Dr Blake Bloxham Posted June 10, 2019 Share Posted June 10, 2019 The patient in today's case is a young man in his 20's who initially presented to us with a pretty reasonable request: he wanted to grow his hair long again. He did not want his hairline lowered, he did not want his corners rebuilt, he just wanted to get away from constantly shaving his head like he had been doing since his hair loss became "bad." When the patient first noticed his hair loss, he tried to keep his normal, long hair healthy by taking Propecia. Unfortunately, he suffered side effects and had to stop. As his hair continued to "miniaturize" it grew shorter and shorter, and he eventually resorted to simply "buzzing" his head -- something he was not a fan of. He came to us restore the ability to grow his hair long. He reported always having a "higher" hairline, and he wanted to keep this. We used the remnants of his existing hairline -- starting behind these to take advantage of their irregular and soft nature -- to rebuild the hairline and pack back through the mid-scalp. He was okay to not address the crown/vertex at this point because he believed it was still strong enough to grow longer and blend with the transplants. We saw him again a year later and he was very pleased to have achieved his goal. Because we started as an FUT he still has plenty of donor left to address the crown in the future (which he likely will want to do), and he can always go a little more "aggressive" in the front once the top is completely stabilized -- though I will admit that I really like the longevity of a conservative front. Here are a few "teaser" images from the video. I only include these because I really encourage patients, especially young patients, to watch the detailed comb-through video. "Teaser" Images: HD Video: Look forward to the discussion. Dr. Blake Bloxham Feller & Bloxham Medical, PC www.fellermedical.com Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Triple7 Posted June 11, 2019 Senior Member Share Posted June 11, 2019 Looking good! Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted June 11, 2019 Author Share Posted June 11, 2019 14 hours ago, Triple7 said: Looking good! Thank you. Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member LaserCap Posted June 11, 2019 Senior Member Share Posted June 11, 2019 22 hours ago, Dr Blake Bloxham said: The patient in today's case is a young man in his 20's who initially presented to us with a pretty reasonable request: he wanted to grow his hair long again. He did not want his hairline lowered, he did not want his corners rebuilt, he just wanted to get away from constantly shaving his head like he had been doing since his hair loss became "bad." When the patient first noticed his hair loss, he tried to keep his normal, long hair healthy by taking Propecia. Unfortunately, he suffered side effects and had to stop. As his hair continued to "miniaturize" it grew shorter and shorter, and he eventually resorted to simply "buzzing" his head -- something he was not a fan of. He came to us restore the ability to grow his hair long. He reported always having a "higher" hairline, and he wanted to keep this. We used the remnants of his existing hairline -- starting behind these to take advantage of their irregular and soft nature -- to rebuild the hairline and pack back through the mid-scalp. He was okay to not address the crown/vertex at this point because he believed it was still strong enough to grow longer and blend with the transplants. We saw him again a year later and he was very pleased to have achieved his goal. Because we started as an FUT he still has plenty of donor left to address the crown in the future (which he likely will want to do), and he can always go a little more "aggressive" in the front once the top is completely stabilized -- though I will admit that I really like the longevity of a conservative front. Here are a few "teaser" images from the video. I only include these because I really encourage patients, especially young patients, to watch the detailed comb-through video. "Teaser" Images: HD Video: Look forward to the discussion. Dr. Blake Bloxham Feller & Bloxham Medical, PC www.fellermedical.com Dr, how many grafts? Has he continued any type of medical therapy. (other than Propecia)? Seems he has a lot of native hair that may be contributing to the overall density. Nice work, I iparticularly enjoyed the staggering in the hairline. Blunting a bit on the corners would have been an added dimension of naturalness. Typically it is African Americans that end a point in a sharp angle. Link to comment Share on other sites More sharing options...
Senior Member LaserCap Posted June 11, 2019 Senior Member Share Posted June 11, 2019 Oh, I forgot. What a great opportunity to "teach" young guys about hairline design. Hair in the front grows forward. So, by definition, the hairline will typically end up lower because of this fact. Stay conservative as this patient decided to do. Eventually you can always return and lower it. What you don't want is to be in a happy home, 100 years old, with a hairline of a 25 year old. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted June 13, 2019 Author Share Posted June 13, 2019 On 6/11/2019 at 6:06 PM, LaserCap said: Dr, how many grafts? Has he continued any type of medical therapy. (other than Propecia)? Seems he has a lot of native hair that may be contributing to the overall density. Nice work, I iparticularly enjoyed the staggering in the hairline. Blunting a bit on the corners would have been an added dimension of naturalness. Typically it is African Americans that end a point in a sharp angle. Thank you for the kind words. Per my records, he is not on any type of preventive therapy. Absolutely there is a lot of benefit from the native hair. He reported that it still grew well in the back, but he could not grow the hair out because the weaker frontal hair would not grow to any reasonable length. He is very happy now that he can grow it all and blend it together. However, he is also aware that the back will likely thin in time and he will probably want to do another surgery down the line. Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Dr Blake Bloxham Posted June 13, 2019 Author Share Posted June 13, 2019 On 6/11/2019 at 6:08 PM, LaserCap said: Oh, I forgot. What a great opportunity to "teach" young guys about hairline design. Hair in the front grows forward. So, by definition, the hairline will typically end up lower because of this fact. Stay conservative as this patient decided to do. Eventually you can always return and lower it. What you don't want is to be in a happy home, 100 years old, with a hairline of a 25 year old. Excellent point, and one that I always try to impress upon patients during the consultation. The hairline always appears about 0.5 - 1cm lower than the "line" we draw the morning of surgery because the hair grows forward. Furthermore, patients must remember that, as you pointed out here, transplants are permanent. The hairline we place on a 25 year old patient must age well and still look natural at 45, 65, and, God willing, 95. And, as you correctly pointed out, we can always go a little lower later once the stop is stabilized with transplants and age. This is easy. What is not easy, however, is raising a hairline that was started too low and now looks unnatural or is eating up huge graft numbers to maintain. Thank you for the great commentary. I know this will help researching patients out. Dr. Blake Bloxham is recommended by the Hair Transplant Network. Hair restoration physician - Feller and Bloxham Hair Transplantation Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center. Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles. Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation. Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
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