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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.

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IMG_0204.jpg

 

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.

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YES, you most definately require another session(depending on goal) - The density looks VERY low IMHO.

 

Who was your doc??- Any pre op pics?

 

This area should have been address appropriately with a 2500+ session IMO - How many grafts did you receive there - 1200-1300??

 

Potentially poor use of donor supply..

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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.

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I have never heard of this doc mate to be honest - I think you will need a lot more density in all honesty mate - It all depends on YOUR goal BUT from the work shown here it appears thin IMHO. - Hope i am wrong but it does depend on YOUR goal and what YOU want to achieve but that number of grafts over that area regardless of hair characteristics this result is going to look thin (Maybe its the high power zoom..) - Hopefully other forum members will give you their honest opinion.

 

The hairline is the most vital part of the HT and its essential that it is performed at the appropriate density to aid the illusion - Hairlines are normally planted at a higher density with the density tapering lower towards the back. -

 

post on hairline importance -

The Importance of the Hairline

 

The frontal hairline is singularly the most important feature of the entire head of hair. It is the aspect of our hair/skin interface that we, and others, see first. When we look in a mirror, or walk into a room, when someone sees us and makes eye contact for the first time, the hairline stands out. On a subconscious level, beyond the rational, it speaks volumes about our age, attractiveness, suitability as a mate, even about our health and vitality.

 

Why is the hairline of such significance? It frames the face. This simple statement belies the artistic and cosmetic impact of this all-important frontal zone. One of the reasons that many men with frontal balding instinctively go for the "comb-over" effect, is that it creates a hairline of sorts; it frames the face at the top and at the temples. The problem is that it is so patently obvious to everyone else as an attempt to disguise the balding.

 

Framing of the face is an artistic metaphor. Imagine a painting without a frame. It may be a pleasing image, but it is incomplete. Add a nice, tasteful frame and voila! You have a complete, aesthetically appropriate presentation. Similarly, frontal hairline balding takes away the frame; restoring the hairline restores the frame. The resulting appearance is one of youth, vigor and vitality.

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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...

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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.

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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

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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.

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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

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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

Chairman, Ethics Committee (ABHRS)
ABHRS Board of Directors

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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.

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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.

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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.

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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.

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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

Chairman, Ethics Committee (ABHRS)
ABHRS Board of Directors

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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?

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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

Chairman, Ethics Committee (ABHRS)
ABHRS Board of Directors

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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.

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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

Chairman, Ethics Committee (ABHRS)
ABHRS Board of Directors

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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.

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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?

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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

Chairman, Ethics Committee (ABHRS)
ABHRS Board of Directors

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