Regular Member Dr. William Lindsey Posted June 19, 2012 Regular Member Share Posted June 19, 2012 Ok fellows. I know from experience on here that many of you guys pull no punches. So I'm putting up a little quiz case. How many grafts does it take to do a hairline? That is a common topic on various websites and its got several variables including: Hair shaft density Color match Size of the planned hairline Slit placement Singles vs doubles Curly vs straight hair Overall balding pattern But most folks don't include all of that in their question. They just want to know how many grafts make a hairline and some want a thick hairline and others are concerned about too thick of a hairline and it looking un-natural. So evaluate this set of pictures please. We are starting with the final result and working backwards. I'll provide info on the case at an upcoming post over the next few days. Lastly, I never claim to be a photographer....and a couple of these pics were taken by Wendy or Chi Chi due to logistics. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member RCWest Posted June 19, 2012 Senior Member Share Posted June 19, 2012 This is going to be fun! You come up with some great topics. Finasteride 1.25 mg. daily Avodart 0.5 mg. daily Spironolactone 50 mg twice daily 5 mg. oral Minoxidil twice daily Biotin 1000 mcg daily Multi Vitamin daily Damn, with all the stuff you put in your hair are you like a negative NW1? Link to comment Share on other sites More sharing options...
Senior Member haircut Posted June 19, 2012 Senior Member Share Posted June 19, 2012 These photos are just of the temple corners. Perhaps I am reading this wrong. Is this case already complete. Hairlines are so individual that it is almost impossible to predict. Everyone is different. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 19, 2012 Author Regular Member Share Posted June 19, 2012 No you are reading it correctly. This is a view of a hairline that Wendy took at my office yesterday while I was operating. I will put up "earlier" pictures soon to give additional info. I simply look forward to hearing comments on this mature--grown out hairline. Thanks Dr. L William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member haircut Posted June 19, 2012 Senior Member Share Posted June 19, 2012 I love this hairline! I have been wrestling with this same topic. I have had a little more loss in my temple corners over the last two years. I am told that my donar area only has between 800 and 1500 grafts left. I want to go conservative. This hairline is beautiful! Link to comment Share on other sites More sharing options...
Senior Member orlhair1 Posted June 19, 2012 Senior Member Share Posted June 19, 2012 I think it looks really nice and natural. While I think it is natural to some degree for those involved in the forum and for those who have surgery to become obsessed with every detail of a hairline, no one in public would notice even half of what tends to get noticed by members of the forum. To me, the key is how natural it looks, which by my untrained eyes in looking at results has nothing to do with how dense it is packed or how many grafts were used. I have seen absolutely fantastic results with a conservative amount of grafts used compared to the area covered that look every bit as good as some of the more aggressive use of grafts. Very interested to see how the thread develops. Surgery - Dr. Ron Shapiro FUT 6/14/11 - 3048 grafts Surgery - Dr. Ron Shapiro FUE 1/28/13 & 1/29/13 - 1513 grafts http://www.hairrestorationnetwork.com/orlhair1 Link to comment Share on other sites More sharing options...
Senior Member aaron1234 Posted June 19, 2012 Senior Member Share Posted June 19, 2012 Looks as natural as one could hope for. A more dense hairline may be nice but too much of a good thing can become an unnatural thing. Dr. G: 1,000 grafts (FUT) 2008 Dr. Paul Shapiro: 2,348 grafts (FUT) 2009 ~ 1,999 grafts (FUT) 2011 ~ 300 grafts (Scar Reduction) 2013 Dr. Konior: 771 grafts (FUT) 2015 ~ 558 grafts (FUT) 2017 ~ 1,124 grafts (FUE) 2020 My Hair Transplant Journey with Shapiro Medical Group Link to comment Share on other sites More sharing options...
Senior Member Shampoo Posted June 20, 2012 Senior Member Share Posted June 20, 2012 Looks great to me. Looks natural, falls right, kind of feathered. Most of us would die for a hairline like that. The patient must be smiling. Excellent work Dr. Lindsey. Dr. Dow Stough - 1000 Grafts - 1996 Dr. Jerry Wong - 4352 Grafts - August 2012 Dr. Jerry Wong - 2708 Grafts - May 2016 Remember a hair transplant turns back the clock, but it doesn't stop the clock. Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted June 20, 2012 Senior Member Share Posted June 20, 2012 759 grafts. I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Senior Member Davis91 Posted June 20, 2012 Senior Member Share Posted June 20, 2012 Love the topic but isn't it hard to tell the area covered? It would be good to see a more high up view with the comb demarcating the area. Anyway, I'll take a stab and say between 1200-1500 grafts to cover an area on either side of the frontal tuft or partly in front as well, maybe 35 CM2 total in all give or take some. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 20, 2012 Author Regular Member Share Posted June 20, 2012 Ok, Here are pictures of the same guy on May 13, a month and 4 days earlier than the original pics in the start of the thread. Sorry I only have 2 pics that are available from that day. There are other pics I'll add but they give away a part of the story I'm not telling you at present...but I will. RCW, how did you pick 759? Do you play the lottery? I'm not saying you hit it, but I was intrigued by your precise guess. William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted June 20, 2012 Senior Member Share Posted June 20, 2012 Ok, Here are pictures of the same guy on May 13, a month and 4 days earlier than the original pics in the start of the thread. Sorry I only have 2 pics that are available from that day. There are other pics I'll add but they give away a part of the story I'm not telling you at present...but I will. RCW, how did you pick 759? Do you play the lottery? I'm not saying you hit it, but I was intrigued by your precise guess. Dr. L, That was my guess. I miss typed 750 with 759, noticed it, and liked the precision of the guess, so I left it. I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 21, 2012 Author Regular Member Share Posted June 21, 2012 Ok now here is a picture from above on May 13 and the second picture is April 14. Not alot of change. William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member haircut Posted June 21, 2012 Senior Member Share Posted June 21, 2012 You are making this difficult. I can't tell the native hair from the transplant. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 21, 2012 Author Regular Member Share Posted June 21, 2012 I agree. Part of it is that I want speculation, part is the limited number of pictures that I have on this character. The last pics that I'll post...meaning the first pics I took...will answer it all. Thanks William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member Davis91 Posted June 21, 2012 Senior Member Share Posted June 21, 2012 Maaaaybe the pics reveal work extending a little further back than orginally viewed in the first photos. Thicker hair it seems. Conservative approach. More grants in front as normal. Now I'll say 1,525 grafts. Link to comment Share on other sites More sharing options...
Senior Member Davis91 Posted June 21, 2012 Senior Member Share Posted June 21, 2012 "Grafts" in front vs. "Grants." Sorry. If we guess it can we get a "grant" for a HT with you? Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 22, 2012 Author Regular Member Share Posted June 22, 2012 Here is April 5, just a week and a half before those pics above. Final pictures to be posted next Tuesday along with discussion of issue. Have a nice weekend. William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member haircut Posted June 22, 2012 Senior Member Share Posted June 22, 2012 That is some amazing transformation in one and a half weeks. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 26, 2012 Author Regular Member Share Posted June 26, 2012 Ok, here is the initial picture taken March 30. And the second picture here I had Chi Chi put a box around the "frontal triangles" and count the hairs she saw. Its a strikingly small amount of hairs. Now a few questions that come to my mind are: Looking at the final result hairline pics (that I posted first last week)... A- are there a bunch of resting follicles you don't see in these pictures that contributed to growth? B- does this guy's fairly wirey hair that pretty decently matches his skin, let him get away with so few hairs along the edges? C- are these all just crappy pictures and this whole thing is a waste of time? D- Or, with proper patient selection and hair characteristics...can you "get away with" not dense packing the hairline? Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member haircut Posted June 26, 2012 Senior Member Share Posted June 26, 2012 Wow. That is amazing. Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted June 26, 2012 Senior Member Share Posted June 26, 2012 So was he transplanted? I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 26, 2012 Author Regular Member Share Posted June 26, 2012 That is a decent question. All answered tomorrow. Dr. L William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Regular Member Dr. William Lindsey Posted June 27, 2012 Author Regular Member Share Posted June 27, 2012 Ok, so the answer is that this is a natural, non-transplanted, receding hairline in a guy with tan skin and fairly wirely, curly hair that has a decent color match of the skin and hair. The head in the pictures is my own head. Pictures were taken on the dates noted when I started letting my hair (shaved for the past year or so while my daughter was having chemotherapy) grow again. The girls in the office had commented that my hairline was looking pretty thin and I agreed. Likely a combination of stress and MPB. So we figured it would be interesting to see what kind of hairline would result from growing out a pretty sparse hairline. Initially, we could all count the few hairs along the edges of the frontal triangles and indeed it was May before it started to look like I would have a hairline at all. But, the texture of my limited hairs and the pretty good color match with my dark skin all added up to a decent hairline. That would not have been the case if I had really light skin and/or fine straight hair. We do a lot of frontal triangle cases, and it became a point of discussion with potential patients as we discussed dense packing the hairline. For example, how much is enough? In April, patients would look at my head and say "I need alot more at the hairline that you have doc" and I'd agree. Of course we pack the hairline with 5 rows of singles and behind that are rows of doubles. But as May and June appeared, and my hairline looked better, guys would frequently say either they wanted a hairline similar to mine (if they were in their 40s) or maybe just a little thicker and lower (if they were younger). And we'd talk about numbers during the case just for something to talk about. So in conclusion, I still believe in packing the hairline in everyone. In the ideal hair/skin/texture/curliness matching patient, you could "probably" get by with fewer hairs if supplies were really limited, in revision cases for example, but it would require letting the somewhat less densely packed hairline patient to keep their hair a little longer and perhaps a little less styled. Thanks for the input you guys gave in this thread. Dr. Lindsey McLean VA William H. Lindsey, MD, FACS McLean, VA Dr. William Lindsey is a member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
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