Brazilian111111

. . Hi, BrazilianPatient. 6 months are gone. What do you have to tell us about the results? . .

Hi Wylie. I have already posted this same (or almost the same) text as a comment in one of your photos. With the photos you posted it is difficult to evaluate. I am not sure whether the newest photos are not showing your real progress or your hairline procedure almost made no difference. By looking the pre-Umar photos and now, it is even reasonable saying that the before pictures show a better head (that's why I am thinking the photos are not showing the reality). Is it possible to upload more clear and zoomed photos or maybe a link to a sharing photo website where we can see it zoomed? Thanks and sorry if my words don't sound encouraging. . .

. . Hi there. I've been thinking: whenever I see a HT which has achieved good results I see that the patient had started seeing hair growth from the 3rd or 4th month. I've heard a lot about "slow growers" or "slow developers" or "late bloomers" who had hair growth starting several months after the "3-4 months pattern". I also have heard that a growth starting later won't necessary mean that the results won't be great. Ok. But... actually I never saw a single case (especially with photos) showing a late bloomer who has achieved significant results in spite of a delayed growing process. Has anybody saw a single case or is it an urban legend only? (if so, links for the cases will be welcome). . .

. . Hi Kaviar. 6 months? It is early to be worried. Concerning about "several" hair transplants in the past: if we talk about 2 surgeries in a same recipient area, no problem (sometimes the 2nd one may achieve even better survival rates, believe). But you are talking about "several transplants". In this case it depends on your skin tendency of forming collagen and/or keratin (i.e.: queloid scars). Even though the cuts made in your skin on the past procedures may not be visible, it is possible that we are talking about a skin with micro scar tissues. Hair follicle hardly grows in a scar. But probably it won't represent a problem for you. wait 4 months more to start worrying, ok? Best luck for you. . .

Hi Bill. Actually, even though we are talking about Bonker's issue it is, indeed, the same subject as Amanindia's issue: a too high cut line that might have resulted in a higher risk of transplant failures (in my opinion). So, essencially what we were discussing here have to do with Amanindia's case. But I don't want to go further, anyway. We (me and Bonker) will stop here. Thanks!!!! . .

Yes, that's right. Best wishes!!!! . .

Oh no... Dr. Hasson's cut line style is not any "obsession of mine", hehehe. I will tell you why I stopped here (actually I have 2 reasons): 1- In another forum we were (and still are) discussing what makes 2 transplants have very different results even though performed by the same surgeon. One of the suspicious subjects was the use of post-operative substances and, among them, the E vitamin. I said that I thought E vitamin could over-excite the immunologic system of some patients and influences (badly) the results. Then one member told me that dr. Hasson directions includes E vitamin oil and I came here to check some surgeries performed by him. By the way: do you confirm Dr. Hasson’s directions include the use (topical or oral) of E vitamin? 2- Besides this, I was searching for procedures done by the only Brazilian surgeon who is a member of the recommended surgeons of HRN website (Dr. Tycocinski). Actually I didn’t like what I saw (including due to the high cut line) and I checked, besides other things, the cut line style of other surgeons. Here in Brazil the surgeons use to apply a lower cut line and the results are good as far as I know (concerning about FU survival, scar concealing and long lasting results at least; here, density is a major issue). I still have doubts about the results that higher or lower line cuts will bring not in 5 or 10 years, but 20, 30 or more years. Concerning about any surgery, I am not sure what I will do with my hair. Actually all I have is a not huge receding hairline and I am not sure if I will change anything due to some doubts and due to the costs, as well. Thanks once again and sorry by changing my mind and changing back again after that. . .

Hi Bonker. I've been thinking a little bit more about the subject of our talk. My intention is find the truth, no matter if I am right or wrong and no matter if good or bad and so, please, don't think that I am intended to brace one or another concept. For the text below I will use the term "dying follicle" no matter how accurate this term is. Ok. Dr. Hasson told that his criteria for choosing the donor area is taking FUs from an area where is less frequent presence of miniaturized (or miniaturizing) hair shafts and, following this point of view, not always the best donor area is the one located at the core (or center) of the safe area (or standard area). Thinking a little bit more, I now ask myself if the miniaturized shafts couldn't be, instead a FU passing through a "death" process, actually a FU that is in its early anagen phase and what the FU is doing, instead, is proving he still has the skills to regrow after a catagen phase. Dr. Hasson has already told something about this in the text you brought to me. But his conclusions were that the best area to be chosen is the one where you can watch the least quantity of fine shafts. Ok. Let's think a little more. Have you ever noticed that some men have a balding pattern which has the feature of having a few amount (if not no amount) of miniaturized hair shafts? I am talking about men who have a very defined boarder between the bald area and the area full of hair. Also Dr. Hasson told about it. The same way, there are men with a gradual transition between those 2 areas (bald and hairy). I would say (once again: this is only my "new" opinion) that when the man has a very defined border the FUs that are condemned to death will be submitted to a “sudden death” (or a very fast process, at least) instead of a slow process. If it is right, we may dare to think that when you see a miniaturized hair in the scalp it is most likely that the shaft is proving his capabilities to regrow after a catagen phase and not that what we are seeing is a dying hair follicle. Once again, if this point of view is right, the conclusions of the doctor who is evaluating the patient’s hair, as long as he is following Dr. Hasson's point of view (i.e., choosing the area with least frequent presence of miniaturized hairs), may lead the doctor to a direction exactly opposite to the one that would bring best long term results (even though the short term results may not vary in almost all cases). Still: in a "sudden death" pattern (I think it is not your pattern, even though your process was fast) the Dr. should not avoid an area by thinking that the presence of miniaturized hair is always a bad sign. After all, no matter how different may be the heads we can see on our day-by-day, I think that almost 100% of the men have strong hair shafts ALWAYS IN THE SAME WELL DEFINED AREA AT THE BACK OF THE HEAD, even in the most aggressive baldness. And I think it is very easy to define this area: put 6 fingers starting right from above your ear and, after that, put 6 fingers starting right above the first line of hairs that are above your neck (if you haven't lost the hairs of your neck yet). Well, on all those measurements the best FUs to be transplanted are always the two "more inner" fingers. This is my opinion. I really gently apologize but I am turning back to my first point of view, not by being eager to defend one or another point of view (I don't have this bad philosophy) but by following a certain reasoning. As I always use to do, I am humble to admit I may be completely wrong, though. If, for any reason, you think that what was said has the minimal chance to be right, discuss this with your doctor or, if you prefer, take this text to him, no matter how great is his experience or how nonprofessional I am. The most important is to achieve good results and you don’t need to be afraid of discussing any idea with your doctor. Thank you very much once again and, no matter what happens or how I think, I will always be wishing you have the best results now and forever. . .

Hi Bonker. Oops... I watched your profile and saw you are 31 years, thus I figured out your baldness could still be far from the end. Sorry if my concernings were over the ideal. One year from NW1 to NW5? Yes, aggressive. So much more I have to say you are in a great shape for a man who had such a fast process. If the evaluations I’ve done meant any bothering, I really apologize, ok? The way you are telling me it looks like you are right: it probably has reached the end of the process. I got it. All you wrote in your 2nd paragraph means that, no matter how it may look, Dr. Hasson indeed have chosen the best donor area. Ok. It is a new information for me, since I thought that the best possible area were almost the same for all men. It is good for you. Ok. Ok. I got it, too. In your 3rd paragraph you say that the strip actually was below it looks like. I read the text from Dr. Hasson. Very interesting when he says: “Most people imagine that this area would lie in the center of the permanent zone but this is in fact an incorrect assumption.” It is exactly what I thought!! Living and learning!! Well. I understood everything Dr. Hasson said and all you wrote (or pasted) brought to me some new knowledge and, besides, makes me more faithfull you will achieve good results. Thank you!! . .

Hi Bonker. Thanks for your response. I said you may be a late bloomer and, also, that you have something to be compared to the mentioned members, but not necessary that the thing in common is being a late bloomer (even though I think all them will be late bloomers). I will be some more specific and talk about what I see in your case in my opinion, if you don't mind but, please, keep in mind that all I have to say is nothing but theories because I have no prove and I am not a surgeon. May be somethings won't sound so good, what makes me sorry in advance. 1- I think your case is not bad. It is clear to me that you care a lot about your hair because, actually, a lot of men who had the hair you have would be happy with it. So, whatever you get from now on you may consider as a "plus", hehe. 2- I think that the patient of this thread (Amanindia), BrazilianPatient, Sammy84 and you have in common that your surgeons have made the cut in a very high area. Not only the native hairs suffer from shockloss but especially the grafted ones will suffer, to. Well... at the back of your head you have a safezone (where there will be hairs for the rest of your life). All hairs in the safezone will survive for the rest of your life as long as they stay where they are. If you, theorically, graft all of them and implant on the top of your hair you will see, as the years pass through, that some of them (the ones at the core of the safe zone) will be alive until the end on the top of you head but some of them will survive for decades, some for years and some (the ones at the boarder of the safezone) won't even resist the shockloss (even though ALL OF THEM would survive in the safe zone if they were not removed). And that's why I am afraid: I am surprised that H & W took a strip from an area so high when they should have taken from the core of the safezone. I told a lot about it at BrazilianPatient thread. 3- So, I think you have no reason for being worry for what will happen in the next, let's say, 5 years because you probably will have a good growth (even though a little late) and, if not, H & W will help you. The real reason to be concerned is the future beyond those next years. In order to check if you have a real reason for being worried, you may observ the baldness pattern of your family. If the head back-bow-line in your family is not too low it is a good sign because it means that your baldness won't pass the scar line. Concerning about your question if I have links to late bloomers, actually I only bring this information in my mind but I remember I saw in a transplant forum some words from a surgeon who told that he had 2 patients (same physical appearance and body type) who underwent hair transplant only one day apart the other. At 7 months one of them showed a head with a great growth and the other one had nothing. But as the months passed through the differences went away and 14 months after the procedures both of them were at the same stage: completely bald (just kidding... they both achieved very alike good results). I am a member of a Spanish language hair transplant forum (even though in Brazil we speak Portuguese) and we are, there, discussing a lot the possible reasons for hair transplant failure and I think we can find some interesting discovers. Bonker, please, no matter what happens do not undergo a new procedure before talking to me. May be I will have, for the next months, REALLY VALUABLE information to tell you. You will lose absolutelly nothing for listening to me. Just repeating: stay calm cause you probably had a lot os temporary shockloss and, even if the progress stops here (of course I wish it goes on and on), the way you are now is very above the average. Patience. Best Regards. . .

Hi Bonker. Actually I tried to mean "I'm sad because the growth is slow", but I knew you have so much ahead and for sure you will have the hair of your dreams. I wish you the best luck. I am sure, also, that H&W will give you the proper attention. I saw your photos at your journal. Actually I don't think your progress is so bad. It is possible that the grafted FUs are in the right schedule (or almost) and actually what you are missing is some native hairs that sometimes take even more time to come back then the time took by the grafted FUs. I've heard about many patients who had reached almost nothing at 7 or 8 months and all of a sudden the things changed and they were great at 15 months. Your story, for example, is much better then mine. I posted some comments to some patients who are in a situation that has something o be compared to yours (but I think yours is better). If you want to see, this is the link (which, in its turn, refers to another 2 links): Post #014 - page 02: http://www.hairrestorationnetwork.com/eve/158869-please-comment%3B-my-donor-area-bad-selection-2.html#post2285989 Wish the best for you!! Best Regards. . .

Thanks for the info. I am sad for your poor grow. I am glad that H&W are serious professionals and are offering you all the support you certainly deserve. I will take a look at your case. Hope you have the best luck. . .

You are right. Actually I thought about a possible kind of refund. I edited the refered post, this time using some other words. If you want to delete THIS post (and/or yours, as well), which has only the reason to inform you, feel free for doing it. Thank you!! . .

. . Well... May be the patient and the clinic made an agreement and, for any reason, the patient quit keeping us informed. Could any PAT from H&W say something? . .

. . Hi there. Concerning about the question you are discussing: I am not a surgeon and for sure I would like to tell you “there is no need to worry about it” but I think you have reasons to be afraid. Before continuing, let me tell you: almost everything in my opinion is nothing but theories, ok? It is possible that all you will read is not what really happens. In order for me not having to copy/paste/custom texts that I have already wrote, please, check my posts on these threads below and, after that, please come back to this post of mine: Post #127 – page 13 at http://www.hairrestorationnetwork.com/eve/160724-6000-grafts-dr-hasson-very-sad-13.html#post2285977 Post #002 – page 01 at http://www.hairrestorationnetwork.com/eve/162433-brazilianpatients-recent-hair-transplant-dr-tykocinski.html#post2285771 Back to the things I wrote at those posts (once again: almost everything is nothing but theories): Your body is always looking at some of your FUs (and not at some others, God knows why) and seeing a cancer. So, your body inactivates some important structures in the follicle and refrain it from producing hair. The fact that some hair transplants fail (even when performed by skilled surgeons who checks every single FU before implanting it) represents a sign that something happening in the patient’s body is significant for the success (or failure) of the procedure. I think, IMHO, that at least temporary almost all implanted FUs (even the best grafted) loses their “keys” to prove the body that they are not a cancer. In a well succeeded transplant (including the body reactions) the follicles recover their ability to convince the body that they are not a cancer in 3 to 6 months. But for certain reasons some FUs only recover this skill many months towards and, sometimes,… never. I think that the FUs taken from an area too close to the limits of the “safe zone” are more about to lose this “key” then the ones that are in the core of the safe zone. I think that the FUs very close to the limit of “safe zone” if were not harvested probably would stay in activity in your head till the end of your life, but once they were grafted (even without any damage) it is possible that their protections against the body defenses got weak enough to guarantee their lives for only some decades or years or months towards. Or maybe they won’t even be active anymore. The nearest at the core of the safe zone, the best. Hope all your FUs survive and your baldness has already stopped, though, otherwise your hair will grow but in some years or decades it will fall (and let your scar visible) or, God help us, only the hair taken from the core of the safe zone will grow. Thanks a lot and God bless all of you. . .

. . Hi there. First of all sorry for any mistake in English. By the way: showing my mistakes is a great favor that I thank in advance. Second: almost everything I will write now is nothing but theories, ok? Someone already said something about it in this thread and I agree: the donor area chosen by the doctor to be cut is TOO HIGH. I would say, IMHO, that the right area to be cut is lower in an amount of something like 2/3 the distance between the patient's ears and the suture line that he actually has now. What does a too high donor area mean? See: The most believable theory (imo) is that AGA is caused by auto-immune reactions that are trigged by male hormones. Our body keeps 24 hours a day looking for cancer cells to destroy (or make them inactive, at least). Sometimes our body makes mistake and thinks that a healthy cell is a cancer and fight it, killing it or, as I said, at least inactivating it. For any reason (but, if so, for sure correlated with male hormones) your body sometimes looks to a FU in a certain area of your body and thinks it is healthy and, at the same time, looks at another FU in another area of your body and thinks that it is a cancer. Both cellular structures are UFs but one is saw as cancer and another one, not. A 10 year boy (for example) has in his face, since he was born, all the FUs that someday will turn into a beard. For any reason his body thinks that those FUs are a cancer and refrain them from expelling secretions that are need to the FU create around himself a fat layer. Without this fat layer there will be no hair shaft. But, in other hand, his body defenses leave FUs at the top of the head alone. When in puberty, for reasons not known, the rules are inverted (not in all men): the body will see the FUs at the top of the head as a threat and, instead, will leaves alone the face's FUs. The boy will gain a beard and lose his hairs. Look: in order for not losing your hair, each FU has to be able to say to your body "I am not a cancer" and prove what he is saying. Concerning about AGA, some FUs in your head are more skilled to convince the body that they are not a cancer. The most "skilled" FUs in the art of convincing the body that they are not a cancer are the ones at the lower part of the back of your head. When a FU is transplanted he suffers a great damage. When well performed, this damage is not enough to kill the FU but is always enough to make the FU loses temporary its skills to convince the body that he is not a cancer. Until a certain FU doesn't convince the body that he is not a cancer, the FU won't succeed in produce hair. That is why is important to choose FUs that are the "strongest" and most "skilled" to do this task. The strip cut on this case was taken in too high area. The FUs located at this area could be very effective to convince the defenses of the body that they were not a threat but… only as long as they were not any damaged (not even a bit). The chosen FUs were "one step from baldness" and the harvesting procedure was "the water drop that made the glass overflow". I am really afraid that the same issue may happen with another patient (not a H&W's patient but a Tycocinski's patient, the only Brazilian surgeon recommended, so far, here at HRN). I am informing you the link for his thread and I would appreciate that you, guys, comment the job done by Dr. Tycocinski because it is very important for me (and some other members) to know what you can expect from his job (I am considering to undergo a transplant with him). That's the thread: http://www.hairrestorationnetwork.com/eve/162433-brazilianpatients-recent-hair-transplant-dr-tykocinski.html#post2277380 Thanks a lot and God bless all of you. . .

Hi WDG. We are 3 years past from your surgery. We would love to see your pics to evaluate how good was the procedure. I didn't see all the threads from Tyco's patients but, so far at least and except BrazilianPatient, I never saw a single patient that posted pics in a thread... not even the ones who most claim to be very happy only few days after surgery. I just want to see something direct from a member. . .

. . Hi Sebastian. Some pics, please. . .

Hi aska. 75 grafts/cm2 (=485 grafts/inch2) ??!! It is not impossible but few surgeons all over the word can get such result with actual success. Over 2 years passed since your surgery, so, we would love to see your pics. Best regards. . .

. . Concerning about Brazilians surgeons, whenever asking for a quotation be sure to ask for the final price, because commonly they told you the surgeon bill only and do not mention the hospital bill, anaesthesist bill and some "hidden costs". Just a tip. . .

. . Concerning about Brazilians surgeons, whenever asking for a quotation be sure to ask for the final price, because commonly they told you the surgeon bill only and do not mention the hospital bill, anaesthesist bill and some "hidden costs". Just a tip. . .

. . Hi summer. Over 2 years have passed since your surgery. Please, share your experience regarding post-op. We would love to see your photos. Best regards. . .

Great result. I am sure the patient is very happy. Congrats.

. . Hi Hat's. First of all I appologize for any mistakes in English and if I am posting you some information too late. Well, I may be wrong but as far as I know Dr. Tyco charges as much (or even more) money as the most expensive surgeons in the world. U$D 3.000 may be the hospital daily bill only. If he worths what charges, sorry but I avoid talking about it. Actually you may find in Brazil some good surgeons, but only something like 4 or 5 among them who will charge a final cost such as you mentioned (3 to 5.000), depending on the extension of your baldness; there are other good Brazilian surgeons who will do a good job, but charging rates alike the ones you have in USA (or even higher, as I already told). I won't say names because, even though we have freedom of speech, I am new here in HRN and I don't know if I can mention names of surgeons that are not included in the suggested surgeons list of the site. Thanks and hope you succeed, whatever is your choice (if you still are to make a choice). Best regards. . .

. . Hi there. Congratulations for your procedure!! You will feel much better after this step of your life. I know how bothering is looking at the mirror and seeing a hair that is not exactly as we would like (all I have is a receding hairline something like the one you have now, after the surgery; and even so I don't like it). I hope the grafts you have transplanted will survive. It is the most important thing. Let me say something about your photos, if you don't mind. Expected survival of the grafts: it looks great only by looking at the low quantity of scabs (almost clean at 6th day!!). Hairline: actually I think Dr. Tykocinski should apply a smoother hairline. In the past the surgeons used to apply a perfect designed line without any dent (looking like an “ant procession”). It didn't take too long to them realize that a too perfect hairline looks great when saw from a distance of 100 feet but looks awful when saw too close. So, they started avoiding this technique and, unfortunately, they over-reacted and started drawing huge-indenting hairlines. Sometimes it looks like the surgeon had printed the Nasdaq (or even Dow Jones) infra-day graphic, glued as a label on the patient's head and used it as a model. Nowadays it is not done anymore (not by the most artistic surgeons). In order to achieve a natural looking, the hairline has to show some imperfections (but not that much). No need to draw huge triangles in the forehead of the patient. So, concerning about the hairline, I think Dr. Tyko should have drawn a smoother line. But since you have good surviving amount of FUs there will be no problem: with tweezers you may pluck one by one the apex of each triangle. Donor area: great suture. You probably won't have an ugly scar because he used a very long strip. This is good for the enclosure because the skin won't suffer stress. But it has a negative point: the longer the strip, the more lost FUs. See: when cutting the strip, in order to obtain a certain area, the surgeon may cut a long and narrow strip or, alternatively, a short and wide strip. The first option means a better post-op for the patient and less stress for the skin (= thin scar) but when the linear path of the cutting is too long, you may expect a higher number of lost FUs that the surgeon will "run down" when cutting (actually I never saw a surgeon who deviates from the FUs on the way when cutting the strip). That’s why the loss of FUs when using FUE is not so different than using FUT, besides the fact that when using FUT you lose FUs that are in catagen phase, because without a contrast material they are not even noticed by the surgeon's staff and are thrown away into the trash. FUs quantity: when looking carefully at the photos of your head (saw right from the top) you may count the FUs implanted in a, let's say, 2cm x 2cm (= 4cm2) or a 3cm x 3cm (= 9cm2) squared area; after that you may figure out the total recipient area and you will see that probably the actual transplanted FUs is, if so, something between 2800 and 3250 FUs, even counting the amount used to restore both side peninsulas (some people call them “islands”) and not even regarding the native hair at the center of the top of the head (which, of course, was already there before the surgery). Maybe the doctor had told you the amount of hair shafts instead the amount of FUs. Long hair shaft: as we can see, Dr. Tyko applied the called “long hair shaft technique”, which another Brazilian surgeon (called Fernando Bastos) claims to be a technique of his creation (actually it is not even a “technique” but nothing else then a style or a choice). No matter what they say, I see no advantage by using “long hair shafts”: you will keep them only for one or two months and, while in your head, they only mean more risk of any mechanical stress than the short hair shafts; besides, you will be even more sad when they all fall down and you will be seeing your head naked again for the next 5 to 10 months. I think you would better seeing, since the beginning, the closest look as possible to the one you will have for the right next upcoming months. Long term results: by looking at photos 1 and 2 from day 1 album; photo 5 (the last one) from day 3 album and photo 4 (the last one) from day 4 album I would say, IMHO, that Dr. Tyko took the strip from a too high area. It would be better if he had cut something ranging from 2.5 to 4.0 cm (= 1 to 1.5 inches) lower than the line he actually cut (i.e., approximately half the way between your ears and the line that was actually cut by him). There is no doubt that the new suggested area to be cut has FUs with a thicker and richer fat layer (it is good for FU survival) and which are, at the same time, less subject to baldness progress than FUs extracted from the area actually cut by the surgeon. If some of the FUs from the strip (especially the ones at the higher part of the strip) are genetically programmed to fall in, let’s say, 20 years, then the top of your head will acquire a spread and unequal pattern of baldness since, I suppose, Dr. Tyko didn’t implanted the FUs in the same order that they were located in the strip because, as far as I know, all surgeons (when performing the implanting step) pick FU by FU absolutely randomly (except by obeying the criteria of choosing FUs with 1, 2, 3 or 4 hair shafts). Even though, the way Dr. Tyko performed won’t necessary mean any huge problem IF (I said "IF") your baldness stops growing before reaching a certain point. But if your baldness is yet far from the end, there is a serious risk of losing not only some (if not all) of the transplanted FUs on the top of your head but, also, the native hairs that are now concealing the cut line and, if so… no need to tell you that your scar may be visible in a couple of decades. I wish it won't happen, though. "State-of-the-art", "cutting-edge" and "ultra-refined" are too honorable expressions and we have to use them with consciousness and parsimony, keeping them reserved for some very very specific situations. Please, post some more photos, now showing your 3rd month. All members are here to help (and wishing the best for you). Thanks for sharing your photos with us and I hope you have the best luck and the best results. . .