HT Repair

[BaltoBill]

I've seen numerous posts on here and other sites about HT Repair, and want to get the Board's opinion. I was unfortunately a patient of Dr. Weidig in Maryland in the early 90s, and my hairline has a pluggy appearance in the front, with not much behind -- the front, at least to me, looks pretty thick and unnatural). I am considering the following doctors: Wong, Shapiro, Feller and maybe Epstein. I haven't heard from Dr. Feller yet (I just sent him the info), and need to meet Drs. Wong and Shapiro in person, and I'm sure they are all top notch.

 

The question I have is that Dr. Wong's staff indicated that they would go around and between my front plugs, putting a little in front and filling it out behind so that it would blend in and look very natural (the largest plugs would be thinned). On the other hand, Dr. Shapiro's office recommended, based on the pictures, removing most of the plugs in front or thinning them out and then coming back later for more procedures to get the hairline the way I want it. Dr. Epstein said (like Wong) that he could achieve major improvement in the first session, but also said he would reduce or remove most of the plugs. I'm really looking forward to what Dr. Feller thinks. It seems that Dr. Shapiro's approach is more conservative than Dr. Wong's. I know I'd be in good hands with any of those guys, but between these four, who would you recommend? And what do you think of the three different strategies (in fairness, are just based on photos and I haven't spoken with the doctors yet) that have been proposed?

 

Thanks to all who reply. Bill

[Waterloo]

Bill:

 

As another option, I would investigate the possibility of removing all the plugs without further transplanting. You have a very large area to cover for a natural look, and failing to do this, you would have spent lots of money, devoted lots of time, and may perhaps expose yourself to a large ear to ear scar which couldn't be hidden with your fringe hair shorter. Since your plugs are spread out, it would make excision easier and more cosmetically acceptable because normal skin can be sutured to close the holes. When done correctly, small linear scars result, which in time, fade to a degree commensurate with your healing qualities. No more worry of wind, water, concealers etc. Doctors who seem to have credible results and experience in this type of repair include Bernstein, Beehner and Vogel. Dr. Bernstein is mentioned most prominently on this board and would most likely suggest 3 staged sessions, 8 weeks apart. This is to allow for relaxation of the scalp so a closure can be made with less tension, and, theoretically, a less obvious scar.

 

If you devote a few thousand grafts to fill between the plugs and you are still not happy with your look, the above option would probably be off the table.

 

This is just one man's opinion.

[BaltoBill]

I appreciate the suggestion and will look into it. My issue is that those pictures that I've seen of removal do not look natural -- but I haven't looked at Bernstein's and Vogel's (who is in Baltimore) websites -- I will check them out. By not natural, I mean the pictures I've seen show a little splotchiness or pitting.

[Waterloo]

With excision in skilled hands, the removel and suturing should eliminate the existing scar and pitting. Discoloration can be addressed using V-Beam laser, if it is an issue after a reasonable passage of time.

 

There are not many examples of excision only posted by physicians on this site. However, Jeff Van Gundy, former Knick basketball coach had a bad plug job for years and had them removed. Just put Van Gundy in a Google search. Zoom in on his picture with plugs and now bald, without plugs, both pictures are available....you decide which looks better.

[BaltoBill]

Thanks Waterloo -- do you know who did Van Gundy's work?

[Waterloo]

I do not...perhaps others can offer information about Van Gundy's surgeon. There is a guy who posted on this forum, ccexxp1, who had many plugs removed by Dr. Bernstein. He posted no pictures and had a subsequent transplant. He sounded very credible and was very positive with his results during the excision process, which would lead me to believe that removing his plugs was a marked improvement in his condition.

 

The process involves a 2-3mm biopsy punch. The plug is removed and the skin sutured together with 1 or 2 sutures. The key is space between the plugs, healling characteristic's and scalp laxity. Usually the older you are the more relaxed your scalp is. With the newer procedures involving thousand's of graphs, removel probably would be more problematic, if not impossible.

 

It would be great if other's opined here, including doctors, since there are many like Bill grappling with what alternatives are possible.

[Curious]

BaltoBill,

 

I would strongly suggest removing the plugs first, having the plugs dissected into follicular units and reimplanted. After the repair is made and healed sufficiently, then have a full blown transplant. I would only have the plugs removed and dissected by a doctor with a lot of experience in performing that procedure.

[Topcat611]

BaltoBill, you should really consider Dr. Bisanga he is a master at fue. You still look to have some very good scalp donor available and judging from you pictures you seem to have some robust body hair.

 

It might be better to fue some of those plugs out in the hailine and then plant in front to soften it up.

 

Take a look at my blog and the link to my pictures. My updates are also available on some of the other forums.

 

At the very least I would suggest an online or phone consultation. I have been around for a very long time and BHR is at the top of the list.

Edited September 24, 2010 by Topcat611

[new2thissite]

I had all plugs removed and was fine for several years. As hair started to thin more over the years, I went for the HT. Tough decision for you. Continue your careful research. Best of luck, BaltoBill.

 

For additional information and pictures, if interested, go to hair loss web site new2thissite.

Edited October 1, 2010 by new2thissite

[qwerty]

I went to Dr. Lindsey in McClean, VA (right outside DC). I had some minor work done in the 90s by MHR and had that pluggy appearance. Although there werent nearly as many as you have, he did build my hairline up just a bit infront of my previous HT....Im only a little over 4 months out and must say he does great work....if I ever need additional work done, Im definitely going back to him. Plus, he is very good when it comes to scarring too.....

[Waterloo]

I had all plugs removed and was fine for several years. As hair started to thin more over the years, I went for the HT. Tough decision for you. Continue your careful research. Best of luck, BaltoBill.

 

For additional information and pictures, if interested, go to hair loss web site new2thissite.

 

 

new2thissite:

 

Did you go for an additional HT because as your native hair thinned over the years, the scars from the excision sites were obvious, or were you adverse to being bald?

 

Would you be so kind as to provide the number of plugs you had removed and who did the removel? Were they mini's or 4mm old school plugs?

 

Thank you for your time.

 

Waterloo

[micmarj]

Dr Vogel has performed two transplants on me over the past two years. These were not for repair work but I got to Dr Vogel through a friend that had plugs originally done by the same doc you mentioned in a previous post. Dr Vogel did an amazing repair job on my friend and he looks totally natural and no longer has the plugs on his head. In fact my friend always used to wear golf and baseball hats but now never wears them. Dr Vogel is really good at repairing previous transplants from what I can see on my friend and other comments on this site as well. Also his staff is fantastic as is his office and operating area. They are very honest will tell you like it is! Good luck

[Time to do something]

There is one on your list who is NOT any longer a coalition doctor that I would NOT recommend. Go with Shapiro.

[j1j9j85]

personaly i would leave the plugs and fill in around them as handling hairs risks damaging them and removing them to replant them or removing them all together is just shooting your self in the foot so to speak if you want hair....

 

i think a good dr would get a nice look planting in and around the plugs quite dense and then getting a good hair cut when they are all grown out will look alot better and fuller. also if you stagger any left over grafts at the rear of the head it will help make the transplanted and non transplanted scalp look less defined ie gradual decrease in density as apposed to a direct stopping point on the head

Edited October 7, 2010 by j1j9j85

[BaltoBill]

Hi all,

 

After much research, I've decided to go with Dr. Jerry Cooley in Charlotte, NC. The plan is to do one procedure with plug reduction, FUT and use of ACell. There are so many people on this board who were helpful to me and the doctors I spoke with that I learned about on this forum were all incredibly helpful.

[Waterloo]

Good luck Bill...please keep us updated on your progress.

 

Waterloo

[orlhair1]

Dr. Cooley has an excellent reputation. ACell was used in my recent transplant as well. Best of luck with your procedure.

[haircut]

You will be in good hands with Dr. Cooley.

[TakingThePlunge]

Bill,

 

Great to hear! Congratulations on your choice. Please be sure to keep us updated as you embark on your hair restoration journey.

 

Best of luck!

[HARIRI]

If you want an excellent repair, go to Ron Shapiro, he is the best among the ones you mentioned. I never heard any bad feedback about him. I would go to him if i was in your shoes. You gotta see how he repaired that British patient (Bulletnut), was an amazing job.

 

However good luck with Dr. Cooley. Wish you a successful repair :-)

[BaltoBill]

Hariri,

 

Thanks for you comment on Dr. Shapiro -- I know you think very highly of him as do I. I consulted with his office and know he would do a great job for me. But for me, the fit or feeling is best with Dr. Cooley and I've seen great results/spoken with people who've had great repair results with him. Bill

[usedandabused]

there is one on your list who is not any longer a coalition doctor that i would not recommend. Go with shapiro.

 

i agree!