FUEblonde1985

archwired.com

The bizarre way in which you have responded to proposed alternative hypothesis to what you are experiencing would seem to indicate to me that you are not able to credibly assess your own situation and you are evaluating your hair based on some type of emotionally impulsive reaction to your continued hair thinning rather than an objective evaluation of exactly what is happening to your hair. You have posted pictures. The quality of those photos are not good and any conclusions drawn by US based on only those photos is highly speculative. Your OWN doctor told you that you will continue to need future transplants from continued recession, and told you he doesn't think your transplanted hair is disappearing by way DHT miniaturization. Your posting on this thread trying to get lay people on the internet to agree with your own assessment as opposed to your doctors, with some grainy photos with unreliable hair styling as your evidence, and when people dispute, your retort is that only you can see what is going on, and your conclusion is definitely the correct one, and any alternative theory is clearly impossible. If this is your position, I am not sure exactly why are you are posting at all since you have made up your mind already about what is happening. No one is saying that your hypothesis is absolutely wrong - I am saying that jumping to the most unlikely conclusion (that your transplanted hair is falling by way of DHT) is pretty counterproductive when you could be using other approaches to solve the problem rather than complain about a non-existent one.

If your opinion that anything is "clearly" represented by a few low resolution photos taken from distances far too back to discern anything meaningful - then the credibility of your opinion seems suspect. The only thing that is "clear" here is that the photos are ambiguous. Could it be transplanted hair shedding? Maybe. Is it the likely cause of the thinning? No. The reasons why it is not likely the cause: 1) The scientific literature has established fairly confidently that hairs transplanted when pulled from the safe zone typically do not miniaturize in people with MPB. 2) His photos indicate that the hair pulled was well within the safe zone. 3) The pattern of thinning here is relatively uniform. If this was a case of "some" of his transplanted hairs being outside the safe zone, then we might expect that the thinning pattern to be less uniform, unless you want to take the hypothesis that "all" of his transplanted hair were susceptible to MPB. 4) The more thin areas of his scalp are the exact areas that appeared to be receding prior to the transplant.

To be totally honest I don't think you can necessarily conclude these are transplanted hairs that have shredded. It looks like the transplanted hairs may have remained while the native hairs have continued to recede, and that is the most obvious explanation for what has happened here. It could also be the result of continued recession and also the natural growth/shed cycle of the transplanted hair.

My pricing was calculated when I booked the procedure which was nearly a year ago. So perhaps his prices went up since then? His waiting list is nearly a year long - if the demand for his service is outpacing his ability to perform the procedures, then it would only make sense from a business standpoint to increase the price. It's also possible that "nearly $10 / graft" is still consistent with what I paid since some people might consider 8.50/graft to be "nearly 10/graft." Or if its at 9/graft that is also nearly 10/graft.

It's in my OP. Approx 16k for 1869 grafts

Not really. The scalp above the recipient area is still quite numb and the recipient area still has some numbness as well.

Not a whole lot new. Donor area is itching more than I'd like - today I scratched too hard and started bleeding. The donor area is definitely thinner but I don't know if is noticeable to others unless you point it out. The skin underneath the donor area is still red but its fairly well hidden by the hair at this point. The recipient area redness doesn't seem to be improving all that much (if at all). I'm not sure if its because I am getting intermittent unprotected sun exposure or what (I'm talking a total of 7-12 minutes total throughout the day for 1-2 minutes at a time just walking from my car to the office or to a restaurant and back). Can't wear a hat because of the environment I work in, and my hair mostly covers the recipient. Dr said I shouldn't be concerned as I may have a histamine positive skin type which can result in redness for up to a year. For what its worth, I also have mild rosacea so my face is usually pink and gets red easily from heat/sun/spicy food/alcohol. It doesn't seem like anything more has shed in the last week or so - there is about 10-15% of the hairs I would guess that didn't shed and appear to be growing. The hairs near the hairline you see in the photos are native hairs. Doesn't seem like any shock loss in the recipient area. Just trying to be patient.

In regards to sun exposure, the general consensus seems to be avoidance of direct sun exposure during the post-op healing period, and you should cover the recipient area and/or wear sunscreen on the recipient for a year - the reason being that the skin is very susceptible to sunburn/damage while its repairing. What I can't seem to find an answer to is how literal these instructions need to be adhered to. Does this mean that the recipient needs to be covered at *all* times - including, for example, if you are walking outside during the day in the sun for a few minutes or driving in a car when there is sun out? It would seem to be that a common sense approach here is appropriate. If you are going to have prolonged direct sun exposure (more than 15 minutes?), you should cover up or wear sunscreen - essentially just treat your skin as if it can be very easily sunburned. Or should I be treating sunlight like its a death plague and treat all sunlight as if every second is burning my grafts to death?

I hope you asked him about his punch. Seems to be the most controversial aspect of his work.

Funny you should ask that. I just started on brand name propecia when I was previously on the generic proscar. My first batch of the drug was a prescription for generic proscar, and I initially had sides when doing 1/4 every day, and experimented and eventually landed on .5 mg every third day. I don't know the manufacturer. That lasted me for a few years. When I had my consult with Diep I was almost out, and he wrote me a new proscar prescription and my local pharmacy (Kaiser) gave me what I think was the same manufacturer (pills looked identical, but I'm not sure if that means its the same or what) - Dr. Reddy's. I felt like over the last year the propecia wasn't as effective - I couldn't necessarily see anything visually but the hair just felt not as thick. So I had Diep write me a prescription for brand propecia and I just picked that up a few days ago. The price was ridiculous ($300 for 90 1mg pills from a local pharmacy in Cali - the tech there said this drug is rarely purchased). But...I had been doing some reading about peoples differing experiences between generics and brand and I figured I don't want to chance it with my finasteride being less effective. If the drug seems to have a noticeable effect in the crown area - I'll probably stick with the brand and go with Merck's proscar to cut the cost a little bit.

We didn't really talk about shaving the head. I made it clear that I did not want that done. He did shave a few cm of hair around the hairline in the recipient - you can see that many of the hairs near the hairline are the natural hairs regrowing right now - so there were hairs implanted behind the existing hairline. My understanding is that going further into the hairline risks shock loss of the hairs around that which is no good if those are the hairs that are next to go on your head. Propecia has halted the further recession (or at least slowed it greatly) of the hairline.

Day 25: The week at the office was pretty uneventful. Everyone was surprised by my haircut since its a lot shorter but I don't think it occurred to anyone that I had a HT. One of the judge's did not even recognize me when I came into his court. The donor area wasn't really noticeable with the use of dermmatch- but my recipient area is still fairly red and you could plainly see it if you were looking at my head. With the way I was styling my hair though, (and the fact that you couldn't really see that my hairline was receding before) - it likely just looks like a redness near my hairline that could be caused by ?? who knows. I told a couple people and they were very interested in the process. I'm sure everyone else can see the redness but no one seemed to really overly invested in figuring out what the redness was. The top of my head and recipient is still fairly numb but I can slowly feel sensation returning. Will probably take a few months at this rate. Many of the recipient hairs have shedded, a lot remain, a few seem to continue growing. Was using bacitracin for a few days on the recipient to address some of the pimples/redness as advised by the Dr. Redness remains in the donor area but it is becoming increasingly less visible as the hair around it grows. I *feel* like there is a noticeable loss in density in the donor and from certain angles it looks a bit worrisome, but it seems fairly comparable to other donor areas I've seen with the same skin type around the same time. I'm guessing there is some mild shock loss - but I can't tell if the visibility is due to continued redness or due to shock loss or overharvesting. Comparison photos are from day 1/3

I don't have any concerns at this point. The lighting is probably what you are seeing. You can definitely still see the redness from donor extractions when the light angles are right. But right now it would appear that the red undertone rather than any meaningful density loss is the cause of visibility in the donor area.

I think the unfortunate reality is Diep wanting to extract so high up necessitated shaving so high. I would have preferred him going further into the left side of the donor instead of going up.

It’s just not long enough on the sides. I can’t cover both the hairline and temple area.

Which part?

The tech unfortunately buzzed all the way up on the sides so I have no hair behind the temple area to brush forward. I can only brush forward the hair on the crown and it doesn't sufficiently cover the temples.

My last weekend before going back to the office. I think I may be successful in keeping attention off of the back. Bought some light brown dermmatch - I don't think its the best match for the hair color but it seems to be working a bit. I also got a haircut today and the unfortunate reality is I don't think my barber could really do a whole lot to create a reasonable style that will cover the recipient area. The problem is that they just went too high when they shaved the donor and I don't have enough temple hair to brush forward, and my hair is too light and fine to really provide any real coverage. That in conjunction with the fact the recipient is still very much red - I have no way to conceal it. I can brush my hair forward but you can still definitely see the red outlines of the recipient area if you look for it. So I'll likely just put it out there on day 1 and tell everyone where I was the last three weeks. Also, there seems to be a bit of irritation (possible pimples) in the recipient area. I don't know if its cause for concern or what. Most of the hairs are still there, but you can see them falling over like limp noodles and many have fallen out already.

Your hair loss pattern seems fairly similar to mine, but I am 6 years older than you. I got on fin 5 years ago when I first noticed temples looking a bit thin. I also styled my hair similarly and no one could tell the temples were thinning (and even today most people wouldn't think I had a slowly receding hairline.) On fin, the temples did recede very slowly each year anyway, and it became harder and harder to style it the way I wanted to, until finally it seemed like most of the time it was just kind of shitty and I wanted "a" hairline back. I would agree with what is written above. I think doing your research now is a great idea - but before you pull the trigger - ask yourself how badly it bothers you right now. Is it just something that would be "nice to have" like a luxury car - or do you feel at this point that your hair has downgraded from a honda accord to a 98 pinto without air conditioning in los angeles. Only you know how much it bothers you, and it clearly has bothered you enough to have you schedule a surgery. Also, you know best whether or not the recession has continued or if it has halted completely. But you should also know there are some advantages to waiting - you can wait to see if the recession continues into your 30s. If it doesn't - great, then have a procedure to fix your temples and hope that the fin keeps working. If you wait until your 30s and the hairloss continues, you might have a better idea what your long term outlook is like and you can plan accordingly. Doing surgery now is going to essentially lay the groundwork for the hair that you will need to maintain for life (who knows if something better will come along). If your temples and hairline keep going, you might need to continue getting small procedures to keep up that NW1, and I can tell you being on day 14 right now, its not the easiest shit to go through, and i certainly wouldn't want to be likely doing it again for at least another 10 years. Are you willing to do another procedure to fill in later temple and hairline recession in your mid 30s? Are you willing to possibly run out of grafts in your lifetime with a great hairline and midscalp but a giant bald spot? These are all considerations to make, and the earlier you do it - it seems the more you are gambling. Only you know if the benefit is worth the risk - because no one else here (no matter how many people here say how great your hair is) can qualify how much benefit you would really get since that is determined by how much the hair is subjectively bothering you. Many people might say that I didn't need to get a transplant either (im a bit further along than you I think) but it bothered me enough that the potential pitfalls (less graft supply, chasing hairline in future) did not outweigh the benefit to me (assuming success, which is also another consideration). I think being a bit older and seeing the effects of fin, I have a better idea (but not perfect prediction) of the next decade, and I've accepted the possibility of needing further procedures, and possibly looking worse in my older age than if I had waited to have a transplant in my 40s. Objectively speaking, I don't know that you would achieve much of a cosmetic benefit compared to your pre hairloss photo. Yes, with recession, there are some hairstyles that you cannot pull off. But you don't look any worse off since you have utilized certain styles to compensate. You have not yet reached the point where the hair loss has affected your appearance in any meaningful way.

I asked him today - he said we won't know which grafts took until at least after 6 months. Perhaps he just didn't want me to get it in my head that some of the grafts didn't survive so I don't feel bad - or maybe it's just speculation and you can't really know (and don't get me wrong - it appears that a vast majority of my grafts have taken hold. Seems like it would be something that could be empirically verified if someone undertook the study. But it doesn't seem the study has any monetary incentive since its just a study designed to rule out potential customers. Here's at least one quoted doc from realself: (in response to question about why transplanted grafts have not shed at the 17 day mark) This is undoubtedly a good sign. Sometimes hairs don't always elongate after transplantation and simply "fall out" No study has ever been done but I do believe hairs that elongate (lengthen) post transplant are extremely healthy and will have high survival. Jeff Donovan, MD, PhD

Had my 2 week follow-up today. It seems that my initial concerns about how the surgery went were unfounded - I was worried about excessive bleeding affecting the surgery and the length of time the surgery took. Turns out, we just got started fairly late in the morning since there was another surgery that was scheduled before mine (FUT I believe). There was no bleeding outside of what was to be expected. The Dr. used a 1 mm punch for my donor area and said that everything is looking good right now but believed I would likely have persistent redness due to my skin tone/type. Final graft breakdown: 4190 hairs 1 - 318 2 - 881 3 - 502 4 - 166 No new pictures to show since everything looks more or less the same.

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I've been trying to google this question and I can't seem to find definitive answer. My question is - how does the immediate growth (or non-growth) of the transplanted follicle have any relation to the graft's viability? IE - does seeing the hair follicle grow out and subsequently shed in the first month indicate that the graft was successful and does the converse necessarily apply - if an implanted follicle does not grow after transplantation - does that indicate that the graft did not survive the transplantation process? Some surgeons that have posted progress pictures of their patients have noted that "day 10 - we can see all of the implanted follicles slowly growing. I told (patient) that that means those grafts were successful and he's going to have a good result. It's important for patients to understand this since it is expected most of these follicles will shed in the coming weeks." I haven't been able to find much regarding the contrapositive. If 5-10 post op pictures show just a small tip of a follicle, while the others around it have grown a millimeter or two - does that indicate the graft didn't make it? Is it possible that hair follicles break off at the stem? Are there any other ways to tell if grafts took hold or not?