What doctors in the Northeast dont shave your head?

[mrkneed]

What doctors in the Northeast dont shave your head (donor area) prior to surgery?

[mrkneed]

What doctors in the Northeast dont shave your head (donor area) prior to surgery?

[djdennis]

Dr. Jeff Epstein out of Miami/ NYC

[MrJobi]

Dr. True. I didnt shave my head for any of the 3 I have had

[Dr. William Lindsey]

Shaving has always been a largely un-talked about issue, so it's good to see it come up here.

 

When I began performing hair transplants we rarely cut hair because the grafts were large compared to today's follicular units. Back then, the recipient slits were likewise large and spread rather far apart making it easy to work between the hair. As we continually refined our procedures we found that making smaller grafts actually made it easier to place between uncut hairs and everyone was happy...for a while.

 

Then we reached a point where we found dense packing large amounts of finely cut grafts was the way to go-the modern ultra-refined method. Once this happened, we realized that the uncut hair was becoming a problem and was actually preventing us from uniformly packing the most amount of grafts into a recipient area in the shortest period of time.

 

When we only performed 1000 or so grafts in a day, time was not such an issue so we were free to work between uncut hair. But when we moved up to 1500 and above, we realized we could no longer ignore the clock. No clinic or doctor would argue that the faster the grafts are returned to the body, the better.

 

Uncut hair is a major impediment to recipient site creation and planting. No matter how good a crew is, they will always perform FAR better when the recipient area is free of obstruction. It only takes a few drops of blood or irrigation fluid between a few long hairs to cause a "matting effect" and blind the technicians who are attempting insert grafts as quickly as possible. No clinic who does not cut hair in the recipient area is free of this problem.

 

Here are the undeniable problems when working with uncut hair:

1. The surgical field is filthy because nothing holds on to dirt and bacteria laden oils like human hair. This increases the potential for infection. This is why even when we perform surgery on parts of the body with minimal hair that we shave the skin. If you take a hair and place it in a culture medium, it will grow a community of bacteria in hours. That's how potent a single human hair is.

2. The surgical field is obscured by the presence of hair over incision sites that are less than a millimeter long making it very difficult to implant the new grafts.

3. The surgery time is ALWAYS lengthened, thereby unnecessarily risking lower yields for the overall surgery by leaving the grafts out of the body longer than is absolutely necessary. This applies double to megasessions.

4. Bleeding is increased on the surface of the skin, as well as clot formation, which further obscures the field.

5. Bleeding beneath the skin is increased causing unnecessary osmotic and pressure changes that can harm grafts.

6. Trauma to these existing hairs is increased when working between them because their angle of exit from the skin is not clear, increasing the risk of transaction and then boil formation from ingrown hairs (foreign body reaction). This is also a component of the dreaded "shockloss".

7. More fluid must be injected into the recipient area to control bleeding which may affect overall yields

 

All in all, there is absolutely no benefit to not cutting hair. It is a practice that may make patients happy initially at consultation because who wants to shave their hair and endure the stares and questions of friends, family, and co-workers? But in the end it is, for the most part, the wrong move.

 

Sure, surgery can be performed quite successfully without shaving the hair. But in almost all cases the number of grafts per surgery will be less and the number of procedures required will be more.

 

In my opinion, the best philosophy is to pack as many grafts as possible in as few procedures as possible. Anything that runs against this premise is not optimal for the transplant or the patient.

 

Dr. Lindsey, RESTON, VA

[MrJobi]

Dr.Lindsey gives some great points however, it is important to point out you can get an exceptional result without shaving as I did.

 

Dr. True did not shave me due to my request. Yes, my hair was a little short but I wanted to be able to hide the surgeries and did so..

 

No doubt it makes it easier for the doctor but there are other doctors who claim it is not a major obstacle as well. Also, I had 3 procedures as well. Then again my laxity and finances were the decided factor in my case ( plus keep things hidden)..

 

All in all I would shave if I could have ( no sense in making it more challenging) but my results are as good as anyone on here so that speaks for iteself

[Jeffrey Epstein MD, FACS]

I respect Dr. Lindsey's opinion, however I have a different perspective. We do not require any of our patients to shave the hair in the recipient area, for a few important reasons: first, it makes it difficult to resume regular activities for the first few weeks after the procedure, and second, during the course of the procedure I find the presence of the existing hairs allows me to more accurately determine the relative thinness of different areas of the scalp. Yes, it may take as much as an additional 90 to 120 minutes longer to perform a procedure of 2500-plus grafts when the hair is present, but this extra time put in is a small price for the advantages of leaving the hair alone.

 

Sincerely,

Jeffrey Epstein, MD, FACS

www.foundhair.com

[MrJobi]

And we thank you Dr. Epstein (and Dr. True)for it !! No way I could go back to work looking like a pin cushion!

 

Again, this is another area where there is no exact answer..

 

As I always say, hair transplantation is not a cookie cutter process ( if it is you will look like it)

[Dewayne]

Originally posted by mrkneed:

What doctors in the Northeast dont shave your head (donor area) prior to surgery?

 

Dr. Cooley doesn't require shaving. I would like to shave my down as I would think it better for sure, but the downside for me is of course the goofy-ass looks. I can't afford to slip out of sight for a month while it grows back.

 

Heck, I'm still trying to get over taking three days off as it is.

[Dr. William Lindsey]

I respect Dr. Epstein's comments on recipient are shaving as noted above, however, in our hands this just does not work for achieving a true dense-pack.

 

First, we currently use CUSTOM MADE 0.7mm blades to create recipient sites. While the difference in size of 0.7mm blades to 1.1mm(what I used to use-and thought were small!) may seem minimal, in fact that difference allows for a significant increase in packing density. But, quite frankly, the slits are harder to see. We place with magnifyers and the "forest" of surrounding un-shaven head would cast shadows that would limit OUR ability to place in these very small and densely packed slits. I say this from experience as I place around 60% of all grafts at this time! From time to time, I do go back into longer hair (at the back end of the transplant site as we are finishing up) and I can't find the slits for the hairs (or see the trees for the forest as it is).

 

Second, even when I used to use larger blades (1.1mm), we had significantly more problems with the existing hairs getting matted to the recipient sites and much more inadvertent extraction of just placed grafts. I have tried savs, lotions, potions, and rubber bands to keep surrounding hair out of my surgical field and it just doesn't work well enough for us.

 

Finally, if properly advised, most patients can plan on the recipient site shaving and compensate by: a-combing over nearby hair, b-wearing a loose fitting hat, c-just telling people what happened(we have been surprised at how this infact generates additional referrals about 6 months after the patients procedure as friends are impressed), or d-getting a close haircut about 10days out from the procedure to mask the descrepancy in the hair-ful and hair-less areas.

 

So, while not cutting the hair may work for some high quality physicians such as Dr. Epstein (who I know slightly from our both being fellows of the American Academy of Facial Plastic and Reconstructive Surgery); it just doesn't work for us. And we offer our patients what works for us in order to consistently achieve a True DENSE PACK result.

 

William H Lindsey MD FACS RESTON VA

[flyby]

Mr. Jobi, I was curious as to whether or not you had shaved your recipient area as I've heard your results are excellent. I guess I have my answer now.

 

Due to work requirements and my desire to keep my HT private I also was in a situation where shaving the recipient was not an option. Dr. Alexander assured me that the results would not be inferior because of not shaving. It would be interesting to see comparison results of shaved vs. not shaved. I respect the fact that each doctor has their own varying points of view and they should perform their procedures with the methods that best suit them.

 

I do not believe that the coalition Dr's who do perform HT's without shaving would risk jepordizing their reputations if they could not achieve excellent results.

 

I did take some exception to another thread where Dr. Lindsey gave an anology that performing an HT without shaving would be like reading a paper through a clear plastic plate with spaghetti sauce all over it and agreed with Bevrotti that it would be like doing the HT in the dark. That would insinuate that my results with Dr. Alexander will be inferior. I'm only 3 months out so I can't give or show any qualified results but as Mr. Jobi and others have confirmed his results are as good as any. I can confirm that my healing process was very fast and I had virtually no shock loss.

 

Excluding Mega sessions (3000 +), I think the "to shave" or "not to shave" question is something that each doctor must address individually and let the results speak for themselves. If doctors that do perform HT's without shaving consistely have inferior results to those that do then I think this would become clear. As of yet I have seen no evidence confirming this.

 

Definitely no disrespect to Dr. Lindsey and his views! Just my thoughts about this topic.

[Dr. William Lindsey]

Defintely no disrespect intended to either Dr. Epstein or others. And, I know Dr. Alexander and feel that he does high quality work.

 

If you read my posting, I emphasized that this is what works for us. I have tried it without shaving and my staff and I can't do as good of a job. People pay me to do the best that I can, and that requires shaving at this time.

 

But, there are ways to conceal this in many cases, and for our patients, the pay back is worth it.

 

Dr. Lindsey RESTON VA

[KulMD]

The best shaving explanation I have read was written by Dr. Hasson last year:

 

http://www.regrowhair.com/hair-transplant-surgery/hair-transplant-shaving/

[MORE_HAIR]

Hey guys.

 

Maybe I'm one of those that's a believer that shaving is over-rated because my doc doesn't shave (Dr.Epstein)...so my view could possibly be slanted.

 

I just feel that the Docs that do the big jobs are usually the docs that shave.

They have to shave to do 4000+ graph jobs on a daily basis.

 

The last thing i am is a Doctor... and have great respect for ALL the Docs involved.

But common sense tells ya...The docs that's are known and make there living doing the monster jobs of course are going to live by the "have to shave" rule.

A huge job without shaving would take 16 hours.

 

Not only does my Doc have an awesome reputation and so far has made me very happy...but Dr.Shapiro is also one of the great ones.

Both of these Docs don't shave.

 

Happy growing to all

 

MH

[Bill - Seemiller]

Great discussion.

 

I think if anything, the varying opinions on the issue show that patients have options. Some elite physicians require shaving and others do not. There are certainly reasons for and against shaving.

 

Thank you Dr. Epstein and Dr. Lindsey for your contributions and insight into this controversial topic.

 

Bill

[La La Land Hair]

Due to my line of work I do not have the option to shave. The HT must be undetectable as soon as possible after surgery. I'm out of work until it is undetectable.

 

SO, with this in mind and the fact that I'm fine with flying anywhere in North America. What are my best options as far as doctors go? (Blogs with photos would be great if you've got them.)

 

I'm impressed with Dr. Shapiro and now Dr. Epstein also seems to be an option. (I did notice however that a few of Dr. Shapiro's patients had shaved recipient areas.)

 

Thanks to all of you...

[blowdry]

You also have the redness issue, especially if your transplant is the front third. My redness lasted months. fyi