FUE performed by Dr. Feriduni – 1938 FU in a single day session

[Dr. Bijan Feriduni]

Follicular Unit Extraction performed on a 34 year old Caucasian male with:

 

- NW II Class T/P

- Donor density of ~80 FU/cm2 in the occipital donor region and ~ 74 FU/cm2 in the temporal donor regions

- Hair diameter of ~60-70 microns

 

Treatment plan:

 

FUE procedure with 1500-1800 FU to reconstruct the entire hairline and the temporal peaks

 

Performed procedure (June 20th, 2012):

 

A Follicular Unit Extraction with 1938 FU in a single day session:

 

* 614 single hair FU

* 1324 double and triple hair FU

 

Extraction performed with a 0.9mm FUE punch with CIT Manual Punch Handle. No microscopic preparation of the follicular unit grafts;

Parallel incisions (single, double and triple units) were made in custom-sized blades technique (~Cutting Edge blades of 0.8mm – 0.9mm).

 

 

Dr. B. Feriduni

Edited June 28, 2013 by Dr. Bijan Feriduni

[Mickey85]

Stellar result doctor. I really wish I had known about you when I was researching so I would have gone to you and FUE...

[hairshopeing]

Amazing result!!!! As good as it gets!!

[nathaniel]

Dr. Feriduni,

 

Very nice work, Sir.

 

I really appreciate all the accompanying details regarding the procedure: graft break down (though I would appreciate a further breakdown of 2 and 3 hair grafts); blade sizes; manual punch size; donor density; hair diameter, etc.

 

I am also very interested in the distribution of 1, 2, and 3 hair grafts on the patient's scalp. His procedure was limited to the very front of the scalp it seems.

 

1) I assume you place only 1's in the hairline and then progress to 2's and 3's the further back you go? 2) How wide is the area of implantation from front to back in centimeters?

3) How far back in centimeters behind the 1's do you start placing 2's? And then 3's?

 

In Mickey85's link below the graft placement diagram (Simplified Graft Place Protocol) is not relevant really to the above patient. Neither is a similar diagram on the Shapiro Medical Team's website.

 

http://www.hairrestorationnetwork.com/eve/170490-hair-transplant-basics.html#post2346762

 

4) I would love to see a diagram of graft placements for the patient's hairline above if possible. Actually, I would love to see several diagrams of graft placements for patients with different levels of hair loss. For example, you only used 1, 2, and 3 hair FU's in the above patient; but might you use a 4 or 5 hair graft in the crown of a Norwood 3? How about a Norwood 4, 5, of 6?

 

Finally, in another thread (linked below) I have asked Dr. Vories about the advantages of using pens versus blades, and I have specifically referenced your work with blades:

 

http://www.hairrestorationnetwork.com/eve/171175-update-fue-procedure-2.html

 

5) Do you use now pens or have you used in the past pens?

 

6) Why do you like using blades for implanting hair grafts?

 

Thank you!

 

Et si vous preferez je peux ecrire en francais, mais je prefere d'ecrire en anglais.

 

 

- Nathaniel

Edited July 10, 2013 by nathaniel
Correct grammar

[TakingThePlunge]

Stellar result Dr. Feriduni!

[Mickey85]

It is indeed a stellar result. Here you see implanting into a totally barren zone and creating an entirely new hairline and the new hairline stands on its own with no assistance from the native hair. Very impressive yield.

[Spanker]

Very impressive.

[Dr. Bijan Feriduni]

Dr. Feriduni,

 

Very nice work, Sir.

 

I really appreciate all the accompanying details regarding the procedure: graft break down (though I would appreciate a further breakdown of 2 and 3 hair grafts); blade sizes; manual punch size; donor density; hair diameter, etc.

 

I am also very interested in the distribution of 1, 2, and 3 hair grafts on the patient's scalp. His procedure was limited to the very front of the scalp it seems.

 

1) I assume you place only 1's in the hairline and then progress to 2's and 3's the further back you go? 2) How wide is the area of implantation from front to back in centimeters?

3) How far back in centimeters behind the 1's do you start placing 2's? And then 3's?

 

In Mickey85's link below the graft placement diagram (Simplified Graft Place Protocol) is not relevant really to the above patient. Neither is a similar diagram on the Shapiro Medical Team's website.

 

http://www.hairrestorationnetwork.com/eve/170490-hair-transplant-basics.html#post2346762

 

4) I would love to see a diagram of graft placements for the patient's hairline above if possible. Actually, I would love to see several diagrams of graft placements for patients with different levels of hair loss. For example, you only used 1, 2, and 3 hair FU's in the above patient; but might you use a 4 or 5 hair graft in the crown of a Norwood 3? How about a Norwood 4, 5, of 6?

 

Finally, in another thread (linked below) I have asked Dr. Vories about the advantages of using pens versus blades, and I have specifically referenced your work with blades:

 

http://www.hairrestorationnetwork.com/eve/171175-update-fue-procedure-2.html

 

5) Do you use now pens or have you used in the past pens?

 

6) Why do you like using blades for implanting hair grafts?

 

Thank you!

 

Et si vous preferez je peux ecrire en francais, mais je prefere d'ecrire en anglais.

 

 

- Nathaniel

 

 

To Nathaniel:

 

Thank you for your great interest in my work, I tried to answer your questions as clearly as possible:

 

 

1. I always use single hair units for the 'feather line' and mix up double and triple hair units immediately behind the feather line to preserve the natural implant of the follicular hair groups after transplantation. The attached picture clearly shows the natural implant of the follicular hair groups, by mixing double and triple hair units we create a similar effect as the natural hair growth.

2. In this patient's case the width of the transplanted area is about 2cm-2.5cm.

3. It depends on each patient 's individual wish, if the patient prefers a soft or a strong hairline.

As mentioned above we mix up the double and triple hair units and do not place them as described in the documentation of Mickey85 or the diagram on SMG 's website

4. I am certainly willing to come back to you on this at a later stage but at this moment I am unfortunately not able to show you these diagrams due to my very tight schedule and lack of time, I can however already tell you that I try to avoid using 4 and 5 hair units, in case we do use them, they are always placed in coronal slits

5. For eyebrow reconstructions we use the Choi Implanter to avoid damage to the follicular units because of the sagital implantation in the eyebrow region, for all other treatments we use forceps for the implantation of the follicular units

6. In my opinion customized blades, I use Cutting Edge blades in my clinic, cause a minimum on damage to the skin, that's basically the reason why I use blades and not needles.

 

Dr. Bijan Feriduni

[nathaniel]

Thank you very much for such a detailed response, Dr. Feriduni!

 

You have given me a lot to think about when it comes to hairline design.

 

1. I always use single hair units for the 'feather line' and mix up double and triple hair units immediately behind the feather line to preserve the natural implant of the follicular hair groups after transplantation. The attached picture clearly shows the natural implant of the follicular hair groups, by mixing double and triple hair units we create a similar effect as the natural hair growth.

 

I am quite surprised by this statement since most people have told me that only 1's should be used in the first several rows and several people (and I should clarify not necessarily doctors) have told me that only 1's should be used to as much as a centimeter or more back from the hairline; yet your hairline designs are consistently met with high praise.

 

1) Your hairline designs are noted for dense packing from what I have seen and read - would you use the same approach of placing 2's and 3's immediately behind the "feather line" in a less dense hairline design?

 

I also find myself wondering if this reflects a difference between American and European approaches to hairline design (you are the first European hair transplant doctor whom I have approached about the dispersal of 1's, 2's, and 3's in the hairline and across the scalp). I additionally wonder (cautiously, as I don't want to over generalize or stereotype) if there are other differences in approach between American and European hairline designs and hair transplant techniques in general. For example, I wonder if FUE is more popular among European doctors than American doctors; I also wonder if dense packing is more popular with European doctors than American doctors; and I find myself wondering if I should replace "European doctors" with "Belgian doctors" in the previous comparisons (and dare I start thinking about comparisons to approaches/techniques among Turkish doctors or doctors in other parts of the world?).

 

3. It depends on each patient 's individual wish, if the patient prefers a soft or a strong hairline.

 

I am also surprised by this statement, as I've never heard anyone expressing a preference for a "stronger" hairline, only a "soft and natural" hairline as I've heard repeatedly expressed by American doctors.

 

2) When you are consulting with potential clients, what questions do you ask them to help them decide if they prefer a "softer" or "stronger" hairline? What other questions do you ask them to help them decide how they want their hair transplant to look when fully grown in? Or another way to state the question: what questions should potential hair transplant patients be asking themselves about hairline design before stepping into the doctor's office?

 

4. I am certainly willing to come back to you on this at a later stage but at this moment I am unfortunately not able to show you these diagrams due to my very tight schedule and lack of time...

 

I understand you are busy, and I await with eager anticipation your responses and accompanying diagrams, Dr. Feriduni!

 

Thank you, again!

 

- Nathaniel