HAIR TRANSPLANT FORUM

[Bereavement]

Hello Dr. Cole and staff


First I want to say that after many years of research and pondering. I have decided that if I do go ahead with a HT it will be with you. After careful selection I have decided that FIT is the way to go.

However in other Hairloss forums they have discussed something that has made me think of the longterm. Currently I am a Norwood 2.5 according to one of your representatives. and I only to choose to restore my hairline to a Norwood 2 look. In other words only restore one temple to make it symetrical with the other.

My question is how does someones donar area look like after 4,000 and up punches? Some have claimed it has a "moth bitten " appearance.
This concerns me. As I know one surgery is not going to be the only one I get in my lifetime. I am almost 30 and I have great coverage in the back and in the crown. But I'm not tottally confident that I will always have that coverage. As you know its hard to predict these things.

And also I have seen that you use 1MM Punches. Do you guys intend to ever use .75 MM, I know you have said you guys try to improve your procedure.

Well I hope you don't take my questions the wrong way, I am just trying to better educate myself before I move foward. I figure I ask you before asking posters from other forums who don't know about the FIT procedure first hand and I'm also trying to avoid $hills

all the best J.M

[FITLocks]

FIT is really where it's at for most patients.

The moth-eaten term should be applied to antiquate open-donor punch harvests. It is does not apply to FIT due the minute size of the incisions and pattern of extraction that we adhere to.

You have been misled about our punch sizes. As far as I can tell, Dr. Cole was the first physician in North America to use a .75 punch. The draw back with this tool is that it is only useful in the extraction of select single hair units. In others words, the usage of a .75 for larger groups ensures hair destruction simply because 2, 3, and 4-hair groups are too big. So to promote maximal hair survival and growth, we vary punch size to the size of the follicular unit. Any clinic claiming to use a .75 exclusively is either misleading the public, inappropriately pulling only singles, or destroying tremendous amounts of hair. This is alarming.

The fact is, there is no evidence to support the notion that a .75mm will leave a different scar than a 1mm. Incisions of either size will contract and heal by primary intention. Therefore the fixation on punch size is misplaced and distracts attention from the relevant issues of donor management and graft survival. Advancements in our technology are geared toward the extraction of intact follicular units, the production of undetectable donor areas, and the promotion of optimal yields in the recipient area. Everything else is rhetoric and nonsense.

And no J.M., we do not take offence to your questions. Not at all. Patients need to vigorously seek out the best care for their hair. There are a lot of snakes in the grass, as you know.

Attached is a photo of a donor area from which 5000 grafts were removed. If you have good density, 4000 FIT will leave a fine donor area for you.

[CITness]

Hi Ounce999,

The most important consideration to keep in mind is that hair loss can be a progressive condition. With that said, patients should realize that efficient donor harvesting is imperative in every case. For example, a strip surgeon will typically destroy at least 5% of the follicles surrounding the strip incision within the donor area. Once the same strip is dissected, another 2% to 5% will be transected (destroyed). We currently produce a transaction rate of 0% to 2% and have 7+ years of experience with CIT. Patients who do their homework will usually discover that every single donor hair is PRECIOUS to the point where it can be debilitating for the patients who come to our clinic after their donor limits (scalp) have been surpassed.

We have several options to help minimize scarring in the donor area. We use small custom instruments to maintain excellent aesthetic results, as well as CIT farming to replete the donor area of patients with advanced degrees of hair loss. The farming is subject to the same limitations of body hair transplantation. As of this week, we offer PRP, and ACELL-matristem technology to help minimize risks of scarring. But if your goal is to also minimize the evidence from the procedure, then your best bet would be to elect all of our newly available treatments and start with a smaller session (500 grafts). By having a smaller session, you will learn how you heal as no two donor areas are the same. Healing well is synonymously associated with CIT hair transplant method mostly because of our instrumentation. Our method is responsible for well over 1 million transplanted grafts, and his medical assistants ALL have 4 to 7 years of experience/training in CIT preparation. Our news release on PRP, ACELL, and micro-needling may be viewed by the following web link: http://www.forhair.com/hairtransplant/post6729.html#p6729


Hair loss in a typical thinning crown (vertex) usually gradually enlarges until the entire crown becomes bald. The most difficult aspect of restoring crowns is mimicking the original orientation that Mother Nature created. In humans, the hair growth pattern in the crown/vertex is helical and is commonly seen as a whorl, growing in all directions. In normal circumstances, this region of the scalp requires more transplanted follicles than any other area due to the fact that it has no consistent grain. Our treatment plan for the crown involves strategic placement of grafts, and placement of smaller follicular units. We have our patients’ best interest at heart and avoid the “island of hair” pattern by using our placement system. Below, you will find a diagram (Figure 1.) that depicts the pattern of a progressively thinning crown as well as a depiction of a crown result (Figure. 2) to show our approach of restoration.

Figure 1. Depiction of progressive hair loss in the crown/vertex

The attachment Progressive thinning of Crown.jpg is no longer available

Figure 2. Excellent results in crown with conservative graft counts

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For future reference, here is a two dimensional presentation (Figure 3.) of an above average donor area. You may observe that the attached figure displays variations of donor density in each box. Hair occurs with different densities in each box. Most patients will have average densities of about 180 hairs per square centimeter while other patients will have higher densities. The number of hairs and the number of follicular units consistently changes as each section of the donor area is examined.

Figure 3. Presentation of variations in donor density

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Hair is harvested from specific areas within the donor area to minimize noticeable decreases in density. Harvested donor hair follicles are best extracted where areas of denser hair growth are within the donor area. CIT has steadily improved and has developed to be highly effective in harvesting many different types of donor areas.


The importance of follicular unit donor density is that it dictates how patients must realistically approach hair loss. Donor density generally determines how much donor resource each patient has to restore hair recessions. Our medical director’s advice to our younger patients is to focus on the frontal scalp, medical therapy and postpone goals of aggressive coverage in the crown. Keep in mind, since hair loss can be a progressive condition, conservative density in the recipient area allows for the patient to look natural in the event of additional hair loss. In so many ways, we teach that a conservative approach to hair restoration is in all patients’ best interests as there is no sure-fire way to completely resolve hair loss in one procedure.


Techniques for harvesting donor tissue have improved steadily over the years. Newer techniques may improve hair yield as much as 50% to 100% over older techniques. Newer techniques generally result in less donor-site scarring as compared to older techniques. Each patient should ask for a description and explanation of donor-site harvesting as part of full preoperative discussion with the physician hair restoration specialist.


In conclusion, I have attached a few examples (Figure 4.) of healing among different patients with different donor area characteristics. I trust that you find this information on hair transplant as informative and invaluable in restoring your hair loss. We look forward to hearing from you!

Figure 4. Various healing in various donor area characteristics

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After CIT (2jh).jpg (209.85 KiB) Viewed 1824 times