PlzRespond

8 hours ago, H & W Doug said:

Hi PlzRespond,

Not sure why you were unable to send me a message before but it looks like we can communicate now 🙂 Thx for reaching out.

Yes, thanks for helping answer the question Doug!

Upshall

are u a former rahal patient?

@H & W Doug why are you not accepting private messages?

1 hour ago, Dr Blake Bloxham said:

Do you mean by day 6-7? In my mind and per my post-operative instructions, no. I let people start scrubbing at day 4 (only pouring with water and shampoo for the first 3 days). Although it probably could use another update because the study looked at slightly larger grafts than what we use today, the best data says grafts are essentially permanent by day 10. Before they become permanent, however, they anchor pretty darn well. It would be hard to dislodge a graft after day 4 or so, but they are technically not a permanent part of your body like the rest of the follicles until day 10. I bring this up because some clinics rely on this more than others and pretty much don't want much washing until closer to this mark. If this is what they recommend, then I suggest following their specific instructions closely. If you were my patient, I would tell you there is really nothing you could do while washing to dislodge a graft after day 4. And I would not worry if you did not see a very specific flow of blood from that area -- a little speck of blood here or there while cleaning is not uncommon. 

Yes exactly, by day 6-7. I’m asking because by that time I began to shower then after while the crusts were moist/swollen I would massage with more force to remove the crusts and they indeed start coming off. I’m wondering if by massaging too hard by day 6-7 there is still the possibility of damaging grafts (there was no blood or dislodged grafts). Thanks

3 hours ago, Dr Blake Bloxham said:

The dreaded "cracking." I think I receive at least one email per week from an understandably nervous post-op patient. Rest assured that this is expected. You did not lose an entire row of grafts, nor did you some how dislodge a perfect row or "chunk" of grafts. 

I have heard differing explanation as to why doctors think this occurs. I believe these cracks occur because the skin contracts as it heals. When you have thousands of small wounds covering tissue that has been stretched and swollen, you will get contractions that will appear like little rivers, canyons, cracks, or roads in the grafted area -- I have heard it described using all these different illustrative analogies. It happens even more frequently when dense packing is utilized. It can also appear more dramatic when you are scabbed up and a larger region of superficial scabbing (with or without some hairs attached) falls out. 

Rest assured, however, that even if you see these "cracks" or missing "chunks" above the surface, the grafts are safely anchored below the skin. They may be temporarily displaced from where they will eventually settle, but they are secure. Many people also assume that areas were missed during the transplant itself, and this is typically not the case. Just part of the healing process. 

Graft dislodging is a pretty specific event that happens within the first 3 days (when true follicular units are used). If you did not see an active bleed accompanied by an event within the first few days post-op, it is very unlikely that you lost a graft. And this to me just appears like the classic contraction from healing. 

Of course you should always keep your doctor in the loop and run this by him/her as well. 

Hope this helps. 

Dr. Blake Bloxham 

Feller & Bloxham Medical, PC | Great Neck, NY 

Dr Bloxham

within the first 6-7 days is It still possible to damage grafts permanently say by more forceful massage in the shower even if there is no bleeding?

Very nice. How many grafts went into the temple points? Why do the immediate post op photos don’t show any grafts into the temple points?

Sorry to hear you began losing your hair so early. I can totally relate though, I began losing my hair around 15-16 also. So know that you’re not alone. Most reputable doctors will not perform surgery at your age simply because it’s difficult to predict how your hair loss will progress. What you need to do is try to maintain your hair with treatments such as finasteride and nizoral shampoo. I’ve seen some doctors recommend surgery after the minimum age of 25 or so. I also recommend waiting it out to see if/how your hair progresses while on fin. I know this isn’t something you wanted to hear but know that this advice is for your own good. 

Hows your scalp health? I know for me when I was losing hair at that young age my scalp was horribly unhealthy. I had uncontrolled seborrheic dermatitis and it accelerated my hair loss imo. So if your scalp is unhealthy also try to address that to give the meds the best chance to work.

in regards to your stress and mental health. Please seek a qualified therapist/psychologist. I dealt with/still deal with the same and it can truly help you. The sooner you start the better. If you’re in college they usually have therapist on site that provide services.

Good luck and feel free to ask any questions!

On 4/2/2019 at 3:52 PM, BjornBorg said:

Impressively collected response from Dr Mwamba after getting attacked from out of nowhere.

@JayLDD

Come on man. We want the doctors to come here and contribute. It's what makes this forum stand out from the others. I very often find myself agreeing with your points of view and your honesty is refreshing. Sometimes though, you could find a smoother way of telling it how it is.

Couldn’t agree more. It’s nice to have doctors actually come and take part in some of the discussions. Just because they don’t agree with your opinion does not mean one should disrespectfully attack them

Great response by @Dr. Patrick Mwamba

I’m in line with doctor bloxham on this one. Sounds hormone related, and while you’ve been on fin for two months, your body is still trying to find “homeostasis” and as a result you’re experiencing acne. Follow up with the doc that prescribed it just in case and maybe a derm that’s well versed in hair loss that has lots of experience with fin.

is ur skin more oily since taking fin?

When I get acne breakouts what works best for me is a leave on salicylic acid lotion once a day (at least 1% concentration). Just my experience but u may want to give it a shot

If under 40 I would seriously consider treatment (mainly fin) before going with a transplant. It’s important to stabilize your loss so you’re not chasing it with transplants. Looks like you have good donor and hair characteristics with relatively minor loss (nw 3). There’s lots of options. First I’d decide fut or fue. Then go from there. Plenty of good docs in North America and Europe. Find patient posted results that have similar loss and hair as u and with a hairline that you would like as your end result. IMO, each doc has their own philosophy regarding hairlines and some go a bit more aggressive in their designs than others. Good luck 

@KO

hi, did lupanzula review why there may have been less than optimal growth? I remember you mentioned you had a scalp condition like dermatitis and I’m wondering what he said regarding that

Update?

How’d the tinder dates go

Very informative video! Wish I could have watched this before my op 

2 hours ago, Dr Blake Bloxham said:

Great replies thus far. 

Bonkling, 

Would you mind sharing a little more information about your specific situation? Age, level of hair loss, family history, and preventive medication regimen -- if any. 

I perform both FUT and FUE, but I am a pretty well known proponent of the FUT method in a lot of situations. In fact, I think most guys would probably benefit most in the long-run by starting with FUT. However,  it would be helpful to get a little more information about your case before making too strong of an endorsement either way. 

 

Dr. B

typically, when you review family hair loss history with a male patient, how detailed does it get? Father, grandfathers, brothers? I’m asking because I have a mixed bag. Thanks in advance

5 minutes ago, Dr Barış Ertürk said:

I found my name on google in this topic hi Dr Barış Ertürk talking

FUT is histhorical method forget it 

FUE  by technicians its like " you buy cheap plane ticket to fly somewhere and this company is flying without pilot " 😊 

Im  allways in contact with my patients maybe its about that you couldnt find any rewievs about me ... 

Im using FUE method with some modifications its calling #iceplasma fue and if donor area is good we can work with high greft numbers 5500 or more without any scar if i can i will put here one of my patients (he is also my cardiologist friend ) before and after photo ( 5300 graft #iceplasmafue ) and if you want to look more resaults you can contact in instagram.com/drbariserturk

instagram.com/drbariserturkclinic

+905370122172 ( whatsapp / viber ) 

 

#1: please brush up on your english or use a better translation site

#2: fut is not a “histhorical” method. It has its place and still produces great results and for some patients is the more logical approach 

#3: please describe how your “#iceplasma fue” is different from other fue surgery? What tool do u use to extract grafts (manual punch, cit, motorized, waw, Harris safe, dull, trumpet, hybrid)? How do u place grafts (forceps, implanters)? Storage solution? We want to know what makes your fue so special that you had to give it a certain name?

Good hair progress 

But

when r u gonna trim ur pinky nail? What is it used for?

On 3/30/2019 at 4:01 AM, Dr. Patrick Mwamba said:

The common ground of causes of hair loss and hair shedding is microinflammation around the bulb .

DHT ( in androgenetic alopecia )  will link with the AR ( androgen receptor )  ;this complex will interact with the DNA of Derma papilla cells and lead to secretion of TGFbeta , BMP , DKK1  which are proinflammatory  molecules .

The goal today is to fight and reduce the inflammation around the bulb .Among powerful anti inflammatory products , you find Prp .

 

The whey protein will get transform to GSH ( Glutathione ) , a powerful anti oxydant and anti inflammatory molecule .The GSH is anti TGF beta , anti PGD2 ( prostaglandines)  and anti IgE.

 

Interesting. Thanks for the response.

does this also mean inflammation driven scalp disorders such as Seborrheic dermatitis can contribute to hair loss?

can one take any type of whey protein concentrate/isolate since that is the main ingredient that has benefits of antioxidant activity?

4 hours ago, Dr Blake Bloxham said:

Optimistic, 

It is extremely variable. Almost all patients are different and you should resist the urge to compare yourself to others -- though I know it is hard not to. I have seen some patients with jaw-dropping growth at 4 months; I have seen others who really did not look "fully cooked" until 18 months (particularly if they had work in the mid-scalp and/or crown region). I even specifically remember one patient who took 24 months to really look fully matured. Now, all of these are pretty much outside the "norm," but just to reassure you that everyone is different. 

I would say the average patient sees a "spurt" at around 3-5 months, they are pretty happy and starting to actually use the transplants to style, increase density, etc., by 6 months, and then reach full maturation sometime between 12-18 months. 12 months for "full maturation" is a nice easy number we use a lot online, but I personally think almost all patients look a little better at 18 months compared to 12. 

Seeing sporadic growth or even no growth at 3.5 months is normal. Nothing to be concerned about. I know it is difficult, but try to put it out of your mind for a while and let your body heal and mature on its own. There is an old adage about a watched pot never boiling, and I think it does apply a little here. 

Best of luck. 

Great post.

after the “spurt” of growth at 3-5 months is there another or several more of these “spurts” where new hairs sprout thru the scalp? If so, when does this typically occur?

1 hour ago, Dr Blake Bloxham said:

Harry, 

You should be fine after 6 months maturation. It is good that you double checked with your clinic and likely even better than you used some sun protection. In general, most patients should be cautious up until the 6th month and then, of course, take general precautions in the sun after that. 

Dr B

are uva rays as harmful as uvb for grafts?

I think you’ll be fine then. I’d just their judgement. For extra precaution maybe wear a hat if you please

What did ur doctor say? I’ve heard differing opinions on this

If you really want to know you should review the data and statistics for each from the fda studies. 

Which exact treatments is the patient on? I just want to know what "maximal medical management" includes

@Parsa Mohebi, MD 2339 grafts went into the crown but there is no crown picture for the post op? Why is there no overhead shot either?