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This 64-year old male had several hair transplants many years ago. His main concern was to add density in several specific areas of his scalp to increase the thickness and density. His donor area had several prior strip scars with significant scar tissue only allowing for a small amount of donor hair to be removed. On examination, he demonstrated diffuse pattern baldness with evidence of prior hair transplants, and significant scar tissue the fibrosis of the scalp.


I had a lengthy discussion with the patient and explained the limitations we had with the amount of donor hair I could obtain, and the diffuse nature of his balding. We discussed the fact that he would not have a dramatic improvement but a mild improvement since he wanted the grafts spread out throughout the frontal and mid-scalp zones. However, we planned to concentrate the grafts into specific areas that bothered him the most to make the best use of the hair we could obtain.


The patient had a strip procedure and we were able to obtain 1014 follicular unit grafts which were strategically placed in the most bothersome areas for this patient.  The postoperative photos taken 1 year later show a mild increase in density and fullness to the hairline and central scalp and improvement in the crown. The patient is pleased with his results so far and looks forward to seeing how his final results will look.


This case is important to demonstrate that not all cases are straightforward, and many patients do not have a significant amount of donor hair to work with. In this patient’s case, we were only able to harvest 1014 grafts, but we placed them in specific areas to satisfy the patient in the most troublesome areas. He is delighted with the results as it met and exceeded his expectations that he was looking for. If he desires more hair in the future, I will consider FUE.




Patient 1736_TOP_800x629.jpg

Patient 1736_RIGHT_FULL_800x629.jpg

Patient 1736_RIGHT_45_DN_800x629.jpg

Patient 1736_LEFT_45_DN_800x629.jpg

Patient 1736_FRONT_45_800x629.jpg

Patient 1736_CUHL_RT_800x629.jpg

Patient 1736_CUHL_LF_800x629.jpg

Patient 1736_CROWN_800x629.jpg

Steven Gabel, MD, FACS, FISHRS

Diplomate, American Board of Hair Restoration Surgery

Diplomate, American Board of Facial Plastic and Reconstructive Surgery

Diplomate, American College of Surgeons


Gabel Hair Restoration Center

Portland, Oregon


Email Dr. Gabel directly at drgabel@gabelcenter.com

Dr. Gabel's Website


Dr. Steven Gabel is a member of the Coalition of Independent Hair Restoration Physicians.

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Great results Dr. Gabel, one question though, is the patients hair wet in the last before picture? 

I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

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Excellent density for so few grafts. He's got to be stoked to see that, especially getting the ability to style his hair again.

Hair loss patient and transplant veteran. Once a Norwood 3A.

Received 2,700 grafts with coalition doctor on 8/13/2010

Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011

Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016

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