57 Year Old Male with Class IV Hair Loss by Dr. Parsa Mohebi

[Parsa Mohebi, MD]

This is a 57 Year old man with Class IV hair loss who received a hair transplant by Dr. Parsa Mohebi. We focused on the front and corners areas of the scalp and covered it with 2,026 follicular unit grafts. 

FUE Hair Transplant was done with 2,026 follicular unit grafts 8 month follow up 

Miniaturization Study (Microscopic Evaluation) 
Location Miniaturization 
Hair Line: 100
Corners: 100
Top: 40
Crown: 40
Donor Area: 10

Here is the patient's hair characteristics: 
Hair loss class: IV
Hair color: Salt and Pepper
Skin tone: White
Hair character: Slight Wavy
Hair thickness: Medium
Donor density: 1.8
Scalp laxity: 2-2.5

Here is how the grafts were distributed: 
Hairline: 200
Front: 1826

Ones: 403
Twos: 1227
Threes: 393
Fours: 3

Total: 2026

 

[LonelyGraft]

I really wish clinics would post after pictures with the hair styled similar to the before pics. This doesn’t give viewers an accurate representation of the improvement within the area that needed the most density

 

Oh well...

[Steeeve]

19 hours ago, jj51702 said:

I really wish clinics would post after pictures with the hair styled similar to the before pics. This doesn’t give viewers an accurate representation of the improvement within the area that needed the most density

 

Oh well...

This looks like a pretty accurate representation of improvement to me. Looking at the length of the hair in the before pictures I’d say that the patient styled his hair forward to hide the half of his frontal third and hairline that was missing. The clinic probably combed it back to show the amount of loss before the procedure.

I mean, this is just a guess but most men style their hair in a way that hides their loss. Not in a way that highlights it, such as in this case where it’s been pushed back and up.

The style in the after photos is probably closer to the way the patient styled it before the hair loss began to occur.

Again that’s just a guess but I must say that I find the after photos look pretty remarkable. Very natural.

Edited September 1, 2018 by Steeeve

[LonelyGraft]

Ok, so how are we supposed to judge how the 2000+ grafts improved those areas if it’s combed in a way to conceal it? Why not include styled and unstyled photos in the afters?

[Steeeve]

Again, I’m only guessing but I’d say the patients’ hair hasn’t quite grown out enough to style it in the way it was in the before picture. Or maybe he got a haircut and can’t style it in that way. He probably won’t style it in that way either because, to be perfectly frank, there was no style there in the before picture. It was merely combed back to show the amount of loss.

I also don’t think one can expect a doctor to get a picture of someone’s hair in every manor so as to appease everyone on the internet. Maybe the patient didn’t want his hair wet. Maybe he had product in it. Maybe he was on his lunch break and decided to pop in before heading back to work. My point is that it’s the doctors job to appease their patient...not a random person on a hair loss forum. I mean no offense by that statement. I just think it is what it is.

The final judgement is in the photo. There is now a considerable amount of hair where there was none before. Enough hair at least so that he doesn’t have to grow it out to conceal any hair loss. 

???

[LonelyGraft]

1 hour ago, Steeeve said:

Again, I’m only guessing but I’d say the patients’ hair hasn’t quite grown out enough to style it in the way it was in the before picture. Or maybe he got a haircut and can’t style it in that way. He probably won’t style it in that way either because, to be perfectly frank, there was no style there in the before picture. It was merely combed back to show the amount of loss.

I also don’t think one can expect a doctor to get a picture of someone’s hair in every manor so as to appease everyone on the internet. Maybe the patient didn’t want his hair wet. Maybe he had product in it. Maybe he was on his lunch break and decided to pop in before heading back to work. My point is that it’s the doctors job to appease their patient...not a random person on a hair loss forum. I mean no offense by that statement. I just think it is what it is.

The final judgement is in the photo. There is now a considerable amount of hair where there was none before. Enough hair at least so that he doesn’t have to grow it out to conceal any hair loss. 

???

Lol ok. Might as well start applying toppik in the after pictures since that is the way some patients decide to style their hair. After all what’s the use of doctors posting results on a transplant forum to showcase their results. They only post these results on a forum to appease only the patient.

[Steeeve]

1 hour ago, jj51702 said:

Lol ok. Might as well start applying toppik in the after pictures since that is the way some patients decide to style their hair. After all what’s the use of doctors posting results on a transplant forum to showcase their results. They only post these results on a forum to appease only the patient.

That’s not what I mean and I feel like you have to possess the brain cells to comprehend what I’m saying. 

I’m not sure why you’re being so antagonistic in your responses to my response. As I said I meant no offense to you nor am I attacking you in my response but since you feel the need to be so condescending this will be my last post to you in this thread.

Everybody has an opinion about something and this is mine. A doctor can only only do so much when a patient comes in to take post-op pictures. They can’t make a person do something if a person isn’t willing to do it. Therefore you, jj51702-AKA: random internet person, get what you get. And it’s not up to the doctor to please you in that way. 

Instead of your condescending response to the Dr, “I really wish clinics would post after pictures with the hair styled similar to the before pics. This doesn’t give viewers an accurate representation of the improvement within the area that needed the most density

  

 Oh well...”

A smarter response to get what you want would’ve been, “hey doc! Got any immediate post op pics? Got any pics where you’ve combed through his hair?”

That would’ve been a smarter, more direct approach. As I said earlier though it seems that you only want to be antagonistic and condescending, even to the doctor-an actual person who performs hair transplant surgery, and that’s why I will not engage with you any longer. Well, that and your original response sounded dumb.

I do wish you all the best, though. Sincerely. I hope you find a good doctor who gives you a good head of hair and I hope that gives you peace. ✌? 

[LonelyGraft]

16 hours ago, Steeeve said:

That’s not what I mean and I feel like you have to possess the brain cells to comprehend what I’m saying. 

I’m not sure why you’re being so antagonistic in your responses to my response. As I said I meant no offense to you nor am I attacking you in my response but since you feel the need to be so condescending this will be my last post to you in this thread.

Everybody has an opinion about something and this is mine. A doctor can only only do so much when a patient comes in to take post-op pictures. They can’t make a person do something if a person isn’t willing to do it. Therefore you, jj51702-AKA: random internet person, get what you get. And it’s not up to the doctor to please you in that way. 

Instead of your condescending response to the Dr, “I really wish clinics would post after pictures with the hair styled similar to the before pics. This doesn’t give viewers an accurate representation of the improvement within the area that needed the most density

  

 Oh well...”

A smarter response to get what you want would’ve been, “hey doc! Got any immediate post op pics? Got any pics where you’ve combed through his hair?”

That would’ve been a smarter, more direct approach. As I said earlier though it seems that you only want to be antagonistic and condescending, even to the doctor-an actual person who performs hair transplant surgery, and that’s why I will not engage with you any longer. Well, that and your original response sounded dumb.

I do wish you all the best, though. Sincerely. I hope you find a good doctor who gives you a good head of hair and I hope that gives you peace. ✌? 

Lol for someone who is not “attacking me” in their post u sure did sneak in a lot of try hard insults in your post. Don’t be so triggered man. Stress raises cortisol which is bad for overall health.

[LonelyGraft]

And also for the naysayers, here is a guide on this forum specifically for physicians on how to present pictures on this forum. It specifically states to try and emulate the hair style in the pre op pictures.

 

funny enough dr mohebi is the first person to post on the thread praising the importance of good pictures 

 

Edited September 5, 2018 by jj51702
Added link

[LonelyGraft]

On 10/31/2008 at 6:50 AM, Bill - Managing Publisher said:

Dear Physician members of our commuity,

 

Thank you for your willingness to regularly present photos on our forum community for review. Unlike the past where patients considering you for surgery heard very little about you online, patients can now decide for themselves based on the regular results you present. In addition, these photo albums will be added to your doctor profiles on the Hair Transplant Network, and Coalition Hair Loss Learning Center (for Coalition members only).

 

However, it's extremely important that when creating photo albums that you provide enough pictures and information for patients to properly evaluate the result.

 

 

Ideal Photos to Present

 

The ideal photo album should include the following photos.

 

1. Hairline Before

2. Hairline Immediately Postop

3. Hairline After

4. 45 Degree Tilt Before

5. 45 Degree Tilt Immediately Postop

6. 45 Degree Tilt After

7. Top of the Head Before

8. Top of the Head Postop

9. Top of the Head After

10. Crown Before (if applicable)

11. Crown Immediately Postop (if applicable)

12. Crown After(if applicable)

13. Donor Scar Postop

14. Donor Scar After

 

Clear closeups of the hairline in particular is extremely important. You may also want to consider adding profile before, immediately postoperative, and after photos as well.

 

 

Consistency in Photos is Vital

 

Each photo cannot be larger than 500K however, photos should be crystal clear and large enough that the patient can see an accurate representation of the result.

 

Each before, immediately postoperative, and after photos should be taken at consistent angles, lighting, and background. It is preferred that you do not use flash for any of your photos. If you insist on using flash, be consistent in your before/after photos. Before and after pictures should show hair at the same consistency (both dry or both wet) and similar style. If you show a before photo parting the hair to show an obviouis bald spot, be sure to do the same in an after picture. Combing hair over the bald spot in the after picture is deceptive (even if unintentional). Ultimately, please be consistent in your photographs.

 

 

Providing Adequate Surgical Details

 

Album subjects at the very least should include the doctor's name and the number of grafts.

 

Surgical details are also extremely important and should be added into the album introduction. Without the number of grafts and strategic plan including patient goals at the very least, patients will be guessing why you've taken the approach you did.

 

 

Allowing Forum Members to Comment

 

By default, a checkbox is selected that allows forum members to comment. However, recently, a few physicians have deselected this box not allowing members to offer their genuine feedback. Please leave this option selected so members can offer their constructive feedback. Allowing members to comment and interacting with them is to your benefit and the benefit of this community.

 

 

Impressive Photo Album Example

 

For an example of a recent impressive patient photo album, see "Dense Packing FUT performed by Dr. Feriduni - NW Class V - 4010 FU Grafts".

 

Though you are not required to add this much detail, the more information and photos you add, the more prospective patients will understand the work that you do which will help them as they consider your clinic for surgery.

 

Kudos to all clinics who have risen to the challenge and presented their photos publicly.

 

Best wishes,

 

Bill

 

[Melvin- Admin]

jj,

I am having a hard time seeing what the issue is here, the pictures are taken in HD in the same lighting, the hair is styled slightly different, but I don't think it's making a significant impact on how the result is being portrayed. Also, it is important to remember that the surgeon takes photos of the patient's as they come in, they do not style the patients hair.

I am fairly certain this how the patient styles the hair himself. Furthermore, having had three surgeries myself I can attest that how I styled my hair is how the pictures were taken. Now surgeons will ask that you not put any thickening products such as Toppik or Dermmatch in your hair when taking progress photos, but how you style it is completely up to the patient. 

[LonelyGraft]

4 hours ago, Melvin-Moderator said:

jj,

I am having a hard time seeing what the issue is here, the pictures are taken in HD in the same lighting, the hair is styled slightly different, but I don't think it's making a significant impact on how the result is being portrayed. Also, it is important to remember that the surgeon takes photos of the patient's as they come in, they do not style the patients hair.

I am fairly certain this how the patient styles the hair himself. Furthermore, having had three surgeries myself I can attest that how I styled my hair is how the pictures were taken. Now surgeons will ask that you not put any thickening products such as Toppik or Dermmatch in your hair when taking progress photos, but how you style it is completely up to the patient. 

Melvin

I’m not sure what’s difficult to understand. The most impacted area of hair loss is being concealed in the afters with the patients hairstyle. It would be nice to see what kind of density is achieved in that area by having a similar hairstyle as the before pictures (just as the instructions by bill point out) and as dr mohebi even agreed with in terms of being a great set of guidelines.

 

obviously there is improvement, I’m not arguing that. But the degree of improvement is very difficult to judge.

[Mick50]

Pics look pretty good to me showing the area which has been covered by the transplant  .The most revealing pics after any transplant  are the top down ,and we can compare the before and after in this case , for a moderate amount of grafts a very nice improvement