Dr. Glenn Charles

I do agree, now that you are at day 5 the swelling will likely be gone in another 2-3 days. In a recent large study by Dr. Hwang he showed that staying in an inclined position after hair transplant surgery increased the incidence of post operative swelling. If you think about it this actually makes sense. If a patient is susceptible to swelling, develops fluid accumulation in the transplanted area after surgery, and remains upright, gravity will make all the fluid pool in the forehead and slowly work its way south. On the other hand, if the same patient sleeps at a normal sleep angle the fluids will spread out over the entire scalp with only a small amount settling in the forehead area.

I have had many patients who are in a similar work situation to you. I recommend they tell their employer that they are having something removed from their scalp and the doctor has asked to keep the head covered for 1 week. Having to explain the hat to a few co-workers may be better than using up a vacation to have the procedure done. I use graftcyte and ocean water sprays on all patients and the scabbing is very minimal.

The Telogen or dormant phase can last up to 5-6 months. At this point you really have no choice but to wait a little longer to see what happens. I have had patients who showed no real growth until after the 5th month and still ended up with a good result. Think positive and hopefully good things will happen.

At 10 months you are probably looking at 80-90% of your results. It really depends on when the hair started growing. If you were getting growth at 3 months, you will be close to a final result at 10 months. If you did not start getting growth until month 4 or 5 then you may need to wait up to 1 year to get a final result. The concern in transplanting a second procedure to soon is that the doctor may make an incision in the recipient area right on top of a previously placed graft that has not yet started growing. It is unlikely that at 10 months that this will occur. One additional benefit of waiting a year or more is that you can make a good decision as to whether you need more grafting in the original transplanted area and if so what areas need more than others.

Patients can have different responses to the same medications. If you feel that you have had an increase in shedding since starting Nizoral, you should consider going to 2-3 times per week. If the shedding continues, you may want to discontinue Nizoral for a while and see if you get an improvement. I have never recommended using Nizoral that often on a patient that doesn't have any symptoms of Seborrhea or dry itchy scalp.

Transplanted hairs are supposed to be placed in a neutral orientation. There should be an attempt to restore the hair to its natural angle and direction. Therefore, you should be able to part your hair in the middle if you desire. I think that hair parted in the middle is not as popular as it once was. Also, remember that the hair usually looks thinner in the parted area. This also holds true if the hair is parted on the left or right. In general people who have hair loss or thinning tend to part their hair to one side because they get better coverage and the illusion of more hair by creating the layering effect.

It is quite possible to make a significant improvement with your hair situation. Usually, even if you have had several older type surgeries there would still be some remaining donor hair to repair or help finish the job that was started years ago. Dr. Haber does great work and will definitely give you an honest opinion as to what your options are. If you want the opinion of other doctors you would need to post a few photos. Remember you can always block out the face and remain anonymous.

36 year old patient looking to strengthen hair line. Patient elected not take Propecia because of no family history of hair loss in the middle and crown areas.

It sounds to me that you do not necessarily need repair work, but maybe just finishing work. I like to think of it as fine tuning. These procedures are supposed to be approached as if each patients head is unique and in order to restore the hair the doctor should think of it as a piece of art work. Unless the hairline was placed way to low on the forehead, you can certainly have some additional work done in and around the previous work to get you where you want to be. You may even have some grafted hairs that you feel are not in the right direction. By placing more hairs in the proper direction around them helps to weight them down so you can style your hair as you wish. I would say at least 30%-40% of my cases are are either repair or finishing cases. If you have only had one procedure then I am sure you still have a lot of good donor hair remaining.

I recommend you at least wait 24-48 hours before wearing baseball cap. You want to make sure that there is no oozing from the grafts that could potentially stick to the inside of the hat when you take it off. You should use a clean adjustable hat and attempt to put the front on first and the back of hat last. How many hours a day you wear it does not really matter. I do agree that you should wear the hat if you are going to be exposed to the sun.

The most important thing to avoid when trying to prevent donor scar widening after hair transplantation is flexing of the neck. Do not try to touch your chin to your chest to see how far you can go before it starts to hurt.I recommend light workouts after 7 days for the first week. At 2 weeks post op I allow for full workouts with the reminder to avoid over flexing the neck. You may have to alter your workouts for an additional 4-6 weeks, but some workout is better than no workout.

It would help if you described the scar in greater detail. At the very least the scars size, shape, and location. If it is small enough a revision may be an option. The percentage of successful graft growth is more unpredictable when placed into scars. It may require several procedures to reach your desired density. Some clinics have a minimum charge and might make the procedure more expensive than you anticipated.

I generally tell patients to wait until day 6-7 before going directly under shower. You could probably get away with day 4-5, but I always worry that a patient might have one of those heavy duty, high powered super showers. When it comes to getting direct sun exposure on the transplanted area, it is really important that you let the skin return to its normal color prior to the sun exposure. If you burn abnormally pigmented skin (red), it may never completely return to its normal color.

Growth direction cannot really be changed. What can be modified is styling direction. The length of the hair strongly influences the styling options of the hair.. The longer the hair the easier it will be to change its styling direction. Hair direction is a very important factor in the planning a hair restoration procedure. In most cases the doctor will be able to find at least a few original hairs in the recipient area, and will match the direction of the new grafted hairs.

I have had patients with Seborrheic Dermatitis. This condition usually occurs on an intermittant basis. I would recommend only having a procedure when the condition was inactive. The irritation and inflammation of the scalp when the condition is active could inhibit the new grafts and reduce the percentage of successful graft growth. Have you tried Nizoral shampoo? I have used it to treat many patients with this condition.

You have to decide if you want to try something less invasive before going for the hair transplant. PRP(Platelet Rich Plasma) and LLLT (Low Level Laser Therapy) are two options. They can be used individually or in combination. You can also continue to take Propecia with either of these other treatment options. Although we do not have any long term data with regards to PRP results, we are hoping that it can be used to help patients that are in a similar situation to you.

The answer to this question really depends on what kind of density you started with in the donor area. If it is high density than there is a good chance that you would be able to have a large/mega session with a strip on the second procedure. If the density is only average to begin with, then after having a FUE megasession the donor area might become to sparse to then have a strip megasession on the second procedure.

It would be very difficult to determine if your hairline is receeding without comparing your current hairline with older photos of your hairline. I can say that the shape of your hairline looks appropriate with your facial structures.

For many people that are considering a hair transplant, being discreet is a major concern. How visible a hair transplant is after the procedure depends on several factors. How much original hair is present, length of hair, color of hair and skin are just a few. I really do not think that there would be much difference in the post-op appearence between 2000 FU's and 2500 FU's.

That is a photo of a donor site that shows staples being used to approximate the wound. It appears to be in a acceptable location. The formation of the scar will take several months. Dr. Hasson is a very meticulous surgeon and has had many great results with regards to donor scars. When your hair grows a little longer it will camouflage the donor area.

It has been shown that 50 follicular units per sq. cm. is an acceptable density that can have a high percentage of successful graft growth. More importantly is how much remaining hair is in the potential transplant recipient area and what are the doctors techniques and capabilities. If performed properly there should be no compromise in graft survival.

Are you taking about a scar from a recent surgery or a surgery that was performed in the past? The treatment and preventative options are different.

There are many patients that have had documented benefits from taking Propecia. That does not mean you are guarenteed to have positive results from taking it. In order to give the medication a fair chance to work you should take it for at least 9-12 months. Any side effects would most likely occur within the first few weeks. There is a generic form of Finasteride that is less expensive. Ask your prescribing doctor for more information. There should be no problems from taking vitamins with Propecia.

I am sure you will be happy with the choice you made to have your procedure with Dr. Tykocinski. I am lucky to have met Arthur many years ago at a ISHRS conference. We have become very good friends. He has given me an open invitation to visit him in Brazil. I have been unable to travel there yet, but am looking forward to visiting him soon. Dr. Tykocinski is one of the great minds in the field of hair restoration. His presentations at the conferences are as creative and innovative as any I have seen in the past 10 years. We have performed live surgeries together at the Live Surgery Workshop in Orlando and his surgical skills are more than impressive. I do not need to wish you good luck. Just be patient and good things will happen in time.

This is actually quite common and occurs more often with coarse hair or with larger grafts. Sometimes conditioners help to soften the hairs. In most cases over time the hair will become less brittle with continued growth and repeated trimming of the hair.