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Why we don't require shaving the recipient area: Dr. Carlos K. Wesley (NYC)


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  • Senior Member

Patients are often pleasantly surprised to learn during their initial consultation that our practice does not require patients to shave their head for a follicular unit transplantation (FUT) procedure. As Dr. Wesley operates on only one patient per day, it is much easier to take the time to carefully navigate around the pre-existing hairs during recipient site creation.

 

The benefit to patients occurs not only in the immediate short term (7-10 days) postoperatively when the redness can be better camouflaged by the longer native hairs, but also during the first few months of early growth when the transplanted hairs are just beginning to grow and provide coverage and density.

 

Here is a recent example of a patient who underwent a session of over 2700 grafts to the caudal region of his scalp. You can see that by being able to comb his longer, pre-existing hairs over the incoming base of new hair, he is able to effectively camouflage the new growth and continue to lead a normal lifestyle.

 

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This is not really a good example of a patient that you didn't have to shave simply because there really wasn't much to shave to begin with. The recipient area is anterior to the region of higher native density but even this area is questionable. Shaved or not the hair of the vertex behind the recipient area would be used to cover the front in most similar cases. Do you have any non-shaved examples of diffused thinners with a megasession?

The Truth is in The Results

 

Dr. Victor Hasson and Dr. Jerry Wong are members of the Coalition of Independent Hair Restoration Physicians

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This is not really a good example of a patient that you didn't have to shave simply because there really wasn't much to shave to begin with. The recipient area is anterior to the region of higher native density but even this area is questionable. Shaved or not the hair of the vertex behind the recipient area would be used to cover the front in most similar cases. Do you have any non-shaved examples of diffused thinners with a megasession?

 

 

A lot of well regarded physicians don't shave - Dorin, True, Bernstein, Beehner come to mind (in addition to Wesley). Some docs seem to prefer shaving, while others are perfectly comfortable working through existing hair. To each their own, but I think you can get a great result either way and it's more important what the physician you've chosen is used to.

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Here are various examples of our patients whose pre-existing hair helped camouflage the redness and the stubble for the short-term postoperative period after surgical sessions with me. I have included four (4) patients with various hair lengths including a female patient. The first patient has a video with an intraoperative segment to demonstrate the surgical pattern. I have attached their intraoperative pattern pictures as well.

 

PATIENT #1:

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His intraoperative appearance can be seen in the video below:

 

 

 

 

PATIENT #2:

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PATIENT #3:

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PATIENT #4:

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JF_Intraop_Frontal.jpg.46e1a37a69b4d96570341af57c1cfa91.jpg

LW_Intraop_Frontal.jpg.25ca87b83057543b6f94fb6865bd604f.jpg

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Dr. Wesley,

 

Nice examples! Thank you for sharing.

"Doc" Blake Bloxham - formerly "Future_HT_Doc"

 

Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

 

All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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I can relate to this.Dr.Arocha didn't shave my recipient site either which absolutely helped me conceal my recent procedure. After 4 months Noone and I mean no one has even questioned me about it . Thank goodness

1st HT 1973 FUT's with Dr.Robert Mcclellan 6/28/2007

*unfortunately I have no info on hair count on my 1st surgery ..

 

2nd HT 3026 FUT's with Dr. Bernadino Arocha 1/9/2014

 

1's - 797

2's - 3700

3's - 246

5634 hairs

 

http://www.hairrestorationnetwork.com/eve/attachment.php?attachmentid=54945&d=1389315686

3026 FUTs 1 day HT#2 post op frontal picture

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  • 4 weeks later...
  • Senior Member

That is great to hear, scooter. In general, patients should be able to return to work or social activities in 7 - 10 days without evidence of the procedure being noticeable. Another trick that a few patients use is to temporarily grow out facial hair. That way, when they return to work, people are initially a bit distracted by their temporary new look (beard or mustache).

 

By the time patients then shave it cleanly a few days later, their friends/colleagues have grown accustomed to their overall appearance!

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Shaved or not, I don't see how any person can go unnoticed after 7-10 days of having FUT done unless it was a super small procedure but even then, I just don't see it. On average, I would say one month minimum.

My Hairloss Web Site -

 

Procedure #1: 5229 Grafts with Dr. Rahal Oct, 2010

Procedure #2: 2642 Grafts with Dr. Rahal Aug, 2013

 

7871 Grafts

 

http://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=2452

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I'm not convinced a HT without shaving the recipient area will be as good as shaved. By good I mean grafts are placed where they should be and need to be and as quickly as possible. Sure without shaving will be less embarrassing but I'd much rather endure short term awkwardness for the best possible outcome.

but with that being said, nice results on above examples.

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  • 1 month later...
  • Senior Member

While a month is certainly a safe bet for anyone who is advancing a hairline and a lot of work is being performed in non-hair-bearing areas (e.g. bald crown, bare recessions, etc.), there are plenty of healthy-sized procedures that can also go unnoticed after 10 days. In addition to the examples that I presented above, a considerable number of female patients in whom increasing frontotemporal (recessions) density is a goal can have all of their grafts well camouflaged by day 10 when they return back to "the real world" (I just saw another example of that today before composing this). 2000+ graft sessions to the patient's mid scalp or filling in their frontal scalp without advancing the hairline recently allowed a few patients of mine who were attending a wedding 10 days after their procedure to make the occasion without any noticeable evidence of a recent procedure.

 

While I agree with 'Cant decide' in that not every patient should expect to be back to looking exactly the same prior to one month postoperatively, there are plenty of examples of patients who certainly can comfortably get back to their routine much earlier. I've included below an old video of FUT and FUE patients as seen one week to one month after their sessions with me.

 

 

 

 

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  • 1 year later...
  • Senior Member
I'm not convinced a HT without shaving the recipient area will be as good as shaved. By good I mean grafts are placed where they should be and need to be and as quickly as possible. Sure without shaving will be less embarrassing but I'd much rather endure short term awkwardness for the best possible outcome.

but with that being said, nice results on above examples.

 

I think it can be done but it just takes longer to do the surgery since you have to work around existing hair. Alexander and Cooley have shown some results the past year of surgeries into non shaved areas. I also wonder if it helps to see the direction the existing hairs are going or if the docs can figure that out even from the shaved grafts? I assume so.

 

Some of these examples in the thread are VERY long hair so that seems like a pain. I could understand working around 1.5" or so hair but once you get past that - man seems like difficult work in a jungle.

Jan 2016 - 3800 graft FUT with Dr. Konior

NW 5A to 6.

 

Docs whose results I am most consistently impressed with: Konior, Cooley (FUT), Hasson (FUT), Diep (FUE) (yeah I like the zig zag).

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Shaved or not, I don't see how any person can go unnoticed after 7-10 days of having FUT done unless it was a super small procedure but even then, I just don't see it. On average, I would say one month minimum.

 

Yes unless you have really long hair in recipient area and cover the scar with pretty long hair and dont get any redness I don't see 7-10 days realistic with FUT. I do think it is with FUE which is one of the advantages of that procedure - a lot of guys look pretty much the same - albeit with a buzzed head, which was probably not their hair style pre surgery - after 10 days. Aside from the redness.

 

I am 2 months out and if I am clipped anything shorter than a "4" you can see the pink scar still and also I had shock loss just under the scar most of the way around so I am far from normal even then. :) But that is up to the body. If you want to hide FUT you have to have longer hair (1"+), and hope for no shock loss near donor area and hope you are one of the small % who lose all redness in recipient within a few weeks.

Jan 2016 - 3800 graft FUT with Dr. Konior

NW 5A to 6.

 

Docs whose results I am most consistently impressed with: Konior, Cooley (FUT), Hasson (FUT), Diep (FUE) (yeah I like the zig zag).

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