Dr. Lindsey 7 and 10 months out from frontal first case, 2nd case next year. McLeanVA

[Dr. William Lindsey]

This middle aged fellow has significant hairloss, a pretty substantial color mis-match, and fine hairs. Nevertheless, our first case is making a good change. He sent these 10 months pics in this morning and scheduled his second case for next year.

 

As I've posted lots of times before...when we have these fine hair guys getting a case working toward the crown, we'll "spend" 300 or so singles to bolster that part-side hairline. You can simply never get the hairline dense enough with fine hairs, no matter how tight you pack them. The trade off between putting 2s too close to the hairline and looking pluggy vs. the tightest we can pack singles that will look natural but perhaps a bit thin..is played out here. A few hundred singles along that left partline will add alot to the result and take virtually nothing away from our progress toward the crown.

 

Dr. Lindsey McLean VA

[Hairsearch21]

Sorry to say, but if his hair is to fine to get near any acceptable density he should not go for the surgery.

Thats only my oppinion by the way.

 

And what is to fine?

I know guys with thicl hair will have the "better" result in times of density.

BUT say a micronnumber.

 

Most caucasian guys have fine hair ~50micron.

 

If his hair is in that range it should be possible to get an acceptable density.

 

Im sure your patient is happy with his result, but in my oppinion its to easy to say that his hair is simply to fine to get a dense hairline.

His baldness is very advanced, thats for sure.

But thats not the reason youre telling us.

You say that the hair is simply to fine.

lets say 50-60FUs/cm2

That should be enough for every kind of hair when the hair is healthy.

But maybe the patients hair is much finer than im guessing..

 

So tell me doc .

 

All the best

[Dr. William Lindsey]

I COMPLETELY disagree with your reasoning. As a surgeon I'd prefer to only operate on Class 5 tan guys with salt and pepper wirey hair. That is the only guaranteed true home run in hair work. Unfortunately other guys, and girls, go bald.

 

As I bluntly tell people...you have 4 choices, and only 4, likely remaining these 4 until I retire sometime in the next 15 years.

1. Do nothing. Nobody had EVER died of baldness.

2. Wear a wig. In my opinion almost always the worst of these 4 choices.

3. Meds. Very variable in results and not without side effects.

4. Surgery, preferably strip, and always by someone who doesn't just dabble in hair as a profit center. AS I type this a lady from California called with what sounds like a disaster to be repaired..all because she reportedly went to a "profit center" of a plastic surgeon who just bought a robot to do his first hair work.

 

Those are the current choices. HT is not perfect. But it is a good solution for many guys. As anyone who has been to my office will testify...I show a bunch of cases of guys with similar heads and hair. No point in showing this particularly fellow an Indian with perfect hair to work with...he'll be sorely disappointed as you suggest in your post. Rather, I show a bunch of pale skinned guys with thin hair and what he can reasonably expect. IF at that point the patient thinks that is what he wants...let's schedule. IF they would only be happy with a different result that I can ever possibly achieve, I don't offer surgery.

 

Even then, about a third of those guys show up here a few years later with a bad results, usually sprinkling a little of that fine hair all over their heads, from a competitor and often they've wasted the little precious donor hair they have...

 

So to summarize, this is a reasonable if not great early result in a hard patient. After a second case, he ought to be "unremarkable" and look like an age appropriate guy with a bald crown. I know, that is what he wants. And its what a lot, but not all, of guys want.

 

Dr. Lindsey

 

PS. All class 5 guys with tan skin and wirey bushy salt and pepper hair....call today, and we'll be so booked out that we never have to deal with anything other than you perfect heads again.

 

PPS. Everyone else feel free to come in as well. You'll get a blunt consultation and if you book, we'll do our best to achieve the best results POSSIBLE with your particular limitations.