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jooeey

Horizontal Slits or Vertical Slits ?

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Hi Guys,

I wanted to know form you guys and the experts here on what should be done in such a case. So I did my Hair Transplant (First) in 2013 and when I got it done in India there were very few hair Transplant Surgeons which were recommended here. so I took my best wisdom call and went with a surgeon. Without taking any names just to not to upset the respected surgeon. It was decided to do a Horizontal Slits on my Scalp. Every since then I have also had small touch up jobs done. the Hair have come and I am pretty much happy with the results (Results concerning Regrowth of hair) but the problem is, ever since the Hair have grown fully it is almost impossible to style them, they just keep falling in other direction other than what they should be, just like a Horn on a Bull’s head.When I recently met one another surgeon he said the reason for your hair not getting styled in correct direction, and falling on the other side as you say, like Horns on a Bull’s Head is because the slits have been done wrong, you as a Patient maybe happy that you have got new hair on your balding areas, but they are far away from being styled, which is a fact. I just cannot style them, because they just do not stay there. So I am made to believe by this another Doctor that the Slits were made wrong, and hence the hair is just growing in other directions.

I have two questions to the community here.

1. Is (Lateral) Horizontal slit an Industry Standard or (Saggital) Vertical slit is ? What do more Hair Transplant Suregons prefer doing ? Horizontal or Vertical Slits ? How much does Horizontal slit or Vertical Slit play a role in hair growing in certain direction, I know it does but is the conclusion made by this another Doctor who I met lately that the slits should have been Vertical and not Horizontal  correct ?

2. Is it now advisable to remove those Hair Grafts which have been now growing well, and are doing just fine. Mind you, I am extremely paranoid and scared, now to again removing those earlier transplanted hair and again placing them in a Vertical slit. Mind you we are talking about Human body there is no permanent assurance in Surgical Procedure. some would argue why does someone wasn’t to fiddle now with an already head full of Hair. It is like undergoing an open heart surgery where you are opening the Heart again to make some fine adjustments, who knows this may call for some unknown trouble. If t is looking aesthetically ok, (which it is) why fiddle with it ? So Am I justified with my fear, should I be playing around with my already transplanted hair which have grown well ?

Should I just leave as it is, and not open a Pandora’s Box by fiddling with it.

Albeit could not be styled ideally !!

Edited by jooeey

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I’ve had lateral slit and I can style my hair anyway I want to, combed back, side part, combed forward, spiked, messy, whatever. I think the question is, did you have true lateral slit or did your surgeon just call what he did lateral slit? 

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1 hour ago, Aftermath said:

I’ve had lateral slit and I can style my hair anyway I want to, combed back, side part, combed forward, spiked, messy, whatever. I think the question is, did you have true lateral slit or did your surgeon just call what he did lateral slit? 

Ok, So going the Lateral slit was the right approach right ? Which is what I am told has been done in my case. I wouldn’t think that my Surgeon told me something else and he actually did something else on me, I wouldn’t think that he indulges in any Malpractices, appears to me a Surgeon of Ethics and Principles so I would dismiss this possibility of being not delivered what I was promised. So but why the hell my Hair just falls apart like a Horn of a Bull !! Could my texture of hair also have a role to play in it ? Just thinking wide ? lol !!

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I’m not saying he duped you, lateral slit isn’t an easy technique to perfect so it’d be down to the surgeons skill how well he performed the technique. I’ve been to a (so called) top surgeon before H&W and had a similar issue after my first procedure. Do you have pictures? 

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2 hours ago, Aftermath said:

I’m not saying he duped you, lateral slit isn’t an easy technique to perfect so it’d be down to the surgeons skill how well he performed the technique. I’ve been to a (so called) top surgeon before H&W and had a similar issue after my first procedure. Do you have pictures? 

Edited

Edited by augustya

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Guys, are you all surgeons? I understand the concept of trying to help the "research-less" but discussing the minutia is going to accomplish little.  And, I am certain, the patient is not going to discuss this with the doctor during the consultation.  "Oh Doctor, make sure you do horizontal, vertical, lateral slits. C'mon. And these, by the way, are not slits.  These are apertures, which is a puncture with whatever instrument the doctor is comfortable using.  Now-a-days it typically looks like a pen. And, while the doctor is doing the work, (which goes very fast), he is mimicking the native hair.  That is, he is tilting the instrument so when the transplants come in, they grow in the same angle and direction of the native hair.  Thus, apertures are rarely vertical.

I think it is important, however, where the apertures are done.  Let me give you an example.  Say you are going to do a 5 follicle transplant.  Draw 5 dots on a piece of peper..... one right beside the other.  These dots are not working together and the patient is going to end up with a diffused result.  But, you were to place 3 dots in the back and two in the front, now you would create a shingling effect...which would lead to the illusion of more density.  This should be part of the jargon.

Ethical doctors, who have spent years developing their craft make adjustments as they review results during post op visits.  It is truly amazing the density some can achieve and I think it is directly linked to this same subject.

 

 

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4 hours ago, Aftermath said:

I’m not saying he duped you, lateral slit isn’t an easy technique to perfect so it’d be down to the surgeons skill how well he performed the technique. I’ve been to a (so called) top surgeon before H&W and had a similar issue after my first procedure. Do you have pictures? 

Is it not all too risky now ? to do anything about that ? Remove the already transplanted Hair Grafts a couple of them may not survive and then to again make them go through the process of placing in a newly made slit and waiting for them to grow and not let them die !! It all sounds very risky and scary !!

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1 hour ago, jooeey said:

Is it not all too risky now ? to do anything about that ? Remove the already transplanted Hair Grafts a couple of them may not survive and then to again make them go through the process of placing in a newly made slit and waiting for them to grow and not let them die !! It all sounds very risky and scary !!

I didn’t have any removed they just worked around what was there and added density. Without pictures it’s difficult to give advice tbh

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So will adding density in that area will negate the problem of my hair falling in wrong direction !

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26 minutes ago, jooeey said:

So will adding density in that area will negate the problem of my hair falling in wrong direction !

It did for me but it’s all relative and again, without pictures it’s difficult to comment 

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Hi @jooeey

can you kindly share some photos? Difficulty in styling is not likely to be whether you had lateral or saggital sites made. It might be the exit angle itself or other technical issues. In fact, I find lateral/coronal incisions great for areas that need a fairly flat angle (temple points, eyebrows etc) as you can have the blade flushed more easily with the skin. Let me known in all cases.

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10 hours ago, DrTBarghouthi said:

Hi @jooeey

can you kindly share some photos? Difficulty in styling is not likely to be whether you had lateral or saggital sites made. It might be the exit angle itself or other technical issues. In fact, I find lateral/coronal incisions great for areas that need a fairly flat angle (temple points, eyebrows etc) as you can have the blade flushed more easily with the skin. Let me known in all cases.

Thank You Dr @DrTBarghouthi  for your expert opinion, I am pretty sure it were Horizontal Lateral Slits that were made. I am not comfortable sharing pictures, (I can share it to you in PM) but I will still see if I can because do not want to upset the Surgeon who did the procedure on me. I just wanted to have an opinion here, is it now advisable to do anything about it ? And in the first place what can be done about it now ? The Hair which have already been transplanted and have grown well, though not in the direction of my liking !! Do you think adding density around that ear even if by little say 50-100 Hair Grafts will create a illusion, camouflaging effect ? By the way this is on my Hair line !!

Edited by jooeey

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IMHO the best docs use a combination of both saggital and coronal slit incisions to accomplish the right angulations and visual end result.  Everyone has their own unique hair characteristics and will require their own individual approach to best meet their goals.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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12 hours ago, gillenator said:

IMHO the best docs use a combination of both saggital and coronal slit incisions to accomplish the right angulations and visual end result.  Everyone has their own unique hair characteristics and will require their own individual approach to best meet their goals.

So what should be done now ? Should I look to do anything about the already transplanted hair, or just leave as it is. I do not want to take risk of them getting damaged during the procedure again or not growing or any risks associated with a Hair Transplant Surgery. I have had people who say, It is not looking very bad, Not ideal but is not looking bad either.

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There are different ways to go about that. It depends where the main problem is. If it’s the hairline, you can either wait and grow it longer and try styling products to fix the angles and directions. You can also have certain ones extracted and recycled with the addition of fine grafts in between with some more irregularities to make the hairline fine and natural looking. Trust me, it can sometimes make a huge difference removing one odd looking graft. 

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On ‎9‎/‎25‎/‎2019 at 4:30 AM, jooeey said:

So what should be done now ? Should I look to do anything about the already transplanted hair, or just leave as it is. I do not want to take risk of them getting damaged during the procedure again or not growing or any risks associated with a Hair Transplant Surgery. I have had people who say, It is not looking very bad, Not ideal but is not looking bad either.

 

In your initial post you stated that things look aesthetically well?...I assume you mean the overall result and although some of the grafts are mis-angled, they are growing well.  How long is your hair length? 

So as Dr. TBarghouthi stated, several of the mis-angled grafts can be removed and possibly re-implanted behind the commencement of the hairline.  You just have to be very selective not to have too many removed because of the scarring and obviously this would require a very skilled FUE surgeon to perform the extractions and then also to cherry pick new grafts to place in the open areas.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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