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[quote][postedby]Originally Posted by 44guy[/postedby]
Hey gang tks for replies:
I just wish Cole had his
temple angle closure set like Armani and Umar team.
Maybe im being hyper critical to Cole.[/quote]
Dr. Cole design hairlines depends on your natural pattern, not based on models with straight hairlines of 16 years old. that doesn’t mean we will not do it if it will look natural and the patient demand it.
here are some examples:
Hello Jotronic
I don’t have any pics of my hair, but ironically in Forhairs last post
my hair is rather spot on to the 6th block of pics the before after large
blue block… diffuse thinning… hair color, density and pattern roughly
3x5 inch diffuse on top so 15 sq inches est.
tks
[quote][postedby]Originally Posted by 44guy[/postedby]
Hey gang tks for replies:
As I stated earlier im slightly afraid of strip I just
don’t know if there are any real benefits to have it done. Any Strip
enthusiasts? Fue seems to be cutting edge. I just wish Cole had his
temple angle closure set like Armani and Umar team.
Maybe im being hyper critical to Cole.
[postedby]Originally Posted by HMorHT[/postedby]
I just learned something new. If you want to use your donor to the fullest, I think you will need to go for strip. This is what I gathered from reading this post, the patient initially had FUE and later decided to go for strip instead in order to get the maximum grafts possible.
[/quote]
Interesting, I never thought about that either, I guess it does make sense that you get more donor from strip considering how the donor is harvested.
[quote][postedby]Originally Posted by 44guy[/postedby]
Hello Jotronic
I don’t have any pics of my hair, but ironically in Forhairs last post
my hair is rather spot on to the 6th block of pics the before after large
blue block… diffuse thinning… hair color, density and pattern roughly
3x5 inch diffuse on top so 15 sq inches est.
tks[/quote]
Well, in that case, here are some results that may be somewhat near to your situation…
5955 Grafts one Session
5479 Grafts one Session. Before pics taken in Vancouver, after pics taken in London.
5820 grafts in one session, 5 years post-op. Before pics taken in Vancouver, after pics taken in Madrid. I have video of him somewhere that I need to edit but it shows a lot of detail.
5480 grafts in one session. Before and after pics taken in Vancouver.
3087 Grafts repair work, one session. Before and after pics taken in Vancouver.
4500 grafts in one session, before pics taken in Vancouver, afters sent from Australia.
4120 grafts, one session. Before and after pics taken in Vancouver.
In a hair transplant of 2,000 FU grafts, a donor strip that is 1cm wide would need to be about 20cm long to provide those 2,000 grafts. Imagine the size strip required for upwards of 4,000 grafts! I remember years ago, The Bosley Medical Group offered a scalp reduction procedure they called an “MPR” or Male Pattern Reduction. Scalp reductions aren’t considered worthwhile today because the scalp eventually returns to a similar state.
There was a raging debate years ago related to the effect removing a strip of scalp has on the donor area. Is the height of the (safe) hair “fringe” reduced in a higher Norwood, or does the remaining donor scalp stretch, causing the distance between follicular units to increase? I would say the donor hair density decreases due to stretching. Cross-sectional trichometry consistently provides proof of this. Donor supply is what it is. The strip incision itself kills some hairs. FUE performed by an unskilled physician kills hair. I have seen the result of shock loss in strip donor areas. Back in the early days I had a scalp reduction which essentially is the removal of a elliptical strip of scalp from the top of the head. I had severe shock loss on top. I believe it is at least partly due to diminished blood supply. Working at Dr. Cole’s office, I see a lot of strip scars. It’s relatively rare that I see a really good one, but that’s because I see a lot of unhappy former strip patients. Good strip scars do exist. It’s very surprising that a decent 2mm wide strip scar can be camouflaged well when the hair is long. Shave that same head and the scar always jumps right out at you. Bad FUE doesn’t look great on a shaved head either. Some men are prone to a widened strip scar. I have seen strip scars that stretched to the width of an actual strip that would contain 2,000 grafts. They are more common than you might think and 1,500 grafts to repair a scar this size is of course a waste of grafts that could be put to far better use in the areas of the head affected by MPB. With FUE, the donor area is greatly expanded. A skilled physician can remove finer hair to create the most natural hairline and beard hair can be used to improve density on top. With strip only, the doctor is restricted to the hair characteristics that exist within the removed strip. If the hair is coarse, that’s great for density, but the hairline suffers. We perform a lot of strip hairline refinements because of this very issue. Get a really good strip scar and you could be happy. The ultimate hair restoration procedure IMO is FUE performed by a skilled doctor who removes part of a follicular unit. When ACell is used in the extraction sites, healing is extraordinary.
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck
H&W not only has superior, natural hairline results, it also seems to consistently get great coverage for the amount of grafts. The latter might be partially a result of fewer transection issues as well as H&W’s placement technique. As for FUE, I think the best results I’ve seen come from Dr. Bisanga, HDC and a couple of others…
Dr. Bisanga and HDC learned and trained FUE by Dr. Cole, your comment doesn’t make sense.
I also think you should decide between FUE and Strip, if you want strip then go with H&W. If you want FUE then go safe with Dr. Cole.[/quote]
Dr. Bisanga and HDC learned and trained FUE by Dr. Cole, your comment doesn’t make sense.
I also think you should decide between FUE and Strip, if you want strip then go with H&W. If you want FUE then go safe with Dr. Cole.
It doesn’t make any sense only if you believe that a student can’t surpass his teacher. Who taught Renoir to paint?
All good, my favorite is the guy with 4120 grafts, he sure got his money s worth.
Jotronic: excellent work tks for samples:
Citnews: tks for samples and excellent imput
[quote][postedby]Originally Posted by 44guy[/postedby]
Citnews: tks for samples and excellent imput[/quote]
My pleasure…
One of the hairline repair patients I posted above stopped by our office yesterday for a followup visit. There is still some pinkness under certain lighting but considering he’s only two months away from his second surgery, I think he’s looking great.
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck
Total extractible hair from FUE or strip:
The bottom line is this - You aren’t gaining any more hairs from a HT and your skull isn’t getting any smaller. All the hairs gained in the recipient area have to come from somewhere.
Getting grafts from a strip means the existing scalp skin gets stretched over a slightly larger area when the wound is closed. That means subtle thinning on the rest of your head.
That thinning from a strip might not seem like a big deal when you imagine it, but 2000 hairs is still 2000 hairs. And some of the lost scalp area is covered in a plain old line-scar, which is a downside of its own kind. Is that so different from just harvesting the entire area of the strip scar with FUE, and leaving a smiley-line of empty skin that way?
If you elected to have FUE grafts harvested from all over your head (including many outside the safe zone) then you could get the same 2000 grafts and thin the donor area no more than with a strip.
Yes, that would mean many of the FUE grafts may thin or be lost over time. But with strip you are still losing more hair on your head to MPB eventually too, its just concentrated away from the grafts you have paid for.
[quote][postedby]Originally Posted by cal[/postedby]
Total extractible hair from FUE or strip:
The bottom line is this - You aren’t gaining any more hairs from a HT and your skull isn’t getting any smaller. All the hairs gained in the recipient area have to come from somewhere.
Getting grafts from a strip means the existing scalp skin gets stretched over a slightly larger area when the wound is closed. That means subtle thinning on the rest of your head.
That thinning from a strip might not seem like a big deal when you imagine it, but 2000 hairs is still 2000 hairs. And some of the lost scalp area is covered in a plain old line-scar, which is a downside of its own kind. Is that so different from just harvesting the entire area of the strip scar with FUE, and leaving a smiley-line of empty skin that way?
If you elected to have FUE grafts harvested from all over your head (including many outside the safe zone) then you could get the same 2000 grafts and thin the donor area no more than with a strip.
Yes, that would mean many of the FUE grafts may thin or be lost over time. But with strip you are still losing more hair on your head to MPB eventually too, its just concentrated away from the grafts you have paid for.[/quote]
Is this what it has come down to? People are actually advocating that grafts be purposely taken outside of the safe zone? To what end? This is counter to the whole point of getting surgery to begin with and used to be considered taboo. I know of a couple of doctors that advocate for this as well and frankly I consider it a shortcut with no long term benefit for the patient but certainly a long term benefit for the doctor due to the inevitable repeat business.
Assuming one decides to NOT go outside of the safe zone and take only hairs that are expected to be resistant to DHT you will have a stronger degree of visible thinning with FUE, no matter how well it is performed, than with a comparable amount of hair taken via strip.
Okay . . . so does the strip patient end up gaining more total hair on his head than the FUE patient, or does the strip patient’s skull get smaller? Which one is it?
If the FUT patient’s donor area remains thicker then that extra density must have come from somewhere. Maybe it’s from pulling the balded area & the back of the neck closer together. That hides the visible thinning better. But it’s not a free lunch. That would slightly INCREASE the amount of balding area to cover on top as the area is moved backward. And it would raise the area of uncovered hair on the back of the neck (which can also be “raised” by harvesting via FUE too, for a real benefit to the hairline IMHO.)
I respect you Jotronic and I don’t want to turn this into an FUT/FUE debate. I will readily acknowledge that FUT has its upsides.
But I’m suggesting a doc FUE-transplant a combination of permanent and less-permanent hairs. I don’t mean about-to-fall-out hairs mostly dead, I mean decent useful hairs that are still going to last years into the future but just not as long as the donor wreath itself. Then you could establish good coverage that is thicker when you are younger and it would thin out more evenly as you age.
Of course people have a bad knee-jerk reaction to the idea of paying for non-permanent grafts. But IMHO this strategy deserves not to be dismissed so quickly. It not only allows the patient to have more of his hair where he wants it in his youth, but it also reduces the donor-thinning that is inevitable if hair is FUE’d only from the most MPB-resistant area of the scalp.
There is a finite amount of scalp hair on the head. It has varying degrees of MPB resistance. If you had all the hairs on the head removed and sitting in front of you, and you were planning out the patient’s lifetime . . . where would you put them? I think programming in a MODERATE degree of thinning over time in exchange for more coverage/density in the MPB-ing areas during the younger years is a decent idea.
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