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My Story

Found 13 results

  1. From time to time, we see a disconnect between hair transplant "expectations" and the "reality" of modern hair transplant surgery. Most of the time online, it seems like patient expectations were outside or above the -- excellent -- reality of hair transplant surgery. However, sometimes in practice, I actually see the opposite; an instance where a patient actually had lower expectations and accepted a less than satisfactory outcome because they thought this was the reality of modern hair transplantation. And I think it is just as important to discuss this because it helps patients understand what they can expect in general. When expectations match reality, patients tend to be happy and achieve good cosmetic outcomes. What's more, by knowing what they should expect from a transplant, otherwise unsuspecting patients reading this thread will hopefully avoid being taken advantage of. The case today is a patient with advanced hair loss -- essentially a NW VI -- who underwent an FUT procedure in India. The doctor recommended doing a 2,600 graft "mega session" to rebuild a "dense pack" frontal band and do some fill behind to create a smooth transition in the mid-scalp. The patient liked the plan and moved forward. Here's how he looked 12 months after that procedure: As members of this forum know, this result is not an accurate representation of the reality of a modern mega session with dense packing. But when the patient presented for the consultation, he was under the impression that this type of result was the norm. I informed him that his expectations did not match the reality of what hair transplant surgery can offer. And I recommended proving this to him by essentially doing precisely what the first clinic claimed: a 2,600 graft mega session with a dense packed frontal band and a strategic mid-scalp fill that transitioned into his open crown. Here's how he looked 12 months after the surgery at our clinic: Now I believe this is a realistic representation of what a modern hair transplant mega session with dense packing via FUT should look like. And while the final result may have benefited slightly from the existing grafts (which, for whatever reason, did not amount of what 2,600 grafts should look like), I still think this is about right. Always keep in mind that results will vary, but this is something I would feel comfortable showing to the average patient to help create realistic expectations. I'm happy to report that this patient is very pleased with where he is at now. I recently did 1 more FUT (this is when the "after" pictures were taken) to fill a little more in the posterior mid-scalp and anterior crown (which is what the patient actually thought he wanted to do originally before understanding how much thicker the front could look). He's likely stripped out now and will probably return in the future for some FUE to finish up. Hope this presentation is helpful to those researching HTs and wondering what they can expect. Here are some comparison shots: Dr. Blake Bloxham Feller & Bloxham Medical, PC
  2. One of the most common requests I receive at the office is: "Doc, I want to cover 'everything.'" In other words, patients want to try and cover from hairline to full crown in one procedure. And while this is possible for some patients -- and I have done it before -- it's usually not the best/most realistic approach for most. Instead, I usually tell patients the best way to really knock "everything" out is in two procedures: one FUT mega-session to rebuild the hairline, densely pack the frontal scalp, and strategically fill the mid-scalp (past the "horizon"); and a second FUT to really do the crown correctly and feather up into the mid-scalp. I particularly like doing this method because a true "crown surgery" really deserves it's own day and a good graft number. I've also found that the FUT scar usually heals roughly the same between surgery 1 and 2, so you get total coverage with very minimal damage in the back and lots of donor left to address any issues in the future -- including some non-strip surgery to camouflage the scar further if the patient wants to go shorter on the sides later on. And that's precisely what this patient did: The patient is a male in his 50's with advanced NW level V-VI hair loss. We planned for two FUT procedures as described above. The first was a 3,200 graft HT aimed at the frontal and mid-scalp. Here are his results from that surgery: And here are his immediate post-operate results from the second surgery -- 2,000 grafts to the crown: And here is a video with more pictures, explanations, and some detailed "comb-through" footage. I highly encourage all members to watch: Thanks for reading. Look forward to comments and questions. Dr. Blake Bloxham Feller & Bloxham Medical, PC
  3. Hi All, Bernstein Medical - Center for Hair Restoration is a state-of-the-art hair restoration facility in NYC that is dedicated to the diagnosis and treatment of hair loss using the most advanced technologies. For an introduction to the practice from Dr. Robert M. Bernstein, founder of Bernstein Medical, and Dr. Michael B. Wolfeld, watch this video http://www.youtube.com/watch?v=rXCyU8wP_WE. They discuss their role in the field of hair transplantation and what to expect when you come to our office.
  4. There are a few cardinal "sins" in the hair transplant field. And while I doubt a standard list of these deadly sins exist, the general consensus is that they include things like: wasting/not respecting the donor, going too low/flat with the hairline in a patient with future loss, etc. This patient presented after undergoing a "mega session" at another clinic where I believe two of these "HT sins" were committed. The outside clinic attempted a large session on the patient to treat his Norwood VI pattern hair loss. In my opinion, however, two things were done that should not have been: 1) An inappropriate amount of grafts were spread way too far all over the entire scalp 2) The donor was harvested (FUT) in an awkward manner (likely an attempt to to a mega session harvest by a clinic that doesn't do a lot of them) and this limited the available donor for future surgeries. Here is how he looked after his procedure at the outside clinic: He was completely gone on top before the first surgery, so all the hair you see on top is the result of the transplant. As you can see, too few grafts spread too far. But what really made this case a "repair" is the state of the donor. The first clinic started the FUT incision high in the back of the donor area, and almost pointed it downward (opposed to naturally curved upwards) on the sides. This meant in order to obtain a good harvest (which was now limited off the bat) and leave the patient with one acceptable linear scar in the back, I had to harvest above the old scar on the sides and below it in the back. Despite the donor challenges, I was able to obtain 2,500 grafts from the donor. And instead of spreading these all over the scalp in a less dense manner (like previously done), I used these to dense pack the frontal scalp and strategically fill the mid-scalp as much as possible. Obviously this doesn't result in as much area being covered, but it's what gives us those dense, natural results. And here is how he looked only 6 months after surgery: And here are some with surgical lines to demonstrate the plan and where we worked: Now the patient has an appropriate result and a framed, natural look. And while it's always nice to get as much coverage as possible on high Norwood patients, it's rarely a good idea to to it at the expense of cosmetically significant density or the state of the donor. Thankfully the patient still has laxity so he is planning on doing one more large FUT session aimed at filling the rest of the mid-scalp and crown. After that he will likely be a good candidate for FUE to finish off any little areas. Thank you for reading. I will update this thread when the patient comes back for a 12 month follow-up -- especially because the camera wasn't being overly cooperative during his appointment and a lot of the pictures didn't come out. But I hope this case serves as a reminder to those with high levels of hair loss looking to undergo big procedures; make sure good, strategic density is utilized and make sure to keep the donor is the best shape possible for future surgeries -- because you may very well not be able to do everything in one shot. Dr Blake Bloxham Feller & Bloxham Medical, PC
  5. Like many other procedures in this field, SMP is a great tool with the potential to help a lot of patients when done correctly by a skilled practitioner. However, like just about everything else in life, not all SMP clinics are the same and not all practitioners work with the patient's best interest at heart. And that is where our story begins; and it's a little bit of a different case, so I hope members enjoy and I really hope it lets others know there are almost always options to improve upon old or bad work, so don't be afraid to consult and discuss your possibilities. The patient here is a male in his early 40s who initially presented to an outside hair transplant clinic for a consultation years before. He consulted with the hopes to have a hair transplant to treat his Norwood level V-VI patterned hair loss. At that time, he was told that he did not have the donor for surgery and was not a candidate. Discouraged, he looked into other options and found SMP. So he decided to go to an SMP clinic and have permanent SMP done on the entire scalp. Unfortunately, the clinic initially went very low and flat (and somewhat crooked) with the hairline, and the permanent ink partially faded into an unnatural blueish hue overtime. He watched some of our YouTube videos where we had repaired previous bad SMP work and decided to come in for a second opinion about a transplant. Here is how he looked during the consultation/before surgery: His donor was definitely below average. In fact, the gaps and spread nature almost made it looks like he had prior surgery. Initially, we discussed doing an FUE to try and create a "haze" of thinner hair on top to blend with the SMP and give him a more 3-D cropped look. But I didn't think his pseudo-afro hair follicle type would do well with FUE, and he had great characteristics otherwise for an FUT approach. I also thought he would received excellent coverage with his follicle type. Here is how his donor looked: So we decided on an "AMAP" or (as much as possible) FUT procedure aimed at rebuilding a more appropriate hairline (above the previous SMP hairline) and filling as much as possible with a slight emphasis on coverage over density. Despite his well below average density, I was able to harvest 3,103 grafts via FUT and use them as described above. Surgery went beautifully. Here's a surgical overview: He came back for a 6 month follow-up and looked great. Even with his hair cut quite short (and the patient cuts his own hair so that is why there is some unevenness in the 6 month pics), he clearly achieved his goals. This is precisely how the patient wanted to style his hair from the get go, though he is going to try growing it a little longer in the future: Based on the patient's excellent laxity and healing in the donor, we're going to do the rest of the mid-scalp and crown in the not-so-distant future. And although he was concerned initially about starting the hairline above the SMP, I explained that I've done this many times in the past and it usually blends quite well. Particularly when he grows his hair out a bit. But a very satisfying result on a challenging case, and an end to the daily worry about the bad SMP for this patient. Hope you enjoyed. Look forward to your comments. Dr. Blake Bloxham Feller & Bloxham Medical, Hair Transplant Institute Hair Transplant & Restoration Services in New York
  6. Wanted to present an update on a case I've shared before. The patient is a male in his 30's who underwent 2 "mini-graft" cases only several years back at a local clinic. The result of the two procedures was an unnatural look that only worsened as he continued to thin in the "frontal band" area. So I did a 2,200 graft FUT procedure (with true follicular units) aimed at naturally restoring the front and blending it into his excellent hair behind. He recently stopped by at 10 months and I was able to do an in-depth video (with dry and wet comb-throughs) and really evaluate how far he's come. I'm also linking to his case at around the 6 month mark; this may be interesting for those looking at how transplants mature. Video: Comparison Pics: And here is the link to his original presentation (a little under 6 months post-op): Dr. Blake Bloxham: 2,200 Graft "Mini-Graft" Repair | 6 Months Post-Op Thanks for viewing, Dr. Blake Bloxham Feller & Bloxham Medical, Hair Transplant Institute NYC Hair Transplant | NY Hair Restoration | Feller & Bloxham Medical
  7. 51 year old man. Norwood 4 1 session 1,500 FUTs 3,775 hairs Patient wanted most grafts in frontal area
  8. This is an update to to thread: http://www.hairrestorationnetwork.com/eve/161214-dr-dorin-1508-frontal-fut.html Ken just had his 2nd session with Dr. Dorin consisting of 1008 grafts - 244 singles, 566 doubles and 198 threes: 1,970 hairs transplanted. The initial donor scar from the first procedure was replaced. Please see the video link below for a view of his result from HT#1 with short hair and a glimpse into Dr. Dorin performing HT#2:
  9. Previous thread: http://www.hairrestorationnetwork.com/eve/158019-dr-dorin-1441-frontal-fue-14-days.html 1441 follicular units were extracted and transplanted to the frontal hairline region in one session. Of the 1441 grafts, 667 are singles, 661 doubles, and 113 threes. This result shows a total of 2,328 hairs after 6 months.
  10. Dr. True recently performed an FUE of 787 grafts on this patient to rebuild his hairline erosion - the extracted grafts consisted of 168 singles, 397 doubles, and 222 threes - a total of 1628 hairs. The heavy caliber of his hair and high percentage of 3 hair grafts should lend to excellent density in the area treated.
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