Hair Transplant Consultation #5 - Joe Tillman Reviews
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- Опубликовано: 9 сен 2024
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Can you see what the problem is?
But first, I am not a doctor and my advice is not to be considered as actual medical advice. Always consult your doctor for surgical or medical advice.
Another hair transplant consultation, this time for this 38 year old male. The first thing this case illustrates is the need for detail. Too many hair transplant patients fail to give enough information for a truly accurate surgical assessment so hair transplant doctors need to rely on their experience to spot things that the patient didn't share, or maybe even wasn't aware of.
In this hair transplant consultation I review a case that is very common, a NW3V and the patient only want to talk about hairline and frontal third reconstruction. But is there enough donor hair to get the job done? Watch the video to the end to find out.
See the consultation where I talk about retrograde alopecia
• Too Thin for A Hair Tr...
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The Bald Truth
So what do you think of the assessment? I wish I had more time as a normal consultation takes about an hour to really drill down into the details but I have to keep it short so you don't get too bored:)
I think it’s a great assessment! I’d say most HT doctors don’t even dive this deep- I wish they did tbh. I think we’d have way fewer botch jobs and people worrying about future loss if they did.
@@joshfloria2895 absolutely 🙏
Love these videos Joe, I'm always learning something.
Thanks Graeme.
Great assessment Joe. I like how you remind everyone that the choice of hairline is one that needs to serve you well over the lifespan. A conservative hairline allows one to grow into it, not out of it. Expectations are everything when it comes to a ‘successful’ result for the patient. Highlighting the need for including as much information as possible is paramount to a happy outcome. Thanks for sharing!
Also I think you have added another level on the Norwood scale. Norwood -1. Thick as Fuck!!’ 🤣
Hey Joe, this was really useful to see and much more detailed than my (albeit limited) previous consultations with doctors.
I think I have quite a unique case whereby I am looking to reduce the appearance of the slope on my forehead. I never noticed it when I was younger but as I've aged my hairline has receded about 10mm at the front and about 20mm on the temples.
I'm going to apply to the YT consultation on your website 🤞
Thank You Joe👍👍
Great assessment (of course lol, lots of experience!)!
My eyes jumped right on temple peaks, specifically visual difference in density in both sides. Of course it looks like the pictures were taken in slightly different light condition, but don't you think left side looks a bit too thin?
Considering the patient isn't happy about this area, would you suggest to fill in a bit with surgery, or rather try minoxidil as it might work wonders for that area (if he's a good amount of time on Fin)?
Thanks.
Excellent question. Are you asking about the left or the right side? The right side is in the thumbnail and is thinner than the left side, which is a normal pattern seen on most males. In fact, the majority of men experience more recession in general on the right side than the left. Regardless, while I did add a small density improvement in my render, I don't believe that the temple point (right side) should be addressed in the first pass as such things can easily be addressed in minor "top up" visits. I consider them to be icing on the cake once the first surgery is complete and we have a strong indicator of growth. If his donor was much stronger then it can be considered.
@@hairtransplantchannel So I guess knowing how much you dislike Minoxidil you wouldn't recommend to look into.
Of course, temple peaks are "icing", absolutely agree. I just noticed some clinics like Eugenix really love to get in and make them perfect on the first go as it creates a good structured look.
Thank for your response.
@@MrRolandas Eugenix does love to do that, and they're very good at it. Sometimes it makes sense to hit them on the first go, and in their case, I can see influence from the travel factor where they'd want to get as much done in one pass since returning is more difficult to do due to the distance. Locals are a different story, of course. A lot of factors can and do influence the approach vector. I think adding minox is fine as it can help as well. In fact, I think it would have far more potential in the temple points than it would anywhere else.
I loved the part where you predicted a result with photoshop Joe. I did that for myself when i was explaining my expectations to my doctor at the clinic!
Hope you do more videos like this
Thanks. I'm usually hesitant to do such things as it can lead to undue influence on expectations, which is why I was pretty adamant about the lack of real density compared to the photo. I would assume however that, with a high level of growth, the result would look pretty damned good.
@@hairtransplantchannel for my case i didnt photoshop hair density. I just drew hairline and temple points outline lol
Thank you
At that age with that amount of loss you'd be safest to assume that the crown and mid-scalp will end up bald at some point in the future - even with Propecia.
Nicely done! I like the hairline design. from the front it looks like a definite improvement. I am a tiny bit concerned about how low down the forehead the center goes. Also, the side image sets up an expectation of thickness. I understand how difficult it is to use photoshop to illustrate this. I hope he gets a great result.
Thanks, Morty! Regarding the center of the hairline, I based it off of the exit point of the frontal forelock hairs, which his higher than where the end of the hairs lay on the forehead. Regarding the density, your concern is exactly why I said this image is not to denote what the actual density will be, and it will be lower than what is depicted and why concealers would be the only real way to achieve such a look. Even with making these clear statements, I'm usually hesitant to use photoshop for the exact issue you pointed out as sometimes no matter what I say, it will fall on deaf ears.
You can use beard grafts when you run out of donor hairs.
I'm actually saving with hopes to have a hair transplant in Turkey. Could you make me some recommendation please? I'm African and I hear it's tough going through the procedure on African hair. I need your advice please.
Where are you located and why are you looking at Turkey only?
@@hairtransplantchannel I'm located in Nigeria. I hear their work is actually good and affordable. So far, Turkey is the cheapest with expert care for hair transplant the internet has provided.
Are there any limitations to the numbers of grafts that can be placed in a given area? Or is it totally up to a patients available donor and willingness to pack grafts into said area?
There is a limit, yes. It can be due to a limitation of the donor supply where there is not enough hair available to meet the goals of the patient but it can also be because there is too much hair already in the target area, or the density of a surgery has reached a threshold where any more grafts will be detrimental to the outcome as opposed to allowing for a good result.
@@hairtransplantchannel Thanks for the response! I’m still a bit curious about where the limit is though. Maybe a more specific question would help if you don’t mind.
Say hypothetically someone wants to make a 1-square-centimeter recipient area match the surrounding areas which have, say, an average of 200 hairs per the same unit of area. The person has plenty of donor and is willing to do as many surgeries as is necessary to avoid necrosis and things of that nature.
Is that possible? Or is there some surgical limitation that would prevent the patient and surgeon from reaching that degree of density?
Why does it matter if it's generic finasteride?
Definitely not DUPA in my opinion. My hair looks like that whenever I wake up or take a hat off. After a shower and comb through it looks fine. I bet that's the case with this guy.
Thank you for confirming this is a thing:) And thanks for your comment.
Joe- if a young man in his early 20s gets on name brand proscar and it stops his loss, is it generally thought to halt his balding for life?
Great question, Josh. It's hard to say as each case is quite unique but in general, if it is easy to see that the loss has been stopped through photographic timeline evidence, then it can be determined that the hair loss has, at the very least, slowed to a very difficult to measure crawl. This can give the freedom to be more liberal with options for surgery but it is, again, very subjective to each patient's unique characteristics. I don't like to say that loss has been completely and actually "stopped" because I know many people that thought as much but twenty years later they realize they simply lost hair very slowly.
The tiled angle of the head in the photoshop is throwing me off a bit. I know it's very hard to do though but next time I'd suggest leaving the angle the same as the original picture. Was there a specific reason you change his head tilt angle?
Yes, because he was looking down at a fairly steep angle so I simply rotated it so that his face angle was more level. I could have been more tidy with it but I got lazy.
@@hairtransplantchannel ah understandable, it might have been good to also angle the original then, something to consider for future videos. Great consultation though very informative
Lol is that chris hemsworth?
Sure looks like Chris Hemsworth
@@SophiePeterActing It is:) I thought it looked better on the thumbnail as opposed to have a colour block on the patient's face.
Do you think there is such a thing as too much density? I was thinking of going with Dr. Sean Behnam and his work is fantastic but his work seems to be too thick in most pics or am I over thinking?
In my nearly 20 years in this field, I’ve never once heard a patient complain of “too much” density:). Dr. Behnam is an awesome doctor:)
Hi Joe. I'm a NW3. I can relate to the video with my hair looking very bad/clumping up when not washed or in the morning after sleep, but when washed and styled it can look very nice. But I'm wondering is what I see when it looks bad my donors TRUE state? You say they are miniature part lines, but I can't help but feel it just brings out how weak my donor actually might be(i.e. Thinness). It makes me nervous as I am looking to have a HT and when I go in for a consult obviously my hair will be looking its best for the doc.
Any doctor worth their salt will be able to tell if there are any challenges. Just be sure to go to good ones and not someone you simply found on Instagram or TikTok;)
Do you think it is possible to have a HT without finasteride, if you are already a NW5/6?
It’s definitely possible but 1) you won’t get the best possible result, and, 2) your native and transplanted hairs will probably continue to miniaturize over time if you aren’t on finasteride.
The reason you won’t get the best possible result is because your donor is limited and a NW5/6 is a usually a lot of surface area to cover-a lot more surface area than even the best donor area can cover with a natural-looking density.
Finasteride might not do a lot to reverse your balding, but remember that the scalp has approximately 100,000 hairs. Even if the finasteride stimulated regrowth of 2% of the hairs you lost-and you’ve lost around 80% of your native hair-that could still equate to 1,500-1,600 hairs regained by taking finasteride. That’s a significant amount of additional coverage when you consider that the hair transplant surgeon is going to try and cover your entire scalp with about 15,000 transplanted hairs. (6,000 grafts with a 2.5 average hair count per graft.)
There is also the possibility that your hair loss will progress beyond where it’s at now. Your NW5/6 could become a NW7. So even if you manage to create the illusion of coverage over what you have now, using what little native hair you have, the remaining native hair could continue to thin and make the hair transplant look less dense.
Finally, transplanted hairs can miniaturize if you aren’t on medication. The hairs eventually adapt to their environment and become susceptible to DHT, which miniaturizes them just as it did the native hair that was there before. So you may be throwing your money in a fire or only renting a better head of hair if you don’t maintain the investment with medication.
instead of a fifteenth transplant you could also comb over that luscious chest hair soon !