Unusual Situation - post flap surgeries

[Hairtoday54]

I am 53 years old, and I am writing for the first time.

I have undergone two flap surgeries- and am very satisfied. Dr. Toby Mayer performed mine in 1997 and 1998. I must say that, had the state of hair restoration been then what it is now, I might have opted for another program. Still, I obtained results that no one I knew then, and few now, can match for density.

 

My situation now, is this: when Dr. Mayer performed my surgery, he felt my scalp was too tight to do proper reductions between and behind the flaps, to eliminate remaining baldness, so he abutted them together. However, I was able to cover quite easily the remaining baldness. It has progressed considerably since then, and unfortunately I did not find out about propecia until a lot more hair had fallen out.

 

So, now I find myself wishing to find a viable, and optimal solution. I read about Dr. Frechet's reduction technique and eponymous device to achieve AR. I have seen many of his patients' results, and am VERY impressed! As an alternative, I have heard many good things about a number of doctors who perform FUE, CIT, etc. The thing is, I wish to have maximal results - not just thin coverage. I am not sure I could harvest enough hair to give me the coverage and density I desire (perhaps I could; I am not positive at this point).

 

So, I am asking you, do you know of anyone state-side who can perform with great expertise Dr. Frechet's reduction method? The only person I have heard recommended is Dr. Mark DiStefano in the Massachusetts. He apparently studied under Frechet (as did Dr. Robert True, from what I understand).I have consulted over the phone with him, and he is very likable. When I had my flap surgeries, I underwent TWO expansion procedures - do NOT really want to do that again! That is a big reason Frechet's technique is intriguing.

 

Now, I have contacted Dr. Mayer, and he feels he can perform a scalp reduction followed by FUE. However, unless he does something similar to Frechet's procedure, I am afraid of stretch back.

 

What are your thoughts?

 

So, as a final question, is there ANYTHING on the near horizon that I should hold out for, before I engage in ANY other kind of procedure?

[Blake Bloxham]

Hair,

 

While I believe Dr. Frechet's scalp expansion and subsequent reduction method was fairly advanced for the time (he invented it in 1991), I do not think it is routinely performed any longer. Frankly, aside from instances where plastic surgeons are trying to fix a deformity in the skull, I'm not sure any sort of scalp tissue expansion with reduction is performed any longer.

 

Here's a piece about the Frechet expansion procedure written by Dr. Sheldon Kabaker. You'll note, the first thing he mentions is that the procedure really isn't performed any longer, and that he's writing about it for historical reference.

 

Today, androgenic alopecia is treated exclusively (surgically) with Follicular Unit Hair Transplantation. This can be achieved either through the Follicular Unit Transplantation (FUT) method - where a strip of scalp is removed from the back of the head, dissected (under microscopes) into individual follicular units (units of natural hair growth pattern), and implanted into recipient sites made with needles or small blades in the balding areas of scalp - or via the Follicular Unit Extraction (FUE) method - where individual follicular units are removed from the back of the scalp with small punch tools, and subsequently implanted into recipient sites in the balding scalp.

 

This is the procedure I would investigate. What's more, I would also take a look at our recommended hair transplant surgeons who perform state-of-the-art surgical hair restoration every day! If you have any further questions, feel free to ask.

 

Good luck!

[Hairtoday54]

Thank you for your response, Blake. Do you believe that the FUE/FUT techniques can achieve the same density and coverage, though, that the Frechet technique can achieve (may I assume you have seen photos of his work?)?

 

I am not opposed to FUE/FUT - I just want to get the best and biggest "bang" for my bucks...

[greatjob]

I would not recommend you to undergo any more flap or reduction/expansion procedures, they are pretty outdated procedures now. There are a lot of surgeons recommended here who have experience in repair work. Dr Lindsey is currently working on a three step repair on a guy with a failed flap procedure located here:

 

http://www.hairrestorationnetwork.com/eve/170224-dr-lindsey-stage-2-3-step-procedure-repair-failed-flap-surgery.html

 

You might want to consider posting up some pics in this thread ( you can block out your face) so that the members and doctors on the board can give you more informed recommendations.

[Hairtoday54]

I will look at posting some photos, if I can block out my face. However, please know that I am NOT hoping to "repair" my flaps - I was - and am - VERY happy with the results. I simply want to "fix" the baldness that developed behind them. THANKS for your ( and anyone else's) replies to my post!

[Blake Bloxham]

Hair,

 

I think FUE/FUT will give you just as much "bang for your buck." What's more, I really don't know if there is anyone in the states practicing scalp reduction in this manner.

[Hairtoday54]

Blake - Dr. Mark DiStefano performs the Frechet technique - having studied under Dr. Frechet himself.

[Blake Bloxham]

Hair,

 

While I'm not overly familiar with Dr. DiStefano's work, I still believe Follicular Unit Hair Transplantation is the current gold standard of hair restoration surgery. After reviewing Dr. DiStefano's site though, you are correct: it seems like he is the only physician in the US practicing the expansion and flap procedure.

 

Have you considered consulting with any other physicians and asking their input on the expansion/flap versus hair transplantation? This might be a good next step.

[StaggerLee123]

I would call Dr. Lindsey as he is currently working on a case of vaguely similiar nature. The only time I have ever heard of people discussing their reduction, expansion, and flap type procedures has been in the context of the "bad old days" of hair restoration and being repaired out of desperation. Top clinics do not do these type of surgeries anymore. I think you are very lucky to be satisfied with what you had done and I would look into getting grafts implanted in your thinning areas and would not tempt fate with another flap type procedure.

[Hairtoday54]

Blake - I have in fact scheduled appointments with some prominent surgeons - including at least one recommended by this forum.

 

I wonder if I have been clear, however, about my concerns...It seems a number of people on these blogs are champions of the latest FUT/CIT type procedures, in part because of reduced, minimal or nonexistent scarring - which I totally understand. However, please know that in my situation, I am not concerned about some scarring, simply because, due to my previous procedures, I already have scarring to the extent that I am never going to be able to wear my hair short - certainly no shorter than about an inch.

 

So, with that in mind, would my fellow bloggers still think a scalp extension is a bad idea? Again, as long as it is safe, I am not worried about scarring. If it is a concern about scalp viability (necrosis), or something like that, then of course I would be worried. MY desire is simply to get the most density (or best appearance of density) and coverage possible, for a fair price.

 

BTW, I hope to prepare some photos this weekend that I might post, showing my results. I am not sure I have any of me, or closeups, going back during or before my procedures - they were 16 years ago....

 

THANKS again to all who provide their opinions and input!

[Bobilero]

That Mayer and Fleming are creeps in my opinion and should not be allowed practice their flap procedure or medicine. Ive seen them respond on hair transplant blogs online where people where asking for geniune advice on yield after having a HT . They reply bad mouting FUT / FUE yields and start asking the poster to 'why not try our flap at a fraction of the cost'. WTF. Downright Disgusting behaviour in my book.

 

That is an awful barbaric procedure in which people can look like a train wreck 10 years down the line. Successful cases are the exception and definitly not the rule.

[james84]

Wow....flap procedures:eek:

 

Glad you are happy with the results tho.

[Hairtoday54]

Okay, I am going to try to post some photos...these are all post flap procedures, recent (last year or less). My surgeries were 16 years ago. I am fine with my hairline (although may soften it up sometime) - would be interested in what Bobilero, James84, and others who obviously disdain the flap surgeries think...I will also try to upload some photos of the crown and back, where I have lost hair, and which I hope to fill in..

 

Okay, not having luck uploading the crown and back; will work on that a bit later. Hope these post! Not sure I know what I am doing!!

[1978matt]

As far as flap results go yours is up there with the best I've seen.

 

I've not had my HT yet but would recommend you contact Dr Konior. (He used to do flaps in the early days)

[wylie]

Congratulations, you beat the odds. I'm not sure I've ever heard of anyone being happy with their result. Looks like you gambled and won, the equivalent of hitting the Powerball.

 

Most flap surgeries don't end up like yours.

[greatjob]

Like others have said you are probably the only flap/reduction/expansion patient I have ever seen with good results. However I could never in good conscious recommend you to undergo another one of those procedures. If you want to take care of your crown I would highly recommend you consult with the surgeons recommended here. if you tell us where you are located we can recommend some great docs in your area or not too far from you.

[Hairtoday54]

Greatjob - I live in Kentucky. But for the best results, I do not mind traveling...

[Hairtoday54]

I was able to post photos of my crown, in another thread; I shall attempt the same here. As you can see, I have a fairly large area. One advantage of the flaps is that I have enough density to provide good cover up!

 

Will FUE/FUT still be able to give me the coverage I desire?

[Blake Bloxham]

Hair,

 

Are you looking to restore the entire bald area shown in the above images?

[Sparky]

those pictures are all blurry and don't show anything!

[Hairtoday54]

Yes Blake, that would be the ideal outcome (which is why Dr. Frechet intrigued me). If not possible, then obviously as much as possible.

[1978matt]

Yes Blake, that would be the ideal outcome (which is why Dr. Frechet intrigued me). If not possible, then obviously as much as possible.

 

I don't think you will get anything more efficient than an FUT session, preferably 4000 grafts +.

 

The advantage is that you can take some hair and potentially spread it over an area 4x the original.

 

No idea if that's feasible though, what with your flap scars etc..

[Hairtoday54]

A local doctor said he felt he could probably get 1500 grafts with FUT - he doesn't do FUE. But he said I could then harvest other areas - including my flaps - with FUE...