Dr. Glenn Charles

I agree that the answer really depends on what clinic/doctor you go to. Some doctors have the capabilities of placing higher numbers of grafts in smaller spaces and still obtaining a high yield percentage. There have been a few recent studies showing very high success in the range of 90-100 FU's/cm. Here is an example of a common delema/question . Would you rather have 60 FU's/cm and get 50 FU's grow or have 45 FU's/cm and get 43 FU's grow. Most would choose the latter based on the percentages of successful yield. The bottom line is that there are countless variables that go into the equation, and it will always be a hard decision.

You made a great choice. You can be assured that Dr. Shapiro will take great care of you. He has a world class staff and takes a lot of pride in his work. Please tell Dr. Ron, Dr. Paul, and the technicians that Dr. Charles says hello and that I miss everyone. It has been a couple of years since I performed surgeries there.

I recommend having a consultation with a hair restoration physician. They will be able to give you more detailed information regarding the diagnosis of hair loss, including the surgical and non surgical treatment options. If this is not possible due to your location you can see a general practitioneer or dermatologist who both could prescribe propecia. Some doctors including myself will do an on line evaluation if good photos and medical history are provided. Propecia can also be prescribed in this manner.

In my experience this is not very common. Most patients trust the doctor to only take donor from an area that is most likely permanant. If a patients is already having hair loss or thinning of hair and the doctor feels that it is due to Male Pattern Baldness, it would not make sense to take donor tissue from an area that may be lost later.

When I have a patient who normally dyes the hair on a regular basis these are the instructions that I give them. Dye the hair at least 1 week prior to the procedure and you should wait at least 4 weeks post-op before dying the hair again. If you have never dyed the hair before it would be a good idea to try it before the transplant to see how your scalp reacts. Check into the ingredients of the materials being used to dye the hair. Some are much more gentle than others.

It would probably be wise to avoid cardio-workouts for at least 7-10 days. No matter how good of shape a person is in, when they engage in a cardio workout their blood pressure will roller coaster ( go up and down ) which may delay the revascularization process. Excessive sweating in the first few day could dislodge a grafts. The other thing about sweating is that it often can bring dirt and unwanted bacteria into the transplanted area. Make sure you keep that area very clean.

There are a few things you can do to alleviate the itching. You must first determine if this is folliculitis which may require a antibiotic as treatment or another scalp condition that causes itching. I have used Nizoral shampoo for patients with similar complaints and have had good success. If possible try to see the doctor who performed your surgery and get their opinion. Sometimes this is just a sign of new hair growth and dissipates after the hair has fully grown in.

47 year old patient with strong family history of Male Pattern Baldness. Wanted to work on the front half first and return in a few years to work on the back.

54 year old patient. Came to clinic 4 years ago with stage 7 balding pattern. Was looking to have some light coverage over entire scalp.

I wish I could say I have visited Dr. Knudsen's clinic in Australia. He has invited me on several occasions, but I have not been able to get there yet. I can say that he is one of the kindest men I have ever met, and he is recognized amongst his peers as a leader in the field of hair restoration. Stay positive it often takes a second procedure to get closer to your goals.

I do not know if LA is to far , but I know that Dr.Kenneth Siporin also does very nice work. I have seen some of his patients and they were very impressive. Remember traveling for quality if necessary is always worth the trip.

I have a few patients currently using the scalp rollers in conjunction with Rogaine foam. It will be a while before I can post the results. I am anxious to find out if there is any additional benefits.

This is one of the potential downsides of taking donor strips that contain 4500 follicular units. Bigger strips=bigger wounds= more tension=bigger scars. Some patients have tighter scalp to begin with. Did your doctor recommend scalp exersises or was a two layer closure used in your procedure to close the donor wound? Scar revisions can be performed at a later time as well as FUE into scars. I admit I have had patients who really wanted to get a large number of grafts on the first procedure, and told me they really did not care about the scar in back. Probably because they intended to always keep their hair longer in back.

The Haber spreader can be very useful and help to minimize transection of follicles during donor strip removal. However, I think it works best when using a single blade to make the initial scoring incision followed by the Haber spreader. You do not have to go deeper just because a single blade is used. I see no advantage in using 2-3 blades. In fact, most view it only as a way to speed up the process which may not always be good for the patient.

I find it hard to beleive that a patient could have a permanant side effect from taking 7 pills. It takes Propecia several months of regular usage to take effect. You will be suprised how strong the placebo effect can be on certain patients. Considering you have dark hair and in the photos it is wet, yet it still looks like you have a pretty good head of hair. There will probably always be guys you know who have more hair than you and many others with less.

No matter what the patients age is the doctor should be thinking, what if this patient looses more hair and does not come back for more transplants. Hairlines should always be at a height that will look appropriate at the time of transplant and 20-30 years later.

That is possible to have another strip procedure and still have some donor available for FUE in the crown. However, you may have more than 8000. I have had patients that have up to 10,000 follicular units. I am not sure were you are, but you can always get a few opinions. It is easier and more accurate to assess the donor after adaquate healing has occured.

What you are saying is partially correct. Some of the older transplants did obtain good density with fewer grafts. This may have been because there were more hairs in those older grafts or the patient had some existing hair at the time of the transplant. In either case as the patient aged the transplanted hairs would look more unnatural. The patients own hair characteristics along with the doctors methods and grafts size are the biggest factors in the degree of naturalness.

You really need to wait 12-15 months before you will see your final result. During that time period you may experience some times when things are looking great and times when it looks like you are going backwards. Are you taking Propecia, using Rogaine, or laser treatments? In the near future we may find that PRP treatments may be helpful in situations similar to yours.

The amount of tension needed to close a donor wound is what really determines what type of scar will form. Using a two layer donor closure helps to decrease the amount of tension present along the wound edges. However, each patient has individual healing properties and exactly what kind of scar a patient will end up with is impossible to tell until the result is present. Most adults have had experiences that will indicate whether or not they heal well or form unsightly scars. I have had patients that were able to use a #2 and not see the scar. I have had other patients who needed a #3 or #4 to camoflauge the scar. Sometimes in order to get something (more hair),you have to give up something (cutting hair very short in back). FUE is another option in hair transplantation that does not leave a visible scar with a single procedure. Most of the stretch from strip removal comes from the neck upwards, not the forehead backwards.

Yes, this could early signs of hair growth. Usually this phenomenon does not occur until 8-12 weeks post-op. However, if you are experiencing many of these pimple like lesions in one area and there is a lot of surrounding inflammation and tenderness you should contact your doctor who may consider putting you on a antibiotic. You should have been given instructions on how to deal with this problem.

It is quite common to have a little fallout when first starting Rogaine. The hairs that are falling out are weak, dying, and probably would not have survived more than another 6-12 months. Some of your current hair loss could be just normal everyday shedding. Have you considered using Propecia to also help slow down any genetic hair loss you are experiencing?

Vitamin E oil should only be used post operatively. I tell my patients to wait until the sutures have removed before using it. Apply at night before bed and wash off in the morning. In the US it is sold in all vitamin stores and even grocery stores. I am sure it will be very easy to find in the UK.

I agree with Dr. Lindsy and Dr. Simmons that from the photos and what you describing these do not appear to be hypertrophic scars. I do think that FUE could be a viable option for you. There is more variability when transplanting into a scar, but I have had some success in patients with similar scars. I strongly recommend using PRP with what ever option you choose. Especially if you go with a scar revision. When removing the old scar tissue and attempting to reclose the wound under minimal tension the PRP may allow the new collegen fibers to align properly leading to a smaller scar.

Did your doctor recommend Propecia? It sounds like you are losing hair more rapidly than the average of 50-100 hairs per day. The average number of hairs per follicular unit is 2.2 hairs. So if you did receive 1500 grafts, it is safe to say you would be getting around 3000 hairs. If you proceed with the transplant, but continue to lose hair during the year you are waiting for the transplants to grow or if you have any permanent shock loss you still might not look similar to a year ago. On the other hand, if you are taking preventative measures and the hair loss slows down while the transplants are growing in you could look better than a year ago.