Dr Umar patient "schmoe" 3000 FUE and BHT hybrid - 7 Months

[Dr. Sanusi Umar]

 

 

 

He is known in the hairloss blog community as "schmoe". Before seeing me, he had a history of prior FUE and BHT at another facility involving mainly the hairline, frontal scalp and crown.

 

He came to me requesting improvement of his hairline from his prior surgery. He wanted the hairline softened and the shape and direction streamlined to taste. The aim is for a subtle but evident change in the hairline.

He also wanted density added to the mid scalp.

 

7 months prior he underwent a 3000 SFET procedure to achieve the above stated objectives.

 

The breakdown of the donor sources were as follows:

 

Head donor: 1293

Nape: 597

Lower abdomen and upper pubic areas: 1115

 

 

The foregoing are before and after photos in a self explanatory sequence:

 

 

 

 

 

 

 

 

 

 

 

[Bill - Seemiller]

Dr. Umar,

 

Thanks for posting these.

 

It's a little difficult to see the results given the difference in some of the angles

 

Do you have any before/after pictures that target the crown? I imagine that these pictures would be quite telling since the majority of the grafts were placed there.

 

Best wishes,

 

Bill

[Dr. Sanusi Umar]

Bill,

 

 

 

The patient in question actually came to me for what is essentially a repair of previous hairline work done on him by another Dr..

 

By the patient's own account; about a year prior to seeing me, he had (at another clinic) about 2600 head FUE (to the hairline and frontal scalp) and 1200 BHT to the crown, leaving out the mid scalp. Result wise, the new hairline was harsh (because it consisted of thick hairs and many terminal doubles), too much of a V (not fitting his face well), grossly asymmetrical as it curved excessively to the right as well as being too sparse...in the overall unnatural looking. He wanted that hairline refined. He also felt there was no cosmetically visible growth of the ~1200 body hair he received in the crown.

 

 

He wanted his mid scalp grafted. He was not happy with the transition between the frontal scalp and mid scalp which and wanted that eliminated. Because of his prior experience he was particular about not having abrupt transition margins between the different zones of the head. He wanted the transition between the mid scalp and crown sufficiently tapered to make for a natural transition in keeping with the basic tenets of hair transplantation. I did NOT work on this patient's crown, another Dr did over 18 months prior to the posting of these results...My surgery would appear to involve the crown, because of the mid scalp tapering that I had to do for a more natural transition between the mid scalp and crown. My basic approach is to have a patient not be compelled to come back for surgery to avoid an odd look. It is always best to assume that the patient might not return for more transplants in the future. Hence they should be left looking natural at the end of each surgery. Tapering transition lines helps in achieving this.

 

 

 

MY SURGERY

 

 

 

The hairline, temporal recesses and the right and left sides of the frontal scalp

 

About 1600 Nape (~50%), and head (~50%) hair grafts were used to:

1. Reshape the hairline to a cross between a V and a U which framed his face better

2. Soften the hairline to obscure the thick terminal hair and multiple doubles

3. A more natural tapering density

4. Realign the hairline from a right curving to a more symmetrical disposition.

5. Close in the temporal recesses ever so slightly to just frame the face more naturally.

6. Fill in the bridge between the frontal scalps and the sides of the head to better compliment above changes

 

 

 

 

 

 

PATIENT'S OWN STATEMENT REGARDING HAIRLINE WORK' Make the hairline softer and more natural. The devil is in the details, bare in mind when you're looking at the photos, you're seeing a fixed view.. in life and in motion we can start to pick out the details..

 

look at "Sides(Full)" and "Front(Full)". The temples are that detail, I HAVE a hairline before, but AFTER everything really looks complete and falls together. and it is much softer now. I'm VERY happy with it. As far as I'm concerned my hairline is DONE!! (well.. we'll see.. lol.. we're all hair addicts)"

 

 

 

The mid scalp was transplanted with ~1600 pure body hair consisting of stomach and pubic hair with tapering towards the crown.

 

 

 

Yellow=mid scalp grafting, Blue=tapering area All body hair

 

 

 

 

 

 

PATIENT'S OWN STATEMENT REGARDING MID SCALP WORK: "I had a wall of hair in the front and it came to a halt in the middle.. making it look a bit dramatic. So the middle was filled in. It was ALL pubic and abdomen hair in the middle; I was happy with the results of the body hair.

 

you can go through my gallery and maybe decide for yourself as to what you think Dr. X's yield was. The front came out well I wasn't too excited about the results in the back, however It's hard to tell if the survival rate was low OR that the body hair just wasn't robust enough (maybe both); the scalp hair clearly came in very well though.

 

 

As far as Dr. Us yield rate go; everything came in well.. the front came in nice and soft, the middle filled up well to be comparable to the front, thus having a much less dramatic transition from frontal scalp to mid scalp.

 

 

I DO feel much difference! here's the vain reasoning behind that.. I would see pictures before the surgery with Dr. U and I wanted to throw away most of the pictures, the hairline (although thicker) was MUCH more clearly defined, as opposed to before the surgery, where it was very thin, it was a very natural transition.

 

This restored the natural transition and I actually see the pictures now and am pretty damn happy with them

 

 

 

Here are relevant statements posted by the patient on another hair loss forum

 

 

 

posted by schmoe, 28.12.2007, 22:45

Hey guys;

sorry I haven't chimed in yet, to be honest, I'm no too worried about my hair right now (for the first time in 10 years), so i've been worreid about all the other things in life besides my hair!

 

I'm gonna try to go down the list of questions here.

 

First off, THANKS for all the support, as most of us know this is a taxing issue that lingers in our minds for way too long and drains us of valuable thought and energy (and money!)

 

>>Schmoe, you look great, soft n natural hairline. How many grafts did you >>have combined counting both XXX and Umar?

 

thank you! I dont have the EXACT numbers on me, the final tally for Dr. X's is posted in my blog.

3800 roughly with Dr. X, about 1200 of those being body hair I believe.

3200 with Dr. Umar; I believe it was half and half

 

roughly 7000 grafts total now.

 

 

>>What was the time frame of surgeries between Dr. X and your procedure Dr. >>U? In other words, how much time separates the procedures?

 

Almost 1 year exactly.

 

>>Once again excellent results from Dr.Umar.

>>Honest pictures with the same lighting, hair conditions (wet or dry) and >>head positions showing the before and after results.

 

>>Excellent job, excellent results, and I am sure this man is estatic.

 

I'm VERY happy; the 2nd procedure addressed 2 issues;

 

A) I had a wall of hair in the front and it came to a halt in the middle.. making it look a bit dramatic. So the middle was filled in. It was ALL pubic and abdomen hair in the middle; I was happy with the results of the body hair.

 

B) Make the hairline softer and more natural. The devil is in the details, bare in mind when you're looking at the photos, you're seeing a fixed view.. in life and in motion we can start to pick out the details..

 

look at "Sides(Full)" and "Front(Full)". The temples are that detail, I HAVE a hairline before, but AFTER everything really looks complete and falls together. and it is much softer now. I'm VERY happy with it. As far as I'm concerned my hairline is DONE!! (well.. we'll see.. lol.. we're all hair addicts)

 

>>People with light color hair are blessed. I don't think he would look as nearly good if his hair were black.

 

I actually had it bleached platinum for awhile because of this and it looked AWESOME! but i grew bored of it.. I still use stuff like 'sun in' to keep the contrast minimal.

 

It's true the hair overall is still pretty thin. I will be addressing this in another surgery this coming year. 1500 to fill in the crown, another 500-1000 to fill in the density of the front; it will be mostly beard hair; no scalp.

 

>>I swear you had a lot of hair already after you went to Dr.X, u feel much difference after the additional 3000 from Dr. Umar? How do u rate the yield between dr x and dr umar ?

 

this is difficult to answer; you can go through my gallery and maybe decide for yourself as to what you think Dr. X's yield was. The front came out well I wasn't too excited about the results in the back, however It's hard to tell if the survival rate was low OR that the body hair just wasn't robust enough (maybe both); the scalp hair clearly came in very well though.

 

 

As far as Dr. Us yield rate go; everything came in well.. the front came in nice and soft, the middle filled up well to be comparable to the front, thus having a much less dramatic transition from frontal scalp to mid scalp.

 

 

I DO feel much difference! here's the vain reasoning behind that.. I would see pictures before the surgery with Dr. U and I wanted to throw away most of the pictures, the hairline (although thicker) was MUCH more clearly defined, as opposed to before the surgery, where it was very thin, it was a very natural transition.

 

This restored the natural transition and I actually see the pictures now and am pretty damn happy with them.

 

 

 

As I said earlier, I'm not done yet. I don't believe HT surgery consists of ONE surgery... its a long road; and I think people should be aware of that when they go for a surgery.. I am WELL aware that my hair is going to continue to thin (yes I'm on meds); so I'm trying to be practical and slowly fill it in with body hair over time to maintain it. Yeah it's not cheap; but if you want cheap you can simply shave your head and move on.. you don't NEED hair.. you WANT hair.

 

good luck to all, thank you for the support; if you have anymore questions, feel free to ask or just EMAIL me! (schmoe5000 @ hotmail.com)

 

if you want any ADVICE on your own predicament, I can give you my opinion.. (bare in mind I'm not a professional, just someone who sympathizes VERY MUCH!)

 

take care!

-------------------------------------------------------------

 

posted by schmoe, 30.12.2007, 14:59

lordy.. I leave for ONE day!

 

I think there may have been a little confusion regarding the yield results and late growth;

 

While Dr. x's surgery was integral to where I'm at; Dr. Umar worked in areas untouched by Dr. x (there may have been some slight overlap in the back, I'm not 100%) BUT Dr. Umar did the midscalp that was left untouched by Dr. x at the time along with the very frontal hairline(in front of Dr. x's)

 

So any growth you see in particular areas would essentially be the result of the Dr. that worked in that area.

 

Hope that clears up any confusion (if there was any regarding that)

 

 

 

posted by schmoe, 30.12.2007, 16:13

a few more things..

 

price.

most of you know that you get a discount for large amounts of grafts by most Dr.s, so generally 'x per graft' doesn't really hold up.

 

keep that in mind when you're pricing HT; there's many Dr.s that offer discounts for various things (photographed results; paying in cash vs financing etc)

 

I don't know how at liberty I am to discuss my pricing so I won't.

35k is a bit higher than what I paid though.

 

You guys also have to keep in mind, it's a process, or journey of sorts; you dont walk into a clinic, drop down 35k on the table and walk out with your Jake Gyllenhaal hair.

 

set goals for each surgery then set a final goal; decide how much you can work on each time.

 

some of that linear thinking is comparable to that of a really obese guy walking into a gym thinking he's going to walk out of there looking like nitro from american gladiators

 

1 year and 8 months later..

 

 

 

For those interested in the patient's hair loss state before he ever had any hair transplants, here are some photos he shared on another hair loss forum:

 

 

 

 

 

Regards,

[Bill - Seemiller]

Dr. Umar,

 

Thanks for providing a detailed account of this patient's surgery including his background. It's obvious you have a lot of passion for what you do.

 

The additional photos are certainly helpful in showing the quality of this result.

 

Do you also have any crown only pictures from the back of the head?

 

I look forward to seeing more of your work.

 

Best wishes,

 

Bill

[PLEASE GROW PLEASE]

I have mixed feelings about Dr umar He does take on extreme cases but I havent seen any WOW results. He seems passionate and never heard anything bad about him as a man but I believe he oversells bodyhair. With bh already having a lower yield and that each graft only contains one hair . You need to have alot of money and time and patience to attain a decent result

[Bill - Seemiller]

PGP,

 

I haven't seen any evidence that he "oversells" BHT as he seems pretty realistic about expectations and reasonable with fees. See Pat's Visit with Dr. Umar's Clinic.

 

I must admit however, that I too am a BHT skeptic and share your sentiment. I have always been and am still one to see the proof to believe, in this case consistency.

 

I do feel however, that the 10,000 BHT hair transplant repair case is quite impressive if you consider the starting point. No after pictures are on the thread, you have to watch the video.

 

I look forward to seeing more of Dr. Umar's work.

 

Bill

[NW4recession]

I have never put much faith in body hair, but I must say that I am impressed with Dr. Umar's result on this patient. If these results can become consistent with BHT it would give many of us a backup reserve of hair to use if we run out of donor.

[PLEASE GROW PLEASE]

Yeah oversells is wrong I should say puts too much faith in it. It should only be used in extreme and rare cases

[TheEmperor]

Is it possible that the problem is not BHT, but FUE in general? Maybe BHT gets the same yield as FUE, but in patients who are resorting to body hair, they already have extreme loss and/or are repair patients, so we do not see WOW results. What we see is at best thin.

 

Add to that the single hair nature of body hair and the fact it does not grow as long as head hair and you would have lowered expectations for it's use.

 

However, im not convinced that lower yield (than typical FUE) has been proven. Sure the % chance for transection is higher, but for these guys without much head hair, this has got to be a godsend.

 

Patient looks great.

[PLEASE GROW PLEASE]

Dr Cole has did alot of bht and this is what he says. Im convinced Not because of this article but by the pics Ive seen on multiple forums.

 

 

http://www.baldingblog.com/2008/01/25/body-hair-transpl...case-of-100-failure/

[MrJobi]

As I posted recently I am VERY surpirsed the vertic is not out on BHT despite the many experiments..

 

I mean, either it works or doesnt or at least a high percentage of the time???

[Arrie]

PGP, I must say many of us are skeptics of bht, but guys we have to see the big picture here, Dr. Umar is taking on worst case scenarios here. Giving pts that have been hacked and taken advantage of a glimpse of hope to return to normalsy, and from what I've seen hes done a pretty darn good job. Remember we cant compare scalp hts to bht's due to the caliber and every characteristic of each hair follicle. Once again if the pt is informed and has realistic expectations then all is well.

Emperor, Good point about the whole FUE possibility

[PLEASE GROW PLEASE]

I agree that he does take on some rather tough ,well extremely tough cases and if there was one doctor that I would go to for bht it would be Dr Umar.

It does seem for some patients with deep pockets bht can be a blessing .

I would just like to see more scalp fue results from him

[Dr. Alan Feller]

Deleted by author

[Bill - Seemiller]

Dr. Feller,

 

Whereas I appreciate and respect your opinion, I disagree with a few statements you have made.

 

1. I do not feel that a physician has to be a strip surgery expert to be an FUE or BHT expert. The procedures are entirely different so therefore, in my opinion it doesn't take perfecting one to evolve into the other.

 

2. From previous conversations with you, you've basically defined the "brute Force" method as extracting follicles from patients who are not optimal candidates. Considering Dr. Umar appears to be quite selective on who he operates on, I don't see any reason to believe he is using "brute force".

 

In my opinion, Dr. Umar represents a small group of patients who have limited options and available scalp donor hair and gives them a viable alternative to strip when appropriate.

 

Best wishes,

 

Bill

[Dr. Alan Feller]

Deleted by Author

[Tembo]

Dr. Feller,

 

Thats like saying that "a strip surgeon who is not a master at the old plug graft technique would not hold up in court".

 

Or that "a strip surgeon who is not a master at Flemming-Mayer Flap or scalp reduction surgery would not hold up in court".

 

Techniques evolve, and maybe FUE is better than strip in most cases and represents the future.

[Dr. Sanusi Umar]

Dr Feller,

 

Unless you are indeed the person performing the surgeries on my patients in my Redondo Beach office, I would advice that you desist from further characterizing my work as "brute force" or any other phrase that occurs to you. If you have been using "brute force" to perform BHT, then I would not be surprised at your apparent lack of success in the procedure.

 

If strip HT defines the limit of your horizon in hair restoration, I would respect that. However, do not judge me by the standards of your limitations.

 

Stop haranguing my cases. No brute force was used on this patient... As you can see "Schmoe" is very happy with the outcome of his surgery.

 

 

 

Originally posted by Dr. Alan Feller:

Yeah oversells is wrong I should say puts too much faith in it. It should only be used in extreme and rare cases

 

If a doctor hasn't put in the time to perform proper strip surgery to the level of expert then he doesn't know what he doesn't know. In this case it is very easy to put too much faith into an experiemental technique which is what all mega-FUE/BHT procedures are.

 

Unfortunately, faith in an experimental procedure can be artificially strengthened if it is the ONLY hair transplant procedure you are capable of performing due to lack of a trained staff and inexperience in modern mainstream HT techniques.

 

I extend kudos to Dr. Umar for his massive brute force approach. For those patients going in for such procedures with their eyes wide opein it is indeed a blessing, but only in so much as it doesn't confuse other would be HT patients into believing that mega-FUE/BHT is an alternative to mainstream techniques. The very techniques that allowed this industry to be reborn with credibility and respect.

[Dr. Timothy Carman]

Dr Umar-

In my opinion this is a great result; reshaping the skewed hairline and adding increased density, it's no wonder the patient is pleased.

This restored the natural transition and I actually see the pictures now and am pretty damn happy with them.

I can also tell from his posts that his expectations were/are realistic, and his tone suggests to me that he enjoys the benefits of a good doctor-patient relationship.

Very nice.

[Dr. Alan Feller]

Dr. Umar is right. I should not be commenting on his thread. I will delete my comments and offer my apologies.

 

Dr. Feller

[Dr. Sanusi Umar]

Dr Carman,

 

I thank you for your input. The result is just as the patient wishes it. I do spend a considerable amount of time in setting expectations right. This patient's outlook from the outset was ideal in that regard.

 

Regards

 

 

Originally posted by Dr. Timothy Carman:

Dr Umar-

In my opinion this is a great result; reshaping the skewed hairline and adding increased density, it's no wonder the patient is pleased.

 

This restored the natural transition and I actually see the pictures now and am pretty damn happy with them.

I can also tell from his posts that his expectations were/are realistic, and his tone suggests to me that he enjoys the benefits of a good doctor-patient relationship.

Very nice.