Dr. Meshkin Ultra Refined Follicular Unit Grafting 1000 grafts

[Dr. Michael Meshkin]

Patient presented with a Class 2 hairloss on the Norwood scale. We performed 1000 grafts for the frontal and temples and some in the mid scalp area. We used Ultra Refined Follicular Unit grafting technique for the front and used Trichophytic closure to suture the donor area.

 

[Blake Bloxham]

Wow! I think the lighting in the before and after pictures may be SLIGHTLY different, but nevertheless, this result is amazing. Complete transformation with only 1000 grafts. Bravo Dr Meshkin.

[Dr. Michael Meshkin]

Thank you. I know the lighting differs because we are in different rooms for before surgery, during surgery and the post ops. By the way if any one wonders, we did 400 ones, 300 twos and 385 threes for this client. He is extremely happy with the result, but a little shy about showing his face .

[Forrest Gump]

Looks good, especially with only 1,000 grafts.

[hair_me_out]

Woah, nice work for only 1000 grafts! Was surprised to see it given how much area there was to cover.

[Am0986]

hope my hair can look this good.

[Bill - Seemiller]

Dr. Meshkin,

 

I agree that this is a great looking result. One suggestion though. Try not to reduce the size of the pictures too much prior to presenting them on the forum. Higher resolution photos would really help our community appreciate the quality of your work even more.

 

All the Best,

 

Bill

[NW4recession]

I have to express some skepticism here. I have slightly less, but almost identical hairloss as this patient and have received quotes from 3 top docs between 2200 and 2700 grafts. The desired hairline that I showed in my pictures was just as conservative, if not more conservative than shown here.

Sorry, but I just don't believe 1000 grafts can do that.

[Ventuoguy]

I'd have to agree with NW4. That's an amazing result for 1,000 grafts. This patient has totally bald widow's peaks and has alot of scalp to cover. The only thing that might confound this is the blonde hair against his fair skin-not much contrast whatsoever. This undeniably helps.. but still??

[Dr. Michael Meshkin]

I have to admit I was a little skeptical in posting this patient result because I knew some people may question the number of grafts, but it is truly 1000 grafts. I only have a few immediate post ups for this client which are a little blurry. I will post the ones that are clearer so you can judge for yourselves. This patient is a little shy in showing his face, but I have a video clip of him and if he allows me, and bill instructs me as to the way to post videos, then I can post the video for you. But again thanks for your complements.

[Dr. Michael Meshkin]

I just posted immediate post ops for right and left temples. Let me know what you think.

[Blake Bloxham]

NW4/Ventuoguy,

I applaud your dedication to demanding transparency. It's attitudes, such as this, that make these boards such an excellent and helpful resource to those seeking hair restoration. Having said that, I really don't think Dr Meshkin has any reason to exaggerate or fabricate the number of grafts implanted. Now, I will admit that I always have greatly enjoyed Dr Meshkin's work, but I think the result can be chalked up to a number of factors:

 

1. If you look at the central 'tuff' of hair that the patient has, the density is good, and it essentially extends from a normal, albeit mature, hairline to the vertex. My guess is that there was not a lot of grafts placed into this portion of the mid-forelock and that none were needed to the vertex. This really just leaves the temples, which probably took most of the grafts.

 

2. I believe Dr Meshkin has stated before that he thoroughly considers hair color and texture against patient's scalps when doing HT surgeries. Knowing that, it is feasible that the coverage or appearance of coverage achieved has a lot to do with careful planning on the part of the Doc

 

3. The caliber, texture, and color of the follicles need to be taken into consideration. When one of you stated (I believe NW4) that you were quoted at 2700 grafts to cover this same level of balding, that could have been attributed to further miniaturization, a darker color hair against a lighter toned scalp, etc.

 

4. The hair styling in the picture (which the doctor really has no control over) is quite flattering, and the blonde hair on the Caucasian scalp does hold up quite well to flash.

 

Sorry if this sounds like a big advertisement for the doctor, and also, to Dr Meshkin, sorry if I am overstepping my bounds in this explanation. These are simply my own opinions (and influenced by no other outside sources) of what I feel is a very nice, overall result.

[Dr. Michael Meshkin]

Thanks future HT Doc, you have already matured in your understanding of hair restoration surgery and I aplaud you for that. You certainly didnot overstep your bounds and I do appreciate your understanding of my comprehensive approach for each customized treatment option, and I thank you for your comments.

[NW4recession]

I think you are right, I think in this situation, the minimal contrast between hair and scalp has helped a lot, plus the hairstyle does allow for slightly less density.

My hair is very dark with slick bald temples, but a thick, intact forelock. I think I was quoted 2200+ grafts because it would take a density of 60 grafts/cm to allow the transplanted hair to blend in with native hair.

[Dr. Michael Meshkin]

Hello NW,

I visited your web blog and looked at your picture that you posted. You do have darker hair against a lighter color skin, so higher number of grafts would be recommended to get a more natural result. I was asked in another thread as to how I come up with the number of grafts needed and I will review that here. There are many factors involved in the decision making process, but I will name a few which are the most important. Keep in mind that even with a certain classification on the norwood scale of hair loss, each case is assessed individually. The elements that influence me to determine the number of grafts include: the patient's age, goal and expectations, the degree of hair loss, donor size, density and laxity, hair characteristics, the hair's texture-fine or coarse, the contrast between the patient's hair and skin color, and whether or not previous grafting procedures have been done and the progression of the future hair loss. Making treatment recommendations require an extensive examination and a frank discussion of possibilities between the patient and I. I also give the patient a realistic estimate of the total cost, number of grafts needed and number of procedures required to get the expected result. Sometimes due to economic factors, patients decide on the number of grafts according to their budget. We try to push for the desired number of grafts for the optimal result but some clients just cannot afford the cost. So we try to do our best with the number of grafts that the patients can afford and ultimatly decides to do.

[notjustyet]

interesting... where are all the "GREAT JOB", "LOOKS NATURAL" comments from the cheerleader squad? Not one positive comment from the squad... wrong doc?. Id say from these pics thats a great job with what was done. Id be thrilled to get this result with so few hairs and i am sure at a good price!

[lost my swagger]

Originally posted by NW4recession:

I have to express some skepticism here. I have slightly less, but almost identical hairloss as this patient and have received quotes from 3 top docs between 2200 and 2700 grafts. The desired hairline that I showed in my pictures was just as conservative, if not more conservative than shown here.

Sorry, but I just don't believe 1000 grafts can do that.

 

its odd, that is just such a small number of grafts for the area covered... and when i look close at the GRAFT PLACEMENT pics it does NOT appear to be packed very dense... this leads me also to believe that the FLASH is adding a false look of density that would not be present in person... my hairline looks pretty damn thick too with flash.. but to see me in person tells a very different story..

 

just my opinion, overall even if is IS thinner in person for the # of grafts it should be considered a success... would love to see the video Dr.

[lost my swagger]

and one other comment-- his pre op hair is wet, making his forlock look thinner that it really is and OBV the strength of his native hair when DRY is helpin out the right side alot... i mean look how much thicker AREAS WHERE GRAFTS WERENT EVEN PLACED look in the afters.

[Dr. Michael Meshkin]

"where are all the "GREAT JOB", "LOOKS NATURAL" comments from the cheerleader squad? Not one positive comment from the squad... wrong doc?."

Dear Not Just Yet

I agree with you completely and I always wonder about that my self.

To Lost my swagger ,

The hairline is very thick in person and also in the pictures. I will post a very close up picture tommorow so you can judge for you selves. And also with most of my clients, I do get very good results with less number of grafts and at a reasonable cost. Again for this patient, there is no photo shop and he looks absolutely great in person. I hope he allows me to post his video so you can see and hear him for yourself.

[Bill - Seemiller]

Dr. Meshkin,

 

Do you have the density in FU/cm2 of the transplanted area verses the density in FU/cm2 of his natural hair?

 

Understand that the term "illusion" is typically a positive, rather than a negative term. Hair transplants are really about the art of illusion since "true" density is almost impossible to achieve in most patients. Achieving a full look with 40 FU/cm2 on a patient with 80 FU/cm2 natural hair density is what we refer to in a positive way as an excellent "illusion of density". While it looks full, there will be certain lighting conditions and angles that may promote a see-through look. This is typical and to be expected with most hair transplants.

 

Obviously, the number of follicles moved, hair density in FU/cm2, number of hairs per follicular unit, hair characteristics, and placement all impact the overall result.

 

I do think our community would benefit from higher resolution photos. I'm not sure what kind of camera you use, but you may want to consider purchasing a high resolution professional camera so we can better appreciate your good work. Also, it would help if you didn't reduce the size of each photo yo upresent too much from their original size.

 

I hope this helps,

 

Bill

[Dr. Michael Meshkin]

Thank You Bill for your comment. What I meant with my response to lost my swagger was that the hairline is also thick and natural in person, I didnot use any element or styling technique to make the post up pictures look good or the preops look thinner as questioned. These picture presentations are done exactly the way presented by many other clinics , as a matter of fact some clinics shave the preop pictures and then post ops are grown out hair with either comb down or styled a certain way to create more illusion of hair. I donot do that and my patients pictures and my results are still questioned.

In regards to the camera, presently I am using 12 mega pixal camera, if you think that is not enough resolution, I will get a higher resolution.

In regards to this client, he actually looks better in person then his post up pictures. To hopefully clarify the skepticism, I will add cropped/ close up pictures tommorow.

[windjc]

Originally posted by Dr. Mike Meshkin:

"where are all the "GREAT JOB", "LOOKS NATURAL" comments from the cheerleader squad? Not one positive comment from the squad... wrong doc?."

Dear Not Just Yet

I agree with you completely and I always wonder about that my self.

To Lost my swagger ,

The hairline is very thick in person and also in the pictures. I will post a very close up picture tommorow so you can judge for you selves. And also with most of my clients, I do get very good results with less number of grafts and at a reasonable cost. Again for this patient, there is no photo shop and he looks absolutely great in person. I hope he allows me to post his video so you can see and hear him for yourself.

 

 

Hey Doc, did this patient get on meds too? His left side looks almost impossible to be what I am assuming is about 500 grafts. However, with Minox/Propecia, I could understand mo betta.

[Dr. Michael Meshkin]

hello all,

I am posting the cropped magnified photos, tell me what you think.

 

Frontal

 

Top frontal

 

Right Temple

.

 

Left Temple

[Bill - Seemiller]

Dr. Meshkin,

 

12 megapixels is more than enough. The question is however, is it a professional camera with professional zoom in, zoom out lenses? A good friend of mine and I both have 8.2 megapixel cameras. However, she bought a professional camera that takes close-ups 10 times or more better than mine. Of course, I only paid about $150 for my camera whereas hers was about $800 or more. However, professionals photographers could never capture the kind of detail they need with my camera. Hers is perfectly capable of it.

 

Your new photos definitely show more detail and look very nice and natural.

 

Nice work!

 

Bill

[TC17]

Dr. Meshkin seems to be popping out top notch results with little fanfare on a rather consistent basis. I think this is another great result, and with a judicious number of grafts too. Although the patient seems old enough so that future loss is of no concern, I'm sure the patient appreciates reaching his goal with the lower cost of only 1,000 grafts.