the B spot

Vallow, hairloss is progressive. If your thinning throughout the entire male pattern, as you are, you WILL continue to lose hair---how much, no one knows. However, from a logical standpoint, the earlier and more aggressive your balding is, the likelihood of your reaching a higher norwood is greatly increased. What your not understanding is that until your hairloss has reached a stabilized point, you nor any doctor will know what you need. Which means you might do 1700 grafts, it grows in only to find you losing more hair around the transplants.... well you can't have a patchy head of hair...so you go back in for another round...only to find 2 years later, you need more---and this happens until you run out of donor/money. Additionally, you have significant loss in your crown/vertex and you have no idea of how propecia/rogaine will work for you. You know, every 20 something thinks this is IT! After my 20's it is all over, etc...well I have news for you--- your insane if you think your looks matter more during your 20's---it matters until you die. Dr. Ross should tell you exactly what I have...at 23, with your level of loss, your not a candidate. I wish you well my friend. Take Care, Jason

Oh scalp reductions and "lifts" are still being done and done poorly, just like HT's are being done poorly. Sounds like severn got lucky and ended up with a solid result---sorry to hear about your numbness----over time there are those who report that the feeling goes away. I hope this is true for you! Take Care, Jason

Hi Vollow, right now your not a HT candidate. I am sorry as I personally know the heartache of loosing hair at a young age, but you have to wait it out a bit I'm afraid. At 23, you show thinning throughout the male pattern, which generally speaking the younger we are and the more aggressive our balding during these years means your going to continue to lose. Maybe at 28-30, coupled with several years of using propecia, then I would reconsider and re-evaluate, if I were you. Cut it short--buzz it to a #2 --channel your energy into working out or getting your masters, etc.... because if you do go forward,(and trust me there are plenty of docs who will take your cash) your going to start a commitment to getting Ht's period---no matter what, or when. From your comments, your simply not ready for that. Please do not take this as a negative, this advice is what is best for you. Take Care, Jason

Hi PMH--- I think this is a great decision. We only want our patients do go forward when they are ready, not when we are ready. Perhaps on the other side of 30, after meds/rogaine, you will be better able to make better informed decision and know 100% it is the right one for YOU. I wish you all the best, and as always, please feel free to contact SMG with any questions. Take Care, Jason

How about posting a pic or two? I'm not too keen on signing up 23 year old's who can barely afford one surgery, let along the 100% likelihood that you will need at least 1-2 more procedures. Have you discussed future loss, and have you looked into FUE? From your posts I think you really need to wait and shave or buzz down for a while why you gather information. I have nothing to gain from your decision making process, but you have a LOT to lose. I hope you take my advice. Take Care, Jason

Hey FE--you still have some growing and softening to do in the coming months. If you look at the difference between your 6 and 7 month pics you can see a difference there. Obviously 2700 grafts is not going to get you to where you want to be, but Dr. Charles is a great doc and I am sure you discussed 2 sessions to accomplish your goals. Depending on how far you want to take things, likely another 3000 grafts would let you go back into the top of the crown and add more density to the top---have you looking and feeling pretty good!!! Keep us updated!!!!! Take Care, Jason

Hey Sunchaser, sorry to hear your dealing with this. I hope you can find some way to relieve your condition soon. This is the first time I have heard of this happening with fue...I have heard of this happening with strip before. Anyway, please let us know how you are getting on and what treatment works for you. All of us are crossing our fingers and pulling hard for you to get this resolved. Take Care, Jason

Hey GQ-- yeah, I will certainly be extremely happy to show off our FUE work, once it grows in of course! Obviously Dr. Feller has a 5-6 year head start on us, so its going to be tough to compare our body of work to his. Anyway, I think Buffalo Soldier should do only FUE at 28 and needing only hairline work, should choose Dr. Feller. Dr. Alexander does fine work as well, but as far as I know does not do FUE, which would remove him from consideration. Both Doctors do excellent strip work, so it would just be a matter of who B.S. likes best. With B.S.'s level of loss, FUE is the best remedy after simply buzzing it down/using concealers. Take Care, Jason

How old are you?

Ok-well I am calling shenanigans and telling blokes to bugger off!

Where you guys at?

I'll check in.

Did you do FUE or did you have strip? I cannot tell from your pics. Thnx, Jason

Max, you do realize this thread is 2 years old?

Wow this is a tough one, but the law says you cannot deny treatment to a patient simply because they are HIV positive. Pretty standard. The only option left for the clinic is to challenge the actual law as unconstitutional or show why in this particular instance the law should be amended to not include cosmetic surgery. It will interesting to follow this story--but I 100% understand the hesitation regarding HIV positive patients---there is no room for error. I can see both sides and it is a tough one. Jason

We posted at the same time Bill--those are excellent points.

The 3-4% is what I personally feel the average loss should be during the extraction process, some patients will have less, some may have more...either way for those not wanting a strip scar, it is an acceptable trade off. Another point is that not all transected grafts are lost, some regrow in the donor and if you transect a 3 hair graft, but still get a 1 hair out of it, it still counts as a transection, even though you have a 1 hair graft left. TC I guess the question of donor extraction is left to each clinic. Most clinics feel the 20-25% mark is about the maximum you want to take from the donor for most patients. Some patients will be less, others who are blessed with thicker donor could possibly be more. It is about being responsible and doing a session, assessing the impact on the donor and then planning out future sessions. Quite frankly you nor your doctor know how a large FUE session will leave your donor looking, which is why using smaller tools, not overharvesting from any particular spot on the donor is paramount to achieve the full efficacy of FUE--- At some point, even if the scarring is non-existent, gaps in the donor will serve to give the donor a moth-eaten look, which essentially will serve to look like scars, imo. To answer your question, there is nothing wrong with harvesting more than 20-25%---but harvesting 30-35-40% at one time might create the scenario I detailed above. We are keeping sessions to around 2000--maybe the right patient 2500 max, over 3 days just to make sure we properly space out the extractions, handle the grafts carefully, etc... once the patients grow, in we can reassess the impact and go forward. I do not profess to speak for all FUE clinics, but if you look at the work of Dr. Feller, Dr. Harris, and Dr. Bisanga (to name a few) they generally do 1000-2500 grafts max in one session--and they all have great results. You never hear of them over-harvesting a patient either. They do a great job, then go back, assess the impact on the donor, then plan accordingly. There seems to be a balance or tipping point when doing FUE---it has to be true---you can take 5 patients with the same level of loss and come up with 5 different results on the donor--some you can continue to take and take from, whereas others one session of 2000-2500 grafts might be it. It is the same with strip--one guy has 10K of strip grafts, one guy has 4000, and the other 3 have 6-8K. My last point to you TC is that even if you go to a NW 6, even if you take all your available grafts, it may not mean you will have a dense head of hair---many of us have to choose higher frontal density and trade a bald crown or light coverage in the crown---it may be that taking 3-4K of grafts, giving you a great hairline, coverage over the frontal 100-120cm and still leaving you the ability to buzz down to a #2 on the sides with a military cut or shorter haircut on top looks great or will give you the same satisfaction that doing 8500 grafts will give you via strip. Sorry for the long post, Jason

Good for him--while I am happy that he was able to get his medical procedures covered, the 30,000 BPS seems a little low for years of hiding under a hat. I am glad that he won a settlement---it would be nice if those who insist on performing HT's like a fast-food chain would take notice. Jason

There are always trade off's when choosing one type of surgery over another. Strip has stood the test of time and will continue to do so. However, it comes with a scar that will be there forever. For most this is no problem and in the hands of a proper clinic, generally results in an acceptable scar easily hidden. FUE is gaining momentum and is now being examined and performed by some caring and ethical doctors who will not over-sell the procedure. If I had to say for most people the yield for FUE will be less than the yield for strip. Even at 3-4% loss via FUE, over the course of thousands of extractions that is still a decent amount of grafts. Most consider this an acceptable tradeoff. We have tried to combat this by taking the slower, more controlled approach--over 2-3 days if necessary. Quite honestly, I think the survival rate of FUE grafts ONCE EXTRACTED is on par with strip grafts---but again, if you ask me logically "If I individually punch out 3-4K of grafts vs taking 4000 grafts via strip, which will yield higher? The answer is strip--but I think doctors like Feller, Bisanga, Harris, Mwamba to name a few have shown excellent yield, using proper tools and by keeping sessions reasonable. The question TC asked was how will doing FUE impact future strip sessions, not which overall yield would be higher. Again, if your using 1mm or less punches and your responsibly managing the donor region (20-25% extraction max) then your just decreasing the overall follicular units in the entire donor region--including the region where you would take the strip. (Ie--if your donor density is 85 fu/cm2 and you take 20% or 17 follicular units per cm, then your overall donor density will decrease to 68 fu cm/2) Hope this helps/clarifies, Jason

Been saying this for some time now---thanks for offering some solid proof TC! Both you and swim are offering some excellent posts and are really fun to read. I'll tell you my maturity took much longer than 23--some would say I have yet to mature at 32 Cheers, Jason

Right Swim--- you would have to estimate --- you know if he actually won a suit like this he has to be in terrible shape, and that most repairs take at least 2 sessions/visits, etc... The doctor could have outlined a treatment plan, based on his assessment of the situation, and that could be presented to the court. I did not see this type of plan detailed in the article. That would have been educated opinion by the expert witness, based on his experience, not, "Well, I'm not sure"---the judge is not a HT expert and will be left to figure it out on his own. Notice the defense expert was able to put a dollar amount on the situation, which is always lowballed.

Terrible lawyering imho.... have your expert witness ready to give an actual cost of repair. Stress the FACT that it will take 2-3 sessions to accomplish his repair. That each session takes a full year to grow in before the next session can be done. That it will take 3+ years of this mans life to do this. Plaintiff is leaving the cost issue to the judge. Be interesting to see what the judge comes back with.

Actual procedure---your transplanted hair generally starts growing at 3 months---it may take up to 6-7 months before you can actually see 60-70% of the transplant. Of course, there are those who are slower than others---and it seems each successive HT seems to slow the time as well. Take Care, Jason

No, not really---it will decrease the number of grafts available via strip in the future, but if your responsibly taking from the entire donor area--you should only be about 20-25% less when you remove the strip. For example, you remove 20% via FUE which ends up being 3500-4000 grafts for you. Then you take a strip 20cm X 1.25cm wide which normally at average density would yield 2125 grafts. However, you have reduced your overall donor density by 20% which should reduce your strip 425 grafts 2125 - 425 = 1700 grafts. Obviously this is an average donor density patient, taking only 20% from the entire donor, and not overharvesting any one point on the donor. Another point is that regardless of laxity you would need to be extra careful to make sure a thin scar is produced as you will have less hair to cover the scar b/c you removed some via FUE. I hope you get the idea of how doing FUE will impact your future strip grafts. My opinion is if your going to max out, strip followed by FUE is your best bet. If your against strip, then do FUE. I think if you do FUE, you should stick with FUE until you cannot take any more from the donor--otherwise the reasoning for doing FUE 1st is severely retarded. Hope this is what your looking for TC! Take Care, Jason

I fondly remember not even daring to post on this thread....Even I have lines I will not cross Glad you got things sorted omar----you had a lot of us worried there. Jason