multiplier

he friggin feminine redistribution of subcutaneous fat (had one gyno operation already),

Can you elaborate on this?

Wow, that look fantastic.

Thanks much, Janna. That makes sense.

Just to chime in, I've taken Finasteride since 2000 (I'm 35 now) and it preserved most all of my hair luckily. Wish I had also been taking Minox all that time too. No sides from either.

Thanks Corvettester. Hopefully after the holidays, I'll get the answers I'm looking for.

I'm trying to not to let paranoia get the best of me, I'm just ultra cautious due to past surgeries. 10 years ago LASIK really screwed my eyes up and I really never should have been a candidate. And my previous HT surgeon never mentioned diffuse thinning + shockloss, so I had to wear a hat for 6 months after the surgery. Some of the hair never grew back.

I guess that leads me to another question: since the front third of my hair is mostly transplants, I'm guessing that's not as susceptible to permanent loss as native hair would be?

I also keep reading threads about diffuse thinners not being good candidates, which scares me. Some of the threads are old and I realize the technology/methods of HTs improve all the time, but still, I don't want to make a precarious situation worse if I'm not actually a great candidate. FWIW, 2 top referred docs said that they would work on me, so I trust their judgment. I'm just a little haunted by Dr Bernstein's "don't take 1 step forward while taking 2 steps back" quote in regards to diffuse thinning, shockloss and HTs.

If I remember right, you had a fair amount of loss before your first surgery. Was it then you started the finasteride?

I guess I'm trying to convince myself that sticking to Fin for the long term while potentially getting another surgery won't result in the later in life "island of hair" you see on some people. I really want to make sure Fin will maintain my hair in the long term. Thanks!

This might sound unusual, but hear me out.

I took proscar tablets, split, for about 5 years and have taken regular Propecia for another 5. In that time, I've noticed no side effects at all.

This fall, I thought I was noticing more loss at the crown, so a doctor told me to try bumping my prescription from 1mg dail to 1.5mg. Last week I begun doing just that.

But within 5 days, I noticed no more morning erections. And even when I had them throughout the day or during sex, it was only intermittent/semi-erect. I even felt a vague numbness like you experience when on anti-depressives.

Until now, I have never had experienced ED. Is it possible an additional half dose would do this? Obviously my first course of action is rolling back to 1mg/daily and hoping the issue subsides. Seems very strange after all this time, a slight change would cause noticeable side effects.

Looking good man.

Can I ask, do you take Finasteride and if so, when did you start taking it and did it help stop loss during all your procedures?

Thanks for the feedback man. 8000 sounds like a good donor supply, wish that applied to me.

p.s. did you edit your post? I don't remember it reading the way it currently reads...

 

Nope, not edited. In fact, when you responded about 4000, I thought maybe you had misread me. I wonder if you saw "2000" but not the part about two separate sessions.

In any case, I don't want to break it up into sessions if it's worse for the donor area. I want to get everything I can out of it. But admittedly it is scary to think 4000 is the max and after that....what next?

I emailed folks from True/Dorin this week asking them to address some of these things, but because it's a holiday week I don't think they checking email.

Well, now I'm a bit more confused.

This is what I read in a previous post by Dr True:

You raised a question about the treatment size I recommended (800 vs 2000). As you have indicated in your previous posts on this forum you are a diffuse thinner, exactly the sort of case in which shock loss could be a very significant factor. In such cases I often suggest proceeding in smaller steps focusing on the areas of greatest thinning and proceeding from there to minimize the shock loss factor. The way you described our interaction suggests that I simply acquiesced to your request for 2000 graft option. I know that in including such an option I would have explained that while the size of your balding pattern could certainly demand a 2000 graft treatment, doing so would carry more risk of shock loss.

 

When I met with Dr True and mentioned a fear of shock loss, he said it was not a term he liked to use since it was often temporary and never scary as it sounded. But I am a diffuse thinner and a 4000 session would no doubt cause significant shock loss, no?

I do want to add Dr True and his staff have been 100% above-board and informative. But seeing this comment made me stop short and think maybe that's why two separate procedures was recommended instead of one big one.

Naturally advanced and formulated with caffeine to prop up the hair strand to invigorate and energize the scalp.

Caffeine "props up the hair strand"? That is some bunk science.

I understand the concern with using up what could be all of your grafts, but as you would be covering most of the entire balding area with them, they wouldn't be being misused. Basically, they'd be exactly where you want them in the future.

Right, that was my feeling, too.

Best case scenario: I get hair evenly transplanted all over the front 2/3 of my scalp and I continue using Fin/Minox religiously to keep the back/crown steady.

Worst case scenario: at some point Fin/Minox stop working and I've got an "island" of hair toward the front, and much balder toward back. Meanwhile donor hair is gone. Then what? This scenario could be 10 years away. I can only hope better options will be available by then.

we cannot assume that you have average laxity

FWIW, Doc felt around and said my laxity was good.

I am kinda wondering why you have so few total grafts.

What would you say is the average total estimate? Keep in mind I already had almost a 1000 done back in 2010. My hair is fairly straight/fine anyway, maybe that had something to do with it?

In any case, we didn't talk explicitly about what my "total" amount would be, other than him just saying, "you have about 4000 to work with". Could be more, but I assume he would have mentioned it.

Well, I guess that puts me at a bit of a crossroads. If the doc thinks I have "4000 to work with", I assume that means my donor is limited to that. Is that a reason not to get the surgery? What is the worst case scenario?

Even with 4000 grafts your crown will still be thin but it won't be bald for sure. The difference will be huge but if you are looking for high density throughout then forget about another HT as your donor supply won't support this type of goal.

No, I'm not looking for crazy density. Just enough to cover the scalp in the frontal 2/3 mostly.

By the way, I have messaged both reps from True/Dorin and SMG asking them to please add their feedback to this thread. I hope they do.

I bet the subject of shock never came up during your first surgery. Most clinics don't talk about it.

The rep's words were: "Oh, you could experience a bit of loss, but it's just hair you're going to lose anyway".

Yeah, but why would I want to lose them now at age 25 instead of 5-10 years from now? That should have been my response. But indeed, many hairs never returned. Which is why I'm so gun-shy for a second surgery.

However, if he requires or strongly recommends shaving, it does not make sense to go against him.

Sure, but the point is that I'm speaking with a doctor who is indifferent to the shaving. And that is what I'm trying to get enlightened on. Should I worry about this or just trust the doc?

Appreciate your stories, Jotronic. I don't know if I could have responded to the "maybe if you didn't have such ugly hair plugs" guy without seriously considering knocking his teeth out!

Why not do it in one session. Save money, not risk infection twice. Why do it in two sessions? You will also save donor hair as you won't have to cut twice and ruin surrounding hairs.

Good question. I guess a larger session like that seemed like it'd be more traumatic somehow. More shock loss, longer healing time, etc, though maybe I'm being paranoid. I also don't love the fact that 4000 might be all I have, donor-wise, and to see it all gone at age 35 when I'm not sure what other treatments might be available in the next 10 years...seems kind of scary. Again, maybe just being paranoid.

4,000 FUT is more like it.

You mean in one session? 4000 FUT was the overall plan, just broken into 2 sessions. Are there reasons to do it all at once?

This fall, I have had consultations with with a reputable/HRN-endorsed NYC doctor who I will probably do a procedure with in the springtime. He suggested I had about 4000 grafts to work with and we could break it up into 2 sessions over a period of a year or two.

I just had a haircut and here's how I'm looking:

I think I am a realistic patient. Aged 35. Fairly straight hair, average quality. I don't expect to have a lower hairline or thick density. I don't mind people thinking I look "thinning". Mainly I just want to avoid the patchiness I have now.

Regarding the hairline, I don't need the temples filled in or the hairline lowered. I just want the procedure to blend everything together better.

Also I have been in Fin/Minox for 10 years and it has mostly halted my loss. Judging from my first procedure with MHR in 2000, though, I am susceptible to shock loss.

So - any feedback? Would two sessions of 2000 get me to a better place? Thanks!

I know some of you out there have noticed peoples' eyes wandering up to your hairline before, either wondering if you're thinning or whether you've had work done.

But do any of you have stories about getting "found out" by friends or families who recognize your transplants for what they are? I don't mean people who recognize you have more hair, but people who recognize specifically you've had surgery. Of course, this can either be an insult or a compliment depending on the comment and context... (for the record, no one's ever said anything to me)...

Just FYI: I have contacted reps from both SMG and True/Dorin asking them to weigh in on what Jo said above regarding shaving and shock loss.

I don't do this to be a pest; I do it because I had diffuse thinning in 2000 when I got my first surgery and the procedure definitely caused permanent shock loss all over. This is precisely why I've been timid for a decade deciding whether to get a second procedure.

If there's reason to believe shaving will prevent significant loss, then this is a major factor for all of us in choosing a surgeon, no?

I appreciate your feedback, Jo. On paper your argument makes sense. I'm wondering if there are people who have done surgeries both shaved and unshaved and have noticed distinct differences in their level of shock loss. I have looked through the archives and seen the arguments, but your statement above seemed the most assured, which is why I wanted to hear some elaboration.

I'd also like to hear from reps from places like SMG and True/Dorin regarding Jo's feedback. Thanks!

I wouldn't ordinarily bump a thread, but I would like to get jotronic's feedback on this.

I have never heard anyone claim outright that shaving prevents shock loss. If it does, that is a major factor to consider, as there are surgeons like True/Dorin and Shapiro who actually don't require shaving. So according to Jotronic, that would mean their patients experience permanent shock loss more often than others'. Is this verifiable?

If you don't shave then you have a higher chance of experiencing permanent shock loss.

That is a very strong statement - where has that been documented as true?