Dr Rahal Patient - 3241 Grafts - 12 Months Post-op

[mattj]

This patient received a total of 3241 grafts to rebuild his hairline. He has just sent us photos he took himself to show his result after one year.

 

Graft breakdown:

Singles: 779

Doubles: 1786

Triples: 662

Quads: 14

 

 

 

 

 

Edited April 28, 2011 by mattj

[HARIRI]

WOW... From completley hairless areas aound the hairline to hairy dense ones. Amazing how the hairline was lowered with superb density. Great work Doc. Dr. Rahal indeed is the master of hairlines. Wish for more posted resultes Matt...

[RCWest]

Dr. Rahal is the Leonardo Da Vinci of hairlines! So natural!

[Superfinehair]

Absolutely flawless!

 

What type of hair does this patient have? Medium/Coarse?

[TC17]

There's no disputing the quality of this work, but this seems like a lot of grafts on a young patient. I just hope he doesn't have much in the way of future loss.

[Spanker]

This is one of the better results I have seen.

[Sean]

very impressive!

[Shadow of the EMpire State]

How old is the patient?

[mattj]

The patient is 26 years old. He has responded well to medication.

[RCWest]

I've never seen such density in one pass. At what fu/cm2 are the grafts distributed?

[MusoInOz]

I love this result!

 

Given it took a fair number of grafts to achieve the result it is stunning!

 

If my results are anywhere near this I will indeed poo my pants.

 

:eek:

[TC17]

That's a lot of grafts, and a pretty dramatic lowering of the hairline for such a young patient.

[Shadow of the EMpire State]

That's a lot of grafts, and a pretty dramatic lowering of the hairline for such a young patient.

Your point is well taken. In fact, 26 tends to be a critical juncture in determining just how bad the loss might become.

 

Would you be more comfortable with the procedure had it been done on someone, say, 35?

[eddiemunster]

TC17 - I think its somewhat inaccurate to call this a "lowering of the hairline." based on the pre-op drawings, it doesn't appear that Dr. Rahal brought the hairline any lower than where the frontal tuff already began. Rather, he brought down the temporal recession to be in line with the frontal tuff. that's a big difference, IMO. I'd appreciate hearing from Dr. Rahal's office on that. In any event, it's an outstanding result, especially for one pass.

[Anouar]

There was a similar case posted by H&W that put 3328 graft in the hairline put appears the patient had less recession than Rahal's patient. I'm not sure of the patient’s age but I find it ironic that nobody commented on the aggressiveness in the amount of grafts placed in that area. Maybe its perception, where H&W are perceived to be more conservative and Rahal more aggressive. But from both cases, I would be leery of placing substantial grafts in case of further loss. From an aesthetic standpoint, both are great results no doubt.

Edited May 4, 2011 by Anouar

[Jotronic]

This absolutely is hairline lowering and it is done very well. The central tuft was only slightly dropped as evidenced from the pre-op design but this is only a small part of the hairline. The rest of the hairline was dropped quite a bit.

 

As Anouar said, the case I posted for 3328 grafts is indeed quite similar to this case but it is not identical. Both patients were 26 when the procedure was performed. This case is 12 months post-op whereas ours is 4 years. The design that Dr. Hasson created had less temple closure. Both cases are excellent however.

[HARIRI]

I agree 100% with Anouar. That makes a lot of sense. Being conservative should also be in the way removing strips from the donor area carefully and not in danger way that can cause infection etc... because of long linear scar above the ear.

 

Hope for more Rahal results to be posted. Good job.

[TC17]

Shadow, I suppose if this patient was 35 I would feel differently, but, the fact is that this patient wasn't 35, he was 26. To me, it was reckless and improper to plant a juvenile hairline on a 26 year old patient who is experiencing MPB. I don't care what this patient's goals were, what his family history shows, or how well he is currently responding to medication, doctors should not do what Dr. Rahal did here.

 

A doctor has the obligation to step step in and say NO to a patient when the patient wants something that is not in their best interests. We cannot simply subscribe to the belief that patients are adults and are capable of making adult decisions and absolve doctors of all responsibility for the decision to perform an aggressive surgery. I'm all for personal responsibility, but assuming that patients suffering from MPB are capable of fully understanding the technical limitations of surgery and emotionally divested enough from the impact of MPB to make rational decisions is not a fair assumption. I'm not saying that Dr. Rahal is unethical or that he doesn't turn patients away if they want something that is bad for them, but I do not believe that anyone can reasonably argue that using 3,241 grafts to lower the hairline and close in the temples on a 26 year old patient is appropriate.

 

As for this patient's family history, I really don't care about it because it's not conclusive about anything for this patient. We haven't yet heard about this patient's family history, but I'll go out on a limb here and say that he has nothing worse than a NW4, maybe a NW5 in his lineage. Also, I'll venture a guess and say that this patient has good donor density and scalp laxity. I say those things because I would find it even more shocking if this patient had a family history of NW6's and 7's, or average to below average characteristics.

 

There is no disputing that Dr. Rahal is one of the most talented hair transplant doctors in the world, but that doesn't mean he is above criticism. Based upon this and other results I've seen of Dr. Rahal's, I believe he uses too many grafts, and is too aggressive in instances where caution is warranted.

[ffar]

If the patient famili history about hair loss ist just NW2\3 I don't see any problem.

[mattj]

Dr Rahal spoke in depth with the patient about his goals and found him accepting of the possible future density compromises that would need to be made over rearward areas of the scalp if his hairloss should exceed his very favourable hereditary indications. He felt that all things considered, the surgery plan was appropriate in this case.

 

Often the decision to perform surgery involves a delicate balance of factors and Dr Rahal doesn't take them lightly. He often has to tell patients to ease back on their wishes a bit, or to tell them that they aren't a good candidate for surgery at all.

 

 

 

The patient had an area of 52cm/2 and the plan was to use 2900 grafts. Due to high donor density the actual number harvested was 3241 grafts, and of course they were all planted. The resulting recipient density averaged at approximately 60 grafts per square centimetre.

[corvettester]

First off, outstanding result!

 

It appears to me that he didn’t lower the hairline so much as he squared out the temples, which makes it look like the entire hairline has been significantly lowered. It seems like he didn’t want to have the typical deep, indented temples—I prefer this as well. I’m ultimately going for the same thing as I dislike even a minor widow’s peak.

 

As for this being too many grafts, I disagree. I really don’t see what all the fuss is about. If he has a normal donor density, let’s say 8,000 grafts, then he still has plenty left over if his pattern develops further. I often see NW5s getting 4,500 graft FUT… and that is including the hairline and temples!

 

So what’s the big deal? In the unlikely event that he progresses to a NW6, he’ll still have enough to cover most of his head, though perhaps a little light in the crown… but is this really likely to happen to this guy? I bet the odds are in his favor.

 

I think it makes sense to opt for density in the hairline and temples and then shoot for the illusion of density in the rest, should it be needed. So I think it’s acceptable and even prudent to be aggressive with the hairline and temples…

 

In fact, if I decide to go back for a second pass, it will put me on the same level as this patient. I already did 1,700 FUT in my hairline and temples at approximately 35 FU/cm2 which covered approximately 50/cm2. If I want to get up to his level of density, then I’ll need another 1,700 grafts FUT.

 

I had at least 8,000 in my donor before my first HT, so that will leave me with at least another 4,700 grafts if I go back for another 1,700 for density in my hairline and temples. Is that really something I should be worried about? Is that really hair greed?

 

Again, I think this looks great! If this is wrong, then I don't want to be right!

 

 

Corvettester

Edited May 5, 2011 by corvettester