Repairing the deep front-temporal region

38 Yr Old Male has 2nd procedure with Gabel

This patient is a 38-year-old gentleman who was concerned about his deep front-temporal hair loss in the front of his head. The young man underwent a follicular unit hair transplant strip surgery, his second procedure with Dr. Gabel, at his Portland Hair Transplant office. In total, Dr. Gabel transplanted 3872 grafts into the area, which dramatically improved the look of the deep front-temporal region. This patient’s before and after photographs are presented in a side by side format to compare the 7-month results from the original surgery.

Deep Front-Temporal Hair Loss nearly gone

The patient was amazed and very satisfied with his results and significantly improvement of his self image.  He feels that it has made him appear many years younger. The deep front-temporal hair loss that was very evident prior to his surgery is now nearly gone, in addition, the thin line scar on the back of his scalp is nearly invisible, in part due to Dr. Gabel’s superior surgical skill using the Tricophytic closure technique.

Committed to what we do

Dr. Gabel and his staff are committed to hair restoration and hair transplants – that is what they do. Dr. Gabel is most noteworthy in that he performs every step of the procedure. He does not hire staff in from a national company to perform the procedure. The doctor has a full complement of staff who have been fully trained in the art of hair restoration. He is the most experienced hair restoration surgeon in Oregon. If you would like to schedule a consultation with Dr. Gabel, please click here, and he will follow up with you as soon as possible.


Front - with Deep Front-temporal hair loss
Front 45 - with deep Front-temporal hair loss
Left 45 - with Deep Front-temporal hair loss
Full Left - with Deep Front-temporal hair loss
Frontal hairline Right 45 - with Deep Front-temporal hair loss
Frontal hairline Right 45 down - with Deep Front-temporal hair loss
Close Up Left Frontal hairline - with Deep Front-temporal hair loss
Close Up Right Frontal hairline - with Deep Front-temporal hair loss

57-year-old Frontal Hairline Restoration

Enhancing the Frontal Hairline

This patient is a 57-year-old gentleman who desired to enhance his frontal hairline due to a slow recession of hair in the frontal region. Rather than bringing his hairline down significantly, he wanted to increase the density of that area to make his hairline appear fuller. The patient underwent a follicular unit hair transplant 1.5 years prior with Dr. Gabel at his Portland Hair Transplant office.

The patient’s before and after photographs are presented side by side to compare the 18-month results. The patient is extremely happy with the final outcome. This transplant has defined the frontal hairline and consequently produced a more youthful appearance for him.

Committed to what we do

Dr. Gabel and his team are committed to hair restoration and hair transplants – that is what they do. Dr. Gabel is most noteworthy in that he performs every step of the procedure. He does not hire staff in from a national company to perform the procedure. The doctor has a full complement of staff who have been fully trained in the art of hair restoration. He is probably the most experienced hair restoration surgeon in Oregon.


Frontal hairline
frontal hairline down
Frontal hairline Left
Frontal hairline Left 45
Frontal hairline Left 45 down
Frontal hairline Right
Frontal hairline Right 45
Frontal hairline Right 45 down

The Hair Follicle Anatomy

The hair follicle is an organ of the body, and as simple as it looks, is quite complex.  The body at birth has about 5 million hairs.  The adult scalp has on average 100,000 to 125,000 hairs. There are several types of hairs throughout the body including terminal hairs and vellus hairs. This will be described in another blog post.

Hair Follicle

The photograph is a close up of a 2-hair follicular unit graft and a 3-hair follicular unit graft that were used in a hair transplant with Dr. Gabel at the Gabel Center. Starting from the top down, one sees the actual hair shaft. The hair shaft actually starts growing well beneath the skin at a region called the bulb.  It starts at the bulb, and as it travels up, the hair gains its characteristics such as thickness, color, and curliness.  Once the hair is at the level of the skin, it emerges and one is able to visualize the hair.

hair follicle-anatomy

Sebaceous Glands

Just below the surface of the skin, the sebaceous glands are found.  They have a slightly deeper yellow appearance because of all the surrounding fat.  The sebaceous glands secrete a substance called sebum.  Sebum is an oily liquid that helps to lubricate the skin and hair.  One very important function of the sebaceous glands is to produce sweat.  Your body produces sweat in order to help regulate the temperature in your body, as we all have experienced when warm.

The Hair Bulb

At the bottom of the hair follicle is the bulb. The bulb functions to actually make and assemble the hair shaft.  It receives its own blood supply because it takes a lot of energy and substances to build the hair.

The Bulge Area

In the middle of the hair follicle is a very important structure called the bulge area, which is just below the sebaceous glands.  The bulge area contains the stem cells, which are important in hair regeneration. During the normal hair cycle, the hair will grow for approximately 3 to 4 years, and is then released and a new hair is formed. The bulge area contains the cells that divide and form the new hair.  Interestingly, almost all of the research in hair cell regeneration and cloning focus in the bulge region. This is the area which contains the stem cells that form new hairs.  Furthermore, if scientists can figure out how to harness the stem cells in the bulge area, hair cloning one day may become a reality.

Hair Transplantation

Dr. Gabel and his team at the Gabel Center take great pride in the work they perform to help patients achieve the finest results. We use sophisticated binocular microscopes to examine and produce the best hair follicles during our patient’s hair transplant procedure. In addition, we will often show patients their actual hair follicles under the microscope and point out the structures of the hair follicle as described above. We feel it is important for our patients to actually see their hairs and understand the complexities of the hair restoration procedure.

Contact The Gabel Center

To learn more about hair loss and the latest techniques in hair restoration and hair transplant surgery, contact our hair transplant surgery center today.  Our team at the Gabel Center look forward to your visit and discussing these matters with you in greater detail.

Learn About Follicular Unit Extraction (FUE)

Dr. Steven Gabel offers his patients a wide array of hair restoration treatment options and strives to stay on the cutting edge of modern medicine while doing so. One of the most sought after surgeries in the field is follicular unit extraction (FUE), which can cosmetically benefit many patients suffering from hair loss or hair thinning.

Our goal here is to cover the basics about FUE and which patients can benefit the most from having the procedure. It is important to remember that each individual patient is unique and not every case should or can be treated exactly like another. Only a thorough consultation with a qualified doctor can determine your best course of action for having a hair restoration procedure.

What Is Follicular Unit Extraction (FUE)?

Follicular unit extraction, or FUE for short, is the technique where individual follicular units are removed from the scalp one at a time using a tiny, round instrument. The result are small tiny, round scars in the scalp where each follicular unit was extracted. FUE stands in contrast to follicular unit transplantation (FUT), also known as the “strip” method, where an elliptical incision is made in the back of the scalp and all the follicular units are removed at once. The result is a linear scar in the back of the head where the strip was removed.

Each follicular unit graft contains 1, 2, 3, and sometimes 4 hairs. The advantage that FUE has over traditional strip surgery is that while patients will develop scars with either procedure, the FUE method allows patients to keep their hair shorter without noticing the scars, while patients who had strip surgery may need to keep their hair a little longer to hide the scar. Also, some patients do not like the idea of having a long incision and scar in the back of their head – these patients are also ideal candidates for the FUE technique.

The goal from both procedures is a natural appearing result.

Who Is An Ideal Candidate For Follicular Unit Extraction (FUE)?

The ideal candidates for FUE are prospective patients who have good density in their remaining hair at the back of the head and like to keep their hair short. They should have stabilized their hair loss (usually with help from medications, vitamins, or low light laser therapy which Dr. Gabel goes over during his comprehensive evaluations) by the time they choose to undergo surgery. It’s important that patients have realistic expectations about the surgery and what it can achieve, as well as the results.

It is not unusual for FUE procedures to be smaller sessions than FUT (strip) procedures, and it may require more sessions than FUT to achieve the desired cosmetic results.

Is Scalp Laxity An Issue With Follicular Unit Extraction (FUE)?

Some patients have very tight, non-mobile scalps which makes it very difficult to remove the hair via the strip procedure. These patients are ideal for the FUE technique since as the follicular units are removed individually irrespective of how tight a scalp is.

Is Follicular Unit Extraction (FUE) Useful To Correct Scalp Scarring?

Absolutely, FUE tends to be an ideal surgery for people who have scalp scarring from prior procedures. In these specific cases, Dr. Gabel is able to extract several hundred grafts and insert them into a prior strip scar to hide it. Additionally, FUE is often called upon to help blend in hair transplant procedures such as mini grafts and plugs.

Contact The Gabel Center

To learn more about what’s best for your individual case as a hair loss sufferer, please reach out for a FREE consultation with Dr. Gabel. The staff at the Gabel Hair Restoration Center are experienced medical professionals committed to providing each patient with a positive, personalized experience to achieve the best possible results.

Frontal Hair Transplant of 40-Year-Old Male

This patient is a 40-year-old male who had a hair transplant with 2548 grafts over 2.5 years ago. He had been slowly losing hair in the frontal area of his scalp hence desired to have hair transplanted there. Dr. Gabel performed a frontal hair transplant of 2548 ultra-refined follicular unit grafts into this region of his scalp to redefine the frontal hairline while increasing density in this area.

Video at 1-year after Frontal Hair Transplant


Video at 2.5-years after Hair Transplant

Frontal view after hair transplant

Frontal 45 downFrontal Hair Transplant Frontal downFrontal Hair Transplant Left 45Frontal Hair Transplant Left 45 down Frontal Hair Transplant LeftFrontal Hair Transplant topFrontal Hair Transplant right 45 Frontal Hair Transplant right 45 downFrontal Hair Transplant Right


Hair Transplant Growth Timeline

Day 0:  Day of hair transplant.

Days 1 – 5:  The first 2 weeks following a hair transplant are the most critical.  Dr. Gabel provides his patients with detailed instruction booklets on exactly how to care for the newly transplanted grafts.  During the first 5 days, patients will experience swelling of the forehead and at the back of the head, which is the donor area.  The skin may also look red at the areas where all the tiny incisions were made for the newly transplanted hairs.  This redness usually resolves after the first week or 2.  After only a few days, the donor area is no longer tender.

Days 6 – 10:  At this point, patients no longer experience any swelling and the redness should only be faint or completely gone.  For each follicular unit transplanted, a “crust” will form which is the attached skin layer drying out.  During this time, Dr. Gabel will have his patients gently remove the crusts by thoroughly soaking the grafts, and then gently rubbing them with a finger.  By day 10, all the crusting should be gone and the transplanted hairs will appear like a “crew-cut” haircut.  Lastly, around day 10, the sutures or staples will be removed.

Continue reading

What is a graft?

A graft simply refers to a follicular unit, which may be a 1-hair, 2-hair, 3-hair, 4-hair, or even a 5-hair follicular unit graft. When hair transplants are performed, the single hair grafts (or follicular units) are inserted into the frontal hairline. Just behind the hairline, the 2-hair follicular unit grafts are placed to add density to the hairline, and behind these are the larger grafts to ultimately add density to the entire scalp and hair restoration procedure. The following diagram shows a close up of 1-hair, 2-hair, and 3-hair follicular unit grafts. Continue reading

Follicular Units

Follicular units are naturally occurring groupings of hairs. They are sometimes referred to as “grafts“. When hairs are examined using a high powered microscope, hairs exit the scalp and skin in “families” of 1, 2, 3, 4, or 5 hairs bundled together. These usually exit the skin at one central location and then fan out over the skin. Not infrequently, one may see 2 hairs exit and a single hair exit very close it each other – this is considered a 3-haired follicular unit. As shown in the photo below of a close up photograph of the scalp, there are distinct groups of hair that are exiting the scalp. When Dr. Gabel and his team perform surgery at his Portland hair transplant office, we refer to the follicular units as grafts. Continue reading