mahhong

I'm not 100% sure about the process, but I think the there is a useful principle is this. Being able to see what your hair looks like on you is really important I feel, but perhaps there is an overall less tricky way of doing this? I'm not sure! The other thing is this doesn't take into account graft yield I presume? It's going to be even more disappointing and harder for docs if the initial results don't match up to the final results and, let's face it, there is a long way to go for any patient at this stage. Ultimately though I think there is some merit in trying to simulate as best as possible for patients what their results may end up looking like. I personally feel the "cost" to "reward" ratio doing things this way doesn't quite add up.

I've read one or two people that have claimed their hair has shed and not seemed to regrow on rogaine, but this is exceedingly rare even by "internet rumour" standards. I don't think I've ever read anybody claiming it's actually sped up their hairloss though. There might be some confusion stemming from the fact that I've heard minoxidil lists hairloss as one of its "side effects". This is only in the sense, however, that the hairs may initially shed before growing back (and likely stronger) again. I can't see any scientific reason why minoxidil would cause increased, permanent hairloss. Always best to stick to the recommended dose though!

Fascinating interview and a good adjunct to Cooley's recent work. Also interesting to note (although I got this information from his website and not from his interview) that Rassman is now researching with ACell. See Dr. Jerry Cooley's Presentation on ACell MatriStem in Hair Restoration and Hair Duplication (Formerly Known as AutoCloning). In my opinion this is a massive breakthrough and there is a palpable sense of excitement about this treatment. It offers a genuine and sustainable way forward; it's not about treating symptoms or combining cocktails of all descriptions to get a little more success. This is real deal hair cloning. There are lots of variables to consider and research but for the first time there's no field of disappointment clearly lurking over the hill. Usually even the layman can spot basic flaws in the hopes of most treatments, but with this it's scientifically, financially and ethically viable. Most interestingly Hitzig feels this treatment could start getting rolled out within a year. I wouldn't interpret that as "we'll have unlimited donor hair within a year", but I think he means they'll be able to start implementing it within that timeframe and introduce gradually more refined and successful ways of doing things; much like any innovation in hair transplantation. The long and short is there seems real hope this does work, can work and can be viable within 5 years. It truly is a revolution if that's the case. Scarless procedures, much greater if not unlimited quantities of permanent donor hair, huge leaps forward in repairs cases etc. And with it already FDA approved this isn't some behind-closed-doors medical roulette that we have to worry won't even make safety grade. This stuff is being used now for a whole range of things (some far more important than hairloss in the scheme of medical science and cosmetic surgery). I'm really excited, but we have to be cautious. I still think a timeframe of more like 3-5 years is likely for this to turn into a really usable procedure, even if all the research does go swimmingly (which it looks like there's a strong chance it will). In addition it has to be refined from a theoretical improvement to a usable surgical procedure. There's no point doctors implementing it unless cost, time and efficacy factors all meet up. The point is this though, for the first time I think we can not feel like over-excited schoolchildren when we say "the future is here!!!". The merit of this method is huge and the safety and efficacy is already proven. It needs a little more time to check how things are really panning out, but I've yet to hear a truly dissenting voice amongst the hairloss or medical community in general. Usually some bizarre new product comes out of nowhere and despite our best hopes it's a matter of weeks before it's derided by professionals. Not so with this stuff. It's an interesting interview, so check it out if you can! It's encouraging that Cooley, Hitzig, Rassman and many more are now actively researching or looking seriously into this area. That's going to speed up the waiting and more quickly establish guidelines and procedures I think. Not that I have any authority, but I would issue a word of warning. I can imagine, especially as this is already FDA approved, there will be many rogue agents out there happy to pluck your hairs, sprinkle a bit of pixie dust on them and re-implant them. Probably right now. Don't do it! I meet a lot of people that claim they will travel anywhere, pay anything and risk any amount for a full head of hair. Be sensible and let the best in the business test this stuff properly and come up with the best ways to make it work. Hitzig states as much in his interview; you have to know how to use this stuff. You can't just pour it over something and watch it work its magic. If you have to wait a couple of years, or even a bit more, to get this done, so what? It's worth it to know it really is a workable and efficient procedure. Do the research and look towards the legitimate doctors and for a time when they feel it's safe to use. Until then, let's just be happy that the hairloss world is moving at such a breakneck pace! To think it was only just over a decade ago that propecia was pretty new and modern transplant techniques were just coming into their own! We really have come a million miles in that short space of time, accelerating all the time. I think we're about to go lightspeed

After about 4-6 months you should start seeing some growth, but some people can be slow growers or only see a small amount of progress. By 12 months your hair should have mostly grown out and you should have a strong idea of whether your procedure has been a success or not. Over the next 12 months your hair will probably continue to "mature". That usually means it should become of a better quality and feel a bit thicker and healthier. I'm not sure if having multiple procedures increasing the waiting time for hair to grow; somebody else on this board might be able to give a better answer. Generally speaking though, after a year you should have the majority of your growth, with the remaining 6-12 months seeing a bit of thickening up and maturing.

Hi Alex, Yep, you're absolutely right, fin is very much "use at own risk"! I would estimate the risk of side effects is fairly small, probably a bit higher than the <2% Merck quote but maybe not much higher. The reported "permanent" or long term side effects are much less common; I would estimate in reality far less than even 0.1% (although it's difficult to quote statistics without doing a lot of research). In other words, risks are pretty small. The potential impact of those risks is high though, which is the downside. If you're one of those guys to get badly affected it would seem fin can be pretty difficult to deal with. But that's not the scientific opinion, only the opinion of a minority. If you're worried about taking fin but interested my advice would be go see a doctor and maybe get your endocrine system checked over (blood tests etc), at least in terms of the basics (which other people on here can help you analyse). It offers no guarantees but it's quite surprising how finasteride is given to patients to treat a symptom of a larger cause. You wouldn't give thyroid tablets out just because someone felt tired all the time; you'd try and pin down what was wrong first. If your endocrine system looks fit and healthy and everything is reading in normal ranges that means you reduce the risks of fin even further. You can't eliminate them, but you can do your homework before you try it. As for laser comb, the jury is still out on it. There are a few websites (you'll have to research them as I can't post links) that tell you how to make your own, supposedly much more effective laser combs. You'd have to really research that because you don't want to mess with lasers, but they're relatively safe as the sorts of strength we're talking about. I don't use a laser comb, but the consensus from some people would seem to be that commercially available laser combs are not really designed well enough to do much good to your hair. Some of the DIY laser combs have reported more success, but that's unverified. Might be cheaper and worth checking out though? Ultimately laser combs are FDA approved safe but not FDA approved useful. Like everything, there are some people who claim they're superb and others that claim they're a waste of money. You have to do the research and decide whether you think it's worth a go or not. I would also suggest minoxidil if you're not on that already. Not as effective as propecia but much less chance of getting serious side effects and not as "intrusive" in terms of how it works with your body. Can cause some side effects but they're usually mild (sensitivity, irritation etc.). Minoxidil effectively works as what's called a "potassium channel opener". In short it would seem to open blood vessels and make them work more efficiently, which in turn causes hair follicles to be enriched and healthier. That;s why propecia and minoxidil work well as a team; they both do very different things, so they have a better chance of "helping each other out".

A couple of things to mention about Saw Palmetto: It has in some instances been linked to the same problems that fin can potentially cause; depression, loss of libido etc. It seems that the instances of these problems are a lot less, but that my be for reasons mentioned below. Secondly, some people have reported SP have caused them to have ulcers and bleeding in the stomach. This is of course a very rare report and hasn't been scientifically verified. Lastly, tests on Saw Palmetto are inconclusive both in terms of efficacy and safety. There have been some trials which have thrown up mixed results, but nothing as large in scale as the fin trial. In addition, proper research on dosage hasn't been conducted. Some people are taking 10 times more SP than others. This may be the reason less sides are generally reported (because some people aren't taking a high enough dose). I suspect the other reason is pscyhosomatic (people believing SP must be healthy and risk free because it's natural and so do not pick up on small symptoms as much). Anyway, I am not wanting to put anybody off; SP certainly cannot be more potent than fin and people have reported good results on it. But it does work slightly differently to fin and all I would suggest is don't be fooled into assuming it's safe and natural and lovely. It still blocks DHT and it can still have an effect on your endocrine system. I would argue that effect could in theory be as small or as large as the effects of fin. One more thing, fin blocks one type of DHT (we have two types). SP seems to inhibit both types, including a type found in the brain. There has been no conclusive research into whether this is a problem or can cause any further issues, but it's something to be aware of. Ultimately it would seem fin and SP are pretty safe for most people. They're certainly not "poison", but fin is still the most thoroughly tested and documented hair loss drug out there (that works). I think taking SP is fine as long as nobody does it out of assumption it's automatically safer or better because it comes under the label "natural".

Hi Alex, I appreciate your concern! Finasteride is generally a very safe drug and it would seem the majority of men who use it experience few or no side effects. Some experience more severe side effects that also seem longer lasting and some have reported permanent (or long term) side effects they would consider quite alarming. My feeling on finasteride is that, whilst generally safe and very usable, its effect on patients will be individual. Each of us has endocrine systems of varying health and stability and so find finasteride affects us in different ways. For some it would seem it has a mostly negative effect on libido, with our symptoms like "brain fog" and depression noted. It is worth bearing in mind, though, these symptoms are comparatively rare. There are very few proven alternatives, unfortunately. There are some herbs and natural medicines that some claim have improved their hair, but there are no scientific studies on these treatments. In the same way that finasteride causes severe side effects in very few men, a particular type of herb of alternative remedy may cause positive hair growth in others. It always frustrates me when people harp on about the negative effects of finasteride and then have a list of about 40 different "natural" herbs and remedies they take which they claim does wonders for their hair. Without scientific proof over a large number of subjects, no remedy can be "proven" to work for everybody, and if a treatment only works for <1% of the population then it's largely useless! In addition these "natural" remedies have not been studied for safety. Just because it says "natural" and you can buy it in a health store doesn't mean taking it is safe or healthy. Don't be fooled: taking any sort of drug or remedy carries a risk, but finasteride at least has a calculated risk. Unfortunately you must make your own decision on finasteride, but there is nothing better out there. That's the fairly harsh reality we face as hair loss sufferers. I can understand somebody not wanting to take finasteride, but don't be fooled by websites telling you to take 'this' or 'that' for guaranteed hair recovery. If anything worked better than finasteride, it would be more popular than finasteride, ESPECIALLY if it was 'symptom' free. You're more likely to be totally fine or suffer only mild, temporary side effects on finasteride, but it is possible your reaction will be more severe. My guess is that Merck's suggestion that that finasteride causes problems in around 2% of people is true, even if others would believe differently. If you say conservatively there are 3 million finasteride users in the world, then 2% of them would be 60,000 people. If you can find even 30,000 or 15,000 individual cases of people complaining about finasteride on the net, I would be impressed! I'm not on finasteride yet, out of the same concerns you share. I know my chances of being healthy on it are very high, and yet I know there is that slim potential for some severe reaction to it. It's a case of working out whether you are comfortable with the risk. Minoxidil, however, is not associated with ED. There have been some reports linking the two but where as finasteride does have a direct involvement in your hormonal system (and therefore it's at least plausible it can cause damage there), minoxidil does not affect your body in the same way. My suggestion would be at very least to get on Rogaine/generic minoxidil 2% (ideally 5%). About the worst you can expect from minoxidil is an itchy scalp, and that's not usually that bad. Minoxidil is not as effective as finasteride, but it's more effective than nothing and it might "buy" you a bit more time whilst you make a decision over finasteride.

That sounds about right. I don't think finasteride is harmful to a woman, per se. But it's very damaging to a male fetus if the woman conceives.

I think, like a lot of art, a good artist can bend the rules. Your post was really informative and demonstrates a lot of the good working rules for hair transplantation, but there seems no hard and fast rule. After doing thousands of transplants most doctors probably get a gut feeling for what will work from patient to patient. Recreating a head of hair is effectively a form of art. It doesn't necessarily follow that imitating nature will always produce the most natural results, I would imagine. Singles in the hairline seem to be the most popular way to go because it's the easiest way to design a soft and pleasing hairline. Nature probably does things somewhat differently, but natures results are by their very essence natural. Hair transplantation must work within the limits of human ability and so the approach, whilst having the same aim of looking natural, has been artificially developed. This is an interesting subject in hair transplantation and probably something patients need more education and understanding of. From a patient perspective there is a tendency to think that packing as much in in as many places as possible is the goal, but when you start analysing the situation that's neither a realistic goal and probably not even the right sort of goal to have in mind. When I started analysing the hair of other people (a phase we all go through I would imagine) I started realising, when you really get down to the detail of hair, a lot of people's hair looks somewhat "abnormal" compared to what you think is the norm. Of course their hair isn't abnormal, it's perfectly natural. But you start realising a 'gold standard' for hair isn't easily definable. Most people spend most of their time looking at the cumulative effect of hair. If an average person sees a head of hair they'll probably look at it in relation to the rest of the person. Having a good physique is a good comparison. I can't tell you how many people I see who, to my eyes, have a good physique. When it gets mentioned though, they start talking about unsymmetrical biceps and ugly deltoids and not enough definition in their trapezius etc. They're looking for perfection in each component but I'm looking at the whole object and casting a general opinion on it. Hair is just the same. We all worry constantly about our hair on here because we've all noticed it's leaving us and we're all checking pretty much every section of our hair each day, sometimes noticing specific hairs that have fallen! I worry about my thinning hair but if I was to think rationally I would imagine a lot of people haven't noticed it yet, or certainly haven't "thought" about it. People don't really think about 'hair', they think about the hair's effect on you as a person and an entire body. That's why a bald person can look great, because it is a considered part of a look. When I think of my hair I tend to think of it as a lump of slowly failing matter! But most people just see it as a part of my larger physical self and, if it looks in principle like it's all there (which it does), they probably make a quick assumption that it is. I guess that's why, when a lot of people get a transplant, people usually say "you look different" rather than "you have hair!". The cumulative effect on yourself changes, but people barely notice the individual elements. For all they know you might have lost weight or started wearing coloured contact lenses or had a nip and tuck. So, in short, I think most doctors usually think about the hair as one part of your overall self. Designing, for example, a perfect hairline is not as important as designing the right hairline for you with the resources available. 99% of people, even some of the closest to you, will probably only ever glance at it anyway, and their brains will make a snap judgement about your physical appearance overall. That's why having a great body is desirable; people look at you and tend to think "phwoar, fit!", if you get what I mean! It almost seems people don't look at faces or specifics, they just latch on to an overall image and make their impressions on that.

I was thinking the same thing. I think I read about small studies being carried out on women taking finasteride but I don't recall it being given as a treatment in day-to-day hair loss cases.

Hi mattj, Thanks for the post! To be honest I'm 99% sure it's MPB - our family is riddled with it on all sides! It struck me as odd though because my thinning is at odds with everybody in our family that I know of (from 2-3 generations back). I know genetics is not as simple as simply 'taking after' someone in your family for hairloss, but I just wondered if it was a good idea to contact a good derm. Thanks for all the advice/thoughts though. Regarding the itching I think what threw me was a lot of pages suggesting itchy scalp is linked more to other types of hairloss, or at least there's no direct correlation between itchy scalp and MPB. Clearly though, as you've said, it's an observable symptom in a lot of men, and certainly not a smoking gun that there's something else going on. I'll probably go and get the thyroid checked out anyway. I've had some other symptoms that could be linked to thyroid and there is thyroid problems in our history, but most of those symptoms have been incidental; tiredness etc. Nothing that would strongly suggest a thyroid problem. I've never had much of a health check anyway, though, so I'm keen to maybe give myself a bit of an examination anyway now I'm approaching 30!

It's heartening that this post has remained civilised! Badluck has been both open and considerate about the whole thing despite what must be disappointment for him at how his procedure has turned out. I do agree, in principle, that a waiver should be discussed and the chance of complications mentioned pretty explicitly by doctors (whether or not Dr. Feller does or did do that I don't know?). The patient has the right to be informed of the facts of any procedure before making a decision on whether to take things further. That having been said, it is somewhat a given that cosmetic surgery and indeed all surgery carries a degree of risk. No patient should really be able to claim they don't understand that fact. Ultimately this is just an unfortunate situation in which it seems no party is to "blame", so to speak. I can sympathise with doctors regarding how they handle the tricky issue of discussing complications or problems. Whilst a patient absolutely has every right to know what may or may not go wrong long before they lay a dime down it's a fact that most HTs performed by an experienced and professional surgeon are a success. In my opinion it's a tricky balance between being honest about the procedure but retaining a sense of optimism in what is usually the face of overwhelming success. It's possible to frighten anybody off a procedure if you start listing what might go wrong, or might not work, or might be a problem. I'm not remotely suggesting doctors should or do withhold information but, as Bill says, communication is a two way system and patients must vocalise concerns and cover their bases with regards to expectations, concerns and fears. I hope badluck and Dr. Feller sort this out since neither deserve to come out of this compromised in my opinion. But this is most definitely a situation that won't be resolved on these forums, so it's up to the parties directly involved to get back in touch and work in good faith to find a solution. I'm sure that can be done!

I see what you mean, but I ultimately agree with Bill. Having read the longer version of the OP's story it seems to me this a case of miscommunication primarily. I do feel for the OP because he's been eloquent in his description of how he feels events have unfolded, and so deserves to at least be commended for that (it's better than somebody who would come on here with hostile or abusive comments, and not be willing to listen to anybody). That having been said, it is one thing to say you did not feel a surgeon did a very good job, but it's another to accuse a surgeon of engaging in illegal activities or being unprofessional to the point of dangerous. None of us here can verify the truth apart from those directly involved, but that's not the point. Dr. Feller has proved his professionalism consistently and it is technically easy for anybody to come on here and say what they want about him. It would be unfair if surgeons were subject to uncorroborated stories and accusations that later turned out to be false or unfounded (and I am not saying this one is; I have no platform to make any comment). Ultimately, in the same way a surgeon needs to post results and prove their abilities, patients must be able and willing to back up what they say. Otherwise the forum could be littered with unfounded accusations that, to a virtual 'passer by', could paint an unfair image of the coalition doctors. This is a tricky case because it seems complex and it seems both parties may be 'at fault' - not deliberately but in an unfortunate and sometimes inevitable case of miscommunication. But the severity of accusations are such that, until proven guilty, no respectable doctor on this forum should be tainted by them. I hope the patient and Dr. Feller come to an amicable solution and are both willing to see each other's point of view and find a common way forward. In the meantime, whilst the patient deserves every right to discuss his opinions, specific accusations of illegal activity cannot be allowed to stand until proven or quashed.

I'm fairly sure I have MPB; my hair is thinning diffusely and my family history would strongly suggest I'm not going to escape unscathed! I first noticed my hair thinning probably about two years ago but the last 6 months it's gone downhill pretty rapidly. I was in the middle of a very stressful job so didn't notice (I work freelance) but now it's over I have most certainly noticed! However a couple of things I wanted to query. From what I can tell of my family history nobody in the family from either side went bald diffusely. My Dad receded at temples and crown but had a strong vertex/mid scalp into his forties - his Dad still has a pretty strong mid-scalp! On the other side my Grandfather went very bald but didn't start until his 30's. In addition I've also noticed the last few months how itchy my scalp has been. Although I've searched on the net I've not found much in the way of itchy scalp being a definitive symptom of MPB. It's itchy nearly all the time, and I've noticed a lot of spots in my head and on my face (I'm 27 and do not suffer from them as a rule, apart from the odd one or two). Anyway, I'm fairly certain baldness is on the cards whatever happens, but I wondered if perhaps there were further underlying causes than just genetics? Perhaps there could be a thyroid issue or the stress of the last job (very stressful) caused problems? My hair seems to have gone downhill very rapidly and in a pretty random way (back and sides still strong, but the hairloss on the top of my scalp almost seems to be starting right at the top and spreading out to the sides. I'm going to the doctor tomorrow (about an unrelated matter, but also a general checkup I guess). Should I push for hormone or thyroid tests? I'm not yet on propecia/minoxidil but that's going to change in the next few weeks, but should I maybe get a diagnosis and look into some other things first? Also, a slightly unrelated question but I didn't want to make a separate thread just for it. Are there any good dermatologists in the UK that have expertise in hairloss (ideally around Bristol/Cardiff but I can travel)? Although I'm fairly sure I have or at least will have MPB I'd feel better getting an expert opinion before I get on drugs, especially as I have some other symptoms that could potentially point towards thyroid problems. I've looked at various dermatologists but I wondered if there were any recommendations from people on here specific to hair. Thanks for your help!

The more I read about this, the more it seems exciting and potentially useful the field of hair restoriation. When I read through the basics of the experiments I thought Dr. Cooley was implanting hairs with the epithelial portion of the follicle into existing follicles in the bald part of the scalp (which I realise now was a stupid assumption, so I don't really know why I thought it would be that way!). My concern was this wouldn't produce a DHT resistant follicle. I realise now the technique is much more simple and yet complex. The hair with epithelial portion of the follicle is implanted into the bald scalp (much the same way as a normal HT, to my understanding), but is coated in the matristem powder, which enables what is essentially 'half' a follicle to grow the other 'half'. That offers a much more viable chance that the eventual follicle will also be DHT resistant in the long term, since its origins are purely from a bald resistant area of the head. That's really exciting and I get the strong impression Dr. Cooley is really optimistic these follicles will be fully functioning, long-term DHT resistant follicles. Potentially it's a normal HT but minus any 'strip' harvesting, minimal invasion to the scalp (so very little if any scarring, especially knowing the matristem stuff) and, of course, potentially unlimited donor supply. There is of course more that needs to be done, but as a preliminary finding this strikes me as incredibly well developed already. The matristem is already FDA approved safe and usable, which means the hurdle of general safety is bypassed. Dr. Cooley, from what I have been able to gather, has had success rates of between 50-70% in some healthy areas of the scalp and 30-50% in less healthy areas (I think there were more factors than that, but basically the success rate ranges from good to not great in some places). Of course there is still a lot of testing to be done and questions to be answered: Are the new follicles DHT resistant and do they work like a 'normal' follicle in terms of cycling/hair production etc? Can the technique be refined to produce more consistent results (which would be necessary in order to justify turning the results into a usable procedure)? Hopefully Dr. Cooley and, ideally, more doctors will now be testing the treatment more rigorously; larger procedures, longer follow ups and more consistent techniques. They have to be able to turn a promising treatment into an economically viable procedure with the sorts of quality control patients should be able to expect. This testing and development will take some time but I don't think it will be a huge amount of time if I'm honest; the bedrock is there and FDA approval means the major clinical hurdles have already been overcome. But the doctors owe it to themselves and, also, to their patients to make sure the procedure is safe, effective and consistent. Whilst this could also potentially solve the limitations of donor hair (or at very least severely limit those problems) it is still an HT procedure and there will still likely be some limitations. It would seem very possible now that getting an even distribution of transplanted hairs across our bald scalps may now be within our grasp, but the treatment doesn't answer some other questions posed to HT physicians. Vascularity in the scalp and human precision will still probably be an issue, meaning that the 100/cm2 hair density lots of people dream is still alluding us. But by contrast comfortably putting maybe 50-60/cm2 from the hairline through to the crown no matter what the size of the balding area may well be a reality within the next few years; a stunning achievement and one that could drastically, drastically improve the cosmetic quality of a HT. I think the majority of men would be bowled over by that idea and, indeed, in many people I reckon this would essentially represent a 'magic bullet' to them, even if strictly speaking that isn't true. Of course, cost could be an issue. Whilst I don't imagine this treatment would be some horrendously overpriced procedure, just the very fact it offers potentially so many extra grafts means that, even if the price-per-graft stayed exactly the same from doctor to doctor, getting more hair could end up being costly. In my opinion, however, it's a price many people would pay. Knowing you have near enough unlimited donor hair and the potential to cover an entire balding scalp; whether it's N3 or N7, would be worth coughing up for! Add to that the fact this would be a virtually scarless procedure (and genuinely so) and you're talking about a simpy amazing development. Anyway, those are my thoughts on Acell and its development. All I know is that this feels like it's going somewhere. I'm not one for mindless optimism, or for hailing every obscure trial from the depths of anywhere as the future for hair restoration. But this feels credible and Dr. Cooley's presentation demonstrated in good detail that the principle works. Whether or not we can turn that into a long term successful procedure remains to be seen, but you only have to look at the results and the underlying science to realise this is not some far-flung pseudo-science stab in the dark; this is applying proven principles to a new area of cosmetic surgery and getting the sorts of results that suggest it could really, actually work. Perhaps this is my more optimistic side bursting through the pragmatic exterior, but I sense from Dr. Cooley's voice in the interviews and presentations he's done that he really can't see why this won't be capable of going all the way. We must always prepare for disappointment, especially the doctors that experiment and tinker away with new ideas. But usually a new 'treatment' in development pretty quickly encounters myriad unknowns, complications, failures and problems. This is the first time I get the feeling, even if it's just a feeling, that the option put in front of us is viable. And I'm heartened to know many other people infinitely more knowledgeable than me are just starting to get that feeling too. Where this will end up? Who knows. But at least it's now been proven this is most certainly not some dead in the water theory. This is working science that has gone much further than most in proving itself. Let's hope the results continue to improve and the research continues to be so exciting!

Hey Dame, Sorry to hear about your problems getting good advice. Although I cannot say anything with authority, my guess would be hearing that your hair is falling out from back (which is usually a safe zone in MPB) is actually a potentially positive thing. What I mean by that is that it would be very unlikely that your hair loss is down to MPB if you're also experiencing confirmed loss from the back. Of course by "back" I'm assuming you're meaning pretty much right the way down the back of the head? With TE you have every chance of growing your hair back, even if it takes some time. With MPB your hairloss is permanent, and only drugs can slow it down or stop it temporarily. So, to stay positive, the potential good news is that it's much more likely you have TE and there is a chance that you'll see very good regrowth again - some people do! It's also good news the shedding is calming down. Are you still on the rogaine? I think that should help your hair grow back if anything will. Let's hope that your TE is temporary and reverses over the coming weeks. In the meantime hope you stay well and glad to hear the hair seems to be making some improvement!

Hi Ken, Could very well be regrowth! Propecia can improve hair density, especially in the crown, so you might be one of the lucky guys that sees not just significant slowing down/halting of hairloss but also some regrowth too! Over the next few weeks you'll probably be able to know more accurately if this is indeed new hair, but the signs are good I'd say! Hope it continues to work out for you!

I couldn't say for certain but I'd imagine you'd be fine! I've seen a few people who've cut their heads open and generally given their grafted heads a bit of rough and tumble, but hair follicles are pretty sturdy and five weeks in there shouldn't be much chance of damage! Let's not forget those little follicles survived being cut out, split up, handled and put back into your scalp! If you're worried you can always phone your doctor to double check what they say but I'd imagine at 5 weeks in they'd be tough enough to handle it; it certainly wouldn't cause any damage with normal follicles so I'd hazard a guess the recently grafted ones should be fine too!

Hi SteelWorker The good news is, not yet! I have seen countless examples of people who have had very little growth at 3, 4 or even 5+ months and suddenly it all starts coming together for them. Really and truly it's only after 12 months or so you can start forming proper opinions on how successful your transplant has been. The shed and slow initial sprouting are perfectly normal! Unfortunately it's just a waiting game now, but all the signs so far point to a normal and healthy procedure that will turn out fine. Of course it's a shame that nobody can guarantee that but, believe me, so far everything sounds spot on. Some people are lucky and their hair barely sheds from the moment it's transplanted, others have only really seen significant improvements around the 6/7 month mark - and plenty of people are between those two extremes. I think you have to wait at least another 3-4 months before you can start really beginning to look for definite progress - up until that point it's very easy for the grafts to sprout slowly, or produce very weak hairs. In time, everything should turn out just fine - there's certainly nothing to indicate that won't be the case! You can check out the hairloss websites on this forum from other users. Many of them don't see much happening until quite a few months after their transplant, and the common consensus is that it takes at least 12 months to really judge the situation properly. In reality a transplant may continue to "mature" for 12-18 months or more, but after 12 you should have a good idea if the transplant has worked or if there may be problems. Transplants done by good doctors are generally very successful, however, so sit back and try to enjoy watching the hair slowly but surely thicken up and grow in - 4000 grafts should make a great difference for you!

Looks great! The hairline looks spot on to me, really natural!

Hey Guys, Thanks so much for all your comments. I guess the reason I thought maybe I could identify a pattern emerging was twofold: 1) Because obviously it's already in our genes as to our final balding pattern. I know a lot of people have the slightly erroneous (though understandable) belief that when you suffer from MPB you 'graduate' through the Norwood stages, almost like you're going from a I to a II to a III and it's almost genetically uncertain where you'll end up. Whilst it may appear this is the case, the amount of hair you're going to lose via genetic hairloss is pretty much established from birth and that's how it is. Of course, the gradual recession and miniaturization makes it appear as if the hair is doing its own thing, but the result is already certain (without drugs/surgery). And following on from that: 2) Because it appeared to me that I have diffuse thinning it also seemed to me (and I could be making a massively wrong assumption here) that all my susceptible balding areas were near enough thinning already. Obviously you can't see for certain exactly where your balding will end up, because I have been diffuse thinning (rather than simply receding) I thought that perhaps it was making the extent of hairloss apparent earlier. mattj - Not that this may mean anything, but it's interesting that whilst two years ago I wouldn't have been able to establish my 'pattern', I would also say that all the thinning hair that you see started near enough the same time in one go. I didn't suffer from temple/crown recession and then started to thin in other places, I would hazard a strong guess that all the hair that is currently thinning started thinning at the same time. To that extent it has seemed to me (whether or not this bears much on future hairloss) that I never really went through the motions of temple/crown loss and recession, but that everything started at the same time! I guess, to try and put it in a succinct form, I was curious as to whether anybody has experienced diffuse thinning and then seen further thinning in areas that had remained strong previously? It just seemed odd to me, though it may be wishful thinking, that my hair has been thinning in this pattern since pretty much I first noticed my hair was thinning. I've never noticed "other" areas of my hair start to thin - within reason the pattern I have now was the pattern I noticed when I first started noticing loss about 2 years ago. It didn't "move" through my hair - it just seemed like a big clump on top started thinning and it's been that way ever since!

Sorry to hear of your problems badluck, and hope that you can get them resolved one way or another. Dr. Feller is a very well respected surgeon on these forums and his record has been largely outstanding from what I can see, both his results and also his relationship with patients. The whole valium situation in particular does not sound like something a good doctor, let alone one with the reputation of Dr. Feller, would be a part of. I'm not in a position to dismiss your claim of course, but it flies in the face of much of what I've read about Feller on these boards. Any surgery carries risks and whilst HTs are usually pretty successful a poor yield is a potential complication. A waiver is there for precisely that reason; to explain and limit the doctor's responsibility against consequences they cannot change even with the best possible knowledge or techniques. Results will always vary to a degree with an HT, but usually the degree of success will be such that even the lower end of results will still constitute an impressive cosmetic change. It's a shame this didn't happen for you. I hope you can find a peaceful resolution to this as I'm fairly confident in saying Dr. Feller's reputation on here is very high and for good reason, as well as his popularity as an ethical doctor. I'm sure he would not have deliberately or intentionally put you in a position where you paid lots of money for a procedure that was to be unsuccessful. Let us not forget it is in no doctor's interests to do sub-par work; they still have to put the effort in on the day and good results are both satisfying and important for continuing business.

Hey Guys, Thanks for the replies! Although I am going to get on the meds I'm also fairly well certain, as you've suggested, the areas that are thinning will one day be bald (perhaps not so on meds, but genetically at least they're predisposed to be that way). But the areas where the hair does not appeared to have thinned - is there a good chance they'll remain fairly strong, or is there absolutely no way of knowing what'll happen to even the parts of the head which appear to have zero thinning? Sparky - My maternal grandfather is dead now (died aged 82) but since I first remember him as a young child (around aged 58-9) he was totally bald and very much Norwood 7 (or, I don't know how medically these things work, but if not strictly an N7 then a very severe N6). How he went bald I don't know as I have no pictures of him in his 30s or 40s, but in his 20's he still had a very full head of hair and most definitely didn't seem to bald diffusely. My mother said she remembers him from her childhood as being totally bald so I'm assuming he was that way since his late 30's/early 40's. Interestingly I have pictures of his father (my great-grandfather, or my mother's, father's father) and in his 40's he seems to have hair on the top of his head (though it appears to be thinning). My mother said by his old age he too was pretty much totally bald on the top of his head. I know this sounds stupid but what's interesting about the pictures of both my grandfather and great grandfather is how low down the side of their hair the parting of their side parting hair style starts! Like, on my head my side parting starts fairly high up (if I style it that way) and most people seem to be that way. But their side partings were both only about 2-3 inches above their ears. My mother's, mother's father seemed to lose his hair in more of a IVA pattern. I don't have many pictures of him but he appears to have strong back, sides and crown/vertex hair with his thinning starting from the front and moving progressively backwards. I can't 100% verify that, but that's what the 2 pictures I have of him strongly suggest. Also, in terms of other genetic traits, I resemble much more strongly my father's side of the family. My grandather was lanky, thin and quite a "pointy" sort of person. I, like my father and his father, am stockier, rounder shouldered, put on weight easier and in the same places. I understand this doesn't necessarily mean anything, I just wondered if that makes me genetically more predisposed to be like them in hairloss as well? Anyway I appreciate the replies! My main concern is trying to establish whether a Norwood 7 is still a perfectly likely pattern for me to fall into, or whether my diffuse thinning and the pattern that seems to be emerging from that is the more likely way my hair will go? Although I understand I'll have to visit a hair physician to get an honest, informed answer, ultimately I'm trying to get some opinions as clearly if I end up an N4/5/6 sort of pattern HT may be an option and a good option, where as if I end up an N7 an HT is much less likely to be an option worth exploring.

Hey Guys, Just a quick question that I'm wondering maybe someone can answer. I'm 27 and have been thinning for around 2 years (that I've noticed, though I strongly suspect it was going on before then undetected). I'm fairly confident my hairloss is MPB but it is also diffuse (with the strongest concentration of loss seemingly at the temples and crown). The hairloss has sped up over the last 6 months which I believe may be down to a very stressful job I undertook, but that's not really my question. What I wanted to ask is how often is the "pattern" that emerges in diffuse thinning the pattern that the hair will actually end up being? For example, right now my hairloss appears to be heading towards something around a Norwood IV/V. My hairline is receding and my crown is thinning, but the "area" that is balding doesn't seem to be too large. I still have a good deal of thick hair across the sides and back of my head that goes up pretty high. I have attached a picture (taken in pretty strong sunlight through a window) that shows my loss, although I don't think (hope!!!) it doesn't look as bad a this from day to day! Anyway, to my untrained eye I would approximate the pattern of my loss to something around a IV/V/Va - perhaps at worst a VI? What I'm hoping to know is, when the hair is diffuse thinning as mine and a pattern starts emerging, that pattern is a fairly accurate assessment of how the eventual hairloss will end up (assuming all "thinning" areas become bald!). The reason I'm asking is really to know whether I can with any degree of accuracy assume what sort of pattern I'll end up as. I'm sure I'll end up going for a miniaturization test soon anyway but I wondered if anybody with a trained eye/experience could tell me the likelihood I'll end up in the pattern I am now, or whether anything could happen and the areas that don't seem to have thinned could just have easily start going too? My father is a Norwood V at 51 but his hair receded in a different way to mine (much more pronounced loss in the crown/temples but less thinning in the mid-scalp). His father is probably more of a Norwood III vertex - stronger hair in the hairline and midscalp but a fairly large bald crown (but he takes oral minoxidil for his heart which may or may not have helped his hair). My father on my mother's side, however, was a full blown Norwood 7 by the time he was maybe 40-45. His hair, however, didn't thin diffusely either and at my age he probably had more hair than me. As you can guess I'm worried an N7 is on the cards! But more than that, I'm just curious as in the last year a pattern seems to have emerged and I wondered if that pattern is "usually" how things turn out, or whether it's simply impossible to tell whether more hair from the back and sides will start going? I have rather naievely and optimistically assumed that because I seem to be diffuse thinning then all the areas of my head that are going to thin have already started and what's left will, by and large, remain that way. Incidentally I'm not on any drugs/hairloss supplements (though that looks to have to change fast, doesn't it!). Look forward to hearing any thoughts!

I could be wrong here but essentially I don't think it matters all that much. I have heard that, generally speaking, it would seem the best way to go to yield maximum grafts is to go the strip route until that method is depleted and then consult to see if FUE is a further option. Whether or not you could get 3k in strip after 4-5k FUE I couldn't say, but my thinking would be it's easier to gauge FUT first and then look at potential FUE rather than the other way around. That having been said there must obviously be cases of FUE followed by FUT so clearly there is the potential to go that route. Also, whilst of course FUE can be used to do an entire hair transplant, it would be my thinking that FUT is generally better in terms of getting bulk and density whilst FUE is generally better for refining hairlines, adding detail and essentially "polishing" up your hair (I use the the word generally since clearly this isn't a hard and fast rule). Hopefully a doctor or experienced consultant can answer in more detail but my inkling would be it's overall easier to do a major procedure(s) followed by a minor one than the other way around. I'm sure both routes can be undertaken by a competent doctor, and of course 700-1000 grafts FUE is relatively small so it's unlikely, as the previous poster said, to 'ruin' your donor area in terms of grafts left. So, those are my thoughts! Strip yields greater quantities of hair and usually a better yield, which is why it's overall still the most popular way of doing things. Because it's also the most invasive in some ways it would seem to me better to "get that out of the way" and then see what you're left for FUE rather than FUE all the way and then start thinking about if you can also take a strip out of there. But so much of it depends on your hair characteristics and genetic history. If NW6 is prevalent in your family in the last few generations then you're safer to assume more aggressive hairloss and go from there, just out of precaution. If both you and your doctor, however, really feel confident your pattern is fairly well defined or your hairloss isn't going to be severe then planning smaller procedures with more refined goals might be applicable. As the above poster suggested, checking for miniaturization might be a good idea because defining a hairloss pattern is hard to do at the best of time it would seem (although I myself am trying to get to the bottom of how well it can be established). Anyway, bottom line is your hairloss pattern will play a big part in whether it's worth having 700 grafts FUE or whether it's better to wait and have bigger procedures, maybe via FUT, with bigger goals in mind. Although it's possible to "patch up" thinning hair I think it's best to be pessimistic and aim for dealing with the potential bigger problems - in the short term that may mean immediate hairloss can't be dealt with, but in the longer term you're using your donor hair to the best of its abilities. Again, though, your doctor is the only person qualified enough to really make a call with you on what route is the best to go for.