hairweare

I suppose it depends on how far you are traveling but for me I preferred being seen at the clinic on the first post op day where they washed my head and went over the post op care instructions. I then relaxed the rest of the day and then flew 18 hours from GB to the West Coast on POD#2.

Regardless of the shock loss, the scar has already stretched which may even widen further depending on scalp tightness and individual wound healing characteristics.

Wavy, salt and pepper thin caliber hair shafts with great donor density makes him the ideal HT candidate.

Speaking medically, wounds actually heal for the bottom up and from the outer edges to the inner. That said, small .9mm holes created with a sharp punch should not result in significant pitting scars.

Have you consulted with Dr. Lorenzo? Since he does both the extractions and implantations himself he would be on the top of my list. Your situation has already been shown to be challenging to a physician who does a lot of FUE procedures. I would be more at ease with a single operator with a great track record than a "team" if I were in your position.

It remains to be seen how good your yield will be, since if you were not the ideal FUE candidate to begin with we can only hope for the best. Skin and scalp characteristics vary between individual patients, your doctor may use tumescence routinely to even the playing field so to speak. Dr Lorenzo used a .9mm punch for my procedure but didn't use tumescence. My donor sites looked a bit smaller perhaps for that reason and healed very quickly within a few days. Going to another doctor for a second FUE might not be the wisest decision. Your surgeon is one the more FUE experienced in NA so you might want to consider an email or Skype consultation with one of the well known European doctors after 4 months at which time your donor area should have recovered. Since you have already proved to be a difficult case why not consult with the top international surgeons before you possibly compromise your limited donor supply further?

Not sure why the doctor proceeded if you were not a good FUE candidate. Rassman used to perform a FOX test prior to FUE and I believe Konior does something along the same lines. I recall a comment by Dr. Feller stating that he will switch to a FUT should the initial attempt at FUE not be to his satisfaction. Not only might the yield be poor but the donor area is now compromised for a subsequent FUT session should that be the only remaining option.

Cryingoutloud, I am afraid that you don't know what you are talking about and should leave the pre and post-operative instructions up to the individual surgeon. Smoking It is well-known that smoking increases the risk of heart and vascular disease, stroke, chronic lung disease, and many kinds of cancers. Similarly, the negative effects of smoking on wound-healing outcomes have been known for a long time (Siana et al., 1989; Jensen et al., 1991; Ahn et al., 2008). Post-operatively, patients who smoke show a delay in wound healing and an increase in a variety of complications such as infection, wound rupture, anastomotic leakage, wound and flap necrosis, epidermolysis, and a decrease in the tensile strength of wounds (Chan et al., 2006; Ahn et al., 2008). In the realm of oral surgery, impaired healing in smokers has been noticed both in routine oral surgery and in the placement of dental implants (Levin and Schwartz-Arad, 2005; Balaji, 2008). Cosmetic outcomes also appear to be worse in smokers, and plastic and reconstructive surgeons are often reluctant to perform cosmetic surgeries on individuals who refuse to quit smoking (Siana et al., 1989; Bennett, 1991). Approximately over 4000 substances in tobacco smoke have been identified, and some have been shown to have a negative impact on healing (Ahn et al., 2008). Most studies have focused on the effects of nicotine, carbon monoxide, and hydrogen cyanide from smoke. Nicotine probably interferes with oxygen supply by inducing tissue ischemia, since nicotine can cause decreased tissue blood flow via vasoconstrictive effects (Ahn et al., 2008; S?rensen et al., 2009). Nicotine stimulates sympathetic nervous activity, resulting in the release of epinephrine, which causes peripheral vasoconstriction and decreased tissue blood perfusion. Nicotine also increases blood viscosity caused by decreasing fibrinolytic activity and augmentation of platelet adhesiveness. In addition to the effects of nicotine, carbon monoxide in cigarette smoke also causes tissue hypoxia. Carbon monoxide aggressively binds to hemoglobin with an affinity 200 times greater than that of oxygen, resulting in a decreased fraction of oxygenated hemoglobin in the bloodstream. Hydrogen cyanide, another well-studied component of cigarette smoke, impairs cellular oxygen metabolism, leading to compromised oxygen consumption in the tissues. Beyond these direct tissue effects, smoking increases the individual’s risk for atherosclerosis and chronic obstructive pulmonary disease, two conditions that might also lower tissue oxygen tension (Siana et al., 1989; Jensen et al., 1991; Ahn et al., 2008). Several cell types and processes that are important to healing have been shown to be adversely affected by tobacco smoke. In the inflammatory phase, smoking causes impaired white blood cell migration, resulting in lower numbers of monocytes and macrophages in the wound site, and reduces neutrophil bactericidal activity. Lymphocyte function, cytotoxicity of natural killer cells, and production of IL-1 are all depressed, and macrophage-sensing of Gram-negative bacteria is inhibited (Ahn et al., 2008; McMaster et al., 2008). These effects result in poor wound healing and an increased risk of opportunistic wound infection. During the proliferative phase of wound healing, exposure to smoke yields decreased fibroblast migration and proliferation, reduced wound contraction, hindered epithelial regeneration, decreased extracellular matrix production, and upset in the balance of proteases (Ahn et al., 2008). Pharmacologically, the influence of smoking on wound healing is complicated, and neither nicotine alone nor any other single component can explain all of the effects of smoking on wounds. What is certain is that smoking cessation leads to improved repair and reduces wound infection (Sorensen et al., 2003; Lauerman, 2008). For surgery patients who find it difficult to forego smoking, the use of a transdermal patch during the pre-operative period might be beneficial. A study has shown that the use of a transdermal nicotine patch as a nicotine replacement for smoking cessation therapy can increase type I collagen synthesis in wounds (S?rensen et al., 2006). Despite the overall negative effects of smoking, some recent studies have suggested that low doses of nicotine enhance angiogenesis and actually improve healing (Jacobi et al., 2002; Morimoto et al., 2008).

Perhaps this is the most compelling reason to choose a clinic where the physician has the most hands on approach to your procedure.

Hello PMA, as of today it will be 7 months. After 3 previous FUTs I have a limited donor supply left so Dr Lorenzo wanted to proceed conservatively which I believe was a wise decision. The 1500 grafts in the frontal third have had significant impact already, and seem far more impressive than the combined 2000 grafts from the last two FUTs in 1994 and 2000. I would estimate the FUE yield to be 90% or better. I am anxious to learn what Dr. Lorenzo plans for the second procedure and hopefully there is another 1500 good grafts left.

I would disagree. The temples are filled with single hair grafts which created a very natural looking feathering effect. I think the design was done very well and the result is quite good.

First procedure of 1500 scalp grafts to front and 300 beard grafts to old FUT occipital scar in March at Manchester. I am scheduled for round 2 in mid November. Will spend the weekend chilling at the ME Madrid in Madrid Centro before checking into the Ibis the day before surgery.

I agree, but the patient should not be funding that study. Without evidence establishing it's efficacy the physicians who currently employ it are primarily enjoying the revenue stream but have no incentive to prove whether or not it is useful.

Diffusely thinning the donor region by FUE harvesting is not necessarily a bad thing aesthetically. One aspect of a traditional FUT for a high NW class is the resultant contrast of density between the donor and recipient areas. With a large amount of FUE grafting the residual horseshoe can be far less noticeable and the overall look more natural appearing. This is evident in many of the Lorenzo videos where is difficult to delineate the difference between the donor and recipient zones.

Utilizing an unproven experimental treatment is not unreasonable as long as the patient has provided informed consent and understands the risks vs benefits. Charging for it is a whole different matter and not something I would do myself.

Utilizing an unproven experimental treatment is not unreasonable as long as the patient has provided informed consent and understands the alternatives. Charging for it is a whole different matter and not something I would do myself.

That is precisely how I do it. The key is to use a sharp paring knife, cutting board and most importantly always start your cuts with the blade against the blue coated surface. If you cut from the white to the blue the pill will crumble into powder as opposed to individual segments.

By the recommendation of Dr. Lorenzo I have been taking Pilfood twice a day for the last 3 mos (I am 6 months out from a 1800 graft FUE) and it does appear that my hair and nails are growing considerably faster. I am not sure why but the quality of my hair also seems to have improved as well, less dry, thicker caliber and more shine. Can't say for sure that it is the vitamins or just the effect of the HT but there is definite improvement. In general I'm not a big proponent of supplements but if you are going that way best to take a balanced complex so as not to create a relative deficiency. I found it on Amazon

I use a razor sharp paring knife and first cut it in quarters and then cut the largest piece in half to get 5 doses. Cut from the the blue coated side toward the white with the blade otherwise it will crumble.

If you are lucky, the stuff you are buying online without a prescription is a placebo.

skill and experience can possibly be mutually exclusive.

Finasteride definitely shrinks the size of the prostate and rather than actually reduce the incidence of cancer may make it less likely to be diagnosed due to reduction of symptoms of an enlarged prostate and its effect on suppressing PSA. Nonetheless a recent large retrospective study of 19k pts. demonstrated that the mortality rate was no different between men who were on the drug or not. There is a large percentage of men who get diagnosed with prostate ca and receive treatment even though it was a cancer that if left untreated would not have been fatal.

I am not so certain that all follicles in the "safe zone" are or will always remain DHT insensitive but your case may be different and only the doctor that is most familiar with your specific situation can accurately assess why your HT did not meet your expectations.

Please clarify if the hairs that you lost were native or transplanted. I can tell you from personal experience that I had a full head of hair at the hairline and frontal region 15 years after my HTs at age 40 and then suddenly 15 years later despite being on finasteride, I lost all my native hair and some DHT sensitive grafted ones as well within a span of 2 years! In March I had 1800 FUE grafts and will be getting a second procedure in November for another 1500 grafts the result of which will hopefully get me back to where I was a couple of years ago after I thought my hair loss had stabilized. With MPB, stabilization is only a hope and hair loss will likely be progressive occurring in fits and spurts throughout your life. If you are lucky drugs may slow it down or give a longer period of reprieve but ultimately we all fighting a never ending battle that at best we can fight to a draw.

I have nothing against techs. As a physician who has worked with techs for more that 20 years I can attest to their skills and experience. That said, in the OR there is only one person ultimately responsible for the outcome and success of the procedure and that is the surgeon. As a patient I would be concerned if the surgeon was not involved nearly 100 percent. If I were to consider FUT Konior would be on the top of my list for that reason alone but for the same reason I chose Lorenzo because I wanted FUE.