harryforreal

I honestly don't think that implanter pens were even available when that section of their website was written

Ok, thanks, Nick - especially for the quote from Dr. Doganay. Anyone else who wants to chime in - especially as to when implanter pens were invented - is welcome.

- Harry

One thing I get confused about is the difference between Sagital/Coronal Slits made with small blades versus how Implanter Pens work.

From Hasson and Wong's website they write:

The lateral slit technique is the only surgical method that is able to duplicate the alignment and distribution of hair as it occurs in nature, maximizing coverage, and eliminating the pluggy results of older hair transplantation methods. The angle and direction of hair growth can be precisely controlled, allowing transplantation of areas previously regarded as too difficult or unsuitable for hair transplant surgery, i.e. the temple and sideburn zones. In the donor area, follicular units appear to be lined up alongside one another in a plane perpendicular to the direction of hair growth. Lateral slit technique mimics nature's arrangement of hair follicles providing the patient with the most natural possible results. In other methods of creating the recipient site, incisions are made sagitally, parallel to the direction of hair growth. In such methods, maximum possible density in a given area cannot be achieved, hairs grow randomly and often atop one another, producing redundant coverage and unnatural results.

Does implantation with implanter pens use Sagital/Coronal slits? I'm concerned that "In other methods" (which I've highlighted in bold) may refer to implanter pens and that implanter pens produce hairs growing "randomly and on top one another, producing redundant coverage and unnatural results".

Thoughts, please, I know Dr. Lorenzo uses such pens....

And please don't say, "Well there's your answer!"....

It is not true that you have to shave your entire head for FUE or even an amount that would be obvious.

Actually, if you have long enough hair and depending on the amount of grafts required (that is, not too many), the doctor can pin back long locks that will not be shaved, then shave in specific areas to extract hair via FUE, and then let the longer locks that were not shaven fall back and cover up the shaven areas.

No one will see the shaven areas.

Yeah - I figured that ^^

i know dr bisanga does manul punches but then leaves grafts in place until recipient sites are done and only then are the grafts taken out. it was explained to me that this allows grafts to be out of body for shorter amount of time.

That's a very interesting technique; I wonder if and how many other doctors do this.

Bisanga and Mwamba were trained by an average surgeon and they both not are among the world's best.

Mickey, that sentence sounds to me a bit like Bisanga and Mwamba are not among the world's best - but I don't believe that's how you meant it to sound...?

I wonder how much of this guy's quick....near panic reaction that his HT was a failure at 17 days post-op is because he was a very poorly informed patient, did not do much pre-op research, and his doctor doing a pathetic job of educating him pre-op?

I would say I was a poorly informed patient without much pre-op research and a slick "educational" marketing brochure from the doctor. To be fair, researching hair transplants, doctors, techniques, etc., is a VERY time consuming endeavor. No doctor should be allowed to offer a "special price for the next two weeks" in order to rush a patient to make a decision about a lifer altering event when they first come on for a simple consultation about hair loss and treatment options.

Also, although I am grateful for this forum, it's quite a difficult forum to navigate and research in. It can be quite confusing just to navigate, much less trying to keep in mind all the doctors, techniques, etc...

Dating sites are far more simpler to navigate even with their thousands and thousands of members...

Hi, Spanker,

Yes, I've started talking with a couple of people about it - and it does help. And being on here talking with people helps.

I will post the photos - just not yet. I am trying to tread much more cautiously than I initially did - and that includes making sure I am not making false or misleading claims about any particular doctor in a public forum.

By the way, is that you in your profile pic with the beard? It's a comforting photo, "dad".

But seriously, I understand that there are indeed some top notch doctors out there, and I want to clarify that my HT doc is not a "Coalition" doc - not that I trust that title completely after my experience. If I had the money, time, and chance to do it all again, I would probably go to Belgium as it seems Dr. Bisanga and Dr. Firendi are doing amazing work and their photos of younger patients look more like my hair rather than some of the older patients in their 50's + with all gray hair and "thinner" hair transplants that are age appropriate. I am also wondering about Dr. Cooley, as some of his recent pics were nice, and I appreciate his response, but again, I feel like his pictures tend to be of older patients (not that I'm some spring chicken, mind you - but most people would not guess my age even before my H.T.).

What thickness/type is your hair? If you have fine blonde/light brown hair (as i have) then the odd 2 hair follicle in your hairline is ok as it adds definition, however, there should only be a couple and they should certainly be angled correctly.

I have blonde/light brown hair that is wavy/curly.

There are by far more 2-hair follicles in my hairline than 1 I would guess; however, I have tried to tell myself that 2-hair units in the hair line can be naturally occurring, but I am obsessive now about looking at hairlines of people I meet every day and don't really see it. I am certainly hoping that with time these hairs soften more - the full cycle can take 3 years?

I have a lot of hair on my head - always had - never IMAGINED that I would loose so much hair at my hairline that I would opt for a HT! God....when I was a kid I used to think, "I can't wait until I get older and my hair thins so it will be more manageable." Be careful of what you wish for!

A month ago I started using Kelo-cote scar gel to help with the redness and, quite frankly though i have not mentioned it previously, what appeared to be ridging in the front of the hairline on one side. It seems to have helped with the redness and certainly with the raised bumps around the hair follicles some, though they are not completely flat it is much improved and not really noticeable from the front, though more "easily" viewable from behind within the hairline....almost impossible to get the bumps to show up in the pics, though, as I have tried...

Overall I have been quite impressed with Kelo-cote, and was wondering if anyone else has ever tried it?

When you say multi unit/pluggy grafts in your hairline, do you mean single grafts with multiple hairs, or multiple grafts placed in each incision site?

s2thoudriver: That is a very good question, and I'm glad you asked it. To be honest it was only a month ago that I had became "enlightened" about the placement of 1, 2, 3, & 4 hair units in specific regions of the scalp: that is, only 1's in the hairline, gradually becoming 2's further back, and so forth - and that was after months of looking in this forum for months in hope of a better outcome than what seemed to be developing. Honestly, I don't know how anyone could be "properly" educated or self-informed about HT's without spending MONTHS of research independent of whatever slick marketing brochures the doctor is handing to you to take home to "learn more about it".

But to answer your question, I have a lot of 2's - that is, 2 hairs coming out of the same follicle, splitting like a "V" or TV antennae; also there are grafts where the 2 hairs are so close together that I am quite sure they are part of the same graft - whether they technically are growing out of the same hair follicle I can't say; my sense is they are not the same hair follicle, but rather a 2 hair unit graft (or in some cases a 3 or 4, possibly 5 or 6) where the hairs in the graft are clumped very close together. But I believe that I am talking about single grafts with multiple hairs.

Several weeks ago I asked Dr. Cooley (who was NOT my HT doc) for clarification, and this is what he replied:

If follicular unit grafts are created under microscopic dissection, they can be accurately separated into 1, 2, and 3 hair grafts. The size incision I make for 1 hair grafts usually won't accept 2 hair grafts and my placers know to be careful about this. Occasionally, we might see a 2 hair graft at the hairline and it is thought that sometimes a practically invisible telogen follicle can be 'hiding' in what appears to be a 1 hair graft. We don't see this very often though.

Based on that statement I don't think one can place multiple grafts into each incision site, but then I'm not a medical person.

I have taken probably over 50 pictures in the last two weeks with my new Iphone 5 and the HD camera in it, and will post a couple pics soon I think as I would like feedback - I'm just not ready yet for several reasons, mainly because I want to understand better this procedure and current medical practice so as not to cast unjust aspersions onto my HT doctor, and I would like nothing better than for my HT to suddenly look "Amazing!" and never have to think about it again, but since I think the primary problem is one of crappy technique I can't see how it will improve...

Also, what blood/skin tests did they do prior to your surgery? Any high or low blood pressure?

No blood/skin tests that I know of were performed - I pretty much just showed up and they got busy, so unless they did it after giving me anesthesia I am unaware of any such blood tests performed. However, I can say that my health is quite good: my last physical was in April and my blood pressure at the time was 102/72.

Is it current medical practice to give blood/skin tests prior to a procedure?

People need to keep in mind that for at least 10months post surgery, the hair will come through more coarse and darker than the native hair, therefore will stand out until they take on the characteristics of the surrounding native hairs. Also, each incision site is a scar site and as with all scars and surgeries, recovery of such can take up to 12 months. This is why final results aren't being seen until up to 18 months.

I am hoping that the coarser hair will soften and that the scars/redness at each incision site will improve - I am now at month 17, and I have been very patient and might as well wait one more month, but honestly, can't see how it will change all the 2 hair units in my hairline....

But thanks for replying, Rob. I wouldn't have come this far in my understanding if not for people posting on this forum.

I personally think you're exaggerating the situation a bit, so please prove me wrong if you can.

It's not for you to tell someone that they are exaggerating when it comes to their feelings. He was obvious insecure enough from the outset to seriously question his results at only day 6 of his first HT. And now he has gone back for a second HT. Perhaps this patient was never a good candidate for a HT based on his emotional/psychological state alone, regardless of how "good" the transplant looks to the average person.

For me in part there is a sense that I have done something deceptive to the people I meet and see everyday - trying to deceive them, and hoping they don't see through my deception. But even if they don't see through it (and I've got a decent comb over going on to hide the gnarly hairline), it doesn't change the sense that I'm trying to be dishonest about my appearance - just like someone wearing a toupee....

No good HT looks fake though, only poorly designed ones or ones where too many double and triple hair grafts have been used in the hairline.

This is me...and I can't understand why the hell they were placed there. I am so angry at the doctor for this. 17 months now and there is still redness - particularly at these 2 and 3 unit hair grafts in the hair line.

I feel constant pain in my chest over my decision to have a HT...

Otherwise for people considering a HT, I agree with what CHB811 wrote and what Mickey85 wrote. Those considering a HT should definitely read their posts repeatedly. I wish I had just done the meds FIRST (that's what I asked for), but the doctor said the only thing that would work for me was 1000 grafts - his minimum charge: how coincidental!!! And there was a "special" going on - special price that is - but only for the next two weeks.

However, the vast majority of patients that I see on this forum who have had work done from elite doctors look better after their HT. The majority of unhappy patients come from hacks, IMO.

That may be true, Spanker, but my doc is a "recommended" doc on this forum - and I've got multi-unit hair grafts in my F**(#@! hairline!!!

I also wonder what percentage of HT patients feel that their HT looks real or is undetectable. It may well be that there are a few doctors out there, or possibly a few patients who possess just the "right" physical traits, to pull off a "natural" looking HT but that these are few and far between. Like going to the craps table at a casino - some will win, but most will loose because the odds are stacked against you...

The multiple unit pluggy hair grafts in my hairline, the continued redness, and the weird crisscrossing angles of my hairs not withstanding (in part due no doubt to the multiple unit hair grafts with hairs growing out in different directions), if all these elements had been come together like they were "supposed" to, I wonder how a HT can look natural if the caliber of the transplanted hairs don't match the native hairs next to them in the hairline. I mean - that's something I keep coming back to - even if the rest looked fine, the transplanted hairs don't match in caliber, so how can it look natural?

I also wonder if it looks more natural for people who have a lot of coarse, gray hair; or for people who have had such significant hair loss that there are very few native hairs to cause glaring contrast in caliber/texture/color. Myself, I'm not sure I was a Norwood 2A, but I can tell you my side hairs are soft, fine, blonde hair. I can't help but feel that propecia might have thickened up my existing hairline without all this...At the very least, I feel i should have been counseled to give meds a try first rather than be subjected to a high pressure sales pitch to make a deposit within two weeks in order to benefit from the "special price" being run that month....

Nice, are you using nape because its a lil more soft and thinner, which is perfect for temple points? I would loveeeeeto see the outcome! Keep me posted!

 

Hariri, I'd like to hear your answer to Ff305

Also, what about Nape hair not surviving or lasting once transplanted into recipient site?

Looks good from the front - I would not have even thought you had a HT from the front pic, so looks like the recipient area is healing great. We're all waiting and watching with you!

Hi, Nick - Yes, I have looked at their website, and I think it is great - wish I had looked at it BEFORE I had my surgery, but I was a bit naive about medical practices. I must say that my opinion of medical professionals has dropped to just about whale sh!t on the bottom of the ocean, even though it's not fair to regard all medical professionals in this manner, but it's my initial reaction now.

I still am interested in knowing how far back from your hairline your doctor started using 2-3 hair FUG's?

I think 100 1 hair graft would look more dense that 50 2 hair grafts, but I don't think that is what he is trying to say.

Yes, that is what I am saying at least. And I only wanted to thicken up my hairline at the front really - I don't feel the doctor listened to what I wanted or just didn't care - was just interested in making his minimum cost procedure. It's interesting to me by contrast that Dr. Feller and Dr. Lindsey have a "200 FUE" option - I probably would have been fine with something like this, but then maybe Dr. Feller/Dr. Lindsey would have said differently....I had 1000 grafts done - don't know how many hairs that was, or how they were divided or if they were divided at all. Also don't know how they were placed or where. I find it interesting Nick that you know exactly where your 1-hair, 2 hair, 3-hair, and 4-hair FUG's were placed:

In my particular case, 45 grafts/cm were placed in my hairline, these were all single grafts. That will be a desnity of 45hairs/cm2. Behind my hairline 30-40 grafts/cm2 were placed of 2-3. That ends up being at the very least 60 hairs/cm2. Further back towards my crown, they placed the 3-4 ones with a density of 20-25 (at least 60 hairs/cm2).

How far back from the hairline did your doctor start using 2-3 grafts if I may ask?

If you can fit 3 pieces of hair into an area slightly larger than you can 1 hair, then you are by definition increasing density.

I don't quite agree - it may be more dense on top where the hairs spread out, but at the bottom of the FUG if all the hairs are coming out of the same follicular unit then there is no density at "ground level" - which is what I see in my hairline. That is also the reason I think so many docs do pictures from above so much - looks more dense from above. But who is looking at people from above like a bird???

But I agree with your original point that doctors should break down the FUG's by number of hairs AS WELL AS indicate where those graphs are placed/dispersed across the recipient area on the scalp.

Oh, and Dr. Lindsey, I did check out Tafoya's training page - similarly pathetic before and after pictures...

I just don't know what to make of this unregulated field...Can anyone literally just cut out hairs, make new slits, and implant hairs without state monitored training, licensing, and regulation? If so - where do I sign up?

Too bad you had to take down so many examples, Future_HT_Doc. It didn't look like there was any additional dissecting of grafts in the first Sean Rima video that was posted and now is removed.

Interestingly enough, the Neograft video on Mickey85's link boasts "No Additional Cutting Needed" at 1:47 seconds:

http://www.hairrestorationnetwork.com/eve/169281-ultimate-manual-versus-motorized-fue-thread.html

Regardless, it is pretty shocking to see Doctor Jeffrey Hall doing nothing more than administering anesthetic in the Rima video. Even the hair line is drawn in by the techs - and that's the only line they draw! No additional lines are drawn for dividing the scalp into different regions like I have seen in videos posted by some of the highly respected doctors such as Shapiro and Shapiro. I guess that's partly why the results posted on Dr. Hall's Austin Hair Graft website look so poor....

Honestly, it seems like these techs were drawn from some "Nails by Design" boutique....wonder if Dr. Hall provided Rima with a pedicure and toe painting while Rima waited....

Whoa, Cant Decide - I'm not a math person!!! The last math class I took was as a junior in high school!

Ok, so, let me make sure I understand:

Can't Decide: On average each implanted FUG (Follicular Unit Graft) has 2.2 hairs supposedly; but you believe the average number of hairs per FUG is closer to 2.0.

Nick: You believe that the lower average number of hairs per FUG results in an appearance of lower density and in contrast a higher number of hairs per FUG results in a higher appearance of density - if strategically placed.

I agree that surgeons need to post the graft breakdown AS WELL AS a diagram of where those grafts are placed. I love how Shapiro and Shapiro have on their website a diagram showing the dispersion of FUG's based on the number of hairs in each graft. I also love how some surgeons on here break it down even further into "fine hairs," so some say 156 fine 1-hair FUG's, 204 coarse 1-hair FUG'S, 233 fine 2-hair FUG's, 275 coarse 2-hair FUG's, and so on.

It's interesting Nick that you believe that FUG's with higher hair count increase the appearance of density. I feel if my surgeon had used only 1's in the front of my hair the appearance would seem more dense because the hairs would be spread out more evenly across my head and lay down more easily thereby covering more of my head,

In my case, all the 2-hair FUG's in the front of my hair line and in the front part of my hair I believe results significantly in a less dense appearance than 1-hair FUG's. They are too coarse, stand up rather than lay down, with no fine hairs in between - it looks like a sickly, old forest with thick tree trunks covered on top by growth but nothing in between the trees grows on the forest floor. Probably looks fine if you are a bird flying above looking for a nice target to bomb; but from the front it looks freaky. Micro-plugs essentially, but still very pluggy and not natural looking...

I can't brush my hair back and find it absurd that after my hair transplant I'm still doing the "comb over" in order to hide these sickly tree trunks. Also the 2-hair FUG's looks like a bunch of little analog TV antennas sticking out of my head. Makes me think of the Saturday Night Live skit series "The Coneheads"....only I'm envisioning a new series entitled "The Antenna Heads"....

After pics at Hall Plastic Surgery.....a bit thin?

**outside link removed by moderator**

The original video published on Apr 28, 2011.

The below video published Feb 14, 2013. Is this really two years post op?

When was this video made? How does his procedure look now?

Shampoo speaks gospel.

It looks great - super clean and very dense - much better than what I got. If you're taking propecia even if it was harvested above the safe zone, then I wonder if it's really such a big deal?

I sympathize with you, Aramis. I, too, am dealing with weirdly angled hairs, as well as multiple unit hair grafts in the hairline.

I would like to know if others think what Daska writes is correct in regards to hair angles improving by molding to the direction of combing:

The other issues like the angle of few grafts and acne on donor area can also be resolved in next session. Usually, once there is growth of all hair. The hair tends to get mold with the parting style as you had to comb them from left to right.

At 2:24 seconds in the Neograft machine video, does the surgeon/tech suction up a 2 hair unit and implant it at the front of the hairline???

What is "permanent shock loss"? In this case Dr. Feller doesn't think it's an issue - or in any cases, for that matter. Is it a real concern after a hair transplant? Why does the other doctor think it's an issue?