LaserCap

The swelling is common, particularly since you had PRP. This seems to have subsided. Oh, and by the way, because of the PRP now you can expect a sooner result. I would not be surprised if you see results in 3-4 months. Hopefully you are doing Propecia or some of the other therapies to help you retain the native hair you have.

If you've shown the propensity to lose, you will continue losing hair. If you are to the point of moving forward with a hair transplant it is because there is, perhaps, a great deal of loss. So you move forward and have it done. You forgo all the doctor discussed about medical therapy, including Propecia. and say you worked the temporal points and the crown. 10 years later you'll look awesome with two horns worth of hair in the corners and an island worth of hair in the crown. Offense and Defense. That's what is all about. Medical therapy, in this case is the defense you need to help retain the native hair. And, if you do retain, then you can consider transplants. It is questionable, if meds don't work, to consider moving forward with a transplant procedure. Why? Because of the donor area. The donor is very important. It is finite. You truly need to be judicious with your grafts. Once gone, they will not replenish. Typically, if you can retain any of the native hair you have. that will eventually be key as to what your results will be. Fortunately there are therapies out there, other than Propecia that can help. Rogaine, PRP, and laser. These work in different ways and are thus synergistic. But, if you do experience a side effect with any of them, do the others! But do something!

Can you post a photo? That would help. Lots to consider....First, let's talk about trust. Why did you choose this particular doctor/clinic? Did you have an initial consultation and did they explain everything to you? Did you see photos of their work? How many. What did the doctor do to build rapport with you? Once the donor area has been harvested, the clinical staff goes to work, (typically under microscopes). Here is where the grafts are separated into 1, 2, 3, 4 hairs. Further, there will be fine hair for hairline work and thicker caliber follicles to be placed farther back into the pattern. Once all has been separated, the staff gives the count to the doctor. This is how the doctor knows how many sites to make. Do you remember someone counting as the doctor was making sites? Here comes the first pitfall....Depending on what you and the doctor decided during the consultation....If the staff is short of the number, (say the only got 3800 and are 200 grafts short), the doctor could tell the staff to get all 4 hair grafts and make them into 1 hair grafts. So splitting grafts is one issue. Second issue, the staff got the 3800 but told you they placed 4000. I've seen it happen. Industry wise and I think most consultants and doctors will agree, when we discuss hair restoration we mention a frontal area, a top area and a back area. And most of the time we promote working from front to back as it is the front you see when you interact with others or when you are looking at yourself in the mirror. About 10 years ago the idea of leaving a separation in between grafts was very prevalent to allow for graft survival. Typically about 1200 grafts were placed in the front and 1200 in the top. For the back we would rely on medical therapy to help with retention of the native hair. As soon as 4-12 months a second procedure was recommended to then fill in. Techniques have improved so much that now doctors can do 2400 in the front without a problem. Seems they finally realized that grafts, while may compete for blood supply, can still survive if placed densely. So the point for you here is...what density do you currently have? This is why posting your photos is important. Did the doctor classify you on the Norwood scale? Did he mention a pattern to you? Are you doing any type of medical therapy to help you retain the native hair? Did he talk about this? Lastly, and what truly irks me is the 4000 number. Most patients do have a donor area. Different head sizes. Can a doctor harvest 5000 grafts at one point? Sure, but the patients head better be HUGE! Off and, if you are on the average head size, I can already tell you that something does not smell right.

This is only the tip of the iceberg! Bet, if you look carefully, or listen, you can find unethical practices everyday. Consider the following example, You go to a consultation, visited with the consultant and the doctor, (which rarely happens). You are quoted a price but, for whatever reason, you hold off. Typically you will then be hounded. Once the consultant figures you will not be moving forward, here come the price breaks. (So, first lesson, if you are budget conscious, wait. I promise you will be getting a better deal in a few days, particularly if you've made it clear to the consultant that you are truly interested in working with their doctor/practice). So, is getting a price, and then getting a better price....does that constitute being unethical, perhaps not. What is unethical is for the Doctor to allow the clinical staff do make sites, harvest grafts, etc. Now, can these employees claim that they are working under the umbrella of the doctor? I've seen medical students harvest FUE grafts. I've seen experienced MAs make sites. Unethical? you bet. This is not brain surgery....And, after a while, you do become the doctor. You see him do the work day in day out. Eventually the doctor may allow for you to make a site......and it goes from there. Is there a difference between this team member and the doctor? Sure! Years of education!....but it happens, even without the patient knowing. How to offset? Perhaps have a conversation with the doctor before the procedure begins. Have him tell you who will be participating the morning of the procedure, including who will be harvesting, who will be placing, etc. Trust it a big issue......

There are things out there that people swear by. I recall everyone around me telling me I was losing my hair when I was in my 20s. I even agreed to have some mixture of avocados put on my head. Obviously it didn't do anything? Could it have been because I only did it one day? Perhaps. Like I tell people, if it works for you, continue using it. Take Propecia, for example. Most doctors believe it takes 3-4 months to notice retention, and it may take up to 1 year to see if you'll enhance any native hair. So, would all the concoctions that you are using be effective? Try them for 1 year, take photos and check. Likely, you'll notice nothing. But something did happen..... Not only did you waste that year, (you could have been on something approved/released by the FDA, but you are probably balder now. The other thing that I find interesting is how much people value their hair. To agree to have all of these things done, speaks volumes about how we feel about having hair.

Great photos. Hopefully you can post another set in 4-6 months. By the third day, it seems, things went back to normal. Because of the PRP you can expect to have a much fuller look in about 3-4 months. Did you get a laser? These work great along with the PRP. Hopefully you get some enhancement of the native hair in the crown.

Unfortunately Propecia, Rogaine, PRP and laser are the only FDA approved/released meds to help with retention and enhancement of native hair. The mechanism of action is different for each and thus, there is synergism when used simultaneously. When Merck's patent expired, doctors started writing scripts for 5mg Propecia and asking patients to quarter the pill. There is documented fact that there is a very small percentage of side effects. With Dutesteride, if you are doing 5mg, you are increasing the potential of side effects by 5 fold. Hopefully you are quartering the pill as well? Perhaps taking the med every other day could help.

Bsmith makes a lot of valid points, good read. But design is far more than just choosing the type of graft. It all starts with symmetry, measurements, proportions, and age and even ethnicity. Let's take age to begin. An 18 year old comes in and has a hairline in the middle of his forehead. He is starting to mature his hairline and one of his temporal areas is starting to recede. He is freaking out. The doctor fills it in. At that precise moment the patient is thrilled. What do you think will happen 20 years later when he now has a horn worth of hair on that particular area? So first consideration is candidacy. Symmetry, measurements, proportions, they all go together. Some doctors use the 4 finger rule. They'll just put their hand on the patient's forehead, starting at the brow line. Others use the rule of 1/3. I know of many that also have a machine that projects a light. The key here, from the part of the doctor, is to consider if this particular design will serve the patient well now and in the future. An age appropriate hairline, despite of what the patient thinks, is important. All it takes is education. If the patient, ultimately, is adamant about a hairline in the middle of his forehead, turn him away! A few other things to consider. Will there be some recession on the corners? (Will depend depending on the sex of the patient. If male, sure. If a woman, corners will typically slope down). Lastly, will there be staggering of the grafts? This will typically add an element of naturalness to the work. With regards to ethnicity, typically African Americans like a sharp edge with an inverted U design. 0 recession. Typically no blunting is discussed. Now grafts. Yes, in the old days the nape was considered. But back then it was just FUT. So, if you see older guys with scars way low, you know that this was early 90's work. FUE from there? Sure, but they retrograde comes into play. Now must doctors get the finer grafts for hairline work from behind the ear. So, shaft diameter is important. This is where the clinical staff plays an important role in all of this. The doctor can instruct, but an experienced staff is invaluable. FUT or FUE? Makes no difference. An experienced outfit can play with all the elements. They can trim, dissect, and even place grafts at different depths. Opinion wise? FUT is typically a more robust graft and allows the staff more options. The FUE, by definition, is already minute by definition. How much more can it be modified? But ultimately how the patient decides to style his hair will help figure out how to move forward.

I glanced at the photos you posted, and paid particular attention to the last one. It seems not only are you thin in the hairline, you are thin in the front and top! I am aware of doctors that would do 3000 grafts! Caliber of hair? Really? The fact that you have dark hair and light scalp does not help. There is always that contrast. (OK, if you did have fine hair it would give you a more natural result, but you would need a lot more grafts). I would give this a full year and continue visiting the doctor. Keep him engaged in the process. If you are not satisfied with the result, talk to him and see how he can help you. There are lots of things to consider that you should be aware of. What if he tells you that you have gone on to lose more native hair? Make sure that you are doing some type of medical therapy to help you with retention and enhancement of the native hair. (Are you on anything?). I would find out exactly where the grafts were placed. Perhaps he concentrated them towards the front? Or did he spread them throughout the entire area? If that's what happened, the transplants will have little to no impact in the overall result. Please post your photos a year out. It will be interesting to see what happens.

Most doctors think that the whirl is a point and the hair stems from there. I'd bet some would think that this is just a bit more than a point. And, if you look carefully, it seems that you can see scalp spreading all around. The fact that you have black hair and light scalp does not help you either. The contrast typically makes it worse than what it truly is. Being as young as you are I would encourage you to do a few things. Find out family history of loss. Go to a hair transplant doctor and have a consultation. Talk to him about medical therapies that can help you with retention and enhancement of the native hair. Seems there is miniaturized hair and you may be at a point of reversing some of this.

Well......Slow down.......Eventually, if you are good, you may seek out, or be approached by a celebrity. What you do with the information, afterwards, depends on the results. If no good, likely the doctor will not say a thing. If the results are superb, you can bet he will promote it in some way. There are practices out there that do celebrities all the time but keep it private. Is that because the celebrity asked them to? Perhaps. We all tend to be star struck from time to time by celebrities. So I think the decision should come from the patient, based on the overall results. Look at tons of photos...of ALL patients before making a decision. Don't preclude yourself of not having a consultation, at least, by a doctor that worked on a celebrity just because of it. He might just be superb at what he does.

So many factors go into this. Young guys, particularly, reminisce about the hairline they used to have, (in the middle of their forehead) when they were younger and they are adamant about getting that replaced. Seldom have I heard the young agree with the doctor when he just drew a very conservative hairline during a consultation. They all point down, as if to create a female hairline with rounded corners sloping down. And they want their whole hair covered. I honestly have never had an issue with guys in their 20's doing a transplant. Why not enjoy your youth if you think that's going to make you feel better. I think that education is key. An ethical doctor will guide the patient properly. The sad thing however is that if the patient does not agree with the doctor, he can then keep searching for someone that will do the work. (I am the patient, this is what I want......and the doctor agrees). This might look OK short term but, as the pattern develops in later years, the patient is going to wish he'd never had a transplant in the first place. Do you think he'll say, "I made a mistake?"

Thanks for posting the photos. This helps. 500-600 grafts? That's a spit in a bucket and it will do absolutely NOTHING for you. Looking at the last photo you submitted, it seems as if your pattern is expanding from back to front. Medical therapy, (all options), should be your first goal. Unless you retain what you have. you may not have enough donor to address the loss that's coming. No one with an advanced pattern has enough donor hair to achieve a full-looking set of hair. Good thing your hair not not stark black otherwise the contrast would make it even worse. On the second photo, when you did the transplants, you drew lines. Of those, concentrate on the one that is long, in the back of the head. I am guessing you think this is the crown area? Forget all that. When you look in the front just look horizontally as far back as you can see, (without tilting your head forward). That's the front and top. Typically the crown will be the intersecting point between these two lines in the back. The problem of filling that line is the fact that if you continue dipping the pattern in the back, now you look as if you have a happy face in the back of the head. One way to do this, and to help you minimize the crown without looking like a target, (think of filling a circle. You fill the circle with hair. But, because you've lost, you will continue losing and you lose all the hair around the circle of grafts - now you look like you have a target area), is to work the area behind the front, (mid back). and go back as far as you can horizontally so as to minimize the size of the crown. The trick here is to finish with an inverted U. This way, if your pattern keeps expanding, you will still round and natural in the back. As you let the hair grow it will help you cover.

You seem to have a nice set of hair. Problem, you have black hair, light scalp and there is a lot of contrast. That does not help. The fact that we have a whirl in that area, that does not help either. Hair is going in all directions and is not shingling like it does in the front and top. I don't believe this is a thinning issue, check with a transplant surgeon. During a consultation he should be able to confirm this. Or you can go to the dermatologist.

Unfortunately, it SEEMS as if these are two different individuals. First photo, looks as if he has crappy hair. Much better on the 2nd photo. 2nd photo, angle is totally different. What medications is he doing? Nice response to medical therapy. I gather you placed the grafts in the front? I've worked with a number of clinics and doctors. Photos are huge. They can truly showcase the work. There are a number of techniques that can be used to get great photos of before and after. This set is just a bit lacking.

This can happen. What color skin does he have? If he is fair complected, it may take a bit. Nothing wrong with going to the dermatologist and see what they say.

Hi Puccinni, I am sorry to hear your experience was less than perfect. I am not personally familiar with this particular doctor, but I can gather a few things by what you wrote. First and let me get this clear. Did you go there first to get a consultation? What happened? What were you told? Did you go over exactly what area(s) he would cover? How many grafts? Medical therapy? It seems non of this happened. You went there the day before for the pre-op. What exactly was discussed? I guess you must have eventually found the right hotel? So you went for the procedure. The morning of, did you discuss anything with the doctor? Graft numbers? Areas to cover? You finally get home and it is then that you called to find out what he did? Seems by what you wrote that you have diffused thinning and your pattern is quite large. It is likely that he concentrated the grafts towards the front and suggested some type of medical therapy to help you retain the native hair, particularly the hair towards the mid back and back of head. Unfortunately I find that the hair max band is not very good. I had one once. It fell and broke to pieces. It would be nice to know how many grafts you did, where the grafts were placed, and if you are doing Propecia, Rogaine, PRP and laser. Did anyone talk to you about these? I understand we are dealing with a language barrier, but try to be specific. Many collaborators here can actually help you.

Many doctors believe smoking will have an effect on hair. Some suggest stopping before and after transplant as it will have an effect on the transplants themselves. Besides, did you know that it takes the body 7 years to clear that stuff from the lungs? I smoked when I was 21. Did it for 2 years. As much as I could. Even more if I had a drink. Now I have all kind of breathing issues. Not good, avoid it at all cost.

It all depends. How do you intend to wear your hair down the road? If long, perhaps FUT. If very short, to the point that you can clearly see the scalp, FUE. That is somewhat simplistic but not a bad way to think about things. The way I see it, why do transplants if you want to continue wearing your hair short? Just had transplants, show it! The main advantage of FUE is NOT the lack of scarring. There is scarring with FUE, it is just different. Every time you violate the skin, it will scar. Instead of having a linear scar, now you will have empty spots all over. Little ones, mind you, but still empty spaces. Depending on how much it is done per procedure, this can end up looking honeycomb-ish. How many times have I seen patients with depleted donor areas that look as if a rooster pick all over it. But, if done correctly, there can be many advantages to this technique. It is, for sure, easier on the patient. There is no cut, no elasticity issues. Within days you are pretty much back to normal. If you need a bit of work and keep your hair military style, OK. But if you need tons of grafts, perhaps considering both procedures would be the most effective way to tackle the issue. This way you are taking advantage of the entire donor area. Are you concerned that people will know you had a transplant? Just tell them! If you do, you can return to work immediately. If you wish for no one to know, it is easier to get away with it with an FUE. Many factors involved but the doctor can guide you and make some suggestions to make it happen. Typically, to do an FUE, the donor area needs to be shaved. Not sure about the yield issue. But the grafts do seem to be more robust with an FUT. Conserving donor? Don't think so. You can keep cutting, typically on the same scar to avoid multiple scars in the donor area. There comes a point, however, that you run out of elasticity. It is then time to move to FUE if you decide to have more grafts in the future. Lastly, cost. FUE is typically more expensive. On the average, FUT should be around the $4 range. FUE is more towards the $7 range. Oh, regardless of what you decide, please review TONS of photos before making a decision. It is always about results. 10 years from now, when you are enjoying a fuller set of hair, you will pay little mind to the type of technique you had. Rather, you'll be enjoying the hair particularly if the work was done correctly. If it's crap, you'll live with that for the rest of your life. Do your homework.

She must be thrilled. I do have a question. 70 is still young. But suppose you get a, 85 YO wanting transplants. And say this individual has been saving his entire life to do this. Do you move forward to grant him his wish? Do you turn him away understanding he doesn't have much time left? Regardless of what his donor looks like...are you better off suggesting he takes a cruise with his grand-kids and enjoy the time he has left? In the 30+ years I've been involved in this industry I've had my share of patients dealing with this specific scenario. It happens. Are you morally obligated to the right thing? What is the right thing? In my case I turned ALL of them away and suggested something else other than a hair transplant. Was that the right thing to do? (Forget revenue for the office - which also comes into play). We are in an industry where I feel patients are very vulnerable. It is our responsibility to educate them and let them make their own decisions. But at 85 or older? What do you think?

You have asked the simplest of questions, and yet the most difficult to answer. Hair loss is complicated. So many factors involved. Perhaps we should start with the Norwood/Ludwig scales. When you go to a consultation, find out from the doctor what stage you are truly in. This will guide both you and the doctor as to what should be recommended and done. If you are found to be a class 1, for example, medical therapy is probably the best thing to do. If you are a class 7, you have some decisions to make. If you are in between the 1-7, the combinations of what you can do are endless. At a minimum, consider that the donor is a limited, valuable source and is finite. And, in an advance pattern, no one has enough hair in the donor to allow for a full set of hair. Thus, medical therapy should be part of the equation. Propecia, Rogaine, Laser and PRP are the only approved/released modalities used to help patients with retention of their native hair. The fact is, if you've shown the propensity to lose, this will continue. If the meds help, now you can bump that bar of density by doing transplants. If meds do not work, again, you have some decisions to make. All medical therapies work in different ways and are thus synergistic. Give them a good year and document the progress. A year later you can decide if you should continue. If you do decide to move forward with a transplant procedure, do your research. LOOK for cases similar to your own and view thousands of photos. Go to a few consultations and see what the common denominator is. Then decide. Oh, and keep reading this site, lots of people that truly want to help you.

A couple of things to realize, Hair goes into resting phases. You'll shed some, then the hair typically returns. How many lives does hair have? Not sure, perhaps a professional can tell you but it will be their best estimate as everyone is different as Recession Proof pointed out. Now the question becomes, once the hair is transplanted, does the hair resume its normal shedding? Bet it does. And it is in spurts. You will not shed all the hair all at once. You will shed one here and one there. Most believe all hair that is shed returns. The hair that does not return is the hair that thins, miniaturizes. this hair tends to not grow very good and eventually disappears. Look at your hairline. Do you seem some hairs that have nice and thick shafts? How about really thin that you can hardly see? That's hair on its way out. Now lets consider hair after transplant. Most will tell you it takes about 3-4 months for the grafts to reincorporate into the blood supply. Then the hair starts growing. Weak at first. It then starts improving. It will be a year before you really see a matured result. I've also seen this take up to 18 months! To answer your question.......Think of an empty head before a transplant. As the results come in, by definition, you will see a HUGE difference. Now consider a year after. Suppose the result was a full set of hair. If you were to do another transplant at that point, you will not see much of a difference since there is already hair there. One suggestion is for you to take photos and put them away. Take another set in 6 months and another in 12. Eventually this will become you and you'll forget how empty you started. It happens to everyone. Are you doing any type of medical therapy? The fact is, if you've lost hair, you will continue losing. It is a losing battle. Unless you are retaining the native hair, you will never bump that bar of density in the future.

I've heard about this for years. I have heard mixed results. Some swear by it. The first thing I would do is as the doctor's opinion. And if it is a go, use it for 6-12 months and keep track of results. After 1 year you can reassess, (by comparing photos - for example), and decide if it is something you want to continue.

Thanks for posting the photos, good job. The ones on the left only serve to confirm, if you let your hair grow a bit, it will cover. So FUT is in play. And, the reason to do transplants is to have more hair, not less. So the question becomes, if you had longer hair permanently, would that be OK. By considering FUT you now have MORE supply to work with, You can exhaust all FUT first and then have FUE available should you need it in the future. When you visit with the doctor, have him check elasticity. Ask him how many grafts lifetime he believes you have and make a record of it. Now, the photos on the right. It seems you have diffused thinning throughout the entire head. And it seems it is a large pattern. If you were to do nothing, it is likely you will end up 6-7. Do you have family history of hair loss? What pattern do they have? For the doctor that suggested doing grafts in the crown, I would run away as fast as I could. When you first interact with people, or see yourself in the mirror - what do you see? The front. This should be the area of concern. Besides, because of the whirl in the crown, everyone, by definition, has to be thin in that area. Once the front and middle are done, (assuming you will continue the use of medical therapy), you can then decide to move farther back into the pattern with transplants depending on many factors including efficacy of the meds, donor availability, etc. Lastly, the contrast between the color of the hair and the color of the skin. There are a number of techniques available today that would help minimize the contrast. With all technical advances, it is an exciting time to consider hair restoration. PROVIDED you find the right ARTIST for the job. Go to consultations, view tons of results of cases similar to yours.

First, ask the doctor. Second, have you tried one day Fin and one day Dut? Most believe there can be potential side effects. Obviously the percentage drops when the pill is quartered, but by adding more med, you are increasing the chance of the side effect. Since you have not had any, it is unlikely you will, but keep an eye on it. I few years ago I worked for a doctor that did his graduate work on Fin. He concluded, long term, that the use of this med would result in dementia. Perhaps. But I think this is true of anything we do in excess. I would be interested in learning what happens to you. I've been on Fin for 20 years and do feel that what I have is the result of the meds and the surgeries I've had. I will probably continue taking it for the next 100 years.