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65 y/o Norwood VII man after 5632 grafts; Dr. Mike Beehner


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This 65 year old man over the past 4 years has had three hair transplant sessions. He has an advanced Norwood Class VI or a borderline Class VII pattern of hair loss with an enormous bald area in need of coverage. Overall, he has received 4801 FU grafts and 831 MFU grafts (4-5 hairs each) for a total of 12,067 hairs. Although it is impossible to totally fill in this size of a vertex (crown), I sought to plant "light coverage" through out that area, with the hairs directed in a natural "whorl" arrangement, spinning off of the centerpoint. He has enough strong hair up on top and toward the front, that he is able to style his hair so that many of them are brought backwards over a large part of the crown.The lighting of one of the photos is a little too bright to make out all the detail of the FU's placed back there. He uses a small amount of Toppik also in his styling regimen and says that, when he is done, it looks like a full head of hair from all angles. He plans one more session of around 1500 FU's, which we will mainly place in the crown area in back. 

Mike Beehner, M.D.

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This can actually proove how it really looks like. 5600 grafts.All other result pictures have only been creating an extreme illusion with "good" and hiding pictures. 

I've been asking this all the time when I see result pictures. What am I seeing? 

 

That is why I appreciate such result pictures from honest doctors like this. I'd rather go to someone like Dr. Michael B. Than someone that is posting "fake" result pictures. 

 

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Pelodinero,

How you present yourself on this forum and interact with physicians and other members is cause for concern. No two patients are the same, there are several variables to hair restoration, hair shaft diameter is one of the most if not the most important aspect to the overall cosmetic outcome of a procedure and it's obvious this patient has extremely fine hair. With that said, I agree this result is not jaw dropping, but you already posted one negative comment about the result, fair enough you didn't think it was a good result.

However, you continue to be demeaning and have an overall toxic attitude. You have had a hair transplant yourself, but you have never posted a picture of your results, I am sure you wouldn't like it if someone continuously put down your result not once, not twice, but three times. I have already warned you previously and it seems you can't help yourself. Every result is attached to a person and you never know if that patient visits our forum. Every single person here is a hair loss sufferer and knows how difficult it is to deal with someone putting you down, this will be my second warning, a third time and I will be forced to suspend your posting privileges indefinitely. 

It's clear the patient could improve further, but it is also clear that his appearance has improved and he now has a frame to his face. Everyone is welcome to share their opinion on the result, good or bad, but guys let's be respectful.

Warm regards- Melvin

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a NW 7 is going to need in the range of 10,000 grafts to look like he has a full head of hair. I would love to see this gentleman a year out from getting an additional 1500 grafts as the original posting claims he may do. I personally would put about 300 of those grafts in the frontal mid section to give a bit more density there and the other 1200 in the crown. I think the overall results would look very good at that point.

 

Results of 5000 to 6000 grafts on other men may look like they are much better results due to them having thick hair growing high on the sides and very small or no crown areas to cover compared to the gentleman presented here. I believe Bill has had over 9,000 grafts for a NW 6.

 

 

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Al

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(formerly BeHappy)

I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here.

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  • Senior Member

Thank you for your post Melvin.  Sometimes people go a bit too far with their comments. 

I am an online representative for Carolina Hair Surgery & Dr. Mike Vories (Recommended on the Hair Transplant Network).

View John's before/after photos and videos:  http://www.MyFUEhairtransplant.com

You can email me at johncasper99@gmail.com

I am not a medical professional and my opinions should not be taken as medical advice.

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Its a very good use of grafts, given his very fine hair and level of baldness. Even light coverage in a crown that size takes a lot of grafts. But that light coverage gives him the option of using concealer on the crown when desired. I agree that it looks natural and age appropriate. 

Edited by Spaceman
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Could the clinic please clarify what exactly MFU means in their practice? The clinic is separating between 4801 FU and 831 MFU.

Please clarify as I think there is some confusion in the thread that was never clarified. Thank you. 

Edited by delancey

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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To review how we refer to grafts larger than being a single follicular unit graft, anything larger than a single FU graft (which usually consists of 1, 2, or 3 FU's) can be referred to in shorthand as a "MFU graft." If someone wants to be more precise, you could name a MFU graft as being either a DFU (double FU) or a TFU (triple FU). In the old days before 1990, these size grafts were just "sliced and diced" under very minimal magnification and were referred to as "mini-grafts." In contrast, a MFU graft by definition is dissected from a strip under 10x power magnification with a stereomicroscope (one which shows three dimensions to the user). That means that, in dissecting out a 4-hair MFU which consists of two 2-hair FU's near each other, that the technician cuts around those two bundles in their natural state, with the exact same distance between them as existed originally on the donor scalp. The hole or slit in which they are then placed must easily accommodate that grafts being placed there. By that, I mean that there should be no compression or "scrunching" of the two bundles so that they are forced to be closer than existed on the scalp. 

I usually only use these size grafts on first and second HT sessions, and never on a third or fourth, if they end up being performed on a given patient. I only place MFU grafts in the front-central area of the recipient scalp. In multiple research studies performed by myself and others, MFU grafts usually survive at around 100%, as opposed to a 90% average survival of FU grafts. The reasons for this superior survival rate are two: One, there is more tissue around the FU bundles, thus making them less vulnerable to drying or trauma in handling. And second, there are often hidden telogen stage follicles in the tissue that is in between the two bundles, and these often sprout out a hair later that one could not see at the original planting. 

There are several things I like about using MFU grafts in this front-central area behind the hairline FU grafts. Most importantly, I think they add density and block light from hitting the scalp. The predictable 100% yield which I see is another reason, plus the fact it saves my patients money, since our charge for a 1-hair FU is the same charge as for a 4-hair MFU. 

Another term which you will see used occasionally is "micro-graft." In the old days, this referred to usually a 1-hair graft which resulted from the non-microscopic "slicing and dicing" of tissue to make grafts. Today, there are still a couple of indications for cutting a 2-hair or 3-hair FU into 2 or 3 separate 1-hair grafts. One is for creating eyebrows transplants. I find that 1-hair micro grafts enable the surgeon to make 150-200 tiny needle puncture openings for the grafts and obtain a more natural result than if larger sites were made and filled with 2 or 3-hair grafts. The second reason for perhaps cutting 1-hair grafts off from larger natural grafts would be if the patient had very few natural 1-hair hair bundles in the donor area and there were not enough of these natural 1-hair grafts to create a fine, natural edge to the hairline in front, where only 1-hair grafts should be used. A 2-hair or 3-hair grafts at the front of the hairline takes the risk of looking "pluggy" and unnatural. 

I hope the above helps clear up some of this for you.

Mike Beehner, M.D.

Saratoga Springs, New York

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5 hours ago, Dr. Michael Beehner said:
Quote

To review how we refer to grafts larger than being a single follicular unit graft, anything larger than a single FU graft (which usually consists of 1, 2, or 3 FU's) can be referred to in shorthand as a "MFU graft." If someone wants to be more precise, you could name a MFU graft as being either a DFU (double FU) or a TFU (triple FU).

Thank you for the clarification. What is known in the industry as a micro-graft is what you are referring to as “MFU.” Is this assertion correct?

Quote

There are several things I like about using MFU grafts in this front-central area behind the hairline FU grafts. Most importantly, I think they add density and block light from hitting the scalp. The predictable 100% yield which I see is another reason, plus the fact it saves my patients money, since our charge for a 1-hair FU is the same charge as for a 4-hair MFU. 

You mention some advantages of using micro grafts above. I am also interested in learning about your clinic's philosophy about whether the advantages of using micro-grafts (MFU) in the front-central area behind the hairline outweigh some of the disadvantages of using micro-grafts. These disadvantages may include: 

1. Longer healing time. Bigger incisions (as compared to follicular units) result in the wounds taking longer to heal. This may also increase the chance of an infection occurring. 

2. Scarring. Micro grafts contain more skin tissue than natural follicular units, which may result in additional scarring.  

3. Density and Coverage. Density and coverage obtained from a modern day follicular unit transplant often result in a more natural and dense hair transplant that mimics nature. Why not just dense pack the area using natural follicular units? 

4. Angles and Direction. How natural do micro-grafts look compared to modern day follicular units when wearing a short hair-style? How accurate are the angles and the hair direction in the recipient zone compared to natural follicular units? 

 

5 hours ago, Dr. Michael Beehner said:
Quote

I hope the above helps clear up some of this for you.

Thank you for taking the time to explain your clinic's philosophy and use of micro-grafts (MFU). 

 

 

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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  • 3 weeks later...
  • 2 years later...
  • Senior Member

Very good results here! 1st of all, he started as a NW 7 with pretty much no hair. 2nd, he is planning to do another surgery of 1,500 grafts which will fill out the top and crown. 3nd, he has not even tapped into FUE or beard hairs.

All of these combined would likely give this person a full head of hair.

Finally, fibers seem to be working already to create a full look!

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