fortune11

I had a hairline transplant done w Dr Shapiro in 2004 - it still looks amazingly natural. Hairstylists get shocked when i tell them its not my original hairline If you are concerned about hairlin, imo Dr Ron Shapiro is probably the only person i would want placing those incisions on my scalp

The drug is VERY effective in stopping hairless, no question . It helped me as well for about 2 years But there is a cost as it affects your endocrine system - most people don't perceive the changes, but for those that do, it can be terrible for them So there is a tradeoff, but more like roulette - if your number is up, then you may suffer. If not, decades may go by and nothing bad happens. I recently got my hormone panel done by an endocrinologist and he recommended I stop taking Propeica. I have stopped for a couple of months now and can already see my hair is less thick than it used to be, Rogaine helps, but not as much. But my transplants are decent enough that I can live with the marginal loss, so no complaints so far in terms of appearance. This is all I have to say. Now people may attack me for "fear mongering" but it does not change the facts of the case for my individual situation.

Bear d hair was used across , especially on the scar . I think it did a good job concealing the wide scar . My biggest problem was w acne that started after the HT was over -- all over the beard area . I have detailed that experience in my other posts this was the single biggest post op complication - which made me take all sorts of anti biotics and even accutane. For me it is a strict no no going forward for beard / body hair - mainly because of this reason. But if you are asking whether beard hair eventually grew and did its job, yes it did. the tradeoff with the acne side effect for me is not worth it going forward but maybe you are not pre disposed to acne as I am so it wouldnt be a problem for you

My HT#4 was a slow growth (see my thread). I think growth is also a function of age and how much trauma the scalp has gone through in the past. I am finally seeing growth at the 13 month mark but it has come in quite nicely all said and done.

your surgeon will give you the best opinion since he is actually seeing your hair in person . very hard to tell from these pics . just follow his post op regimen strictly and then revisit this forum in a month or so when your scabs have all fallen off . as to smoking / nicotine , that is not advisable for any medical procedure (pre and post op), so I would lay off on that as well as far as you can.

thanks for the compliment htsoon I have used toppik and various toppik like concealers but every time I have tried them , I have eventually quit. something just doesn't feel right w them and when I travel it becomes a real hassle to maintain the same regimen

thanks mikeyhwk. Below is another picture, this time of the hairline . And here is where I want to make an important point for anyone undertaking this journey -- especially if you are heading to a NW6 or NW 7 , a position I am in now . Pretty much all the hair you see on top is transplanted hair Very critical to have a solid foundation to build upon. That hairline is from 2004 and still looks natural. I was lucky that I went to Dr Shapiro for my first HT and he designed a hair line knowing well where I was headed. Some one else who might have been more aggressive in order to appease a patient ( I was younger and in a different mindset back then) may have given me a low or aggressive hairline and then left me scrambling afterwards to keep chasing it . And having gone through 4 hair transplants now, I can tell you it gets more and more difficult to get good coverage as time goes on, especially if you have black hair on pale or olive complexioned skin (as opposed to blond hair on pale skin. I changed my hair stylist recently and the new one when I told her all the hair on top was transplanted, could not believe it . her jaw dropped . This result is as natural as anyone or I could hope for . She also had a hard time locating the scar from previous FUT. This is also why HT is as much an art as science . It is more than just getting a whole bunch of grafts and jamming them into the scalp. Having a skilled surgeon who knows how to place each and every follicle to create that irregular , natural look with enough randomness thrown in to create an illusion of denser than it actually should be , helps a lot. I spent some time trying to figure out if I could tell which hair in the frontal third was from beard FUE and which hair was from scalp donor region and I could not . The last leg left for me now is the back of the crown. I will revisit that later maybe next year. But I am now done with the top of the scalp and hoping to maintain it as long as I can with meds like propeica and rogaine.

Here are some post op pictures at the one year mark. these are after a fresh shampoo , with no product or concealers in the hair, taken with my iPhone . All in all, you may recall me mentioning that I had faith in Dr Ron and was willing to be patient , and as you can see from the pics , it turned out to be quite good, even though it took a bit longer this time around. a factor may have been this being the 4th hair transplant. I know I had posted several issues with my progress after HT so let me address these points one by one 1. Shock loss - has completely recovered by now as you can see the hair looks fuller and thicker 2. The big scar is now barely visible at #4 . I am very satisfied with this result 3. The frontal third where I wanted more support behind the hairline has filled in nicely - so that is objective achieved 4. The side channels and the top of the crown where I have marked with a red are still developing I think . I am going to wait some more to see how these look in a few months from now 5. Beard area Acne -- you may recall I was taking accutane for this. It Is effective , but absolutely a horrible medication as far as side effects go ( propecia has nothing on this !) . I stopped it after a month of usage. The acne is still there but a lot less than what it was at the peak of the problem and looks to be gradually improving . 6. One interesting observation is that the hair is a bit more curly now as part of it is coming from the beard area singles. but the placement is so amazing that you cannot tell which is beard hair and which is scalp donor hair - it is this mastery of placement that I think is unique to Dr Ron, in my opinion - making your donor hair give more bang for the buck , so to say. Also I want to emphasize that Dr Ron continued following up with me throughout the year and took a keen interest in every aspect of the case from the medication I was taking for the acne to my dosage of propecia to video chatting with me to understand what the problem areas on the transplanted scalp were. Very happy with the post op care. I will post again as results continue to develop but happy to take any questions

I didn't take fin after my HT#1 or HT #2 but did take it after HT #3 and beyond. It does help with better growth from my experience. I was a lot younger when I got my HT#1 so that could also be a factor - maybe as you age you need all the crutches you can get your hands on.

Here are some photos at #5 cut where you can see the scar but it is a bit faint and only if you know what you are looking for -- so yes, the FUE into scar was effective . The third pic also shows a bit of the side channel thinning that I wanted to fix -- no improvement there yet

I avoided taking propecia for the first 15 years of my hair loss but finally succumbed to it 2.5 years ago after my HT #3 -- It actually helped w regrowth after HT, and also led to generally a fuller appearance. So for me it worked . Side effects - mainly I had issues with brain fog (lack of coherence) once in a while and to combat that , I cut the dosage to 1mg every other day which seemed to alleviate that issue a bit. I switched from oral to topical 10 months ago after my HT#4 and my hair is a lot worse for it . Not sure if the switch itself is the cause but to test that theory I am going back on oral propecia now.

Accutane is serious stuff and I am aware since I took it back in my early 20s (and I thought I was done with it forever ). I have never seen so many warnings on a medication as I have for accurate. I was also asked to sign some sort of generic pledge and my information is in a database for monitoring . Plus regular blood tests needed to monitor liver ! But yes, Dr Ron is aware of accutane. He didn't seem to think it would be a problem with the hair growth per se (there are other side effects of course). ALL -- If you have a prior acne condition from your youth and are thinking about using hair from beard - please be very very careful and give it a serious second thought. I would have never gone through with sourcing beard hair had I foreseen this acne breakout that has become a scourge in my life now , esp given in middle age and my client facing profession. And I agree w you on the micro scarring - I have no idea whether this is a factor or not with the absorption as I only have my personal experience to go by and it didn't work for me . I have also asked Dr Ron whether introducing a different type of hair (beard) which is not native to the scalp has any effect on the more "native type " (if you can call it that) hair that was there before from the previous FUT transplants from original donor, On your last advice . I agree -- Don't change what works .

Thanks Pete-from-Farjo . Hair implanted into scar hair did grow- closer inspection the scar is a bit visible at #5 but it is meaningful improvement from before. Given many of the hairs were from the beard they feel a bit uneven, curly and coarse to the touch I will try to post some pictures tomorrow.

Thanks HTsoon. I am hopeful too. The one thing I will re emphasize is Dr Ron is the ultimate professional and he has shown great degree of personal interest and support for my case. Since he made the incisions himself I am hoping it is not a case of permanent shock loss from inserting new hair into existing transplanted hair and should grow back eventually. mikehwk - re: topical fin., a lot depends on the absorption into the scalp and maybe mine has been so jaded now after 4 HTs that penetration is not as effective , who knows , I am obviously not an expert on this subject. But the fact also remains that I was NOT on propecia after HT#1 and HT#2 and in fact did not start propecia until after HT#3 in Jan 2015. The only way I will know if topical versus oral is the cause is that if my hair comes back fuller as it was before say in the next few months. So this is something definitely worth monitoring.

This is exactly what I had done 10 months ago - you can read up my link

HT soon you are correct -- post 24 is 10 months post op and 27 and 28 is the day I walked into surgery . On the question that did I even need surgery ? --- Like I said in a different thread, pictures can be a bit deceiving . Outdoors and especially under direct sunlight , the side channels would become visible and I also wanted to create more fullness behind the hairlines to get more styling freedom. Lastly I also wanted to fill in the big scar on the right side side that had developed after FUT #3 in early 2015. Right now, as you can see I look worse than before the FUE surgery. There was considerable shock loss right after some of which has gradually recovered , but I am hoping rest is not permanent One factor that Dr Ron and I discussed two weeks ago was maybe switching from oral to topical finasteride could have been a factor, To rule that out as a possibility, I have switched back to 1mg propecia every other day. Right now, you may say I was better off before surgery and why did I bother (except for the scar). Well, I have great faith in Dr Ron's work (HT #1 and HT #3 were a success) . I want to wait for 6 more months, continue taking oral propecia and then decide whether it was a success or failure. One thing that is obvious to me from the small sample size of one (my own experience) - growth after FUE has been much, much slower than the growth bounceback after prior FUTs. I don't care how many studies people (and FUE fanatics) throw in my face, this is just a fact I am living with right now . To be clear - this is not a " complain " or being " unhappy " . I am just documenting my experience , as it happens, with changes and swings in either direction, for every one else to see and draw their own conclusions. I am assuming people on this board would rather have access to my complete thought process than me going radio silent for 1.5 years . I have learnt a lot from this forum over last 15 years reading other people's experiences and hope I am doing my part by sharing (or oversharing as the case may be).

Another pre op photo from the top view Here you can see the thinning areas in the frontal third and midscalp that I wanted to fill in with the new FUE transplant , to provide more support to the hairline .

These are two pics right before the HT in December 2016

It is easy to be passionate about one's own viewpoint and especially when it has worked in your favor. Let me address questions regarding what I have observed now and what I thought back then. Sorry but lengthy post below. - Hair always looks better in pictures (especially those taken with cellphones) and I look quite decent in photos esp from the front but in real life, under different lighting conditions and when the wind messes up your hair, the gaps in coverage and those between native hair and transplanted hair begin to show. I know one is always more critical about self than what others think so maybe I have that bias but the amount of time I have to spend on styling my hair has increased dramatically compared when I would just towel dry my thick hair, brush it loosely and walk out the door. - Using 3600 grafts on the frontal third and hairline (FUT #1 and FUT #2) is actually good planning especially when you are looking to frame the face and when you have a big head with a a lot of surface area like I do. This is why I wasn't too fond of the option of shaving my head back when I first started losing hair in my 20s. The problem was , my HT #2 on the frontal third and midscalp, yielded somewhat mediocre results (despite being FUT) and the coverage on the frontal third wasn't as good as should have been. If you have a decent hairline but no support behind it , what ends up happening is you cannot comb your hair back as there is no support behind to hold them up and it ends up looking weird. I tried to correct it this time with FUE into those areas but so far not seeing any growth from FUE at the 10 month mark - Meds -- I have not been a big fan of meds (esp fin) and am a reluctant user since I have experienced side effects like brain fog and a loss of coherency at times. I tried to find a balance with reduced dosage which seemed to help unto a point. Right now I am trying to maintain 1mg every other day, Also switching from oral to topical fin after surgery was a mistake (obviously in hindsight) and I have gone back to oral propecia now I am not married to any strong opinions, just that decisions need to be evaluated in the context of other variables that affect your life. Would I get a hair transplant again knowing what I know now 15 years ago ? Absolutely . The advantage and confidence boost it gave me was worth the effort, But need to also acknowledge its limitations especially for those on the path to a NW6 - and many hair loss patterns ultimately end up here as you age and age. As to FUT vs FUE. Comparing results FUT, #1 was the best FUT , #3 was decent FUT, #2 was not as effective FUE, #4 -- TBD -- if I get good results say after 6 more months , I will be the first to come back on these boards and admit that FUE worked for me as well as the FUTs .

I think we need more posts like the one here by jsrader . I was an optimist in my late 20s when I got my first HT. Now in my 40s , things aren't looking so good and am much more realistic. Meds can work , they can stop working or they can cause problems after a point. Newly transplanted HT hair looks good until it also starts miniaturizing after a decade to two. Ultimately law of averages catches up with you -- we like to think we are all unique individuals but we are not . Look at median distributions not a few outliers. And look at cases that have been in the making for 10+ years . How many of those do we see around here ?

I like jsrader's post -- HT is a lifelong commitment. Young'uns who can't stop gushing about their latest FUE miracle will have a different story to tell once they hit their late 40s / 50s I have gone through both FUT and FUE and my experience so far (at 10 months post op FUE) -- FUT was much much better growth than my current FUE . I had obviously no choice since my scalp was tight and " stripped out" but would I go through another FUE ? Probably not. My only hope is that my hair stays somewhat. "style-able" and I don't look like a combover freak in the next 10 years. Unless you are absolutely sure you won't progress beyond a NW3-4 - FUT is the only route . I doubt if long term hair loss ever stabilizes at NW4 . People I know for 20 years who I initially thought were a NW3 now look like NW6 - their only option is to shave their head , or embark on a long and obvious HT journey.

You have diffuse thinning on top - assume you will eventually lose almost all of the native hair -- meaning you need to plan for an eventual NW6 . FUT will be denser coverage and better yield . I have gotten both FUT and FUE. FUT was much better in terms of yield and hair growth but left a scar and I can not shave my hair close. FUE may seem alright for now but as you age , you will likely continue losing hair and then need multiple FUEs . Not sure it will be enough to cover the entire head. HTs are a lifelong commitment , no mistaking it -- there is no " one and done" unless you go for a super mega session and even then it is debatable.

My hairloss pattern is (or was , before HT) actually very similar to yours. FUT growth for me was much better than FUE growth (at a similar stage post transplant) . I would recommend thinking hard about FUE vs FUT if you want good coverage. The "scar scare" should not be a factor - if thats your primary concern, recommend not wasting $$ on any HT.

I had a quick chat with Dr Ron Shapiro yesterday and explained the issues that I have been having . Quick reminder -- I am a NW6+ to 7 diffuse thinner who has been chasing hairloss for the past 13+ years via successive FUT transplants, best of which has been the hairline work by Dr Shapiro back in 2004. 1. Acne all over the FUE donor region - a) beard and b) back of the scalp. My dermatologist has now put me on accutane - which is the most severe, last resort (google "accutane" and you will know) as the antibiotics had gone on for too long (5 + months running) and wasn't good for long term health of stomach etc. 2. Lack of growth at this stage - in fact I am hard pressed to see any growth at all and my hair at this stage looks somewhat worse than the day I went in for surgery (in December) with thinning even in the previously decent-looking transplanted regions. My goal with this transplant was to 1. fill in behind the hairline to be able to style my hair better 2. fill in the side channels above the horseshoe to add thickness. Both these goals seem to be out of reach (at least for now) and in fact there is some more separation as you can see in the picture on the left side , where the horseshoe permanent hair is starting to show separation from the top transplanted hair. On 1. Dr Ron recommended a topical remedy, I will likely apply it once I give the accurate a few days On 2. , I agree with acting, I have reason to be patient since these things can take year + to develop. I did panic a bit as to why prior good FUT hair was also thinning and here Dr Ron suggested a possible cause may be switching from oral to topical finasteride. I have gone back on Propecia now and will see if that makes any difference Obviously, I am not satisfied with the acne breakout or how my hair looks at this stage but I will have more to report for you guys at the 1 year mark. Right now, I am inclined to think my luck has finally run out with the transplants but I am keeping some optimism and waiting for the 1.25 to 1.5y mark before I decide what to do next.

Ok. Here are a few photos taken today. This is at the 9 month mark after my FUE with Dr Ron.