Dr Rahal Patient - 2084 Grafts - 7 Months

[mattj]

Dr Rahal restored this patient's temples and hairline with 2084 grafts via the strip method

 

Age 27.

 

The 2084 grafts contained:

 

379 singles

 

1227 doubles

 

478 triples

 

The after photos were taken at 7 months by the patient himself at home. We hope to soon have some better ones which will do the result justice.

 

 

[JayWalker]

Thats one of the best results I have ever seen.

 

Great work!!!!!

[NEWHAIRPLEASE]

Justice?? Ha ....thats funny mattj....those results are excellent!!!!!.....

[Cant decide]

Nice result.

 

Matt - I have said this before and I will say it again, Dr. Rahal is outstanding and one of the best hands down. He changed my life so I know firsthand. However, it would be great to see different types of results posted by the clinic on here other than NW 2 and 3 patients packing in 2-3000 grafts in the front. These cases are also great to see as well but I know I would love to see more crown results, front/mid restorations, 8000+ grafts complete restorations, NW4, 5, and 6 patients, etc (Stellar is a great example).

Edited February 19, 2012 by Cant decide

[orlhair1]

Nice result.

 

Matt - I have said this before and I will say it again, Dr. Rahal is outstanding and one of the best hands down. He changed my life so I know firsthand. However, it would be great to see different types of results posted by the clinic on here other than NW 2 and 3 patients packing in 2-3000 grafts in the front. These cases are also great to see as well but I know I would love to see more crown results, front/mid restorations, 8000+ grafts complete restorations, NW4, 5, and 6 patients, etc (Stellar is a great example).

 

Agree that this is a really nice result. It would also be nice to see the before pics without the hair pulled back. I like the ones with it pulled back as it shows the planned surgery, but it doesn't really show what his hair looked like when he wore it normal before the HT. Adding that dimension to the presentations for Dr. Rahal would be great.

[ffar]

Wow. JUST WOW. It is just 2k graphs!! Rahal used somtimes 2 times more in simular area.

[ManinSpace]

I absolutely love this look on this guy and its obviously a fantastic turnaround for such a small amount of grafts as well, Dr Rahal is undoubtedly a very proficient surgeon, but can someone explain to me please why this is not going to look silly when the patient reaches say, 50, 60 maybe even 90 years old? Im not having a pop or anything, I am just ignorant and I genuinely dont understand how this can age well.

[NEWHAIRPLEASE]

I absolutely love this look on this guy and its obviously a fantastic turnaround for such a small amount of grafts as well, Dr Rahal is undoubtedly a very proficient surgeon, but can someone explain to me please why this is not going to look silly when the patient reaches say, 50, 60 maybe even 90 years old? Im not having a pop or anything, I am just ignorant and I genuinely dont understand how this can age well.

 

Preventative meds!!! There is no guarantee this patient won't have to have a surgery again somewhere down the line, that just comes with the territory. But, this hairline won't look silly ever!!! Not at 50,60,90, or 120. The work is excellent. It will NEVER look bad!!

[Cant decide]

A couple of comments stated that the amount of grafts used was "only" 2000. That is actually a ton of grafts for the size area covered and most likely he was able to get 65-70 per sq cm at least which is considered very high dense packing.

[orlhair1]

A couple of comments stated that the amount of grafts used was "only" 2000. That is actually a ton of grafts for the size area covered and most likely he was able to get 65-70 per sq cm at least which is considered very high dense packing.

 

Agree.

[chrisdav]

Great work.

[Travis1]

This is beautiful. Will all patients experience the same results in terms of dense packing performed by Dr. Rahal?

[ManinSpace]

Preventative meds!!! There is no guarantee this patient won't have to have a surgery again somewhere down the line, that just comes with the territory. But, this hairline won't look silly ever!!! Not at 50,60,90, or 120. The work is excellent. It will NEVER look bad!!

 

Thank you for answering newhair but ideally im after some discussion thats not just based on opinion, though i do appreciate your input. Im curious to know how anyone can know how its going to look considering how relatively brief history of transplants of this efficiency are. It is simply unknown as we havent seen young men with dense packed hair in the front grow out to that age yet and thus i always feel that a natural conservative approach is better.

 

There are so many variables, this man may diffuse, not now, but in 30 years time, causing density discrepencies, obviously the threat of further loss etc but its not just simply that which concerns me. There is also the simple fact that you dont even see many 16 year olds with hairlines like that, and thus, I feel whilst looking spectacular, it is already unnatural looking and if its like that now, how unnatural is an 80 year old going to look with a thick NW1? Even if I was 80 i still wouldnt put an NW1 on my head, it wouldnt be age appropriate.

 

Like I said Im not looking to stir up nothing, I am just genuinely curious about the matter. I am not as knowledgeable as many here so that is why I am asking.

[Travis1]

Hi Maninspace, thanks for bringing it up, can anyone direct me on the forum thread on risks of HT? Many apologies if this looks like a wetblanket topic. I would like to keep myself informed too.

 

Travis.

[Cant decide]

MiS - I do not think this hairline is as low as it may appear. Therefore, when he ages, iit should not look strange. Most likely Dr Rahal determined based on his family history, etc that he would not lose much more hair and whatever he thinks he will lose can be filled in with his remaining donor. Meds may also be working well for him.

[lcsulla]

Just curious but what's the density per cm2?

[ManinSpace]

Travis- you just need to have a long look through and educate yourself, there are many pros and cons but if you want to fast track why not start a thread on that topic and people will gladly help you out

 

Cant decide- thanks for addressing my question. I still believe the hairline is a little unnatural in so much as mens hairlines beyond their childhood are generally not so linear, if i saw this man in the street i would suspect a HT because it is so perfect, Im not sure if perfection is a criticism, but I am certainly a little wary of it.

 

Something that I dont understand is that Armarni was crucified for packing grafts into the front, Im not sure how when Dr Rahal does it, it is more ethical? This is not an attack, it is simply not clear to me how it is different, I would actually quite appreciate someone like Matt J to address my question if he finds the time.

 

The reason i am so forceful in asking is that having spoken to a few drs and clinicians and I get wildly varying opinions about what is good procedure. Why do other doctors recommend a much more cautious approach? For instance, I have much less recession than this patient, yet I was assertively warned by a world leading surgeon not to change my hairline to this degree. I suspect were i to consult with Rahal he would be able to achieve this look for me, thus there seems to be a procedural distinction. My point becomes, why do some Drs such as Rahal see lateral hairlines and lowering into bald areas, increasing the surface area that a finite donor must cover practical and and some other world leading surgeons do not? I genuinely dont understand the differing modus operandi amongst such well regarded Drs and I would love to see the logic explicated.

 

The truth is, if i could see it rationalised i would consider it myself, who wouldnt want elvis hair like this gentlemen if it is practical in the long term?!!

Edited February 20, 2012 by ManinSpace

[Capelli11]

ManinSpace: Every patient is different...in that we each want different things regarding our hair and how we want it to look...some go conservative while others go more aggressive. There are also some doctors who are conservative and others who are a little more aggressive...I can tell you from my personal experience with Dr. Rahal that he is not aggressive as we spoke for a long time regarding my hairline and what could be expected. I was the one who was pretty aggressive at first and he told me he wouldn't go below a certain point because I probably will experience further loss and it will be wiser to go less aggressive. He didn't force any specific hairline on me as it is pretty much the patients first pass at it and then the doctor dictates whether it is achievable and/or feasible considering other factors such as family history, meds and how much further hairloss one could expect. I personally love my new hairline design as i literally designed it to my liking and Dr. Rahal indicated that it is feasible considering my loss and we made sure that I had plenty in the bank to fill in any other areas that would need addressing in the future. I personally think my hairline design is perfect...but that is also my opinion...some may think otherwise just like I have opinions of other patients hairlines...everyone is different with what they want and/or what is feasible for their personal situation. There are soooo many different factors that there is really not one magical answer to give to you regarding your question...not every patient is created equal...there is no template. Dr. Rahal has different plans/objectives with each patient...there is def a method to his approach.

 

My opinion regarding dense packing and my hairline being conceived as potentially aggressive is I want to enjoy my hair and life TODAY...not in 10...20...30 years...I have spent enough time losing sleep and precious years worrying and being insecure about my hair that I am done with that...so why not enjoy a great head of hair (also practical) now so that I can get my life back and lose my insecurity. I will probably need another procedure at a minimum when the time comes but I'll cross that bridge when I come to it hopefully many many yrs from now. I refused to go conservative and still not be 100% happy now worrying that when I am an old wrinkled man in my 50's that my head isn't fully covered because I was too afraid to put some more grafts in my hairline and miss out on all the fun I would have had with a great head of hair at 30. I loved Rahal's hairlines that is why I chose him vs. other doctors who were more conservative and/or I didn't agree with their hairline placement.

 

I think with your question you may need to continue to research HT's and you will be able to see what I am talking about as I have learned all of this from my experience on this site for years and speaking with many great HT surgeons.

[ManinSpace]

Once again, thanks for your input but your response was anecotal evidence and your own personal biases. Whilst your opinion is appreciated, these are not what im looking for. Im after a medical vindication of the approach taken here on this patient being in the the long term interests of the patient vs a conservative approach.

 

For me, it is precisely your argument that you want to enjoy hair today and not worry etc that concerns me. Say for example in 20 years time significant dangers are found with long term finesteride use, if a dense packed forehead is being supported by a drug that was to cease to be in circulation, all of a sudden aggresive hair restoration would start to look an inadvisable practice. Now I know this is unlikely, but the recall of a drug is certainly not without historical precedent. With this in mind it is simply my belief that ones donor must be used with extreme caution. In that context, I am asking sincerely if there is any evidence that the approach on this patient and others like him is viable in the long term both medically and aesthetically? Hopefully you can see how your post did not answer my questions. Thanks again.

[HARIRI]

Omg !!!

[Capelli11]

There is no perfect answer to your question that is what I was getting at...unless you have a crystal ball and can determine exactly how much someone is going to lose in the future and if you can do that you shouldn't be worrying about that and you should be buying a lottery ticket instead! There are many "what if's" in HT's...that is what makes getting one more risky in that you could lose a lot more in the future. The goal is to try to create a reasonable plan with your surgeon that makes sense given your family history, hair type, amount of current and future loss you will have and hope that it works out that way. That is how every patient goes about getting a HT...we also take into account that say FIN will wear off after a certain period worse case scenario...I don't want to make my "aggressive" stance seem like I and Dr. Rahal were careless in placing a ton of grafts for no reason...that is not true. When I say "aggressive" I meant I wasn't afraid to put a few extra grafts to beef up my hairline so that I can enjoy it while I was still young but also have enough in the bank for future loss which is exactly what I have done. I could have been a lot more conservative but that just didn't suite me...will I pay for it one day...hey who knows...that's life...you have to take risks sometimes and jump in fully...otherwise you will live your life conservative and never go all out. In conclusion it is up to YOU and YOUR DOCTOR to decide what approach...if you stay on this forum to find an answer to your question you won't have to worry about being too aggressive with your HT and the potential side effects bc you will be 95 years old and wouldn't have to worry about it anymore!

 

Have you consulted with any doctors and posed your question to them?

[ManinSpace]

I could have been a lot more conservative but that just didn't suite me...will I pay for it one day...hey who knows...that's life...

 

 

Thanks again for your input Capelli, but this is the exact opposite of how a medical procedure should work. For me, it is simply not a good enough argument to say ill worry about it tommorow so long as its good today. Obviously, its fine for a patient to think that way, this is normal, but a Dr has a duty of care and thus should be doing all he can to prevent problems down the line. Im not saying Dr Rahal doesnt, I have no idea of how he is planning to manage this patient or yourself. Im simply asking, how does he plan for the future when especially in cases like yours, he has designed a very low hairline and total temple closure using up 4500 grafts in just the frontal section when you already have extensive hair loss? Its all well and good to say ive left enough in the bank, but have you? You were already suffering a pretty extensive amount of loss, you now have A NW1 hairline so you have used up thousands of grafts largely packing totally bald areas of your head over half of it is now gone and you have a vast surface area remaining to cover with your remaining donor, how will that work down the line if your crown goes which it appears it may well considering how much loss youhave already experienced?. I think it is reasonable to ask for an answer that isnt simply, hope for the best. If that genuinely is the best answer Im going to get then i will simply go away from this discussion and let everyone get on with admiring the work. However Im hoping someone will be able to provide a better argument than that which you present. I dont mean this with any malice and i appreciate your trying to address my point.

 

I have consulted with two Drs, neither recommended this level of procedure and one categorically stated it was not in a patients long term interests to close the temples. I have much less recession than this patient too. Im a 28 NW2 with thinning in small areas to the sides of the hairline, density of 80FU/cm medium hair charecterstics. I would be an ideal candidate for this procedure and like you, i have been tempted. However the reason i persist asking the same questions is that i havent recieved a satisfactory answer. The Drs I have spoken to and also various clinicians on the forums who suggest a conservative approach make a considered and convincing case for their approach. All im asking is that Drs who are more aggresively inclined also provide their case. If the best answer is pack it in the front and wait and see, then obviously i have my answer, but i actually believe that its a little more considered than that, at least, i sincerely hope it is.

[chrisdav]

It is a valid question Maninspace.

[RichFrog]

Matt work looks fantastic

 

Have you got any pictures just after the op showing the recipient area placement?

 

Thanks

[Capelli11]

If you have done enough research I feel you will be able to realize as I noted in my prior posts that YOU the PATIENT and the DR have to decide what is best for your personal situation…if you go to a doctor and you don’t like his hairline design and/or philosophy then you simple walk away and go with a doctor whom you like better...which is what everyone who has had a HT has done. As I also said earlier, myself and Dr. Rahal worked out a very feasible plan for my HT and any future loss I may have. I had a large area covered (approx. 90 cm) which is quite large and my graft count is appropriate for such a large area. Dr. Rahal told me what was reasonable and what he would not do based in part because I may lose additional hair down the line which is exactly what you state a doctor should do in “prevent problems down the line and “duty of care”…so I’m not sure why you may think he didn’t exercise these characteristics. In addition we did not lower my hairline…all we did was fill in my lost temple corners and behind it and also increased my temple points. My hairline is actually higher than I would ideally like it but again Dr. Rahal and I exercised caution and care in not “lowering” the hairline. He told me what he was comfortable in doing and wouldn’t recommend nor do anything lower than what we did. If you look at my pictures you can easily see that we continued from where the middle of my fading hairline was and went across from that on each side. I am NOT a NW1 although I appreciate the wonderful compliment you have thrown me…I wish this was true…a NW1 is Brad Pitt and I am no Brad Pitt…my hairline is appropriate for all ages 30+. To also say I have “extensive hairloss” is being a little aggressive yourself in that I am a NW 3 and anyone will tell you that is not deemed to be “extensive”. In regards to using up 4,500 grafts…that is what I needed to use up to get the desired result I was looking for and if my crown goes as it may one day I will have plenty left to cover it as Dr. Rahal has indicated that I have enough based on his professional opinion and also that I have dense hair in my donor region. You should not pass judgment on any doctor let alone Dr. Rahal until you have consulted with him and got to know what his philosophy truly is which I have described in small detail above. Your question that you keep posing should be posed to him and he will easily answer you as everyone who has ever had a consult has asked that question before…so you are not the first nor will you be the last!

You have only consulted with 2 dr’s? I have consulted with every major doctor in the world and they literally all had different opinions on how many grafts I should receive. It was up to me to decide which one I thought could give me the result I was personally looking for…I obviously took into account not going too aggressive in fear of potentially losing more in the future…if anyone went into a HT without thinking that they would be careless and clearly not educated enough. You say you are a NW2 with some thinning…first off lucky you lol…secondly you seem to be more conservative so I feel you should go with a doctor who you think has your vision for a conservative restoration…there are a lot of doctors on this forum that are deemed to be more conservative so that is your choice to proceed with them and stay away from other doctors whom you deem to be more aggressive as you do with this case in question.

Bottom line..I am CERTAIN Dr. Rahal based on his professional opinion concluded that this patient’s grafts were suitable based on the patients history and future hairloss patterns. Again, instead of posting on this forum anymore you should go to his website and make an online consult appt so that you can go directly to the source and ask him yourself but I will tell you it will be similar to what I have noted above. No 2 patients are alike even if they have the same NW…each can be a NW 3 but end up being very different NW patterns in say 10 or 20 years…no one can predict this future but they can predict as much as they can see based on a lot of criteria they have today…at the end of the day it is up to your doctor and also just as importantly you because you are the one who has to live with the results. It seems you are more conservative than me and that is fine you should get a conservative HT…me on the other hand didn’t care for an ultra conservative approach…as I had different visions of what I wanted and I found a doctor that shared my vision along with his professional opinion and visions and that to me was a match.

So I ask you to please consult with Dr. Rahal and come back to this post and let us all know what he in fact told you and you will clearly see he is a true professional with zero malice in dense packing just for the heck of it without factoring in future loss.