duchaine

I will be brutal...
From my personal experience, you need to understand that this "clinic" do not have to tools the handle an adverse reaction.
Som if the doc is scared that something could be wrong, he/she abort the surgery. Then the/she say "I aborted to protect you from this or that".
But keep in mind...they try to protect themselves as first thing.
 

On 11/17/2023 at 8:23 AM, EvansLawrence said:

they dont look better at 6 months man. Look carefully.

the final result is this

You can see better the lack of density when shaved. Angles are the key since the first line is not the most affected.

but you can see the patches are there.

and that area was receipt at HLC's

being that small area covered with 3157 grafts. 

You can see duchaine's case where he got 2,1k grafts for a small area as well but at least he had complete survival (or like 90-95%).

the patches are just there, where the grafts where implanted. Is not hairloss progression since I hopped on finasteride right after  y surgery there, and switched to oral minoxidil as well + ketoconazol shampoo. (plus implanted is not affected by androgenic alopecia)

Maybe I had 95% survival but 95% transection as well, so the overall improvement was not so great!

On 10/13/2023 at 11:50 AM, Spring15 said:

I don't know if it's just me but that hairline looks very low on the side shot, but still very dense. You should embrace the ugly duckling phase. It comes and goes quick 😁

I was thinking the same.
HL is is too low and flat.
In any case, the angles and directions look very good, so he end result will be good.

7 hours ago, nevo said:

If oral minoxidil help regrow hair. What about tadalafil/Cialis? Does someone heard of it's helping with regrow hair?

Someone suppose that Cialis can help post op.
But none of them is a "5 ininitor"

I can't see a great density in post op pics.

4 minutes ago, Den said:

Yes and yes I decided to rebuild my temporal peaks. I wanted to have something like 'Z' shape and told this to Dr.Keser. He designed the lines and I liked it and said yes happy to go with that. I mean he listens to his patients. If you have a specific design in your mind for temporal peaks, you can tell him and he can tell you what can or cannot be done. 

Thai is great.
Wonder the kind of attitude that Keser has with his patient...
Can you talk with him and discuss the hairline? 
how long does he take for hairline design?
Important: how many grafts did he quote for you at the beginning?

53 minutes ago, Den said:

Getting old  should try to catch the same light for the photos tbh

Joke apart, the black was your natural color? 

did you decide to rebuild the temporal peaks? Or it was a doctor's choice?

Did you discuss the topic with him?

From what I see, he created to very straight lines. Did he explain this choice?

I am looking for a new HT to rebuild my Temporal peaks but that are a very "dangerous" area so I'm looking for the best doctor (Keser is one of them) and any input can be helpful.

On 4/18/2023 at 6:39 AM, DrMunibAhmad said:

Hi Delta,

 

Thanks for the nice words. Imo the hair needs to have a max micron size + max flexibility to ensure it looks 100% natural. That’s why I don’t recreate temples with every hair type. I have my own ways of measuring the suppleness. The depth of the incision at the temple area plays also a very big role in making it look natural. I’m writing a textbook about it which i will publish in the future. It’s a guide for patients to follow to ensure that they get a natural outcome. 

when you say that "don't recreate temples with every hair type" you mean temporal peaks or the whole lateral hairline?

Another question: I see some people (me included) that do not lose temporal peaks but the hair are ultra thin and naturally short (the hair are something between hair and vellus).
Is this the "natural condition" of temporal peaks...or is this because there is a minor thinning of the area?

On 12/20/2023 at 5:56 PM, mustang said:

Always prefer topical than oral Fin.

You bypass the liver avoiding metabolite accumulation and long term side effects.

hair growth is a side effect of a drug created for prostate enelargment.

If a durg doesn't have dises, that means that doesn't work (Dan Duchaine*)

* D. Duchaine it is not me, he was the steroids guru.

https://pubmed.ncbi.nlm.nih.gov/24499417/#:~:text=DP cells from balding scalp,contributing to male pattern baldness.

3 hours ago, Cospine said:

I'm three months post HT and good results so far. I stopped TRT after my ht but have experienced some of the effects of not being on TRT....some depression, low libido, lack of energy. I decided to start TRT again but to monitor very closely and be very conservative with the amount of TRT. My Dr asked if my hair loss accelerated with TRT before my ht and I don't believe it did. BUT....my hair loss was fairly substantial before I started TRT.

I was at 120mg TRT before my ht. I'm doing 60mg 2x per week now to avoid high peaks. I will pull all the tests for TRT after a month and make sure I'm within normal ranges i.e. less than 950. If I can't keep it in the normal range, I'll have to stop and find some alternative therapy to help with natural testosterone production. I'm also going to be very mindful of hair loss and watch closely. 

See the chart I received from Dr Nadar on Anabolic index rating factors. I've stopped energy drinks, creatine and Whey protein.

Bottom line, TRT will most likely impact hair loss.

This chart is an over semplification.
The second substance on the score list is DHEA but DHEA increases insulin sensivity as well amnd the most recedent stanford research showwed that GH (third on the list) and DHEA reverse biological clock and...suprise suprise, make wonder on hair!
IGF-1 role is still not clear in hair loss as well as the rose of insulin.

On 12/20/2023 at 4:39 PM, Etownone said:

I have a long journey with hair transplants...  I've had 6.   First one in 2008.     And I've been on trt the whole time. 

If I could do it all over again... I would have never had a hair transplant.   The older we get, the more beneficial trt can be some certain men.  

I guess it all depends on each individual....  You have men like Jay Cutler that still have a full head of hair,   while there are other guys that go on a low dose of trt and it destroys their hair.

 

Jay? Jay is thinning like any HRN user!

5 hours ago, SY7 said:

I don’t understand why some doctors are better in higher norwoods. I do understand the part of experience but it is still the same procedure only spread out to a larger surface? Maybe some doctors just do more grafts in a session? Or am I seeing it wrong?

You are wrong!
a) skill for a small area: artistic sense, HL requires an high artistic sense. A doctor can be technically perfect but can lack of the ability to "read your face" and see what fits better.
b) skill for larger area: greater extraction ability. if you lack that ability but need to extract only 2000FU...doesn't matter. But if you need to extract 6/7000 FU, it makes a huge difference. Zarev, for example, is considered a god for larger areas bucasse his particular technique.

On 6/3/2022 at 11:24 AM, mrmane85 said:

Why did you choose the 9 month photo rather than the 12 month to critique?

same here.
Some flaws don't disappear in 3 months.

On 6/2/2022 at 7:07 PM, jjsrader said:

 

This does not imho look like natural temporal closure for a caucasian nor is the dense packing adequate (singles) before the wall of multis.  Good yield for sure - I'd like to see this surgeon take more care & better aesthetics in these areas - but what do I know?

totally agree.
The hairline design is wrong and the FU placement is poor.
If it was from a Turkish clinic, some people were blaming the doctor, the clinic and the entire turkey.

4 hours ago, LaNada said:

Hello all. I've been devouring this site for the past several months in preparation for my first transplant. I still have a lot of questions, so I can forsee myself starting a lot of threads. I apologize in advance. 

One of the clinics I've consulted with is H&W. From what I gather they seem to advocate pretty strongly for doing temporal points. This is not something I ever envisioned and would be inclined to not do in favor of saving grafts.

However, do people feel these are essential for aesthetics? Or are they more a matter of personal preference? If I go with H&W I want to know how hard to push back against these, or if I should accept their recommendation. Thank you so much!

 

the are 4 step of recession of TP.
In grade 3 and 4, it is mandatory to rebuild TP or you will get a toupee effect.
That said, if I well understand his thought, I partially agree with gastby.
Rebuilding lateral hairline is crucial to lower the frontal hairline.
But you can rebuild the lateral HL and not rubuild the temporal peaks.
Couto (maybe the best surgeon along with Keser in Europe to rebuild temporal peaks)  has a lot of cases like this.

If your concerne is grafts sparring, don't worry, temporal points don't require many graft.
The first cm is about 15 FU/CM
The second is about 25%.
So, 100-150 grafts per side can work the trick.

My concerne is the end result.
If a person doesn't have a Great Recession of TP, I suggest not to do.
I love natural temporal points.
Saw very few cases of nice temporal points from an HT.
 

On 12/17/2023 at 10:21 PM, Den said:

 

Hello all,
It has been one month since I got my hair transplant, and I wanted to share some pictures. There is some redness and some pimples, which concern me a little bit, but I'm hoping that everything goes right.

why are u turning grey???

3 hours ago, GoliGoliGoli said:

Which angle? 

Not trying to argue btw, just curious what you mean. Also you can't see his eyes so kind of confused

think the head as a box. The lateral hairline stays outside the eye and the frontal hairline above the eyes.
The frontotemporal angle should stay on the edge between the top oy your head and the side of your face.
From what I see, the angle is located more on the lateral side of the head.

Did you have pre-op medicines?
Anti-hystaminic and cortisone?

2 minutes ago, Melvin- Admin said:

I have said it before but I’ll say it again. Dr. Bicer is one of the most ethical doctors in the business. She truly cares about her patients. 

I had a free consultation with her and she was stunning.
She is a very good person.

39 minutes ago, alopie said:

I had to switch to topical finasteride due to some side effects (mainly testicular pain and longer term concerns)

My current routine:

- 2mg oral minoxidil daily

- 5% topical minoxidil 0.75ml daily (stubborn areas)

- 0.1% topical finasteride ~0.8-1ml daily

- Ketoconazole 2% 3x/week, some biotin supplements and LLLT cap 3x week

 

I am concerned that since I stopped oral finasteride (I used to take 1mg daily), there might not be enough androgen inhibition. 

Is topical finasteride 0.1% enough? How about microdozing oral (let's say 0.5mg MWF + 0.5ml of 0.1% topical daily)?

You are not using anti androgens, except a little bit of fina on your scalp.
 

34 minutes ago, GoliGoliGoli said:

What do you mean by "too wide"? Do you mean too thick? 

From what I see, the apex of the angle should be closer to the Cantus of the eye.
Turkish surgeons tend to draw this kind of hairline.

Great.
You have been very lucky.
 

On 12/18/2023 at 8:16 AM, Chrisno said:

There is no 100% right and 100% wrong when it comes to hairline design, it all depends on what you want to achieve. Your example #3 gives a more recessed look. You find this 'design' in nature when the hairline corners and templed are receding.

Different surgeons do this differently. Some surgeons do more rounded corners (Konior comes to mind, some of the Spanish doctors as well), whereas other doctors do more acute angles (which, in my opinion, looks the best and most natural usually).

In my view, the lower the hairline, the more actute the angle should be.

 

This is the HL I was talking about.
Let apart personal presences, is it anatomically correct?

4 months