When is Eyelid Surgery Better Than Botox?

Our eyes can reveal our age and make us look tired. They are usually the first noticeable signs of aging. Now that we are wearing masks to protect us from Covid-19, as well as engaging in more Zoom conferences, our eyes are even more on display. Board-certified plastic surgeon, Dr. Charles Slack, will restore your youthful appearance with a customized treatment plan for addressing your goals in the eye area. Botox, eyelid surgery and browlifts can all improve the appearance of the skin around the eyes but do so in very different ways. Botox® Cosmetic treatment is well known for improving the appearance of wrinkles around the eyes (crow’s feet) and elevating the eyebrow by temporarily paralyzing muscles around the eye that contribute to these problems. Eyelid surgery, also known as Blepharoplasty and browlifts, surgically removes the excess skin and fat (in the case of a blepharoplasty) that make the upper eyelids look tired and puffy.

Botox® Cosmetic, Jeuveau®, and Dysport® are neurotoxins that are designed for the temporary improvement of moderate to severe lines caused by muscles used for some facial expressions. Using these products does not paralyze the whole face, just selective portions of facial muscles in order to achieve an improvement in appearance. A common fear is that using neurotoxins will create a “frozen” look. This is not the case. With selective injections by a skilled injector, treatments are individualized to each patient with specific goals in mind. This is particularly true for treatment around the eyes. Botox injections are effective at providing smoother skin and elevating the eyebrow (which can reduce the amount of excess upper eyelid skin) producing a refreshed, yet natural appearance. Because Botox is gradually degraded and eliminated by the body, the paralyzation and hence the result is temporary. Treatments need to be repeated every 3-6 months depending on how long it lasts in you. This is both the good and the bad of neurotoxins. If you do not like the way you look, you are not stuck with it for life. However, if do you like what it does for your appearance, you must repeat the treatment. Deeper lines and lines that are present without any facial expressions, may not be completely eliminated with neurotoxins but will usually look better.

As our eyes progressively age, our eyebrows begin to drop resulting in excess upper eyelid skin and a tired, “hooded” appearance. The amount your eyebrows have fallen will determine whether an upper eyelid lift (upper blepharoplasty), a browlift (forehead lift) or both are needed to achieve the rejuvenated appearance you desire. Many patients believe that they need a blepharoplasty when they begin to notice excess upper eyelid skin. However, as you age, the skin on your forehead begins to stretch, causing the eyebrows to drop and excess upper eyelid skin to appear. The amount your eyebrow has fallen will help determine the better option to rejuvenate your youthful appearance. To demonstrate this on yourself, just lift your eyebrow up with your fingers and notice how much improvement there is in the amount of upper eyelid skin.

As our skin ages, it also becomes thinner and easier to see the “puffy” fat pads and dark vessels that appear under our eyes. Lower eyelid surgery (lower blepharoplasty) utilizes a discrete incision along the inside of the eyelid to remove fat from underneath. While the eyes do continue to age after any facial cosmetic surgery procedure, the signs of aging become much less obvious by addressing the folded, excess tissue.

To answer to the question blepharoplasty or Botox, if you have moderate to severe skin excess around the eyes, cosmetic surgery will most likely be required. Botox, however, is a suitable treatment for mild to moderate wrinkling between and around the eyes and can provide some elevation of your eyebrow

thus helping to reduce the appearance of excess upper eyelid skin. Dr. Slack would be happy to go over your options and create an individualized plan for you through an in-person cosmetic consultation. To schedule a consultation, contact us.

What happens during Breast Implant surgery?

Breast implant surgery is performed to add volume, restore firmness and add fullness to the breasts. Breast augmentation can also subtly lift the breast but not enough to correct significant droopiness. Dr. Charles Slack, voted one of the best plastic surgeons in Dallas and Collin County by D Magazine, helps women achieve a natural look that is long lasting.

After pregnancy, breastfeeding, and/or weight loss, breasts can lose volume and fullness. On the other hand, sometimes you are just not happy with the size of your breasts. A breast augmentation procedure is obviously intended to enlarge the breasts. However, a great surgical outcome involves much more than simply deciding on the cup size you want to be. It is important to choose a board-certified plastic surgeon who has extensive experience in cosmetic surgery. Also important is to be in good physical and mental health and have realistic expectations. In a cosmetic consultation, Dr. Charles Slack can guide you in achieving your desired look.

There are numerous types and sizes of breast implants to consider. Natrelle®, Ideal Implants®, Sientra, and Mentor are all options that Dr. Slack offers to his patients. Choosing the appropriate implant for your breast is a critical part of the process to help you achieve the breast augmentation results you are looking for. The factors considered in determining the right implant for you include:

  • breast shape
  • breast width
  • desired height of fullness
  • natural or rounded look
  • body type
  • desired increase in size
  • your lifestyle
  • Dr. Slack’s surgical judgment and recommendations

Now through August 31, 2020, Dr. Slack is offering savings on Natrelle® silicone breast implants! After breast augmentation surgery using Natrelle® silicone breast implants, you will receive $250 in credit toward Botox Cosmetic®, Juvederm® or other skin treatments. As an added bonus, you will receive 25 units of Botox Cosmetic® treatment. The best way to consider how you can look amazing is to schedule a private consultation with Dr. Slack. He will discuss your concerns and goals in detail with an explanation of what can and cannot be achieved for you with breast augmentation. Patients find Dr. Slack to be the kind of surgeon whose wisdom and compassion make him easy to talk to about the sensitive topic of breast surgery. Contact Dr. Slack today to schedule a consultation.

What You Should Know About Plastic Surgery Videos on YouTube

Everyday people watch more than a billion hours of YouTube. Increasingly, those hours include some time searching for health information and watching plastic surgery related videos in particular. Unfortunately, many of these videos are low quality and should be watched with caution, says new research published in the journal Plastic and Reconstructive Surgery.

Researchers graded over 500 videos on subjects like breast augmentation, breast lift, breast reduction, eyelid surgery, face lift, and tummy tuck. The videos analyzed came from a variety of sources, mainly physicians, patients, and product companies.

The videos were rated using the EQIP (Ensuring Quality Information for Patients) scale, scoring on a wide variety of criteria including:

  • Quality and accuracy of information presented
  • Clarity of video sponsorship or funding
  • Disclosure of risks, potential complications, and alternative treatments

With the average video scoring 13 out of 27 on the EQIP, the results of the study were not encouraging.

“Patients should be aware that the information contained in aesthetic surgery videos could be of low-quality and has the potential to be inaccurate,” said Ash Patel, MBChB, senior author of the study in this press release. “It involves a little research from the viewer, but they should check if the video is produced by a board-certified plastic surgeon.”

YouTube is a social media and entertainment platform, never intended as a gatekeeper for high quality medical information. Nonetheless it is a place where people seek this kind of information, and what they find often influences their health care making decisions.

That is why we urge all our patients to use a critical eye whenever viewing plastic surgery information on social media platforms like YouTube. Here are some questions to ask yourself the next time you view one of these kinds of videos:

Who produced the video?

Anyone can upload a video to YouTube and say nearly anything they want, but, according to the study, videos created by physicians tended to be of higher quality. Make sure the video you are watching is produced by a legitimate medical center, government entity, plastic surgery society, or board certified plastic surgeon. Look for logos and links to websites for verification.

Is the language general or product specific?

No one product, medication, or surgical procedure is perfect for everyone. Watch out for videos that appear biased toward one brand, as they are likely sponsored and created primarily to sell you a specific product. Language should be clear with limited use of jargon, and products should be presented using generic names. Not all sponsored videos are bad, but this information should be clearly disclosed.

Are risks, complications, or alternative treatments mentioned?

A well trained board-certified plastic surgeon is trained to put the patient first, and sometimes this means saying no to certain procedures. A careful balance of risks versus benefits should be part of every treatment decision. Pre-existing medical conditions and lifestyle choices are among the many considerations that come into play. A high quality video will address issues like risks, complications, and treatment alternatives to some degree.

Here, at North Texas Plastic and Reconstructive Surgery, we encourage you to do your homework when it comes to medical procedures and choosing a plastic surgeon. The internet, YouTube, and other social media can be terrific sources of information, as long as you use a critical eye. Always back up any information you learn there by talking to an actual board-certified plastic surgeon who knows you specifically, like Dr. Slack. And be on the look out for Dr. Slack’s new YouTube channel coming soon.

If you have questions about something you’ve seen on the internet, contact our Allen, TX office. You can make an appointment for a consultation today

Preparing for Your Plastic Surgery Appointment

For many people that walk through our door, it is the very first time they are seeing a plastic surgeon. A bit of nervousness is common. Louis Pasteur said, “Fortune favors the prepared mind,” and we believe that is true. The time you spend preparing for your first appointment will help calm the butterflies while it will also help ensure you get the very most out of your visit.

Hone in on your goals

The path that leads us toward plastic surgery is different for everyone. It can start with a vague notion of wanting to look and feel better, or a clear objective to change a specific aspect of your body. Either way, it is important to match what you have in your head with the reality of what plastic surgery can or cannot do.

We have found that the people who are the most satisfied with their surgical outcomes have very specific goals in mind: something like reducing their breast size by two cup sizes, instead of something like make me more beautiful. The goals should also be realistic. No matter how much surgery you have, you will probably never be able to look like your favorite celebrity.

A good place to start is by looking at some before and after photos of people who have had procedures done on the part of the body you are thinking about changing. Feel free to bring notes and pictures that show what you mean so that you and your surgeon can be sure that you are on the same page.

Consider your timeline

Does the change you want to make have something to do with an event coming up? Say, a wedding, a job interview, or a Hawaiian vacation? Knowing your timeline is important because different procedures have different recovery times. Unfortunately there is no way to force nature to hurry along when it comes to healing. Pain, swelling, and not being able to get incisions wet can all dampen a good time. If you have less than a month until a special event, you are better off considering a non-surgical procedure like botox, fillers, or skin resurfacing. Save that tummy tuck for when you will have the time to fully recover.

Take a health inventory

To get the very best results possible you should be in the best health you can be. This means eating well, exercising, and not smoking. You will also need to limit your intake of alcoholic beverages before and after any procedure. Make sure to get a handle on any bad habits before considering surgery. Certain medical conditions, like diabetes, which can impair healing, may also impact results, so work with your primary care doctor or any other specialists to get these under control.

Know your surgeon

Just because someone offers to perform a procedure, doesn’t mean you should let them do it. To start with, look at their credentials. They should have an MD after their name and be board certified by the American Board of Plastic Surgery (ABPS). They should have hospital privileges in your area, even if they will be performing an in-office procedure. It is also a good idea to find out if they have a professional membership in the American Society of Plastic Surgeons. Here are some good tips for choosing a plastic surgeon.

Nail down logistics

Nothing will put a kink in your plans like getting lost on the way to your appointment. Make sure you have considered even the simplest of logistics, like where the office is and how you are going to get there. You will also have some forms to fill out when you arrive so have your ID and insurance card handy. Bring the contact information for your primary care provider, pharmacy, and any important specialists you see. A list of current medications and health history will also be a big help to your surgeon.

If you have any concerns or questions about what you will need for your first plastic surgery appointment with us, don’t hesitate to give us a call. We look forward to partnering with you as you take that first step toward the change you are looking for.

Why Drinking Alcohol and Plastic Surgery Don’t Mix

Woman drinking during the holidays. Remember Alcohol and plastic surgery simply don't mix.

‘Tis the season to be jolly, and often that means drinking more than usual. In the month between Thanksgiving and the New Year holiday, Americans spend more than $12 billion on distilled spirits – that is one-quarter of the industry’s yearly profit. If this season, you are giving yourself the gift of plastic surgery, however, we recommend you skip the spike in your eggnog. Alcohol and surgery (before or after) can be a bad mix.

We’re not just talking about excessive drinking, either. Research has shown that even drinking moderate amounts of alcohol before surgery can impair the immune system and increase the risk of respiratory complications. Heavy drinkers are also more likely to suffer from complications of wound healing and infections. They are 30 percent more likely than non-drinkers to be admitted into the intensive care unit after surgery.

Alcohol affects a number of different body systems already taxed by surgery. Here are five of the most common types of complications:


Alcohol in your system can make it more difficult to get the dosing of anesthesia to an optimal level during surgery. This can result in pain and increased awareness during surgery. Alcohol consumption also decreases pain tolerance in general, making for a more difficult recovery.


Swelling is a natural part of any kind of surgery. Alcohol has the effect of dilating blood vessels and can make your tissues even more prone to swelling. This is not only uncomfortable, it can result in poor fluid balance after surgery as well as poor wound closure.


Alcohol is a natural blood thinner. Its use can lead to increased bleeding during surgery as well as in the days and weeks following a procedure. Excessive bruising and increased swelling are also possible, both of which can cause more pain and delayed healing time.


Surgery can result in dehydration. Add alcohol, a diuretic, to that and the effect can be dangerous. Dehydration can affect wound healing and it can make your recovery far more uncomfortable than it has to be.

Wound Healing

Excessive Alcohol consumption is linked to poor wound healing. This is especially important when it comes to plastic surgery. While your surgeon will do all he can to minimize the appearance of scars, they are nonetheless a natural outcome of surgery. Infection or excessive swelling can result in larger more misshapen scars, greatly diminishing the beneficial effects of having plastic surgery in the first place.

Dr. Slack takes the medical risks associated with drinking alcohol very seriously. He, like many other surgeons, requires patients to quit or significantly limit alcohol in the weeks before and after surgery.

Quitting alcohol may be no problem for you, but if you are a heavy drinker you need to consider the risks of withdrawal if you quit suddenly. Withdrawal from alcohol can be dangerous and can further complicate surgery and recovery. That is why it is important to take a hard look at your drinking and take steps to quit in a safe manner, well before any planned procedures. Sometimes this means quitting under the supervision of a physician.

The holidays can be an especially difficult time to quit drinking. But remember that being healthy and safe is the best gift you can give yourself. So if you have plastic surgery coming up, let that thought help you resist the champagne and hot buttered rum.

Will Breast Density Limit My Plastic Surgery Options?

Getting good news about breast density and plastic surgery options

The last time you got your mammogram results, did you notice a little note about your breast density? If you are like 40 percent of women, it might have said something like, “Your breasts are heterogeneously dense, which may obscure small masses and may put you at greater risk of developing breast cancer in the future.” Though this may sound a bit scary, it’s actually a normal reading.

Normal breast density exists on a spectrum from not dense at all to extremely dense. Knowing this information is important; it helps women and their doctors decide which breast screening methods are best, and how often they should get them. According to the American Cancer Society, whether a woman has dense breasts or not, regular screenings (mammograms in particular) are still the best way to find cancer early.

Because of the relationship between breast density and cancer risk, it is now the law in many states that breast density information be conveyed to each woman who has a mammogram. You may have seen talk of this newer legislation on the news.

What this means is that more women than ever before know that breast density matters, and many can tell you just how dense their own breasts are. Knowing this has also left some women wondering if their breast density will affect their options when it comes to cosmetic breast surgery.

To help answer this question, it will help if we first explain what doctors mean when they talk about breast density.

Breast density is a radiologic (mammogram) finding that has nothing to do with how breasts look or feel from the outside. The classification of density has to do with the ratio of fat (not a dense tissue) to everything else that makes up the breast, including glandular and fibrous tissue. On a mammogram, the fat shows up dark and the other stuff shows up white. The more white seen on a mammogram, the more dense the breast classification. The breast density classifications that may be assigned are – from least dense to most dense – the following:

  1. Fatty
  2. Scattered Fibroglandular
  3. Heterogeneously Dense
  4. Extremely Dense

Only about 10 percent of women are categorized as having extremely dense breast tissue. You can learn more about these breast density types, and see images too, at the American Cancer Society.

Here at North Texas Plastic and Reconstructive Surgery, Dr. Slack performs a wide range of cosmetic breast procedures including breast implants, liposuction, breast lifts, and breast reductions. In some cases, he may perform a combination of one or more of these procedures, depending on the goals of the patient. Here is how breast density may come into play with each of these procedures:


Breast implants are placed underneath the breast tissue not within in. This means that the breast tissue itself, no matter how dense, sits on top of the implant and therefore has little bearing on whether a breast implant is possible.


Liposuction alone is sometimes an option for women who are looking for a mild reduction in breast size. It is possible that a woman with extremely dense breasts, which means they have a lower ratio of fat to other tissue, may have a limit as to how much fat can be successfully removed using this method.

Breast Reduction or Lift

A breast reduction or lift sometimes includes liposuction, and the limitation just mentioned may come in to play to some degree. However, because these procedures also include an open surgical component, the goal of the reduction usually isn’t limited by breast density.

Here is the big takeaway: None of these procedures are off limits to a woman simply because she has higher breast density.

There are many factors that will limit a person’s plastic surgery options, including poor health, weight instability, and a bad smoking habit, but breast density usually isn’t one of them. That said, every person who walks into our clinic has their own unique anatomical identity, and that includes breast density. Dr. Slack takes all of this (and more) into consideration when advising each patient and planning their surgery.

If you have more questions about breast density and which breast procedures might be right for you, call our office today and schedule a consultation with Dr. Slack.

Men, Masculinity, and Plastic Surgery

Though many more women still seek out plastic surgery than men, according to recent statistics, that gap is closing. In 2018, 1.3 million cosmetic procedures were performed on men. That is up by nearly 30 percent since 2000.

Men seek out these procedures for many of the same reasons women do: to increase attractiveness, to stave off the effects of aging, and to increase self-esteem. Increasing the appearance of masculinity is also a goal some men pursue through facial plastic surgery. 

“Of biggest concern to men and one that often times affects their masculinity and feeling of vitality is hair loss,” says Dr. Charles Slack. “I am seeing more men for this as I have started using the Neograft system for hair restoration. In my practice I would say that botox is the most common treatment for men followed by fillers and then eyelid surgery.”

A new study, published in JAMA Facial Plastic Surgery, showed perceptions of attractiveness, likeability, social skills, and trustworthiness all increased after surgery. Interestingly, this study showed facial surgery had little effect on the appearance of masculinity, however. The authors point out that this is contrary to similar studies that have shown significant increases in the appearance of femininity in women who have had facial plastic surgery.

The JAMA study was conducted using the before and after photos of 24 men who underwent a number of facial procedures at Georgetown University Medical Center. The procedures included one or more of the following:

One hundred and forty five people reviewed the men’s photos and rated them on attractiveness, masculinity, and a variety of personality traits, including aggressiveness, extroversion, like-ability, risk-seeking, sociability, and trustworthiness.

The ratings of each of these traits tended to differ with the type of facial surgery performed. For example, facelift and upper eyelid lift were associated with increased like-ability and trustworthiness. The only procedure associated with an increase in masculinity was a neck lift, which was also associated with perceived extroversion.

Oddly enough, chin implants, a procedure commonly sought to increase the appearance of masculinity, was the only procedure that had no effect on any of the factors: personality, attractiveness, or masculinity.

“It is really interesting that different anatomic areas of the face have varying degrees of contribution to overall personality perception,” says the study’s senior author Michael J. Reilly, MD in this press release. “And it is also noteworthy that the study did not find a significant change in masculinity. […] This suggests that the current menu of cosmetic procedures for men are likely not as gender-enhancing as they are for women.”

Regardless of this study’s findings, masculinizing plastic surgery is on the rise. According to statistics by the American Society of Plastic Surgeons, in 2018, nearly 10,000 men got chin implants, that is up five percent since the year 2000. They also underwent about 4,000 cheek implants, a procedure that can give a broader more masculine shape to the face. These were up 133 percent since 2000.

It should be noted, however, that these numbers are small when compared to the total number of cosmetic procedures performed among men in 2018: 1.3 million. Of those, one million were actually non-surgical or minimally-invasive treatments like botox, laser hair removal, microdermabrasion, and fillers. The same trend is seen in women: of the 14.7 million cosmetic procedures performed on women in 2018, the majority (13.3 million) went in for non-surgical procedures.

These statistics tell us that while the gender playing field is still far from equal, when it comes to cosmetic procedures, the aims of men and women may not differ that much. And according to this latest research, increasing masculinity may not be as viable goal as once thought for men undergoing facial surgery.

All that said, no matter the reason you are seeking cosmetic surgery, it is a decision that should not be made lightly. Despite what national statistics or one research study tell us, all procedures affect each individual uniquely. If you are considering any cosmetic procedure, make sure you consult with an experienced board certified plastic surgeon. If you are in Collin County, Texas, call our office and make an appointment to see Dr. Charles Slack.

Liposuction and Your Weight: Clearing up Common Misconceptions

Woman taking body measurements around the hips.

In 2018, more than a quarter million liposuction procedures were performed in the United States. That makes it the second most common type of plastic surgery, after breast enhancement. Combine this with the fact that more than two-thirds of all Americans are classified as overweight or obese, and it’s easy to imagine that liposuction is a tool for weight loss.

It is true that the goal of liposuction is fat removal, and whenever any part of the body is removed, there is a small amount of weight lost. But liposuction is used for shaping or contouring the body, not for weight loss. In fact, the ideal candidate for liposuction is near or at their ideal weight.

According to Dr. Slack, “A good candidate for liposuction has one or more deposits of fat that are out of proportion with the rest of the body and can’t be eliminated with diet and exercise.” This includes “love handles” or stubborn areas of fat on the thighs, hips, belly, arms, chin, neck, and cheeks (face and buttocks).

Liposuction is best done in areas with good skin elasticity, and it does not address loose or sagging skin. For this reason, liposuction is often used in conjunction with other body contouring procedures like breast reductions, tummy tucks, arm and thigh lifts, and mommy makeovers.

During a liposuction procedure, a thin, hollow needle, called a cannula, is inserted through a small incision in the skin. For larger areas, several incisions may be made. The inserted cannula is connected to a vacuum pump which sucks out deposits of fat underneath the skin. Liposuction cannot be used to remove visceral fat, that is fat around the organs in the abdomen, common in people who are overweight or obese.

There is also a limit on how much fat can be removed at one time. “Large volumes of liposuction can cause significant fluid shifts inside the body. In certain circumstances this can be dangerous,” says Dr. Slack. “The American Society of Plastic surgeons recommends anyone having liposuction over 5 liters stay overnight in a hospital or ambulatory care center for observation and fluid management.”

With liposuction, fat cells are permanently removed, but that does not mean you can’t still gain weight. The more weight gained, the less effective the liposuction results.

According to the American Association of Plastic Surgeons:

“If the patient gains a small amount of weight after their procedure, say 5 pounds, fat cells throughout the body will get a little bigger. While this slight weight gain can diminish results, the overall improved body shape provided by a liposuction procedure will still be visible as treated body areas have less fat cells (and thus experience a lower enlargement rate) compared to surrounding areas.”

If someone gains more than about 10 percent of their body weight after liposuction, in addition to the remaining fat cells in the body getting even bigger, new fat cells can develop. This can happen even in the area that was treated. However, because there are still fewer fat cells there, the body contouring effect of the liposuction may still be visible. In other words, you may still have the body shape you desire, even if you are heavier.

Issues of body weight are complex, entangled with issues of health and body image, and they are not always easy to solve. There are tools that can help like building self-esteem, diet, exercise, and even bariatric surgery, but liposuction shouldn’t be considered one of them. If you are thinking about having liposuction, make sure you see a plastic surgeon who understands this.

If you want to learn more about liposuction and whether you are a good candidate, contact our office today and set up a consultation with Dr. Charles Slack. He can help clear up any misconceptions you may have.

Dr. Slack’s Patient Discusses Neograft® Hair Restoration

“To be perfectly honest with you, I wasn’t having a mid-life crisis, so I wasn’t really looking for this.” For David D., it wasn’t a mid-life crisis, but mid-night tv watching that triggered the decision to have a hair transplant via Neograft® hair restoration.

With a young son who is often up at night, David occasionally finds himself channel-surfing when infomercials rule the airwaves. And aside from a small George Foreman Grill problem and a few groggy mornings, this turned out pretty well for David, because it’s where he first learned about follicular unit extraction (FUE), the newest method of hair transplant.

David had never liked the look of other transplant methods, so it wasn’t something he had ever considered. But this method made sense to him, and it put the idea of a transplant on his radar. Shortly after the infomercials, David started seeing billboards with some of his favorite athletes advertising FUE. That really sparked his interest, particularly when he saw the transformation in Brian Urlacher of the Chicago Bears. After extensively researching the procedure himself, David decided to take the next step.

This is when he reached out to Dr. Slack, who uses the Neograft® hair restoration system for FUE. “Dr. Slack was able to answer all of my questions and really pretty much brought everything to light before I even had a chance to ask any questions.” Dr. Slack then put David in touch with a previous Neograft® patient to answer his questions about the experience.

At this point, David knew the procedure was what he wanted, and he was convinced that Dr. Slack was the surgeon to do it. “He pretty much was the reason why I did this. I’d probably still be thinking about it if it wasn’t for just how comfortable he made the whole thing for me from the very first time I stepped foot in his office and the way he conducts himself. There was no pressure or any of that stuff.”

On the day of his procedure, Dr. Slack prescribed David a single dose of valium to help him relax. Then he had injections to numb the areas of the scalp where the procedure would be performed. David explains, “If there was any part of the procedure that had any kind of pain level to it… when he was injecting back in that area in my head, it smarted a little bit. On a scale of one to 10, it was probably a five.”

Next they cropped David’s hair a little shorter in the donor area on the back of his head. Then they went to the room where the Neograft® machine was and David got comfortable face-down on a massage-style table with his favorite music playing on his earbuds. During the extraction of the follicles from the back of his head, David says there was no pain, just some occasional pressure.

At this point they bandaged the donor area and David turned around face-up. Dr. Slack used a marker to draw the new hairline and made sure that David liked the proposed look, and then began implanting the follicles according to that guide. This part was important to David who had done so much research ahead of time, “There’s an artistry to it. This is one of the things I talked to him [Dr. Slack] about when I did my research… I think this is where, if you don’t get the right people… if you don’t get the hairs put in properly and aligned the right way… there’s a lot to it. It’s just not pulling hair out and poking a hair back in your head.”

David’s procedure went a little more quickly than expected. It started first thing in the morning and wrapped up at about 2 pm, even though they anticipated it would take the full day. Then he was bandaged up and sent home.

The recovery went more smoothly than David expected. This can be credited to the fact that he carefully followed Dr. Slack’s instructions during the days and weeks following the hair transplant. These instructions include

  • keeping the bandage in place for 24 hours;
  • removing the bandage after 24 hours and applying antibiotic ointment to the donor site two or three times per day for a few days;
  • no rubbing, scratching, or lying on the grafted area to avoid dislodging the grafts during the first week;
  • washing only after 24 hours by pouring a mixture of shampoo and water over the scalp and rinsing in the same manner – no massaging of the shampoo into the new grafts!

By day ten, David returned to work. David explains that his results are so natural, no one outside of his family even realizes he had anything done.

David on Day 1 following Neograft® hair restoration

David on Day 1 following Neograft® hair restoration

David on Day 7 following Neograft® hair restoration

David on Day 7 following Neograft® hair restoration

Dr. Slack points out that taking off from work is more to maintain privacy about having a hair transplant. Most patients can go back to work in two or three days if they don’t feel self-conscious about coworkers noticing they had the procedure.

Dr. Slack emphasizes that one of the giveaways that a patient has had hair restoration is that the back of the head is shaved. For this reason, he recommends patients have a close crop hair cut (with a 0 or 1 guard) a week or two ahead of time. That way people will have had a chance to get used to the new short look, and it won’t draw so much attention after the procedure.

This process is not for those looking for immediate gratification, as it will be full year before the final results are evident. The following pictures aren’t of David, but they give a sense of the typical one-year progression following Neograft hair restoration:

Progression of Neograft® hair restoration


David is still early in the process, but now that four months have passed, he is pleased with the result. “Ask me again at the 12-month mark and I would hope to be that much more excited than I am now. My wife’s like, ‘Yeah, I can tell a big difference.’ So honestly I’m pretty excited about the results so far.”

“I would highly recommend Dr. Slack. He’s a great guy. I can just speak for myself obviously, but the whole experience was fantastic. The healing process was a lot faster than I thought it was going to be. The whole thing was just really good. I still feel great about it and I’m not even at the halfway mark.”

Are you researching your options for hair restoration? Dr. Slack would love to sit down with you and help you understand the Neograft® procedure and answer any questions you have. Just contact our office to schedule a consultation.