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7-MONTHS RESULT-DR. PAUL SHAPIRO

janna

janna

Invaluable Member
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#1
7-MONTHS RESULT-DR. PAUL SHAPIRO





Pre-Op - Recipient Area to be addressed





Next Two pics are Pre-Op and 4 days Post

you can see slight redness in the recipient area and hair parted to show recent work.









Pre-Op and 7 Months Post Op - Front view





Top view - slight tilt







Topview





Sideview





Close Ups











 
Nervousnelly

Nervousnelly

The Coolest Member
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#2
Beautiful, natural result. The guy is good to go. He likely will never need another result and essentially looks like he has a full head of hair.



NN
 
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north country boy

north country boy

Valued member
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#3
another great result, and not shaving down either, only 7 months post op, 12 months will be excellent :) NCB
 
bullitnut

bullitnut

4 awesome repairs with SMG
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#4
Thats a1 work dr Paul the work looks totally undetectable and natural. Any reason he did not get more grafts,was this down to not shaving the patients recipient area.

Well done top job ¬b`
 
Paul Shapiro MD

Paul Shapiro MD

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#5
To shave or not to shave is a concern that comes up frequently so this patient is a good example why we addressed his concerns the way we did. Below is my write up on HTN and my response to a question that was brought up.

This 38 year old male did not want to cut his hair short prior to surgery. If I cut his hair it would have done a 3,500 + case, but without cutting his hair it was a 2,600 case.
He came in at 7 months, very happy, and most likely he still will have more growth.
The results are not as dense as a 3,500 case, but still cosmetically there is a big change.
So like most things in life there is a trade off.
Without cutting his hair, he did not have to deal with a "funny" hair cut for 3 to 6 months, and none of his colleges knew he had a hair transplant. The transplanted hair grew in so gradual that no one has known he has had a transplant.
If he had allowed me to cut his hair, he would have ended up with more density, but would not have been able to hide the fact he had a transplant. Hiding the fact he had a transplant was important to him.
I have included photos 4 days post op and it is almost impossible to tell he had a transplant.
Sorry the 4 day post op photos are a little blurry. I tried to take them without a flash indoors and the contrast did not come out too good.


The question was........."why a limit of 2600 grafts"......

The reason the number of grafts I can do in one session is lower when the patient does not cut is hair is mainly technical.
When the patient cuts his hair short it allows me to dense pack while avoiding transecting existing hairs. When I am making incisions and a patient cuts his hair I can see clearly between all hair follicles and I can make my incisions closer together while still being sure not to transect existing hair. When the hair is longer, even with careful combing there is overlapping hair which partially obstructs my field of view and I need to make the incisions further away from the existing hair to avoid transection. It is also much easier to keep the field clean when the hair is cut short. There is always bleeding after an incision is made. When the blood sticks to the existing hair, it is more difficult to keep the field clean and see the field for making incisions and planting the grafts. When the technicians or I am planting the grafts and a patient cuts his hair short, it is very easy to get the angle of the incision, and plant the graft. When the patient does not cut his hair, the longer hair can get in the way so I need to make the incisions further away from the existing hair. It is important that the planting of the grafts go quickly and smoothly for good graft survival.
In the first few post operative days, most patients ooze some fluid from the incision site.
When the hair is long there is a chance that the existing hair will stick to the new transplants and then if the patient brushes his hair, he may pull out some grafts. This risk is only in the first couple of post op days. It is a small risk and if a patient follows the post operative instructions it should not happen. But it is still a risk.

Because of the above technical aspects of surgery I believe that graft survival can be compromised if one tries to do too large a case between long hair, and there is an increase chance of damaging existing hair with transection.

Sometimes it takes longer to do a case in a patient with existing hair and sometimes it doesn €™t. Factors such as how long the patient wants to keep his hair, the color and texture of his hair, whether his hair is curly or not, the quality of the patients skin, how much bleeding there is, can all effect the time it takes to do a transplant.

I do think the time element is an important factor in all surgeries and I like to keep the total time for any surgery to under 8 hours. Once the strip is taken out graft survival starts to decrease after 4 to 6 hours. Also, I think some of the risk of surgery starts to increase after 6 to 8 hours. But that is a whole other topic I would like to address sometime.

I hope this is helpful

Dr. Paul

 
bullitnut

bullitnut

4 awesome repairs with SMG
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#7
Thanks dr Paul for clarifying this, makes perfect sense and the end result is visibly fantastic cheers bullit
 
Bigmac

Bigmac

Administrator
Staff member
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#8
He is looking great for 7 months,i love these unshaven results as this was my own preference.

Thanks Dr Paul for that detailed explanation.
 
timuk

timuk

My member is cooler than NN's
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#9
That is a great result and I think goes to prove that if someone is willing to accept a sacrifice in the number of grafts in one session it is possible to avoid shaving down..

I for one would opt for this rather than endure an extended "down time"......

Also... great result and 100% natural and undetectable as usual...

Tim
 
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D

Dazzster26

Valued member
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#10
Hi this is result i would die for its all been said outstanding, excellent result for the Patient

Dr Paul

If I could get a result like this it would not bother me if my barnet was shaved or not brilliant

¬b`