DrTBarghouthi

This depends on your actual condition and your HT result/ density. Each person can have different final results depending on his original hair loss condition and the number of grafts he received. Light will always reflect off the scalp even with the slightest gaps. It should not show that it is transplanted but it may well show less dense than your donor for example in extreme light conditions.

I personally see no role for mesotherapy in male pattern hair loss. Same goes for PRP in my opinion but maybe with some weak evidence emerging here and there.

@fabofly Best of luck with your Ht. My advice would be : 1. Delay the crown area. I am not sure what your age is but crown will require a considerably large number of grafts. What is potentially ore dangerous is if the crown expands further and then you are trapped to filling it with another procedure and allocating the grafts to chasing that pattern up. Not the best value for money. I am not sure what age you are but even a slight enlargement in the crown will require a good number of grafts to repair. 2. Use the 4000 for Front and Midscalp. Once you're happy with this and the pattern is maintained, you can think of any further surgery . 3. Make sure the team has experience with your type of hair ofcourse. I personally have patients with your type of hair consent for both FUE and FUT at the time of surgery, since if the curls are too tight regardless of the punch we use, an FUT is at times a safer option. Ofcourse, provided you have no documented history of keloids. Best of luck

Temple point reconstruction is best done using refined single hair grafts and an almost flat angle following the natural direction that yours have. I would not recommend body hair for this area of the face.

The most important thing here is that lots of multiple haired grafts were used in the hairline. This is definitely not acceptable and does not adhere to best practices where single grafts only should go into the transition zone of the hairline.

Thank you and all the best.

Happy New Year to you all. Thanks for posting more pics! Yes it is obvious that the density is low and that the angles and direction of hair is off too. A good repair would be needed. You will need around 3000 grafts considering the area that needs coverage. You might be able to camouflage some of the more odd angled grafts or even extracting some and placing them back in a more appropriate manner. Both H&W and Dr. Rassman are excellent surgeons ofcourse.

Hi @George27 it is perfectly normal to see all sorts of scabbing, dead skin, shedding hairs few days after the surgery and really within the first 4 weeks or more. It is unlikely that follicles fell and in fact the follicle separates and stays deep in the skin. In 3 months some of them slowly begin to break through the skin. Final results are usually 12-18 months from Surgery. i will not worry about what you just described. It is a long waiting game for sure! All the best.

Yes. Plavix is an anti-platelet sort of medication and when someone is on it, then in most cases that person had some stents placed and I would therefore consult with their cardiologist as to the best regimen on when to stop it before or what to switch them to pre-op. In some cases of older stents/stable conditions, they may clear stopping it for a short period and then resume it after surgery. Remember, with elective surgery, safety has to come first and the risks of any cardiac event has to be minimized to justify having the procedure.

Blood thinners pre-op are generally stopped pre-op if only used for pre-cautionary measures. We usually consult with the patient's cardiologist if indicated for cardiac conditions such as stents or Afib etc. There is usually a protocol that can be followed in certain cases where the dose is reduced or shortened or even switched to a shorter half-life version. I usually prefer to resume back the normal medications as soon as possible following surgery as there seems to be no harm in doing so. Remember that most of these anti-coagulants take some time before they start working fully and therefore if something has been stopped for few days before surgery, then they will not start working immediately when resumed. Therefore, there is no need to delay resuming them as it will take sometime for their action to resume. It is always important to liaise with the cardiologist in cases where anti-coagulation is important.

Transplanted hair will grow without help if properly transplanted through the entire process. Nonetheless, the native hair needs good maintenance using what was discussed. A hair transplant is similar to having a “Hollywood smile” done at the dentist. You would still need to brush your teeth daily.

I totally agree with @LaserCap. Invest in approved maintenance regimens (minoxidil, finasteride or low level light therapy.)

Topical minoxidil (regaine or rogaine) has a half life of 22 hours. Therefore once a day is enough.

There are different ways to go about that. It depends where the main problem is. If it’s the hairline, you can either wait and grow it longer and try styling products to fix the angles and directions. You can also have certain ones extracted and recycled with the addition of fine grafts in between with some more irregularities to make the hairline fine and natural looking. Trust me, it can sometimes make a huge difference removing one odd looking graft.

Hi @jooeey can you kindly share some photos? Difficulty in styling is not likely to be whether you had lateral or saggital sites made. It might be the exit angle itself or other technical issues. In fact, I find lateral/coronal incisions great for areas that need a fairly flat angle (temple points, eyebrows etc) as you can have the blade flushed more easily with the skin. Let me known in all cases.

It is not uncommon for surgeons to do a maximum of 2000 grafts per day with FUE, especially if their level of involvement is right. It sounds like a very reasonable advice to split the case. As @Dr Blake Bloxham mentioned, it reduces fatigue and out of body time.

@akc this needs to be treated by your doctor or a dermatologist. There is definitely an infection based on the photos and I do believe it warrants a proper swab to culture what type of infection it is and also some oral antibiotic medication in addition to some topical treatment. You have to see someone locally.

I personally believe you should take the doctors advice regarding the removal time. Leaving things longer is not always a good thing as you could increase the risk of pain, obvious scarring and infections. It is of course needed in some case when healing is slower than usual based on medical conditions (diabetes, cancers etc), however, reduced laxity does not necessarily mean that it needs to stay longer. In fact in some cases, staying longer unnecessarily could be related to widened scarring too. Was the wound closed in two layers or just the staples?

Yes exactly. It’s good to see more photos and have details about your age, family history etc.

Can you kindly post more photos in order to better answer your questions? These pics show a good mature hairline.

The main aim of modern HT surgery is to mimic to the best of our ability what's natural. A typical hairline is composed of two main regions : a transition zone and a defined zone. The transition zone is really as the name implies that zone of few millimeters that marks the end of your bare forehead and the beginning of your hair/scalp. Hairs there are usually fine and thin. Ofcourse, in nature, some may exist in doubles but the calibre and nature of hair in that area is best transplanted using single only fine hairs. This zone is only few millimeters in width and is irregular (not a straight line) and hence the macro and micro irregularities are also drawn in a hairline. As for the defined zone, this comes immediately after and in fact blended with the transition zone. Here, it is best to integrate and blend bigger grafts in order to start giving the illusion of density. If this is nicely done and blended behind the initial transition zone of single hairs, then we should get a nicely balanced and natural hairline.

What age are you @CanadianPT? You definitely need to be on good maintenance. As for HT, I'd say around 2800-3200 grafts should be enough to cover that. Depending on your hair calibre and number of hairs per follicle too.

I believe that some aspects of the HT are best done by experienced techs. Moreover, the procedure is physically demanding and i do believe that the entire procedure will be extremely exhausting to do entirely by one person (doc or tech), and this in turn will have a negative effect on the quality of work and results.

Yet another interesting question @Melvin-Moderator. I'm not really sure of what might be triggering the changes in millennials, but I personally think that it simply a matter of us being surrounded by a group of friends, work colleagues etc that are in the age group that represents 50% balding prevalence. I'm not sure if this is quite clear enough, but when you're a young kid or teenager, you'd look at people in theirlate 20s or 30s as generally old and hence them being bald or balding would be simply attributed to age (old age at that time). Nonetheless, when you are among a generation that fits this category, our brain tends to make us think that balding people are getting younger. I'm not implying that we aren't young ofcourse but we generally would consider ourselves not among the older-bald generation that our childhood brain used to construct. Interesting to hear what others have to say though.

5 weeks is a relatively short period when it comes to healing after any surgical procedure. Just give it time for the whole area to heal. For any scar to mature, it can take months to years. Nonetheless, it does seem you have some pimples/ folliculitis. This generally resolves on its own or with some warm compresses. In some cases, antibiotic ointments or even oral antibiotics may be needed- rarely though. Best of luck going forward- remember it is a waiting game.