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DrTBarghouthi

Elite Coalition Physician
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Everything posted by DrTBarghouthi

  1. DrTBarghouthi
    The way I see it is that anything that punctures the skin with a punch or a knife should be done by the doctor. So In this case, extractions/excisions and incisions. What matters most is trusting your techs to do the part that they are given the task for. If Techs are not then the doctor should technically do everything.
  2. DrTBarghouthi
    Thank you for the mention @JohnAC71 Can you kindly share some photos here when possible?
  3. DrTBarghouthi
    Dear members, This is the case of a 30 year old with NW stage 3. He underwent a hair transplant FUE procedure on May 30th 2020. The surgical details are as follow: Date: May 30th 2020 Total grafts: 2019 FUE grafts Hairs/Graft avg: 2.18 Singles: 425 refined singles for the hairline Meds: Finasteride 1 mg alternate days. Punch used: 0.85 mm hybrid punch Recipient sites: 0.9 mm and 1.3 mm Sapphire blades. 6 months results: (regular updates to follow )
  4. DrTBarghouthi
    Nicely done doc. Massive improvement.
  5. DrTBarghouthi
    Thank you very much Don for your kind words. Yes unfortunately the borders are now closed with the covid situation I believe. We had several cancellations from there and other countries. Hopefully things go back to normal in due course. I hope you will be able to get a good improvement.
  6. DrTBarghouthi
    Yes benzodiazepines help a lot with anxiety. Usually given in the morning or on the way to clinic so as to calm the patient down.
  7. DrTBarghouthi
    It seems like the sides/temples and also parts of midscalp. The front from photos is hard to assess. May need some density to it but from what I see, other areas need priority.
  8. DrTBarghouthi
    Hello sir. It is quite unusual as we just had such a similar case yesterday. We had a very similar case yesterday. The good thing is that you only have few multiple grafts in the hairline so these can be hidden or recycled. The sides is something that we tend to remove a lot. I dont know why but some clinics seem to believe that this curve has to be done and I just dont understand why. You will definitely need density in the frontal zone. Here are some fresh photos. Ofcourse a repair always has you making some compromises as to the hairline height and design etc. It's not like when we design it from scratch. So essentially, we removed some bulky grafts from the temples and hairline and recycled them. We did more irregularities in the hairline and did a fresh set of 350 single hairs in the entire hairline. We then added density in the frontal zone, and crown. Donor was mediocre but we were able to extract 2200 grafts.
  9. DrTBarghouthi
    Hello, Are you on any maintenance meds? It is very important that you are. Given you are 30, any crown work at this stage has to be avoided or at least confined to certain areas of the crown only. I personally would avoid the crown because it does seem you have some lateral hump involvement- although early. Maintenance is a must and invest the grafts in the frontal, temporal and MS region for now.
  10. DrTBarghouthi
    True. A 1.25 mg a day has been an acceptable dose for many years especially at times when propecia was the only 1 mg drug. Nonetheless, there is no need now to go through the hassle of chopping tablets into quarters - which is not an easy job. Try to source a generic 1 mg. It is around 10-15 USD for 30 tablets here. This can possibly last you two months if you go with alternate days.
  11. DrTBarghouthi
    That’s a good question and I don’t think there is yet a clear evidence as to whether the side effects are less on such dosing or not. It is mostly observed and probably relates to the fact that the effect of DHT reduction in the scalp lasts longer than the effect of the medication in the blood. If sides are related to a certain level of drug bioavailability in the system then a reduced value will lead to less sides, while maintaining a healthy level of reduced DHT excretion around the follicles.
  12. DrTBarghouthi
    I'm sorry. Can you provide more details regarding your enquiry? Age? Family history, medications for hairloss that you take? Any previous transplants? Thanks
  13. DrTBarghouthi
    works well. This is almost the recommended daily dose usually
  14. DrTBarghouthi
    There is some drop in efficacy every 5 years but even so it still remains more effective than anything else that is approved. As far as I know, the alternate days regimen is not yet well studied in terms off full effect but we know it works. I see excellent results on it from my own group of clients. I have been advising alternate days for around 2-3 years now.
  15. DrTBarghouthi
    But you probably had lidocaine in your first and second procedure too apart from the emla. I mean injectable lidocaine.
  16. DrTBarghouthi
    I don’t believe that was related to your G6PD. As you may know, the prevalence of this in my geographic practice is quite high, possiby the highest globally. Lidocaine is a very popular anesthetic. We would be running with similar problems as the ones you had quite a lot if that was the case. I do still believe that you had a harder time with the second procedure for some reason and that made a physiological drop in your blood pressure by the sound of it. Staying hydrated during breaks and eating a good meal often helps. Regular monitoring too.
  17. DrTBarghouthi
    I totally agree with these two limitations. Andre Agassi highlighted it quite well in his biography when he lost the french open final because his hair system wasn’t well attached. At that time no one knew about him wearing a system. There is an ongoing cost too which I agree with. So far I only see partial systems in low priority areas and with limited donors as a suitable option to offer for some patients.
  18. DrTBarghouthi
    I do favour good quality ,custom made systems. As long as they are of a good quality in terms of the base and hair and the general attention to detail in manufacturing. I really love the combined approach. If someone understands the level of commitment that a system requires/ ongoing costs/ etc and is happy with all that then I literally think that miracles can be done. There are areas that can be completely left for the system (crown/ depleted donor for example) and the rest can be dense packed with a HT. As you mentioned, the limitation in my opinion so far is the hairline. Looks too thick and dense and most people might not like it. But the combination approach solves this nicely.
  19. DrTBarghouthi
    Sorry I missed the last part: you can group singles in the same slit. You sort of double up 2 single units in one openning. We do that when we have a higher percentage of singles and and area that needs bigger grafts.
  20. DrTBarghouthi
    I think a similar approach was employed by a clinic in Amsterdam that I came across that claims harvesting partial grafts. I had clients who went there but needed so many planned procedures to reach the desired density. I don’t think that was right. They all eventually had procedures with us and see that traditional HT delivered a more visible result.
  21. DrTBarghouthi
    It's hard to know really. Hopefully the science will be more understood in the next 5 years.
  22. DrTBarghouthi
    I really hope hair "cloning" kicks off in the future. No need for any combinations or BHT. Just extract few grafts, replicate and transplanted on demand. Happy days.
  23. DrTBarghouthi
    Hello sir. Please see the answers of each point made above.
  24. DrTBarghouthi
    I'm guessing around 2000 from donor and 800 from beard. It is more of a guess as the photos are really not ideal for deciding especially with the lighting.
  25. DrTBarghouthi
    It will give some benefit. Below the statistical range but will certainly do.
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