herbert

Well, the area spans 2+ cm, so there's no way that the root can be damaged for the strip excision... this is quite sure, I think. I was in doubt that this thinning was due to skin stretching... new, lower density. But I remember a post by Jotronic saying that the variation in density is not macroscopically evident...

Thanks, JacobS. So you think this is clearly shock loss? h.

Hello, a question for the veterans... 3 weeks post-op, I'm ready to expect and bear some shock loss in the donor area, but I'd like your opinion on this. Is this shock loss (temporary ), in your opinion, or it's just the hair thinner due to skin stretching (permanent )? Thanks...

Hello, a question for the veterans... 3 weeks post-op, I'm ready to expect and bear some shock loss in the donor area, but I'd like your opinion on this. Is this shock loss (temporary ), in your opinion, or it's just the hair thinner due to skin stretching (permanent )? Thanks...

Well, I understand that there's always a risk... but I suppose it's sufficiently small up to a given density, and then it increases along with density. What's the "safe limit"? I've read around that most HT docs (even those against high density) agree that up to 40-45-50 FUs/cm2 the yield is still good. (provided that the surgeon knows how to pack). After that, they start debating about the survivability issue... In other words, 40-45 FUs/cm2 is not even more considered "dense-packing". Some surgeons (e.g. Shapiro) simply prefer to achieve 40-45 in 2 passes for "strategic" reasons (e.g. fine tuning at 2nd pass, assess the hairloss progression, etc.), but they wouldn't have any problems in placing 30-40 in one step. Another reason for the 2 pass is the size of the medical staff: packing at 40 instead of 20 would mean covering half the size. If the staff is able to handle 2000-2500 grafts sessions, they would limit the one-step coverage up to 60 cm2, which is not enough for a lot of patients. Basically, this is the same reason against big megasessions. Did I understand correctly?

Hello, I've browsed a lot of posts about shock loss, and read that FUE is a good way to work in thinning areas in order to prevent shock loss... Why??? As far as I know, FUE is a new harvesting tech, which of course produces more skinny grafts compared to the average chubby strip-harvested grafts. The skinny grafts can be placed in smaller incisions on the scalp, thus reducing the trauma and harm for existing hair. But I know there are some strip surgeons that prefer to work their grafts skinny before transplanting. According to the considerations of FUE and shock loss, placing these skinny strip grafts should achieve the same improvement in terms of shock loss prevention... or am I missing something? Now my doubt is: is there any difference between FUE skinny grafts and strip skinny grafts, to justify the more famous FUE benefits in reducing shock loss? thanks for any clarifications.

Hello, I've browsed a lot of posts about shock loss, and read that FUE is a good way to work in thinning areas in order to prevent shock loss... Why??? As far as I know, FUE is a new harvesting tech, which of course produces more skinny grafts compared to the average chubby strip-harvested grafts. The skinny grafts can be placed in smaller incisions on the scalp, thus reducing the trauma and harm for existing hair. But I know there are some strip surgeons that prefer to work their grafts skinny before transplanting. According to the considerations of FUE and shock loss, placing these skinny strip grafts should achieve the same improvement in terms of shock loss prevention... or am I missing something? Now my doubt is: is there any difference between FUE skinny grafts and strip skinny grafts, to justify the more famous FUE benefits in reducing shock loss? thanks for any clarifications.

Dr. Beehner, thanks a lot indeed. I think this definitely clarify the point... Let's see if I've got it: if no transection occurs, the terminal hair may be subject to an effluvium (go & come back) but not to a "forced" and faster miniaturization. Just two more questions: - which density is "extremely dense packing"? - what does it mean "to respect the blood supply"? Thanks a lot again!

thanks! I can understand that experienced surgeons, with proper techniques (e.g. lateral slit) can prevent transection risks at high densities... but what about blood supply? If there's a risk for poor blood supply, how can the surgeon's ability help in any way? h.

Smoothy, If I understood well, there should be any risk or lower survival rate when the density is smaller than 50 FU/cm2, right?

I have more or less the same problem: bald areas, but thinning areas as well. Dr. Beehner is providing very useful info about the risk for existing hair. I'm ready to say goodbye to my existing nearly-vellus hair, but not to my forelock terminal ones... I'd like to assess the risk for them, as well. Big1, I'm on Minox + Progesterone, etc. for the frontal part. No propecia, since my dermatologist say that it's more appropriate for the vertex. Is minox good as well to prevent any damange to existing hair?

Dr. Beehner, thanks a lot! Does this "rule" apply to existing terminal hair, as well? I mean, does their miniaturization speed up like that of nearly vellus hair... or... they just recover well after the HT effluvium (if any) and in the future go on thinning (if they are doomed to) without any negative influence by the HT? This would be a much worse effect!!!

Hi, Dr. Beehner's provided a good and comprehensive explanation, but as you could see I still have some confusion in my mind. Actually, my purpose was to trigger a number of answers from different doctors, since I suppose the "permanent influence" of an HT on the thinning process is a yet-to-be-clarified topic. Different doctors might have different views on this, I suppose...

Hairworthy, amazing HT!!! Any news about your progress? Any shock loss in the recipient area?

Dr. Beehner, thanks a lot for the clear explanation. My main concern is that those hairs "bumped" into the next life-cycle will climb the "miniaturization stair" at a higher pace. I mean, we all expect that an hair in a thinning zone will have a lower quality (in terms of shaft, length, etc.) in its next life. If I remember well, there are a number of miniaturization classes (or "steps"), from terminal to vellus. What worries me is that an HT does not just push an hair into its next life cycle, but then, permanently, influences the way the thinning hairs goes on miniaturizing. E.g.: each new life-cycle, the hair will miniaturize faster (climbing up the miniaturization stair two steps at once). So, HT pushing an hair in the next cycle is a price to be paid, but it's just a step on the stair. But what if the stair changes its shape, permanently??? I hope I've been clear enough; it's just a confused suspect hard to express. Thx for any further explanation.