Dr Feller - 9 Month Update

[repo-man]

Hey Everyone,

 

Since its snowing up here in the NE, I thought I would update my blog with some new pics.

 

Moderator Note:

 

Ten days after originally posting (x number of before and after photos) Repoman deleted all but one of the photos presented in this album. However, his before and after photos can be viewed on his blog by clicking here.

 

 

 

[crow1]

My thoughts are that I would be very disappointed with the results and Dr. Feller should address sooner than later. sorry

[Ceasar08]

Hey Repo---

My guess is that you planned it with Dr. Feller so you could comb it forward-- am I right? I'm wondering if he weighed it heavily that way in order to maximize the illusion for that number of grafts in that size area.

Huge difference between when you comb it back and forward. You've still have some months of growth ahead of you too. I'm not sure if you'd mentioned it on your blog or not, but had you gotten previous work prior to Dr. Feller?

[TonySC]

Repo-man,

 

Do you have any before pictures ? How many grafts did you have ?

[Dr. Alan Feller]

**** UPDATE: JANUARY 5, 2008 ******

 

Repoman visited my office last Thursday and we took photos of the hair in several different styles. We also took pics with the hair wet and the hair dry.

 

I can't state the importance of proper styling more strongly. Without it, most hair transplants are near useless.

 

THE VERY FINE AND UNRULY HAIR IN FRONT OF THE TRANSPLANT IS WHAT'S LEFT OF HIS ORIGINAL HAIRLINE AND HAS NOTHING TO DO WITH THE TRANSPLANT. SEVERAL PEOPLE VIEWING REPOMAN'S POST OP PHOTOS HAVE MISTAKEN THIS DYING HAIR FOR HIS TRANSPLANTED HAIRLINE, IT IS NOT.

 

Here is a video of the hair WET being combed backwards and forwards:

 

http://www.fellermedicaldata.c...o/repoman-clip-2.wmv

 

Here are his nine month 'AFTER' photos:

 

http://www.fellermedicaldata.c...epoman/after-9/1.jpg

http://www.fellermedicaldata.c...epoman/after-9/2.jpg

http://www.fellermedicaldata.c...epoman/after-9/3.jpg

http://www.fellermedicaldata.c...epoman/after-9/4.jpg

http://www.fellermedicaldata.c...epoman/after-9/5.jpg

http://www.fellermedicaldata.c...epoman/after-9/6.jpg

http://www.fellermedicaldata.c...epoman/after-9/7.jpg

http://www.fellermedicaldata.c...epoman/after-9/8.jpg

http://www.fellermedicaldata.c...epoman/after-9/9.jpg

http://www.fellermedicaldata.c...poman/after-9/10.jpg

http://www.fellermedicaldata.c...poman/after-9/11.jpg

http://www.fellermedicaldata.c...poman/after-9/12.jpg

 

Here are his 9 month 'BEFORE/AFTER' photos:

 

http://www.fellermedicaldata.c...re-after-9-mos/1.jpg

http://www.fellermedicaldata.c...re-after-9-mos/2.jpg

http://www.fellermedicaldata.c...re-after-9-mos/3.jpg

http://www.fellermedicaldata.c...re-after-9-mos/4.jpg

http://www.fellermedicaldata.c...re-after-9-mos/5.jpg

 

http://www.fellermedicaldata.c...re-after-9-mos/6.jpg

 

 

Repo,

I don't remember your identity and don't have your medical chart, but I will address your post and those of the other with the information currently available.

 

In answer to your question, YES you still have thickening coming. I don't consider the HT result final until you have hit the 14 month mark. By then 98% of patients are about as thick and grown as they are ever going to get. I have seen some amazing exceptions, but by and large 14 months is my cut off. So you have some time to go.

 

This post, and a few of the responses from viewers, create some important points worth talking about.

 

1. The very first point to be made is how hard it is to tell what benefit, if any, a patient received from his HT from photographs. As TonySC pointed out, there are no before pictures with which to compare.

I have found repo's before pics from his blog and put them together:

 

http://www.fellermedicaldata.c...an/beforeafter/1.jpg

 

http://www.fellermedicaldata.c...an/beforeafter/1.jpg

 

 

In my opinion, it looks as if Repo has benefitted quite a bit from the surgery when the hair is styled properly. Which brings me to the next point

 

2. Hairstyling is key in HT, ESPECIALLY after only ONE procedure. There are very few exceptions to this rule. Sometimes I know in advance what style the patient will utilize after the HT so we plan accordingly, OR we perform the HT in the best manner possible and whatever hairstyle best suites the HT after growth, usually becomes the one that is ultimately adopted. Since I don't know which of my patients repoman is, I can't say if we planned his HT with an eye toward combing the hair forward as Ceaser already suggested in his post. From looking at the 4 day post op photos:

 

http://www.fellermedicaldata.com/images/repoman/3.jpg

http://www.fellermedicaldata.com/images/repoman/4.jpg

 

I can only conclude that this may have been the case. The density is not as tight as I normally pack HTs at and this may have been for one of two reasons:

 

1. Repoman was more interested in covering more area than density.

2. I determined during the surgery that it was best to leave more space betweent the grafts which necessitated covering a wider area.

3. Repoman wanted me to place the grafts in such a way as to favor the "Ceaser" style (combed forward) after growth.

 

Perhaps Repoman remembers and can tell us.

 

3. The next point is continuing hairloss. If you look at the top of the head and the crown where the surgery was peformed, you can see that he lost more of his original hair. If you look at the edges of his fringe hair, you will see a significant decrease in density as well as further recession. That's a problem with HT that must always be kept in mind and why I try not to count on surrounding hair too much in my presurgical planning.

 

4. Determining where the hair transplant was performed is a bit of an art. To the untrained eye, areas that were not covered by the transplant may be misconceived as areas that simply didn't grow. That's why I take so many photos and include photos where the transplant area is demarked in purple pen. But since I don't know which of my patients Repo is, I can't post those photos.

I can, however, point out that if you look at the 4 day post op photos you can get a good sense of the shape of the transplant. You will notice that the back is slanted higher on the left than the right. That's a good landmark to use when comparing the befores to the afters. When you get a fix on the area I transplanted, his growth is rather good:

In this after photo from the right profile, you can clearly see the slant I was talking about.

 

http://www.fellermedicaldata.c.../repoman/after/3.jpg

 

This leads me to believe that by choice, or default, we decided to implant these grafts in such a way for Repo to comb his hair from left to right. A style not represented in any of the photos. Again, perhaps Repo can tell us. For the record, when I planned my own HT, I also slanted my transplant to be higher in the back left because I knew I would comb it from left to right. This is called polarizing the HT and it is a very useful tool for making an HT look fuller than it really is.

 

5. The size of the head and bald areas is another variable that we are always wresling with as HT doctors. In Repos case his head is BIG..nothing personal. But the associated bald areas are also very large. 3,000 grafts may sound like alot, but on a head like this it can get swallowed up pretty quickly. Look at the 4 day post op pics and you can see how we try to customize the surgery to his particular bald pattern with an eye toward maximizing coverage after growth.

 

6. Skin type, as dictated by race and ethnicity also play key roles. From the photos Repoman looks of East Indian extraction. Again, I'm not sure, so you will have to tell us Repo. Anyway, Asian hair should rarely be as dense packed as Euro/American hair becuase the follicles are a bit larger and fragile. The bottoms of the follicular units tend to splay out more and therfore require slightly larger slits. Larger slits require slightly more space between slits and so on.

 

So if you compare this 3,000 graft case to one like the one I did on Thanna, you will see a huge difference. There is no one size fits all.

 

In my opinion I think the results are average and typical for the post op time and believe there is more thickening and coverage to come.

 

Grow well, Repo

[Mr. GQ]

how many grafts????

 

thanks for posting!!!

[Bill - Seemiller]

repo-man,

 

Before pictures and the number of grafts would help us evaluate your progress at this point. I'm not sure how anyone can comment on it otherwise.

 

You will have more thickening to come since 8 months is still pretty early.

 

Your hair looks pretty decent in the front combed down it seems.

 

Best wishes,

 

Bill

[repo-man]

Thanks to all and Dr. Feller for all the posts, questions and comments.

 

- My apologies if my blog address didn't show up earlier, but I'm including the direct link for comparison. There are pictures before HT and at intervals following the procedure.

www.hairtransplantnetwork.com/...e-page.asp?WebID=689

 

- The pictures do look vastly different because of the way its combed as mentioned by several posters and Dr. Feller. Prior to my hair loss, I always combed back my hair but as the hair loss began in my early 20s, I switched over to the combed forward look. I did mention that I would eventually like to go back to combing back my hair. Before the HT, I knew that I planned on getting more than 1 HT, which is why Dr Feller dense-packed 3,000 hairs in the frontal 1/3. I'm of East Indian origin and Dr Feller mentioned that since I had a darker scalp, it would give the illusion that it was thicker than it actually was. I'm not quite sure why it doesn't appear to be as densely packed, but I was keen on density vs coverage.

 

While its good to hear that I should be expecting more growth, I'm not quite sure on how much more growth expecially with what I have thus far. Also, it seems like some areas have not grown in at all (my right side towards the back) and I'm not sure of what to make of it.

[hairthere]

repo, i recall month 8 as being a big growth spurt month for me in both my hts. a lot can happen in the next few months so be patient.

 

that being said, i can understand your concern if you want to style your hair back. it definitely looks tons fuller combed forward. either way, i'm sure if you planned accordingly you can reach the density goals you desire with a 2nd ht if this one doesn't suffice.

[lost my swagger]

im sorry, but some of you guys are making it seem like he has plenty more growth yet and improvement left.. i just dont see it... will it thicken a little?? sure. will it make any kind of real cosmetic improvement from his current state?? i would say more than likely it wont this late in the game.. im sorry to say and i HOPE i am dead wrong.

 

this is not a good result and you deserve to not be thrilled. your styling options are VERY limited(one) ... for 3000+ grafts i would want to see more.... from wht i see you have 2 options either use another HT to thinken the area ALREADY worked on and MAYBE a little further back on your midscalp(if your donor allows), however your crown will remain pretty bare..... OR.. option 2 is try to get as much overall coverage are you possibly can overthe large area you have remaining, but you will have an overall THIN look....

of course what you can achieve depends on how much donor you have left....

 

ive seen plenty of great work from dr. feller, this is not one of them... perhaps consider another top strip doc/clinic for your 2nd go around.....

[lost my swagger]

also when i look at his graft placment pics of his hairline, while its not a high density hairline that was planted it STILL has not grown well when i compare it to his recent hairline pics... it looks like poor growth and lets be real... at this stage the grafts that are gonna grow in and get thicker are GROWING BY NOW... so unless the patient agreed on the ceaser look as his only option, which it appears he did not, he is justified in wanting more at this stage

[Ceasar08]

Check out Orion at around 6/7 months and then at 8 months:

 

http://www.hairtransplantnetwo...e-page.asp?WebID=145

[Mr. GQ]

yes i agree that for 3168 grafts it looks very thin. but also i see that your hair is wet on all of your shots and it seems that you took the pictures right after you applied minox. i know from my personal experience that i have twice as much hair right before i put that dreadful minox.

 

so few more shots with dry washed hair would be required for me to come up with the final verdict. court is in recess.

[Mr. GQ]

Originally posted by Ceasar08:

Check out Orion at around 6/7 months and then at 8 months:

 

http://www.hairtransplantnetwo...e-page.asp?WebID=145

 

wow great find ceasar

 

from 8-16 months is also huge!

so i guess it's true when they say that the hairline is last to grow after HT.

[Bill - Seemiller]

lost my swagger,

 

Though I'm certainly not aiming to predict the final result, I trust you understand that some patients can be slow growers and can take longer to fully mature. This may or may not be the case for repo-man. But I trust that's why people are telling him to wait it out.

 

Repo-man,

 

There appears to be a huge difference between your hair combed back and down. Combing your hair down, it looks nice and thick. Combing it back makes it appear much thinner.

 

I trust you've contacted Dr. Feller at this point to identify yourself so he can discuss your case publicly?

 

I think this will help give us a better understanding.

 

Best wishes,

 

Bill

[hairthere]

lms, i saw a HUGE difference after 8 months and so do a lot of the results we see. making him feel like this ht is a failure before 12 months are up is wrong.

 

spex has posted some great examples of why you shouldn't jump ship on an ht at 8 months. maybe he can repost them...

[FacelessMan]

repo-man,

 

With my own HT (the first one) I did notice a significant change between the 8-month mark, and even the one-year mark. From what I could tell, the difference was primarily in thickining, based of course on my highly scientific practice of feeling the top of my head for pricky new growth

 

My blog photos may show this difference, as well, although I stopped taking the "left side/top/right side" progress shots at around the 8-month mark; those after that point are mostly casual shots.

 

Some things to consider...having fine-textured hair myself, I've noticed that it looks far thicker combed and parted as I generally have it than it does disheveled, especially when even slightly damp; you may find this as well. Looking at your before and after "top" shots, with all your hair combed forward in the same manner, I see a distinct difference.

 

Additionally, there may be other factors at play -- the continued loss of your non-transplanted hair since your surgery, perhaps, or shedding related to Rogaine or Propecia if you're using either of them. Of course, Dr. Feller is far better able to evaluate the latter.

 

Good luck!

 

Benjamin

[thanatopsis_awry]

Bit peculiar.....combed down his hair looks as dense if not denser than mine in like-conditions. Under most conditions, and all the conditions that truly matter, my hair looks perfectly dense -- however, I can make it appear quite thin quite easily.

 

Repo, you mention a certain area having little to no growth? You may very well be a slow-grower, which is always the best case if you are feeling like growth is lagging; I'd also recommend keeping your hair totally dry and then styling it forward, creating a layering effect.

[repo-man]

Thanks for all the comments and advice. I myself am shocked how the two styles look completely different. I did reach out to Dr. Feller's office this afternoon, but I think his office may be closed for the holiday. In any case, I will reach out to him next week so that he can give an update on the case.

 

Mr. GQ - I don't use Rogaine or Propecia, but I'll take pictures once again and repost.

 

I'm really hoping that I'm just a slow grower and that things will come in. I did have one picture where one side looks like the back end is not growing or coming in very lightly...which is odd. When I did meet with Dr. Feller in November, he also noticed it and said that it could just be slow growth and that it would come int...I'll keep you all posted!

 

Have a great holiday!

[Mr. GQ]

I'll take pictures once again and repost

 

thanks repo-man, it's just that the hair on these pictures look a bit wet. so a towel dried hair would give us all much better representation of your current situation. but as some mentioned earliar 8 months is still too early to judge.

 

p.s. do you repossess cars or houses???

[repo-man]

Will post the pics tonight.

 

Mr. GQ - Neither...I work for a firm that repossess major corporations when they go into distressed situations...interesting work especially in this market!

[repo-man]

I've included the pics under a post on my blog since I wasn't sure how to add them to the existing discussion. The link for the pictures:

 

http://www.hairtransplantnetwo...opyID=2584&WebID=689

 

Let me know what you think.

[Petchski]

Your new pics don't look to great growth wise unfortunately. You look to have aggressive hairloss, no doubt you have lost a lot of native hair since as your not on fin...

 

Have you banged your head or scratched at your head much? Hopefully your are a very slow grower

[Ceasar08]

Repo--

I'd love to see a photo with it combed left to right. I think the way you're leaving it now might be the least complimentary way of styling it.

I know with my own transplant (I'm at six months now), I can see it beginning to take shape slowly, but it's pretty essential that I style it correctly.

In any instance, I'm sure Dr. Feller will help you sort everything out.

[Mr. GQ]

hi Repo and thank you for taking your time to post some more photos. first of all to be perfectly honest with you the new photos didn't make any difference in terms of density illusion.

 

this is what i think so far. after browsing through your profile i noticed that you still had a very red scar (considering your skin tone) after 4 months. that gives me the impression that you are a slow healer. also a slow healer could also be a slow grower but not sure about that one 100%. i also noticed that you were putting a ton of concealer in 1 month post op photos which in my books is still way to early. not sure if you were doing that every day but i think that that could have played a huge part in graft survival since the recipient area was still healing. Bill and Dr. Feller i would love to hear your comments on this or if i'm way out of line regarding "slow healing vs. slow growth" and "concealer too early". this could be very educational for lot of us here.