DrTBarghouthi

Thank you for sharing your experience here. Your case is possible to repair but would require a more thorough consultation and examination to assess the possibilities.

Considering that you will be undergoing the procedure under local anaesthesia and that the local anaesthetic will be administered in a site different to where the transplant was done- in this case the eyelid- then there should be no impact on your transplant whatsoever.

Hi @Luna5 and thanks for the mention @J.A.C It seems to me from the one photo that your forehead is at the right height/distance. It seems to me any lowering “may” not look right. Happy to see more photos to assess facial symmetry.

Thank you for the mention @J.A.C I believe it’s important given your history to start on some good maintenance therapy such as finasteride. You frontal and anterior Mid scalp will require around 3000 grafts for decent density. The over harvested area will need to be left alone without harvesting, but other areas are luckily untouched it seems.

Thank you for your message. I strongly believe that you should stay on the medications for now. Your age, donor area and desired plan can lead to undesirable results if you proceed at this stage. I would wait for few years to see how your pattern and donor progress. The donor is average and you do have thinning areas across the entire scalp. This warrants good medical therapy and above all patience.

Yes that’s unfortunate sir. Just as @slmentioned it can hopefully be amenable to repair.

You can implant the grafts in the “rough” order of their extraction. So once grafts are extracted, they get counted and sorted etc and that pot gets put back first and so on. There is a couple of hours between the first extracted and the last extracted grafts at least so you can accommodate that into the work process. Each method can cause a delay in placing in its own way. If you do a stick and place, there will also be a delay because you are waiting on slits being made and filled one by one and usually less technicians can work together in this method ( assuming a doctor is making sites and one technician is implanting)

Thank you for the informative read. I am not in favor of one technique over the other as long as it delivers. I personally go for pre-made slits always. I tend to keep few in the end for a stick and place if needed as I feel that once the grafts are all done, I can visualise areas that may look emptier or less packed, so I tend to add in between. Thank you again.

Thanks for tagging. I’m happy to help if you can share some photos @Hopefulandhelpful

This number to sort out into singles and doubles and triples etc takes few hours of a dedicated technician doing it. If they need to trim singles to make more of them in cases where more singles are needed than extracted, then this takes even more time.

I can’t stress enough how important microscopes are. I did this trial/experiment once with the technicians where one was using loupes or the naked eye to sort out (singles) and then those singles were checked over under the microscope. You won’t believe the number of doubles detected. Microscopes are crucial!

Thank you. I do not recall any major studies that could compare these exact methods in terms of effectiveness. But over the years, the topical route has been Somehow more effective in maintenance therapy- possibly due to more compliance and frequent use.

Dear community, This is a 35 year old gentleman who had an FUE procedure done in January 2021. He is a NW 3-4 pattern with a family history of the same. His donor area is good with some fine to moderate hair calibre. We did around 3234 grafts for both the frontal and midscalp zones to add definition and density. He is currently on compounded finasteride and minoxidil for maintenance. Photos were taken at around 13 months from surgery. Surgical details: FUE 0.9 mm punch 1's: 500 2's: 851 3's 1116 4's 867 hair/graft: 2.78 Sites made using 0.9 mm and 1.4 mm Sapphire blades. Surgical photos: (13 months from surgery ) Before and Planning Immediate 13 months after:

Ethanol can be irritating even without the gun or roller. I don’t believe it causes permanent damage if used like that. Minoxidil solutions have some ethanol/pG and have been used with rollers and possibly guns for a while. However, as I mentioned, you should use what makes you comfortable and consistent and at ease with.

It is hard to say exactly but I would highly doubt anything over 1500.

Yes clearly he needs your help in this @Melvin- Moderator This is total disgrace. Strips if properly done can yield around 2000-2500 grafts at most and that’s in good hands.

🙏🏻🙏🏻🙏🏻🙏🏻

Yes continue the antibiotic for a bit To protect the weaker skin initially.

Thanks for tagging. It is hard to tell exactly, but seeing the immediate photos after surgery, I do feel that some areas were dusky. This refers probably to some level of ischaemia/ necrosis. This resulted in delayed scabbing and slower healing in these spots and then final healing by secondary intention (scarring). You can have hair put in those areas later if no growth occurs in it though. The redness could simply be related to your skin type having delayed healing after all the trauma. Remember 5000 is a huge number for this area.

Thank you. Areas just above the ears and towards the lower part of the donor can be good for the hairline. However, I tend to further trim and refine all our hairline hairs for males and females even further in order to be able to fill in more density.

Thank you all for your comments 🙏🏻🙏🏻

Dear community, This is a 44 year old Lady who was complaining of Androgenetic Alopecia and a background of temporary hormonal imbalances in the past giving a Male pattern Female type hair loss. We decided to proceed with a two staged procedure: the first stage to fill up the areas in the front and Mid scalp but maintaining a male type hairline. Stage two would be to recreate a female hairline and closing all temple recessions. She had a total of 1979 FUE grafts for the first stage of procedure. Her second stage is not yet booked due to work related and personal matters. She currently remains on minoxidil 5% once daily. Surgical details: FUE 0.9 mm motorized punch Total grafts: 1979. 400 of which were refined singles for hairline. Average hairs/graft: 2.58 Sites made using 0.9 mm and 1.4 mm Sapphire blades. Before: Immediately after stage 1: 5 months : Photos taken 18 months after surgery

Given your case and age, I believe 4000-4500 could address all areas. The donor looks great. With 3800 i think only frontal/Midscalp can be done mostly.

Thanks for the mention. In such cases, I would rather get a biopsy to see what might be the cause of this abrupt cycling. It could be chronic TE or some anagen cycle abnormalities. A biopsy can tell more about the character of Anagen/telogen ratios etc

I currently have no update and this is mainly due to the shortage of the medication globally. It doesn’t seem to be available here yet and this is delaying the chance of me trying it. I am still keen however and have made some enquiries today about it. Will keep you all posted.