Implanting Grafts in Rows

[PizzaWolf]

It was brought up in another topic that some doctors, like DeFreitas and Diep, opt to implant grafts in the hairline without microirregularities. I don't know much about the technical aspect of creating these irregularities, but it was kind of jarring when I looked more closely at the surgical photos from Dr DeFreitas and saw how symmetrically the grafts were placed. The end results that I've seen look natural and aesthetic, but I am curious what the reasoning behind this surgical approach is. My best guess is that it increases the illusion of density with fewer grafts.

Does anyone know what the reason is?

Do results achieved in this manner look strange when the hair is cut shorter, like a 9-10mm buzz?

[NARMAK]

I am sure those doctors have probably had a long enough time to evaluate what they feel gives a natural looking enough hairline. 

Most examples i come across always advocate that a hairline should consist of rows of singles at the very front and then multi grafts can be placed behind to help minimise a see through effect. A little bit of light apparently going through the singles helps further the illusion of naturalness. 

I think in some cases, even using singles if they do look too straight then it will look unnatural and i'm sure the doctors must account a little into that.

There are however people out there who don't listen and want it literally that way. Gregory Gage is a guy on YouTube who basically had an entirely flat looking straight line requested. When transplanted without the irregularities it did look weird, but once hair kicks in, due to the singles, it doesn't stand out as much it seems. 

[giegnosiganoe]

I'm not sure of the reason, but I've noticed that De Freitas seems to implant in rows only horizontally and only near the very front of the hairline, whereas Diep does also does it vertically and over most of the transplanted area. Vertical rows result in a more unnatural appearance because people looking at you face on can clearly see between the rows.

[digi23]

I do not agree that De Freitas is planting in rows, but Diep does and in my opinion it does not look natural and have no benefit whatsoever in my eyes.

[PizzaWolf]

8 minutes ago, digi23 said:

I do not agree that De Freitas is planting in rows, but Diep does and in my opinion it does not look natural and have no benefit whatsoever in my eyes.

My intention wasn't to critique DeFreitas' or Diep's work, only to understand the technique and what benefit it offers, as clearly they both feel it has merit.

1 hour ago, giegnosiganoe said:

I'm not sure of the reason, but I've noticed that De Freitas seems to implant in rows only horizontally and only near the very front of the hairline, whereas Diep does also does it vertically and over most of the transplanted area. Vertical rows result in a more unnatural appearance because people looking at you face on can clearly see between the rows.

That's very observant, and I hadn't noticed that difference until you pointed it out. I would hope that it actually has a technical merit and not just a time saving one. Both doctors are known for their high density with low graft numbers, so I still think it has to do with increasing the illusion of density, but I'm not sure.

I was hoping someone knew about the technique and its potential benefits.

Does anyone know if this symmetrical row style of implantation becomes apparent if you cut your hair short, or if it requires a certain hair length to look natural and blend together?

[Kharmacoma]

Apart from asymmetries, the angle of the hair that is implanted is equally important to make the result look natural. 

[BDK081522]

Implanting grafts in rows is never indicative of refined hair restoration. This simply does not occur in nature. Of course some surgeons can get away with it if the restoration is very high density with thicker caliber wavy hair. Horizontal rows broken up by finer singles implanted in front can look passable but vertical rows will never mimic the way natural hair grows. There's many examples on the forum but this one comes to mind relatively recently. Yes, when the hair is cut very short this will look very unnatural. Also, as mentioned above the more perpendicular angles also stick out and make styling harder. 

 

Edited January 10, 2022 by BDK081522

[PizzaWolf]

@BDK081522 Thank you for answering my question, especially about the rows being visible when the hair is cut short.

Why would two well regarded surgeons like DeFreitas and Diep use this implantation technique if it offers no benefit to the patient?

[BDK081522]

@PizzaWolf that's a great question and one that I can't answer with absolute certainty. I don't have any experience with Dr DeFreitas so I can't speak to his clinic or hair restoration philosophy. However, I will just say that for some surgeons and clinics it's not all about the patient and doing what's best for them. The only logical explanation I can even surmise is that implanting in rows is simply easier and overall it saves surgical time. 

[Melvin- Admin]

Guys, 

Honestly, I have no idea how this nonsense gets started, but I've noticed one thing someone says another will parrot and then it becomes a fact, when it's nonsense. Very few surgeons have impressed me like Dr. De Freitas, I would put him at the top of my list and definitely in the top of all Europe. Of course, some grafts will be parallel to each other, but that doesn't mean they are in rows. 

 

 

[PizzaWolf]

@Melvin- Moderator I'm scheduled for surgery with Dr DeFreitas. I didn't intend to make this into a drama thread.

However, with all due respect, it isn't nonsense. You cherry-picked a patient from DeFreitas where the horizontal rows are more difficult to detect, but they are still detectable even in that patient.

My personal concern with this is: 

I want to still be able to wear my hair at a length of 9-10mm after surgery. Will I be able to do that and not have the symmetrical rows become apparent?

Edited January 11, 2022 by PizzaWolf

[Melvin- Admin]

1 minute ago, PizzaWolf said:

@Melvin- Moderator I'm scheduled for surgery with Dr DeFreitas. I didn't intend to make this into a drama thread.

However, with all due respect, it isn't nonsense. You cherry-picked a patient from DeFreitas where the horizontal rows are more difficult to detect, but they are still delectable even in that patient.

My personal concern with this is: 

I want to still be able to wear my hair at a length of 9-10mm after surgery. Will I be able to do that and not have the symmetrical rows become apparent?

I didn’t cherry pick, I literally picked the last two results he posted on the forum. One of the few reviews here by @Adam87 he was nice enough to share his post-op pictures from the clinic, there are grafts that are slightly parallel, but not in rows. His graft placement is excellent and definitely not artificial or in rows. You can see this when the scabs have shed and the graft placement is apparent. 

[PizzaWolf]

@Melvin- Moderator This was from a very recent clinic posting:

Another clinic posting:

Would this be visible if these guys opt to wear their hair in a shorter style (9-10mm)?

[RandoBrando517]

45 minutes ago, PizzaWolf said:

@Melvin- Moderator This was from a very recent clinic posting:

Another clinic posting:

Would this be visible if these guys opt to wear their hair in a shorter style (9-10mm)?

How is this rows? 

[PizzaWolf]

Call it whatever you like, but hair doesn't have this kind of symmetry in nature:

Another:

I'm not saying the doctor is bad or that he isn't producing aesthetic results.

I just wanted to know if this pattern of implantation would be visible with a 3 guard buzz, or something in the neighborhood of 9-10mm?

Or does it require a longer style to mask it?

Edited January 11, 2022 by PizzaWolf

[Melvin- Admin]

Again, these are not rows, some grafts will be parallel that’s normal. I don’t see any issues with this graft placement. 

[PizzaWolf]

@Melvin- Moderator Do you feel that DeFrietas' style of implantation could hold up to a 9-10mm buzz? Is that an unfair expectation after a HT surgery?

[A Fue Good Men]

Why don’t you ask the clinic? I don’t think anybody here can tell you why certain doctors choose specific surgical techniques. It’s all conjecture. I think your short hair question is also valid if it concerns you.

 

freitas is a top notch doctor. If you visit Spanish forums you’ll see him and couto are MVPs of Spain.
 

Freitas is somewhat known on those forums to front load grafts at the hairline but I think that adds to the overall end result and makes his hairlines youthful and very dense from the front

[PizzaWolf]

@5BetaReductase I asked the clinic, but they aren't an unbiased source.

Surgical techniques are discussed all the time here. So far no one is even sure if it's a "technique" to implant in rows (or symmetrically, or whatever anyone wants to call it) or if it's just a time saver.

[shami26]

Dr. Lindsey wrote about this in an old post.

 

[De Freitas Clinic]

Good afternoon, everyone.
I have consulted your question with Dr. Rafael de Freitas in order to give you an answer.
Dr. Freitas has explained to me that he performs the implantation in such a way that the final results look natural and dense alike.
In the photographs after the surgery, in which there are still scabs, it may give the impression that the follicles are placed in line. However, there are micro-irregularities between them, and when the final result is observed, those micro-irregularities give a natural look to the hair. 

We are at your disposal to answer any question.

Best regards!

[Melvin- Admin]

10 hours ago, PizzaWolf said:

@Melvin- Moderator Do you feel that DeFrietas' style of implantation could hold up to a 9-10mm buzz? Is that an unfair expectation after a HT surgery?

I pulled up a picture of how the grafts look placed with a buzz cut, and they look natural. I hope we can put this nonsense behind us, Dr. De Freitas is one of the best surgeons in the world. Certainly one that I would put at the very top in both naturalness and density.

[NARMAK]

12 minutes ago, Melvin- Moderator said:

I pulled up a picture of how the grafts look placed with a buzz cut, and they look natural. I hope we can put this nonsense behind us, Dr. De Freitas is one of the best surgeons in the world. Certainly one that I would put at the very top in both naturalness and density.

I think OP has gotten himself mentally into that corner where a mole hill seems to become a mountain per se and gnaws away at you till you can unwrap yourself hopefully with a satisfactory amount of information to cool you down and reassure you. 

Hopefully that's the case and OP will see he's in good hands. Generally speaking, i think this is a good example of why taking your time and not booking until you feel 100%-ish is the right move. 

[Melvin- Admin]

22 minutes ago, NARMAK said:

I think OP has gotten himself mentally into that corner where a mole hill seems to become a mountain per se and gnaws away at you till you can unwrap yourself hopefully with a satisfactory amount of information to cool you down and reassure you. 

Hopefully that's the case and OP will see he's in good hands. Generally speaking, i think this is a good example of why taking your time and not booking until you feel 100%-ish is the right move. 

I think you're 100% right, seems like he's doubting his decision. De Freitas is a surgeon who I would place at the very top along with the likes of Konior, Hasson, Sethi, etc.

[Melvin- Admin]

@Curious25
I removed your comment from the clinics presentation. I don’t feel presentations or journeys are the appropriate place to have comments such as yours. You can post that comment here or on a separate thread of your own.