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  1. #11
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    Alvi Armani are a disgrace. Disgusting unethical marketing. They seem to cake all their patients with makeup to make them slightly more tan and to be honest I'm not even entirely sure that they're not putting some dermmatch in the hair.

    Their long term strategy for a norwood 6 is as follows (I copied this from another site):

    Take someone such as yourself who has never had a procedure before, and Dr. Armani asses that he can harvest 8,000 grafts from your donor area over time.

    You eventually need coverage from front to back, here is how it would be managed roughly:

    Here is what is recomended to the patient
    -----------------------------------------------------
    Zone - 1: 2500 follicular units at 80% density
    -----------------------------------------------------
    -----------------------------------------------------
    Zone - 2: 2000 follicular units at 40% density
    -----------------------------------------------------
    -----------------------------------------------------
    Zone - 3: 1240 follicular units at 30% density
    --------------------------------------------------
    -----------------------------------------------------
    Zone - 4: 2030 follicular units at 20% density
    -----------------------------------------------------
    Total grafts 7,770

    This strategy gives a high density front with a full dense hairline with many styling options and a lower density crown with great coverage.
    Attached Thumbnails Attached Thumbnails Click image for larger version

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  2. #12
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    what will happen when replicel and histogen will be able to revive dead follicles.... all you people with hair transplants will look ridiculous

  3. #13
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    Zone 3 and 4 are going to look pretty odd relative to the front. By all means if a patient is norwood 6 and strip out with say 55 or 60 up front which may be possible and they have nice coverage in the crown. They could always decide to add another 1000 FUE to the crown to boost density there by 10 FU/cm2 and they may even have some more for the front. However transplanting at 80% native pre mpb density without knowing how bad future hairloss will be is madness.

    Dr. Rahal seems to be slightly more aggressive than most and he did work with the Alvi Armani outfit for a short time but the highest I've seen him go up front is 65% native density so the Alvi Armani approach is by far the most aggressive. At 75 or 80FU/cm2 I can't imagine the yield being very good. Such a waste.

    Unfortunately there's some Armani patients out there that had work done back around '05 thinking that HM would be here now to take care of their future loss. Oh dear. They're in trouble now.

  4. #14
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    Great post !

    the shape of zone 4 is an ` egg shape ` this shape should be put in zones 2 and 3 and grafted via fue ,with a side weighting to create the illusion of density , further down the line you can expand on this , donor and finances allowing , or retain the option to shave down and look ` normal ` .

    There are a couple of Drs grafting with beard hair ,this is another source of donor ,that I think will come more to the forefront in the future , more so than , replicell etc ...

    ejj

  5. #15
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    Quote Originally Posted by Jotronic View Post
    If you are bald hair restoration surgery will NEVER restore a full head of hair. For a dose of reality, check out the following image. I have used my pitiful Photoshop skills to show what a donor strip with approximately 4800 grafts would look like if it was just laid on top of a bald scalp. This is assuming a donor strip of approximately 30cm X 2cm and full density of about 80 FU per cm2. If this doesn't make the reality of this procedure clear, nothing will.

    This is actually what I suspected all along and is precisely the reason that I'm so against hair transplantation. I mean, if transplantation could give us a full head of hair back, I'd easily shell out $20,000, no questions asked. But to pay thousands of dollars for something that can't even give you close to a full head of hair, leaves permanent head scarring, and requires a lifelong commitment to Propecia and most likely more than one hair transplant, is something that I would never do. This really illustrates the absolute need for much better methods to regrow and preserve hair, and it's really inexcusable to me that we don't have better hair regrowth options today. But I give Jotronic lots of credit for being an honest person and posting this. Plenty of doctors and their representatives would never be this honest and admit to the limitations of hair transplantation and would blatantly lie about what transplantation methods can achieve.

  6. #16
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    And lastly, this is precisely the reason why we should be shooting for cellular hair regeneration as opposed to unlimited donor hair. Even if unlimited donor hair could be achieved, God knows how many hair transplants a person with significant hair loss would actually need to achieve anything close to a full head of hair. Surgical transplantation is just so limited and invasive (there just aren't enough hairs to redistribute from one part of the head to the other), whereas cellular regeneration (or just regeneration in general) could promise massively better results.

  7. #17
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    Do you think it's unethical to do super dense packing and low hairlines in the front of the scalp based upon an assumption that the patient will be able to maintain their hair forever on meds? I see a lot of the really good docs placing low hairlines and high numbers of grafts up front (for example, 3500 in the front hairline alone) in patients who are taking propecia. But it seems that at some age, maybe even 60 or 70, the genetic pattern is going to take over or there will be some reason along the way that the patient may need to stop the meds. Will these patients end up with a super dense front half and a bald crown and midsection?

  8. #18
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    I think this is a great post , I also think its an extreme , the picture shows it as ` black and white ` ..its brutally honest and fair in my opinion .

    The variable would be a patients characteristics and Drs skill , alternative pictures `could` show Dr Bisanga`s patient rep who has had complete restoration via fue only, using beard and scalp hair , this was a norwood 6 fully restored ! , Dr Umar has some full restorations also using beard and body hair also Dr Woods , so I think my earlier post is relevent, fue procedure to the ` egg shaped` area and see how things go

    regards
    ejj

  9. #19
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    Quote Originally Posted by ryan555 View Post
    Do you think it's unethical to do super dense packing and low hairlines in the front of the scalp based upon an assumption that the patient will be able to maintain their hair forever on meds? I see a lot of the really good docs placing low hairlines and high numbers of grafts up front (for example, 3500 in the front hairline alone) in patients who are taking propecia. But it seems that at some age, maybe even 60 or 70, the genetic pattern is going to take over or there will be some reason along the way that the patient may need to stop the meds. Will these patients end up with a super dense front half and a bald crown and midsection?
    It depends on a lot of factors (age, rate of loss, response to meds, available donor, etc.), but in most cases it strikes me as unethical.

    The length of time an MPB sufferer can maintain his hair on medication varies a lot from person to person. Some people keep what they have for more than 10-12 years; some people start losing hair again only a few years into treatment.
    If you use 3,500 or more grafts for the hairline on a guy in his 20's, what happens if finasteride loses effectiveness 24 months later? The patient still has decades of life ahead of him and only like 3 thousand grafts for his entire head...
    Someone feel free to correct me if I'm wrong about any of this, but this approach just seems like a disastrous method of hair restoration.

    And I agree with FDR about Armani's marketing and ethics.

  10. #20
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    3,500 in the hairline is of course ridiculous. However I can see a good argument for those with donor reserves of 10,000 by strip and FUE to go for up to 3,500 in the first 65cm2 or roughly frontal third. Assuming that number is available for maximum donor a norwood 6 can have the following:

    3,500 in the first 65cm2 - about 54FU/cm2
    3,000 in the next 65cm2 - about 46 FU/cm2
    3,500 in the crown, 110cm2 - about 32 FU/cm2

    I have heard of people with 11,000 available by all methods so they can reach just over 40 FU/cm2 even in the crown. Good results are still possible but if you don't have 9,000 available and are headed for norwood 6 you may not be satisfied.

    Still there are some great successes. I really like this one. I believe the patient has used up 7,300ish of a donor rated at over 10,000. Plus as far as I'm aware he never availed of meds. I think the outcome is great.

    http://www.baldtruthtalk.com/showthread.php?t=2326

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