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Found 326 results

  1. misterno- Probably the easiest thing to do to give you peace of mind is to simply pay for the proscar (about $220.00/yr), rather than having them foot the bill and therefore having any say in the matter at all. Dr. Timothy Carman
  2. Perhaps I am not able to appreciate the scar fully, but in general, that scar really is not that "bad". The length is not unusual (although I can't see how far forward each side extends). Even the best healed of incisions will be visible with your head shaved. As for the graft survival/shock loss, unless the graft survival was an issue, since you are adding more hair, the only other explanation to ending up with LESS hair was that there was a high transection rate of pre-existing hair which did not "come back" after the procedure. A hair restoration surgeon, under high magnification, should be able to tell the approximate proportion of native vs transplanted hair. You r on finast, right? Dr. Timothy Carman PS What's the 'konji' (spelling?) on your neck stand for?
  3. Curious_George; dakota3 pretty much said it all. In the hands of a skilled hair restoration surgeon, who understands the need to keep an eye on the future and carefully plans with you given your personal, medical and family history parameters, those fears should be minimized. The decision to utilize rogaine and/or propecia is relevant to your surgeon as it can affect the surgical plan in terms of pattern, density and long term goals. True, while you may not regrow hair with these medical modalities, the vast majority of men (90%) greatly slow down/cease their hair loss. This is a very powerful tool that will go a long way to supporting your long term goal of maintaining a natural appearance following your procedure. It also has been shown to assist in growth of hair following transplantation. Most of your fears could be minimized following the guidance of the folks here on the forum and carefully researching and choosing your hair restoration surgeon. Sincerely, Dr. Timothy Carman
  4. possiblymaybe- Good question. In general, split-thickness-skin grafts (STSG) or skin graft substitutes are utilized in surgery primarily when there is a large defect or absence of epithelium (skin) due to any number of factors (eg, tissue avulsion injuries, burns, the after effects of severe skin infections, etc.). What all these insults result in is the same: loss of a skin layer over existing subcutaneous tissue (fat, muscle, etc.). This is a different situation from the condition that results from removing a donor strip from the back of the scalp. There, along with the full thickness of skin, subcutaneous tissue is removed, and the two skin edges (and subcutaneous tissues) are re-approximated. The developement of scar tissue is a natural process, the remodeling goal of which is to actually shrink the incision site over time. Factors that play against this, and may result in a larger scar are; 1) Increased closure tension across the wound 2) Loss of hair follicles along the skin edge due to transection during donor harvest 3) Unusual wound healing characteristics unique to an individual patient (hypertrophic or keloid formation). In general, to minimize scar formation and encourage healing, we recommend neosporin ointment applied twice daily for the first two weeks following surgery, followed by a good moistening agent such as aquaphor once daily. So you see, there is no "filling in" that needs or could be accomplished as your question poses. Does that make sense? Hope that helps. Sincerely, Dr. Timothy Carman
  5. Dear forum members, I have been asking Dr. Carman for examples of surgical and grown out patient results. I'm pleased to see that he has been getting involved with us and posting immediately postoperative pictures so far. I expect we will see some true result pictures in the near future. Best wishes, Bill
  6. Dr. Carman, You certainly have demonstrated that you do ultra refined work by your immediately postoperative photos. I hope your next photo albums will focus on the final result. We are anxiously awaiting Best wishes, Bill
  7. This result looks very nice at this stage. I think the density blending into the existing hairs outward into the area where it was more sparse looks natural. Nicely done Dr. Carman.
  8. Dr. Carman, Thank you for taking the time to share these impressive and ultra refined results. We look forward to seeing more of your work on this community. Pat
  9. Johnson- I am familiar with fluridil. Without going into too great a detail, this preparation acts TOPICALLY to inhibit the effects of DHT on the hair follicle. Current studies show that, similar to finasteride, there is an increase in the total percentage of hair in the active (vs resting) stage (from 76% to 87% at nine months.). I happen to personally know the clinical investigators (Dr. M Sovak, UCSD) and the clinical research facility (UCSD). Their results are clinically significant, and their research work and ethics are highly respected in the scientific research community. At this time however, fluridil is not licensed for use in the US. The main advantages fluridil boasts of are that it is a "hydrophobic" compound; that is, fat soluble. In addition, it is deactivated when coming in contact with water (a "hydrophilic" environment). This last fact makes so that IF it is absorbed into the bloodstream from the scalp, it is deactivated as soon as it hits the blood (an aqueous or "hydrophilic" environment). Hence, since it doesn't enter the circulation, there reportedly are none of the (normally low incidence anyway, 5%) sexual side effects. Hope this helps- Timothy Carman, MD
  10. Dr. Carman, Thanks for posting. Immediately postoperative pictures look nice and clean and ultra refined. I hope you'll have a chance in the near future to post some mature hair transplant results as well. Thanks for participating! Best wishes, Bill
  11. Thanks Dr. Carman.... But what about the procedure... 1. I just have the classic manline. No hair on temple, decent hair on the vertex, but thin at the crown. I just want more hair on the crown so it looks the same as the rest of the top of my head. I have had the manline for 5 years. Would the crown need to be shaved for the procedure? 2. Considering the way I style my hair, could the graft be taken high enough where the scar would be hidden? 3. Would FUE be a better option because I only need enough hair to blend with the rest of my head at the crown? 4. What would be ballpark figure for either procedure? Thanks.
  12. One day...and 5 amazing responses..I am in love with this forum !! dakota3 : I have checked the Consult a physician section and researching all the docs now. Thanks for you advise on looking at other states. hairthere: Thanks. I will definitely look up Alexander and others also thanks for the estimate that is the number I came up too. I am more interested in fixing my hair line on the front because the hair around the crown is not a concern for me now but I will chew on your suggestion a bit more Dewayne : Thanks...thats a interesting thing you did there @ stitches, something I might consider too if I decide to fly out for HT because of my busy work schedule Dr. Carman: Thanks for the detailed reply. Lot of good stuff in there. Appreciate all your replies guys. This week I will research the docs and planning to set up consultations in the SoCal area first. You all have a great week !
  13. "Every area of hair transplantation starts with one doctor who identifies a challenge and then finds a way to meet it. The rest of us follow with the secure knowledge that it can be done. Many of us owe a debt to Dr. Beehner for his forelock work." I couldn't agree more. Thank you Dr. Beehner. Timothy Carman, MD
  14. Dr. Carman, I appreciate your follow-up post. I am familiar with the studies you mention and if I recollect properly these individuals of which you speak are exactly the same types that do not perform dense packing sessions, or megasessions or both, on a regular basis. The vast majority of those in the ISHRS do not and cannot dense pack as you mentioned and have for many years looked upon the mere prospect of doing so with disdain. To be able to perform these sessions one needs to work slowly and carefully. This takes several years and cannot nor should not be attempted for any reason other than the desire to do so properly. I can certainly appreciate the indication of such studies but they cannot simply be thought of, executed, then have the data be considered valid if the proper experience to perform the studies to begin with is absent. This is not a slam on any one clinic or doctor. I am trying to simply get the point across to the readers that not every clinic in the ISHRS is the same, far from it as I'm sure you'd agree, and that different clinics have different ways of doing things. Most clinics are still performing sessions that max out at 2500 or 3000 grafts but other clinics are consistently cranking out 4000 to 5000 graft sessions on a weekly and even daily basis (where called for). And for dense packing, the same applies. ThininHouston, "Certainty they dont get 5000 graphs/units out do they?" I cannot speak for other clinics but since we do these sessions on a regular basis I can say that the grafts are intact follicular units. There are occasions where some singles are made from larger grafts but this is in order to insure that enough singles are used for the appropriate area. One would think that a large 4500 graft session would yield enough singles naturally, which is usually the case, but there are cases where extra singles are necessary for increased naturalness in specific areas but this is not to artificially inflate numbers. It is for true "ultra-refined" follicular unit grafting for the most natural result for the patient and all of the better clinics utilize this method.
  15. Dr. Carman, The problem I find with most "studies" is that they are not actually studies in the true sense of the word when apllied to hair transplantation. These "exercises" as I prefer to call them are usually performed on only one patient whereas a proper study would be carried out on many patients. Secondly, these exercises are performed by practitioners that have not had experience in dense packing, in this case, above 40 grafts per cm2 therefore any result they get is limited only to their ability and experience which is limited to none. I have no problem with physicians and clinics operating within their own parameters of comfort but the hair transplant industry is hardly an industry where one exercise by one clinic is necessarily relevant to that of another. I think studies that are less exciting, like those of storage solutions, etc., are more in line to give a larger scope of possibilities than those that have tried to support or refute dense packing and/or megasessions. Therefore, your comment about throwing away grafts when planting above 40 per cm2 must be qualified by stating that this is in your practice or the practice of those that conducted said "studies".
  16. Thank you all for you input! A special thank you to you, Dr. Carman! It is terrific to get professional feedback from a hair restoration surgeon and you offer some wonderful advice. Thank you again for taking the time to respond to my thread. Jupiter, Thanks for the compliment. I'm trying for a shaggy look, but I could pull it off much better with my hairline repaired and the forelock stabilized. david, I do think I am very fortunate, but I still know the pain of hair loss - especially at a very young age. When I say that I was loosing hair at 17, I mean it was noticeable and I was made fun of... Now that I've gotten a little older, I think I've gotten to where I look at things from a bit of a better perspective; my first transplant was out of desperation and for other people, my next one will be for me - I've seen the best results from candidates for HT I've seen with this attitude and they are happier in general. I don't expect miracles, but it never hurts to do something for yourself and improve your self-esteem. I like my hair now, but I would love to LOVE my hair and from the input I have gotten on this forum and medical professionals so far, that seems entirely possible with only a little bit of effort. So... why not? Bill, It's always great to have your input. You add an analytical and friendly outlook to everything and I for one - though I am sure I am not alone - appreciate it. I am also glad to see this discussion be so productive. I don't know if some men, and perhaps even physicians, speak enough about personal hair loss history. I mean, I think I would think twice if a man had started loosing his hair only two or three years ago and wanted a transplant. As one surgeon mentioned, and I believe it was on this forum, propecia COULD mask the native aggression of the hair loss making it difficult to tell how aggressive the loss could become should the medication loose efficacy or become unavailable to the patient. Although hair loss can accelerate and stabilize at different periods, I think that there is clearly a point, given enough time without interference, where you can get a good "baseline" (if you will) on how aggressive the loss is and is likely to become in the future and can become invaluable data with which to judge how aggressive or conservative one should be with their hair restoration plan - taking into account all other variables also, of course. Thanks guys! Great discussion! Maybe we can keep it going on this forum. I certainly have not seen it in any prevalence on other forums and IMHO, it deserves more thought in relation to HTs for possible candidates. P.S. - My next step will be (as adviced) to consult with some top docs.
  17. Dr. Carman, It's nice to see you on our forum posting evidence of the quality of your work. The immediately postoperative pictures look good on this patient, nice and clean and ultra refined. I look forward to seeing the finished result when it grows out and seeing some of your full results. Best wishes, Bill
  18. Josh-b In general the density in this case was 40 FU's/cm2. Since completing my fellowship with Dr. Reed I have had the distinct honor of joining him at that practice as his partner. Thank you for your input, and yes, I will post updates as things progress. Timothy Carman, MD
  19. HLBD, You are truly asking some great questions and receiving excellent answers from veteran forum members and physicians. From everything you have presented, you appear to be in great shape and a potential candidate for hair transplant surgery. Age and family history of hair loss ought to play a role in determining how "conservative" or "liberal" your hair restoration goals should be at this point, but given your seemingly good donor hair, your low level of hair loss at 29, and the fact that you had previouis work done, consulting with a few elite physicians is a good next step. In my opinion based on statistics alone, that based on your age and your low level of hair loss, you will most likely not progress to higher levels of hair loss such as NW5-7. Dr. Carman, It's nice to see you on the forum. Thanks for your participation! Bill
  20. Hello all, I am considering getting a hair transplant operation mostly in my front hairline. For what I have read FUE is the way to go, I can't seem to find any doctors in my area (las Vegas) that do FUE however I found some doctors that are not far away from here like La Jolla Hair Restoration Medical Center with Dr. Reed and Carman Also DermHair ClinicDr. with Dr. Sanusi Umar, are they any good? It is confusing trying to choose a doctor, I am hoping you guys can recommend me a good doctor, the closest to Las Vegas the better. Thank you to all in advance.
  21. Hello all, I am considering getting a hair transplant operation mostly in my front hairline. For what I have read FUE is the way to go, I can't seem to find any doctors in my area (las Vegas) that do FUE however I found some doctors that are not far away from here like La Jolla Hair Restoration Medical Center with Dr. Reed and Carman Also DermHair ClinicDr. with Dr. Sanusi Umar, are they any good? It is confusing trying to choose a doctor, I am hoping you guys can recommend me a good doctor, the closest to Las Vegas the better. Thank you to all in advance.
  22. Red- First of all, I am sorry to hear of your experience. Regarding your situation: "Sometimes even small numbers of grafts, given limited donor supply, can make a big difference when these hairs are placed strategically, and/or combined with graft removal and retransplanting techniques." I couldn't agree more with Dr. Epstein. Placed in the appropriate manner, a small number of (newly transplanted) grafts can go a long way to improving a situation such as yours. Although we can address your situation in a general manner here, perhaps you could upload a photo or two which would be very helpful. Of course, the ideal case would be to have an evaluation in person, and I recommend physicians listed in the coalition without hesitation. Incidentally, that small number of grafts could probably be harvested as part of a scar reduction procedure- you mentioned you wanted to address that issue as well. Sincerely, Timothy Carman, MD La Jolla, California
  23. Benihana, Though I believe you will be in good hands with Dr. Reed (I'm not familiar with Dr. Carman - and he is not on the coalition), don't let location determine which clinic you choose. Go only to a doctor that you are most comfortable with. Traveling across the country for who you see as the best is worth the price IMO. Edit: Since this old topic has been recently updated, I felt compelled to ammend my original statement. While I still ultimately believe that location shouldn't be the primary factor in selecting a quality physician, having been the managing publisher of this community for years, I have full faith in Dr. Reed's and Dr. Carman's ability to provide world class results. Both Dr. Reed and Dr. Carman have both been thoroughly reviewed and prescreended by this community and have been approved for the Coalition of Independent Hair Restoration Physicians based on their dedication to performing ultra refined hair transplants with excellent results. To see our demanding standards for the Coalition, click here. End Edit Bill
  24. Does anybody have any experience with Dr. Reed or Dr. Carman? They are the closest reputable doctors that are near me that are in the HT coalition. I'm having my cousin sent to him next week for a consultation, and his prices look really good for the grafts, something like $2/graft after if going over 2000 grafts. I myself would like to go to Hassong or Wong or Rahal, Rahal seems to do amazing work. At first I wanted Armani, but I heard he stopped doing Strip procedures and only does FUE, which is VERY expensive $14/graft that he charges.
  25. I agree with Dr. Carman on this one... Regardless of how many subsequent procedures are needed, I believe the gold standard should always be applied for every surgery. That being said, I believe there ARE times a surgeon many not employ the Tricho closure technique. One example MIGHT be a patient with less donor laxity, not as concerned about the scar and still wanting to maximize as many grafts as possible. I believe there was a case like this that I read about over the last year or so. But it would be interesting to hear this answered by a doctor... Bill
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