There is an abundance of hair transplant ‘before and after’ photos at the fingertips of anyone interested enough to perform a search online.  However, educated consumers need to understand that certain clinics and physicians will deliberately publish misleading photos that do not accurately depict the true quality of their transplant outcomes.

When basing a hair restoration surgery decision on a physician’s photos, make sure the images are large, clear and very detailed.  Doctors who are proud of their work will have nothing to hide and no qualms about posting high-quality images, showing details such as the patient’s hairline.  Excellent hairline work should have a gradual “feathering” effect and a natural look.  Look for consistent lighting in before and after photos; overexposure of the results photos can be misleading.  There should also be consistency in hair styling (whether hair is wet, dry, gelled, styled, etc.) and the angles from which the patient is photographed.

Some doctors’ websites provide only small, dimly lit images, in an effort to disguise details that may detract from the results they wish to convey.  Some photos may even be deliberately out-of-focus or blurred.  Doctors who are trying to disguise the lackluster quality of their work will avoid showing detailed hairlines in their patient galleries, or will style the patient’s hair so as to conceal the hairline.  Some doctors will even digitally alter images, using software such as Photoshop, to blur hairlines.  One way to detect whether the images have been altered is to look carefully for detail; watch out for ‘blobs’ (where an editor may have tried to smooth the hairline appearance) and a lack of individual discernable hairs.  Beware of doctors who hide behind poor quality images in hopes that prospective patients will not notice the lack of clarity or detail in their results images.  A top quality physician will have nothing to hide.

My dermatologist just recommended me to take accutane for my acne. I’ve been doing some research and I read somewhere that one should be off of accutane for atleast 6 months before having a cosmetic surgery, because of scarring reasons

No one really knows for sure. Accutane is supposed to affect the sebaceous glands and as such it had an affect on skin resurfacing. It has not been studied in hair transplant surgery, but the general rule of thumb is that you should be off Accutane for 6 months prior to a hair transplant. I’ve done a strip on a patient who did not tell me he was taking Accutane until after his surgery. He healed just fine. Patients on Accutane probably respond well to FUE. Going with the general rule though, you should wait 6 months after stopping Accutane prior to having a hair transplant.

There are also a few reports of hair loss on Accutane.

You can probably have a hair transplant and safely start Accutane a month later, but this has not been studied either.

.

I had a consultation and the doctor said that FUT is more powerful procedure than FUE and has more advantages, What is Dr. Cole opinion?

FUE allows for the harvesting of hair all over the permanent zone. This allows for potentially more hair than one may achieve from strip surgery especially if strip surgery is limited to a single strip scar. The disadvantage to FUE is that you will thin out the donor area. This should be carried out in a manner such that the area is equally thinned out. Also FUE is not a completely scarless procedure. In some individuals white spots may occur at the extraction sites. Overall these white spots are considerably less noticeable than the strip scar.

Strips result in distortion of hair growth angles. Properly performed FUE does not distort the direction of hair growth angles. FUE is a far better procedure that is in the hands of the physician. Conversely, strip surgery yields fewer hairs per graft and the graft dissection is in the hands of the surgery technicians with varied degrees of skill and no medical license to practice medicine.

FUE is a far more advanced procedure with greater potential to the patient. Patients have the capacity to receive more hair from fewer grafts. This results in better results from fewer grafts. The transection rate from FUE is better than with strip surgery in nearly 100% of the cases.

Dear, Dr. Cole my nature of hair is curly can i use my body (leg. chest hair) in crown area by FUE in your clinic. i did no more donor area but the doctor said to me i can’t do FUE because my hair is curly!!! and the grafts will be damaged during extarcting. Is it true?

Those with curly hair can be good candidates for FUE, however, it is very important that these individuals select an experienced physician who is properly trained in how to remove such grafts.  The extraction process must be modified slightly because it is more difficult to detect the direction of follicle growth underneath the surface layer of the scalp.    Curly hair will generally take more time to extract but, as with all hair types, the transection rates and yield will ultimately depend on the physician’s expertise and skills.

One advantage to curly hair is that it provides more coverage value than straight hair, meaning that less grafts will be needed, per square centimeter, to achieve desired results.

Ever since my surgery, I have been losing ALOT of hair. Now, I have
heard about shock-loss, however, I though shock-loss was suppose to
happen further down the road (2-8 weeks after surgery). I have also heard about HAIRS BEING “TRANSECTED”, which will subsequently fall out.
Now, I am really afraid that the large volume of hairs I am losing is from TRANSECTION because the surgeon implanted ALOT of hairs in “crowded” areas and therefore, A high probability for transection. Also, the surgeon did NOT shave my head to minimize the chances of “transection”. Taking this all into consideration, what do you think?

Shock loss generally begins about 2 weeks after a procedure.  Since your surgery was 2 weeks ago, I would think that the hair loss you are experiencing is most likely shock loss at this point. However, you also indicate that you experienced increased hair loss immediately following surgery; this  is not typical of shock loss. You may simply be experiencing a normal progression of hair loss.  Hair loss will often go dormant for a long period and then suddenly resume at any point in time, including right after a surgery.

Skilled and experienced physicians will rarely transect hairs when they make their recipient sites; less gifted and experienced ones may.  If a large portion of your hair was transected during surgery, I would expect them to start falling out and shedding very soon after a procedure.  Top physicians do not need to shave the recipient area, but it does help any physician do a better job of making the recipient sites and placing the grafts when the head is shaved (due to improved visibility).