cheers,good luck.

Hi bullitnut, as i mentioned on another forum, more than happy to help in anyway i can mate. What has happened to you previously is just despicable and I feel for you mate.

how would the scars looked if you shaved to skin with Mach 3

not sure mate never tried i cant afford mach3 ha ha i use pound shop razors. joking appart though mate i really dont know perhaps ill try

Much of hair transplantation is subjective and therefore open to wide interpretation and discussion by doctors and laymen alike. However, the proper location of donor incisions based on anatomical landmarks is NOT up for debate.

The bottom line is that the scar in Allan’s photo is demonstrably and unequivocally in the WRONG position because it is located BELOW the occipital bump (also known as the "inion" or "nuchal bump").

The reason for this is simple. The area of scalp below the bump is thinner and contains three layers of skin that do not easily slide over each other. The result is greater tension and potential for a wider scar than excisions made above the bump. The area above the bump, in sharp contrast, contains FIVE layers that glide over each other much more easily.

THE textbook on the subject of hair transplantation: “Hair Transplantation, 4th Edition, Unger/Shapiro” clearly lays out the anatomy and physiology and demonstrates with diagrams and text why excision below the bump is plainly WRONG:





I have verified the anatomy and physiology put forward by Unger and Shapiro using Moore's textbook of anatomy and Gray's Textbook of anatomy and can confidently confirm the accuracy of their information and conclusions.

Above or on the bump- GOOD.
Below the bump- BAD.
Pretty simple.

If we apply what Unger/Shapiro, Moore, and Gray taught us, it is pretty obvious that Allan's scar is BELOW the nuchal bump in direct contradiction to the authoritive texts. While there are exceptions to this rule, they don't seem to be in evidence either in the report Allan gave or the photo he displayed. His surgeon has some explaining to do.

Besides the academia cited above, any experienced and astute surgeon knows that the area below the bump is usually tighter, more fibrous, and less conducive to stretching and sliding. The same goes for the donor area just above the ears.

Falc,
I would like to respond to your reference as to the appearance of the location of the scar in my patient Richie, Allan, and Balody.

Plainly stated my excision was made in exactly the right position with respect to the nuchal bump and within the safest area of hair bearing skin available in the donor area. It is NOT too high as you have perceived and the relative angle of the camera is inconsequencial. I would ask Richie to please post an immediate post op photo of the donor area that may show where his scar is with respect to the nuchal bump. I know it is on or above the bump because that is standard operating procedure with me.

As for Allan's scar, it is obviously BELOW the nuchal bump because you can plainly see the bump in the photo and the scar is clearly below it. Doesn't matter what angle the photo is taken at.


As for Balody's photo.

I can't tell where the bump is because his hair obscures the anatomy and I've never met the man. It appears to be below the nuchal bump but I couldn't say for sure. Either he would be kind enough to post an operative or immediately post operative photo, or perhaps you can dig one up as I believe he posted them after his second procedure. Balody, perhaps you can provide the photo for us.

This is a very very important post for doctors and patients alike. The position of the scar, with respect to the position of the nuchal bump, is a concrete and tangible way of sizing up the doctor you are thinking of using for YOUR hair transplant.

I'll also bet $10 that every doctor reading this post will (hopefully) read the textbook sections I cited here and will act accordingly for the good of their patients and their practice.

Dr. Alan Feller
Great Neck, NY

I swear to God Doc, you never cease to amaze me

I wish all doctors could be this upfront. I've read some posts of people calling you cocky (you are right and everyone is wrong) but you prove once again that any discussion/argument without evidence, which you DID provide, makes them look like amatures.

Great post Doc...

Dr. Feller,

I agree that the ideal location of the scar is not up for debate. I also have the text book you are referring to and am enjoying it very much.

The point of my post was simply that appearances can be deceiving. Just as Balody's scar "appears" low in the referenced picture, Richie's "appears" high in one of his pictures posted in comparison on this thread. I have posted a few images below for your reference.

The first picture, seemingly based on the camera angle, the scar "appears" too high, but in looking at the scar from the side angle, it appears normal. In comparing it to other pictures on his blog, the scar looks normal.



Now if you compare the picture you referenced of Balody's scar to this one below, you will notice it looks much different. Whereas it "appears" low in the picture you referenced, this one appears perfectly normal.



I do appreciate however, you taking the time to post this detailed information.

Falc

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Hey Dr Feller ,hope you and your staff are well

As requested , more photos of my scar and donor .

Falceros , below I have posted 12 pics of my scar from all differing angles and different lighting , i have been as honest and as transparent as i can be .

You will see that in all the shots my scar looks to be in the exact position show by Dr Feller earlier in this thread , to be the most optimum for the best healing with mininum scar stretch , i have even put my scar next to the diamgram used from the teaching manual published by Unger and Shiparo using Moore's and Gray's text book of anatomy to show you .

My scar has also been scutinised in person by atleast 8 people at our Manchester show case less than two weeks ago , these people ranged from veterans to newbies but most had similar knowledge to yourself on were a scar should roughly be located and certainly showed knowledge of what would be concidered a low scar or a high scar , all these people commented at how neat and healthy and perfectly placed my scar was .

Balody was invited to this show case but unfortunitally couldn't make it ,which is a shame as many menbers of the ht "club" could have verified the hight of his scar and put this topic to bed once and for all .

Falcorus have you ever met Balody to inspect his scar or are you only defending the hight from the photos from his blog ?

I only ask this due to the fact most of the pics on balody's blog show the scar looking very low , even the pic you have shown above has got bolody with a very tilted forward head with the scar looking very close to the nape of his neck , clearly out of the optimun zone shown demonstated by Dr feller in his above post .

here are my pictures ;









You can quiet clearly see from the photos above , what is a low area regards the medical infomation supplied by Dr Feller and which scar is right were it should be and within the lighter shaded area , as explain by Dr Feller in his above post .

You can also clearly see from the variety of my pics I have posted , that some do look a little higher then others ,however the most accurate are my side profile shots , were my scar can be seen clearly falling into the safe zone .

Perhaps Balody may be willing to supply more photos ,which would also help to clarify things ?

I hope that clears up any confusion
richie

My Norton scar is well below the hump....hence it has given me the right hump.They obviously haven't read any manuals on hair transplants.

Richie,

I appreciate your post, but I'm not sure exactly why you felt the need to post all your scar pictures when I've already stated in plain black and white that your scar looks perfectly normal.

Once again, the purpose of my post is that LOOKS can be DECEIVING. And by this, I am referring to the APPEARANCE of your scar looking high and the APPEARANCE of Balody's scar looking low.

In ONE picture, your scar APPEARS high, but doesn't in your other pictures. Likewise, the picture you have selected of Balody's scar APPEARS low, while yhet other pictures show otherwise. Once again, see the below picture:



You can his 3 month scar pictures from the side view by clicking here.

Another 2 month picture is below and the scar also appears normal



In both of your pictures, it is quite difficult to see the Nuchal bump, and we must keep in mind that this bump is higher or lower in certain individuals.

Compare your scars to mine below:



According to some of the pictures displayed, mine is right in the middle between both of yours . And I'm also sure if I tilt my head up or down, the scar will appear higher or lower than it really is.

I believe both you and Balody are in great shape!

Best wishes,

Falc

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Thanks for replying falc

I apologise to balody in advance for using his pictures , but you did direct me to them , so for the purpose of this dicussion I have posted them here .

Also Dr Feller asked me to supply him with some more photos to back up his point , so I obliged .

Thankyou for directing me to balody's side pictures , however after looking at these pictures they only confirm my origional opinion regards balody's scar position being very low .

The two pictures you chose to post have balody with his head tilted very far foward , which is even harder to accuratly see the scar , if anything leaving you wondering and seeking further clarification with his other pictures .

The following side pictures clearly show were it falls with regards his "bump" , as Dr Feller has already stated earlier

Above or on the bump- GOOD.
Below the bump- BAD.
Pretty simple.

In this pic you can clearly see how low the scar is , even how low it falls regards his crown loss and "bump"

In this pic , which you directed me too , you can clearly see the scar , lower than his "bump"

On this pics i have produced a yellow line to show the position of my own scar to directly compare it to balody's

Again i have produced the yellow line to show were my own scar would fall in relation to balody's lower than his "bump" scar , his scar also appears extreamly close to his ear in this shot .

If I am proved wrong by seeing this in person at one of the next Manchester meets ,or even the London or Birmingham meets , were balody is invited and I take some of my own photographs to rule out any mis-interpretation , then i shall publically apologise and offer to buy him a beer , but based on the evidence you have shown me , I still believe the scar to be very low , my concerns go out to balody as , I believe the lower the scar the more suseptable they are to stretching .

I origionally accepted the mis-interpreted picture theory but the more I look , the more the evidence suggests balody's scar to be low .

Again I apologise to balody in advance , but I was directed to these pictures and as a resulr of our debate I moved them from your blog to this post .

What do you think Falc ?

richie

Richie,

Thanks for pointing these out.

The scar does appear to be a bit lower than normal in several of these pictures. Perhaps it is, I can't be sure. It is interesting however, that some pictures show a higher scar and others show a lower one. Some can be written off as the angle of the head while others may be more revealing.

Nonetheless, I suppose only Balody or Dr. Farjo can really attest to it and if it is indeed lower (as it appears to be in several of the pictures), the reason for it.

I also know that some surgeons occasionally take hair lower on the sides to get more of the fine hair for the hairline.

The good news is, his scar is healing very nicely and there are no signs of scar stretching.

Falc

Falc,
As you and everyone knows on this site Richie has both here and apparently on other sites has continuosly had digs at Farjo.Concerned for Balody, well come on do me a favour.
I am not sure what his long term aims are but it's likely i will retire in a couple of years and he is doing his chances of applying for a position no good at all with his continual harrassment.

Mick

dr feller,
i appreciate the knowledge you have as a dr at the top of his game,and your experience is valued on this site aswell as many others.
but could you refrain from using me as an example and stick to your own patients.i think it is highly unethical for a dr to "in effect" critisize another dr,s work on a public platform as you are doing here.
beleive me if i have any concerns with my proceedure(which i havent) i will go to my dr personally to air them.

im sure you understand,
cheers
paul

Hey Mick

Thankyou for taking time to reply , much appreciated , and thanks for your kind offer to take your place as patient coordinator at Farjo, however I will have to decline , as tempting as it is hahahaha .

Its a shame that since this debate has been very helpful to many that you have actually chosen instead of finally coming forward to explain and help clarify your patients scar position and getting involved in the debate, which would have helped you. You have chosen instead to have a little dig at me , rather than make any attempt to back up your clinics result with any information which i think may have helped to stem any confusion .

With all due respect , may I make a suggestion that you, yourself , try to be a little more interactive on the forum and responsible for your clinic before you retire and not leave these questions surrounding your patients for others to answer , this only leads to speculation .

I have seen on another forum that balody has now stated his scar is below the bump , so at least we are finally getting some clarity .

I look forward to anymore information .

your sincerly
richie

Mick,

I am very disappointed with your post on this thread.

In my opinion, you would have been much better off addressing either the content of the thread or posting impressive patient photo albums that display a multitude of quality scars indicative of the quality of work that Dr. Farjo regularly performs.

Remember that all physicians are open to constructive criticism as outlined in the Coalition membership standards under the "physician accountability" section. See below:

-------------

Membership in the Coalition requires members to maintain a high degree of patient satisfaction. Members care for their patients knowing that their patients are free to post their experiences on the popular Hair Restoration Discussion Forum. On this open forum patients are free to critique physicians and to hold them accountable for their actions. This forum is run and moderated by hair restoration patients.

-------------

It's hard to tell whether or not Balody's scar is normal or low by the pictures as some appear normal whereas others show the scar as below the occipital bump. The great advantage that you have is that you can obtain proper permission from Balody and then discuss the actual placement of the scar and Dr. Farjo's reasons. If it is low, I suspect Dr. Farjo did it with good reason.

But an honest explanation is more powerful than accusation. Instead of questioning posters motives, I highly encourage you to combat criticism with the truth, explanation, and evidence.

I also strongly encourage you to gather a great multitude of impressive scar pictures and present them in a new photo album and continue to show the world that Dr. Farjo does high quality work.

Best wishes,

Falc

falc,this started as allans thread about allans norton scar,not my scar or dr farjos work.
stupidly i responded to allan(dont worry i dont think ill bother in the future)and richie jumped in with both feet as usual making up blatant lies as to what i posted and then supposedly edited.now,yet again we(me and the farjos) find ourself in the dock being cross examined by richie,feller and now you.
im getting sick of it.
if richie is that happy with dr feller that he has to let everyone who will listen know on a daily basis then hey thats his perogitive,im glad he has the time.
i just wish he and all the other "back slappers"
would leave me out of it,end of the day i too am happy with both my proceedures and would even consider a third with dr farjo if all the factors were right.the scar is fine and my hair is improving by the day.
now i wish everybody would stop being"concerned" and concentrate on their own experiences.

Balody,

I am not cross examining you, only addressing the content of this thread. You have posted your photos on a public forum which means that they are open for discussion/criticism. That's the advantage and disadvantage of posting photos openly.

Try not to take personal offense. In my opinion, nobody is attacking you....and I most certainly am not.

This is a discussion about scar placement and some of your photos appear ambiguous, hence the discussion. I cannot tell with certainty based on the photos presented whether or not your scar is a little low or on the occipital bump. This is not a criticism, only a question.

I do realize that this is Allan's thread so perhaps this discussion should have taken place on another thread.

Sorry if you are taking it personally.

Falc

Hey Allen,

Sorry to see another victim of Hartley, me too!
this pr1ck is a staff doctor working in an a&e ward, he holds the most basic qualifications permitted by law, I have a wealth of information for this clinic and if you need any help in your legal action PM me.
regards
Nortonvictim

I don't agree that there is one certain place to take grafts from. My hair loss goes very far down the back of my head. If you were to take hair from the bump in the back and above then you'd be taking out bare skin. I had my HT done before I lost hair down the back. I do have a scar that's just above the bump and later lost hair past that area, so I now have a scar showing across my bald area in the back of my head. The scars on the sides are showing too because I lost hair down the sides as well. I would much rather have lower scars because I'd be able to hide them better. I can post pictures if you like.