charlie,

quote:

2. Falc/Pat can you tell me if Dr Jen has ever replied or made any post on this site ever ? if she has never i doubt she will, and this thread is cause for my concern enough to ring her personally

Dr. Martinick did reply to Pat's initial inquiry. We are still discussing the matter and will be back with you shortly.

quote:

i hear people say it will have no cosmetic affect at all...i will have to disagree here, i think it will make a big difference...reasoning.

In my opinion, there will be a small cosmetic difference, but it will not be significant. 1200 follicular unit grafts over such a large area (no matter how they are transplanted and especially that spaced apart) will not be enough to create a huge cosmetic difference.

Take a look at my immediately post op photos in the crown from my third surgery (link below). You will notice that the FU grafts are placed much closer together. The cosmetic improvement is significant however, the crown is still thin as expected.

I still have reservations about the graft placement - but Pat and I are discussing this with Dr. Martinick - more detail to come.

Falc

i have to say...I really cannot wait to hear what the story is behind this....

quote:

Originally posted by charlieb:

3. For Jagish i saw your corn rows and i have to say it did turn out better than it looked, im just hoping mine will also get me over the line...for several reasons diferent to yours, 1. my procedure is on the top and you were saying it would look funny from the left or right, however i have existing hairs there which will blend this in , would you agree?

I have attached two of my pictures to show how it looked when I had a buzz cut. I used to grow my hair longer to hide this effect. I hope yours will turn out good.

rows.JPG (21 Kb, 122 downloads)

Look at the area marked in red.

rows1.JPG (23 Kb, 125 downloads)

I realize that these surgeons are very busy and it is possible that Dr. Martinick is out of town or has some personal things to attend to, but her reputation is in jeapardy here and she really should be making some comments soon or have a representative from her clinic address things.

Pat/Falc lets face it, we all know that if she actually did this work there is likely not an explanation that is going to satisfy the masses. She either did it or she didn't and if she did, we all know the verdict. Not even OJ could get out of this one.

NN

Guys,

I just had a personal phone call from Dr Jen and she has laid any concerns i may have to rest. She has said I have had an exception above average transplant and if im not happy with the results she will be the first to fix it...she also said my breakdown in hair count was 15% 1s, 20% 2s and 35% 3s and 4s , which was very good and 2000 follicles were transplanted...she went on to discuss the method she uses is not practiced by alot of doctors on this site...she uses coronal instead off sagital...this is the last post i am going to post for now, and will let the results speak for itself...she has urged me to post the results on the net once it has grown out...thanks for all concerned.

Dr Jen has written so many papers on new techniques and I have no doubt i am in good hands....

just something i googled on coronal methods...

Coronal (horizontal) vs. Sagittal (vertical) Incisions
Follicular units emerge from the scalp in either a bundle or in a linear array. When in a linear configuration, the orientation is generally in a coronal (horizontal) plane, allowing the follicular units to shingle and provide more coverage than if they were sagittal or random. It has been argued that during a hair transplant there is less scar contraction with a coronal incision compared to a sagittal one. This would allow follicular units to remain linear after they have been transplanted and provide the rational for using coronally angled grafting (CAG) to best approximate the way hair grows in nature. [36]

The main advantage of CAG is that it would provide a fuller look to the transplant compared to traditional (sagittal) incisions. Another advantage is that grafts may be positioned at a more acute angle with the surface of the scalp and there may be less tendency of the growing hair to elevate in the vertical plane. This is particularly important at the temple/sideburn area where the hair lies very flat to the scalp surface. It is also felt by some practitioners that CAG exhibits less popping and that the wounds cause less damage to the vascular bed.

Hair restoration doctors using sagittally angled grafts (SAG) feel that the pre-made vertical recipient sites are easier to see and that grafts are easier to place in these sites, minimizing injury to the follicular unit grafts. This may be particularly relevant in areas where there are significant amounts of hair present and the hair transplant surgeon does not have the luxury of shaving the scalp before the procedure. It has also been pointed out that coronal incisions (which cross Langer’s lines) potentially cause more damage to collagen and the cutaneous vasculature, than sagittal incisions. An additional concern is that, although there is possibly more hair elevation with sagittal than coronal incisions, there is less lateral (radial) splay of hair when the former is used. Al with minimizing lift, minimizing lateral splay is also an issue of significant cosmetic importance. Finally, if one considers that many follicular units are not linear and that many linear units may indeed contract during the healing process and lose their linear orientation, CAG may offer only a theoretical advantage. [36-38]

At the time of this writing, there is no consensus on which method is best and if the differences are even significant for most patients, although there is a general trend towards CAG. As with many techniques used in surgical hair restoration, the advantage of one over the other may ultimately depend upon the particular patient, a particular transplant session, or the skills and preferences of a particular surgeon. A number of researchers are currently examining these issues; however, regardless of the outcome, considering the rotational orientation of follicular unit graft adds an important new dimension to follicular unit hair transplantation. (Figures 17 and 18)

charlieb,

I'm confused on the breakdown #s; the percentages do not add up to 100%; did she give you exact hair breakdown #'s or just percentages; I do not think that the "Coronal vs Sagittal Incisions" is the issue or concern here; the actual grafts' placements (symetrical rows and spaced wide apart) I feel is more of the concern.

his right, your 30% missing.

I spoke to Dr Jen for about 20 mins today just before she was due to fly out to Melbourne, i emailed her yesterday expressing my concerns.

We discussed the numbers of hairs in % , I cant rememebr the exact percentages but i definitely remmeber her saying 15% for 1s, 25% for 2s and 35% for 3s, so the rest must be 4s, Ill check when i go back in to get the stiches removed..

she also said that this is the method she uses to do the crown area for most of her patients and she has seen very good results..she has offered me if im not happy to fix it, as her reputation is at stake and she has spent a long time building up a good reputation in the business...which i believe to be true as you cannot have a good rep if you do shit work can you?

we talked in depth about coronal vs sagital placements and she said , not all doctors agree but studies she has done has led to her methods, she also has pictures which she will be happy to email me off similar work on the crown..but this will take about a week due to patient confidentialy, she also said the description of cornrow was incorrect and hers is in a spiralling formation, and mimics nature..., she also said this pattern will disappear once the hairs grows, either her theories are wrong or they are right...but then again she does have repeating and happy patients.

Also i have hairs from my previous transplant which were sagitally placed and they stand up in an unnatural way when they get long, she has fixed this and also improved my scar..she said the scar will be unnoticable once healed.

Personally i have a good feeling about this transplant, i think i will get the results i want...however i will remain healthily sceptical, however it is day 3 and i feel great..even in the midst of all this negativity...why ? its the gut feeling you get...and my gut says it will be good, ive examine the pictures and i think it will be ok...so please lets just wait and see the results before you all go and question a doctor which has helped many many people.

i will keep you guys posted with pics in due course. Please no more non constructive criticism i already know your opinions on the graft placements etc..

on a side note...a doctor cannot just come here and post things about patients unless given approval from the patient..ie Pat and Falc wouldnt get a response unless i explicitly approve due to patient doctor confidentialty, so doctors that actually post here without consent are breaking this rule, thats all

Charles...

I guess the most important thing here is that you are happy and that the Dr. has said she will correct anything if it does not look right.

However, this thread will make all other potential clients of Dr. Jen run a mile !!

Charlie,

I agree with the numbers not adding up. Using the numbers you would have had around 2000 hairs moved before adding in the missing 30%.

If that missing 30% were 4 hairs, you would have ended up with well over 3000 hairs moved. There must be some mistake.

It is not the incision type or size in question, just the layout in rows. That is what we want the DR. to explain.

I think my estimation off 2000 hairs previously was incorrect, ill check and post back , hopefully its over 3000 hairs.

As for the layout all i can say is my hair is in her theories...hope they are right..ill post a day 3 pic now..

Sounds good Charlie, I hope you did get what you paid for.
Look forward to your pics.

Moderator Note

I wanted to give everyone an update on this.

Pat and I have been in touch with Dr. Martinick regarding this case and her continued recommendation on our network.

Dr. Martinick has presented a compelling case for her methodology in this hair transplant patient's case despite the fact that it goes against what we know today as the "gold" standard as ultra refined follicular unit hair transplantation.

I admit however, that I have reservations about this approach.

In my opinion, this patient's hair transplant should not be fully evaluated until the results come in. Basing a suspension of membership solely upon immediately postoperative photos doesn't seem fair.

However, in order to continue Dr. Martinick's recommendation on our network, she is required to present compelling evidence of her recent work in our hair transplant photo album forum.

We have already received an email from Dr. Martinick's associate, Sarah, who will most likely be posting photos in our gallery soon.

I ask everyone to reserve final judgement on this hair transplant patient's case until 12 months - after the results come in.

In the meantime, her continued recommendation is dependent upon her providing compelling results in our photo section.

Thanks,

Falc

Falc,

I have always believed you to be a fair and honest individual and I understand your concern about suspending a doctors membership based on post-op photos. I personally believe that Charlieb will look better in a years time if he maintains his current level of hair, but this unorthodox methodology in no way mimics nature and if all native hair is lost it will look strange. Most of us believe this and are unlikely to alter our stance irregardless of any explanation. I have seen enough bad results to know that it can be devastating to an individual and I for one lean heavily towards "stand alone" Ht's and this is obviously not one of them.

I definitely don't need to wait a year to decide on things. I don't like what I see relative to work performed by other physicians. Most of us know this to be a against the norm. Why have no other physicians on this site chimed in as a defense of this technique? She may have her reasoning and ofcourse she has to defend her case, but I will not endorse her work as I want to know that I can be confident in my referal and with what I just have been witness to, it's not going to happen.

NN

I agree with NN.

I see no reason for us to wait a year to get an straight explanation on this "technique" irregardless if the result comes out OK in a year.

I think most of us here who contribute on this forum know this pattern looks strange. Is this some new technique??

I am surprised this seems to be getting brushed under the rug with a wait a year approach. Can we get a straight explanation on the reason for this weird pattern?

NN and nobuzz,

I am in agreement with both of you. Despite the evidence in support of her technique, I am 100% skeptical and do not believe it mimics nature.

Please understand that this is in no way is this getting "brushed under the rug".

Pat and I are discussing. Please give it some time for us to make a decision based on the evidence before us. Recognize that the decision we make will be what we believe is best for our community.

Thanks for providing your feedback.

Falc

charlieb,

1126 grafts doesn't seem alot, I think we have a similar case.
However, I just received 2300 grafts from Dr. Alexander
Here are my pics.



I've had previous surgeries. As you can see, there are hairs growing on my crown and kind of scattered and some are thicker. That was from a previous surgery.

I had my 3rd one and this is where I got my grafts.



and then Dr. alexander fixed my hairline because I had some obvious hair transplant in the front from previous surgeries.

Dr. placed the grafts to cover and fix them.

I think it's a good idea that you keep using your laser comb, rogaine and propecia. I'm going to do the same.

I also changed my food habit. I eliminated a lot of food that might cause hairloss and started eating food that promotes hair growth.


Since I don't eat meat, protein is very important for healthy hair. I eat alot of protein rich foods such edaname, tofu, soy, seeds, beans and nuts.

I cook a lot, so I always include lots of biotin rich foods as brewer's yeast and soybeans in my food and lots of Vitamin B rich vegetables such as kelp, bananas, sunflower seeds, almonds, lots of green veggies.
I don't like fatty foods and if I crave chips, I usually cook my own using olive oil. My favorite is Kale, it's a green vegetable that is rich in vitamin A, C, B6 and manganese. I usually roast it with almonds and it's really good.

Falc,

Thanks for the clarification. Officially maybe she has not been removed, but unofficially there aren't too many of us that will ever make a recommendation to see her based on what we just saw. I know you well enough to know that you understand fully where I am coming from with that statement.

I am willing to overlook a poor yield, scar, or occasional unnatural result as some of these issues are out of the doctors control; however, to create a pattern as obvious as to the "corn row" we all try to avoid is not acceptable.

At this point the only thing that might possibly change my mind is for some of Dr. Martenicks peers (regular posters) and talented physicians on this site such as Dr. Feller or Dr. Alexander for example to chime in with an explanation.

I do understand the difficulties for you and Pat when faced with something like this as it is very concerning and there should always be a standard protocol to follow. I'm certain that you will make a decision that is ultimately best for the community.

NN

I, too, applaud Falc's consistent fairness and the need for an appearance of open-mindedness to be maintained in this case, but I fail to understand how Martinick's defense of this work could be considered "compelling" if Falc still maintains "100% skepticism". I can't imagine any other doctor coming to the defense of the placement of these recipient sites. And on an unrelated note, I think it must be said again, mrphoenix, that there are no foods that "cause hair loss" or promote hair growth. Unless severe malnourishment is the case, diet has nothing to do with hair loss....