LaserCap

PRP can help in two ways. At the time of the procedure...It can bring the hair in sooner. It can also help reverse miniaturization. The problem, however, is the fact, like any other modality, the process needs to be repeated to keep the effect. If Minoxidil and Finasteride are having a good effect, do not stop them. Doing so is just a waste of time and money.

Black hair, light scalp...Because of the contrast, this will typically make things look worse....In your case, however, it seems you are thinning into a 5 pattern. It is important to understand this classification as it will dictate what can be done. One thing I like about your hair is the waviness. This, ultimately, will give you more lateral coverage. I'm glad you are doing medical therapy. Get on it. If you decide against Fin, add a laser or even PRP. You seem to have a lot of miniaturized hair, could be you are experiencing retention. 3500 grafts would be a nice addition to your entire front. I would avoid the crown until you're happy with the density in the front. Also, start thinking multiple procedures as one will not be enough to achieve the density you seem to have elsewhere.

What you're experiencing is normal. Most patients report just about the same - even a few days after the procedure. People are people. Some will say this is the easiest thing they ever did and felt nothing. Others, this is the worse pain ever...Most fall in between these two. The feeling of tightness is typically in the donor and this will subside. Feeling "numb" is also common. When the doctor is taking the segment, he is cutting nerve endings. There was a report some years ago claiming, if the doctor goes a bit too deep, this will cause the numbness. Perhaps a doctor can chime in and explain. 3 weeks and just now the crust and the hair that came with it is starting to shed? After 3 weeks it's OK to get in the shower, let it soak, and scrub away. You're not going to hurt anything. If you're too gingerly and don't follow proper hygiene, can result in an infection.

Every time you violate the skin, you'll scar. All transplant procedures leave scars. What type scar? It all depends on the technique. FUE scars can be as small as dots which can be easily covered as the hair grows. For this to happen it is imperative the doctor use a punch no larger than .9 mm. Scars tend to dissipate with time. A lot depends on the color of the skin. and wound physiology.

You're right! It takes multiple fine hairs to accomplish the density of one coarse hair. Exaggerating but the right concept nevertheless. So, it is smart to consider all options before moving forward. One, in my view, is to start out with a very conservative hairline. Let it come in and, if you feel it is too receded, then you can lower a cm. Keep doing this, provided the donor is there, until you are content. Keep in mind hair in the front grow forward, so wherever the hairline is, imagine 1" lower than that. Fine hair gives the most naturalness, and more so when blond or light brown, (contrast issues). Off hand think multiple procedures, either to add more density to the same area or because of area coverage. Don't forget about medical therapy. Whatever native hair you can keep is a plus....

If you were able to shave it before, you'll be able to shave it after. Should have no effect. Why though? What's the sense in getting anything done if you're going to keep shaving? A gradual transition perhaps? Make sure you don't shave prior to the procedure. The doctor will want to see the angle and direction, quality, density, etc. It's a lot easier to mimic when you can see actuality...and not going in there blind.

The scratching is a concern. The first thing I would do is go to the dermatologist. There are several conditions that cause this.....and shedding follows. I don't think you need to biopsy, but have a doctor evaluate your entire head. There are two types of loss, Shedding and miniaturization. The follicle gets tired of producing hair and it takes a vacation. That hair returns 3-4 months after the fact. Hair loss is different Go to the bathroom and turn on the bright light. Look at the hair in the hairline area. You'll note some strands are nice and thick and others thinner. That process will continue until the hair dissipates and withers away. This is called miniaturization.

Beautiful place! Your hairline has receded to a mature placement and it will serve you well. The corners are also receded but not terribly. But if you've lost, this will continue. Propecia, Rogaine, Laser and PRP are the modalities we typically discuss when dealing with this debilitating condition. Have you spoken to a doctor about this? Take a photo from the top and back.

If you are planning on keeping a 2 guard, I would dissuade you from going FUT. You can always do FUT down the road if you decide to change the length of your hair. You are developing into a class 6. Yes, I do agree you've retained and enhanced the hair. Keep it up and consider adding a laser and perhaps PRP at the time of the procedure. Consider grafts in the front and blend to the mid scalp. Do NOT do crown, it takes too many grafts - which you need elsewhere.

Having dark hair and light scalp does not help you. The contrast always makes it look worse than it is. It would be nice if you could pull your hair up so we can see how far the corners run. It also seems as if you are thin in the entire front. 2400-3000 grafts would be nice....and keep in mind a second procedure may be needed down the road, particularly if you lose more. Are you doing any type of medical therapy to help you with retention? Combing your hair straight back may be helping your crown a bit, but not the front. It would be smarter if you combed to the side. The hair would shingle and give the illusion of more density. That does bring up a point..... A part line always makes things worse. This typically prompts a patient to put more grafts on one side than the other. This, in my view, is a mistake. If you're going to do one side, do the other as well. You will not be lopsided.

A few things to consider..... You've been on Fin for a long time and but you feel you're still losing hair. I'm guessing you are referring to the ("visual") hair you see in the tub, sink, floor? Let's address that issue. There are two types of loss, the one you see and the one you don't. The one you see is shedding. Most believe 100 hairs a day is the norm. The follicle gets tired of producing hair and it takes a vacation. 3-4 months later the hair returns. This will happen randomly to every hair in your head - throughout your life. Hair loss is the hair you don't see. Go under a bright light and notice the hair in your hairline, particularly the temporal areas. Notice some strands are nice and thick and others are very fine. That's miniaturization. Eventually the hair dissipates and withers away. Once gone, that hair does not return. That's hair loss. Based on your assessment, I believe you are experiencing retention, otherwise you would have nothing by now. Is it a good idea to add other modalities? Of course! The mechanism of action of each is totally different and thus, there is synergism when used simultaneously. With regards to Rogaine.....I suggest the foam. Using it 2X per day you get 100% of the medication. 1X per day you get 90%. Typically most will do it once a day as it is labor intensive. Most people don't have the time to do it twice. Do it at night as per the recommendation you've been given so far. This way you don't have to worry about it during the day. Why foam? It is not greasy like the liquid and the application is simple. The medication is systemic. By putting it on any one place, it is working your whole head. Take a cap full, but it on your palm. Press down in the crown area, for example and press down. They massage. Should take you no more than 15 seconds to do this. It is believed Rogaine can help with blood pressure as it's a vasodilator. Lots of misinformation out there. Soon we'll read it will grow a third head. Laser and PRP are the other modalities you should consider. Give all of this a good year as it does take that time period to confirm what exactly the meds will do. Based on the results you can then decide if transplants are for you. Do meds for as long as you want to keep your hair.

"Trichophytic Closure." Awesome name, but quite common. It's a technique used to help camouflage the scar. It's done in such a way - it helps have the hair grow "through" the scar. That's all. Sometimes it's best to do a closure under and one above. This helps keep the tension below and allow for a finer scar. During the evaluation the doctor will check elasticity and make a decision. Your pattern is similar to a 5A in the Norwood chart. Fortunately you've kept a lot of the native hair, which seems to be miniaturizing. Also, looking at the donor, it seems you're limited, and may be experiencing some retrograde. My suggestion - get on medical therapy and give it a year., (Propecia, Rogaine, Laser, PRP). If you can retain and perhaps enhance what you have, you may end up just doing grafts towards the front.

In the old days, it was believed by many a separation between grafts was required for graft survival. This was due to the global idea that grafts compete for blood supply. So, during a consultation a second procedure was always discussed to achieve density. 25-32 FU/SI was the goal. Like Sean indicates, hair density does play into this. You would require far more if the hair is very fine. What existing native hair exists is also part of it. Lastly, the doctor's instrumentation, (the size of the punch). During the consultation just tell the doctor you want as much density as possible. After the fact you can ask him what the outcome, number wise, was.

Thanks....I've had help along the way...been the poorest man of earth and also the richest in so many ways. I know far less now than ever....and funny how we can always learn something else. I am now learning Chinese. Fascinating. So many people need help out there. It's almost like a crusade. It does not cost anything to be nice to people....

You've hit on something that's important for all cases. This is a forum where we get to discuss, give opinions, share experience and all that goes with it. Unfortunately we are not there to assess. That is, it is imperative you visit with a doctor so he can "manually" evaluate you. He can "comb" through your hair and perhaps see things we can't. Can't tell you how many times I've seen patients with lengthy hair only to find out they were poor transplant candidates. With your hair shaven it is difficult to ascertain your case. I would suggest you let it grow a couple of weeks and post again. With regards to evaluating your donor. Much consideration goes into that. First, skin conditions as these can transfer at the time of the transplant. Self immune systems is another. How about scalp burns from coloring? The list goes on and on. Lastly, density. The separation in between strands is also taken into consideration. The areas you've marked seem to be childhood related that healed with time. Were you accident prone? They mean nothing.

Wow, only 4 months? That's great!

When dealing with younger guys, since we don't know exactly where they are going to end up, it is typically recommended they do their front and top first. Once happy, then they can tackle the crown. Medical therapy plays a big part in all of this as it can help retain the native hair. Let me give you an example why this is important, 24 YO comes in and wants grafts in the crown which, by now, is the size of a grapefruit. The Doctor moves forward and puts 1500 grafts. The patient decides he does not want to do any type of medication and the loss in the crown progresses. Now he's left with an island worth of transplants and nothing around it. Almost looks like a monk. We call this "chasing the pattern." Eventually the patient runs out of grafts and now he as nothing left. Suppose he then loses the entire front. The area of most impact is the front. It is what you see when looking in the mirror, and it is the area others see when they interact with you. At 72, however, if you are happy with what you have....why not. A dusting is better than being empty. Keep in mind we all share a whirl. The hair in the crown grows away from the point unlike the front and top. (In the front the hair grows forward at an angle. The hair on top, (mid scalp), also grows forward and it shingles). So it takes many, many procedures and grafts to create density. You would be better served by going as far back as you can horizontally in the patter so as to minimize the size of the crown. As you let the hair grow - you can comb it in such a way that it will help cover the crown. What color is you hair? I ask because you mentioned SMP. This would help if your hair is dark as it will help minimize contrast. Otherwise don't waste your time or money.

Yes, I had native hair, particularly in the forelock but had little to nothing on the rest of my head. Had my first procedure in 1999 Donor is great, I don't feel I lost any in that area.

For some reason the word "monochrome" comes to mind when I read this. SMP can be used for other applications other than to just wear the hair buzzed. Minimizing contrast, camouflage an FUT scar etc. The issue I have with this is the fact that, like any other modality, it has to be repeated to maintain the effect.

Did you have any native hair when you started? How long ago was this? Is your donor intact or did you lose hair there as well?

7 procedures, 20 years after.....Great. But this is a difficult question when you consider medical therapy which should be incorporated in the answer. Regardless of how natural the results are, if you look worse now because you did nothing, (meds wise), it is unlikely you'll get a positive response. If worse, most feel the procedure didn't work or they lost the transplants all together.

Best results in a quick time...how quick? Board certification....in hair restoration? Expertise....Where did you learn? Do your doctors have fellowships? What types of procedures do you offer?

If despite the meds you are still losing hair, I would suggest you get a laser and consider PRP at the time of the procedure. How can you determine if your loss has progressed? I'm curious. Please be specific.

Seems you have a lot of miniaturized hairs. Your hairline seems to be in a good "matured" position and will serve you well as you age. Is it too soon to do hts in the corners? Perhaps. Could you do it? Sure! But I would be one to wait. Get on medications to make sure they'll work. And, if they do, then , by all means. And I am certain you'll want to match the density you seem to have elsewhere. 1400-1600 grafts and perhaps a second procedure depending on what happens to the native hair. "Seem to have".....Your are holding the hair in such a way, it is impossible to tell if you are also thinning through the entire front. The other thing that doesn't help you is the contrast you have between the color of the hair and the color of the scalp. Let me reiterate....get on meds and give them a year before you do anything.

This might be coincidental. Go to the doctor.