PAI Medical Group Virginia

Let's take it one step at a time....You are a young man and you are already showing an aggressive pattern of loss. First caution is in order. Start thinking that there is limited donor available. Where can you put the grafts where it will make the most impact? Go to the mall and start looking at how people lose hair. Advanced patterns will typically keep a forelock, have some diffused thinning, and be emptier in the crown. Why not mimic mother nature for the most natural result? Something to keep in mind. Next, meet with many hair experts and see what they have to day. If the first thing you hear from the consultant is "we can give you a full set of hair with a single procedure, run the other way fast! I am curious to learn why are you considering FUE? Medical therapy should be part of the jargon. To achieve the most density you may want to incorporate all medical modalities available to you to help you retain and enhance the native hair. Make sure to ask about what these can do for you when you go to the consultations.

8000 grafts? I gather you've done more than 1 transplant procedure. If you are only 3 months post op from the last procedure, wait a full 12 months to see a matured result. With regards to coloring, typically the suggestion is to color a week prior to the procedure so that you don't have to deal with that aspect while your new hair is coming in. You could color as soon as 14 days after the procedure but, if you abuse it, you loose it. A lot has to do with the type of color you use. I recently went to color my hair and was asked if I wanted permanent or non-permanent. The hairdresser went on to say that permanent color typically lasts a few months, (only to find that a few weeks later the roots were beginning to show the white hairs. Realistically, I think that most colors last about 1 month. Most importantly, go to someone with experience. It's unbelievable how many times I have heard stories of people coloring at home or had it done with someone that knew nothing and eventually they experienced chemical burns, permanent hair loss and all sorts of other issues.

Flaking of the skin is typically due to using shampoo the have alcohol in it. Your scalp dries and then starts flaking. So, first thing....avoid avoid shampoo with alcohol. Second, visit a dermatologist. There are conditions, other than a hereditary one, (as already posted by others), that can also irritate and dry the scalp. The derm should be able to prescribe what you need. If the condition worsens, getting a biopsy might not be a bad idea. I noted many discussing the use of Propecia. Remember that there are other modalities also available to you that can help you with retention and enhancement of the native hair. (Propecia, Rogaine, laser and PRP). The mechanism of action of each of these is totally different and are thus, synergistic when used simultaneously. Talk to your doctor or hair professional about them.

There are many things to consider. If you were in your twenties, perhaps, the conversation would be totally different. Many agree that the older we get, the breakdown of testosterone to DHT slows down, slowing down the level of loss. It seems, but the photos you've posted that the forelock has remained the strongest. Your corners are well receded, and there seems to be a nice bridge behind the forelock. Not sure if that's because of the way you style your hair, (which I think you re being smart by parting on the side, (hair shingles and gives you the look of more density). That being said, look at yourself in the mirror. Do not tilt your head down. What do you see? (The front). This is also the area others see when you interact with them. Understanding that we all have a limited donor supply, lets be judicious with the grafts. A second point to consider is how typically hair grows. The hair in the front grows forward. The hair in the middle also grows forward and it shingles to that of the front. This is the reason why, in most people, the front and middle always look a bit fuller. Now the crown. We all have a whirl. That is, if you think of a point on a piece of paper and drawing lines outwards from that point, you'll realize that hairs are not working together like they don in the front and top. Because this is the spherical part of the head, it would take many, many procedures to achieve density. You could probably put your entire donor hair in the crown and still look thin. Eventually, when you empty the front, you will have no donor available to fill it. You will then be asking "why did you put all the hair in the crown? When people look at me I still look bald." So, place value to the front and the middle. When you are happy with the density in that area, then it's time to consider grafts in the crown. Lastly, medical therapy. Think of the crown as a circle and you fill the circle with hair. Now, if you've shown the propensity to lose, you will continue losing. So, you fill the circle with hair and then you lose the native hair around it. You end up looking like a target. Propecia, Rogaine, Laser and PRP are the modalities approved/released by the FDA for retention of the native hair. I would suggest you speak with your PCP or hair professional about these. With regards to your crown, and considering everything outlined above, perhaps taking the conservative approach may be a good idea. If you are able to retain and enhance the native hair, that may be all you need. Seem, by the photos you provided, that it is the swirl, (hair growing away from the point), that is causing the "thinning look." The fact that your hair is darker is also a contributing factor as there is a bit of contrast with the color of the skin. Hope this helps.

Typically, so that the hair matches perfectly, some doctors will choose to harvest from under the chin. The area is invisible to most, and more so when you let the hair grow some. The size of the punch will matter. Some doctors find it a lot easier to use the bigger punch. It really takes a lot of experience to do the work with the smaller punches, less than .9mm to no detect the harvested area.

Something you fail to mention which I think makes part of the equation is the fact that some doctors will place a small number of grafts over a large area. The grafts will be there but the results are so diffused that the patient will see nothing. This typically starts with the consultant that will over-promise. "You'll have a full set of hair with one procedure."

Propecia, Rogaine, laser and PRP are the only modalities approved/released by the FDA for retention and enhancement of the native hair. These work in different ways and are thus, synergistic when used simultaneously. That being said, there are many practitioners getting involved with PRP with results that are negligible. Unfortunately, and you would think that everyone would get together to compare notes and see what works and what doesn't, everyone just seems to be doing their own thing. I would encourage you to do a lot of research and review before and after photos. Additionally, there are plenty of published studies that can help guide you. Good luck.

Unfortunately the quality of the photos is not very good. It does seem that you are keeping a longer length which could be either because you like it that way or because it serves to cover the thinning. What I do like about your hair is the fact that you have waviness to it which helps with the coverage. With regards to hair length, there seems to be a length in which all hairs work together to provide some shingling and the most coverage. I would visit with your hair dresser and start experimenting with different lengths. When the hair is too long it weighs down and the thinning becomes more apparent. If you are content with the density in the front and top, you may want to consider adding grafts to the crown. Be conscientious that the crown is the "sphere" of the head and requires many, many grafts. Medical therapy, (Propecia, Rogaine, laser and PRP), should be something you should discuss with your PCP or a hair professional. Retention and enhancement of the native hair is imperative if you are considering hair to the crown. Imagine, (and think of the crown as a circle), you have an island worth of hair and you continue loosing native hair, you may end up with the "target" effect. An island worth of hair and nothing around it.

Typically when an FUE procedure is done, the donor area is shaven, (no hair with the follicular unit). Consider the aperture the doctor made at the time of the procedure. a crust will develop in each of the incisions and days later, as per the instructions of the surgeon, you can scrub all that off. It is typically 3-4 months later the the hair will begin growing. (This is the time it takes the follicle to root). Hair then starts fairly thin and it keeps improving. It will be at about a year before you'll notice a matured result. Remember that it is the hair from the donor area that was transplanted. Eventually it will be the same quality hair that is in the donor area. Be patient. It is likely you are being self aware since you just had the procedure. Perhaps cutting all the hair short at this time will help to even things out.

You mentioned you started to recede in your early 20's. Were you, perhaps, maturing your hairline at that point? There are two types of loss. The hair that you see and the hair you don't see. The hair in the brush, bath tub, floor, is normal. Many agree that 100 hairs a day is normal. This hair typically returns. Hair that miniaturizes, seems not to grow any more and eventually disappears, its hair loss. So when you say that you can pull hair easily, perhaps that is the hair that will return? You really need to be judicious with your grafts. The donor area does have a finite number of grafts available. I would encourage you to go to the mall and look at people. Particularly those that are thinning into a class 5/6. What does their hair look like? Mimicking mother nature can only result in the most naturalness. If there is a limitation of donor hair, where will it give the most benefit? To most, it is in the front. It is the area you see when looking at yourself in the mirror and it's the area that people see when they interact with you. This also serves to frame your face. And, as you let the hair grow, you can comb it in such a way that it will help cover the back area. A very acceptable style that many use today. What I do not encourage you doing is tell a doctor to place the grafts diffusely throughout the pattern which is a mistake many make. Once you are happy with the front, you can then move farther back provided there is donor availability. The waviness you mention is actually a good thing. This gives more lateral coverage. With regards to the retrograde, I am certain the surgeon will look at the donor and harvest from the area that is not being affected. Most important is to consider all medical modalities that have something to do with hair retention. Propecia, Rogaine, laser and PRP are the only ones approved/released by the FDA that have something to do with hair retention. I would encourage you to visit a hair professional, or your PCP and find out if these would help you. They do work in different ways and are thus synergistic when used together. If you are able to retain and reverse some of the thinning, this will, perhaps give you more options down the road.