Opinions needed

[SlowlyThinning@59]

4th pic

[SlowlyThinning@59]

4th pic

[Jotronic]

Well, let's start with some questions before opinions. What would you say your NW pattern is? How old are you? Are you taking meds to stop your loss. Have you had a procedure before?

 

Opinion? Good donor hair. It appears to be quite full which might indicate high density although the texture (see below) may lend itself to making the density appear higher than reality. I see salt & pepper hair, coarse texture and a slight wave. Good characteristics for good coverage. That's it. No idea what else to tell you other than that. Can you share some more photos and what it is exactly that you would like opinions on?

[SlowlyThinning@59]

Jotronic,

Thanks for your reply. I am about a NW 3, am 59 years old and am presently on .05mg propecia. Dr. Limmer said I have very good and plentiful donor hair so that shouldn't be a problem. I just wanted your imput if I should split the 3000 grafts evenly between the frontal and crown. I'll post more pics when I get the chance to get my wife to take the pics. No, I've never had a HT before. Thanks, John

[MrJobi]

Hi

You are in a great situations ST59 , many of us would kill for your situation due to your advanced age, low degree hair loss, and donor area..

 

Your result should be very good

[SlowlyThinning@59]

Thanks for all the imput guys, I really appreciate it. My surgery dates are July 2nd and 3rd, two sessions. I will keep you all posted. John

[NervousNelly]

Slowly,

Please see my response on the other thread that you started.

 

My question to you is why 2 days for only 3000 fu? Seems strange for a modest session size by todays standards. Oh well, results are what count and Dr. Limmer is known for good work.

 

NN

[Guest]

Slowly, what is the reason Dr. Limmer gave you for this approach of 3000 grafts in 2 sessions?

 

I believe there is more of risk concerning the strip/scar with 2 consecutive surgeries.

 

Who wants to go back after the first day's surgery for another? Not if you can help it!

 

With only 3000 grafts this is routinely accomplished in 1 session unleess there is an underlying condition that prevents it.

 

I think it would be prudent to get this question answered before proceeding with the surgery.

[SlowlyThinning@59]

Don't really know, I just know it's a 2 day session. I believe they do 1000-1500 grafts in one session and takes 6-8 hours. I thought about that myself and don't know how I will feel the day after the 1st session going in for a 2nd one. Maybe it's because doing 3000 in one session will tramatize the area more? Guess I will find out. Thanks, John

[Bill - Seemiller]

I believe there is more of risk concerning the strip/scar with 2 consecutive surgeries.

 

I agree with this statement. What is the doctor's reasoning for this?

 

Since strip is pretty invasive, doing two strips back to back seems overly traumatic IMO.

 

I'd like to hear doctor's opinions on this...but I am very uncomfortable with it.

 

Bill

[Jotronic]

Breaking up a strip procedure into two days is something I've heard of before. While I cannot speak about this situation with first hand knowledge I do know that some clinics will do this when they simply don't have the man power to get the job done in one day. This is why it is important for clinics to invest in more technicians and training so that the procedure can be done in one day.

 

Usually, the doctor will take a strip from one side of the scalp then the other half on day two. One end of each strip will meet the other in the back of the scalp thus resulting in one scar. I thought this was getting to be more and more rare but I guess not.

[Gorpy]

Joe, let's clarify something - Dr. Keene does this. In her case it has nothing to do with lack of man power. It has to do with her high standard of demanding that she do most of the work including placing the grafts. I know that the general consensus is that techs place the grafts, but we have already had discussions on this.

 

Having said that, she can easily do 3000 grafts in one day. So it is a bit puzzling why Dr. Limmer's clinic breaks this doable amount of grafts up into two sessions - especially considering Pat's recent visit where it was revealed that the techs both make incisions and place grafts. Are the techs a bit slow at making the incisions?

 

BTW - this post was edited in an effort to become the "kinder gentler" Gorpy

[MrJobi]

Hi

 

hmmm. 3000 in 2 days? Sur eit is not FUE?

 

I have never heard of it either but if Dr. Keen has done it then atleast we know it is a viable option .

[Guest]

Yes Dr. Keene does do the consecutive day mega session.

MEGA being the key word here. She will do 5000+

in a two day megasession.

Dr. Limmer has proposed only 3,000 in two

sessions.

 

I know my scalp was very tender, even as the surgery progressed it became more sensitive to the numbing needles.

 

I mean it is a fairly brutal day in the chair for 8 hours, but to go back the next day to do it all over again??? For only 3,000 grafts???

 

Someone needs to rethink this logic...

[Bill - Seemiller]

I actually just posted about this on another thread.

 

What Joe posted was as I suspected....taking from one half of the head than the other.

 

I'd like to hear an explanation from Dr. Keene as to why she does this, and really any other clinic (such as Limmer), etc.

 

Other than lack of manpower, I see no benefit. In fact, I wonder if there is any extra trauma to the donor area as there has to be some overlapping from the previous days scar.

 

Of course, if we are talking about FUE here, that is a completely different ball game.

 

Bill

[Guest]

How do you manage 0.05mg propecia? I mean how do you get such a small tab strength?

[SlowlyThinning@59]

Dr. Limmer gave me the 1mg tabs which I cut in half with a pill cutter. John

[SlowlyThinning@59]

Sorry, should be .5 instead of .05, my mistake. John

[Gorpy]

Bill, I thought I just gave a pretty good explanation above. It allows Dr. Keene to continue her hands on approach. She feels strongly about it and so do many of her patients. That's the benefit. I know we have had discussions of the techs doing much of the work, but that's it in a nutshell. We could debate all day on whether her hands on approach is worth it, but I don't think it would lead to anything useful.

 

Read all about it at her website here.

[Guest]

We could debate all day on whether her hands on approach is worth it, but I don't think it would lead to anything useful.

 

I think your hairline is proof that her approach is worth it gorpy.

[Bill - Seemiller]

Gorpy,

 

I understand what you are saying...

 

I just personally don't feel it's beneficial for the patient...but that's my opinion.

 

Where is the proof that the doctor placing the grafts yields better results? This is not a direct question to Gorpy...but to anyone who can provide such proof.

 

Putting a patient through 2 days of surgery, adminstering the anesthetic twice, cutting the donor area open twice, etc. doesn't seem to be beneficial to me when there is no proof that a more "hands on" approach by the doctor adds benefit.

 

I personally feel that overworking oneself could have adverse effects on performance and results.

 

I suppose I can't help but think of other types of careers and what lack of delegation implies.

 

In an office environment, when management fails to delegate tasks to their employees, it creates all kinds of problems. Some of them include:

 

1. The manager is overworked and overstressed - putting in many extra hours creating fatigue

2. Employees don't feel trusted and as a result don't perform optimally.

3. Employees aren't ever trained thoroughly because the manager does too much and has no time to train employees.

4. Typically creates a distance between management and employees, lack of communication, with can create a negative working environment.

 

Now I'm not accusing Dr. Keene of this...only making some generalizations that may or may not apply.

 

Anyway...just some food for thought.

 

Bill

[Gorpy]

Interesting points Bill, but let's face it, this is not your average office job. It's artistic, creative work. I understand how you feel, just as others understand how the good doctor feels. Let's just say, it's nice to have choices when choosing a doctor. They are not all clones of each other. They each offer something special and unique.

 

And besides, how would you ever prove something so subjective? Let's just take it for what it is - another option, another approach.

 

Gorp

 

Thanks Folica.

[Bill - Seemiller]

Gorpy,

 

Agreed...

 

Options are good...I have no problem with that.

 

My only concern about it is...could this be creating more trauma to the donor area? Since one side of the donor is already going to be traumatized, could this create more trauma when taking out the other half, especially as the doctor gets closer to the half already taken out? I assume there won't be any overlapping since the one side is already stitched up. How close will the doctor get to the existing scar? Will the scar connect? If not, the patient would lose some grafts.

 

Anyway...these are just some thoughts and obviously it depends on HOW this is done.

 

Bill

[Gorpy]

Good question, but is there really more trauma than taking out the strip in a one day session? After all, the strip is taken out in sections, is it not? When you traumatize the area by taking out one section, do you not go in next to it to cut out the next section? Same thing, just different day.

 

I think what you are getting at is that somehow there would be more shockloss or healing would be somehow impaired.

 

I suppose Dr. Keene would know more about that from looking at her own results.

[Guest]

I don't agree with the 2 day surgery but I do like the doctors hands on aproach.

 

Can I prove it is a superior approach?

Well, Like said in my last post, Gorpys hairline is one of the most natural I have seen.

 

One might argue that Gorpy's own characteristics are the reason for his natural hairline.

 

I'm not so sure he would have the same results with a different doctor, I guess we will never know...