Regular Member Marko Ramius Posted July 9, 2008 Regular Member Share Posted July 9, 2008 So this is what I look like now. I had my operation done last Wednesday. Almost all the little scabs and crusts are gone. Is it likely that I'm going to want to come back later and do another one of these, to improve the density? I have plenty of donor hair. Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 9, 2008 Author Regular Member Share Posted July 9, 2008 So this is what I look like now. I had my operation done last Wednesday. Almost all the little scabs and crusts are gone. Is it likely that I'm going to want to come back later and do another one of these, to improve the density? I have plenty of donor hair. Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 9, 2008 Author Regular Member Share Posted July 9, 2008 Doc was Daniel McGrath. I currently have no pre-op pics, but perhaps I could dig some up. It was about 1500 grafts. As of right now, my goal is just to look better than I did before, which I think will be accomplished with this. Eventually, I'd like to be able to cut my hair shorter and not look ridiculous. I do think I'm going to need a little more density. I will meet with my surgeon again on Friday for suture removal, and we will discuss this possibility. Link to comment Share on other sites More sharing options...
Senior Member Arrie Posted July 9, 2008 Senior Member Share Posted July 9, 2008 Spex I have to agree with the importance of an appropriate hairline placement, very well put. Marko I have to agree with Spex that it looks like its gonna be thin. Given your hair disadvantaged characteristics (like mine) fine, thin caliber, dark hair, light scalp etc. What concerns me though is that it seem you were not well prepared for this procedure possible Dr. selection, unknown number of grafts, unsure what 3 hair grafts mean (from previous post) etc.. I hope everything works out for you and I hope I am wrong. The good news is you have found this place and you can rectify this situation if it doesn't work out for you. Good luck You only live once... Link to comment Share on other sites More sharing options...
Senior Member hatrick Posted July 9, 2008 Senior Member Share Posted July 9, 2008 ya i dont mean to concern you, but it will be very thin. It appears the doctor you chose isn't to familiar with the art of hair restoration. I dont understand why he gave you a straight hairline but placed the grafts so far apart. he should have given you a much more conservative hairline and packed in those 1500 grafts. Or if you were going for a straight hairline, he should have doubled your graft count to atleast 3000. honestly, if you choose to go back and get more density, pick a more qualified surgeon, preferably a coalition surgeon. I hope i'm wrong, just giving you my opinion though. My Hair Loss Weblog - Hair Transplant with Dr. Tessler Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted July 9, 2008 Share Posted July 9, 2008 Marko, I agree with what the others have been saying. 1500 grafts over such a larger area will be a nice start but you will require another session if you want to portray any real illusion of hair density. Is there a reason you and your surgeon chose to place the grafts further apart and didn't opt for a larger session? But don't fret. I started in a similar place. I had 1600 grafts for my first surgery over my entire balding head which didn't amount to much in the scheme of things but was certainly a nice start and improved my appearance slightly. Best wishes and keep us posted. Bill Link to comment Share on other sites More sharing options...
Senior Member the B spot Posted July 9, 2008 Senior Member Share Posted July 9, 2008 Marko, your going to want to book with a top hairline doc after these grafts grow out. They seem to be exiting the scalp rather up-right which might not look the greatest, especially considering there is going to be a disparity in density between the transplanted grafts and your existing native hair. Good news is, a top doc can transplant back into the area and blend the work better. Happy growing and good luck!!! Jason Go Cubs! 6721 transplanted grafts 13,906 hairs Performed by Dr. Ron Shapiro Dr. Ron Shapiro and Dr. Paul Shapiro are members of the Coalition of Independent Hair Restoration Physicians. Link to comment Share on other sites More sharing options...
Senior Member Gorpy Posted July 9, 2008 Senior Member Share Posted July 9, 2008 Yes, it looks like 15 or 20 grafts per cm2, which will not get it done. I would start thinking about visiting a hairline specialist like Dr. Ron Shapiro for your next one. ____________ 2700 Total Grafts w/ Keene 9/28/05 663 one's = 663 1116 two's = 2232 721 three's = 2163 200 four's = 800 Hair Count = 5858 1000 Total Grafts w/Keene 2/08/07 Mostly combined FU's for 2600+ hairs My Photo Album See me at Dr. Keene's Gallery Link to comment Share on other sites More sharing options...
Dr. Timothy Carman Posted July 9, 2008 Share Posted July 9, 2008 Marko- Could you upload a photo that depicts your present hairline from a greater distance than the one above as this will enable us to see the design of the hairline in context with the rest of your facial features (ie, forehead, pre-existing hair, etc.). And congratulations on getting into med skule!!! Sincerely, Timothy Carman, MD ABHRS President, (ABHRS) ABHRS Board of Directors La Jolla Hair Restoration Medical Center Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 10, 2008 Author Regular Member Share Posted July 10, 2008 In defense of the doc, he did tell me ahead of time that I may want to get another one of these done. I didn't really know what he meant by that. All I knew was that anything would be better than what I had, so I told him to use his best judgement, within my current budget. As for my budget... I have pretty much leveraged my life away to go back to college for my med school pre-requisites. I also took a job at the hospital, to get clinical experience, that pays about 1/3 of what I would make, had I stuck with my original career. On top of that, I have to move halfway acros the country, I've got deposits to pay for my med school, I had interview trips, application fees, and all that nonsense. And that's on top of the regular stuff (rent, car, bills, etc). So my credit is mediocre at best, and I'm doing this whole thing with cash. So what did the doc do? He let me pay $2500 up front, and "promise" to give the rest ($2000) when I get my student loans in. I signed a promisory note that he typed up in about two seconds on his computer, and he didn't ask for a credit card, a post-dated check, or anything. If I wanted, I could probably just disappear and never pay him the rest. Of course, I'm not going to do that, because that would be a shitty thing to do, and I really appreciate the favor he did me, which basically amounts to him giving me a no-interest loan out of his own pocket. If I can swing it, I will get him to do another procedure to fill in the gaps, when I've got the money. Perhaps next spring. In the event that I can't make it back home, for whatever reason (I.e., school is too busy), I'd like to find someone in or near Atlanta to do the job. At any rate, you can probably count on one hand the number of docs in this world who would do what he did for me. He will be who I look to first for another procedure. And he will also be the first person to get a check from me when my loans come in in about a month. I am also not too worried about the hairs pointing straight up, at this point. If there's anything my hair does well, its lay flat. Dr. Carman: I don't have a pic of the hairline from a better angle right now, but I will say that I like what he did with it. Actually better than my original hairline, before I started losing it. If we can get it filled in well, I think it will work pretty well for me. Link to comment Share on other sites More sharing options...
Senior Member hoose Posted July 10, 2008 Senior Member Share Posted July 10, 2008 Marko, Just because he gave you an interest free loan shouldn't make him the doc you "look to first for another procedure." You only have so much donor hair, laxity etc., so you will want to get it right the second time around; I would go to a coalition doc for HT #2; I'm not trying to sound harsh; it is just that a HT is a big decision and the decision to go with a doc shouldn't be based on if they are nice and gave you and interest free loan. Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 10, 2008 Author Regular Member Share Posted July 10, 2008 Well, I'm probably 6-12 months away from doing this again, but I am going to explore my options. I also plan on keeping my current doc as one of those options. I'd also like to add that, from the top, it looks pretty sparse, but from the front, it looks like it is going to make a pretty big difference. I'll try to get some other angles loaded up on here. At the current density, I don't think I'll be able to cut it too short though, which I would eventually prefer. I do think that another procedure in the future will be in order, for that reason. Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 10, 2008 Author Regular Member Share Posted July 10, 2008 More pictures... Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 10, 2008 Author Regular Member Share Posted July 10, 2008 I hadn't washed my hair yet when I took those pictures. That's why I'm so greasy. Anyway, I'd like it to be a little denser, but at very least, I think this is going to be a good place to start, and I think what we've got done now will make a difference. I could be wrong, but I think my budget in the next year will allow for another one of these, if need be. Any opinions on about how many grafts I will need? Could 1000 do the trick? One thing I've got going for me is that I've lost nothing in the crown at all, so anything I need to do will be done up front. And I've got plenty of donor hair to work with too. Or so I'm told. Also, propecia, when I'm taking it regularly, does a pretty good job of holding steady. That is, I don't lose much, if anything, when I'm on it. I just need to stay on it forever now, as I have no idea how far back on my head I am programmed to lose hair. Link to comment Share on other sites More sharing options...
Dr. Timothy Carman Posted July 11, 2008 Share Posted July 11, 2008 Marko- Those photos are great. It would appear that (and granted this is an estimate from a photo) that a second procedure of 2500 grafts would be the maximum one could safely place, assuming an area of 60 cm2. If in fact the angles (of your newly transplanted hair) proved not to be as acute as they should have been, carefully placing the grafts in the area at a more acute angle (so as not to traumatize those hairs from the first transplant) can overcome any styling problems which you might experience. Timothy Carman, MD ABHRS President, (ABHRS) ABHRS Board of Directors La Jolla Hair Restoration Medical Center Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 11, 2008 Author Regular Member Share Posted July 11, 2008 Thanks for the input, Dr. Carman. To be honest, after looking at some of these pictures, particularly from the sides, I'm pretty encouraged. I'm not an expert, but I like the doc's idea for my hairline, and I think that it will look pretty good for me. I also agree that I'm going to need another one of these. My hair is pretty densely distributed on my head (except for where I have loss), so this might look a little funny, but I think I'll be able to get creative with haircuts and stuff to make it look okay. I also think that when I get it filled in, its going to be just what I need. I just need to stay on the propecia. I'm thinking another 1000-1500. I don't know that 2500 is in the cards, given my next four years living on student loans, and then resident's salary after that. Any thoughts? Link to comment Share on other sites More sharing options...
Dr. Timothy Carman Posted July 11, 2008 Share Posted July 11, 2008 Definitely. From a surgical point of view, you don't really want to limit your session size(s) based on $$ considerations. It would be best to wait until you can afford to "do it right", so to speak, from a surgical risk/benefit point of view. Additionally, by following that plan it would actually be less money in the long run. Timothy Carman, MD ABHRS President, (ABHRS) ABHRS Board of Directors La Jolla Hair Restoration Medical Center Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 11, 2008 Author Regular Member Share Posted July 11, 2008 Gotcha. But does "doing it right" necessarily mean another 2500? Do you think another 1500 would be half-assing it? That would be 3K all in this area. Link to comment Share on other sites More sharing options...
Dr. Timothy Carman Posted July 11, 2008 Share Posted July 11, 2008 Well, I don't want to go so far as saying "half-assing it", but realize that native hair density is 100 FU/cm2, and IMHO it doesn't appear that 2500 (assuming 60 cm2) is too far off the mark. And again, the concept I want to get across is that, ultimately, surgical considerations specific/pertinent to this procedure should dictate the size of the case, not your budget. Timothy Carman, MD ABHRS President, (ABHRS) ABHRS Board of Directors La Jolla Hair Restoration Medical Center Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 11, 2008 Author Regular Member Share Posted July 11, 2008 The area we're looking at is not quite that big. I'd say 40-50 cm2. Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 16, 2008 Author Regular Member Share Posted July 16, 2008 So a little update on this... I talked to the doc yesterday, and he wants me to wait and see how this comes in before we decide what to do next, and that I might be surprised by how it looks. I also did an online consultation with Dr. Cole in Atlanta, who said he'd be willing to do about 1000-1500 on me. But apparently, he is booked up way into the future. So, in short, I will probably wait and see how this comes in before I make a decision on where to go next. I have probably shed about 1/5 of the hairs so far (2 weeks post-op), so I'm just waiting now for the rest of this shit to fall out, and then for it to start coming back in. Link to comment Share on other sites More sharing options...
Senior Member dakota3 Posted July 17, 2008 Senior Member Share Posted July 17, 2008 but realize that native hair density is 100 FU/cm2 Dr. Carmen, I was under the impression that you only need 1/2 of your "safe zone" density to achieve an appearence of good density??? Is this not true? Link to comment Share on other sites More sharing options...
Dr. Timothy Carman Posted July 18, 2008 Share Posted July 18, 2008 Dakota- In general that is a "true" statement, however in my experience most patients perceive their "density requirement" as requiring "more" than that 1/2 figure- It all hinges on the subjective assessment of "good density". As an example, if you look at the last case I posted: http://www.hairrestorationnetwork.com/eve/showthread.php?t=152740 This gentleman had a density of about 1/2 his "safe-zone" density in his transplanted areas after his first procedure (see one year results), and it did look great by his and our assessment, yet he still wanted additional density not possible in a one procedure pass. So, you see a lot of our "rules of thumb" are just that- guidelines that help speak to the general picture, but, in the end, we are dealing with the "human subjective element", and there can be quite a bit of variation between patients as to what they subjectively assess as "good density". Good question. Does that help? Timothy Carman, MD ABHRS President, (ABHRS) ABHRS Board of Directors La Jolla Hair Restoration Medical Center Link to comment Share on other sites More sharing options...
Regular Member Marko Ramius Posted July 18, 2008 Author Regular Member Share Posted July 18, 2008 Thanks for all the info, Dr. Carman. I saw on your website that you started your career in the ER. I am strongly considering going that route myself, although I reserve the right to change my mind as much as I want during med school. I think the use of minoxidil in the last week has really sped up the shedding process. I've got maybe 1/3 of the little bastards left. Just waiting... Link to comment Share on other sites More sharing options...
Senior Member Speegs Posted May 11, 2009 Senior Member Share Posted May 11, 2009 Your hairline looks realistic, he really lowered that bad boy aggressively. maybe a little too aggressively, can't tell by these pics. It seems to me the 1500 would've gone further with a slightly more mature hairline, perhaps a smidge more forehead. Can't really judge until i see you at 6 months and beyond. I'm looking at Mcgrath, your pics would be most helpful. Hair loss patient and transplant veteran. Once a Norwood 3A. Received 2,700 grafts with coalition doctor on 8/13/2010 Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011 Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016 Link to comment Share on other sites More sharing options...
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