I have posted my very ugly photos in the transplant photo section (emantogo)hoping for some feedback ,without a SINGLE reply from either veterans or doctors.This has been frustrating as I have looked to this site as a forum that could provide me with the information and guidance to help me with an obviously bad situation.To add to the frustration I have been seen in person by two of the highly recommended physicians and sent numerous photos for telephone counseling to yet another. They have all had different takes to my
difficult corrective situation.
1."Camouflage" existing harsh frontal hairline
with more grafts and fill behind with what little donor is available.Also cut out "floating plugs"
cut into FUs and use wherever possible.(This part of the corrective process was shared by all.
2.Strip harvest(yes just like donor harvest!)
the lines of 4mm plugs in front in separate sessions and cut into FUs ,fill in wherever
they are able and repeat the process over
again to fill in when harvest scars heal.
3.Selectivly punch out the larger more harsh
grafts (just as they had been originally taken from by now mutilated donor area)cut into FUs and distributed wherever possible. Like the strip harvest This would take multiple sessions to allow area to heal.
I am the poster boy for the transplant nightmare experience.Those of you that are able to avail yourself of the present information and technology are lucky indeed.I've been through it all and I would rather be bald ,but now it is too late for even that!
Please look at my photos and tell me what you think of these confusing options for my situation.
Hoping for answers

Reply to EMantagno (Eric)
Eric,
I went back to the November photos you sent and reviewed them. It appears you have had a Y-shaped ("Mercedes") scalp reduction (I am assuming and hoping it was only one, and not more, which would cause the scalp to thin more). You have a fairly strong front hairline which is reasonably high in its placement, which is good, as it leaves room to put some more natural contour and "feathering" in front of it. At the same time, this "wall" has to be broken down a little and softened in appearance, as no amount of micro's/FU's will completely hide it. There is a technique, first promoted by Dr. Manfred Lukas of Germany (who died a few years ago) in which a very small cylinder punch (with electric drill mechanism, which lends toward crisper, sharper removal of the hairs, so they can be used again) of a few of the hairs at different places along the hairline are removed and the resulting hole fills in nicely within a week or two.
The square area of balding scalp that you have is reasonably large, but, on the other hand, it looks like you may have substantial amount of donor hair, as your fringe appears to come all the way up the side of your head. A rear and side view would give a better idea of the amount of donor hair available. Obviously, some part of it will have circle scars from harvesting your previous grafts. The bottom line is that it could all certainly be made to look better. You don't have enough donor hair most likely to fill in the entirety of your bald area, but if you opt for having the front 60-70% filled in and are willing to adopt a hairstyle in which the hair is swept back (either to either rear side in back or straight back), I think the final look would be a natural one and it would be your own natural hair. It would probably require around three transplant sessions. Another factor is whether or not you are coloring your hair or not. If you are and your natural color is a mixture of brown with gray, your transplanted result would look more natural if you let a little of that gray return.
I also find that it is sometimes difficult to get a man who has worn a large thick hairpiece all of his life to trade that full look for somewhat lower density. A man has to dislike the hairpiece so much that he is willing to trade that density for the natural, but slightly less full look of a good transplant.
There are any number of fine surgeons in your area who could probably perform the steps I outlined above. I wish you the best.
Mike Beehner, M.D.

I'm not a doctor, but you adressed your question to "Veterans, Doctors, Anyone..." so I'll put in my 3 cents. Our situations are similar.

I don't see a huge difference between the three opinions you've reported getting in your post, except one doc would not excise any frontal grafts, and the other two would. The "line excision" is more aggressive, and leaves a more recognizable scar. (Which obviously gets camoflaged with grafts). It's really a judgement call whether that type of approach is called for, and it's hard to offer an opinion on that, based on the photos I see on the site here. A lot of this is a matter of opinion, and different doctors have different approaches. What is "right" for you may not be so easy to decide.

I'm not sure, but it seems like you might have "too much" density in front, (in relation to the "all-over" results you'll eventually get) so my guess (and it is only a guess) is that some graft "redistribution" would be a good thing. However I have a bias towards a thin coverage with more distribution, rather than a thick hairline with a large bald area behind it. (The Joe Biden look... I don't care for it personally).

I would say find a doctor who you trust, first and foremost, whose goals seems to jibe with what would be acceptable goals for you. Pick a top doctor, obviously. Keep in mind that the repair process is done in stages, if you use the "selective excision" approach (not the line excision) so you are not "jumping off a cliff" by going forward with that. If you do the line excision, it's more dramatic and more aggressive. I can't tell if that's what you should do, though, it may very well be. It's a tough call.

It doesn't hurt anything to wait, and think things over. Just pick a top-notch doctor, if you decide to go through with repairs. Ideally every step you take would be an immediate improvement, so if you stop at some point you won't be "in-between" steps.

If you can't decide what to do, keep talking to doctors, keep researching, keep thinking things over. Give yourself plenty of time to make up your mind.

On the plus side, it seems like your hair is coarse, which is positive.

Are you trying to do this in Northern California, or could you travel? I don't know if you are up for travelling for this, but I would throw a couple of names out for you, as a possible docs to consult with: Dr. McLellan at NHI in Los Angeles. And if you haven't considered him already, you might think about Dr. Woods in Australia. He is controversial, but I've seen photos of an amazing repair job he did.

[This message was edited by arfy on March 05, 2002 at 12:03 AM.]