hairweare

Actually medically speaking stress can result in hair loss if it manifests in the extreme such as by hair pulling (traction alopecia) or a psychotic breakdown characterized by self multination e.g. Britney Spear's shaved head.

For saw palmetto to be efficacious it would block 5ar1 to the same extent as finasteride does. Inhibition of an enzyme is not a "natural" process so whether the agent was derived from tree bark, animal dung or made in a test tube makes little difference. Both efficacy and incidence/severity of side effects would be similar. If on the other hand it has no significant effect on decreasing circulating DHT then you are wasting your time and money taking it.

The positive placebo effect is directionally proportional to the amount of money spent on the product. How else can one explain how a billion dollar industry based on fraud continues to flourish?

A doctor who performs FUE exclusively and controls all aspects of the FUE procedure with years of experience should be on anyone's short list who seriously considering a HT. That his rates are more than competitive and that he is centrally located in Europe are big pluses as well.

The results for these products are actually immediate. Your funds are directly transferred to the bank account of the seller, thus you become instantly poorer and they are now richer. Anything beyond that is pure serendipity!

He looked better before the procedure which in my opinion was a waste of grafts and money.

Keep in mind when clinics are performing megasession, multi-patient procedures, it is not possible that only one doctor or even one technician for that matter will be exclusively working on your case. There are many variables in play when going this route which I believe explains the continuum of posted results from horrid to amazing that emanate from these clinics.

Not the best photos which are also out of focus but I agree it appears that your have diffuse alopecia with low density and would be a challenging HT case even for the most skilled surgeons. I would only rely on an in person consultation before deciding whether or not to proceed or not. Keep in mind that a bad HT looks much worse that a someone who is just naturally balding. I would consider a trip up to Chicago and meet with Dr. Konior to discuss options. Good luck!

I am sure that Dr. Emre meets the qualification standards set forth by the Network. My only reservations are his use of motorized vs. manual extraction to which we agree to disagree on. I do concur with his opinion that any physician doing manual as well as his own implantations has limited shelf life but that should not be the concern of a prospective patient whose only interest is that of the success of his own immediate procedure. I am also troubled by his earlier comment that while he believes strip is often the better procedure he will still do a FUE as it is more profitable and what the patient may want regardless. I suppose I am just an old fashioned doc who believes that you must always put the patient's best interests first. I am uncomfortable with a physician who would perform what he believes to be the inferior procedure just because the patient demands it and would go elsewhere if not given what he wanted. Nonetheless these are just my personal subjective feelings and from a technical standpoint I believe that this physician meets the standard for inclusion.

Prices for FUE in NA are very much prohibitive at this time. From what I can tell Reddy is the most expensive in Europe and has charges on par with NA clinics. (It may be possible to get better Reddy rates if is still operating at the satellite clinics away from London). The Belgium docs and Lorenzo are significantly less and in my experience Lorenzo doe not charge for grafts over his original estimate which tend to be conservative. The clinics in Cyprus and Turkey are among the lowest and Bhatti in India may be somewhere in between the Turkish and the Euros. Rates for FUE in NA need to come down which will only happen if more docs offer it and the demand continues to increase.

What information are you seeking? If you give up your self appointed position as the hall monitor and read through this thread again I believe you will find that all of your questions have been addressed. I am no cheerleader but rather a doc myself who is also a HT patient.

First off, unlike the legal profession where referral fees aka "kickbacks" are both common and not illegal, such an arrangement between doctors will get them in trouble with the dreaded state board and result in sanctions against their licenses. Furthermore, hair restoration fellowships are few and far in between so most practicing docs have no formal training in this field and even if they did it would not have likely included large session FUE. Board certification in "cosmetic surgery" or hair restoration is a marketing ploy and not a stamp of approval for quality. As previously said these doctors may be legitimately board certified in ENT, Derm(Umar), Plastics (Konior) or even Family Practice but what does that have to do with how well the physician can perform a HT? Of the specialties, a board certified plastic surgeon should be expected to perform a excellent wound closure but the rest of the procedure was not necessarily part of his earlier surgical training which likely involved cleft palate repairs or skin grafting for burn victims instead. If you are looking to go with FUE look for a physician with years of experience specifically with that procedure who does not rely on techs to either perform the extractions or implantations. Board certification is irrelevant in this regard.

Absolutely, when I was there last month most of the patients I met were Spanish but one came from Greece and I know of two from this Network, one from Europe and the other from the US who had their HTs done within the last 2 weeks. Email Pilar Lorenzo to check for available dates.

sorry, for some reason the post was duplicated -

Since people are asking, and there seems to be some misinformation circulating, I can offer a few things of note: -His fees at Farjo were considerably higher than in Madrid but still less than Reddy's. -I believe that he purposely underestimates the number of grafts possible during the consultation and then goes over the estimate without any additional charge so his actual fees may not be as high as originally quoted. -At Farjo he was doing only one patient a day and exclusively both the extractions and implantations. -In Madrid Dr. Villa is also doing cases at the same time and together there might be 3-4 procedures between them going on simultaneously. Several techs are also participating in the extractions, but to my knowledge all graft placements are still done by Lorenzo with his Lion pen implanter. Dr. Villa of course does her own implantations. -For my most recent procedure all of the scalp grafts were extracted by Dr. Lorenzo, the 500 beard grafts placed in my crown mixed among the scalp hair grafts were extracted by his most experienced tech. -A Spanish patient I chatted with who is also a MD, told me that he believed that the clinic's reputation and referrals came primarily from local word of mouth. Lorenzo does not market the way the clinics in NA do and mentioned to me that he is not equipped to handle an onslaught of NA patients with his current set up. -Since he does not have the time to read and respond to posted comments, and has no employee rep like many of the other clinics assigned to the task, he was considering withdrawing from the Network and may have already done so. -

The issue is one never knows how the donor area will recover for better of worse until at least 4 months post op. To play it safe for ones first FUE procedure and density is questionable, I personally would want to lay up and play it safe at no more than 1500 grafts. Perhaps 3000 over two days for a virgin scalp with excellent scalp characteristics and dense donor supply.

In my field of specialization very large multi- center RCTs were performed over many years but even so much of the data has later come into question when yet another similar trial demonstrated disparate results. I have not been satisfied with what I have seen in regard to the scientific data pertaining to adverse effects from 5aR inhibition. Any biologic process which involves hormones, active metabolites, enzymes, multiple and diverse tissue receptor sites will have confounding variables, dose and idiosyncratic variabilities due to differences in genomes that cannot be reasonably expected to be resolved by such small uncontrolled non randomized studies. Personally, I remain concerned but more so frustrated by the lack of dependable medical evidence that address the long term safety issues of DHT inhibitors. That being the case in no way would I regard the advice of a supplement salesman with no scientific background as being either useful or legitimate.

A 12 pt. open labelled study without a control is not very convincing scientific evidence

This supplement peddler has absolutely no idea what he is talking about. Is there an ignore function here?

You appear to have backed off or changed the subject from your original claim that finasteride affects insulin sensitivity and subsequent central neural function. I would rather rely on credible published medical research than unfounded claims by a supplement salesman with no advanced degree.

Of course, I am referring to DHT and it's receptors. You have offered no evidence that selective partial inhibition of R2 has an effect on insulin sensitivity and central neural function. Again, do you have a science degree or are you just an internet huckster peddling supplements?

A hormone must interact with a receptor in order to have an effect. The quantity and location of these these receptors are of paramount importance in the basic understanding of endocrinology. May I ask what your scientific background or degree is?

I haven't had the opportunity to yet read your references but they don't appear to address your comment regarding 5aR2 inhibition and insulin sensitivity. While your statement about androgenic potency may be correct you are neglecting to account for the quantity/quality and location of specific DHT receptors outside of the prostate and hair follicles which might account for a direct relationship between partial inhibition and other clinical manifestations. The role of these receptors are still being studied and are by no means considered "settled science."

Do you have a published reference from a legitimate medical journal?

To correct the above inaccuracy, Dual inhibition of 5αRs, but not inhibition of 5αR2 alone, modulates insulin sensitivity in human peripheral tissues rather than liver. Finasteride blocks R2 whereas Dustasteride blocks both R1 and R2