hairweare

Getting a good short graduated haircut might look a lot better. A funky long-short look which you now have I think brings out more attention. In a week or two the redness will start to fade and you will look much more normal than you think. You have enough hair to get it styled and then just forget about your grafts for the next four months and get it cut every 4 weeks. Your new hairline will come in so gradually no one will ever notice it but rather think you lost weight, started to work out more, or just came back from a long restful vacation.

Perhaps this example in my own specialty of Interventional Cardiology will be illustrative. In the late 70's the state of art treatment for coronary artery disease was either medical therapy or bypass surgery. A Swiss doctor began experimenting and promoting the novel technique of balloon angioplasty which was a non-invasive method of treating blocked arteries. Several prominent European physicians embraced the new technology and many were trained in it by this Swiss doctor. Meanwhile the doctors in the US were much slower to accept it. This changed when the Swiss doctor came to a major US university and taught the procedure to those willing to learn the it. Many of the original disciples of this doctor went on to start their own US training programs and over a matter of 10 yrs balloon angioplasty became widely accepted as an viable 3rd treatment option for CAD. Younger physicians at the time such as myself were specifically trained in the new technology and became experts because of that intense training and high volume of experience before setting out into private practice. However, the vast number of cardiologists already in practice had no specific training yet slowly had to learn it by "practicing" on their own patients. Suffice is to say there was a varying learning curve and not all practitioners were able to achieve optimal results. Now recognized as a distinct specialty, hospitals will no longer allow new physicians who have not been specifically trained in the procedure to perform it. I view FUE much in the same way. There is no a priori reason to believe that every physician who does great HT work is also an expert in FUE. I personally selected a physician who does FUE exclusively, controls both the extraction and placement process and has demonstrably shown consistent stellar results.

As patients we tend to rationalize our ultimate decisions in regard to choosing both the type of procedure and the physician who performs it. The results will be permanent and will have a profound long term effect both emotionally and financially so this decision should never be made in haste. Considering that FUE is not yet state of the art for the majority of practitioners and that those who do it exclusively in high volume are relatively rare, I believe one should go with a surgeon who has the most expertise and experience in the particular procedure that you decide on.

People are free to draw their own conclusions but It would appear to me that far more than 2700 grafts were placed in order to achieve such a result. In the before pictures the vertex is totally bald. I have never seen finasteride and or minoxidil produce dense thick growth in a large area of the crown which was previously "shiny bald." Furthermore, the post op pictures show grafts all the back to the crown. As a NW6 myself when I had my first surgery I had a lot more native hair on top yet with 3600 grafts only the hairline and frontal 3rd was covered. My hair thickness is 56 microns, very wavy, and light brown in color so my characteristics were optimal as well. I tend to view testimonials from patients who are doctor advocates with a grain of skepticism regardless of the pictorial presentation.

Unless the physician has already undergone substantial hands on training by the mentoring physician I for one would not want to be that physicians first case for an elective cosmetic procedure. This coming from being a doctor myself. Back in the 90's I allowed Dr Rassman to sub his associates on the day of the procedure without knowing anything about the other doctor. His assurance that the "team" was the same and that he would be "looking in" from time to time worked out fine in the first case but the second time left me with a very unsatisfactory result that in retrospect I could have avoided by simply refusing the surprise substitution.

I would be very hesitant to wire money internationally. I am still grappling after 4 months with a well respected European Clinic who initially couldn't find my deposit and then after having my bank provide irrefutable evidence that it was deposited correctly have still not received a refund despite their claim that it was wired 3 weeks ago. In the future I would only make a deposit with either a credit card or PayPal. Wires can be risky and the banks will not go out of their way to help you should there be a problem. Keep in mind that if the recipient is either careless or less than honest you will have no recourse in recovering your money.

Your hair is very short and would likely appear much more even and dense if you were to grow it out another inch or so.

Again, you have to keep things in perspective. In the early 90's not too many physicians were doing 3500 graft sessions and he took a lot of heat for it. He was also one of the earliest to provide FUE but neither he or his colleague at the time Dr. Bernstein seemed to realize at the time how far that technique would eventually develop and gain acceptance. I chose FUE and Dr Lorenzo for my most recent procedure because with him you know exactly what you are getting and with whose hands are doing the work.

I agree completely and frankly I am still surprised that Dr. Rassman would do that since he has staked his reputation as being one of the more ethical leaders in the field. The high turnover at his clinic most likely was a reflection of docs wanting to join him so as to learn his techniques before heading out on their own or ones that just couldn't cut it. In retrospect I wouldn't have wanted to be operated on by either.

I was one of Dr. Rassman's first "mega-session" FUT patients back in the early 90's. At the time he was truly a pioneer and way ahead of the majority of HT physicians of that era who were either still using large plugs or very limited mini graft sessions. I was a NW6 at age 43 when he placed 3600 grafts to my hairline and mid scalp. Back then, microscopes were not used and after care instructions were much less refined i.e., recipient area was not cleaned POD #1 and I probably returned much too quickly to strenuous activity resulting in a widened scar. That said despite the less that optimal graft viability and scar minimization techniques the results were actually quite satisfactory. I didn't take meds post op and over the ensuing 7 years had progression of hair loss affecting the mid scalp and crown. I subsequently had two additional strip surgeries of 1200 and 800 grafts respectively. The second procedure weighed the grafts on the right side of the mid scalp and the third addressed the crown. Again the results were satisfactory for another 5-7 yrs but over the last 3 yrs while in my late 50's I lost a significant amount of density throughout the hairline, mid scalp and crown resulting in noticeable patchiness and uneven coverage even in the front which I always assumed would have been permanently addressed by the first HT. As Dr. Konior had previously pointed out miniaturization can occur even to grafts that were thought to have been harvested from the safe area, which I believe is what happened in my situation. While it would not be fair to judge Dr. Rassman's results by today's standards, I did have concerns that the latter two procedures were performed by his associates after I was led to believe that he would be the operator. Both times I was informed of this on the day of the surgery which I felt was inappropriate and less than professional. The third surgery not only yielded a scant 800 grafts but left me with a widened scar and misdirected hair due to a slight "dog ear" closure above my right ear. The crown grafts were also placed at a 90 degree angle resulting in hair that now appears somewhat pluggy and does not lie quite right. I am now 3 months s/p 1500 FUE grafts to the hairline and mid scalp and 300 beard grafts to the scar performed by Dr. Lorenzo. My donor area is obviously limited although Dr. Lorenzo believes that another 1000-1500 grafts are available to address the crown for another procedure which I will consider towards the end of the year. I don't believe that Dr. Rassman does much surgery himself these days. His associate Dr. Pak is doing the majority of the work and NHI current emphasis appears to be more geared towards SMP

Best to follow post op orders specific for your situation but I don't recall Dr. Lorenzo advising me not to get a clipper cut. I had the recipient top which was not shaved for the procedure scissor trimmed after two weeks and the shaved donor/recipient sides clipper faded last week. My donor area appears the same to me as it was pre-op. One interesting and unexpected observation is that the scar not only already looks better but actually feels less tight that before. I wonder whether the 300 perforations with beard grafts had anything to do with the regrowth of new nerve endings but the area feels much more normal. I didn't expect to experience either the pain in that area both during graft implantation and the 3 weeks post op but the result so far is looking very favorable.

I noted that Dr. Wesley had recently posted the result of a viability study comparing beard and chest hair for scar repair and although the numbers were relatively small the conclusion was that better growth occurred with BHT than beard. In my case I am 3 months status post 301 beard grafts that were placed in a scar 26cm long by 5mm wide. I just had a very short clipper cut last week which would have earlier exposed the entire scar for 2-3 weeks. I can see and my stylist agreed that the scar on the right side which was not quite as wide, has completely disappeared while 8cm of the left sided scar is still visible but to a lesser degree and the area is no longer entirely bare. It may require another 100 -150 to be perfect but I will know for sure in another several months. Dr. Lorenzo does measure the hair diameters of both donors sources to evaluate compatibility. My scalp hair measured .058 and my beard which I would consider coarse appears to have blending in very nicely.

Yes, I meant a total of 6000 between the two procedures which is quite remarkable considering your earlier history. Personally, I don't think my beard hair will look good anywhere other than my scar which was one of the reasons I didn't go with Dr. Umar who wanted to use 2500 beard grafts right away. I would strongly consider another procedure with Dr. Lorenzo even if only 1000 could be harvested. You are fortunate to be able to stop in personally to the clinic for follow up. I have found communication via email with the Farjo Clinic somewhat difficult but surprisingly Dr. Lorenzo responds very promptly despite his busy schedule.

You apparently have excellent donor density considering that to get another 6000 grafts by FUE after previous FUTs is quite amazing. Dr Umar felt that I might have at most 2500 available before I went to Dr. Lorenzo and after conservatively harvesting 1500 he thinks that another 1500 is possible. I am nearing the 3 month (11 weeks) mark and there are definitely some sparsely grafted hairs that about 1/2" long, but mostly beard like stubble when I rub my fingers over the grafted areas and a few bare areas where hopefully hairs will soon start to sprout. Once I get a bit further along I will provide pictures on a separate post. I can see why this is considered the anxious phase as it is difficult to avoid looking in the mirror hoping for daily progress when one really needs to wait another month or two to appreciate a difference in new density.

Your scars are already significantly improved at this early date as are mine. I am fairly certain my beard grafts also did not shed as I could feel the subtle difference in texture there as the shaved donor area grew back in. I will be cutting it shorter later this week so the improvement should be apparent. The main reason I chose Dr. Lorenzo was that he is in total control of both phases of the procedure. He is meticulous in how and where he harvests and is also extremely focused on the best placement of every graft. I am certain that the lack of shedding and early growth experienced by so many of his patients is not a coincidence. I suspect that the percentage yield I will get from the 1502 FUE grafts will far exceed that of my earlier FUT procedures. The difference may be as profound as 95 plus versus 70 percent. My new salt and pepper hair color and .058mm shaft thickness are factors working for me this time as well. At this early stage the short new hairs are creating a "floor to the forest" or Toppik effect which has enabled me to avoid the so called ugly duckling phase but I am anxious to get to the 6-7 month point to really reap the benefits. I look forward to seeing your updates as we progress along the same timeline.

As a physician myself I can dispel two notions. First physicians do not get commission for the prescribing of drugs, accepting payment would be grounds for losing ones license to practice medicine. Secondly, gauging a drug's side affects are only as good as the data collected. Not all men will report side effects, many get lost to follow up and others claim side effects that have nothing to do with the medication. So the answer while less than satisfactory is that what is reported could be close to reality or grossly under or over estimated. From a personal viewpoint I decided not to take the chance since disrupting hormonal feedback loops and assuming that a receptor blocker is 100% selective in the past has sometimes proved to be not necessarily a good thing. If it comes to a decision having to choose between my hair or health, I give the latter the benefit of the doubt.

Being somewhat of a public person keeping my anonymity is an issue at this time so I am hesitant to post pictures even though I realize how much more effective it is to do so. Perhaps after progressing further and some editing I will reconsider posting photos down the road. I will comment from time to time hopefully to help others where my own experiences and medical background might be helpful.

It appears that much of your hair on top is the miniaturized native and that you have gotten a very poor yield from the grafts. Was this FUT or FUE? I agree with the suggestions of seeing either Lorenzo in Manchester or the physicians in Belgium. Hopefully you have an excellent remaining donor supply because I sense that you will need to tap into it again in order to get a satisfactory result.

I am older but was in a somewhat similar situation. I started with a FUT mega-session in 1993 with Dr. Rassman. I was 40 at the time and although I had a lot of thick wavy medium brown donor hair Dr. Rassman correctly predicted that I would eventually be a NW6. I ended up having two more FUTs at NHI but the last one in 1997 was very disappointing. Dr. Rassman who was supposed to do the procedure informed me on the day of surgery that an associate would be doing it instead. Using the now antiquated triple bladed knife the surgeon (who I won't name) took a very large strip which only yielded 800 grafts that were placed in the crown with a very unnatural pattern and incorrect angulation. Worse yet the incision was under too much tension and was slightly dog eared on one side resulting in a widening of the scar and a misdirection of the native scalp hairs on one side. Despite this, I had enough remaining hair to create a decent overall appearance and kept my hair at a medium short length to camouflage the problem areas. I took fina for a few years but stopped since as a physician myself I started to become concerned about the possibility of permanent side effects. What many prospective patients might not realize is that hair loss while progressive is not always linear. Even off drugs I was stable throughout my late 40s to mid 50's but over the past two years I starting to lose hair to the point where the limitations of all 3 previous procedures starting to become quite apparent. At first I blamed my stylist and even tried switching to another but after taking selfies in normal light, I could no longer deny that last 20 years of not being bald and overly concerned with my hair and appearance was coming to an end. Despite being 60 I have stayed in great physical shape and was lucky enough to inherit youthful skin as well. For most of my adult life people have assumed that I am 10-15 younger than my actual age. While I didn't do as much research and consult with as many physician as you did. I narrowed my plan to FUE with the likelihood that BHT would be part of the procedure since after 5600 total grafts with at best 70% yield, I was running low on scalp donor hair. I met with Dr. Umar twice a year apart who suggested 5000 grafts split evenly between scalp and beard for full coverage or only 2500 if I only want to address the hairline, front and mid scal. I also consulted with Dr. Lorenzo by email who advised a plan identical to the one he suggested for you. 1000-1500 for the the front and then wait to see the result and recovery of the donor area before repeating the procedure for the crown. My own medical intuition led me to choose the more conservative approach even though going to LA would have been far less of a hassle. (I live on the West Coast). I am now 9 weeks s/p 1500 scalp grafts to the front and top and 300 beard hairs to the .5 cm widened ear to ear scar. The post op period has been uneventful and I am just beginning to see some early growth in the front. As for the scar it seems as if the beard grafts never shed and at 9 weeks after being shaved the scar is now completely covered with both native and grafts. While there were some logistical issues in going to Manchester none of which were the fault of Dr. Lorenzo, I have no regrets with my decision and will keep in close contact with him in order to plan for the second procedure. Stay optimistic and good luck regardless of whom you decide to go with

I wouldn't be so inclined to subject myself to a cosmetic procedure that has not yet even come close to FDA approval. The company has been around for quite some time and has been hemorrhaging cash. The CEO just stepped down and after being under fire for his compensation and poor performance. As a physician I tend to be skeptical about their clinical claims. If your scar is not particularly bad beard grafts seem to work quite well. I too saw Dr Umar who advised 600-700 grafts. I am now 7 week status post 300 grafts placed by Dr Lorenzo and the scar is barely noticeable as the beard grafts grew along side the shaved donor area with apparently little to no shedding or rest phase. I suspect that in 4-5 months the scar will be undetectable even with a very short haircut. I will say however that the placement of the grafts did hurt a lot more that the scalp grafts and the area post op itched and stayed tender for 3 weeks post op. Everything now is back to normal and I will be getting my first haircut since the procedure next week. I have little concern that the scar will be all that cosmetically visible even at this early stage.

Apparently I had my procedure the day before yours with Dr. Lorenzo and echo your comments regarding his professionalism and intensity ( as a physician myself I feel that I am a good judge of that). I previously had 3 FUTs totaling 5600 grafts from 1993-2000. I am a NW6 with wavy medium brown (now graying) hair. I had a pretty good result considering that no scopes were used and the yield was not as good as what could be expected by todays standards. The last procedure was 800 grafts to my crown which only provided thin coverage. Unfortunately the scar widened after this procedure and the remaining native hair in the front and top which had hung in well into my early to mid 50's has now at age 60 essentially disappeared. This has left an overall thin appearance that I was not expecting. The progression of baldness is not linear which is something that many younger men fail to consider and at this stage in my life certainly took me by surprise. Dr. Lorenzo was able to transplant 1502 grafts in the front and top regions and repaired the scar with 300 beard grafts. I am now 5 weeks out and the beard grafts have predominately not shed and appear to be already growing! Half of the scalp grafts have shed but the ones remaining lend a slight improvement or at least an enhanced illusion of density. Due to limited donor supply Dr. Lorenzo took a conservative approach but thought I stood a reasonable chance to get another 1500 for my thin crown in 6-8 months. Good luck to you and I hope that both of our beard to scar transplants yield satisfactory results.

You have made a very good choice, I have no doubt that you will end up with a phenomenal result after only this one procedure.

I think you will get a great final result. How many previous FUTs did you have and how many grafts? Your scar didn't look nearly as bad as mine after 3 procedures.

I started to experience thinning and minituration of the center of my nape hair line in my mid fifties and have had four HTs with 7000 grafts as a NW6. I am inclined to try minoxidil on the area as I have nothing to lose but there is not much reported on the net regarding it's efficacy.

Thanks for the reassurance. Since I have a fair amount of hair in the front and sparsely everywhere else I suppose I won't look too bad after only 1500 or so grafts. Mainly I assume Dr. Lorenzo will be trying to fill in the "holes" left from where I progressed from a 6 to a 7 to where my previous 5600 left off. I am slightly nervous, but not in a bad way. To break up the long trip and to relieve the pre-op anxiety, I will be spending 3 days in Amsterdam before taking the short flight to Manchester. My flights connect there anyway so I thought it was a good idea to extend the layover on the way there. I don't want to further hijack someone else's thread. If Dr Lorenzo's and Mick want to put the pictures up I will do so in a separate post.