jjsrader

Agree - I was on 15% and then 30% creams from Murray Avenue Apothecary Compounding Pharmacy vis a vi medicalwellnesscenter prescribing physician for many years. I switched to ORAL Minox and ORAL Spriro in May of '18 two doses per day - there is no comparsion between topical and oral systemic results. Taking the pills though has potential side effects at higher doses; I would not recommend this for the majority of male hairloss sufferers. Better to stay w/5% foam in the long run.

C'mon man! Use logic. Unless you were fat and lost alot of surgery after strips - 2 strips in and your scalp has less skin in the same area. Simple as. I would guess your doctor can give you an accurate guess w/another consultation. Alot of guys can do up to 3 strips - some are done after 2 strips - and a minority have to be done at 1 strip. I've had about 8,500 grafts via strip. My last surgery was March '17 - it streched in some places. I'll wait 'til near end of year and see if I can get it cut out and get as many grafts harvested out of there. I'll have staples done this time. I don't want the scar to stretch this time if I can help it. It might be FUE time for me. I'll find out when I do consults in late fall '19. peace...

Laser is an adjunctive therapy and works best when your remaining hairs you are trying to 'revive' (lengthen hair cycle and increase overall/length of thinning hair) are still alive and have diffuse hair loss. It works best w/oral medications (dut/fin, loniten/spiro). If it works for people it usually improves a females hairloss quicker/better than men due to hormonal interactions and females have overall higher quality density/hair caliber than men. I've written before that it works better with 5 to 6 uses of about 22 minutes per week. Also, one really should use 400+ diodes for better overall coverage. Finally, it is my experience that from month 12-15 I started noticing the subtle yet visible results w/more coverage of my existing hair (subtle but visible). To the untrained eye - very little difference. To the critical eye a modest improvement. That was all I expected (at best). My overall hair quality is better all over and just a bit of thickening of weaker hairs. It's really not for 99% of men unless you like putting a laser helmet on your head 6X's per week while you are in your recliner and can schedule consistency over time (also - I don't recommend ever using if other people are around). You will be mocked relentlessly (reason I keep it in a drawer next to my recliner & only use it alone). peace...just my personal experience and I'm 52 - so I'll take what I can get 'cause I've been balding since age 21 (and have had many surgeries and use alot of meds progressively stronger over the decades).

I wish all photos were done w/a camera this good - clinics should be using only professional-quality as well. Nice! It's worth the 5K-15K on a good studio-quality setting w/good cameras/lighting/consistent backdrops, etc... at each clinic.

Consult w/the most respected plastic surgeons in a major city or teaching hospital - this is not as uncommon as you think and a full brow lift is probably not the ideal answer. Maybe there are some new developments in this type of surgery? Good luck!

Regardless, you waited 'til your mid 30's - had very little miniaturization (as you noted) and got a great yield vis a vi strip and yea, Konior combines the ART of a hair transplant w/the science & has a very good eye for his craft. How many grafts for your strip, btw?

No problem. If you are really into the whole thing you could even go to a makeup artist w/all your 'gear' and see if they could give additional tips - although I doubt it. It's a fine line (as you know) between too much and not enough and keeping the natural sheen/color/light-diffusion under the most varied lighting conditions in one's day to day. Once you do that - you've reached the endpoint. Frankly, 95% of the people on the street don't notice subtle details like we do as hairloss experts. If you introduce something 'new' to your concealer routine - the only other advice I have is to use less than you think you need for several times and see how it really looks throughout your day. Better to be a bit cautious as you know than overkill. Every now and then when I do use my full arsenal of hair products/concealers and such - I look at mutliple angles in different lighting environments (before I leave my compound) and I say - nope. Be more subtle today. I don't use everyday (usually 1X per week when I'm a very light color) and about 6-8X's per month w/dark hair. I sometimes think about having expensive hair added to my own when my hair is long - but that's just ridiculous (2-4 hairs attached to single follicular unit hair groupings, advanced yet very light 'weaves' and all that) and is a market that is 99% female oriented.

Your natural hair caliber and wave are extraordinary for a male at age 40 (your native hair). Frankly, I'm pleased you are so happy - but you're results are not typical. They are so far outside the norm from a statistical standpoint. I would put it at less than 1% of hair patients could possibly acheive your look - maybe those Spanish guys and dudes w/insanely thick/wavy donor hair that is the best of the best (comparitive to a woman's hair diameter and natural density). Also, as a Norwood 2 who then had a hair transplant (considering how likely your donor hair's exceptional quality) - your doctor really did a great job cherry-picking the best fue's - after all he could use your entire donor area and be very picky 'cause you didn't have a large procedure, right? Results like this used to trigger me - now I take the high road. Rock-star hair my man. And the hairline will serve you for a long time. I'm sure you know all this and are grateful for your doctor's excellent work and your proactive research that most people don't fully appreciate. Cheers!

Awesome update! Well, as experienced clients of multiple surgeries know - even at times pretty damn dense hairlines (like the kinds H&W can pack upon request and w/the right hair characteristics) sometimes need tweaking after a 1st surgery. Very very few surgeons will ultra-dense pack on 1st pass - even w/really good donor hair (thickness/caliber/texture) that original poster seems to have. Dr. Nader gave him a good base and now he came back for more density and refinement. Hope it gets him satisfactory results. It's the rare bird that gets ultra-refined and real density results in a 1st pass - it happens. Just not as much as we all hope for. I'm glad original poster provided an update. I think he also has a really good SLR camera he uses for photos (see his 1st thread). I would say his original pass resulted in about 30% of normal density. Now he's trying to bump it up to near 50% which will give him the 'appearance' of a nearly full head of frontal hairline that flows into his temporal corners that meet his native density hair on the sides. If growth survival rate of terminal donor hair is 80% or even more - I think the results will be excellent. Don't know if Dr. Nader inspects each graft after extraction for quality - but poster has what looks like better donor than most and he is very young - w/stronger genetic healthier and younger donor hair. So should get a good bang for the buck for sure. I'm curious if Dr. Nader gave you a density rating of recipient area? How many follicular units per cm2 for this frontal 'zone' and line leading into temporal peak areas. Good growing!

If you wanna' get really OCD about it I would (when hair is wet) apply just very small amounts of Dermatch (diffused w/water) w/fingertips or applicator brush from your mid-vertex blending forward to near your hairline. I find fingers work better than applicator on scalp if you separate your hair for each small zone going forward. This would cut the contrast from your frontal hairline 'zone' and soften the transition from your frontal hairline of transplanted hair and create a bit of a shadow effect into the hairline zone just behind your frontal hairline. Some girls use mineral-based eyeshadow powder w/brushes to do the same thing or use root-zone touch ups. I find the powdery products on the scalp are too sensitive to clumping or patchy spots. So Dermatch is really the absolute top product for larger zones. You could use a minor-touch up of your very frontal zone (I'm being very picky 'cause I also would like a bit more in the very frontal zone to break the contrast of darker hair w/white skin) 'cause you have visual gaps. Probably only us transplant guys are this critical of your frontal hairline. At regular glance I would be totally checking out your eyebrows and wondering what hair paste/clay/wax you were using to get nice clumping high off your scalp w/your longer hairs. Overall, your use of Caboki is top notch and the way you are doing it is sneaky smart mixing w/other thickeners and then going for product that gives your hair a bit of natural sheen afterwards. Even fibers like Hairatin (I consider this the best fiber product) need a bit of blending that is very subtle along w/other products to get the best results - you are doing that exact process, imho. Just my .02 cents. I was a licensed cosmetologist whilst I attended University to get my degrees, as was my older brother. That's just my critical-eye perspective for a guy that wants to go all out.

I change hair color frequently - sometimes using demi-permanent to go very dark (blackest black) - then sometimes all the way back to permanent hair color (using an experienced colorist) of sandy blonde/lightest blonde. Dermatch has 'discs' for all the base colors and w/really good brushes - that's my base (if I'm doing my hair and feel like putting some time in). After that I'll use a root plumper plus that lifts and separates my hair at the scalp level but doesn't overdry. I find this gives a bit of hairs at the very root line a boost that Dermatch can sometimes overwhelm. After that, I'll sometimes use just a pinch of Prothik as a spray (but rarely). I've tried about 10 fibers in the last 20 years (mostly out of boredom) - the light-diffusing properties (doesn't give off typically brashy 'off-color' overtones other fibers do) of hairatin are the best I've ever used. I rarely use it but if I want a super boost; it's the most natural. I find all these products work best w/proper volumizing routines (shampoo/conditioners/mousse/root plumpers/finishing dry sprays/dry pastes & styling creams for thinner hair volume & heat-protecting products w/a blow dryer etc...) and really learning how to blow dry the hair properly for different purposes (if applicable). Finally, I use deep-conditioning oils and treatments every week to keep my hair very soft and shiny and healthy 'cause all the thickeners can be a bit harsh on hair at times - even though when my hair is lighter I basically don't use any fibers or mineral-based scalp concealers. Just keeps my very fine and bone-straight hair strong & healthy looking. My day to day? About one night a week just a blend of dermatch and high-end eye shadow blends (w/the proper brush) to minimize the color of my scalp contrast. I have about 45% of my natural density in my frontal hairline and transition zone & nearly 50% thru frontal 40% of my scalp - going back to crown and the last part of the back vertex I'm probably at 65-75% of normal density. In my crown probably 80% of normal density. So, when I'm sandy blonde and/or lightest blondest blonde there is very little scalp contrast (I'm extremely fair/white skinned) - I might use some combination of the above every now and then but not on the regular. With darker tones, more frequently, maybe 6-8X's per month. Like alot of transplant guys, us very picky guys know the best people to cut our hair due to the surgeries we have had & are quite knowledgeable on products & care that gives us the biggest bang for our bucks for this silly vanity we spent so much money on. I'm thinking of doing SMP or Mark Weston for 'base' down the road but since I change colors I'm not sure which 'base color' is neutral enough for very dark to very light hair and in between? If that even exists. At the gym, nothing & I wear a bandana or large sweatband or hat just so I can just concentrate on working out and not give any attention to how my hair looks. 💲🙄

Do alot of research on hairpiece forums. I would just get creative and use a tiny hairpiece w/crown whorl details and make sure the hair is non-processed w/cuticle intact and matches your hair diameter and 'wave' nearly 100% - w/a perfect color match the blending would be nearly seamless. Maybe even a very thin/fine partial w/less density that you bump up ever so slightly w/Dermatch or very subtle amount of hairatan fibers (they deflect/diffuse light best when blended w/scalp and real hair). Good luck w/your eventual decision. Or you could get another crown surgery - say 1.5K grafts and work w/like a 20-25% of natural density and use concealer products that help w/the 'base' you've established.

Dude - w/your native hair caliber and density - I would think you are near 10K availability for FUE unless your head is really small. You could literally take fue extractions from a huge donor area over time as you get older and keep up w/your very slow hairloss.

I apologize and will let this thread take its long & winding road forward. Okay, delete my post. I'll try and keep my comments objective going forward. ty. peace...

That was me; you are correct sir! Always remember, physicans are real people too - we are talking about difference in doctor approaches in the end.

H&W Asian techs are MILES ahead of Erdogan's techs - it's not even close. 1) Better intelligence & hand-eye coordination 2) Longer/better more experienced training. 3) I am sure the average age of H&W techs is older and I am 100% sure that the vast majority of hair techs employed by H&W have some medical background (Nurse, etc...) 4) I guarantee H&W techs interact real-time and in so much better granular detail with each doctor. 5) Finally, H&W took some of Erdogan's best of the best initial talent - had their techs interact and now H&W FUE is top 5 in the world. Simple as. -------------------- Erdogan's approach now is ludicrous. Mr. 50K gross per day and he chills in his 9 monitor room 75% of his day. Have you noticed how he dis-engaged from the forums? He'll take the hits here and expand his marketing (don't get me started on his marketing youtube videos from years ago) and hire more 20 year-old Turkish girls w/no medical background and limited training and keep ballin'~~ Some shameful ethics imho. It's a money grab now and he is looking to optimize his profit model w/the least amount of personal involvement as possible. It's a factory w/average results - and I suspect a lower-than FUE survival rate than top-tier FUE surgeons. Oh, the techs who are supposedly examining each graft under a microscope probably aren't even doing that 100% of the time or correctly. Finally, although I believe Erdogan's incision reception sites are angled properly, those techs are just banging those grafts in there as fast as they can while they laugh and listen to music and gossip among themselves in a foreign language. It's a shame. Had he stayed intimately involved in 1 surgery per day, used his most experienced techs (2 or 3) that are the best of the best and he had a bit more artistic approach to hairlines - this guy could be charging $4-6 USD per graft or maybe even more and not have to be a factory. Turkey really is a moneygrab for 99% of the surgeons there. Erdogan is building up his wealth quickly once he saw he could automate his earlier work. That, to me for a physician, is laugable.

Hey Legend! This patient has extremely fine/thin-caliber hair w/a big skin/hair-color contrast and a massive family history of alot of balding. He's going to be a NW5+ or NW6 - so it really doesn't matter if he wants to proceed slowly over time. If his Artas harvested grafts survived just like other FUE extraction methods - what difference does it make? I think Artas even has small mm punches now - down to .7 and .8mm. I recall Arocha, H&W and other top clinics buying the machine - although I think they realized eventually it was ALOT more work for them in the long run than extracting via mechanized fue punches (AROCHA) or manual w/technicians doing the work (H&W). Also, this doctor is showing a small procedure on a guy w/alot of balding already and less-than desirable hair characteristics - so apples to apples I always say. Many of the smaller FUE procedures we see on this site are very young guys w/'in-their 20's' hair qualities and superior donor quality and very exceptional hair characteristics (caliber and wave). I would consider Dr. Rosanelli a 'boutique' surgeon - and I bet he does too. His career is based on conservative work that he feels should hold up 20-30+ years over time. I am sure alot of his clients are high-net worth and even if you are worth mid 7 figures and have a family history of alot of balding and you hit your 50's and 60's, if you went HUGE young and blew out your donor, with the progressive nature of hairloss that intensifies as one gets older (40+) - those guys don't want to have to explain visible excessive fue scarring and would rather be a bit more subtle in the way they present their hair restoration surgery over the decades. I don't think alot of young guys understand that completely. Dr. Rosanelli's primary client base is most likely the wealthiest guys of N. California fwiw. I understand the doctor's attitude towards erring on the side of caution and believe it or not alot of guys that are subtle don't mind smaller surgeries just so that virtually no one will ever know. In high-net worth society and corporate life - just the stigma of noticeable plastic surgery/hair restoration can trickle down and these types of guys are trying to avoid that (methinks) as much as possible. A complete 5000 graft or mega-session w/a funky shaved head and downtime for many of these guys - it simply can't happen. Too much $$$ on the line imho. Many probably won't allow the appearance of excessive vanity - people that work w/and under them could use it against them. I consult (work only-in person quarterly) w/alot of high-power attorneys in South Florida, East Coast & some from Israel and China. Not a single one of them would ever consider having a large procedure at one time. Two of them are using the incremental approach over time very discreetly. Since I have had many surgeries but do NOT interact day-to-day in an office setting nor do I have a social circle of high-net worth friends; a few of the attorney's ask me in great detail about what I've done over the last 29 years - but really aren't considering a cosmetic procedure seriously. Normal everyday Joe types - it doesn't effect them quite so much in terms of sheer economics & a upper-echelon social circle. Of course some guys overcome bad work (ALOT do) and just say screw it and live their lives w/bad work regardless. Just my perspective.

With just a bit of dermmatch or a sprinkle of hairatin hair fibers - he could look near normal density. Dr. gave him back the foundational aspect of the crown 'whirl' - nice work! Add a bit of volumizing shampoo/conditioner and a volumizing mousse and finishing spray and that crown would look pretty normal. Always remember w/the crown you can drop 5K of grafts and you may not achieve the illusion of normal density. It's a black hole for grafts as they say. Looks like his hair is lying flatter in the after photo and his hair is more forward oriented than in the before shot. Sure, another 2K of grafts would look even better - that's 3.5K grafts for a small visual area but proportionally larger surface area. He looks like he has wonderful hair characteristics though - which is a good thing.

This thread is probably the best thread on the entire website - it meanders all over the place at times. But I really don't care. Everyone gets a say so - as it should be. And Erdogan keeps pumping out 50K+ per day gross revenue and doesn't engage here. It's a very good case study and throughout the thread many types of surgical approaches (pros & cons) are discussed. Thread delivers page views for sure!

Systemic absorption (oral dose) is MAGNITUDES more effective than topical. Case closed. If you ever took ORAL minox (Loniten) vs even pharmaceutical-grade (and tested/verified) 30% minox cream - again. NO comparison. Topical is unfortunately a poor alternative and there was some hype but I would guess if you asked the most trusted surgeons out there if they have good feedback on topical dut - if they are NOT affiliated w/making any extra money off of prescribing/selling it to you; all would tell you topical is better than nothing but in no way compares to systemic absorption (oral dose). Oh, and generics are a no-go for meds. One should always pay up for name brand if using oral meds (which you are not). If you really understand generics in the pharmaceutical industry you would realize that there can be significant differences in quality/purity/efficacy. But how would people know without controlled double-blind studies? Simple. They wouldn't.

This is why you go to long-standing reputable impeccable surgeons like H&W, Konior, Shapiro and a FUE doctor in Georgia who can't be mentioned here. With these particular surgeons in N. America - you get 100% straight-up knowledge and they have spent 20+ years building up their reputations and employ rigorously trained personnel. These top-tier surgeons know EXACTLY the major & ever-so-subtle differences between FUT & FUE and create a custom/boutique-like plan for each patient. Specifically the meticulous cherry picking during FUE is vital if you are stripped out or only need 5000 grafts or less lifetime. Frankly, Legend's hair quality from donor absolutely sickens me - but in a good way. A better choice than the other FUE surgeon he was considering w/larger FUE extraction 'holes.' Now he'll look good for his wedding and in 2 years his wife won't even care and he probably doesn't need another surgery for many many years if he stays on his meds. Hasson's hairlines are very very good and he can even 'fine-tune' it if one is a perfectionist.

Looks like you have very fine hair. Give it time. It is my opinion that those w/thinner diameter hair & straighter hair take longer for initial shock to wear off and begin the growth process.

18 months is 18 months. You can either spend the money and have it corrected properly by a very experienced/caring doctor that knows FUT/FUE & repair (like Shapiro Medical Group or another clinic that is experienced in all types of hair transplantation and corrective procedures) and then can live the rest of your life properly or Go back to Turkey, the machine/factory of Erdogan will NOT take out your grafts and pack in a bunch more (mostly by his techs) - sure they may use microscopes now, but that might be just another promise and they don't do it consistently. He's bullshitting you and you know it. You are a number/paycheck to that guy. You need at least 50% of the incorrectly angled grafts removed and many of the multi-hair grafts at/near frontal hairline zone taken out. Don't go back to Turkey - this guy's operation is purely a business to him at this point. Ramping up to 8 surgeries a day - probably 12-16 a day w/n another few years so he can retire sooner. Good luck.

If you want to do this right you can probably have the 1st two rows fue'd out and microscopically dissected into proper follicular units and placed back in behind the hairline. Maybe it takes 3 procedures every 4-6 months? I would consult w/Shapiro Medical Group guys. They know what they are doing. You'll begin to look better once the big plugs are mostly gone. Then when enough healing has occurred you can dense pack a new hairline (might take 2 more sessions). In 18 months you could be almost done. I would begin now and mentally prepare. It will be worth it in the long run. Don't go back to Turkey - you will regret it.

FUE out the 1st 2 rows in two separate procedures. Have a top-notch clinic re-pack your frontal zone properly. This is 2-3 surgery process.