Limmer Hair Transplant

Central frontal circular spot of hairloss

2012-01-17T08:52:00.000-08:00

This case shows both the preop and one year post op photos of a gentleman who underwent a single pass of ultra-refined follicular unit micrografts. Just over 1500 grafts were produced from a 17 sq cm donor harvest followed by trichophytic closure. In addition, patient is using low dose finasteride & rogaine to combat future loss.
While a very straight forward case with excellent results one of the more interesting things to be seen in his pre op photos. He represents a Norwood pattern 3A who has retained a bilateral frontal forelock. I enjoy these cases as that central frontal circular spot of hairloss is for many the most important cosmetic location to have hair.
Brad Limmer, MD/jac

You DON'T need thousands of grafts to implement meaningful change

2012-01-17T08:49:00.000-08:00

I wanted to present a case that made a dramatic improvement in a man’s life even though his hair loss was minimal and the grafts required small. The case presented is one of a Norwood pattern II-III with asymmetric (R>L) temporal recessions. He underwent 750 ultra-refined follicular unit micrografts, placed 60-65% of these in the right temporal recession and the remaining 35-40% in to the left. He was finally able to make it into the office for follow up photos showing his final results from one pass of micrografts. He has done quite well and shows zero loss behind the grafted zone and is extremely pleased by the change made. So while many would feel his loss to be minor, to him it was very disconcerting and the results achieved improved his quality of life.

Brad Limmer, MD/jac

3500 graft procedure....

2011-03-29T12:23:00.000-07:00

Today’s case originally presented for transplant 15 months ago. On initial presentation he was a Norwood pattern 3 and not on any medical management (his pre op shown above). Following extensive consultation we agreed upon a dual prolonged approach combining full medical management with transplantation focusing on recreating a new frontal hairline as well as some work to be done on the vertex. Ultra refined follicular unit micrografting was performed using standard elliptical harvesting of 36 sq. cm. of donor scalp with an f.u. density of 96-98 grafts per sq. cm. Of the nearly 3500 grafts produced, nearly 2000 grafts were used to restore the frontal 1/3 of his balding scalp with ~1500 grafts used on his crown. Shown are both his initial pre op photos as well as follow up photos 15 months post op. He has done quite well and is very pleased with his results. Brad Limmer, MD/jac

Patient had 2 large procedures

2011-03-03T08:14:00.000-08:00

After 1 procedure

2011-03-03T08:13:00.000-08:00

6000 grafts and MEDICAL THERAPY

2011-02-28T10:26:00.000-08:00

Today’s case first presented 3 years ago at age 27 with fairly dramatic loss and fairly fine/miniaturizing hair across a Norwood pattern 4-5. Being from outside the US extensive consultation was performed using Email/phone calls.

While a candidate for transplantation, I informed him I would suggest against it unless he would utilize full medical management…starting on it prior to the hair transplantation to ensure he had no adverse side effects and could remain consistent with the medical program.

In early 2007 we performed his first transplant, harvesting 32 sq. cm. of donor at an f.u. density of 96 grafts/ sq. cm. generating just over 3000 grafts. It was allowed to grow in and then in the fall of 2008 an additional 36 sq. cm. of donor was harvested producing just over 3000 grafts.

Today’s photos show his initial pre operative as well as his fully grown in post operative photos taken last week when he was back in the US. He has done quite well and I think his great results are from a combination of both surgery and full medical management.

Brad Limmer, MD/jac

STAY COMMITTED TO MEDICAL THERAPY

2010-10-12T11:32:00.000-07:00

The case presented today has had just under 5000 grafts from two sessions, one in 2006 and the other in 2008. He came in yesterday and has had an additional 2600 grafts to primarily chase after loss in his mid scalp/vertex resulting from the discontinuation of medical therapy. Patient opted to D/C medical treatment for unclear reasons (had no adverse side effect), but now understand its importance and hopefully will remain dedicated to both finasteride and minoxidil. Presented today are his preop photos from 2006, his final growth photos taken preoperatively yesterday after having had ~5000 grafts (~1700 grafts in 2006 and ~3300 grafts in 2008) and an immediate post op photo taken today after an additional 2600 grafts were placed in his crown and mid-scalp.

Take home message for those who see this…
If you are going to move forward with transplant surgery you need to stay committed to medical therapy as long as you are not having adverse side effects.

Brad Limmer, MD/jac

HOW OLD IS TOO OLD FOR A HAIR TRANSPLANT?

2010-05-03T08:01:00.000-07:00

The answer to the above question is probably, you are never too old as long as you are in good health and your goals can be met. The oldest man I have ever transplanted was 86 and the oldest woman was his wife at 78. The case presented today was 76 yrs old on his initial transplant in 2008 and returned 7 months ago, primarily to expand his area of coverage.

This case illustrates some of the aspects a lot of older patients struggle with when trying to decide if transplantation makes sense at an older age. He originally presented for consult in 2002 at the age of 69. While he wanted to have it done he struggled with the vanity issue…felt he was too old, what would his friends/co workers think and most of all, his kids thought it was silly for him to have done.

So he put it off. Six years later, 2008, he came back knowing he absolutely wanted to have a transplant and finally address something he had struggled with for the better part of 50 years. He still struggled with the vanity issue/what would his kids think, but decided if we could keep the price reasonable he would move forward.

In September of 2008 he moved forward with transplantation. As a full blown Norwood pattern 6 and only wanting to spend $4500 we had to design a transplant that would produce a very natural cosmetic result with only ~1300 grafts to work with. We placed his mid-frontal hairline at ~10 cm above the brow and kept deep temporal recessions to help minimize the surface area we were to cover.

His post op was uneventful and within the first 6 months he was already enjoying the cosmetic improvement transplants can provide. His natural result, cosmetic improvement and easy recovery not only made him a believer, but helped him get past his vanity issue he had related to doing this so late in life. While he still remained conservative, he did move forward in September of 2009 with an additional 1100 grafts to work through the mid-bridge region and augmentation of mid-frontal tuft.

I think his case/photos presented show that if you are in good health you are never too old to enjoy the positive change that can be made through transplantation. Obviously, none of know how long we are going to live, but this patient sure wishes he had gotten past some of the things holding him back from doing transplantation in 2002 as he could have enjoyed the results even more. But in the end, we all need to move forward when we are truly ready, have a plan and fully understand what we are committing to…no matter what your age.

Brad Limmer, MD/jac

a transplanted hairline never changes...

2010-02-22T13:32:00.000-08:00

BEFORE PHOTOS:

The case presented is that of a young man who came in at age 25. During his original consult it was noted that he was already committed to a regiment of propecia/rogaine since age 14. Being so young is always a concern. But his commitment to medical management and his understanding the implications of moving forward with transplantation has, we were able to devise a plan/design a hairline that would work well for him now and look appropriate as he aged. He also understood that if he lost hair behind his newly transplanted hairline he would have to come back and at least transplant the frontal/mid scalp.
On the day of his surgery we mapped out our plan. We harvested 18 sq cm of donor at a fu density of 86, producing just over 1500 grafts and planted at a density of just over 50 grafts/ sq cm. His case proceeded very easily without any bleeding and no popping of grafts. Shortly after lunch we opted to harvest an additional 300 grafts so we could maintain our tight packing, but also plant a little further back creating a nice transition.
While we kept in touch, he finally was able to be seen in follow up this past Friday. He has excellent results which are only helped by his good hair color-skin match. He remains committed to medical therapy and desires to slightly thicken his hairline while he uses the majority of his planned upcoming procedure to reinforce his frontal 1/3 of scalp behind his new hairline.
Presented are his before and after photos. He has excellent density from his single pass grafting session and a hairline design that works well now and for his lifetime. Something young men always need to understand…years will come and go, but a transplanted hairline never changes. So be cognizant of that and design something that looks appropriate for your entire life.

Brad Limmer, MD/jac

AFTER PHOTOS

Nurse Tracy's hair transplant

2010-02-17T11:56:00.000-08:00

THESE ARE MY PRE OP PHOTOS:

Woah, glad those days are over....

THESE ARE MY POST OP PHOTOS:

BELOW

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