Had HT on 22nd Dec with Dr. Madhu

[suresh_reddy]

Based on the confidence on this forum and speaking to few forum members here who had got it done from Dr. Madhu, I zeroed upon Dr. Madhu

and got my HT done on dec 24th. I got 2420 grafts in a single strip. I have attached pre and post op pics. Please do comment what you feel

about the HT.( not expecting standard answers saying u'll see the result in 10 months, but comments as to how the hairline looks after HT, about

num of grafts,can i expect good density as hairs grow etc). There are few grafts transplanted on sides too(but not seen in the pic)

 

I only remember the initial strip cutting part and the final cleaning part with continuous spray of some saline solution. Was unconscious

for the rest of time. So not exactly sure as to who among the docs did my HT Also mine took around 4 hours and I see pple saying min 5-6 hrs here..

Crown area which is thinning remains a concern to me. Maybe 1 more session is needed in future. I think it would have been better to go for one more strip like Pratik at a shot and avoid this entire process in future.

 

PS: Didnot wanted to start one more thread so posting here. Pls do drop in your comments.

[suresh_reddy]

Signature somehow didnot work.

Blog here:

http://www.hairtransplantnetwo...-page.asp?WebID=1528

[Bill - Seemiller]

Suresh,

 

thanks for sharing your experience with Dr. Madhu. However, I'd like to reserve this thread for Pratik since he is the thread starter. Feel free to start your own thread to share your experience and photos.

 

Best wishes,

 

Bill

[Bill - Seemiller]

Pratik,

 

I do have some concerns about any approach that leaves more than one scar, even if you ended up with a few hundred more grafts. However, I'll wait for Dr. Madhu to explain his reasons for this approach.

 

Best wishes,

 

Bill

[Dr. Pathuri Madhu]

Dear forum members and respected Dr.Humayun Mohammad I will respond to all the above concerns soon.

 

Regards,

Dr.Madhu.

[shines]

MirzaTechie and HaiRisWhere ,

 

Thanks for supporting one doctor all the time.\

[Bill - Seemiller]

Shines,

 

What is your problem with posters showing support for a quality doctor? HairIsWhere and MirzaTechie are legitimate posters and I'm not going to have you pawn off your fictitious notion that covert promoters exist on this forum on them.

 

I've already told you that I carefully monitor for covert promoters and at this time, I see no evidence of this with any of our current posters. Thus, I expect that you will not spread false information and falsely accuse legitimate posters of wrongdoing.

 

Best,

 

Bill

[shines]

Dear Bill,

 

Did I say anything wrong about them in this post ?

 

Thanks .

[Bill - Seemiller]

Shines,

 

It doesn't take a rocket scientist to put together the statement you made regarding your concern about covert promoting on this forum and the above post. It's obvious that the above post was designed specifically to insinuate that the above posters are covertly promoting Dr. Madhu rather than simply sharing their genuine opinions.

 

Since I see no evidence of this (and have told you this publicly and privately twice before), I expect that you won't troll and harass legitimate members of our community simply for sharing an opinion that differs from yours.

 

Bill

[Dr. Mohammad Humayun Mohma]

Well I think the number of grafts be exactly what Dr Madhu has stated and as i am looking at the picture only I would not be able to give an opinion.

I think when Dr Madhu will respond we will be able to know exactly what he has done.

 

Mind you having two scars or one scar is totally dependent from one surgeon to other. It does not mean he is wrong, its just that I have severe reservation to the outcome in long term.

 

Lets wait for his opinion. I respect his views just might not agree with them.

 

I also do not agree with those doctors who tend to give wider scar just to make sure they are doing bigger and bigger surgery.

That is why I always tell people I do not believe in one stop surgery.

 

Again my personal liking

[Dr. Pathuri Madhu]

Hello Dr.Humayun Mohammad & forum members,

I have a great respect towards you and your valid points as well. I know pretty well the above mentioned points. Actually this procedure is not for each and everyone and I am not doing on each and everyone also, this may be one alternative method to get more no.of.grafts for those who are really very suitable on basis of total width of the donor area and laxity of the donor area. If the donor area is narrow we should not venture into this method and if the patient is convinced and agrees for two lines then only we can venture.

 

The scar always depends on the degree of tension on the wound, nature of the skin, surgical technique and many other parameters. If one is prepared for one scar there may not be much difference to be afraid of having one more as both are to be covered and managed in the same manner. Nowadays we are in a position to give very fine scars to more than 90% of the patients by adapting the latest methods. In most of the cases as you suggested i go for the lengthy strip and wider strip by doing an approximation test each time. Always the width of the bit makes a big sense for width of the scar, so instead of going for very wide bit at a single point, we can minimise the width there to some extent and at some other point where the skin permits for one more strip then only i venture for this. In this way we can decrease the tension on the suture line to some extent. All these are not for all and not to be practised on all and I am also not practising on all.

 

Dermatologists and hair transplant surgeons can predict to some extent the possibility of future miniaturisation in the donor area and also to some extent we can prevent further miniaturisation by medication. Those who have strong hair, not containing miniaturised hair in the donor area are to be considered for this. So far i tried only on few patients where all the parameters are good. So far the scars are appearing thin not appearing wider. I am still following the cases, so far all are happy. In all those cases i could get more than 4000 units, only in this particular case I got about 3360 units, because he has less donor density and other hair characters are also moderate like thickness of the shaft etc. In this case the donor area is very wide and sufficiently lax. Actually he can go for one more session in future also. Then he can ask for inclusion of the earlier scar in the bit. So at any point of time we can make only two scars. In another perspective if one person is ventured to have one scar there may not be much more difference in having one more as both the scars are to be managed by growing some hair. To hide one scar one should grow some hair, like that for two scars also the same hair length is required to cover them. As we know width of the scar always depends upon so many parameters as I mentioned earlier, we can expect in more than 90% of cases very good faint scars. But in a very few even after taking all the steps to minimize it we will get wider scars because of the nature of the skin and healing capacities. At the same time we know pretty well that the scar will get matured as the time goes on and will be fainter and thinner year after year.

 

While implanting generally we all give importance to the front 2/3 rds of the bald area giving last preference to the crown. So in first sessions I always implant on to the front part not covering the entire area. If he wants to undergo one more session, if the front 2/3rds is sufficiently dense then only i cover the crown. So front 2/3rds come roughly 80-120 sq cm. In this particular patient I covered front 80 sq cm only giving a density varying from 25-50 units per sq cm depending on the discretion.

 

In India we get patients seeking more hair in a single session in view of good look by the time of marriage. Some patients they cannot afford time to wait for the second session.

 

In my view only 5-10% of the transplant patients may be suitable for this; remaining 90% are not at all suitable. At the same time we have to mention that the patient would get two scars.

 

For any reason in my patient these two scars appear or interfere for the future session there is always an another possibility for going for FUE and I am sure in another session we can try to take out the bit with the one of the scars and make it as a single scar., and I am repeatedly telling you this is not possible for all. As you know we cannot assess the donor condition, correct laxity and density through photographs, only on real examination we can really feel whether he is a suitable candidate or not for this. Regarding the density we use our senses where to implant with more density and where to implant with less density. For this procedure one has to look for whether the donor area is very wider. In this patient it is very wider and if it was narrow i would not have ventured into this.

 

For any further queries you can always contact me, furthermore i appreciate your own reservations about this.

[Bill - Seemiller]

Dr. Madhu,

 

I appreciate your response on this topic. I have a few questions about your two scar approach that I hope you'll answer for me.

 

1. What makes a patient a suitable candidate for your 2 scar approach?

 

2. Where do you harvest both of the strips? Do you have photos you can present illustrating this? Are they both above the nuchal ridge? How far apart are they?

 

3. How do you minimize the risks of additional tension placed on each wound by creating two scars? Depending on the placement of the scars, I'd be concerned that the pulling of the skin surrounding the wound would put additional tension on the second scar.

 

Of course, I'm pleased to hear that those you've performed this method on have minimial signs of scarring and are happy with their results. Perhaps you'd be willing to start a new thread in the "Results Posted by Leading Hair Transplant Clinics" section of the forum and present some photos demonstrating this approach?

 

Thanks and Best wishes,

 

Bill

[Dr. Mohammad Humayun Mohma]

Dr Madhu

 

I am not convinced with your arguments. I personally still think there is no room what so ever for two scars at one or separate time.

 

I do have very very strong reservations on that. The scar no matter how fine is still a scar and will show. I am not sure how I can predict the outcome of scar.

Every time I close a scar I hope this is a good scar, as there is no guarantee.

 

Anyway, i fear one patient who ends up with two ugly scars. it might be a statistics for us as less than 1% but for him its 100%. but as I said its just another way, and as far as I understand lots of doctors around the world do it. In this year I corrected about 10 to 12 such patients.

 

anyway, i would suggest you to present your point of view in forth coming ISHRS meeting.

[saifudheen]

very nice answer dr humayun

[shines]

Well said dr humayun.

[subbu]

i feel either Mr Patrik or Dr Madhu should post the pics of scar to end our long awaited curiosity .i dont understand why these people are taking so long time.

[mirzaTechie]

hi subbu,

I've freshly uploaded my current donor scar situation (done @ madhu).after 1 month 14 days.

i was least bothered about the donor scar, anyhow thatz going to be covered by hair from top.

 

your comments are appreciated.

[Pratik]

Guys,Updated my blog with donar scar marks.Have a look.

[rpachigo]

I am not a fan of this technique at all.

[Maxxy]

Interesting, though there isn't a chance in hell I'd go for this technique.

[Bill - Seemiller]

Quite honestly, I have the same concerns as Dr. Mohmand regarding harvesting two strips from different locations whether or not it's in one or multiple procedures. It seems to me that each closure would create more tension on each wound, putting the patient at greater risk for wide scarring in both scars.

 

I am willing to keep an open mind however, I'd like Dr. Madhu to present the technical requirements of those he feels are candidates for this technique and what he's doing to minimize the appearance of scarring.

 

Best wishes,

 

Bill

[pink]

Dear Pat,

 

pls do look for more doctors from India... Its a big country and just 1 doctor is never enough.

 

Regards,

Pink

[Bill - Seemiller]

Pink,

 

If we find another physician in India worth considering for recommendation, we will certainly prescreen them. It took a long time to find Dr. Madhu, but thankfully, we finally have a physician doing cutting edge work in India to recommend.

 

Best Regards,

 

Bill

[pink]

Thanks to you and Pat for the hard work.

 

Pink

[pink]

now lets get back to the 2 scar thingy..... i haven't seen this before. 2 strips taken for 1 transplant????? How does this benefit?????