Dr. Ron Shapiro - "MERCER" Result from Surgery #1 & 2

[Janna]

Dr. Ron's patient who goes by the sn "Mercer" created two albums on HTN to share his experience and progress. We've compiled photos taken at SMG and add surgery info below. He's scheduled for a 3'rd procedure later this month. I'm sure he'd be happy to answer any questions.......

 

 

 

[aaron1234]

Fantastic presentation and gotta dig the layout! The before, immediate post-op, after photos really do Mercer's HT journey true justice. I'm really impressed with what the 2nd surgery did for him density wise. Once again fantastic work Dr. Ron.

[hairthere]

Nice, natural result. I think it was wise to keep the hairline conservative. Does he intend to fill in the crown with a 3rd procedure?

[orlhair1]

Really looks good especially with the extent of his hair loss pre surgery. I am sure he is already happy and with his third procedure he will make even more gains......very nice.

[Blake Bloxham]

Janna,

 

Excellent presentation! Thank you for sharing this case with the community.

[Spanker]

I think this is not really a WOW result for 2 reasons.

 

1. How conservative his hairline is

2. He appears to have a very fine caliber hair

 

And just because it is not a wow result IMO, it is a very good one. It is nice to see the difference that a second pass can make as well.

[orangehair]

Janna.....another nice result from Dr. Ron.....thank you for the detailed presentation as well.....this is a more challenging case than may appear because of the fine nature of his hair and potential hair loss pattern - and i suspect there was a little give and take between native and transplanted hair....well designed and realistic outcome....seems like he could benefit from Propecia in the crown if he isn't using it already

[kathie47]

Nice results! Like Hairthere asked, what's going to be the focus of the third procedure? Will it be to fill in the crown more?

[Janna]

Spanker’s comment illustrates an important point I’d like to address -

 

Because this patient is in his 30’s and upon examination, he has fine caliber hairs, low donor density, and the very real possibility of further hair loss progression. He fit in the category of “conservative” approach. The lower you go with the hairline, more potential for trouble. A lower hairline would increase the area by a power of 2 because area is pi r square. A cm lowering of the hairline increases the area significantly and uses up quite a bit of donor. With fine hair this could have created a much thinner, more see through look then concentrating things more centrally. It would be hard to fix this if his donor area turned out to be inadequate…But if he turned out to have more the upper limit of what is hoped for the hairline can be lowered. Although the chances of this happening are not real high…maybe 10 %.....that is still one in 10 and if he happens to be the one that got in trouble for him it is 100 percent a problem. So when we have patients who don’t have the best donor ( fine hair, tight scalps, lower density and potential for type 7 due to younger in ages) we opt for a slightly more conservative initial approach. Then there’s the option or ability to get more aggressive later if we are pleasantly surprised with his donor supply. This does not mean a more aggressive approach would not work in 8 out of 10 patients, we just don’t like to take the chance with the other two.

But spanker is right, it is more conservative for all these reasons and we feel this is correct and safe approach for this patient. This patient had the same concerns and specifically asked, “what happens if I progress”.? He may let you know himself that we were all in agreement on the approach and plan of action.

Thanks Orangehair for your input. You are correct in the addressing the challenges for a great outcome. He is on Fin and Rogaine Foam.

 

The 3rd surgery will address the crown and temple corners.

 

Thanks everyone for your comments!!!

[Mercer]

Janna, thank you so much for taking the time to post my results. I really appreciate the fantastic presentation and everyone's feedback has been great to read. As Janna said I'm indeed on Propecia but I only started using it after my 2nd procedure. I do intend to stay on it and haven't had any sides. I'm looking forward to my 3rd procedure with Dr Ron Shapiro on 22 Aug and I'm super excited!

[TakingThePlunge]

Janna,

 

Thank you for your detailed presentation and explanation of this case.

 

Mercer

 

Congratulations! You've come a long way. Best of luck with HT3!

[Spanker]

Janna,

 

Great write up. In no way was I putting this off on the doc, I could see the less than optimal points he had to work with and I assumed that Mercer was on board with the hairline approach.

 

I could be wrong but if it is any comfort to Mercer, I do not see, even without surgery, him being a NW7. Having that much hair in his 30's is way better than in his 20's...while we all advance, I did not see his being that bad, especially being on fin (but I am no expert). Much more that his level of loss was the caliber of his hair and possible donor density.

 

 

Mercer, your hair looks great and you picked a great clinic.

[Janna]

Hey Mercer,

 

Glad you like the new layout for posting our patient's results. Credit goes to our new staff member for putting it together. Our original plan was to convert our results into slide show videos for youtube and Shapiro Medical facebook account. Feel free to check out our facebook to see your presentation in a video format http://www.facebook.com/pages/Shapiro-Medical-Group/323838379464 or click the youtube video below.

 

Spanker,

We didn't take any offense at your comments. It's good to point out limitations and challenges for each patient and it's important to address those issues regularly. Often times, everyone expects a "wow" result when it's just not possible. All things considered, we are pleased with his outcome. Mercer, being in his early 30's, agreed with a cautious approach. It's very difficult to know where he'll end up on the NW scale. As he said, he didnt' start Propecia till after his 2nd surgery. I think had he started Propecia before 1st surgery, his result after one year would have looked better.

 

Thanks David, glad you like the new layout too!

 

 

Edited August 9, 2011 by Janna