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Visit to La Jolla Hair Restoration Medical Center in La Jolla, California October 22

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I had always heard positive comments about Dr. Bill Reed from both physicians and patients.


But it was not until finally visiting his clinic and seeing him and his staff in action that I came to understand why he receives such positive accolades. Dr. Reed exudes compassion, sincerity and commitment to the patient and it shows in his work and in the attitudes of his entire staff.


He and his staff sweat the details and trim all grafts under microscopes and devote their time to one patient a day. They are not dogmatic about using only 1, 2, 3 and 4 hair follicular unit grafts, since they believe it is in the best interest of many patient's to use some multiple follicular unit grafts in the central areas to create an optimal illusion of density for the patient.


While they primarily use follicular units Dr. Reed, along with some other leading physicians such as Dr. Ron Shapiro, now believe that a limited number of multiple follicular units grafts strategically placed in areas of the mid scalp can create an illusion of density that can't be achieved if only follicular units are used.


These multiple follicular unit grafts typically contain two or even three follicular units that are naturally close together. Thus such multi haired grafts are able to achieve a higher density of hair than can be achieved by placing separate follicular unit grafts into even the most densely packed incisions. Thus by judiciously and strategically placing a limited number of multiple follicular unit grafts in and among standard follicular unit grafts in the central areas, physicians like Dr. Reed believe that these denser grafts can break up and mask what might otherwise be a see through or transparent looking hair transplant.


Dr. Reed does perform sessions of all microscopically dissected follicular unit grafts, when optimal for a patient. In fact on the day of my visit the patient had opted for an all follicular unit graft session. To see the photo highlights from this surgerical visit, click here.


However, Dr. Reed sincerely believes that many patients, especially those with fine or light colored hair, can achieve both naturalness and a greater illusion of density ultimately by combining follicular unit grafts with a smaller number of multiple follicular units that are strategically placed in the mid scalp areas.


Dr. Reed and many leading physicians believe that using small grafts exclusively often results in a natural but sparse/thin look. I tend to agree with this assessment, especially in regards to the mid scalp region. Of course, only one and two hair grafts should be used in the hairline areas and in areas of the crown that are exposed.


Creating both naturalness and the illusion of density is really an artful shell game. No physician can recreate our original density hair for hair even if they are using only our 1, 2, 3, and 4 hair naturally occurring follicular units exclusively. That is why many very experienced and artistically skilled surgeons choose to place a limited number of multiple follicular unit grafts strategically so as to break up an otherwise potentially transparent and uniformly sparse look.


I think such a uniformly sparse look is even more evident in sub follicular unit grafting sessions in which the naturally occurring 3 and 4 hair grafts are sub divided into all one and two hair grafts. Such small grafts do work well when densely packed in the hairline or perhaps even the frontal third areas. But in patients with extensive hair loss there will generally not be enough donor supply to achieve the illusion of density in the central regions when using only one and two hair grafts since the low hair density of these grafts will tend to produce an even and sparse look.


That is why some physicians like Dr. Reed choose to place a limited number of multiple follicular unit grafts in the mid scalp regions even though they could create and place follicular or sub follicular unit grafts exclusively. Thus while "follicular unit grafting" has been the dogma preached by me and many others over the years in reaction to the grafty looking mini/micro grafting that was the standard ten years ago, I believe that a limited amount of carefully trimmed multiple hair grafts placed in critical areas of the mid scalp may in the long run give many patients the optimal combination of both naturalness and the appearance of fullness.


I had an opportunity to view some of Dr. Reed's patients during the live patient showing at the ISHRS meeting in San Diego. In my opinion these patients achieved both an excellent appearance of fullness and naturalness (even upon close inspection) from such combination follicular unit grafting.


Ultimately it is up to the patient and their physician to choose the technique that is best for them based on their hair characteristics, extent of hair loss and their goals.


Dr. Reed provides ultra refined grafting techniques using various sized grafts depending on the needs and desires of the patient. He also uses the smallest incision possible to safely accommodate each sized graft. In my opinion his procedure and techniques are ultra refined and responsive to providing each patient with the optimal technique for achieving their ultimate best results.


Dr. Reed is also a hair transplant patient and had two session performed in 1994. One year later he opened the La Jolla Hair Restoration Medical Center in 1995. Just recently he had another hair transplant surgery performed by his prot???©g???©e Dr. Tim Carman, who has been training extensively with Dr. Reed over the past twelve months.


Dr. Carman shares Dr. Reeds philosophy of putting the patient's best interest above technical dogma and as well as his intense compassion and commitment.


In addition to a medical background that includes experience in plastic and reconstructive surgery, Dr. Carman has a strong interest in painting, sculpting and music composition. He enjoys the artistic aspects of hair transplantation and expects to join Dr. Reed and La Jolla Hair Restoration once his one year fellowship in hair restoration surgery in completed in the next few weeks. Based on what I have heard about Dr. Carman, I expect he will be an impressive hair restoration physician in his own right.


I was also very impressed by the commitment of Dr. Reed's entire staff from the front desk to the careful graft cutting being performed in the back room. The entire staff is highly experienced and they work together very harmoniously.


Given Dr. Reed's long track record of patient satisfaction, his obvious skill, refinement and commitment I would like to invite him to join the Coalition of Independent Hair Restoration Physicians. I believe it is in the interest of potential patients to offer Dr. Reed and his staff this community's highest recommendation ??“ membership in the Coalition.

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Pat--- thanks for the good write-up of Dr. Reed.


It will be good to add another Coalition Doc in Califonia.


I hope that those who read this can differeniate a "naturally occurring follicular graft" and a "mini" graft, and why Dr's are using these larger hair groupings in the right areas in order to optimize density.


I like the idea that using these type of grafts actually reduces the number of incisions in the scalp, helping to curb scalp trauma.

This "combination of sub-follicular division and use of larger naturally occurring grafts" seems to be able to provide the optimal coverage in patients like myself, who have extensive balding.


Thanks Again Pat!!!!!!!!!

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B Spot,


You bring up a good point that multiple follicular unit grafts do reduce the amount of incisions that have to be made to relocate a given amount of hair follicles. After all minimizing trauma to the scalp is important.


However, you also wrote -


"combination of sub-follicular division and use of larger naturally occurring grafts"


Dr. Reed is not doing "Sub follicular" unit grafting but follicular unit grafting some times in combination with using a limited amount of multiple follicular units.


Best regards, Pat

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Yeah, I should have used different terminology, but what I mean is that perhaps Doc's sub-divide 50-100 4 or 5 hair grafts in order to produce a few more 1 or 2 hair grafts to place in the hairline/temples/etc... Which is a necessity in many instances.


I have no problem whatsoever with that practice.


I agree with you that using predominately sub-divided grafts can produce a sparse look.


Like everything else, this practice has its place when used properly and in conjunction with other refined techniques.


Thanks Again Pat!

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Great review as always!


What do you know and/or think about DFUs which I believe has been explained to me as double follicular unit grafts which have gone all the way up to 6 hairs per graft. This may not be the best place to ask this question, but since Dr. Reed holds a similar view as Shapiro medical group, I thought it might be appropriate since another member of the forum has recieved a few DFUs by Dr. Paul Shapiro.





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