TheHairLossCure

How wide is the scar? Obviously a wide scar would explain the issue you are experiencing. Are you actually seeing the scar through your hair, or does the hair in the donor area just look odd to you? Sometime strip excision will slightly alter the direction/angle of hair growth in the donor area. This may become noticeable after many sessions. That could explain your problem but only if you had other surgeries prior to the 1,900 grafts.

In my experience Strip and FUE are pretty similar in terms of consistency. Strip lends itself to larger and/or denser sessions whereas FUE is beautifully suited for touch ups and smaller sessions. FUE was a huge marketing tool for some clinics (sadly) and I think, as a result, some docs started doing very big surgeries without monitoring the small sessions etc. If there are some sub par FUE results around, I would guess that is part of the reason. I hope FUE does not get a bad name because, in my opinion, it is a great technique in the hands of good surgeons.

You are smart to travel for your consults. Sounds like you being very proactive in your research. This is a must, particularly when your donor resources are running low.

I don't know that we can say that needles are the culprits here. Also, we don't need to jump the gun and starting thinking that this issue is permanent. First, I absolutely believe you need to call your physician and explain your situation. Second, it would be interesting to check out any photos you might have. What, if anything, have you been applying to the scalp post surgery?

Byehair ??“ Yes, I think it could be more intuitive. I'll see if we can change that.

Hairthere and wanthairs ??“ You are correct that many of the photos online of Dr. Rose's work show 2,000-2,400 graft cases. These are, in fact, pretty typical sessions. But remember, this has nothing to do with a technical inability to cut more grafts (not by any means!). The crew does 3,000 graft cases given the right laxity, density, and hair loss pattern. Dr. Rose, as you may know, developed the ledge closure technique. The goals is to get a pencil line scar with hair growing through it. By closing the donor area without tension, you increase the chances of a very faint scar. In some cases, if the strip is too wide, the scar can be less than perfect. Dr. Rose likes to maintain a balance between the donor and recipient area. That is, he always tries to remove enough tissue for the balding zone while at the same time creating a very manageable wound in the donor zone. If patient wishes to be more aggressive in a single session, there are certainly benefits and risks. Dr. Rose is very candid during consultations, either way.

Hairthere ??“ On megasessions, it depends on your definition, I suppose. Dr. Rose did a repair case last week and harvested 3,200 grafts in one day. I suspect that, had there been no prior donor scarring, a few hundred more grafts would have been harvested. It should be noted that the patient had better than average donor density. Anyway, it sounds similar to your case, judging by your signature.

You can check out patient blogs and photos here in Dr. Rose's Coalition profile: http://hairtransplantnetwork.com/Consult-a-Physician/doctors.asp?DrID=19 Additionally, you will find photos here on the website: http://thehairlosscure.com/hair-loss-restoration-procedures.php

Bingo.

Bill - I knew, and know, you were not blashing Dr. M Just adding my .02.

The message is not about transection so much as it is about splitting grafts into smaller units. It is also an exaggeration. It is absurd to suggest that all surgeons split grafts. Some do, certainly, but not all...not by a long shot. I have noticed many of Dr. Shapiro's patients posting their graft numbers and also their hair numbers. The average of hairs per graft is almost always over 2. This is my experience with Dr. Rose as well. You cannot split grafts and, at the same time, get 2+ hairs per graft in most of your patients. By the way, if 600 "special" grafts can look the same as 2,000 "normal" graft, does that mean 1,800 "specials" can look like 6,000? How about 3,600 "special" grafts? Do they look like 12,000 "normal" grafts? That is silly, unless you are getting "plugs".

Fal - Mwamba is a good guy. Never heard anything to suggest poor ethics (although I understand why you mentioned it).

The ISHRS is not a list of "recommended hair transplant surgeons". It is important that patients understand this. Being a member is a good thing but it is not necessarily indicitive of a doc's surgical skill.

Bro - you look better...without a doubt Congrats!

First, you should follow the post-op instructions, as you said. Second, don't cut or burn the scalp. I know that that sounds like a silly thing to have to say, but some guys might not think of UV damage affectting growth, etc. As far as bills... Your surgeon is probably not going to charge you for basic follow-up stuff (removing sutures/staples, check ups, etc.). If you have reasonable concerns about the results, most top clinics address these even if they are unrelated to the surgery/technique. It is only right to take care of patients and, furthermore, from a business standpoint, good patient care means more referrals. If you get very sick as a result of the surgery (which is unlikely!!), it obviously helps if you have a primary care doctor and health insurance. Just remember that signing a consent form is not signing away your rights. If you become ill due to negligence (I believe) you can pursue the issue legally. BTW, I am not an attorney so anybody who is can correct me here. Anyhow, if you are going to a good clinic, do not worry too much about the what-ifs. Like I said, becoming ill from a HT, while possible, is far fetched. I believe all the docs you mentioned are ethical and good at what they do! Don't worry. Just be sensible with post-op stuff.

PJ, Firstly, like Dr. Feller, Dr. Rose would not use large FUE tools unless 1) there was some special reason and 2) you understood the reason and gave consent. In other words, it does not happen that much. Perhaps I am misunderstanding Dr. Feller, but I think it is reasonable to isolate 2s and 3s without assuming the groups are double follicular units. I also don't think this approach requires that the physician uses a 1mm+. But, again, I may be missing some of the nuances of his stance. Since you did hairline work in your initial procedure you necessarily had a higher percentage of singles. This is simply how natural hairlines are built. I think it is safe to say you will get a higher hair count if you aim to build up the core area. I will run this by Dr. Rose, though, and I'll be in touch.

Dr. Feller, I understand that what looks like a single hair, superficially, may in fact be a multi-hair follicular unit. On the other hand, I really never thought, with FUE, that a multi-haired follicular unit may turn out to be 2 separate units within extremely close proximity. Since I am not a physician, I've never extracted. Still, I would think that pulling a double unit via FUE is a rare thing. Would you agree?

It is very unusual to see a doc using a .7mm or smaller. I would say the range for competent FUE is .75 to 1mm. You can isolate the 2s and 3s to get more hairs with FUE, which as a big plus.

The short answer is no(t really). The hair that grows through the scar can be harvested and transplanted if/when you have another surgery. So the hair is not "lost."

The first several months after ht can be an emotional roller-coaster! It is understandable. You spend weeks or months doing research and planning...and then the immediate surgical "result" is a pinkish recipient area and a line in your donor. Hang in there though. Things are going to start getting good for you. God's delays are not God's denials

Nervous, I noticed, in your signature, that you got some work in '89. Did you do some camouflage/repair work in your recent surgery (if you don't mind me asking)? I am sure you posted about that, but I must have missed it.

If you can place several rows of single hair units in front of old work I think that is the best way to go. In some cases the hairline is already build too low and there is risk in lowering it further (or there is just a limited donor supply). Another option that has not been mentioned is partially removing the front row and rebuilding it with follicular units.

When you read these discussion groups you find a lot of guys that are nervous prior to surgery. It is normal. The question is: have you really decided what the best solution is for you? Many HT patients do exhaustive research to find the doctor and the technique that addresses their needs. In other words, they know what they are doing and they have decided to do it. The nerves are mainly product of anticipation, not massive uncertainty. To me, it sounds like you are not sure that you even want surgery. It sounds like you have not made a decision. Surgery is not a joke. If you are not sure about what to do, just wait.

The cost of BHT is similar to that of FUE, I believe. Even with perfect technique, BHT is usually not nearly as effective as scalp hair. If your doctor is forthcoming with you, I am sure he/she with explain some of the limitations. Are you looking for BHT because you do not have enough donor hair on your scalp?

B- What are you referring to? The "physical activity," or the surgery that causes you to temporarily abstain?