VIDEO-Dr. Feller with patient in actual consultation

[Dr. Alan Feller]

One of the most important, if not THE most important, topic during consultation is WHERE to put the hairline.

In this case we have a patient who visited me today who goes by the name "Questionable Hairline Guy".

He is 28 years old and has lost his hairline. The video covers my suggestions and his concerns.

Please comment on what YOU think should be done.

 

 

[Shampoo]

Dr. Feller this new video series is so valuable, especially for new guys that may be worried about going in to see a doctor just for a consult. This shows them how informal it is, more of just a dicussion betweem patient and doctor.

 

No pressure and very private in nature. Basically just discussing and educating about a possible game plan to one's self improvement.

 

As far as this patient. at his age I completely agree with a conservative approach because he is probably going to lose more hair.

 

Three questions to get some insight into this patient's possible future.

 

#1. Is this patient currently on meds?

 

#2. Does the patient have a family history of balding?

 

#3. What does the patient's crown look like? Any signs at all of thinning yet?

[tacolinowest]

Hey doc when I come in for month 3-6-9 we should make a video showing my growth for each month, well use my pre op pics and go from there

[TakingThePlunge]

Very interesting Dr. Feller! I would also like to know if this patient is on meds or plans to start. He's got quite a lot of hair at the moment.

[Misteroz]

Dr. Feller , Misteroz here (yeap still alive).

I think the patient is not looking down in time. As you said a lower hairline may make him happy but he is not facing the fact his loss is already about an inch back from his hairline. Your hairlines are extremely natural and using valuable donor hair to bring the hairline to a point that most likely he never had (we all seem to have this "memory" of a hairline that was one inch from our eyebrows). So thickening from back to front on lessening density fashion , seems to be the solution. You also have the temples filling process that will visually give him the lower hairline he wants by bringing the whole front hairline a more natural (and full) wrap around the face.

[chrisdav]

Loving the videos Dr.

 

I agree with Shampoo with the 3 additional questions.

[hairshopeing]

Great videos and great idea!! The guys got very good hair already, just goes to show how it affects people will very minor loss!!! I agree with the hair line placement and shape, I think he would be very happy with the outcome!! Keep the videos coming, very interesting!

[Cant decide]

I would LOVE to see one of these for a crown case!!!

[1978matt]

I thought you drew it in the perfect position Doc!

 

He has a nice vertical forehead, as opposed to a slopey one. Anything lower would look a bit odd.

[Spanker]

I think the Dr. Feller hairline is the was to go. I had almost the exact procedure. When it grew out it looks and feels more aggressive than it looked on surgery day.

 

I agree, I would want to know what the crown looked like, was there miniaturization in the frontal third besides the hairline and corners, and is the guy on meds.

 

To say he would likely lose all of the front seems to be a bold claim based on the video which doesn't show everything the Dr can see of course, so I wonder what other factors came into the assessment. It makes me wonder how much faith doctors have in meds as well. Does everyone that loses their hairlines and corners by 28 end up a nw4 or greater?

 

The important thing about hairlines is that you can always drop them later but you can't raise them.

[tacolinowest]

if your a norwood 3-4 in your 20s, deff expect norwood 6 by 40

[harryforreal]

What is "permanent shock loss"? In this case Dr. Feller doesn't think it's an issue - or in any cases, for that matter. Is it a real concern after a hair transplant? Why does the other doctor think it's an issue?

[Spanker]

if your a norwood 3-4 in your 20s, deff expect norwood 6 by 40

 

This is probably mostly true but it depends on the pattern. I think there is a big difference in 23 and 28 in terms of being a nw6 by 40. Spex was a 3 and won't be a 6 by 40. I have a friend that was a 3 at 20 at and he is 48 now with the same hairline and very slight thinning in the crown. My bro was a nw6 by 25. It took my dad 25 years to progress from a 3 to a 5. My grandfather has been a 3 since I can remember.

 

I think someone the QHG is likely to progress but how far who knows.

 

I think people whose hairline creeps back solid are better off as far as future loss than losing it in more of a diffused manner like me and the gentleman.

[Dr. Alan Feller]

He uses propecia regularly.

It looks like everyone is on the same page, so that's probably why he called me today to agree with my plan. Thank you everyone for helping and participating.

 

I want to address one comment from Harry:

"What is "permanent shock loss"? In this case Dr. Feller doesn't think it's an issue - or in any cases, for that matter. Is it a real concern after a hair transplant? Why does the other doctor think it's an issue?"

 

1. Permanent shockloss is the killing of native hairs as a direct result of surgery within a particular area.

2. This is not an issue for this patient in the area outlined because:

a. There is virtually no hair in that area right now. Even loss of the fine residual hair would have no cosmetic effect (and he's definitely going to lose it no matter what)

b. You almost never see shock on the hairline because of the massive uninteruppted blood supply coming directly from the forehead area below which itself does not have to support hair and therefore compete. In contrast, the top middle part and crown are VERY prone to shock loss (permenent or temporary)

 

3. Don't know where you got the idea that I dont' think Shockloss is NOT an issue in ANY case. That couldn't be more incorrect. Perhaps you are confusing the fact that I turn patients away in whom I believe shockloss to be a significant probability and hence my patients rarely if ever suffer from it.

 

In this case implanting behind the hairline may produce shockloss, that's why I avoid it in my plan as shown in the video. Review it again and look closely. You'll see the recipient area is confined to a "shockfree" zone.

 

Thank you all for the input. It really helps and I'm sure more doctors will eventually join me in the use of videos since it's so relatively easy nowadays.

 

Grow well everyone.

Dr. F

[Eman]

Coming from someone with significantly more hairloss than this guy, there is no way that I would have the HT at his stage. Everyone is different in how they feel about their hairloss and he is probably feeling the way I did when I started losing hair in my early twenties. Mine progressed to a NW 4 and I am glad I didn't do anything until that stage. This guy may have stabilized and the new hairline would work great, but what if he begins to have more recession-- he'll have to go back in for another HT to keep up with the new loss.

 

In my opinion, I would wait if I were him. Should he decide to go forward, he is in great hands with Dr. Feller and I like his conservative approach on this guy.

[Cant decide]

I tend to agree with Eman. I do agree with Dr. F approach but for a patient like this, I have to say, I may turn him away. Of course this is coming from a former NW 5/6 so it's all relative and if it bothers him that much then who am I to judge. Using 1800 only is wise. If 3000 were going to be packed in there, I would totally disagree.