TheHairLossCure

Slick, Congrats on your results. This is natural and subtle work from Dr. Paul. Glad to see it, hope you are pleased!

Just to add on to Laura's point, Dr. Rose has the same staff working on all his cases. These individuals are not simply trained to do hair transplants - they are trained specially in the techniques that Dr. Rose has developed and employs. Laura is the lead assistant and has worked with Dr. Rose for many years. Terri, another assistant, has worked for Dr. Rose since 1991. All the other techs, while they have worked with some of the most prominent transplants docs, primarily work for Dr. Rose. Hair restoration is a team sport, so you need a great team as well as a great doctor. Dr. Rose absolutely recognizes this and works with a top staff. Patients can rest assured that they are in very safe hands with the crew.

Sometimes issues with variable hair shaft diameter can be overcome and blended with the pattern, distribution, and density of the transplanted hair. I am curious, if your hair on top is so thick, what are you hoping to do with a transplant? Hairline rebuild, perhaps? Also, is your donor area visibly thin?

Good HT work should be undetectable, even on close inspection. Pictures do lie sometimes, but this is more in terms of density. If you have substantial hair loss, you can only realistically build higher density in limited areas (hairline, frontal 1/3). In other areas of the scalp, there may be only a dusting of grafts for light coverage. Interestingly, light coverage can look quiet full in certain light or with certain styles. When this is captured in a still image, a picture can lie. The opposite is true too; a thick plant can be made to look thin in certain situations. Still, I feel that naturalness is conquerable and should be your expectation. You just need to be picky about your doc.

Doing a bit of eyebrow work along with a scalp transplant is totally reasonable. I'm sure the physicians you mentioned would be happy to evaluate your situation to see what's possible.

Hi Arrie. Congrats on taking the plunge! If you lost any grafts from the procedure, you would have noticed some bleeding or oozing from the site on the scalp. So it doesn't sound to me like you lost anything

1,200 grafts would only be appropriate if you were treating limited hair loss, building a hairline, or augmenting prior hair transplant work. I agree that, if a person has moderate to advanced loss, it is appropriate to do at least 2,000 grafts. 7,000 FU grafts in the donor bank? Yeah, that is about right. Some gifted patients have more, and some patients have NONE.

Bill, Who is claiming to do 3,000-4,000 fue in a single day? That is off the wall...

If you are considering a hair transplant operation - but are still on the fence - I think it is a great strategy to shave the head. You may really like that look once you get used to it. If not, you can go for surgery without having to wonder whether the shaved look might have worked for you.

WantHairs ??“ Definitely feel free to drop in for a meeting. I know Dr. Rose will be happy to talk with you. In terms of another surgery, it is good to wait about a year after the first session, give or take. Timing somewhat depends on the recipient area of the first surgery and the area you hope to treat during the second. Emu ??“ I am not sure about Pat's reason for choosing Dr. Shapiro and Dr. Rose. Like Bill said, he (Pat) would be the one to tell you. I would just add the Paul and Ron worked together for many years, and I know many patients that have had surgeries from both doctors. Though I do not work for Dr. Shapiro, I hold both him and Dr. Rose in the same high regard. They are top surgeons, and artists. Juan ??“ You've certainly had to wait a bit longer than usual for your first sprouts. It does happen though. The good news is that this "fuzz" you see will continue to grow, increasing in length and shaft diameter. It sounds like you are on your way. BTW check your PMs when you have a chance; I just left you some contact info if you have any questions or anything.

Emu, Couple comments here... First, feel free to call in. Or if you like, you can email Laura at lciurlizza@tampadermatology.com. She can get you going on a consult and/or fix you up with some local patients etc. Regarding larger sessions: Dr. Rose and the staff can do mega-sessions, but patients need to meet a criteria (moderate/advanced loss, high laxity, high density, minimal risk of shock loss in recipient area). Dr. Rose is very meticulous about getting small strip scars. Part of getting a fine scar is wound closure without tension. As a result, Dr. Rose rarely removes tissue in excess of 1.5 cm wide (usually it is 1-1.3 cm). The donor harvest is a balancing act between getting an unnoticeable scar with the Ledge closure, and getting the graft numbers. B-Spot's comments are fair re: session size, as one would need very good density to get 4,000+ intact units from a relatively narrow strip. It happens though. As wanthairs states, patient should be interested in moving hair, not necessarily grafts. It very rare that Dr. Rose has the staff divide the large natural groupings from the strip into singles and doubles. That strategy has its place, but Dr. Rose tends to avoid it unless deemed necessary to build a hairline. The average donor area has more 2-hair groupings, followed by 1s and 3s, with a smaller amount of 4-, and sometimes even 5-hair groups. In Dr. Rose's hands, there is a similar breakdown when the hair is transplanted to the recipient area. On pricing: the surgery fee is on a sliding structure, starting at $5.00/graft (STRIP). If you have a moderate to large size session - 2,500+ grafts ??“ your average price per graft will be somewhere around $3.00/graft. Hope that info helps.

Emu, I am sorry to hear you are not getting all the information you need about Dr. Rose. Since Dr. Rose was with another group, SMG, for years, many of the photos are not necessary at our fingertips. As far as the clinic in Tampa, well, photos were not the biggest priority for a while, although we understand these are important for prospective patients. Truthseeker is right; Paul is pretty low key and sometimes recoils from self-promotion. But I assure you that his work is nothing but top notch. You might find it helpful to do a search on Dr. Rose with the find feature on this forum. Over the years many posters have had surgery with Dr. Rose and the comments are very positive, pretty much across the boards. I let Paul know that you would like to get a hold of some of the patients, so we are getting some contact info together for you.

dhoose, Just a few thoughts to add... Ideally it is better to remove the entire scar and remove enough tissue to yield the appropriate number of grafts - IF the wound can be closed under minimal tension. Remember, sometimes a scar will go wide as a result of poor closure. But, in other instances, the scar is simply located in an area of the scalp this more susceptible to stretch back. Should the latter be the case, you may be playing with fire trying to revise the scar AND get a decent number of grafts. So, while it is better to leave a single linear donor scar, it is not always possible depending on what happened with a prior physician or prior surgery.

Without knowing the length and the width of the donor scar, it is difficult to comment on what is possible, even in general terms. I would add that Dr. Rose has done scar revisions that have yielded more than 1,600 grafts. So it is certainly possible for some patients.

Michael, That is great to hear. With good closure technique, under little or no tension, excellent results like yours are very possible. Congrats!

Grafting scars with FUE can be effective. It should be noted that, for some patients, growth in scar tissue is less than perfect. Regardless, I have seen some excellent scar repair with this method. So it would seem logical that body hair grafts into scar tissue would work well - but I can only think of one instance when this worked to any great effect. This may due do the fragility of BH grafts, compromised survival, or the relatively thin shafts of the hairs.

It is very common to graft through thinning areas to increase density. There is a risk of shock loss, of course, but experienced hair surgeons know how to negotiate these risks. Now, if you are thinking about preemptively grafting an area of the scalp that has yet to succumb to the effects of patterned hair loss, I would implore you not to. Furthermore, I would implore you to avoid any physician that would suggest such a strategy. It is VERY risky, and I cannot think of a situation in which such an approach is justifiable.

Hathead, Was the goal solely to remove the scar, or did your doc try and get some grafts from the excision as well?

In addition to Dr. Griffin, Dr. Cooley is in North Carolina and Dr. Rose is Tampa - both do great work (hairlines, closures, etc). If you are willing to travel a little, you really should. You will get a better transplant at a lower cost than some of the hair mill-ish places you are talking about it Georgia.

Ridging is another issue that can come up.

Sorry giants, I see now that you are talking about the foam .

It might be counter productive if you only wait 10 minutes before shampooing with Nizoral. Your probably not giving the Minox enough absorption time.

Certainly survival is not the major theme in this thread, but it was brought up. I was disagreeing with this comment: "It seems you would get the best graft survival rate this way [strip out first and then go the FUE] thus the max number of grafts." While you usually can produce the max number of grafts with a STRIP/FUE hyrid, graft production should not be confused with graft survival.

Hey Bill. I disagree that strip surgery followed by FUE is the best way to maximize the survival rate of the grafts. I do agree however that this approach makes more sense ??“ but not because of survival. Strip is a more efficient way to move hair mass therefore patients with advanced hair loss are often better candidates for strip.

Not sure that I agree with that comment. There is however one conclusion that many practitioners ??“ reputable docs that do both strip and FUE ??“ seem to arrive at. You can generally move hair with strip alone than you can with FUE alone. Dr. Rose has stated this as has Dr. Harris, Dr. Wolf, and Dr. Bisanga. I know at least two of these physicians have lectured on FUE and are quite skillful and knowledgeable about the technique. Regardless of the many benefits of FUE, strip is the preferred surgery for patient requiring the maximum number of follicular units to treat their hair loss.