Coligion

How soon can you start scalp exercises after having a procedure? I would think if you start them too soon you could risk stretching the scar.

Originally posted by Maxxy:

In a study conducted by Dr. Bernstein and Dr.Rassman in which graft pulls were performed, it was found by day 9 the grafts were fully secure and no longer at risk of dislodging.

 

As it's been 2 months, you have nothing to worry about.

Sadly, I had a graft dislodge at over 4 months post-op. Not a good feeling at all...

Dr. Konior, you mentioned the patient wanted to avoid shockloss. What measures did you take in the hopes of reducing the impact of shockloss?

Originally posted by Dr. Alan Feller:

 

Coligion,

Yes, the donor area for FUE is much wider than that for strip surgery. The more you spread out FUE the better as the holes tend to coalese into a sheet of scar tissue making future FUE procedures that much more difficult even if this excess scar is complete invisible.

 

 

Dr. F

Dr. Feller, thanks for the reply. Since FUE is much more widespread than FUT, is there ever a fear of going beyond the "safe-zone" for donor supply?

When working with the donor area, does a FUE procedure go higher in the donor than FUT? Whenever I look at FUE results I get the impression the grafts are harvested a bit higher. Thoughts?

Jojo, your hairline looks excellent. Based on your pre-HT pics, you appear to have gained symmetry and good density. I would definitely count my blessings with this result

Originally posted by MikeTheDane:

Coligion: True, i am. Did your shockloss return? How long did it take? Shockloss so far hasn't been a concern for me even though i'm a diffuse thinner (which are usually the ones getting that) and as long as it's not permanent i don't mind even if it happens. But yeah 1000-1200 to the hairline should hotfix me for sure! Still, im very tempted to hit the crown. Very.

Like you, I'm a diffuse thinner. Unfortunately, I don't believe much, if any, of my shock loss hair returned. In terms of benefits, I feel like I took one step forward, and two steps back with my first procedure. That is why I will remain extremely hesitant for round two. Being resistant to shock loss is a quality I envy in you

Originally posted by Crosby:

Thanks for the comments and feedback. I'll post another donor area picture in a few days - I really think the lighting and angle factor in to that photograph. Also that was Clipper #3, very short and not usually how short I keep my hair.

 

I've been on Finasteride for about a month. Been in conversations with Matt Zupan from SMG for a long period of time. Just bought Revita Shampoo as well. Not on Rogaine or any MInoxidil however - thoughts on that?

Personally, I would just stick to Finasteride for now. Since you've only been on the medication for a month, there's no telling how effective, or ineffective it will be. By placing Rogaine/Minoxidil into the mix, you'll never know which, if any, of the meds are benefitting you. Give Finasteride at least 6 months and then reassess your situation.

Originally posted by thanatopsis_awry:

Re: cost of a small FUE session...I know Dr. Feller does a "lunchtime"/"postage stamp" session that is essentially priced and designed for a situation like you might be in.

 

Also, SMG/Shapiro have FUE priced quite competitively so I don't think you'd be gouged if you went to them looking for a small sesh.

 

Regardless, though, FUE *is* more expensive than strip/FUE, graft for graft.

Thanks for the reply, thana. I understand the cost difference between FUE and FUT, and also realize most clinics want you to do larger sessions (larger the session, the less cost per graft). A lot of clinics even have set minimum amounts you must pay, regardless if the graft count total is far below that price. I don't exactly feel comfortable paying for a procedure of 1500 grafts, when I'm only getting 200. I suppose most folks might tell me "tough," but nobody wants to get taken. I will continue to research and see if anyone is more accomodating for smaller procedures such as mine.

Mike, you're a younger guy (not too unlike myself ), so I urge you to move forward with caution. We've talked a bit about shock loss, and from what I remember, you had told me it was not a huge issue in your past surgeries. I had significant shock loss from my first procedure, so I will not likely touch my crown for another ten years. In your case, it seems your hair has reacted well, so maybe this would not be an issue...I also think your hairline is looking solid, but I understand your concerns. I would think 1000 grafts would provide adequate density to finish off your hairline. Best wishes.

Thank you for the the honest replies. In addition, can anyone that has had procedures of smaller graft counts (less than 500) elaborate on how they handled the cost? I have done a lot of research, and it seems every doc out there wants to charge me the cost of a 1500 graft procedure when, in fact, I'm only doing 200-300 grafts. I understand why the price is so high: staffing, overheard, etc. Regardless, I would have hoped having less hair loss would mean the ability to not be as financially impacted by the procedure. Everyone has individual hair loss concerns and needs, and it's frustrating that for such a small procedure I'm looking to pay that of a large session. Unfortunately for me, my current area of concern is a great one, so I'm having to bite the bullet in a sense

Hair loss is generally progressive in nature. However, many different forms of hair loss develop that are unique to each individual. Just look at the Norwood scales for reference. Many people are only affected by frontal/recessive hair loss; some people have loss only in the crown; many of us are unlucky and have loss in all those areas. You are too young to determine if your hair loss will stop in the frontal-third. My advice to you would be to research Finasteride, and see if medication can help slow down your hair loss. All of us react differently to hair loss, but you will likely need to wait 5+ years more to judge where your hair will be headed.

I've made the decision to move forward with another hair transplant, but I'm hoping to receive some advice on how to approach my concerns best. I've already had one procedure via strip, and I'm wondering if FUE is a better option for me in this situation. The area where I want the work done is small--200 grafts in the right, temporal zone. I know such a small graft count screams FUE all the way, but my first procedure has left me with a wide scar. I live in Arizona, and visited Dr. Alexander this past week to discuss my concerns. He seemed adament that if I were to have this procedure with him, he would want to remove the scar tissue that had developed from my first procedure as a corrective measure. He could then remove the scar, hoping the revision would heal better, and also extract the grafts for my temple work.

I guess I'm really trying to decide if a scar revision and the temple work in one procedure would be the most beneficial to me? The other option is to leave the scar alone, and go the FUE route for such a small zone. I know for a fact 5 to 10 years from now I will need another surgery, so do I leave the scar alone and tackle that in the years to come? The problem I have with FUE is who is really available and reliable in the West? Any input here is appreciated. Thanks.

TTP, next time you update your blog with photos, could you possibly show a closeup of the hairline? I would really like to see some pictures that have the hair pulled back on the left and right sides to see how your hairline has matured.

After looking at a lot of FUE results, it seems there are times when the donor area is utilized a lot more aggressively then what I would feel comfortable with.

TTP's hairline was conservative to begin with, so I still believe 2500 grafts should have yielded a better result for him.

Dr. Feller's pictures show the forelock and 1/3 zone as fairly thick and dense, while GettingItRight's current photo shows extensive thinning in the same areas. Like Bill mentioned, the hairstyles are not consistent and are likely causing irregularities. If GettingItRight's current photo is an accurate representation of his final result, I too would be disappointed.

I'm sure these past ten months have been an anxious time for you, TTP. You do your research, take on a large financial burden, go through surgery, wait months and months, and then the result you had hoped for has not been delivered. You deserve much better than this, and I hope Dr. Alexander accommodates you as much as possible.

Personally, I feel that your drawn hairline is a tad too aggressive. In my opinion, I would straighten out the hairline some, but I would want to mainly bulk up all around the existing hairline. I'm also mentioning this because you seem very concerned about your available donor supply. Like you said, donor supply is unique to each individual, but 20,000? That seems extremely excessive. I'd feel more comfortable putting the average available donor supply between 4,000-10,000 grafts. As for shockloss, that is generally an unpredictable occurence. The best thing you can do is continue to take Propecia. Since you are relatively young, and your forelock looks to have some miniaturization, I would definitely be leery of potential shockloss.

Originally posted by spin266:

ronald where can i purchase in u.s. and what does it cost.thanks

I picked up a bottle at Fry's for about $4. I've only used it once, so I can't really comment on it yet.

Originally posted by ZAZ:

Yeah the above pics are PRE OP pics (before my hair transplant)

 

I ll be uploading the latest 8.5 months photos shortly

 

How extensive is the loss on the above pics and how many grafts would i need for good coverage?

Where did you have the 3000 grafts placed? Did you and your doctor try to spread them out evenly across your scalp, or did you focus solely on the front/crown? If you want decent density, I'd say you'd have had to use those grafts either in the frontal 1/3 to 2/3 or entirely in the crown to achieve proper density.

I agree with the others here saying that your proposed hairline is much to low. If you're set on having a procedure done at your age, I would advise you to bulk up the existing hairline you currently have. Like shanti said, if you go lower, you'll more than likely be wasting precious grafts that you will need in the future.

You should give your transplant at least a year to mature so you can properly asess your results. Before you can have another surgery, your donor zone needs time to heal, and your grafts need time to fully emerge from the scalp. The time frame for future surgeries is about one year post operative from the intitial surgery. However, if you're having grafts placed in an area that was originally untouched, six to eight months is likely an acceptable time frame.

I don't have a lot of knowledge on how older hair transplants were performed, but from my understanding, it seems like a lot less grafts were used in the early to mid-nineties than today? I don't have a lot of information to back that up, but my father is a good example. He had multiple procedures (Bosley and some independents), but he claims he had no more than 1000 grafts in total. My father had prevalent loss in the frontal third and crown, so it amazes me when I see patients today needing 4000+ grafts to achieve a good result. In fact, most people tell you to expect very little from a transplant that is under 2000 grafts. I realize naturalness and refinement is centered around hair transplants today--and my father's work is not the most "natural"--but he has excellent coverage for the loss he incurred throughout his life. I guess I'm just wondering if the methods used 15+ years ago offered better coverage (with less grafts), but obviously at the cost of naturalness?

Everything is looking good so far. Seems like you've had a decent shed by the one month interval? How's the donor area feeling these days?