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Hair Loss Forum - Sofarsogood: 200 grafts with Dr. Umar, immediately post op pics

SOFARSOGOOD'S Personal Journal

Sofarsogood: 200 grafts with Dr. Umar, immediately post op pics
(posted by Sofarsogood, Los Angeles area, 17.12.2008, 04:29)

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After 15 strips since 1992, it seemed time to explore FUE/BHT for some “touch-ups” to my hairline. In short I was looking to “soften/shape” the micros and FUs that seemed a bit abrupt and create more of a “{“ shaped hairline as opposed to “)” while creating a more irregular pattern as well. I’ve been researching BHT for months because I have ample body donor hair and after so many strips I fear that my scalp laxity is not what is used to be. My former strip doctor warned me not to do more than 2 more strips. However he was down on FUE and BHT comparing FUE to old style punch graphs only smaller. His take on BHT was, “Do you want a bunch of scars on your chest?” I knew from his attitude he was behind the times and hadn’t gotten around to learning FUE/BHT for obvious reasons that have been discussed here before. It came to my attention that Dr. Umar was “right in my backyard” here in SoCal. I read all I could about him and discussed his work with two of his clients who post regularly both here and on another site. I decided to take the plunge and move forward with a conservative number of BHT around the hairline. Yesterday I received 200+ BHT from my thighs. What an exciting “cutting edge” (pun intended) HT experience. Dr. Umar was generous, thoughtful, kind and very skillful. His new offices by the ocean and supportive staff added very positively to the experience. After an initial examination of my hair, we discussed my desires and expectations, filled out some paper work and soon after began the procedure. In every way this was better than a strip procedure. It took a bit longer but there was much less discomfort, pain, bleeding and intrusiveness. If these BHT graphs grow well and my legs heal up nicely, I'll be Dr. Umar’s patient for life. Dr. Umar took pictures and I will follow up when the tiny scabs fall of and new hair is visible. Thanks to Doc U. & EH who shared their knowledge and experience and put many of my concerns to rest so that I could relax and venture in the next frontier of HT technology.

Dr. Umar says "Thus far, state-of-the-art hairline design using strip HT and scalp FUE has entailed the use of single hair follicles derived form the safe zones. The relatively thick caliber of this donor hair can often contrast with the naturally thinner hair that populates the hairline especially in a NW 1-2+ patient. This problem though not immediately apparent to the unpracticed eye, can be a give away to a discerning observer. A NW 2 hairline with a wall of thicker single hair follicles can sometimes impart a somewhat unnatural look that can be made worse by a higher scalp to hair color contrast. Some measures used to address this issue in strip HT and scalp FUE includes selecting hair from the temporal scalp area (in strip HT), or the peri-auricular areas (near the ears)/nape of the neck (in Scalp FUE). Hair from the nape of the neck and the peri-auricular areas being outside the “safe zones” may present a problem in the event of MPB progression while safe zone temporal hair may not be fine enough. The advent of BHT has presented us with another option. An increasing number of patients are beginning to request the use of cherry picked finer and like textured body hair to feather out what was hitherto considered a good HT derived hairline. In other words, we seek to use a perceived disadvantage of some body hair (namely thin caliber) to our advantage. The surgery performed on Sofarsogood is an illustration of this"

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My last procedure (out of 16 now) was in 5/25/04 with Dr. Ziering. He put 200 one hair FUs in front and 450 FUs in back. I've been doing small procedures since I was 23 to "keep up with my hairloss". I know, not a popular concept here. Although I have been on propecia/proscar and monox (on and off) since 1990, these meds have not completely stopped all hairloss. It has, in my opinion, greatly slowed it down. After researching BHT, I wanted to see if finer body hair from my thighs would create a more “soft and feathery” line with an accentuated peak in front. My old hairline looked good (a little too even) but considering Dr. Us experience and great (if temporary) price, it seemed like a good time to go for it. Don’t think I ever stated that I was 100% satisfied with my HT. 85-95% maybe. You are right, I am somewhat hair-obsessed (as many of us are here) but I am hoping not to have to touch my hairline for a long while. Maybe one more time if this BHT procedure isn't dense enough or something. Also don’t want any more strips. Hoping to use body hair to fill-in any thinning spots that may bug me in the future. I do use some Toppik on occasion and keep some on hand in by briefcase. Not everyday though. It would be hard to tell how the body hair is growing in between existing hair in back or on top so I took a chance and had Dr. U. put the 200 or so BHT in the hairline. If it grows out well there, I’ll know I can use BHT exclusively in the future. (Maybe some scalp FUEs). My scalp probably can’t take more than one or two more strips. Hoping those days are behind me.

Dr. U. explained to me that my hairline was already dense. Putting more hairs in between the old graphs would only make the “wall of hair” thicker and increase the risk of shockloss. Instead he put the BHT just in front of the old hairline as seen in the pictures to diffuse and distract the eye from the “pluggier” areas. A “soft zone” before the old hairline if you will. In addition, I wanted three “peaks” that did bring down the hairline slightly in those areas. One in front center and one on either side. It’s a pretty subtle procedure. I am looking forward to watching it grow out.

Here is a pic of the back of my head. I keep my hair fairly long these days so it is hard to really see the donor area. I can cut it to about an inch and still be fine. Having wavy, course hair helps a lot. In the future, I may add BHT to the scars but this is not a problem for me now. I'm not the buzz cut type. All things considered, doesn't look to bad back there but I wouldnt want to shave my head. Again, not my style. My hair is about 2 inches shorter these days. Below is a pic of me with very short hair from 2 years ago.

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According to Dr.Umar: "The aim of the hairline refinement procedure on sofarsogood is to remove the appearance of abrupt transition from bare skin to a wall of thick caliber hair. He also desired to break up the appearance of a solid uniform line by the placement of a few “peaks”. In many areas (frontal region), his original hairline was dense enough and the placement good enough. In these areas, the only perceived flaw is the quality of hair in the previous HT (Not fine enough). Here, a few grafts were placed and angulated in such a way that would have the eye focus less on the thick caliber hair behind. You do not require to dense pack to achieve this effect. As a matter of fact, dense packing the fine body hair grafts would lead to an actual advancement of the hairline which is not our goal. Since the original hairline is dense enough in these regions, placing grafts in between will only create a denser hairline at the risk of shock loss without achieving our aim. Taking the focus away from the thicker caliber hair would necessitate placing the hair in front of the hair you seek to obstruct. Doing so without dense packing and advancing the hairline at the same time is the aim in this instance. In the lateral areas (sides), the original grafts were pluggier with significant spaces between the grafts. In these areas, finer body hair grafts were insinuated around and immediately in front of the plugs. Again, placement was done in a way that would avoid the appearance of hairline advancement except at the areas of the newly created “peaks”. The 3 peaks created have been sufficiently packed to achieve the desired effect. Finally there were elements of ridging in some aspects of the hairline that would benefit from this approach on the overall. The subtleties of this procedure should become apparent when the hair grows out. In keeping with prevailing cautionary tenet in BHT, we remain cognizant of the possible need to revisit an area for the purpose of adding density if desired Attached are photos of the lateral aspect of the frontal hairline.

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Hairline refinement often would entail adopting different strategies to satisfy specific requirements. Sometimes, the requirements are different even within the same hairline. Sometimes dense packing is necessary, and at other times, goals can be achieved with a lesser number of grafts with proper planning. Sometimes one must confine the work to the preexisting hairline, sometimes advancing the hairline is prudent. For instance in the following patient, the plan was to refine a HT hairline that had large caliber hair with plenty of spaces between. His HT hairline location and placement were of no concern to him. With about 500 grafts to work with, a combination of scalp and body hair was used to achieve our aim. Single scalp follicles were used in the posterior areas, while most of the vanguard hair consisted of fine thigh hair. All work was kept within the confines of his pre-existing hairline. ."

Detailed forum discussion for these pics can be found at: http://www.hairsite4.com/dc/dcboard.php?az=show_topic&forum=12&topic_id=26745&mode=full

 
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