Indi9

Kanth is busy enjoying his Happy Hair Days :)

Dear Dr. Blake, Would you please explain your rationale for suggesting FUT for such small a procedure ? (That said the question also remains if he really needs one). But I just wanted to understand why would some one go through FUT for such small a procedure. Appreciate if you could explain please ?

Hi Joel,

 

I just found your thread and watched your videos. Thank you for taking the time to make these. Since you mentioned Dr Feller earlier -- as pointed out, I'm his partner and we do our procedures together -- I figured I would provide my opinion.

 

First, you're not crazy. I do see some of the thinning areas you're referring to. However, it is difficult to really pinpoint precisely what is happening and how much -- if any -- surgical intervention you may benefit from. I think this is caused by several factors: 1) Your adherence to preventive medications (which has obviously helped you to hang on to a lot) and 2) The characteristics of your surrounding hair -- which seem very strong and provide a lot of strategic camouflage, and you're clearly skilled at styling to minimize the thinning areas as well.

 

Having said all that ...

 

I think you have classic male pattern baldness that is more difficult to detect because of the reasons I've listed above. It looks like it started in the "corners" (fronto-temporal angles), moved slightly into the frontal scalp, merged towards the middle, left you with a more narrow hairline in the front (which seems to be slightly affected as well), and worked its way back into the mid-scalp. I see the most obvious thinning areas in the corners and middle of the scalp, so the above would be my best guess at what's going on. Again, never easy to tell in a video, and I think your case is a bit trickier too.

 

Now, should/can you do surgery?

 

Depends. Don't you just love that answer?

 

I think there could possibly be -- and I would really need to evaluate you in person to be sure -- three different approaches here: 1) Continue with the preventive medications; skip surgery for now; and see what happens in a few years because you are at a very unpredictable age for hair loss; 2) Undergo some small refinements (as I think someone suggested earlier) -- there is some merit to this approach, but sometimes these small "piecemeal" procedures can leave an unnatural appearance if you thin around the patches of transplant work (and you very well could); 3) Take a more aggressive approach and re-build and reinforce the frontal and anterior (closer to the front) portions of the mid-scalp. This would probably give you the look you're seeking, and also may be a good defensive strategy for thinning up the road. However, it is the most aggressive of all the plans, and I'd recommend undergoing a thorough evaluation with a doctor IN-PERSON before considering something like this.

 

Here's a video where Dr Feller describes a similar hair loss pattern to what I think you may have AND outlines a more aggressive/defensive (if that even makes sense) strategy he took towards the case:

 

 

I also probably wouldn't recommend anything in the crown right now. I do, however, agree with your thoughts on using FUT in this case. For frontal work of this nature, it is what I would have recommended as well.

 

Hope this is the type of feedback you were looking for. Again, nice work on the videos. Feel free to ask any additional questions.

1500...1800 Max. Beyond that will be difficult as they would need to align with rest of the hair density to avoid looking odd. Beware of shockloss...when u have more...there is more at stake

Will be interesting to hear back from you on what the leading docs say

Excellent result, Amazing density and Super Natural hairline

A question though...The first post says that there was no medication taken by the patient where as his hair has grown thick even in areas where there was no impant done. Can you please clarify?

2 Weeks is sufficient time for you to be able to conceal the transplant. But you will need to put on a bandana or a cap to cover it up as it can still be easily figured out in the first month or so due to redness on transplanted area, scabs(will come off in 2-3 weeks max), remaining transplanted hair that did not shed. Go with an open mind...do not think too much about what others will think if they come to know. Every one has their own problems and no time to wonder about your HT. People will move on to some thing else even if they figure out that u got it done. One of friends went out telling everyone that he is going to get it done before the HT so much that when he got it done it was no big deal for folks in his office. Another one shaved his head off a week before the surgery so people did not notice the difference when he came back after the surgery wearing a cap to work.

So there are options to cover it up...but no guarantee. Don't make a decision based on this.

Do it if you really want it and best to understand the entire process. Clinics and docs just show before and after. But the After is typically 6-12 months after and there is a period between before and after where one needs a lot of courage.

In short take an informed decision. Do your Due Diligence before taking the plunge.

Good Luck!

Empathy is one key attribute that the clinics and surgeons need to ensure. Specially more so post op when the first timer undergoes through so many emotions and situations and when you just have an email address to talk to its not that great & comforting.

Hope you have researched well and selected a recommended surgeon from this site or similar other ones ? Would you like to name the clinic or the doc ?

There is more than enough experience on this site to help you out, only if you seek help in time.

Great! Any recent pics to share ?

Excellent results and must say genuine advise at this stage & age to preserve for future.

Hi indi..No I don't think they bled a lot as u can see from the pics .. Also the pillows and sheets had no blood stains from sleeping .. Hopefully it's all good ..fingers crossed!

Great! I agree...still get a travel pillow and yes its not common knowledge.

If there was no blood and no grafts on the pillow and bed sheet then be rest assured and draw a lot of courage to go through the ugly duckling phase. But like all things it will pass too

Agree on the travel pillow bit. That is something the clinics should inform the patients upfront to avoid such situations.

The good part is that they got pressed inside and not sideways/brushed out. Did it bleed a lot from the same place ?

If it did not bleed then fingers crossed you should be ok.

Make sure you take good care from here on...there are a lot of things you'll need to be careful about at least for the first 2-3 months.

All the best!

A month after the op/surgery you could trim or cut with scissors even the transplanted hair. Would advise on staying away from shaving it though. Not until post 3 month from op.

For patients there is no better advice but to go with their doctor's. Having said that various doctor's prescribe different medicines post op. For example some advise to take biotin, finasteride n minoxidil whereas some suggest to take topical finasteride with neutriderm anti hairloss lotion and biotin but not just biotin...tablets with other supplements & biotin, like grape seed extract, saw palmetto, iron,zinc etc etc...

So the question is what are the best ones that a patient to take.

Just stick to medicines...take a cyclic course with finasteride on one day and supplement it with vitamin_e , biotin and other multivitamin with daily minoxidil application overnight and you will be just fine.

Frankly,you don't qualify for a HT yet. Try to preserve what you got(it's good) and assess at a later stage if things turn bad. Good Luck!

Ok...sounds reasonably correct.

But what about the side effects from long term usage of finasteride. The typical suggestion from the aurgeaons is to use finasteride daily for 6 months post op...What about after 6 months? Should one still take finasteride daily and will that not have side effects?

Would minoxidil not result in loss of hair once it is stopped, per your recommendation?? Or one needs to take it for lifetime ? Then why undergo a transplant?

Hey Spidey...

By now you must have figured out whether doing that buzz cut 9 days post your FUE did damage the follicles or have any adverse even in your hair growth like shock loss etc..

Eager to hear more on this from you

Cheers!

Hi Sam23,

Is it any better now?

No responses here from anyone so can't make out if you tried anything ?

Let me know.

Thanks,

Minoxidil

Finasteride

Biotin & Folic acid tablet

No Minoxidil advised along with other medicines you quoted ?

How many grafts you have left for your crown ? Did the doc advice on the count of grafts remaining at the back of your head ?

Those streaks are beginning of your crusts coming off.

@Dolphin1969... How could you do a rough count and make a judgement. Looks pretty densely packed to me.

Request experienced and Senior members to review and provide their views as well please. I am considering getting it done from same doc

What density did the doc do this transplant at ? Also why was crown not touched at all when there is very visible balding existing.

You will have to back to him next year. In my view that could have been handled now as no one wants to go thru it frequently. Lets hope the 6 months of finasteride & Biotion plus minoxidil will add some volume to the crown.

Will be interesting to see hiw the hairline comes out