LaserCap

Interesting indeed. I do know of a doctor, in particular that did work and grafts did not grow. Every case! Would then do a repeat case at no cost and that too, did not grow. Incompetent? I don't think so. But something was causing the issue. Staff? Perhaps. Time of harvesting? Were the incisions made too deep or shallow? How about placement? Many points to make but the most important, the patient was truly screwed. No donor left. It is imperative when you consider this subject, that you do the research. Ask to look at photos. HUNDREDS of them, not just a handful. Consistency, results, density...what will the doctor be doing? What will the staff be doing? ASK.

Take another set of photos and comb your hair out of the way. It could be nothing or it could be something. My first suggestion is find out if there is family history of hair loss. If there is, go to a reputable hair transplant clinic, (or a dermatologist), and see what they say. Depending on the outcome you can get started with some medical therapy. Have you started seeing some recession the frontal hairline? In the area of the crown the hair grows in all directions out from a point. The hair does not shingle like it does in the middle and the front. So this could actually be whirl issues and not thinning. Nothing wrong with finding out and being proactive.

Doctor, it looks like your design is that of a male, with receded corners. Perhaps is the angle of the photo. Too early to tell what the density will be. Please post in 6 months another set of photos.

When it' taken out, about 9mm. There are doctors however that will take a lot more which just puts a lot of pressure and can lead to wide scars.....But I realize you are asking about the scar once it has been closed and healed. This is a function of wound healing and it can vary. I've seen linear scars that are hardly visible and have seen a scar as wide as 1/2 inch. Typically this happens because the patient either slept in a certain position or he went to the gym and started lifting weights. It is imperative the patient avoids neck-stretching exercises after a procedure. Length will depend on what number of grafts you are discussing. Say ear to ear, 22-24mm depending on the size of your head.

With all the groups I've worked during my career I have yet to encounter any doctor that will not move forward with a hair transplant procedure if/when dealing with the conditions you've listed. You were specific to mention FUE, but I don't think this is an issue. FUT, FUE , are just different techniques. Like Dr. Charles indicated, a lot will depend on what the donor area looks like and the medical history. Do you take aspirin? A lot of patients don't think of this as a medication....but it is. I've seen doctors suspend the procedure because of it. Typically they would like you to be off 3 days prior to up to 2 weeks prior to the date of the procedure. It is important when you visit with the surgeon that you tell him all the medications you are taking.

Thanks Doctor, that makes sense.

Nice work, nice design.

While I do appreciate patients being thankful most times for our interceding in their behalf, emails like this contribute absolutely nothing. They actually do more harm than good. It almost looks as if the clinic is involved somehow. When did you have the procedure done? How many grafts. What type of procedure? How many techs were involved? Was the Doctor there the whole time? How long did it take? How many procedure rooms do they have? How long has the Doctor been there? Did he do the consultation? Or was it the consultant? Did he recommend some type of medical therapy? How did Ola help you gain trust? What did Farah do that was so great? Like I once heard, help me to help you.....

If you have no hair loss, I would avoid anything with DHT blockers. Consult with your doctor. Bioting, a vitamin, will help to have the hair look as good as it can. I don't think it is hurting anything but, again, consult with the derm.

Thanks for the photos, this always help. The first observation is that your hairline is still in the middle of your forehead. The only patients that tend to keep this "teenage" hairline, (call it youthful hairline), are patients that enjoy a full set of hair. Looks like your hairline is starting to mature. This is normal. The whirl, looks normal as well. If you did a biopsy and that's what you were told, I would place my trust on that. I would not even bother with any medical therapy at this point. These modalities are such that you need keep up with them for life. If you stop them, you will resume losing hair, provided you are losing,. I think this would be just a waste of money and time. (The stress alone that you are putting on yourself may end up causing you to loose. Stop it). Do nothing? No. Take photos. Put them away. 3 months later do the same. Keep track and then decide if something needs to be done. Lastly, there are two types of loss. The type you see and the type you don't. The hair that you do see on the floor, tub, etc...this is normal. the follicles on your head get tired. They need rest. The hair sheds. Typically this hair returns. The hair that does not return is hair that miniaturizes and eventually disappears. That's hair loss.

When Merck did their studies, they found 1mg was what was needed to maintain hair retention properties. So, Propecia as a 1mg tab came into the market. The problem arised when Merk lost the patent and doctors started giving out prescriptions as a 5mg tab and asking patients to quarter it. This would be as close as they would get to the 1 mg. So here are a couple of issues, First, the tab does not come pre-scored. This means that you are not getting 1mg daily. The dosage is varying daily. Some days you may be getting more and some days less. Is this an issue? Perhaps. (In my view you are still getting something. And, with the blessing of the doctor). When the subject of side effects come, I find doctors scrambling. This is typically because they are truly trying to help the patient, They''ll suggest taking the tab every other day, in some cases every third day, and sometimes just laying off the med and resuming some time later. I seem to recall a doctor saying that the effect of the med lasts 24 hours? Don't quote me on this, and perhaps doctors that participate in the forum can give their view, but if this was the case why not prescribe it differently. Taking the med every other day then does not become so far fetched. Lastly, the power of the mind. If I was to give you a piece of candy and tell you that you would experience a side effect, do you think you would? If you are quartering the pill, and we know the amount of medication is changing daily, what....taking just a bit more or less would cause you to experience different things? Here is a suggestion..... Many believe there is more testosterone with the medication, than without. (Apparently the body then figures it out and regulates itself, so this is very short lived). So, when I take it, (and have been doing for the last 20 years), I think I am going to perform better. So far I've never had an issue. And, if you never did, you never will. I do have a question. For how long have you been taking the medication? When did you start experiencing all these different effects? If you say...withing the last 2 weeks...then OK, talk to your doctor. If years, still talk to the doctor, but I would start checking on what else could be causing the issue. Have you had blood work and a physical?

Tablets come coated so you would need to break them. With regards to the semen, most believe a male would need to ejaculate a quart before this becomes an issue. I don't think even an elephant can do that. Agree, since Merck lost the patent I have heard little to nothing about this particular subject.

Go to a Norwood chart or better yet, print it. Now get a pencil and lightly, cover the top of the head so that you can still see the pattern underneath. This means that a patient can have hair. The amount is of no consequence. It is the pattern that a patient is thinning into that is important. This will dictate what the recommendation from the doctor will be.

Since you brought up the subject of having more density on one side than the other, let's address that first. This typically happens a lot when you have an older individual that has been combing his hair to the side. As the hair at the end drops, it helps to cover that corner. The other always seems to be of more importance to the patient. When this happens, the conversation of working asymmetric comes up. It is typically best to work both at the same time so this does not become an issue down the road when the patient now wants to comb his hair in a different way, (all the way back, for example) Transplants are important! They can help to frame the face and give the ILLUSION of having more hair. Some doctors are true masters at this. Some can create the LOOK of some amazing density. Most doctors believe, at the end of the day, that patients may have 7000+ grafts available lifetime? Say you have an average of 2.2 hairs per graft, this gives you just over 15000 hairs. This is doing the job 50,000 which is what most believe is the number at which patients start noticing thinning.

Here is what I understood when I entered the industry. Proscar, a 5mg tab, (the parent medication), is used by millions for prostate issues. These patients were returning to their doctors with more hair. Merck did the studies and went to the FDA. They found that 1mg was all that was needed for hair retention. Here came Propecia. At the time the reps indicated that there were a few side effects involved with the drug and this particular birth defect was discussed. Specifically they spoke about hyospadias. A defect that does happen in real life. For this to happen, they said, the woman had to take Propecia, cut it in half, (it became coded after a while), take it during the first trimester, etc. I just told patients to take it to their job to avoid this issue. Can you blame patients for being confused and misinformed? No. The internet is a wonderful tool but be careful Lots of misinformation out there. Doctors too. Not sure if this is do to complacency. But the fact is some professionals formed an opinion long ago and will tell patients that this med can lead to procreation issues. Sad.

You are putting too much on. Sprinkle and come off. The residue will remain. Think of blending. If you can blend it through the hair, that will help. The front is tricky. Play with it. To make this look more natural, however, I would consider NOT putting it right in the very front. Allow about 1 inch and then apply. Think of the front as a transitional zone. Everyone, by definition, will be a bit thinner in that area.

I am glad you brought up the subject, it comes up often. First problem, you have dark hair and light scalp. The contrast is such that if you get under intense lighting, you will see right through. This contrast makes it worse than what it truly is. By definition, more hair will allow for more density. But consider the diameter of a hair shaft. It covers nothing. Tons of grafts and many procedures will help but will not prevent it. And forget about the sun. Patients think that a transplant will help avoid this issue. It doesn't. My first suggestion is get sun-block. The second, avoid looking at yourself in a restroom or areas that have intense lighting otherwise you'll be questioning yourself.

If you are a class 6, you will always be a class 6. Adding hair does not change your pattern. By definition, you will have more hair within the pattern. The idea of doing transplants is to get away from baldness. More hair! If that's the case, why wear it short? We want to show it? So, if the plan is to have more, and NOT to keep it short, why not keep all your options open and consider both FUT and FUE? This would allow you full access to your entire donor area. First thing that comes to mind is an age appropriate hairline...or a very conservative one. You know what takes lots of grafts? Lowering a hairline. So, by staying conservative, not only will you look natural, but it will allow the doctor to work farther back into the pattern. A year later, depending on the density achieved, you may then start lowering the hairline a cm at a time. This will help to frame you better and, perhaps, help you look younger. I find it laughable when people talk about the "scar" with an FUT. There a true masters out there. I've seen scars so minute that it is hard to detect them even with a very short haircut. How you heal, however, is not a function of the doctor. This has to do more with wound healing. If the doctor is any good, this should not be an issue. Once you run out of elasticity, you can then move to FUE and can actually put FUE grafts into the scar. Lastly, there is scarring with an FUE. Different kind of scarring, but scarring non the less. How many times have I seen depleted donor areas because the doctor got a bit too greedy? Talk to the doctor about all of these subjects and then make a decision. Medical therapy!! Seems you still have a lot of miniaturized hair that perhaps can be reversed. Have you done any research about PRP? Something to consider.

Thanks for posting the photos, this helps. First observation....Dark hair, light scalp. This contrast is always going to make matters look worse than what they really are. There are agents out there that seem to adhere to the hair to make it thicker while, at the same time, reduce the contrast. While you do that..... The fact is, if you've shown the propensity to lose, you will continue losing. When? Who knows. The second photo you posted shows that pattern of loss, perhaps, seems to be moving from back to front. You are at a GREAT time to start some type of medical therapy to help you retain and perhaps even enhance miniaturized hair. This speaks about two types of loss. The loss you see and the loss you don't see. The hair that you shed, and you will shed all the hair in your head at intervals. Mind you, not all hair goes away at the same time. (The follicle gets tired and it needs rest). That hair will typically return. The hair that does not return, however, is the one that miniaturizes and eventually disappears. (Go ahead, go to a mirror and look at the hair on your hairline. Go to the corners and look carefully. Do you see some thick and some thinner hairs?). Propecia, Rogaine, PRP and laser therapy are the only modalities approved/released by the FDA that have anything to do with hair retention. Propecia being internal, comes with a history. Read up on it. Talk to your doctor and then decide if you want to make the commitment because, once you do, this is a "for life" medication. It does not do you any good to start and then stop. If you stop, you will resume losing hair and, once gone, it will never return. Perhaps starting with Rogaine and a laser is not a bad idea. If they work, you may not have to go with Propecia. Keep photos and look at them every 3-4 months to compare. If your loss is dramatic, however, perhaps you should consider all of them. But do something if you value your hair. The biggest thing to consider, besides what's already been noted is the fact that the donor area is a finite source and no one with an advance pattern has enough hair available to allow for a full set of hair. Keep you much native hair as you can and leave your donor for the future pending the outcome of medical therapy.

Excellent like always.....

Gabreille, let's take your "report" one step at a time.... Finasteride might just be the most misunderstood drug or the most manipulative seducer. (What are you talking about)? Proscar, the parent medication, is used to treat prostate issues. Patients were coming back to their doctor with more hair and this was the beginning of it all. Especially when it comes to the part of a physician prescribing it to the patients or not prescribing it, it becomes almost impossible to come out unscathed. One most definitely does not want to be blamed for being the cause of anybody's sexual disintegration Perhaps it is the specialty of the doctor that dictates their level of knowledge. I think it is fair to say that a PCP in a family practice would probably know a lot less about hair loss than a hair transplant surgeon that has been dealing with the subject for years. Perhaps this is the misunderstanding you are referring to? If you don't know something, ask or refer the patient to someone that does know the answer. The worse thing that can happen is for a patient to remain uneducated and do nothing. How many times have we heard "I wish someone would have explained all of this when I still had my hair." You mention "sexual side effects" throughout your script. There are other side effects associated with the medication and there always seems to be more come out that had not been discussed previously. And there have been benefits discussed as well. The latest I heard, from a doctor that did his thesis on the subject, dealt with possible dementia after years of use. We'll have to wait and see what comes of this. For me, I plan to take the medication for the next 200 years. (Let's bring back the parent medication, Proscar, for a second. How many millions of patients take this medication, successfully to address prostate issues? Do you hear of all the side effects they are experiencing? Consider that this is a 5mg pill, which is 5 times Propecia/Finasteride dose). The power of the mind is incredible. If I was to give a patient an M&M and tell them there would be a side effect with it, do you think the patient will eventually experience that exact side effect? You bet. Many doctors believe that there is more testosterone under the medication than without. Why not tell patients this? If a doctor, without giving enough time to confirm that there will be side effects, does not prescribe the medication it is typically because he is under the strong belief that the medication will either be unsuccessful, or has developed predetermined notion that the medication will eventually result in harm to the patient. Who's fault is it? The rep that gave him the info originally? Is it what you can read on the internet? (Which brings up the question, who wrote it?). The fact is, all patients are different, some will experience side effects and some won't. But how would you know without the patient trying it? Thanks for bringing up the subject of a medical therapy. It is a huge component when it comes to hair retention. Do research, speak with the doctor(s) and decide if is the path you want to take. Lots to consider, particularly when it is a long-term medication. Once you're on it, stay on it otherwise you will lose the benefit and and the time and money invested will be wasted.

Check Arocha. Go to the website and scroll all the way down. There are interactive videos that show what can be accomplished in a single procedure.

After a transplant, regardless of technique, the clinical staff will go over post op instructions. Unfortunately, half of the time, (if not all of the time), the patient is typically still under the effects of the local and will forget half of the stuff. This is why typed up instructions are given before the patient leaves. These include how to take care of things for the first few days. Most want you to be quite gentle with the grafts so that nothing is dislodged. 7 days after, however, most ask that the patient get under the shower, let everything soak and scrub away. Not doing so and just leaving the crusts, along with the small stubble that came with the graft, can lead to infection. Sometimes these crusts can be persistent and difficult to remove. I think that most patients are quite gingerly with their grafts because they are under the belief that they will damage everything by scrubbing away. A doctor once told me that it is difficult to damage anything after 3 days, but because most clinics are very conservative, they will tell the patient 7 days. So, scrub. Just waiting for the crusts to fall off by themselves is not the way to go. Please get in the shower and scrub the stuff away! Sometimes the hair that came with the follicular unit will grow from day one. This just means that you are ahead of everyone else by 3-4 months. It means nothing. Eventually this hair will shed and a new one will grow in its place.

The benefit I see is the fact that you know for sure that you are taking 1mg. The pill does not come scored so it is difficult to get a perfect 1/4. Not sure if the slight variation will make a difference long term.

55-60 density...What does that mean? I realize it is per square inch....but so much more goes into this. Is that the density in the donor area? What native hair do you currently have? Are you doing any time of medical therapy? Where are you working...hairline? front and top? To be able to help you you need to post photos. 1600 in the crown is a waste of time. You'll see no visual change. Cover? What does that mean? Consider most believe we are born with 100,000 hairs. By the time you are a teenager you have 50,000 and don't yet realize there is any hair loss. Consider that most believe patients can have 5000-8000 grafts. On the average 2.2 hair per graft. So, at the end of the day you are asking 16000+ hairs to do the job of 50,000. It is an illusion. Again, best way to help you is if you post photos.