Gorpy

Thanks guys!

What!!! More points of contention among doctors? Can it be? Who's right? Who's wrong? It's all so confusing

Originally posted by Jotronic:

Gorpy,

 

"There is no technical reason for you to shave your head. A doctor like Dr. True or Dr. Keene can gently move your existing hair out of the way and will NOT transect any existing hair."

 

You knew this was coming

 

- Yes, I did :-)

 

I will go on record with this statement. Quote me to whomever you wish. Any doctor that says there is no transection from making incisions in recipient areas with any appreciable amount of hair is lying or just doesn't know any better. That is a fact. ...

 

- Well Joe, this is an irresponsible statement. I can make irresponsible statements also. Watch - Any doctor that tells you that you must shave the recipient area to avoid transection is either lying or doesn't know any better. See, it's easy.

 

- Not a fact Joe, an opinion.

 

Fact. Doctors tell patients that shaving is not necessary because shaving scares patients away. It is not necessarily the biggest thrill for patients to look forward to.

 

- Opinion, not fact.

 

Fact. Shaving the area makes the recipient area easier to work in. The spaces between the hairs are easier to see. The exit angle and direction is easier to see. Transection is easier to avoid because of this.

 

- I agree that it is somewhat easier. See, we can agree on something :-). The key word being "easier" - not "impossible".

 

Fact. If the native hair is pushed to one side the exit angle is distorted thus reducing the accuracy of incisions that are supposed to mimick the native angle and direction. If the hair is left long the very weight of the hair shaft can distort the angle and direction.

 

- Opinion - not fact. If you look at your hair when long, it does exit at a clear angle and then a few millimeters up it begins to curve towards the way it lies on the head. The exit angle is CLEARLY visible and not distorted. It would only be distorted if you pulled very hard on the hair.

 

When you are dealing with a procedure that requires even a couple thousand incisions much less several there is absolutely no way, none whatsoever, that native hairs are not transected and permanent shock loss induced. I do not have statements of "my doctor says so" to back this up. I have seen this with my own eyes on dozens of occasions because I sometimes like to sit in on surgeries to gauge these things for myself. I've worn loupes and looked at what the doctor and the technicians see.

 

- More opinion. What you have seen with your own eyes is a layman's viewpoint. I don't care what kind of loupes you wear, you are still seeing one way of doing it. Of course you are going to agree with that way. Could we expect anything less? To say that doctors are transecting permanent follicles is another incorrect and irresponsible statement. Now, if we take a step back and look at it from a purely H&W way of implanting, them maybe, yes. However, not every doctor implants that way. See what I mean?

 

Does any of what I said mean that a result won't be good? Of course not but it does say that while good may be good enough the best is the best and shaving the recipient scalp is the only way to get the absolute best result. When your hair grows out, you want it to be indistinguishable from native hairs with regards to angle and direction and shaving is the only way to accomplish this.

 

- Opinion again. My hair IS indistiguishable from the native hairs. Angle and direction are perfect.

 

 

Keep in mind that I don't just pull this stuff out of left field. I have had extensive discussions with Dr. Keene on this issue. My point is, doctors will strongly disagree on certain technical issues. We are not usually privy to all of the debates. But, to say FACT this and FACT that is one doctors opinion, not necessarily a FACT.

Gorp

Oh and BTW - this is my 1000th post. It's only fitting that it would be in a debate with Joe :-).

LOL Bezane,

I might agree with you somewhat on the finasteride, but is a little topical Minox really going to kill you?

BTW - I haven't experienced the srivelled dick thing, EVER. So I'm not sure what you're referring to there

You would think that at 51, I'd be the first to experience sides. But nothing, absolutely nothing. Sex is still as strong as ever.

It sounds like this gentleman has plenty of coverage. What he needs is some filling in to provide a level of camouflage which in turn will produce a very natural result.

There is no technical reason for you to shave your head. A doctor like Dr. True or Dr. Keene can gently move your existing hair out of the way and will NOT transect any existing hair. If you want further details on this please send me a PM.

Gorp

Bienvenido amigo,

Viendo tus fotos creo que el B Spot tiene razon. Si trabajas nada mas con la parte delante, unos 2500 a 3000 te hace falta. Es recomendable usar una medicina finasteride o minoxidil o las dos para la parte atras.

Al mismo tiempo, he visto a Dr. Keene usar menos y al mismo tiempo conseguir un resultado bueno. Tal vez unos 2000 se podia usar en ese caso.

Si miras mis fotos puedes ver que he consegido bastante densidad con el segundo transpante de mil grafts. Es segun tus deseos.

These post op results look nice and clean. Pat, can we get some long term results pictures?

In my opinion Dr. Keene in Tucson is a master at creating natural looking results. And you won't need to shave.

Hey Burt,

Here's some numbers to help you understand what you are looking at:

If you get 3000 grafts and only implant into the front half of your head (lets assume for now you leave the crown alone), you'll be covering around 80 to 90 cm2, depending on how conservative your hairline is. That'll work out to an average of about 37 grafts/cm2 for 80cm2 coverage or 33 grafts/cm2 for 90cm2 coverage.

If you get 3500 over 80cm2, that'll be close to 44 grafts/cm2.

Of course, you have "some" existing hair there, that hopefully you can keep. That'll add to your overall density.

What that will look like in the end depends on many factors like hair caliber, contrast, number of 3 and 4 hair grafts etc.

Hope that helps.

Gorp

Count me in also.

Spoon is very knowledgeable and I like his input. There is a good balance on this board and we all kind of keep each other in check.

Many patients have come on this board and really pushed their surgeon immediately post op. That is normal excitement when your post-op procedure looks good. I mean, look at Pushing 40. He's recommending H&W and has only seen a few hairs so far. I'm sure Pushing 40 will have great results, but let's take a step back here. Are we picking on patients because of a certain amount of bias against some doctors?

Hi Peter,

I've seen your pictures over on the other forum. Thanks for posting here. Your results look great. Your hairline looks extremely natural.

Hmmm... think I could get away with a style like that

That's interesting Bill. I'd be interested in hearing further information on why you think a 42 year old would not need finasteride. Do you think they don't lose more hair due to DHT?

Taking pics by yourself can be difficult. If you have someone to take them for you, it would be better. If not, well start with these tips:

1) use the zoom on your camera. You are getting the "hourglass" effect. That is typical of cameras when you do closeups and don't zoom in. Zooming in tends to flatten out the picture and thus it eliminates the hour glass effect. Of course that requires that you hold the camera as far away from you as possible.

2) Get some better angles. Do a true top down angle. Then some side angles slightly elevated (maybe 20 to 30 degrees).

Hope that helps.

Gorp

P.S. San Francisco has Mexican Food???

Hi Lucky,

Your picture quality makes it a little difficult , but I'd say about 3000 in the front also. That is, without touching the crown. You might consider leaving the crown alone and trying finasteride + rogaine to see if you can bring it back.

It's not quite like plucking a chicken. To pluck a chicken you would just pull on the feathers. FUE is more like using a shovel to loosen the dirt around a plant so that you can pull it out to transplant it, without damaging the roots.

You should not be "rubbing" you should be "patting". Work up some lather in your hand and then just lightly pat the recipient area. Then just carefully pour water over it to rinse. After a week, you can lightly rub.

That looks great for 6 months. Thanks for posting your pictures.

I received approx. 30 per cm2 the first time. The second time is more difficult to say since the 1000 grafts were placed in specific areas that I wanted to thicken up. I estimate that I have around 40 to 45 grafts per cm2 over then entire front half of my head now (90 cm2). Of course, right at the hairline it is somewhat less, since it is a feathered hairline. If you look at my latest gallery pictures you'll see that in some very harsh sunlight, I'm getting some good coverage from that (and only at 5 months). Much of it depends on your characteristics and how many hairs per graft you have in the back part. I think I can safely say that nowhere in the recipient area am I over 50 grafts/cm2.

Scooping appears to have had around 40-45 grafts/cm2 in the hairline. I think he'll get a good result from that.

Originally posted by SlowlyThinning@59:

Did you just rinse your hair with saline then pat it dry, both donor and recepient areas? I know saline is saline but any particular type/brand? Thanks

Yes, but I only did the recipient area.

Make sure you use the normal saline, not the multipurpose kind.

Looking very nice!!!

If you have the same hair loss pattern, color and texture as this gentleman then you could expect to get a similar transplant. With existing hair in the recipient area, one has to be very careful with permanent shock loss, so going very dense can be dangerous.

Bill said,

MAY involve a little graft loss

I think that would be interpreted as graft damage. Correct me if I am wrong Bill, but I think you are referring to some grafts left behind (not harvested), not a literal "loss" of grafts.

I actually agree with John and Tisab. It looks a little sparse up front. A couple of postage stamp FUE's with Feller and you'd be golden Bill

I would like to 2nd what Pushing 40 said. Dr. Limmer, we are appreciative of your input.

Bill,

I must say that I think you are making a big deal out of nothing here. So what if 1 cm of grafts are left intact (not lost) in the back? Is that really a huge issue? The total number of grafts via strip is determined by the length and width of the strip. You could make the same argument if the strip didn't extend to the very edge of the safe zone. Unharvested grafts, right? Why not extend the strip .5 cm on each side to make up for the 1cm in the back?

The only time this would be an issue is if someone told the doctor that he wanted the longest strip possible to extract every last FU possible. Otherwise, 3000 grafts are 3000 grafts (at least when you are comparing uncut grafts).