mahhong

BMW - I think you're right to some extent. The truth is finasteride must be fairly safe in the vast majority of men. There are simply too many people taking it worldwide for some unreported epidemic to be happening. Of course, the problem is, what do we do about the guys who appear to have temporary or perhaps even permanent libido and sexual issues during and after taking finasteride? There's never much rhyme or reason as to why some people get side effects on any drug - some people get the craziest side effects from something as simple as a headache tablet. Granted these are nearly always temporary, but the point still remains. I agree that it's likely some men are probably genetically predisposed to side effects from finasteride - there is possibly some issue with the endocrine, vascular or neurological systems that perhaps finasteride accelerates and/or exacerbates. It's still a scary notion though - and Post Finasteride Symptom, whilst definitely not proven, does seem something of a reality. I'm glad it's working out for you though - you're probably in the vast majority of men who experience a fairly normal life even on the drug. The issue is finding, diagnosing and treating those men who do not seem to tolerate the drug so well.

This is a very pertinent topic for me. I started balding at the age of 26 in what was/is a diffuse NW V pattern. I'm now 32 and I've lost a lot of the hair up top. I have just enough to use some concealer to make it look "thin" instead of largely absent, and the sides and back seem to have held up fairly well (I do have crown loss but it doesn't, as yet, look expansive like a lot of people's). I would like to think my "pattern" was visible from early on and has remained consistent - but I also know there's no way to confidently say that. I tried Propecia twice; the first time for about 3-4 months and the second for about 6-8 weeks. Both times I had what I would describe as mild but persistent side effects - mostly loss of libido/erection issues. I'm a firm believer in the scientific process and was perfectly well aware this could be a nocebo effect, but ultimately I decided to not use the drug any longer. My hair has continued to thin, which is the bad news, but there would appear to be a relatively stable pattern emerging with a relatively high back and sides. I'm rapidly getting to the point where I have a decision to make now; either begin seriously thinking about starting my HT journey, or shaving down and resigning myself to my fate. I would very much like to go down the HT route and restore my hair and believe, the way it is at the moment, that would be possible. However I could of course end up an NW6 or even 7 and, personally, for me the idea of 6,000 or so grafts smattered thinly across a seriously bald head doesn't fill me with much joy. Don't get me wrong, I know even advanced balding cases can become great results, and I also understand and respect (particularly in older gentleman) that thin coverage and facial framing are more than acceptable goals. But I don't want to be spending my 30s and 40s with that sort of look - I'm realistic about what HTs can achieve but I'd need some assurance I could achieve reasonable density and good coverage, with a mature but acceptable hairline - there are similar case studies out there that I would be very happy with. I've digressed with my own personal story somewhat, so I apologise! Bringing it around to the central question, I think the bottom line is DHT is an important hormone and part of delicate ecosystem that some men disrupt with seemingly serious consequences. I do believe the issue has been sensationalized because there's millions of men taking finasteride worldwide and probably only a handful experiencing the very extreme of these problems. However there would seem no doubt taking finasteride is somewhat playing with fire - especially when you consider it is a lifelong commitment and if, at any stage, you decide for whatever reason you cannot tolerate the drug, you lose the gains or stability you have and have to start planning a contingency. Adding to the question if I may (especially because Dr. Bloxham has posted up); what do you think is a sensible plan of action for men considering hair restoration, in light of the fact some may not or even cannot consider using finasteride? Also, just to edit and add something else I've been thinking about - do you think men who take or are thinking of taking finasteride could benefit from a baseline hormone panel analysis and closer monitoring of their test/DHT/estrogen levels? I had my testosterone levels checked recently and whilst in the normal range they were low. Here in the UK between 9.70 and 38.20nmol/l is considered normal - mine was 13.9. Of course, that "normal" range is calculated from a huge variety of men - some 16, some 85, some diabetic, some obese, some smokers, some drinkers etc. As a 32 year old man in reasonably good health, I would consider mine too low and have been taking steps to improve it (lost 3 stone, go to the gym regularly to weight lift, eating better etc.). I haven't had them re-checked yet but I'm hopeful they will have improved. It got me thinking, though - clearly different men will have quite significantly different hormone levels and someone with a lower testosterone level would (so far as I can tell) also have a lower DHT level? We're living in an age where unfortunately lower testosterone levels are increasingly common for men thanks to lifestyle. Maybe there needs to be more emphasis on baseline hormone and sexual health checkups for men prior to starting finasteride - and better monitoring whilst on the drug? I'm not sure if this would make a massive difference, but it seems strange to alter a man's hormones without knowing what they were to begin with. It's a tough decision. I would love to go on the drug, even if it was .5mg or every other day - but I know it's something I have to take regularly for the next hopefully 40, 50 years of my life. Given the possible side effects and unknowns (and the fact I've experienced them), it's very hard to say yes - but what do we do in the meantime?

Lots of good advice here. The bottom line is most young people want their hair restored to how it was a few years ago; they want low hairlines and excellent density and coverage pretty much everywhere. Whilst that may be possible, it's not usually ethical. People who start balding young (late teens/early twenties) will almost always go on to bald quite significantly and once you start down the road of hair transplantation you really have to see it through or there could be trouble. If his hairline was lowered and restored to good density that could easily take 1500 - 2500 grafts (out of a likely donor supply of somewhere between 6000 - 8000 grafts). Imagine if he goes on to lose the rest of his hair - he'd have an dense hairline and nothing else, and maybe only 3000 - 6000 grafts left. It could be disastrous. As others have said, it would definitely be worth him consulting with a reputable surgeon just to see and get educated - but he'd need to understand the facts about balding and the facts about hair transplantation and donor supply/demand. I would imagine most reputable doctors would be unwilling to do the work - especially if it was lowering a hairline.

Fantastic result! I have a couple of questions if you're able to answer them, as this case may have some relevance to my own hairloss. I tried finasteride on two occasions (about 4 months and 8 weeks if I recall) and both times had mild but persistent side effects, which makes me reluctant to try again. Being a fairly analytical person there's a fair chance these might have been more "in my head" or eventually resolved, but ultimately I felt unwilling to take that risk - it really has to be all or nothing with that drug! What's H&W's position on people like myself and this gentleman? I appreciate meds are always advised but, in the case of this gentleman for example, it seems a workable plan has been developed with a contingency for future surgeries if needed. It looks like this gentleman, despite being NW5 (and possibly heading further), has got an excellent result and could deal with future loss through available donor? I only ask because, at 32, I would say my hairloss level appears similar (perhaps I've lost slightly more in the thinning areas, but I have lighter hair so it's hard to tell). Like him I have an NW5/6 horseshoe that is seeming to appear fixed around the thinning hair, but the sides and back seem relatively "high" and the crown does not seem to extend significantly behind the head (in fact it looks almost identical to this gentleman's). I'd like to think I could develop a realistic but aesthetically pleasing plan similar to this gentleman's (especially considering how few grafts he's used). I'm obviously realistic about what can be achieved, especially on more advanced cases, but I've seen a lot of impressive transplants even at advanced Norwood levels. I'd be very happy with this guy's hair, even at 33-34 - especially if there was still a fair bit of donor left to deal with continued loss or adding a bit of density and refinement on a 2nd pass. But obviously at 32 I wouldn't want to end up with an ultra-conservative hairline and very thin coverage. As I say, this looks fantastic to me.

I'm sorry but I've seen equally good (or equally bad, if you want to do it that way) documentation from pretty much every doctor on this board. This whole groupie context is a tad childish. There are plenty of equivalent sets of documentation from many of the doctors you would also appear to be "cheerleading". I don't even want to get into a debate about that because all the doctors on here are by and large excellent and I'm not into picking sides on that sort of thing. KO - Nobody gets a HT on the basis of one set of photos (or at least they most certainly shouldn't). If I was considering a doctor I'd trawl through this site and look at virtually every case of theirs that bore some relevance to my own situation, and then do the same on their own sites and other forums. I'd meet with the doctor, I'd ask my questions, talk through a plan; I'd put forward my concerns and look for reassurance there, and probably contact a few patients myself to get personal insights. To that extent, context is essential and no one case could possibly hope to tell you everything you need to know - the whole is inherently greater than the parts in choosing a doctor. No single set of photos could give you an idea of what your own experience may be like - to that extent context is essential. No single documented case proves, disproves or suggests anything. What if, hypothetically speaking, this gentleman and the doctor purposefully chose to go fairly conservative on the hairline because it was the patient's choice to style his hair this way? One could then argue the only true way to present this case would be the way the patient intends it to be shown. Or, let's even go with your own belief and say, actually, the hairline didn't turn out as spectacularly as hoped. Does that make this presentation invalid or, worse still, deceptive? As shampoo said - all HT is illusion in some way and so even if you were right and there was a less than stellar hairline lurking under there (there isn't), would that prove H&W are a poor choice? By your logic anybody side parting their hair is covering something up and all cases should be presented with the hair brushed back to get a true sense of the patient's outcome. I would contend this isn't true. Virtually all documentation is lacking in some sense. For example there is no documentation of the scar in these photos - are we to assume there's some hideous, uneven, 3/4cm monstrosity of a scar lurking under there somewhere too? Saying you shouldn't have to go "traipsing" through other threads isn't true - actually you should want to do that and it's essential to put a case into context. These threads are actually not here to satisfy your every desire, they're just documentation. They're not perfect demonstrations, I don't think anybody has suggested they were. If you were considering having a HT and you could be put off a surgery because one set of photos didn't come up to your standard, ask yourself; is that a bigger reflection on you or the surgery? As I say, it's not that you don't have a point, it's just that you have nowhere near the point you think you do, in my opinion. I've seen some fluctuations in the documentation and the work of every doctor here, that's to be expected. Over time though, I feel I've got a handle on who has produced consistently quality work and I'd have no trouble saying H&W are among the best for that. No cheerleading, no groupie conspiracy, just a lot of gathering info and being objective.

I don't really understand the whole "cheerleading" concept personally. H&W have been doing great work for years and by and large continue to do great work. They've done a lot of groundbreaking stuff and have produced some of the most "legendary" results in the hair restoration community - the sorts of results that have contributed to the legitimization of hair transplantation over the last two decades or so and pushed the envelope on what is possible. I think that's why they're popular, I don't think there's any cheerleading, it's just a recognition of good and durable work. Shampoo makes a really important point, too. I remember a case once where a man wanted his first HT to focus on his crown and vertex and wasn't too bothered about his hairline (despite it being pretty much non-existent). It was an odd choice to many people but that's how the guy felt about his own goals and the doctor, after educating the patient about the various pros and cons of the approach, went ahead with it. I'm 99% sure it was posted on here several years ago and the doctor explained the context behind the restoration. It wasn't what many people would have chosen but the patient was happy. People have their own goals. For all we know this guy wasn't that fussed about a dense hairline; perhaps he was happy to be conservative in approach or is planning a final HT to deal with it. Perhaps this hairstyle was part of a carefully considered plan to meet his goals. This is all hypothetical of course, but that's sort of the point. I do feel too many people judge the work of doctors by their own goals sometimes. As I say, if H&W were consistently posting photos where the hairline was obscured, or their documentation was erratic and half-hearted, I'd be inclined to agree with some of the concerns. But there are results on the front page of this forum from H&W of patients with their hair styled to very clearly show and make use of the hairline, so it's unfair to take one case and suggest it's indicative of some kind of cover up. These are not scientific case studies, they're simply presentations of the outcomes or progress of various patients. Yes some consistency and quality is necessary and rightly demanded by the admin but we are not talking about controlled studies here, just informal presentations of work. These are large photos, taken from consistent before and after angles, showing pretty much every facet of the work in good detail. Some video or hairline examination would be nice but absence of it doesn't warrant suggestion of hidden problems or failures - that's particularly true in the absence of us not knowing the patient or his specific goals and medical history personally.

You can see the hairline pretty well in the documentation from the first procedure - the work is fine. I cannot see that a second procedure would have done anything to diminish that. If you think you cannot see from this set of photographs that this is a very good result for 7,000 grafts then you're mistaken. This is a solid result, the hairline isn't going to look bad if the wind catches it, that's obvious. As I say, I agree with you on the very basic principle that it would have been nice to see a video, because I'm always happy to see more documentation and I like detail. However in your initial post you basically suggested the result was sub-par and you'd hate to have to style your hair to cover it up. It's pretty clear to me that's an accusation of both sub-par work and an attempt to cover up that sub-par work through some elaborate hairstyling. Personally, for a surgery with H&W's reputation, who have provided one of the best, most consistent and most detailed archives of hair restoration success stories in the world, I feel that's a little harsh and makes an awful lot of assumptions for which there is very little evidence. I'm simply contending it's unfair. Saying, "I'd love to see a video" or, "would be good to see the hairline" would be one thing, but I would suggest your initial comment was more of an accusation that the result is some kind of coverup that shouldn't fill anybody with confidence. The photos do not "scream" comb over - the last 3 or 4 photos make that abundantly clear because if the density was too low you would get something of a 'see through' effect pretty easily. You'll see in HTs with lower graft numbers this happens a lot - in fact in the patient's first HT photos you can see what I'm talking about - a sort of shingling, see-through at the very edges of the top down shots where the density and length are not quite optimal (in that case it's clearly because it's a first HT and the density probably isn't that high). I guess I feel that we as regular forum members have a job to be balanced but honest in the same way surgeons do. When surgeons post up sub-optimal, blurry, inconsistent or underwhelming photos (which rarely happens on here) I understand that they're held to account or more is demanded. Similarly everybody has a right to an opinion and free speech and that's obviously cool with me and everybody else no doubt. But I'd hate for somebody to come on here for the first time and see this and somehow get a sense it's poor documentation or, worse still, hiding something. It's fine - as I say, not the absolute best, not even close to being the absolute worst documentation. H&W have a great reputation, a goldmine of great, documented results and this one would appear to be another success story. I concur it would be great to see a little more but I think there are ways of asking for that without insinuating, because it isn't up to your standards, it's not good enough.

You need to remember doctors have no say over if or how a patient is presented - the wishes of the patient are key. Many patients will not allow photos of them to be made public, some will want their faces hidden. When patients return for followup they may have styled their hair and be reticent about having it brushed or combed - perhaps this man had a busy day ahead of him, perhaps he had another appointment or meeting. Doctors cannot demand or force a patient to be presented in any way. The bottom line is H&W have an excellent reputation and an absolutely huge archive of photos, videos and interviews of patients old and young who have had all manner of small or large HTs. This presentation may not be the most thorough we've ever seen but to insinuate it's second rate is wrong. The photos are clear, consistent, well lit and from pretty much every major angle. You don't actually know any of the circumstances of the patient; whether they were unable or unwilling to have their hair combed, whether they are or aren't wearing hairspray etc. but in light of the fantastic reputation of the surgeons and very acceptable presentation, not to mention the clearly documented improvement, I think you've been a bit harsh really. You've made a great many assumptions and you haven't really put the result into the large context of this surgeon's body of work.

The simple fact of the matter is you're inferring an awful lot from very little. You can't accuse a doctor of hiding something unless you have good reason. Maybe there wasn't time to do a video, maybe the man didn't want to be on video, maybe he'd styled his hair and wasn't really wanting to have it combed and messed up. You also seem to have overlooked the part where you can get a much better view of his hairline in the documentation of his first transplant - it looks fine there, a very solid result. I see no reason it would be any worse off for a second HT. I've seen great transplants by all the great doctors documented on these forums - Feriduni, Bisanga and Feller are fantastic, as are Hasson and Wong (and more beside). You cannot really compare one transplant with another as a whole variety of factors will play into the overall documented result - there is no objective pinnacle to hold them all up to. To say you've seen better than this case is one thing (I've seen HTs that have impressed me more and impressed me less, I'm sure we all have) but to say this is sub-par work or that there is some cover-up going on is something else entirely. All we can really do is decide whether the improvement is substantial and I'd defy anybody to say otherwise. After all you don't know what plan the patient and doctor developed, you don't know whether there's a third HT in the pipeline, you don't know whether this hairstyle is absolutely by choice and he has great density at the front. You have to remember that your expectation and ambitions are not the patient's expectations and ambitions and there may be many factors you don't know about at play. As I say, I'd like to see a video - you can never get enough documentation. But to infer this is a sub-par presentation because there isn't one is not fair. The HT looks great and for 7,000+ grafts I'd say it's clear he's had fantastic work done with clear cosmetic improvement. It may not be as good as X or 10 times better than Y but that doesn't really matter - this is good work and there would appear to be nothing untoward whatsoever about the presentation.

Good result! Come on, to the poster who said this was a "semi comb over", seriously? I can partly concur that I would like to see HD videos with brush through as well but for various reasons this can not always happen. That's no reason to act like this is a suspicious case - particularly as you can see the transition from HT #1 to #2 (and see the hairline and density more clearly in HT #1, where it was looking pretty good already from baseline). The improvement is clear - it's night and day. In addition, it must be taken into consideration that no hair transplant restores a full head of hair. Every HT is to a greater or lesser degree an illusion of sorts, so somehow chastising HT doctors because they aren't showing you HD videos of thick, lustrous hairlines and vertexes is a bit unrealistic. This guy was to all intents and purposes bald and he is now to all intents and purposes not bald, with a big smile on his face, and some great photos to illustrate how he's making the most of his new hair and styling it. Anybody who has a basic familiarity with HTs and hairline design will tell you the bottom photo (from behind, focusing on the whorl) tells you everything you need to know about the hairline density, which looks solid (literally solid - you can't see through the hair!). This is a good HT. There's nothing suspicious. Yes, I like videos and thorough road tests too, but it's unfair to suggest a doctor is hiding something when there is no evidence to suggest otherwise. And, frankly, he's a happy customer - that really is all that matters whatever anybody else thinks.

I agree with the above comment. I've never had any interaction with Rassman but know he's a very credible and respect member of the field, who has been something of a pioneer in some aspects. The examples I have seen of the work performed by him and his associates are largely very good, but I too feel there are more impressive bodies of work by other doctors. That's not to say I don't think NHI do quality work as they do, but that's my honest impression. I think they're a very safe pair of hands though, and Balding Blog is always an interesting read.

But you have to be concerned when people use phrases like, "my life has become a nightmare", or "all my hopes are broken" - especially when you see the results they're talking about are frankly really not that bad. It could just be hyperbole or a particularly sensitive moment, but if somebody really is feeling that utterly distraught because their hairline is a bit thin there are deeper and more profound issues at play. What happens if that person needs a second or third, or even fourth HT? There are no guarantees somebody will be able to keep up with their loss. I very much hope that won't happen to this person (certainly the hairloss doesn't seem extensive), but none of us know how things will pan out. I think a big part of hair transplants, ironic as it sounds, is that you want good hair but don't invest absolutely every hope you have in the belief you need it. You have to be able to place your desires into a realistic framework and accept the limitations and risks that come with entering the world of hair restoration. I keep looking at the photos and think, not only do they represent a vast improvement on where the patient started but it's also pretty decent work for 1,400 grafts - especially considering there are a few months left of maturing and thickening. In short, I think it's fair to say objectively the reaction doesn't balance up with the outcome. And that unfortunately suggests somebody who won't be able to deal with the inevitable ups and downs of hairloss and hair restoration. Sometimes yield won't be quite as high as you'd like it and sometimes it can go a bit awry or not quite fulfill expectations. Those eventualities need to be thoroughly built into your mindset - if you absolutely cannot handle them, you have to question whether it's a path worth going down. As I say, I think it's a different kettle of fish if a patient gets "butchered" and I know this patient has had previous bad experiences - but not with Rahal of course. If you're left with life changing scars or a ravaged donor area and virtually no yield, then being extremely upset and angry is understandable - but these extreme instances are rare so long as you go to a reputable doctor. I think the work here is good. Sure it might not be one of Rahal's absolute "knockout" results, but nobody can fail to see the difference and for 1,400 grafts an very appreciable cosmetic difference has been made. You have to be able to handle the expectation and reality of hair restoration, and the fact it is an ongoing journey and rarely a destination. I feel for people when I see them talking doom and gloom over results that are really not that bad - I hope this patient gets to where he wants to be aesthetically.

I hope it doesn't sound condescending, but I too would also seriously suggest counselling or some kind of advice might be useful, if you feel so desperate as a result of this transplant. To me, your photos look great. A huge improvement on where you were and a very normal looking head of hair. Sure there might be the mildest hint of sparseness at the hairline, but you're only 8.5 months in and your hair looks natural and pretty full overall. The frank reality is 99.9% of people would class you as having a nice full head of hair. Sure, you might be able to compare it to genuine non-balding men and notice a difference yourself, but this has by no means been a failure - not only because the current result is great, but because you still have another 3-4 months minimum of growth. As many others have pointed out, it seems your feelings about this transplant suggest that your esteem, self-confidence and personal perception are what need improving, not your hair. One of the biggest problems with cosmetic surgery is that many people don't put it in perspective with the rest of their lives, and instead believe a physical change will solve everything. Your hair looks natural and good. It may not be quite as dense as you would like - but that is ultimately going to be true for nearly every hair transplant patient no matter how good their results. Nearly everybody here would like a little bit more, even if they're happy with where they are. If your results had caused some sort of disfigurement or serious cosmetic imbalance I could understand - but if you could see how almost everybody else would see you, I think you'd realise most people weren't judging you by your hair anyway, and even if they were, almost everybody wouldn't see anything remotely lacking with it. You have to change yourself from the inside too, if you are unhappy or feel unable to face yourself or the world. We're all here because we want good hair, but most people also have wives, girlfriends, friends, careers, hobbies, passions and a sense of worth outside of their appearance. If your reaction to this result is so extreme, it suggests you were placing too much emphasis on your physical appearance alone. Don't become reclusive, or refuse to acknowledge yourself. That is a slippery slope and one nobody, least of all yourself, needs to be on. If you feel you are on it, you can get help and support and in time I hope you'll realise you're more than just your hair and, in fact, you look good and should hold your head up high. You have to be more than just the follicles on your head, else all the follicles in the world won't change how you feel. Next it'll be wrinkles, or body shape - we can always find something we'd like to change, but it's important to be proud of what you have. I hope you find a way forward from this, because life is too short and it's not even like the results have been disastrous. I appreciate we scrutinise and criticise ourselves and we're all capable of doing so, but you have to be able to see the real you and how looks in context. There are millions of guys walking around out there with worse hairlines, or no hairlines at all! And they do great. This is not the reason to throw it all away.

Pretty sure that's fake! I'm also pretty sure that man isn't actually bald! Wayne Rooney was pretty bald!

Unfortunately, there isn't a huge amount of cases out there to look at, let alone any full studies. You can find some cases on this site and some reputable doctors are convinced they're seeing good results with the PRP. So no iron clad guarantee, unfortunately. There isn't much data at all, though that doesn't mean the technique isn't useful. It doesn't really have much of a track record outside of a few handful of cases.

Certainly sounds interesting. Not to put a damper on anything though, I think the opening words of the article are to be heeded: "One day". Stem cell research is still in its infancy, 3D printing even more so. I'm immensely excited by both but I just can't see this type of application being anywhere close to imminent. Stem cell treatment in hairloss is still being explored and I don't think a seriously useful, consistent technique has really been refined. Adding a 3D printer to the mix is even further down the line. Also, I have very little experience in stem cell technology and research, but I'm not entirely sure "printing" stem cells solves any particular problem currently being faced. It might be a more ethically acceptable way to get stem cells, but I don't think we lack for the ability to obtain them. Exciting news all the same, but I don't think this will really be applicable for any of us in the next two to three decades. I think we'll see a lot of other techniques to battle hairloss arrive before this does. In the future though, the implications for this could be huge, and not just for hairloss. Good find!

I don't think there is any medication that can prevent balding from happening at this time, unfortunately. If there was, that would likely be a lifetime drug too. As soon as you notice thinning and a doctor diagnoses MPB, starting propecia and minoxidil early is the only current chance you have of holding on to the majority of your hair. If you start these medicines early you have a decent chance of slowing or stopping your balding for a period of time - perhaps years or even more. You will probably notice your hairloss a long time before anybody else does, so starting medication as soon as you have a firm diagnosis may mean your balding will not become noticeable. That's unfortunately the only recognised way of slowing or delaying genetic balding. It is likely that, even if there are new drugs that come out in the future, you will have to take them as long as you want to see the benefits. I can't imagine any drug that you could take for a short period of time that would stop balding indefinitely. Balding is a genetic issue, so propecia and minoxidil can only slow down the biological changes and not actually treat the underlying condition. This is unfortunately not likely to change in the near future. Propecia and minoxidil are generally considered safe and with minimal side effects. If you are comfortable with the risk and a doctor is happy to prescribe you them after examining you, that is your only real medical option at the moment. If you do experience side effects you are not comfortable with, stopping the drugs should also stop the side effects. I am not sure what is currently being researched in hairloss at the moment, but most of the research I know of is based around reversing the biological changes caused by genetics in hairloss. Some of the research is showing promise but I don't think anything is imminent. When it does arrive, it is likely these new treatments will offer additional improvements alongside propecia and minoxidil, rather than completely new ways to guarantee to stop or reverse balding. These treatments will also likely carry side effects and risks. Everything does, from surgery to taking a few painkillers for a headache! My recommendation is to look into propecia and minoxidil if you are concerned about your hair (and, of course, visit a doctor to get prescribed them first!). There are some exciting new treatments that may prove useful in the future, but I don't imagine anything being commonly available for at least a few years yet. Even when it does become available, I don't think it will be any more than an additional tool in the fight against hairloss.

Meh... I kid, of course! Wonderful result. Natural, wonderful coverage and seriously impressive in terms of the ambition. Absolutely fantastic!

Thanks, Blake

The word cure is, in many ways, one of the most unfortunate terms in the English language. The problem with it is that it conjures up the idea of a singular, catch-all treatment that can completely reverse or stop a particular medical or biological problem. In reality, science has "cured" virtually nothing. We haven't cured diabetes, or heart disease, or infection. I don't say this to be pessimistic, because we have made some problems treatable to the point that they are virtually non-problematic. Infection is one of those; it's still as deadly as it ever was but in the overwhelming majority of people it is controllable and we win the fight. There are always a few who succumb, mostly due to other factors such as age or co-morbidity, but we have made tremendous advances. I am unfortunately knee deep in research about cancer at the moment (one of my family members has it). It has put hairloss into perspective (though I'd still like to see it dealt with!) but it has also made me realise that the term "cure" is equally mistaken in that field. Cancer is not curable, yet every day many sufferers go into remission, often for years or even for the rest of their lives. The human body and disease is almost infinitely complex. I would hazard a guess that virtually nothing can be "cured" in the sense we can develop something that, in one fell swoop, guarantees complete cessation of the problem. But, as one of the oncologists I was studying said - cancer will become manageable and will probably go out not with a bang, but with a whimper. There won't be a day when we can hold up the elixir that cures cancer, but as each therapy becomes refined, added to, more targeted, combined with emerging therapies, people with cancer find their life expectancy and chance of remission increase by months and years and, hopefully in the not too distant future, increasingly large amounts of cancer will become chronic illness and not imminent death. Back to baldness - that too will go out with a whimper and not a bang. There won't be a cure. We are talking about a mind-bogglingly complex biological problem. It involves genes, enzymes, proteins, environmental factors and much more. No drug will deal with all of those at once, straight away. Being an optimist, though, I do believe that within the next 10-20 years several new treatments will be developed that can be combined with existing and emerging treatments to create a regimen that will deal with the major factors of balding - giving men the chance to hold on to seriously impressive amounts of hair. That, perhaps combined with surgical restoration on a smaller scale (not to mention the cloning, stem cell and other treatments going on in the surgical field) will mean that all therapies and surgical options combine to make, in theory, balding no longer a problem. Will it be a cure? No. It probably won't work for everybody. Even if 999 out of every 1000 men see great responses, there will be somebody who doesn't get the results they want. But will balding become increasingly treatable, and the options increasingly plentiful? Absolutely. My advice is to not wait for a "cure" but research a regimen based on current therapies and stay well tuned in to what is emerging from trials. If you wait for that pill that will regrow every follicle on your head, you will be disappointed. Balding and cancer share a lot in common in that respect (I don't mean that morbidly). Neither are, strictly speaking, "curable". But in the same way there are cancer survivors and people battling successfully every day, I see men on these forums who were bald and who are no longer bald. Some are not just no longer bald, they have impressive heads of hair. The chances are they got there through a balanced combination of the best available treatments, surgery and the occasional sprinkling of good luck or unexplained fortune. That's just how medicine works. I am becoming increasingly wary of the word "cure" in any field. A cure rarely exists, but a well-researched regimen and balanced approach can be indistinguishable from a cure in many diseases and problems. Sometimes it's not cheap and sometimes it's not easy, but it's often doable. My advice? Remove the word cure from your head - it distorts thinking. But do live in the hope that one day balding might be more of a nuisance than a condemnation. There will be options - perhaps not always an easy, single option, but an array of tools that will get you where you want to be. Many of those tools are already out there and some look like they're about to land, so don't forsake them in the hope the cure is around the corner.

I agree. This guy looks to have something around 200cm2 to fill up and at 3,800 grafts that averages out around 19g/cm2. I would imagine that was concentrated in the frontal half so it didn't spread evenly but, even then, the density is not going to be brilliant given the space needed to fill. As such I'd say the results look pretty solid and, as a previous poster mentioned, stand up well on their own. A second pass will hopefully be able to near enough double his density in key areas and that should give him a very good head of hair, although even at the moment it's looking pretty decent considering the size of the case.

That's a good point, it might not be the Acell that is responsible. That having been said, for something that is supposed to promote healing and be of significant benefit in that area, you wouldn't expect this to be happening if Acell was a consistently good, useful and cost-effective addition to hair transplantation. I'm not up with the current position regarding Acell, but it certainly seems that overall it hasn't provided significant benefit in the hair restoration field. I remember 2-3 years ago listening to Dr. Hitzig (and a few others, in fairness) talking very positively about Acell, almost going so far as to hint it was going to be the key to unlocking unlimited donor by using it to promote total regeneration in partial follicles. That position quickly shifted to having more realistic benefits in limiting scar tissue and promoting growth, but it would appear overall it's not even really doing much of that. Dr. Rassman's verdict wasn't overly enthusiastic and the results that I see popping up on here have been mediocre at best. As I say, I have no idea where Acell is currently viewed in the whole restoration industry, but I'm sorry to hear it hasn't been a success for the OP.

Well, it's useful because it happened. It is not a common case and the chance to understand what motivated a respectable doctor to perform the procedure is interesting and insightful, in addition to how the results bear up over the months and years. In addition to the relative rarity of 17 year olds who will be seriously considering a hair transplant, I also think you underestimate how sensible most of them would be. This case is in no way suggesting it's normal and acceptable for any 17 year old to go and get a HT. It's pretty clear the family were involved and the doctor felt there were circumstances here which warranted the surgery. The whole point of these forums is to show all sides of the hair restoration world in an honest and transparent way. No case condones or condemns anything - they are simply documents of an event that happened and the results over months, often years. Unethical doctors aside (they will unfortunately find their victims, of all ages, with or without anybody else's involvement) the overwhelming majority of 17 year olds who go to see a doctor will continue to be turned away. This case isn't going to represent a sea change for either doctors or patients, but it happened and we should be thankful we get to see even the most controversial of surgeries. That's my opinion, anyway. We shouldn't be so quick to censor the work of reputable doctors because they don't fit the status quo of hair transplantation. As I say, I have my own doubts about how this case will pan out, but that makes it all the more useful that I have the chance to see it for myself. The doctor made his decision and this is a documentation of how that decision pans out - as transparent and honest as it can get.

I think it's a useful case to post up, even if it is a divisive one. Dr. Mohebi made a choice to go ahead with this procedure and the case is interesting because it's relatively rare given the subjects age and background. I for one am also very much unsure about this procedure, but we have to defer to the doctor really. Only he knows the specifics of this case and it would be rash to call his judgement wrong. To that extent, this case is a useful one to document and keep track of, making it all the more important these sorts of cases are referred to publicly. Dr. Meija sums it up well I think. Hair transplantation is increasingly prevalent, increasingly effective and, therefore, the types of cases coming forward are increasingly different. Transplantation on a 17 year old does seem a risky decision, but that does not guarantee it will be a failure.

It's funny. I tried browsing through the cases today and noticed Rahal's name was missing. I was shocked and even considered that he might no longer be recommended which, in light of his amazing and consistent results, seemed utterly ridiculous. Glad to know there is a logical explanation, but dismayed to actually find out what that explanation is! Hopefully the continued stream of posts from satisfied patients of both Rahal's and Simmons will keep them present on the forums. I also hope that law gets thrown out! Utterly absurd.