Dr. Ricardo Mejia

I generally remove sutures in two weeks. I have had some come back in three weeks with excellent healing. You should not be worried about the three weeks. Dr. Beener has summarised it well.

As Bill mentioned, alot depends on the clinical exam of the patient. I do not like to go to low or close to the ear because tof the risk of visibility if you have thinning in this area. As a general rule, some state approx two finger breadths. You can go higher if a patient has better donor area and you do not feel they are at significan t risk of recession. Age plays a major role as well. In the end, it depends on the clinical circumstance. In some cases, there is more tissue laxity as you go higher which allows you to get a wider strip and more grafts.

If in the opinion of your doctor,2000 grafts is nothing with minimal to no tension and he gives you good comfort with the donor scar, then many would consider this a reasonable risk to get what yhou want without sacrificing the donor area

It all depends on your density and physical examination and tightness of scalp etc. You can get multiple different personal opinions. However, as a physician i can not tell you what to do without a proper consult and exam. For some cases it is conservative, in others it might be stretching it.

I typically advise my patients it is a personal decision. If they are happy where they are at then they do not need to do anything. IF you are concerned about the scar on a second procedure and want to have something done, consult with your doctor, explain these concerns and be conservative. Do not give your Doctor an ultimatum I have heard before, this is my last procedure so take out the max you can do. This usually will lead to areas of potential increased donor tension. Accept that you want to be conservative to get the best acceptable donor scar irregardless of the number of grafts obtained. Make sure he or she understands that the donor scar appearance is your highest priority.

Bumps on the head can be Lipomas or fat tumors, Pilar cysts, hematomas or abscess/infections, ingrown hair follicle. Best to see your doctor. Good luck

Examples of trichophytic closures from different angles.

Here is the link to the thread on understanding shock loss

Understanding Shock Loss

We do not require shaving. You still get quality excellent results. Most of my patients are professionals and do not want the downtime look.

see my previous topic Understanding Shock Loss

Alot of it depends on how much hair you have to cover, the density, the amount of grafts being placed, if you are lowering the hairline. Ther could be redness around the follicles from healing, stubble from the graft hairs. It will not be perfectly normal but manageable depending on the above factors. This is a case by case evaluation and can not be generalized. In many cases, hardly noticeable.

I am typically a non shaver. However for cases over 3500 grafts with dense packing, it is easier to plant when the hairs are not there. This can save considerable time and knock off an hour or two from the surgery which is a considerable amount of time. Either way it depends on the patient and his desires. Patients are aware of the advantages and disadvantages and the results are equally good.

Nice post

Unfortuantely we are aware of too many places across the country that are still performing inferior work and practices that do not bother to keep up with the latest advances. In todays society this is a case of where people either do not do the proper research on their doctors or who are looking to get the cheapest deal. I am glad you were able to help him. Good job.

Juan:

There are many good reasons why doctors do not do hair transplants. It is not about money, it is about doing the best for your patient. IF doing a surgery is not in the best interest of the patient (despite a patient wanting it done), this is not good medical practice. A good ethical doctor should always take that into account. It is no different then the bar example you gave. There are many clubs that cut clients off after they have had too much to drink, They do not have to serve individuals even when they flop money on the countertop. It is the same with physicians, we are not obligated to do anything that we feel is not good medical practice. You have the right to a second opinion and maybe get the procedure done. It is no different than walking into another bar and getting a beer when you someone was just cut off. The establishment/bar and the doctor is ultimately responible. If there is a bad outcome or accident or unreasonable exdpectations, the physician is liable. This is not the answer you wish to here and I know that. Take at heart the many tips reasonable posters have commented on. Get a second opinion from a competent ethical doctor and if he tells you the same thing , try to understan dthe reasons behind it.

remember even with fue you can get hypopigmented scars. When you do a number so close together in the hairline, you risk visible scars. Laser hair removal can work. The closer you go to the existing hairline, there can be laser light scatter inthe dermis affecting the normal hairs. It is possible with it's risks and benefits. The picture I saw was not the most clear, but a personal consultation would certainly help dilineate things better. Fractiobnal co2 lasers like the deep FX have been used to minimize and treat different types of scars. Can't say I would recommend it without a clinical exam. Good luck. Keep us advised.

Nice work.

the highlights look good.

57 year old male recovering from stroke desired coverage of over 150 cm squared of hair loss.

2878 total follicuar unit grafts achieved with an overall density less than 20 fu/cm squared. Patient advised on higher density and need for more grafts given larger surface area. Patient very pleased with results , objectives met and has no desire to augment density.

57 year old male recovering from stroke desired coverage of over 150 cm squared of hair loss.

2878 total follicuar unit grafts achieved with an overall density less than 20 fu/cm squared. Patient advised on higher density and need for more grafts given larger surface area. Patient very pleased with results , objectives met and has no desire to augment density.

agree 100%

Yes you are correct. There are exceptions to the rule taking into account the variety of factors number of grafts transplanted etc.

Aaron. That is a great term especially in todays environement.. "the hair greed virus" Kudos. I will keep using it. Thanks for the comment

My general advice to patietns is nobody needs a hair transplant and you do not need one. Nobody should convince you to have one either. You should enter into this voluntarily after having had a proper consultation with a physician and understanding the risks benefits and limitations in your specific case. Keep in mind you will get many personal opinions which may not be relevant to your case, history and or goals and expectations. Carefully research and determine if your hair loss is a significant concern to do something about and consult with a professional to give you the proper counseling and recommendations. Consider your options carefully before jumping into any decision.

Thanks for your comment.

The whole frontal hairline was excised. He is very pleased and it has changed his whole outlook dramatically. He is no longer fearful of a windy down or swimming in the pool.

I usually put patients on meds rogaine, Propecia and wait at least one year. I generally am very cautious for anyone under 25 and would rather patients wait. You may find priorities change as youget older where all of a sudden you find perhaps you do not want one, you get married and no longer "need" one, you shave your head and more comfortable with a shaven look. Things change and better to wait.

To answer the possible causes, refer to my previous thread on understanding shock loss:

understanding shock loss