*VID/PICS* 2,200 Graft Hairline & Frontal Transplant / Feller & Bloxham / Dr. Bloxham

[Dr Blake Bloxham]

Patients are unique. Each has a different level of hair loss, a slightly different hair loss pattern, a different likelihood of future loss, different hair type, and a unique head shape.

 

Therefore, each patient requires a unique transplant plan. Especially in the hairline region. There is no "one size fits all" approach, and what works great for one patient may not be the right approach for another.

 

So I wanted to share an example of this type of in-depth planning:

 

The patient is a gentleman in his 20s who was embarking on a new phase in his career. And, understandably so, he wanted to get his hair fixed before starting his new gig. He suffered from frontal (including hairline) and slight mid-scalp hair loss. He previously covered it up with a forward "comb over" and even dyed it blonde (on the advice of a hair stylist) to try and camouflage the loss (and you'll notice this in the "before" pictures).

 

I saw him for a consultation and we agreed that hair transplantation was likely his best option in this instance. But based on his age, head shape, views on preventive medications, hair type, and family history, I explained that he should seek a more conservative and feathered approach in the hairline. This would allow for a full but also soft and natural frontal transition, and also look natural if he thinned behind where we worked. We also made donor management a priority, and ensured he had plenty "left in the bank" for future procedures.

 

I ended up doing a 2,200 grafts transplant. He returned a little over 11 months later, and the plan worked!

 

Please view the video and pictures below. Enjoy!

 

Video:

 

 

 

 

 

 

Pictures:

 

 

 

 

 

 

 

 

 

 

[hsrp10]

Very dense result Blake!

Would like to see the hair pulled back to evaluate the hairline but that's my only nitpick.

 

Reminds me of the hair forward and hairspray routine I used to do lol.

He has many styling options for sure now.

[hairthere]

Great result, the patient must be thrilled!

[Dr Blake Bloxham]

Thank you for the kind words!

[harryforreal]

Would like to see the hair pulled back to evaluate the hairline but that's my only nitpick.

 

Me, too, Dr. Bloxham!

 

I explained that he should seek a more conservative and feathered approach in the hairline

 

What do you mean by "feathered" approach?

 

And how did you feel about his rejection of meds? When I look at his initial hair loss, I wonder if he should have been advised to at least first try meds before going to surgery. A lot of guys on this forum reject the idea of meds (including me at one point).

 

But when a parent says to their GP, "No vaccines for my child because they aren't natural," what is a doctor's role and responsibility in counseling a patient to reconsider medication?

 

Thank you, Dr. Bloxham, for your thoughtful input over the years.

[Dr Blake Bloxham]

Me, too, Dr. Bloxham!

 

What do you mean by "feathered" approach?

 

And how did you feel about his rejection of meds? When I look at his initial hair loss, I wonder if he should have been advised to at least first try meds before going to surgery. A lot of guys on this forum reject the idea of meds (including me at one point).

 

But when a parent says to their GP, "No vaccines for my child because they aren't natural," what is a doctor's role and responsibility in counseling a patient to reconsider medication?

 

Thank you, Dr. Bloxham, for your thoughtful input over the years.

 

I'll see if I have some good hairline pictures. I'm out of the office for the holidays this week, but I'll pull up his file and see what I have when I'm back after the new year.

 

By "feathered" I simply mean the hairline was more broken-up and staggered to provide a softer transition. If you look at the immediate post-op in this patient and compare it to the immediate post-op in this hairline case (2,000 Graft Hairline by Dr. Bloxham) you'll notice that the patient's hairline in this case has more irregular "peaks and valleys" and the shape is less uniform in general. Whereas the post-ops in the other case show a much straighter, defined, and more abrupt hairline. And I went into some detail about different approaches and when I think it's appropriate to do one versus the other. Interesting stuff -- to a "hair geek" like me, at least!

 

I always have a very thorough conversation with patients about medications during consultations. Preventive medications are made for a guy like this: early hair loss with lots of follicles left to preserve for as long as possible. I always explain the pros and potential "cons" with patients, and make sure they have all the correct information to make an informed decision. Some people are adamant about taking or not taking medications. And, at the end of the day, it is their decision. Like you said above, it's the doctor's role to counsel and make sure the patient has all the information, but I can't force them one way or the other.

 

For a patient like this who is choosing not to take preventive medications, I make sure they understand what this entails and hammer into them that this decision makes hair transplantation a very strategic, conservative, and long-term game. The donor must be left in the best shape possible, lifetime grafts must be maximized, and the approach must be smart (IE creating a more "feathered" hairline). And although I can't control the patient's decision to take medications, I can make sure the surgical plan is ethical. If this patient came in at his age with his potential and asked for a super low, flat hairline with temple point augmentation, and closed in corners, and would not budge, I wouldn't do the surgery and I'd implore him to seriously re-consider and be more conservative. But even then, there will always be physiological limits and we'll always want more hair. So it is worthwhile to really consider adjunct preventive treatments with hair transplantation.

 

Hope this helps! Thank you for the kind words. It's been a true pleasure contributing to the community for years now, and very exciting sharing my work!

[TakingThePlunge]

Well done!