LaserCap

Work, walk, read, sleep and watch the news from time to time.

The whole idea of the site is for everyone to share their point of view, I am glad you're sharing your opinion. Let's break this one up.....Every class 6, 7 .....had hair at one point or another....agree. How did they get there? Either they never became aware of medical therapies, took the meds at one time or another and stopped, never took or did anything.....The combinations are endless but in the end he has an advanced pattern. Who will be a class 7? You've hit the $10,000 question. We don't know. If we had a hair crystal ball - that would be amazing. That's why medical therapies are discussed during a consultation. Mind you, the medications are not for everyone. Some will experience nothing, some may experience side effects...Again, the combinations are endless. But say the meds work, now you can move forward with a hair transplant procedure. If not, you can now search for other alternatives. Some patients are adamant about a transplant procedure regardless of medical therapy outcome. This is when disaster hits. And, if the patient does end up being a class 7, he'll have no recourse. During a consultation we plan for the worse but hope for the best. A conservative approach is always best, (in my opinion). Depending on the situation at the time of the consultation, why not suggest medical therapy first? If it works, you can not move forward knowing you will not be taking 3 steps back. If the medication works, it will work for as long as you take the medication. (throughout my career how many times I have heard, "I was on finasteride for 10 years and stopped because it wasn't working any more." People tend to get confused with shedding and loss. Other times, and it does happen, the patient was not supposed to lose any hair in that specific time period. Unfortunately we just don't know. In my view getting on medical therapy is the best approach. With the millions and millions of people on this earth, you'll always find people that match your criteria and sometimes you'll find people that match my brief explanation. Regardless, it is the responsibility of the doctor, staff, (even the industry), to look out for the best interest of the patient. Naturalness is what we're all trying to achieve. The recommendation will be based on what the patient looks like at the time of the consultation, (regardless of what the future might bring). If things do change for the better or for worse, he can then schedule another consultation. These are stand along consults. A doctor can not be held liable for what happens to the patient. (He could have stopped the medication, etc).

Benign prostatic hyperplasia occurs when the cells of the prostate glad begin to multiply. These additional cells cause the prostate glad to swell which squeezes the urethra and limits flow of urine. Most believe the main culprit is an imbalance of hormones. It is my understanding alpha blockers do not reduce the size of the prostate but can help relive symptoms. It would be interesting to learn from the doctors in the forum how much DHT is still active in older gentlemen. Propecia, which I learned from the rep is an alpha reductase inhibitor can partially shrink the prostate by reducing DHT levels.... Doctors....help!

Do you have the name of the publication? Perhaps you can direct me to the correct website. It will be interesting to read the studies. It's a shame you feel educating us all on this site is a waste of time. While I understand it gets repetitive, there are a number of people that do visit, leave, return and call combinations in between. If we are able to help one, it makes this communal effort worthwhile. It is about helping people after all. It is the belief of many testosterone drops considerably as we age. Last commercial I heard on the radio indicated we lose about 10% per year after age 50. If less testosterone, less DHT. To me that makes sense. For the follicle to be more sensitive....makes no sense. This is the first I hear of this. It is evident - the older I get the less I know. Must be...my wife keeps telling me the same. Oh, don't mean to be confrontational at all....I just tend to question dilettantes.

A couple of things...what difference does it make if others were or were not able to move forward? This pertains to you and to no one else. My suggestion is to schedule a consult with a few doctors and see if they concur. Worse thing that can happen is for you to move forward based on anecdotes of others and end up with a widened scar. Fortunately you do have FUE as an option. Why play with fire? I am curious...were you born this way or did something happen to cause the tightness?

What are you talking about? If you do find cases of older gentlemen with hair in the front and crown only, (and had transplants), we can assume a couple of things. 1, poor planning - perhaps by both the doctor and the patient. 2nd, little to no use of medical therapy. "This is unfortunately true even if on fin/dut." How do you know this? " Androgen sensitive follicles become far more sensitive to even the tiniest amounts of DHT with aging." How do you know this? How do you determine which follicles are more sensitive?" Are you a scientist? "studies in which older guys receiving anabolic steroids with abrupt sheds vs younger guys who don't usually lose it as abruptly." What does this have to do with anything? My understanding, there is less DHT as we age. You seem to insinuate it is the other way around! There are many reasons why a patient moves forward with a procedure. For the younger guys, they want to enjoy their youthfulness. For older gentlemen, they want to improve their looks. It is a fact hair does make a difference. I've known of many ladies with CCCA that would kill to have just a bit more hair to be able to achieve some type of style. Whatever the reason, if you can accomplish a goal - yes it is worth it. Keep in mind - gratification is experienced almost immediately. Choosing the right doctor is HUGE! Poor planning and just doing what the patient wants is not truly looking out for the best interest of the patient. Education, a proper consultation, are and should always be part of the process.

From the photos, it seems, your scalp is fine. I don't see any flaking - signs of dryness. First thought is check the ingredients of the shampoo. If you see any class of organic compound belonging to the alcohol family, glycol - for example - avoid it. Change to baby shampoo. Alcohol promotes dryness. This, by the way, has nothing to do with the behavior of a graft. The donor will dictate if a graft will remain or eventually miniaturize and wither away. If permanent in the donor, it will be permanent wherever it's placed. The follicle does retain a memory and will behave as if it was still in the donor. But wait......you are not asking this. You are asking about fallout...particularly right after an intervention. During a procedure the doctor makes recipient sites. By puncturing the skin, there will be some blood involved. Eventually this blood will dry and form into a crust. Upon washing, 7-10 days later, depending on protocol, the crust will fall - along with the hair the follicle came with. (This short stub is what the clinical staff will grab when transporting the graft to its new home). The follicular unit will be under the skin. 3-4 month later the new hair will start growing. From time to time the stub can start growing. This just means you are ahead of everyone else by 3-4 months but it means nothing. This hair will eventually resume shedding - which is normal. (You will randomly shed every hair on your head, (not all at the same time). The follicle gets tired of producing hair and it takes a vacation. The hair will typically return 3-4 months later). From time to time a doctor will go a bit too deep and cut nerve endings. When these ends re-connect, the numbness goes away. This is more of a nuisance than anything else. With regards to the donor being over-harvested, difficult to say based on photos. Return to the clinic 6-12 months and have the doctor give you the answer. If you still have crusts, get in the shower and scrub away. You need to get this stuff out of your head to avoid infections, etc. Hygiene is very important as bacteria can crawl into any of the apertures. I am truly amazed you were asked to wash every other day. Who did the work for you? At this point, WASH! Again, avoid alcohol and use some type of moisturizing conditioner.

Biotin and other vitamins will help make the hair look the best it can but it is not helping you with retention nor enhancement. Propecia, Rogaine, Laser and PRP are the modalities we typically discuss when dealing with this condition. The mechanism of action of each is totally different and are thus synergistic when used simultaneously. Talk to the doctor about adding more to the mix. Unfortunately not many out there know how to work with PRP. Given the meager results, I would question the treatment the clinic is using. Did they do a syringe worth? What binder did they use? When is your next scheduled treatment?

Take photos, don't stress. Look it again at 6 months and at 12. Sometimes it can take up to 18 month to see the matured result. Oh...but you did PRP..... 6-8 months to see full results? Possible. You are just a bit early. The other part of the equation is - how much native hair did you have when you started? Are you doing any medical therapy besides the PRP?

More than just a whirl. Get on meds, it could improve the area.

The first thing you need to do is find a doctor that can provide density in a single pass. Review post op results of cases similar to your own. 2500+ is not out of the question but a lot will depend on what you decide to do hairline wise. Many want to start lowering - which takes tons of grafts and typically end up looking unnatural and not-age appropriate. Leave the hairline where it is and work from there back until the doctor runs out of grafts. I am curious, how can you decipher Rogaine has actually stabilized the loss?

You are going to be pretty beat up after the procedure. Go straight to the hotel and sleep. Have the staff given you verbal/written instructions, (you will not remember a thing). Go back to the clinic the next day for a wash. You'll feel better and it'll be something less to worry about. Travel with a neck pillow so the donor does not touch a surface. Have a cap you can wear. The staff can show you how to put it on properly, (first front and let it drop in the back with plenty of room in between to avoid dislodging). Take it easy that day. Return to the clinic next day for another wash. Ask the doctor his protocol with regards to sunblock. 7 days should be OK and keep wearing the cap. At this point there are no restrictions. Sign up for tours. They're wonderful. You might even want to visit the largest flea market in the world and learn a thing or two. These are perhaps the best salesmen I've matched wits with. Smart to stay away from home... no one will know when you return except, perhaps for the new hair style. (Are you doing FUE)? Lastly, wash your hair constantly. Coronavirus seems to be spreading rapidly and you're going to be in areas with a great number of people...and in concentrated areas.

You've accidentally hit on something we rarely discuss. During the initial consultation there is an intrinsic responsibility ....the doctor should not only be discussing, designing....etc. He must also look out for the best interest of the patient. Thus, future planning is huge for the same reason you've posted the question. If a hairline is designed too low, everyone will know something is up when he is in a happy home and he looks 15 years younger than everybody else. You seem to have just about the same hairline you had when you were younger, just a bit sparse. Why not strengthen it? No need to lower it, etc. It is also important to recognize hair grows forward at an angle, (I do realize you style your hair towards the back), so whatever is added to that area, you can imagine a hairline about 1/4 inch lower than that. Were you ever on any medical therapy to help you with retention of the native hair?

If you're willing to travel, why limit yourself to only two? Why not call them and explain your situation. Tell them the reason why you want to work with this particular doctor and also discuss the price. If you make yourself available to them when they have nothing going on, I am certain they'll be grateful and help you with a lower cost. If you were to travel in the continental US, what part of the Country would be most convenient for you?

It will depend....Did you do PRP at the time of the procedure? PRP can not only help reverse miniaturization, it can bring in results sooner. I've seen it. If no PRP, wait patiently. Typically it takes 3-4 months for the hair to start coming in. It is vellus-like and, with time, it starts maturing. It is likely you'll see a difference in 6 months but truly, I've seen patients say "Wow, I can actually tell a difference!" a year later. Some can take up to 18 months! Now, add the fact, if you've lost, you'll continue losing. So, if you are not doing any type of medical therapy....and continue losing native hair...You will then question the entire result. "Nothing grew." How can you tell? Scope. Scope and take photos. Scopes are relatively inexpensive. Grafts are placed in a random pattern based on the doctor's training and experience. They'll be placed at a certain distance from each other. You can tell the difference by the quality of the hair. Remember, the grafts came from the area where the best hair is located. Everything else will have a different caliber hair. Do this for a few months. Eventually you'll notice the native hair miniaturizing and withering away. The more robust hair will remain. And by they you're in trouble. Once gone, the hair does not return. My suggestion? Get on meds if you're not ready on them and go through the exercise.

Do you know what caused the scar to heal that way? Sleeping on your side, exercising? Second, if it happened before, the possibility exists it will happen again. Are you planning more transplants now or down the road? I would wait until then to have them re-excise and replace with a new one. In the meantime you could do SMP which would buy you time. Widening at the ends is common, particularly when guys start doing exercised that involve the neck. Sleeping positions can also have an impact.

He must be thrilled. Great job. PRP does work when done correctly. So much ignorance out there....it does pay off to do your homework.

Hair restoration has come a long way....From scalp reductions, to plugs, to minigrafts, to follicular unit transplants to follicular unit extractions, (a glorified punch). Thinking about FUT, how easy for the doctor, (still doing surgery but having a 9:00 to 5:00 job and not having to be called in an emergency). Removes a strip, gives it to the team to dissect. He then makes recipient sites and the team does the placing. In the meantime he is reading, sleeping....I've seen it. FUE comes. No one likes change. But if you decide this is the best for your patients, OK. You'll spend a long time harvesting. New pains - back, hands, posture....etc. Why do you think harvesting is typically done by others? After harvesting the process is the same. In my view, the reason to do a hair transplant procedure is to have more hair, not less. Let it grow! If so, FUT. Why? Cost is probably in the minds of many...but the true reason should be to maximize the donor, particularly when dealing with advanced cases. With regards to retrograde, it could be a haircut issue. Change to another hair dresser.

You are a young guy with a lot of loss. And, if you've shown the propensity to lose, this will continue. Strong class 5 rapidly going to a 6. And, looking at the donor, it looks like you are starting to experience retrograde. First order of business is medical therapy. Get on as many as you can since they work in different ways and give it 6-12 months. Again, you're young with native hair that has not left the building. If you can retain and enhance some/most of what you have, you can then plan on transplants towards the front. FUE or FUT will depend on how much improvement there is on the donor. The other side of this...is not to pay attention to any and all suggestions and move forward with the procedure. If you are experiencing retrograde, all the grafts harvested from that area will be lost as well.

Solid advice from everyone. Medical therapy for 1 year and reassess. Do all you can. You still have a lot of native hair. If you can retain and enhance, the transplant option may open to you in the future. (Propecia, Rogaine, Laser and PRP). If you are experiencing side effects, do it every other day or cut down on the dose. Take photos and keep a record.

The suggestion should always be to get on the meds ASAP. A day without them just means the possibility of more loss. Doctors work under magnification and can easily work around the native hair. This truly is a sad excuse not to use a modality. As far as side effects go, you will know immediately. If you never had them, you never will. Are you experiencing any? What exactly? Minoxidil contains alcohol which dries the scalp. The medication is systemic. This allows for you to put it on any one spot. You can change the spot the next day. Regardless of where you put it - it is working. No need to rub it all over. Do it once a day - at night before going to bed. See if that helps.

It's a big step, congrats. Dr. Arika suggested you don't take the medication? Since we know finasteride does not regrow hair, he must be talking about enhancement of the native hair. And he does not wish you to experience this? IT WOULD NOT ONLY ALLOW FOR A FULLER RESULT, IT WOULD ALSO ENHANCE HIS WORK!!! Perhaps he does not believe nor understand the purpose of the medication. The whole idea of medical therapy is to help you retain hair. In some instances it can help enhance the native hair. It looks like regrowth but it isn't. Understanding the donor is limited in everyone, we need all the help we can get to achieve the fullest result possible. Propecia is meant to be a long term med. If it works, it will continue doing so for as long as you take the medication. Stopping only results in losing all the hair you saved...and you will resume losing. So, it is a difficult decision to make as you'll practically be on medication for the rest of your life. Starting/stopping only leads to waste of money and time. To help with the shedding I would encourage you to research Rogaine/Minoxidil. Something to also keep in mind is the fact that all modalities available to treat this condition work in different ways and are thus synergistic. Propecia, Rogaine, Laser and PRP. Perhaps doing more than one would help you achieve your goals. During a procedure the doctor uses a very sharp instrument and inadvertently, can cut the native hair. It looks like shedding but it isn't. And, if the hair does shed due to the trauma of the surgery, that hair typically returns along with the transplant. Talk to the doctor about getting on Rogaine 2 weeks prior to transplant.

This subject comes up from time to time, particularly when something caused the loss - other than a hereditary condition. In no instance have I confirmed the insurance company paid a cent. Interesting what's happening with the transgender issue.......it is a choice and not medically necessary...does anyone know the basis of the argument?

The crown looks good. You can start in front and go back as far as grafts allow as it involved the horizontal plane. Concentrate most of the grafts in the front and mid scalp and just blend towards the back. It's normal and natural to be a bit thinner towards the back. The numbers will vary depending on the density the doctor can achieve in a single procedure. Ask to see photos of cases similar to your own - and results of 1 procedure. Depending on your density goals, you may need a second procedure. I would also consider some type of medical therapy to help you with retention. If you can enhance the native hair you have, this will also contribute to the overall density.

Unfortunately you did not post photos of the donor. Seems you are well demarcated. Are you doing any type of medical therapy? Concentrate on the front and mid scalp. Get that completed. Tackle the crown once you're happy with the front. Keep in mind in the crown we all share a whirl. It is the weakest point for everyone so being a bit thin is normal. Too much density truly looks fake. Do as many grafts as you can afford - and what the donor will yield. Are you planning FUT or FUE?