HATS OFF NEWS

Patient e-mailed on Jan 16, 2004
Subject: Future Customer

Dear Dr. Wolf,

I have tried to include several current picture's of myself. Back in 1983 I underwent a session with the ******* clinic in Pittsburgh. Big mistake. I have lived with it every since..I am 43, good health, and am currently looking into correcting my situation. You come very highly recommended. I have done extensive research into this and would like to think I am older and wiser.

Could you or would you do an FUE to remove some of the scaring on the back of my head? Would you remove any of the larger grafts from the front or just "build" around them? Have you personally had good results with repair work? Your pricing seems reasonable. I have 3 things I would like to accomplish with any surgical procedure's I have done. In order of importance. First I want a natural appearance. I don't care if things are a little thin. I am tired of running for cover when the winds blows or wonder what people are thinking sometimes. I am sure you have heard it all before. Second I would go for a little more volume in the front "peak". And lastly a "dusting" in the crown area. Do you generally have to do more than one session? I started on Proscar and Rogain about 8 months ago. Bottom line is I would like your thoughts and if you think you can help, then a consultation.

Thank-you

J.

Dr Wolf responded on January 17, 2004

Dear J.,

Thanks for contacting me. One third to one fourth of my practice consists of upgrading prior hair transplants. This week three of my four patients had old wide donor scars removed, grafts placed in front of, between, and behind old grafts, and grafts removed. So I am very familiar with situations like yours. Since hair transplants have been performed since 1960, there are a lot of patients in your situation. In my experience the ******clinic that you have visited consistently performed some of the worst transplants ever seen. Actually yours don't look too bad probably because you didn't continue to have more done and because there is not great contrast between your hair and skin color. You appear to have excellent hair for transplantation with regard to color, wave, hair shaft diameter, and density.

To answer your questions:

• We generally do FUE to thin out the large existing grafts. Another alternative is to totally remove the large grafts. Your large grafts appear high enough to be able to transplant below them to hide them. Again they can be removed, totally or thinned by FUE. Some patients have grafts put in front of, in between, and behind the grafts, wait to see the result, and if they are still noticeable at a later date thin or remove them. As far as the donor, I would need to see it to determine what is best. If the donor was taken using the open method, these scars are usually removed with a strip and transplants are obtained between, above, and below the scars. If you have a linear scar it can be removed using a strip depending upon its width. If the scars are too large to remove grafts can be inserted into the donor scars using FUE.
• I have had very good results with repair work. This week we put 600 grafts in front of a prior hairline built with big grafts in an area 17cm by about 1 cm. We are going to see if this hides the dense pluggy hairline. If not we will thin out the old grafts.
• A natural appearance is what I specialize in.
• We are performing up to 2500 grafts per session. I don't know if that would be possible if scarring in the donor is removed. It may be possible to add density to the front as well as the crown in one session but in may take two.

I can better answer your questions during a consultation. I would like to see and examine you. Thanks again for contacting me and I look forward to hearing from you.

Bradley R. Wolf M.D.