Dr. Arocha Long Term Result at 6 Years

[ArochaHair]

This patient originally came to see us six years ago when he was concerned about his receding hairline and the small area of his crown that was experiencing additional loss. He felt that his otherwise youthful looks, especially for being in his mid-thirties at the time, were being compromised by these developments.

 

Dr. Arocha and the team moved 3010 grafts via follicular unit strip surgery (FUSS) in one procedure and placed the grafts amongst his existing hair without shaving. The patient has continued on finasteride since the surgery.

 

 

 

 

 

 

 

 

[TakingThePlunge]

Great case! Very natural.

[starscream]

IMO 3010 is a lot of grafts for his hair loss! Do you have immediate post op pics of this patient by any chance ?

[andy_+_+]

I agree with starscream.

 

3100 grafts for the extent of balding seems like a waste of grafts .

 

But hard to say without seeing the post op and how far back the grafts went.

[ArochaHair]

Thank you for your comments and questions. When Dr. Arocha assessed this patient's loss he noted that he was a partial diffuse thinner but he could only see this after close examination. Dr. Arocha was able to place grafts in between the patient's existing hairs without causing damage. This is one of Dr. Arocha's specialties and this allowed the patient to have a reinforcement of his existing hair.

 

We do have some placement photos and we have one photo showing the crown before placement, but wet, so you can better see the target recipient zone.

 

Roughly 2/3 of the grafts were placed into the frontal hairline and distributed into the existing hair. Dr. Arocha slightly lowered the existing hairline and added density to what was already there.

 

 

 

 

Here you can see the general area where Dr. Arocha felt the crown needed density. You can see the outlines made with his marker.

 

 

If you have any further questions do not hesitate to ask.

Edited August 12, 2016 by ArochaHair

[Pete-from-Farjo]

Nice work and very natural result. Congrats.

[BadBeat]

Honestly, there was nothing wrong with his hair that would warrant a hair transplant.

[andy_+_+]

Looks like in the after pics that he got transplanted the first inch of the hairline and reconstructed the temple points.

 

Seems like 2000 grafts would have sufficed not 3010 grafts.

 

If he loses more hair and becomes a Norwood 4 - 5 he will be hooped.

[ArochaHair]

Honestly, there was nothing wrong with his hair that would warrant a hair transplant.

 

Hi BadBeat,

 

I agree, there wasn't anything "wrong" but the patient had in fact experienced recession and thinning in the frontal zone and he wanted to rectify this issue. He's very happy now and has been for six years.

 

Looks like in the after pics that he got transplanted the first inch of the hairline and reconstructed the temple points.

 

Seems like 2000 grafts would have sufficed not 3010 grafts.

 

If he loses more hair and becomes a Norwood 4 - 5 he will be hooped.

 

Interesting observation, Andy. I'm not sure how he would "be hooped" if he moves into NW4 or NW5 territory. First, he's in his forties now, and since he's not lost any hair in the past six years, it's unlikely this scenario will unfold. However, if he does, why would he be hooped?

 

The placement went a bit further back than one inch but it was isolated to the frontal zone and also the crown, as has been stated, so your observation that about 2000 would be best for the front is pretty much how this unfolded. The rest were placed into the crown so based on your assessment of how it should have been addressed, which is was, it doesn't appear that he'd be hooped if he progresses to a NW4 or NW5:)

[andy_+_+]

I just think you could have got a similar result with less grafts.

 

But I commend Arocha hair, ASMED , Hasson and Wong and some other clinics that consistently post results.

 

The more results posted the greater the chance of criticism whether warranted or not warranted.

 

For this community it is great that some clinics show results for different ethnicity, hair characteristics, age , gender etc.

[ArochaHair]

Dr. Arocha shares your opinion of posting results and thank you again for your comments.

 

Your reiterating of your position is confusing. You first said that 2000 grafts would have been better (assuming you meant for the hairline) than the assumed 3010. I then clarified that roughly 2000 grafts were used for the hairline with the remainder in the crown but now you're saying that you still think less grafts would have sufficed. With you feeling 2000 grafts were necessary for the front, and my confirmation that 2000 grafts were used for the front, why would you still say that too many grafts were used? We have no problem with critical commentary but I don't see why you'd have the same criticism after the basis for your criticism is shown to be false and the reality of the case aligns with your opinion of how it should have been addressed.

[andy_+_+]

I think that 2000 grafts would have sufficed not 3010.

 

1500 grafts in the front and 500 in the crown or not even addressed the crown.

 

There has been 3 or 5 results in the past week that have been posted that were a Norwood 3 - 4 with significantly less grafts (1800 - 2400) that made as impactful or more of a cosmetic change and left the patient with a significant amount of graphs to combat further loss.

 

This patient had a really good head of hair beforehand and if he is on Propecia and decides to discontinue use of the drug will have used up 3000 grafts for a one inch hairline and a sprinkling of grafts in the crown.

 

If this patient has a donor of 8000 grafts and has used 38%(3010 grafts).

 

Do you think its wise he used 38% of his donor on amazing hairline that will look unnatural if he becomes a Norwood 5 -6.

[ontop]

I'm pretty sure the member has a little more than 8k donor grafts total. I wouldn't put him in the 12k range given his density..

The patient is in a good place right now at 40s so I think hes good for a good while especially if he sticks with meds which no reason he should toss them away after all this time.

 

Nice up to date journey.

[ArochaHair]

I think that 2000 grafts would have sufficed not 3010.

 

1500 grafts in the front and 500 in the crown or not even addressed the crown.

 

There has been 3 or 5 results in the past week that have been posted that were a Norwood 3 - 4 with significantly less grafts (1800 - 2400) that made as impactful or more of a cosmetic change and left the patient with a significant amount of graphs to combat further loss.

 

This patient had a really good head of hair beforehand and if he is on Propecia and decides to discontinue use of the drug will have used up 3000 grafts for a one inch hairline and a sprinkling of grafts in the crown.

 

If this patient has a donor of 8000 grafts and has used 38%(3010 grafts).

 

Do you think its wise he used 38% of his donor on amazing hairline that will look unnatural if he becomes a Norwood 5 -6.

 

Thank you again for your comments and your opinions. You do bring up good points but in the end, this is not a case of us showing a result nine months after his surgery where your points would have stronger legs. You originally said 2000 grafts would have been enough for the hairline, which is what it wound up receiving, and the latest point was that 1500 grafts would have been enough, which is only a 500 graft variance. In the end, we and the patient feel it was an appropriate number of grafts because he's dealing with actual density, not an illusion of density.

 

He's six years post-op and he has no plans on stopping Propecia so it looks like the approach and overall plan was as good as the actual result.

 

Thanks again or your comments.

[ArochaHair]

To address the percentage question, he has more than 8000 grafts. Dr. Arocha assessed a 9000 graft availability via strip and a 2000 to 2500 graft availability via FUE so with the assessed 11,500 grafts available in total we used approximately 25.4% of his available donor hair. Even if you were correct with his remaining donor hair being 38% less, if he were to proceed to a NW6 we'd still have 5000 grafts to fill the mid-scalp and blend into the crown. With his actual assessed donor at 11,500 he's got 8500 grafts left for such an unlikely outcome. I don't think in either case his future surgical prospects are at risk of a low donor supply.