TheHairLossCure

Actually, it is very possible to do more than 50 grafts per cm2 in a single session. And you can add additional density in subsequent sessions as well. High density grafting is technically achievable. The question is, what patients are good candidates given the finite donor bank and progressive nature of hair loss? Age, level of hair loss, hair characteristics etc all play a part in planning the right grafted density.

Hair growth normally *starts* to appear at 3-5 months. If you are on the later end of that range, it is still normal. Hang in there, nothing to worry about.

This is a great inquiry since most patients cannot simply ditch a system right after surgery. I fully agree with the above comments. I would add that you should probably avoid wearing the system as much as possible (in the privacy of your home, in situations where you can hear a hat or cap, etc). As previously stated, recipient cleanliness is key. How is the system being applied to your scalp?

Chris Bisanga is in Belgium. He is a good guy. I think he is worth a consult.

Mark, One other thing to note: I think you will find the fees for some of the top doctors to be a good value for the patient, in particular for mega-session surgeries. As the session size increases the average per graft fee usually decreases inversely. It only makes sense as large sessions are quite efficient. For Dr. Rose, fees start a $5/graft (small sessions). But most medium size session here fall in the $3-4 range. For session greater can 2,900 grafts, the fee is actually *less than* $3/graft. My point is that you do not need to look for bargain prices with unknown physicians, as most of the elite guys are fairly reasonable depending on what you need to have done.

Hair transplantation is a team sport. The surgeon is the quarter back on the field, not the coach on the sidelines. The doc needs to be THE player.

There are many options in Florida for hair restoration surgery - some very good and some, not so much. My idea of value is great patient care, excellent graft yield, and an aesthetic result that appears totally natural. I believe that the 3 docs mentioned provide a good value, and I know for sure that Dr. Rose does some of the finest work in the US. Get some opinions. I believe you will find a good fit.

I know you have your husband's happiness and wellbeing at heart with your surprise, but hair restoration requires much patient education. I believe your husband will need to do his research before choosing a hair transplant and, at the tender age of 21, I think he may come to the conclusion that medical (NOT surgical) therapy is his first step in restoring/maintaining his hair. Perhaps you can refer him to this discussion board. Certainly hair loss can be a sensitive topic but, if your husband is really bothered by his hair, he may get some relief in knowing there are certain meds (Propecia, Rogain, etc) than can help to stabilize his loss.

I think Bayscholar makes a good point. It is always best to contact your docs office as there may be medical factors that the community overlooks that are obvious to your hair surgeon. Again, you should get with your doc, but in my experience the answer to this questions is no. At this stage in the game water pressure is not going to dislodge a graft. You should able to wash your scalp without a problem and this will help to remove lingering scabs, dead skin, etc.

Making the strip long and narrow rather than short and wide should take tension off the wound, giving the best chance of a great closure and faint scar. Creeping Back, I would agree with Jotronic that keeping the strip *very* short can be problematic, particularly if this commits you to multiple surgeries. I would ask you to keep in mind that most top physicians in the field will carefully examine the hair in the area they are surgically excising. If you have notably poor density or poor hair quality on each side above the ear, I suspect your physician would shorten the strip slightly for a couple reasons. 1) It is inefficient to surgerically remove thinly haired scalp. 2) As you expressed, there may be a problem with the concealablity of the scar in that area. Although I have never examined your scalp, I suspect that the strip dimesions could be altered *slighty* to avoid creating an issue while still removing a reasonable number of grafts.

PB, Things are much improved just from the initial session. Congratulations

I understand your points, Bverotti. Surgeries evolve and require much dedication. Still, my feeling is that some patients have grafts that are harder to extract than others. That does not mean they can't get a good FUE procedure. But it does mean that the numbers of grafts extractable per day cannot be as easily predicted (assuming the doc has high quality standards). I am glad to hear your clinic's procedure is working well.

Bverotti, Dr. Rose recently performed a 700 graft FIT session. The patient was not necessarily an "easy" FIT/FUE candidate and, as a result, the procedure took the ENTIRE day. Transection was not an issue AT ALL; the grafts were beautiful and intact. The surgery was a very long process however. It surely would have taken 3 sessions to get this patient to 2,000 grafts. Fortunately, only a small number of grafts were in order. In Dr. Rose's hands, growth is *excellent* with FIT/FUE. Most folks are candidates for this work. They must understand the nature of the surgery though. With some patients the grafts are cut with great ease, with others the procedure is arduous and time consuming. I agree that where there is a will there is a way, but I respectfully disagree on other points. Strip is more predictable in terms of surgical time frame. You can finish a session in a day. I find more variation with FUE. Ultimately, we cannot sacrifice the quality of growth for the quantity of grafts.

There is a lot that goes into the placement of grafts and a lot that can go wrong. One must be well-trained and meticulous in order to be a great placer. That being said, modern follicular unit transplantation involves moving THOUSANDS of grafts into balding or thinning areas. These units need to be removed (excised or extracted), slivered (during strip sx), dissected under the microscope, and placed into tiny sites. There is only so much the doctor can do in a given period of time. He or she is still the quarterback for the entire procedure though! The doctor must be involved in the patient consult(s) to fully understand the patient's needs, expectations, and physical characteristics. The doctor can then plan the procedure, taking all the patient variables into account. Excising the strip and suturing the wound (or extracting the follicles) is the sole job of the doc. So is making the recipient incisions. These tasks, respectively, determine the (un)delectability of the donor scarring and the aesthetic design of the recipient area. Having techs or an assisting physician help in the silvering, dissecting, and graft placement is ok. The staff must be well-trained and take the patient's precious donor supply seriously. They must be experienced and work well with the surgeon. Similarly, the doctor must able to deftly conduct his team to ensure a seamlessly executed procedure. When you research a clinic, ask about the doctor's involvement in your case. It IS important. Also ask about the staff too. How long have they worked in the field? How long under that physician's direction? Etc. Consistent results are the bottom line.

On the subject of building a natural hairline, I think you will find this article interesting: http://www.thehairlosscure.com/images/Hair%20Design3r.pdf

(a prior post of mine) A patient inquiry that emerges time and again involves the shaving of the recipient area for hair restoration surgery. Patients can, and in many cases do, go forward with a large session of follicular unit transplantation without shaving the recipient area. While this approach can be hugely successful, there are advantages to allowing your physician to trim the recipient area. Many hair restoration patients wish to go forward with their surgeries with longer hair. Indeed it makes sense to keep the remaining natural hair in the recipient area long, as this hair can be combed over to conceal the scabs immediately after the operation. It would also stand to reason, if an individual is seeking hair restoration to address their baldness, they will not be inclined to buzz the precious few remaining follicles in their recipient area. In some cases it is beneficial to partially or entirely trim the thinning hair in the recipient zone. A crucial factor in recipient site cutting and grafts placement is visualization. The better the doctor can see the recipient area, the easier it is to design the site and place the grafts. While it should be no problem for a qualified physician and staff to work in and around longer and uncut recipient hairs, the process is tedious and takes more time. This should not present a problem for a moderate-sized session over a large area of scalp. Assuming a skilled staff is handling your surgery, you should not be concerned with a decline in the quality of the result. On the other hand, there are circumstances during which the doctor and patient should consider trimming the recipient area. For dense packing and for surgical sessions with a large number of grafts it can be a good idea to shave. When cutting many tiny slits within extremely close proximity, increased visualization may help with accuracy as well as minimize the potential for shock loss. Although studies indicate that well-stored grafts can remain out of body for many hours without comprising growth rate, it is advisable to place grafts quickly and accurately. Moreover, grafts will need to be placed rapidly during mega sessions in order to finish the surgery within a reasonable period of time (for the staff and the patient). Patients should discuss the pros and cons of different recipient area preparation with their physician prior to surgery to get a sense of the best approach for their particular circumstances. While shaving the recipient area helps the techs and the doctor the vast majority of patients do not wish to have the hair cut short. Obviously some professions prohibit patients from cutting the hair. These patients would prefer to hide the work.

This is rather ambiguous terminology, so I understand your confusion. Follicular unit grafting is a type of micro grafting. It (FU grafting) honors the anatomy of the scalp and the structure of natural hair clusters, whereas general micro grafting may not. Micro grafting is an old technique. The state of the art is FOLLICULAR UNIT micro-grafting. To me the inclusion of the word "micro" muddies the waters so I prefer "follicular unit grafting" or "follicular unit transplantation."

ASDS, The maturation of a hair transplant can never be quick enough from the patient perspective. A bit of impatience is totally understandable. Typically we see the first signs of growth between the 3rd and 5th month post op. It may be that you are on the slower end, but try not to worry. It is not indicative of quality of the final result. You are seeing a cosmetic change and feeling the grafts come up which is a very good sign. Definitely expect to see further maturation and improvement over the course of the year. Can you post some photos of your current situation? Or, if you would rather send them privately, try thehairlosscure@yahoo.com.

BTW, tisah, you are correct. Roughly 10% of your transplanted hairs will be in the telogen phase (once everything has matured). Therefore, if your HT yields 90% you have a perfect or near perfect result in terms of growth. Unfortunately, as I mentioned, precise yield from a hair transplant is difficult to determine.

Hair counts for measuring growth are VERY difficult to do. They are even harder if the grafts were placed into preexisting natural or HT hair. Yields may be accurately calculated but only with a small number of grafts over a small surface area. I have never seen ANY study where yields were calculated for a mega session.

Mrjb, Hair characteristics are not consistent in the donor area. In the "sweet spot" of the donor region one might have high hair density, high follicular density, and good hair shaft diameter. Donor density tends to progressively diminish within the safe zone as you go toward the temple area. For some this phenomenon is pronounced enough that it may not be worth creating a long incision. In the Bill's case the longer strip harvest seems like a good choice given his acceptable donor hair quality.

Whether or not you 'need' a HT is really up to you. If you were 24 I might frown on it, but a medicated 34 yr old with your pattern is a good candidate. If you want to re-shape that frontline a bit, I think 1200 FUs is probably appropiate (more or less depending on the FHL location). 2500 is alot to me, and I do not understand the reasoning.

Since I can't see photos it is hard to say if the graft rec sound appropriate. I would not worry about doing FUE first then strip or vice versa (I say that as Dr. Rose does both types of harvests). If you need a few hundred grafts to treat a scar, FUE is very reasonable. If you want to do a hairline rebuild and fill in, then a strip harvest becomes a possibility. BTW, you mentioned a concern about your age. At 34 your age is not a major issue. I would just like to see where or in what size area the doctor plans to place the 2500 units. It is not a lot of grafts necessarily, but that is not to say they cannot be misused.

No need to place a tape measure on your dome for me Just wondering if you knew. There is great potential to get some bonus grafts by passing over the ears toward the temples on a strip excision. On the other hand, one of the downsides to such an approach is that the donor density and hair quality in this area tends to drop of a bit. Like anything, it is a balance act. In your case, as we see at 7 months, it paid off beautifully.

You ARE greedy! Dropping the frontline by 1-1.5 cms is aggresive, but if you and the good doc agree, I say more power (and hair) to ya. Congrats on round 3!