle.

If a patient wants to tip techs, I usually tell the patient it is not necessary, but if they want I am sure they would appreciate it greatly, which no matter how well the techs are paid they always like the exrtra cash.

In my opinion, you need lots of doubles and triples for successful crown work in order to give coverage and the illusion of density ...and you generally you don't get a lot of multi hair'ed grafts with FUE - Therefore strip would in my opinion be a better way to proceed if you chose to to address the crown region appropriately - best of luck!!

 

S

Spex. You are right on. I agree you get better coverage and density with strip. I find the same thing even when you are not working on the crown. Kudos to your great insight. Keep up the great posts.

The following are a few examples of how the hair grows through scars to reveal invisible like results following strip excsions.

Thank you Blake.

On Monday we did a hair transplant on Carlos Miller and live streamed it. We will be posting pictures on a blog here shortly. For now you can see some of the pictures on our Facebook page: Skin and Hair Doc - Health/Medical/Pharmacy - Jupiter, FL | Facebook

Carlos will be documenting his process on this link: Carlos Miller's Awakening If you click on the link there that says Live Stream you can see videos of the surgery from Monday.

We've been livestreaming a live hair transplant today. Probably some more sessions until 6PM. All prior live streams will be viewable on this page:

Live Stream Hair Transplant | Carlos Miller's Awakening

All the live streaming will be on this page: Live Stream Hair Transplant | Carlos Miller's Awakening

Our next live stream will be at 3:30PM

You can also follow posts on Facebook: Skin and Hair Doc - Health/Medical/Pharmacy - Jupiter, FL | Facebook and Ricardo Mejia M.D. (@skinandhairdoc) on Twitter

Carlos will be documenting his journey on the blog this year with videos and pictures.

The answers below are pretty accurate but it really depends on your density and if you have retrograde alopecia or not.

The one with the least experience

Need to give the hair more time to grow

I would not think twice. He is an excellent surgeon and you are in good hands.

Dr Ricardo Mejia