Postdoc

Hairs can’t actually be suffocated as the growth is at the follicle level and it’s irrelevant what’s happening on the scalp itself. The exception to this is excessive exposure to sunlight as UVB goes deep. Some guys might choose to shave the hair where the system is attached, but personally, I wouldn’t as I’d want to see the little buggers growing. I’d suggest using narrower, stronger tape in front of the hairline and use plenty of solvent when releasing the tape.

Polyurethane ('thin skin') is much more durable than lace, but lace is generally preferred for full-size systems as it has a better look and feel. You've probably got a surround of polyurethane with lace in the middle, which is fine. 

It's strange revisiting all the hair system stuff after six years of ditching systems in favour of hair transplantation! TBH, having a HT was one of the best decisions of my life.   

I think most HT surgeons would recommend clip-on systems as being better for the transplanted hair than ones that are glued or taped, although I doubt there's actual evidence one way or another. Probably the worst would be a glued-down, non-porous mono base. At the end of the day, hair just grows whatever you do to it. What sort of base is yours? French lace?

Well, guys routinely wear hats to cover transplanted grafts and you won't need to worry about grafts being exposed to the sun.

It's impossible for me to be categorical about that as it's all down to the attachment your stylist has used and making sure that the clips and tape are well away from the grafts. Make sure your stylist is heeding your concerns when you next see her.

Wow, that's certainly biting the bullet!

There'd be more of a tug with a larger piece.

I'm pleased it's worked out for you. 

If you're wearing a partial system for a month at a time, the risk of traction alopecia should be small. Traction alopecia usually results from long-term use where there's a lot of pulling on the hair (e.g. weaving, cornrows and Sikhs' turbans). But keep the clips well away from those precious grafts.

It's difficult to say exactly when I first noticed the bald patches from traction alopecia, but certainly not within the first five years. Gillenator may have a different experience, of course.

Check with your stylist what clips she uses - that's crucial.

And the front??

Hi Leftwithrope,

I also wore systems with clips for a decade or more (see my weblog) and the traction alopecia was very significant, necessitating grafts into those areas. As you're planning to wear a partial, there should be less traction on your native hair - for instance, if you're sleeping with the system on - although this depends on the clips your stylist uses. The ones I used were about an inch long by quarter of an inch and they gripped the hair very tightly. Your biggest concern should be the front, and you need to ask your stylist what she plans to do about that before agreeing to anything.  

When attaching a system with tape, the scalp is shaven up to where the edge of the system meets the original hair, which should give a seamless transition between added hair and real hair. If clips are used, the system needs to be larger so that the clips have got hair to attach to. 

I'm not sure what can be done about the front. You definitely shouldn't be using clips on transplanted hair. I suppose the only option would be to shave the transplanted hair in order to attach the tape, but I can't see your HT surgeon being too enthusiastic about that and it seems counterintuitive doing it after a HT anyway. Have a word with him and see what he says. It would be so much simpler to cut your hair and apply fibres. I think you'd be surprised how realistic they can look.

It's not so much how often you wear the system as where the clips are attached. You'll need a considerable overlap with your existing hair at the back and sides to make sure there's no chance of the clips engaging with the transplanted hair. Using clips at the front is a complete no-no, so you'll have to use tape in front of the hairline - again with a safety margin to avoid the transplanted hairs.

It's obviously a difficult dilemma for you and I hope your hairpiece designer is inventive enough to consider what's really best for you, if that's the route you choose.  

Clips are tricky because they can cause traction alopecia. If you were to go for a partial system, the clips would need to be well clear of the transplanted area. At the front, you'd need to use a narrow strip of tape in front of the transplanted hairline. Doing this as a one-off for your special social event might be okay, but I wouldn't do it for 5 months because of the risk of pulling on the transplanted hairs.  As VicTNYC and Triple7 have suggested, cutting your existing hair and using fibres at the front would be the best way to go. Why not try a can of hair fibres and see what it looks like?

The general consensus seems to be that 5 alpha-reductase inhibitors like finasteride and dutasteride don't increase the risk of PCa. In fact, there's some evidence that finasteride may reduce the risk of low-grade PCa (Gleason 6-7) PCa. There was some suggestion that dutasteride could reduce the incidence of high-grade PCa (Gleason 8-10), but this hasn't been borne out in further studies. Taking both drugs together would be an unknown quantity.

8 hours ago, spex said:

No sides. If you stop any treatment you'll lose the benefits. 

No side effects from Dutasteride? Really?  Spex, I suggest you read the following: 

https://www.sciencedaily.com/releases/2017/06/170622110452.htm

Regards,

Postdoc

Excellent write-up and incredibly clean work. You should have a fantastic result. I look forward to seeing your progress over the next six months. 

Hi Jowin86,

2000 - 3000 grafts seems realistic and it's good that you've been to a number of clinics. The problem in the UK is that clinics spring up the whole time and most of them employ sessional doctors who simply don't have the training or track record to ensure a good outcome. The Kensington Hair Clinic and Harley Street Healthcare are cases in point. Dr May at the Wimpole Clinic has been around a lot longer, but his work doesn't bare comparison to the best in the USA, Canada or Europe. If you're keen to have the work done in the UK, Dr Reddy at The Private Clinic, Dr Farjo at the Farjo Hair Institute and Dr Ball at the Maitland Clinic should be on your list.  I had my 3rd HT done by Dr Ball (the two previous HTs were with Dr Hasson in Vancouver), which is why I'd personally recommend him.

Regards,

Postdoc

Hi Jowin86,

Congratulations on taking the plunge, but I'd strongly advise you to steer clear of Mr May and the Wimpole Clinic. If you're looking to have the procedure done in the UK, I'd personally recommend Dr Ball at The Maitland Clinic.

Regards,

Postdoc

At 57 and Nw5 it is a little late in the day to take on HT compared to many who have gone before me but the timing is as good as I can hope for.

I am 6 months into my research and visiting specialists. I firstly met with a representative of an international company. Unsurprisingly they said I was a good candidate for HT. They had impressive robotic FUE equipment but steered me towards FUT claiming good Laxity in the donor area ( I disagree on this point, it all feels as tight as a turnip to me ).

The second specialist was Harley street based. Excellent reputation. Offered either FUT or FUE...the choice was mine. Both interestingly came up with the figure of 3200 grafts. In summary two opinions, the first ,expensive and uninspiring, the second very expensive and totally inspiring.

I appreciate that you cant chase the price in this field but you also have to cut your cloth accordingly. I want to move forward, my question is can good quality FUE be had at reasonable cost in the UK. It has been suggested to me that I may need to look further afield and should seriously consider specialists in Belgium.

If anyone has already travelled this path or has some insight and would care to share their findings I would be interested to hear from you.

Your situation now is similar to mine back in 2012: late 50s, NW5 and finally able to do something about my hair loss. Like you, I hoped that I'd be able to achieve the look I wanted in a single pass. Six years on, I've got the coverage I wanted, but that's after three procedures, amounting to 8500 grafts in total: 4500 via FUT with Hasson & Wong in 2012; 2500 via FUT with H&W in 2013; and 1500 via a mix of FUT and FUE with the Maitland Clinic in 2016. Cost wise, that adds up to about 25,000 GBP. I did consider Belgium clinics, but the reputation that H&W had for big FUT sessions convinced me to go with them. Fast forward to 2018, there are now more clinics in the UK, but it's vital to choose one with a dedicated, named surgeon with a proven track record. Personally, I'd recommend Dr Ball at the Maitland Clinic who does both FUT and FUE. I wish you the best with your journey!

Just like to say thanks to everyone that contributed and answered this thread. I came here looking for some advice and I've got it.

 

One question - may seem daft - how do you get propecia in the UK, do you need a prescription? I've no doubt there'll be lots of ways to get it online, but I want the real deal. I see places like Belgravia offer it, but surely this will be double the price of sourcing it yourself?

Hi Marley76,

Branded finasteride (Propecia) is double the price of the generic drug (Aindeem). Try Assured Pharmacy in the UK. Their price includes an online prescription.

As others have said, your hair looks good, but some filling in at the temples would be worth considering. As far as UK surgeons go, I'd recommend The Maitland Clinic. I've had two HTs before at Hasson & Wong and the third with The Maitland Clinic. I know which I'd choose if I was starting afresh.

Regards,

Postdoc

Patrick and Postdoc thank you very much for your replies and recommendations of surgeons. Patrick you said you got yours in Greece, can I ask who with? Postdoc have you had any dealings with Dr Edward Ball? Can I also ask if what I am currently doing, medication wise, still appropriate? Does Kirkland foam make much difference for hairline loss? This has become something of a chore to be honest. Is there anything I can be doing in the mean time while I consider surgery? Once again than you very much for your help.

I had my 3rd procedure (FUT/FUE) at The Maitland Clinic in October, so I can vouch for the professionalism of Dr Ball and his team. I'm sure he'd be happy to Skype you for an initial chat about your situation. Medication wise, finasteride (Propecia) is still the mainstay when it comes to retaining hair. There's some evidence that dutasteride (Avodart) can be better for frontal regrowth, but you run the risk of more (non-permanent) side-effects. Switching from finasteride to dutasteride might be worth considering if you're continuing to lose hair; if not, I'd stay put with the finasteride. Long-term minoxidil is a tricky one: it probably doesn't do much after 7 years, but there's the concern of possible shedding if one stops. Nizoral has much less evidence behind it than finasteride and minoxidil. If was using the 'Big 3', that's the one I would consider stopping. But before you do anything, arrange a Skype chat with Dr Ball (or someone else), so that he (they) can assess your situation and recommend the best way forward. I hope that helps.

Hello everyone!

 

I started this thread when I was 17 and struggling with my receeding hairline. I'm now 24 nearly 25 and while I don't think it is particularly worse it still bothers me. 7 years ago I was adviced to take the 'big 3' which I have done over the years. I am currently using 'Kirkland Foam' on my hairline and still takin Propecia and using Nizoral shampoo. Are these still considered the 'big 3'?

 

The other advice I was give was that I was not a candidate for a HT due to my age would this still be the case at 24/25? Around 2010/2011 Dr. Rahal was well thought of and would have been my prefered choice is he still reputable? I also visited Dr. Farjo who was seen as a decent option here in the UK and he had someone from Spain also working with him for a while who was sought after for FUE? I was also told that 'In 10 years they will be able to clone hair so you'll be fine'. Has this happened or is it likely to in the nex 3 years?

 

My apologies for the long post but I am now in a financial postion to potentially have a HT (assuming they haven't gone up drastically!) and would like to 'rebegin' my journey in a sense. Any help would be most appreciated!!

 

Many thanks

 

thebutterflycollector

It sounds as if you're doing everything right to keep your hair. 24, going on 25, is certainly a reasonable age to consider having a HT. FUE has come on leaps and bounds over the last 8 years, so this might be a good option for you. Cloning, on the other hand, still seems years off from being available. Other drug treatments are similarly waiting in the R&D wings.

If you're interested in discussing your case with another UK surgeon, I'd strongly recommend The Maitland Clinic. They're based in Portsmouth but see prospective patients for a consultation in Harley Street. Both Dr Edward Ball and his patient advisor, David Anderson (ex-Hasson & Wong), are extremely approachable and the the clinic's results seem to be as good as any.

David

Hi

 

I am from Dallas. Last week I met hair loss treatment facility and they told me about Dermal Lens Procedure. Is any one aware of this procedure. If so what would be the maintenance involved

 

Thanks

Naga

I'm afraid it's just another non-surgical hair replacement, i.e., a hairpiece, albeit one using a very fine base. That adds up to a lot of maintenance and high costs.

So my clinic advises not to use hair products for 6 months post surgery. I will of course abide by what they say but curious as to the guidance from other clinics?

 

As I've always used some type of product (gel, creme, mousse, etc) the thought of not being able to us anything (particularly once it gets longer) stresses me a little so was wondering if I could combine any approved stuff like Aloe Vera and maybe some type of oil to create a solution that would act as a styling product? What you guys reckon, thoughts, ideas?

Your clinic is being overly cautious.You should be able to use whatever hair product you want once you're a month post-op.

Various pre-op photos and one post-op photo added. The main area of concern was the crown which received about 1000 grafts. Other areas addressed were above the old H&W scars and behind the hairline.

With two FUT procedures at Hasson & Wong under my belt (2012: 4400 grafts; 2014: 2500 grafts), I’d rather hoped that that would be it, but, as everyone tries to warn you, MPB isn’t something that just stops being a problem, even after two HTs. The main thing that concerned me was growing reliance on ‘hairy dust’ (Caboki fibres) to thicken up the crown. Without it, I felt a little exposed, particularly when someone was standing behind me. Returning to Vancouver for a third HT didn’t fill me with much enthusiasm, so I decided to explore closer to home, which is now rural Kent rather than North London.

I was interested to see Dr Edward Ball’s name and The Maitland Clinic cropping up on various websites with very positive reports and results. It was also intriguing that David Anderson had decided to end his role as Hasson & Wong’s patient advisor and join up with The Maitland Clinic instead. So, after an initial, 30 minute Skype call with Dr Ball, I arranged to meet up with him and David in their Harley Street rooms for a consultation. This proved to be an excellent, unhurried opportunity to look at what I’d had done before and to consider options for a third procedure. My original idea was to have FUE, but Dr Ball thought that FUT would be better and still leave me the option of FUE in the future. It’s worth pointing out that both David and Dr Ball have undergone HTs themselves, and there’s a complete lack of any hard sell. One thing I decided as a result of the meeting was to start on finasteride in the hope of holding back any future hair loss. I’d been on dutasteride prior to the first HT, but I’d weaned myself of it following the second HT because of side effects. Dr Ball also recommended Viviscal, which I’ve been taking since meeting up, although the evidence for it isn’t exactly convincing.

Travelling to Portsmouth from Kent is best done by car and takes about an hour and three-quarters. The alternative of a train up to Victoria and then down to Portsmouth on the troubled Southern Rail network wasn’t attractive. As with any surgery, it’s best to avoid stress prior to the procedure! Having booked into the nearby Marriott hotel, I walked the route to and from 1000 Lakeside North Harbour so that I knew exactly where to go the following morning. There’s actually a faster route that goes directly into the Lakeside North Harbour campus and it avoids walking alongside the busy Western Road. The Marriott hotel is as comfortable a place to stay as any big chain hotel and they’re used to having Maitland Clinic patients stay. My concern about coming down to dinner and breakfast post-op proved unfounded, as the lighting is on the dark side of subtle.

1000 Lakeside North Harbour is a large, modern building and The Maitland Clinic is on the 2nd floor, occupying part of the space taken by a cosmetic medicine clinic called Changes. There’s a pleasant view out of the windows, although it doesn’t quite match the Vancouver sky-line. Only one HT procedure is carried out each day, which creates an unhurried and relaxed atmosphere where the patient is the sole focus. The beginning of the procedure is agreeing what needs to be done and then consenting to it. Dr Ball is extremely thorough and professional in this respect, but he also has an engaging personality that makes it easy to relate to him.

The room where the procedure is carried out is workman-like, with the usual dissecting microscopes and couch, but there’s a view of woodland and a flatscreen TV for watching movies. FUT starts with injection of local anaesthetic and excision of the strip. In my case, because of two previous procedures, Dr Ball carried this out very cautiously and the entire extraction process, including two layers of sutures (internal absorbable and external ones) actually took 2 hours. In addition to the 1200 grafts from the FUT strip, Dr Ball decided to use long hair FUE to harvest a further 300 grafts. I was hugely impressed by his meticulous approach at FUE, which involved trimming every other hair in the nape region below where the strip was excised and then using an almost silent motorised punch. I can now completely understand why ARTAS robots are gathering dust!

The rest of the twelve-hour session was spent with Dr Ball making incisions and Janna Shafer and the rest of the team implanting grafts. Twelve hours might sound a long time for a relatively small procedure, but like the FUE excisions, the implanting was done without any shaving of the recipient area. One thing I appreciated greatly is that Dr Ball was hands on throughout the long day and adopted a dynamic approach to adding hairs here and there as well as to the areas we’d discussed previously. It was also great to have David Anderson drop by in the afternoon to check how things were going.

When everything was completed, I was handed a generous goody bag, which included medication (antibiotics for five days, steroids for three days, analgesia for three days), liposomal ATP spray (to help graft viability), a neck pillow (too hard, I’m afraid!), a jar of Vaseline and gloves (for the sutures), pillow protectors and an extremely helpful management plan for the week post-op.

Back at the Marriott, I felt sufficiently normal looking to brave the restaurant for a late dinner without wearing anything on my head. I’d never have done that after the H&W procedures! Not surprisingly, sleep that night didn’t come easy and I flitted between the bed with double pillows and trying to sleep upright in a chair. Come the morning, I was glad I’d booked a taxi to take me back to Kent. Driving oneself or going by train wouldn’t have been either safe or fun.

Overall, I’ve got nothing but praise for The Maitland Clinic. Dr Ball is exceptional at what he does and he’s also a very nice guy. Janna Shafer and the rest of the team work incredibly well together and help to make the experience of lying on the couch for protracted periods of time as pleasant as it realistically could be. The bottom line is that the UK now has a hair transplant clinic that’s up there with the best in the world and I’d strongly recommend it to anyone considering surgery.

I've attached a 2012 photo showing my NW5A state plus three pics from just before the consultation with Dr Ball and David Anderson. More to come ...

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I had a FUT done in London but they charged by the graft (Ziering) most expensive HT I have had !

I had FUT with Hasson & Wong, and even with business class flights that worked out considerably cheaper than Ziering quoted!