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Dr. Carlos Wesley

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Everything posted by Dr. Carlos Wesley

  1. The Little Baby Face Foundation is a not-for-profit organization matching children suffering from facial and cranial birth deformities with trusted surgeons. We are proud to be a part of this worthwhile endeavor.
  2. Thanks for your comments. The results are real and nobody is being "duped". I've posted a close-up before and after of this patient's crown. In it, you can see that miniaturized hairs were indeed present. I strongly encourage everyone to take a look at the Grand Rounds Lecture I gave regarding the efficacy of PRP on genetic hair loss. While PRP is certainly not the answer for all patients, it can have a positive impact on the right type of patient. We are continuing to monitor patient outcomes after PRP to determine the ideal hair characteristics for this procedure. This patient has NOT taken Propecia. However, HGB (our hair growth blend) does contain a topical finasteride component. It is described in a bit more detail on this page.
  3. Thanks @Spanker and @Sean, for your comments. While platelet rich plasma (PRP) treatments are certainly not a replacement for hair transplantation, they can provide help to patients that would otherwise not benefit from surgery (e.g. patients with a very high percentage of miniaturized hairs and/or diffuse thinning). We have certainly seen patients benefit from PRP in areas that underwent shock loss (it's a common treatment for women after pregnancy to prevent shock loss). The key is the presence of miniaturized hairs that can benefit from increased caliber, length, and number of hairs per bundle. So, @aWidowsPeak, your observation of darker hair is not uncommon. It's not, however, due to hair dye but rather reactivation of melanocytes. This feature especially helps patients being treated for alopecia areata and patchy loss of hair coloration. The best I can do for you in terms of "real proof" is refer to the Grand Rounds Lecture I delivered to an NYC dermatology department recently in which I detailed the pros and cons and findings of PRP thus far. I've also included magnified images of the patient seen in this thread. Hopefully, this is helpful.
  4. Thanks for your comments! I'll track down the specifics on how the beard and scalp grafts were "reaccommodated" and have our team post the details shortly.
  5. Dr. Carlos Wesley


  6. While every patient is different and every clinic generates different results, it has been demonstrated that after two (2) platelet-rich plasma (PRP) treatments spaced a few months apart, the benefit from the PRP sessions last for approximately 17 months.
  7. Thanks, Bill & hsrp10, for your comments. Interestingly, this patient claimed that the majority of his grafts never "fell out", but simply grew from the outset. While I'm not sure this was actually true, it may be an indication of less "shock" to the follicles during the transplantation process.
  8. Despite the important function that this social network provides in terms of vetting the various physicians and surgeons who treat hair loss, there still exist plenty of places that have unlicensed personnel performing surgeries both in the United States and abroad. Even as recently as June 2016, the state of Florida's Board of Medicine issued a declaratory statement related to the legality of this practice. For those interested, please read…
  9. Here's a 5-year update! This patient can be seen before and 5 years after both the front and crown of his scalp were treated.
  10. Thanks for your comments. It should have been pointed out that this patient was a revision surgery after previously having an FUT at another hair clinic. Therefore, his FUT procedure with us included not only an increase in recipient area density, but also a revision of his prior FUT scar. Importantly, I take out the prior FUT scar and reduce it rather than creating multiple scars in the donor area. I have included images (distant and close) of the patient's donor area a few months after his FUT procedure with me.
  11. The solutions in which the transplanted hair follicles are stored when out of the body can have a profound impact on the ultimate procedural result. Here is a an example of a patient who had two FUT ("strip") procedures at a different surgical practice in NY before having an FUE session with our group. Clearly, his results and graft survival were not consistent with the findings of this investigation.
  12. The work of a respected physician in our field, Dr. Michael L Beehner, may provide the most objective data yet comparing the yield of grafts using follicular unit transplantation (FUT) versus follicular unit extraction (FUE). While I still believe that there are numerous methods not used in his investigation to optimize growth, the effort to minimize the number of variables that may influence survival rates of grafts was considerable. Ultimately, it’s important that physicians are proficient in both methods (FUT and FUE) in order to provide patients with unbiased and objective information regarding both methods of surgical hair restoration.
  13. @Spanker. Thanks for your kind comment. This guy happened to be a big fan of Roger Federer, the tennis player, and wanted a hairline just like his!
  14. Thanks for your comments, everyone. We really appreciate them. @bitethebullet. Regarding your wavy hair comment: it's not uncommon for transplanted hair to initially grow in just a bit curlier. Yes. This is certainly something that can aid in overall coverage. Over time, however, the curliness does tend to fade and take on the original hair characteristics. Some believe that the initial "curl" results from the mild trauma or shock that the grafts undergo as they are transplanted from one part of the scalp (donor area) to the recipient area and spend a brief time period out the body. Again, thanks for your comments!
  15. While seemingly every clinic has their own protocol for the frequency of PRP treatments (some do every month, others every 3, and others one-and-done), I think that it makes the most sense to wait at least six months after having had surgical hair restoration before attempting to accelerate or stimulate further growth with a platelet-rich plasma (PRP) session.* To my knowledge there is no clear data to support this, however. It has also been demonstrated that newly-transplanted hairs continue to come in for the first time even 18 months after a hair transplant. So, my preference (as was the case with this patient) is to wait over a year after a surgery before embarking on any further intervention.
  16. Here is a bit more interesting information regarding the body's absorption of topical finasteride... In 2014, the Int’l Jour of Clinical Pharmacology published findings from their investigation of this specific topic. 1) SERUM FINASTERIDE Levels with TOPICAL versus PILL form. The finasteride levels found in the serum (blood) of patient who used 0.25% topical finasteride once daily were well below the assay’s ability to detect and quantify at nearly every point. The spike in serum finasteride levels of patients taking the pill can be seen below. 2) SERUM DHT levels with TOPICAL versus PILL form. Once-a-day use of the 0.25% topical finasteride resulted in much a less severe decrease in DHT plasma levels (19%) that those seen in patients using the pill once a day (70%) or twice daily use of either topical or pill form. Our blend uses a lower percentage of finasteride than that used in this study and our patients only use the blend once (not twice) daily. 3) No significant change in serum testosterone levels detected with either treatment. 4) A follow-up study showed the topical solution reduces scalp DHT levels by about 70%. Despite these findings, this alternative to the Propecia pill is not necessarily for everyone. Safety profiles of topical finasteride has not been properly investigated at this stage. Not everyone may have the hair growth that we have seen in many of our patients when using the topical blend. It is important to highlight the facts as they have been demonstrated. For those interested, I strongly encourage you to use the NIH PubMed website to obtain trusted medical information via peer-reviewed journal articles:
  17. Thanks for your comments! Another interesting aspect of his surgery was that his scalp was markedly thinner than a healthy scalp. This forced graft site creation and placement to occur at a much more acute angle than normal in order for the graft to be fully embedded within the thin scalp. It's exciting to see this type of healthy growth as it's an indicator that other patients with scalp conditions akin to his may also benefit from surgical hair restoration.
  18. In order for our patients to have an objective measure of their hair growth after PRP, I like to find a landmark on their scalp (e.g. freckle) so that they can quantify the hair-by-hair change. I have included the magnified images of this patient before and a few months after initiation of this therapy. While each patient responds differently, PRP has been demonstrated to have a beneficial effect for 24 months after initiation of therapy. We are finding and increased likelihood of young men with a significant amount of hair miniaturization benefiting from combination therapy rather than PRP alone. While our "n" isn't great enough to point to one catalyst over another, the majority of patients credit the PRP as the most beneficial.
  19. This 48-year-old was left with severe scarring alopecia on the caudal region of his scalp for over a decade. The cause was an aggressive scalp condition called folliculitis decalvans. He had undergone various antibiotic therapies to control the condition and stabilize it for about 11 years. Finally, because of the significant cosmetic impact it had on his day-to-day life, he reached out to our team to treat the area with surgical hair restoration. There were numerous aspects of this 2074-graft follicular unit transplantation (FUT) case that made it memorable. Scalp thickness and health in the recipient area is often compromised from this condition. Platelet rich plasma (PRP) coupled with an extracellular matrix may have helped graft viability in the recipient area.. However, within a few months, he could already see improvement and one year later, his confidence was back as his scalp coverage was as seen in the images below. While not all instances of cicatricial alopecia result in this type of transformation, it is certainly treatable. For those interested, I co-authored a chapter on this condition years ago in the textbook, Dermatologic Therapy. I believe the full text is available for free.
  20. After either a follicular unit extraction (FUE) or follicular unit transplantation (FUT) session, the time period until the full benefit of the procedure can be appreciated requires patience. The term "Early Growth" is often used to describe the initial phases of this transformation. But what does that mean? After being transplanted from the donor area to the recipient region, hair follicles lie in a "resting phase" or "dormant phase" for a few months. This does not necessarily mean that they are all hidden beneath the scalp surface. Some follicles persist in the "stubble" phase as shorter shafts as they lie dormant. Platelet rich plasma (PRP) can help reduce this resting phase. Patients sometimes grow concerned that persistent "stubble" means dead graft after a few months. However, that shaft still has yet to be activated into the growth (anagen) phase. To illustrate, I've included a patient as seen eight (8) months after a procedure and his "early growth" as seen with global images as well magnified. As evidence that the "stubble" is not dead (but rather resting) a hair shaft from within the same follicle has taken off in the anagen phase. In time, the stubble will elongate into a lengthy hair and the "early growth" phase will become "full growth". What Does Early Growth Actually Mean?
  21. @chrisdav. Thanks for your comment. However, this patient stopped taking finasteride as soon as he had the procedure. He elected for FUT in order to get off meds.