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  1. Today’s case presented 3 years and 2 months post 2050 ultra refined follicular micrografts. The original work was done in December 2009 and in February 2013 he decided to move forward with another 1700 grafts to further augment the midsection of his scalp. Shown are his original pre op photos, 10 day post op photos and his final growth photos just over 3 years post surgery. As noted above he moved forward with another transplant 13 days ago. Hopefully we can get his regrowth follow up photos towards the end of the year…. Sometimes it’s just hard to get patients to follow up as the post op is typically easy/straight forward… and then the regrowth is 6-12 months down the road making it hard to get them back for photos.
  2. This case presents as a classic Norwood Pattern 3A. He is in his early 20’s and was willing to accept a conservative restoration, so we moved forward with 1700 + grafts on 12/06/11. As he was from out of state he did not follow up in person until he came back for a second transplant 1 year to the date of his first, 12/06/2012. Shown are his original preop photos and his one year post op photos. On 12/06/2012, as many young men will do, he did a second transplant procedure of ~1200 grafts to augment the density of his original transplanted zone. We did not alter his hairline as he is still young and understands that with so many years ahead of him, even with being committed to medical management we need to remain conservative with design in case he begins lose hair again. Dr. Brad Limmer
  3. Final post of 2012 is a patient whose first transplant was in Nov. 2010. He was a classic Norwood pattern 3A, had nearly 1800 ultra refinded follicular unit micrografts dissected from a 21sq cm donor harvest closed by the trichophytic technique. Presented today are his original preop photos and his follow up photos from 12/14/202…… the day he underwent a second but slightly smaller 1600 graft session to slightly lower and widen his hairline as well thicken his original work. Currently he wears his hair combed forward, but tried to make sure we had some good post op photos with his hair pulled back. Happy New Year! Hope everyone has a safe weekend and a success filled wonderful 2013.
  4. The case presented today had originally gone to another hair transplant clinic 2 years prior having `1500 micro/mini grafts placed. He presented for consultation with me in December 2011 and in January 2012 underwent 1050 ultra refined follicular unit micrografts with excisional harvest and trichophytic closure. Presented today are his original preop photos which show his previously planted minifrafts along his frontal hairline.His follow up photos from November 2012 showing both his transplanted zone as well as his trichophytic closure. Dr. Brad Limmer
  5. Zhuling is an employee of Dr. Brad Limmer. Today’s pictures are from 10/13/12 taken before her surgery, immediate after her surgery and 13 days post-op. We planted a total of about 1200 follicular unit micrografts to lower her frontal hairline and fill in her temporal recessions. A trichophtic closure was also done to ensure she gets a great result from her excision. We will post more follow up photos in the months to come at 3 month intervals to show her progression.
  6. I believe your H/T will be a success as any procedure done correctly. I have had 1700 FUT grafts done for $6850 5-2013 with Dr. Limmer in San Antonio TX .I was very happy with the results but not the price.I have been evaluated to need around 3000 more grafts and can get it done in Tijuana for $3000. I'm going to Mexico for the same reasons as you...to get my hair back and not break the bank.I have done extensive research on hair transplants in Mexico and believe a person can get a very good H/T and have a safe trip at a fraction of US prices. I am definitely having this done & will let you an everyone know the out come.
  7. The case presented today originally was seen in consultation in Feb, 2009. At that time options regarding medical and conservative/aggressive approaches to transplantation were discussed. After 6 months dilberation the patient opted for medical management with a conservative frontal restoration only transplant. In the summer of 2009 he under went a single session of ~ 1600 ultra refined follicular unit micrografts. He was lost to follow until he came back 3 years later to finally plant his crown. At that time I was able to get a set of after photos showing not only his graft growth, but also his donor zone with both normal length short hair and after it was shaved. While he was not planted with extreme density he represents the classic example of white haired patient not needing as much hair as the average dark haired person as white hairs reflect more light back to the human eye leading the brain to think more hair is present….an advantage white haired patients have over dark haired patients. Dr. Brad Limmer
  8. The case presented came in yesterday exactly 10 months post op from a 1600+ grafts case to augment her frontal region. Presented are her original pre op photos from October 2010 and her 10 months post op photos from yesterday. She originally presented to the office in June 2010 with a 20+ year history of slowly thinning hair. While her loss extended over the majority of the top of her scalp I felt based upon donor hair quality and availability she would be best served by initiation of medical management combine with a limited restoration of her frontal forelock. I felt this approach would address her area of greatest cosmetic concern through hair restoration while using medical management to hopefully increase the overall volume/quality of hair across the remainder of her scalp. As seen in her photos, her frontal forelock responded following one pass of ultra refined follicular unit micrografts and at the same time she gained additional hair volume through medical management. Brad Limmer, MD/jac
  9. Thank you PupDaddy/Blake/scar5, You've really helped me put all these pieces together for the start of my journey, it is a shame that Limmer in San Antonio isn't currently around for consultation from what I hear as well for this. While I am sure his successor is more then capable, I am not willing to risk it for my first go around and hopefully last transplant if I react well to fin+minox. I do look forward to seeing Dr. Krejci's work on this forum though when that happens. PupDaddy, thank you for that explanation, I have read time and time again FUT had generally been better for yield, but its never been explained in the detail you laid out. This has helped me a great deal. Blake, thank you for your confidence in Dr. Arocha as a choice. This is a very scary time for me as I am sure you well know for anyone first transplant. I have not consulted with anyone just yet, Dr. Arocha so far is the only person I have chosen to consult with. Looking at his work and listening to you guys he sounds like a great choice. Although, I don't think I would be willing to travel to consult with other doctors across state lines for this. I may consult with Limmer's team as well too, but I worry I am not consulting with enough doctors. I have done tons of research on this topic, with only what I feel being small gaps in my knowledge. I feel like I wouldn't go wrong going with Dr. Arocha so maybe I shouldn't need to consult with 5 other doctors.
  10. ~3250 grafts, 1 year of growth, a drastic hairstyling change and even a guy with straight somewhat limp hair can have a profound change. He also began low does Propecia and Rogaine. While I present this case for his transplant results, I think he better presents what someone can accomplish with effort in styling. Some of you might think it’s too much but truth be told his style fits the image of the band he plays in…which takes me back to my youth 30 years ago. Brad Limmer, MD/jac
  11. Today’s case originally presented in March 2009 and while she appeared to most likely have Androgenetic Alopecia, Ludwig’s II pattern, there were some things about her exam that worried me about the possibility of a scarring alopecia. A full work up was performed, including biopsy/ANA studies, to rule this out. While scarring alopecias can be transplanted, you definitely want it ruled in or out before heading down the path of transplantation. After we confirmed her diagnosis of Androgenetic Alopecia she was started on Rogaine and Biotin. She no longer felt she was losing hair after 15 months of medical treatment, but failed to make significant gains and decided to move forward with transplantation. In August 2010 we placed ~1300 ultra-refined follicular unit micrografts across the midline/part region of her scalp. As noted in her preop photos her region of loss was concentrated down the center of midscalp. We were able to focus our grafts in this region to provide a fairly dramatic change. As she lives in Mexico she was unable to follow up until last month. Shown today are her original preop photos from August 2010 and her 9 months post op photos from May 2011. She remains on Rogaine and Biotin. In addition she may add topical Estrone. Brad Limmer, MD/jac
  12. As some of you know, Dr. Brad Limmer in San Antonio passed away last year. I spoke with him by phone about my hair loss a couple of years ago. His father Dr. Bobby Limmer returned to the practice after his son's passing. I had a transplant consultation with Dr. Bobby several months ago and appreciated his honesty and expertise. Since that time, I decided to go ahead with an HT surgery appointment with Dr. Bobby Limmer. He offered 1800 grafts for about $5800. I've since learned his practice has brought on a new doctor who will take over for Limmer, a dermatologist named Dr. Krejci who has been trained by him but hadn't previously done HT from what I understand. In fact, I was told she will be performing my surgery, but Dr. Bobby will be there and can assist if I would like. If you were in my position, would you be comfortable with this? I understand all HT surgeons have to start somewhere, but I'd rather not have it be on me. On the other hand, the elder Limmer will be present, the rest of the staff is the same and the price is hard to beat. I've also looked at Dr. Arocha in Houston (at $5 a graft, he would be $9000, a significant difference) and Dr. McGrath in Austin. Any feedback appreciated.
  13. Today’s case originally presented for transplant 15 months ago. On initial presentation he was a Norwood pattern 3 and not on any medical management (his pre op shown below). Following extensive consultation we agreed upon a dual prolonged approach combining full medical management with transplantation focusing on recreating a new frontal hairline as well as some work to be done on the vertex. Ultra refined follicular unit micrografting was performed using standard elliptical harvesting of 36 sq. cm. of donor scalp with an f.u. density of 96-98 grafts per sq. cm. Of the nearly 3500 grafts produced, nearly 2000 grafts were used to restore the frontal 1/3 of his balding scalp with ~1500 grafts used on his crown. Below are both his initial pre op photos as well as follow up photos 15 months post op. He has done quite well and is very pleased with his results. Brad Limmer, MD/jac
  14. Today’s case first presented 3 years ago at age 27 with fairly dramatic loss and fairly fine/miniaturizing hair across a Norwood pattern 4-5. Being from outside the US extensive consultation was performed using Email/phone calls. While a candidate for transplantation, I informed him I would suggest against it unless he would utilize full medical management…starting on it prior to the hair transplantation to ensure he had no adverse side effects and could remain consistent with the medical program. In early 2007 we performed his first transplant, harvesting 32 sq. cm. of donor at an f.u. density of 96 grafts/ sq. cm. generating just over 3000 grafts. It was allowed to grow in and then in the fall of 2008 an additional 36 sq. cm. of donor was harvested producing just over 3000 grafts. Today’s photos show his initial pre operative as well as his fully grown in post operative photos taken last week when he was back in the US. He has done quite well and I think his great results are from a combination of both surgery and full medical management. Brad Limmer, MD/jac
  15. I had a hair transplant done by Dr. Limmer in 2010 and in 2012. The results were amazing. I still can't believe it. My hair looks natural. I can't even feel the scar in the back of my head. I can't tell what hair was transplanted and what hair is original at my hairline. My hair is better in my 40's than it was in my 20's. I even style it. The results were much better than what I expected, but I know that this isn't the case for everyone. I have thick hair in the back of my head, and I wasn't completely bald when I went to Dr. Limmer for the first time. But, I couldn't deny that my hairline was receding. His office in San Antonio was plain, but I was impressed with his knowledge and confidence. I scheduled the transplant procedure in August 2010, and I started propecia, rogaine, and head&shoulders shampoo per his advice. I can see now that Dr. Limmer wasn't the only person that provided a good hair transplant. He had a team that made it all possible. Jessica arranged the surgery and blood testing. Dr. Limmer removed the strip of hair. Frances cut the strip into individual hair follicles. Christina planted all the grafts (an all day job). The team probably took years to develop. Even though Dr. Limmer has passed, the staff is still there.
  16. I am considering HT with Dr. Limmer in San Antonio for 1800 grafts. I have another thread in the doctor forum about Limmer, but I wanted to post photos and get some input on my thinning and number of grafts. The thinning and loss has occurred over the past 4 years, starting around my late 20s. It primarily affects the front and front-center portions of the scalp. Since I generally have very thick, wavy hair, it is less noticeable when dry, with the exception of the front-right corner, which is my problem spot. I currently use minox foam 5% twice daily and take a hair supplement with Saw Palmetto. I briefly tried fin and didn't like the side effects. The minox seems to have gotten somewhat less effective over time. To me, this seems to be an unusual pattern of loss, as I don't know that I even fit into the Norwood scale. Does this make treating my loss with HT surgery a more difficult process? I've consulted with a few different doctors, and the recommendation has been about 1800 grafts to fill in the front-right spot and restore thickness to the rest. In looking at my loss, does that sound about right?
  17. In keeping with ongoing trend of more women seeking treatment for hairloss, I am presenting another female case. This patient presented today sought treatment because she inherited a high hairline with deepening temporal recessions. This case differs significantly from last months (http://www.hairrestorationnetwork.com/eve/157594-week-i-had-five-female-transplant-cases-brad-limmer-md.html), but still falls within the list of most common reasons why women present for transplantation. The case presented today shows a female patient with a classic high frontal hairline (creating a tall forehead) and deep temporal recessions. Women tend to hate this type of M-shaped hairline as is more classically seen in a man and not well adapted to various hairstyles women prefer to wear. The good news for many women with this particular problem is that they overall have a great head of hair, usually are not experiencing loss elsewhere and usually do not need to be on preventative medical therapy. Below are both preop and post op photos after a total of ~1400 follicular unit grafts were used to create a new lower hairline and fill her temporal recessions. As noted she has been transformed from a high mid frontal hairline and deep temporal recessions to a more classic female shaped hairline. While her forehead height has been reduced, I feel her greatest cosmetic change came filling her temporal recessions. Brad Limmer, MD/jac
  18. The case presented today arrived in my office with three specific challenges/goals: 1.) correct a very asymmetric hairline. Basically his right temporal recession is much deeper and more pronounced than his left. 2.) correct a scar behind his ear as a result of inner ear surgery performed years ago. 3.) address the miniaturization and early loss on his crown. The first two challenges were best handled by standard follicular unit micrografting, while the latter I felt was best addressed through medical management. My reasoning about not transplanting the crown is two fold. First, he is only 28 years old and second, he had a reasonable amount of miniaturized hair that he could easily see a positive response with regrowth of hair in this area. Presented today are his preop/pre medical management photos, immediate post op photos, 1 week post op photos and 1 year follow up photos. With regards to surgery he had an extremely nice correction of his right temporal recession planting it at a density of just over 50 grafts per square cm. and bringing it into harmony with his left. This achieved his goal of a more natural, balanced hairline. In addition, he no longer had to worry about his scar showing behind his ear with shorter hair styles. Finally, he got a fairly good response to medical therapy, regrowing a reasonable amount of hair on his crown as noted in the photographs. At this time he shows no need for additional grafting and fully understands (from a long term perspective) he needs to remain on medical therapy. Brad Limmer, MD/jac First 4 photos are preop Next photo is immediate post op Then you will see 2 photos that are taken 1 week postop A single photo taken of the crown pre-meds And the final 5 pictures are taken 1 year post op and post medical therapy
  19. Let me give a few comments after I received my HT from Dr. Limmer in San Antonio on 2/2/2010 (sans B.S.): I am now 59 years old---

    ---the Propecia (3 days a week) has appeared to me to make my hair "fuller" and more dense

    ---per Dr. Limmer's suggestion, I have been taking biolin, 5 mg, per day

    --minoxidil 5 % - twice a day

    --dandruff shampoo, every two to three days

     

    Basically, I now have what most would consider a full head of hair. I was almost bald on top 4 months ago, and now I have what in Miss. we call "whooped hair" on the front, or tufted hair on the hairline. I would not have believed this 4 months ago that I would have this full head of hair, and I hope it holds out for the next few years.

     

    My suggestion - go see Dr. Limmer and he can help you out.  

  20. Hello friends, I had my HT no.1 by the traditional FUT Method by Dr.Limmer from SA last year for 1600 grafts. While I am satisfied with that result, I am consideRing FUE for HT no.2 Does anyone have a good recommendation in my area. Thanks Mark
  21. He had surgery with Dr. Rosati. The same doctor that gave Antonio Conte the bad result in the past (before he was fixed) . Its funny because I have met quite a few patients that had surgery with Rosati that are in need of repair. A lot of them say since Belusconi when there he must have been the best. For a long time Rosati was showing Conte result after his last transplant (that he didn't do) and saying its his work. He even told one Italian that he gave Conte five transplants in order to make him look that good. Complete BS!
  22. Hi, I am a 32, Male from Austin, TX with a hair loss problem since the last 10 years. A while ago, I started exploring the option of getting a transplant, and have benefited a lot reading through the forums on this site. Thank you all. I have consulted with two surgeons recommended in this forum - Dr. Brad Limmer from San Antonio and Dr. Fisher from Nashville. Both explained the transplant process very well, and came to similar conclusion. Given that I do not have enough donor hair, they will not be able to cover my entire head; they would be able to cover the front, and would need 1500 - 2000 grafts. Both of them, and seems like a majority of surgeons in this forum - use the strip method. The more I read about the risks of the scar that is created, the more I am inclined to explore FUE as an option. I understand that FUE also involves tiny scars, but I would like to consult further with a surgeon who provides FUE transplant before deciding which way to go - strip/FUE. Some questions that I have. 1. Are there any FUE surgeons, who are recommended by this forum? 2. I have heard that FUE cannot be performed on someone with more than Norwood 3. Is that true? Have enclosed some recent photos for reference. 3. An apparent risk of FUE is that some grafts may die eventually in the next 5 - 10 years because they were not pulled from the safe donor area. In that case, can I go for a strip transplant later? Or, does a FUE transplant preclude me from any future strip transplant? Thanks much for your time in advance!
  23. The case presented below is that of a 47 year old Vietnamese man who has always been disappointed with the fact his central mustache was very weak/sparse and the two sides basically not connected. In addition there were a few small gaps within the main mustache that he desired to have filled. Presented are immediate preoperative and immediate postoperative photos from 9/25/12. Just over 200 one and two hair follicular unit micrografts were used to fill the central gap, the scattered hairless spots within the main mustache and finally increase the overall density. As he comes back for follow up we will post additional photos to show his progress. Dr. Brad Limmer
  24. Four years after the operation and I would like to share my thoughts. My initial post above was 10 months after the procedure. Since then I have realized through research and personal evaluation quite a few different things that I wish to share. I went through with a second operation with a well known surgeon in San Antonio. I was still not satisfied with the procedure afterward. I mentioned above that after my procedure with Dr. McGrath, I could estimate only a few hundred grafts. There were certain areas on my hairline where there were only a few hairs. With my second operation, of the same amount of grafts, my recipient area doubled in density. This has led me to several conclusions and possible explanations to the issues I brought up in my initial review: 1) The second operation garnered the same amount ~ few hundred grafts out of over 1000. 2) McGrath's restoration was equivalent in success to this second, renowned surgeon. 3) Thus, this might point the issue to my own physiology or post-op care rather than McGrath's. Like I said, my own natural hairline is relatively high. I wore my hair very long at the time which perhaps gave the impression that my hairline was receding whenever the wind blew my hair. I think my initial quest for a hair restoration was more in vanity and insecurity caused by my natural hairline than restoring a hairline. In essence, I feel my operation was "lowering" my hairline rather than "restoring" my hairline. Post Op Feedback pertaining to an Asian with naturally thick, dense, black hair. Thickness This being the case, I had a full head of thick, dense, black hair on my crown, perhaps just a few CMs beyond the wrinkles of my forehead. After two operations, my hairline is about 50% (HT Surgeons aim for 50% density to create the illusion of thickness) the thickness of my naturally thick, black hair. While this contrast may not affect blondes, brunettes, or caucasians with thinner hair, on my head, it is absolutely noticeable as when looking from below one can notice the scalp behind my hairline. This is perhaps my gripe with the operations as an Asian male with the aforementioned attributes. This issue is however, unsolvable as most surgeons can at best do 50%, anymore than that and I've been told it may damage existing hair. Scar I was told at both consultations the scar would be tiny, un-noticable. This may well be the case for light complexion or light haired caucasians. However I cannot wear my hair with lower than a #4. Anything below and a linear line running from ear to ear can be seen through my hair. The scar is also a source of discomfort. As there is no hair there, I can certainly feel when the wind blows through my hair and is able to reach that linear scar. I'll admit McGrath did tell me I couldn't wear my hair short, and I assured him I would only wear my hair long. However, I think it was not stressed enough about the permanence of the situation, and also how "short" was short. In my opinion, a #4 cannot be considered that short. McGrath Here I want to mention that my post-op meetings with him were stellar. He really showed his concern and took the time, completely un-hurried to address all of my concerns. With such a major operation, you need a doctor who will be there before, during, and after. I can say McGrath will be there to take care of your concerns. When I mentioned the spots of thin hair on my hairline, and asked whether he could remove those for me, he offered to remove them for free. --------------------------------------------------------------------------- What I have come to learn is that McGrath is not any different than the other surgeons. Their approaches are mostly the same. I walked into them expecting something different. I hope the industry can evolve better practices one day: 1) Spending more time coming up with a hairline and projecting what the result may be... after all this is something one will need to live with for the rest of their life. 2) Hiring actual nurses. 3) Employing "consultants" really gives it a business feel, rather than a medical vibe. 4) For younger gentlemen, the aim should be to dissuade, not to persuade. There should be a level of ethic in this line of work. I've read the stories of many young people who went to a hair transplant surgeon after a bout of intense insecurity about their newly receding hair and make rapid, irreversible decisions. If any surgeon had to experience the mental torment I went through the years afterward -- shame at what I had done, unable to tell anyone. regret that I tried to fight the process of nature, and might not even look like what I used to. remorse that I had other options to explore (shaving, propecia, laser, etc). further insecurities, more so than pre-operation, due to results not being as perfect as one would hope to imagine (perhaps at no fault of the surgeons) -- walking down the street wondering if people would look and think this boy just had a hair transplant. I spoke with McGrath on the phone and voiced these concerns to him. That he was able to listen to all this with an open ear is a testament to his dedication to his patients. That is a quality I can attest to. I do trust in him (and trust is the most important aspect when selecting a cosmetic surgeon) after my post-op experiences, and I do plan to see him about removing some hairs from my hairline in the near future. Bottom Line: If you are young: consider taking propecia for a year, or shaving your head. If your hairline is receding, but not bald: consider taking propecia for a year, or shaving your head. If you are bald, and don't want to shave your head: See McGrath. If you are Asian w/ thick, stubborn hair: consider wearing your hair like Mao. or just shave it. But remember, like a tattoo, when you are 70 years old, your scar will show. If you replaced a receding hairline, the hair there will remain but your crown will be bald. You are perhaps delaying your insecurities until a later date.
  25. vanitysucks...I would suggest since you want to stay local that you go see Dr. Armani for consult...what have you got to lose?...Get a feel for his facilty and his bedside manner. See if his facility is clean and cutting edge looking. Dr. Armani did attend very good universities and medical schools. Ask him how many technicians he has on his fulltime staff and are they actual fulltime employees? What is their experience level? Ask him how many HT surgeries his clinic does per week. Ask if you can see many more before/after pics than his website shows....ask if you can meet former patients....ask if you can observe an actual procedure for a few minutes to check out the techs and how smooth the operation is during a surgery as opposed to during a consult. I'd highly suggest getting a consult with Dr. Arocha and maybe Dr. Limmer in San Antonio too....so you can compare and contrast and decide what is the best fit for you.
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