Grafting into areas with native hair present. Which Docs take the time to do this?

[crowngarden]

I know every Doc I've ever consulted with says they take special time and care to not damage follicles where native hair is present. Even the Doctor I had a procedure with 20 years ago told me he would do this. But when making the incisions in the recipient area it was more like rapid fire so there is no way he even bother to worry about existing hair in the area. I've read from other patients that this has happened as well.

Just wondering if any patients here have had a positive experience with a Doctor where they took the extra time to work around healthy follicles instead of piercing them. I'm guessing this is easier to do with FUE? (I had FUT). Would ARTAS be something to consider? Can it really be programmed to work around growing hair follicles? Thanks for any replies.

[jamesst11]

NO NO AND NO.... I really don't understand the reasoning here. First off... if you have MPB and are considering having a HT closely around native hair, I WOULD THINK AGAIN!!! I have NEVER heard of ANY experience in which this has worked out.

[crowngarden]

Well the reasoning is I have a very thin crown area that still has native hair around the edges and transplanted hairs spread out throughout the crown area. I've seen some very good results of guys who have had transplants into the crown/vertex where they still had some hair before the transplant. My hair loss was very aggressive from ages 18 to 24 but pretty much stopped in it's tracks after that. I would like to fill in the crown some now after many years of maintaining the same head of hair. I would just like to find a doctor that would work around the hair that's in the crown now (both native and transplanted). I just don't want to make the same mistake of choosing an impatient doctor that is just concerned with the new hairs he's transplanting and not worrying about working around growing hair in the area.

[crowngarden]

Here is a great example of what I'm talking about: https://www.baldtruthtalk.com/thread...hlight=el+nino
This patients crown was not slick bald. While clearly thin in the crown area, he still had hair in the crown area that needed to be worked around and that doctor did an excellent job and his results are one of the best and most natural I've seen. So I wouldn't say it never works.

[CaliD]

I would say many guys who have hair transplants still have some hair. I got work done on my hairline and mid scalp but I wasn't slick. My brother in law got his hairline and crown worked on and he wasn't slick. Both of us are just fine. We both had excellent results. With that said I wouldn't got trying to fill in an area that's already fairly full (say 60 follicular units per cm2).

[JoeTillman]

I know every Doc I've ever consulted with says they take special time and care to not damage follicles where native hair is present. Even the Doctor I had a procedure with 20 years ago told me he would do this. But when making the incisions in the recipient area it was more like rapid fire so there is no way he even bother to worry about existing hair in the area. I've read from other patients that this has happened as well.

Just wondering if any patients here have had a positive experience with a Doctor where they took the extra time to work around healthy follicles instead of piercing them. I'm guessing this is easier to do with FUE? (I had FUT). Would ARTAS be something to consider? Can it really be programmed to work around growing hair follicles? Thanks for any replies.

The issue of whether FUT or FUE is better for graft placement in between existing hairs is irrelevant. These are extraction methods and have nothing to do with how or where grafts are placed. Same goes for ARTAS but that will change soon as it is being pushed forward with new programming to allow recipient site creation.

The key to placing new grafts in between existing hairs has to do with experience and prep.

Experience comes into the picture where a doctor with experience will be able to discern whether or not an area has too much hair to safely place new grafts. A few things can go wrong if there is too much native hair.

1. Transection can occur no matter how well the recipient zone is prepped. In many cases it is preferable to shave the recipient zone so no hair obscures the view. This also allows for the true hair direction and angle to be revealed so the new incisions can be made to match. This helps to avoid transection which is a major cause of permanent shock loss of pre-existing hair.

2. Shock of native hair regardless of transection can occur if there is just too much blood flow interruption. This occurs usually for hairs that are already miniaturized and and do not offer much cosmetic benefit but even a lot of peach fuzz disappearing due to shock can make the area appear thinner than if they were not shocked out.

Keep in mind that in the two points above I'm referring to permanent shock, not temporary shock. Temporary shock is unavoidable and unpredictable. Most get it, some do not.

In many cases the recipient area does not need to be shaved which means that there isn't a lot of hair in this area to begin with. In fact, most clinics that are known for shaving won't force the issue if the session is 2500 grafts or less but it is deterined on a case by case basis.

When you consider the number of surgeries performed on a daily basis, or even the number of cases presented online by clinics and patients alike, you will see that the majority are not slick bald and most will have some pre-existing hair in the recipient zones but of course this varies widely from case to case.