LaserCaps

It'll depend on a couple of things. If you're working an entire separate area than what was worked on originally, you could do it as soon as 4 mo post op. Same area? 7-12 months. Are you talking FUT or FUE? This will also have a bearing on the answer. FUT scars take 6-12 months to mature. You want to make sure this heals before doing a 2nd procedure. Typically the first scar will be re-excised so that there's only one scar left. With FUE, a lot will depend on how the work was done originally. What sort of scarring was left on the donor? If a big punch was used, there would be circular scars to deal with. Most frequently the doctor wants to see the results of the first procedure before moving forward. The can then work in and around what was transplanted the first go round.

Crown pattern moving forward. Review the Norwood chart. If you look at the perimeter of your loss, it sure seems it would be a sizable area. Perhaps close to a class 5. The key here is to keep in mind, if you've shown the propensity to lose, you'll continue losing. Glad to hear you're on some sort of regimen to help you slow down/halt the loss. I'd be one to do all I could, non surgically, to help retain and enhance the donor area. Why? The crown is the weakest point we all share due to the whirl. It's the point from which the hair stems. That is, no hair is coming into the area to provide any shingling. The hair grows away from the point, exposing the area. And because the doctor will follow this same pattern, it would take many procedures and many grafts to achieve density. We refer to this area as the black hole of hair restoration. If you've been a long time user of Fin, I would talk to the doctor about adding Dut a couple of days a week. You can transition as you go along, depending on results. Why caution? I'd venture to say you haven't experienced any sides with Fin. The half life of the medication is only 7 hours. That is, if you were to experience a side, the main ingredient would only stay in your body for 3 days. With DUT, it would be 6 months. Regardless - yes - add Rogaine. The mechanism of action of each modality is totally different and there's synergy when combined. You may also want to research PRP and Laser. When done correctly, these can help reverse miniaturization. Give everything a year, take photos in the interim. Transplants pending outcome.

Always valued your hard work. Are you going to be totally out? Hopefully you'll continue contributing.

I am sorry to hear this.

There's no such thing as "who is the best at doing....." You either know or don't know. Please do your research and review photos of results, particularly of the area of concern. With regards to temple points, that hair is very specialized. Nowhere in the body are you going to find the same quality hair. Thus, if you only put a few "coarser' hairs from the donor, they'll stand out like a sore thumb and leave you with an unnatural look. The best approach is to fill in the temporal points and allow the native hair to help add density. Unfortunately this is not a regulated industry. Anyone can do this. All they have to do is go to their local library, read up on the subject, and be in business the next day with zero experience. And watch out for "Double Board Certified, Triple Board certified." If you dig deeper it's likely you'll find these regard something else other than hair. Don't be fooled by fake reviews and stock photos. Take your time, ask where the doctor learned to do this. Who will be doing the work, the doctor or the techs? Lastly, if you've shown the propensity to lose, you'll continue losing. What are you currently doing to mitigate the progressive nature of this condition?

Glad you found this forum. Lots of experience and people who can help guide you along. First thing to realize, this is not a regulated industry. Any doctor can do this. All they have to do is read up on the subject and be in business the next day with zero experience. 1. Any planned cosmetic surgery should be done before. Imagine a patient doing an eyebrow lift which will have a direct impact on the hairline. You'd be better served by doing transplants after the fact. 2. Most clinics today will use FUE. FUT involves surgery. (I'd venture to say, if you were to call clinics in Turkey, none do FUT). FUT is still a viable harvesting technique and one you could contemplate doing since you seem to keep your hair on the lengthier side. You could exhaust all FUT, (always re-excising the original scar so as to keep the area as clean as possible with only one scar), and then move to FUE. You could actually put FUE grafts on to the scar. By considering both FUT and FUE, this would give you access to your entire donor area. (It's always suggested - when doing FUT - to avoid weightlifting that affects the neck for 6 months as this will cause your scar to widen. Thus, if you're a weightlifter or keep your hair shaven in the donor, a high and tight haircut, FUE would be preferable. But let's discuss FUE as, it seems, is the approach you're considering. Artas, Neograft, Smartgraft are robotic type techniques. These use a much larger punch as it's easier to extract with O than with o. These will leave circular type scars in the donor. Think of honeycomb. Manual systems use a much smaller punch. As long as the punch is smaller than a .9mm, it'll leave a micro-scar which is not detectable. DHI is an FUE method using an implanter. More often than not this involves shaving the top of your head which, in my view, is more of a negative. Leaving the hair long on top allows the doctor to decipher the angle and direction of the aperture. Once the new hair comes in, it'll match angle and direction of what you have. Let's go back to - "any doctor can do this." Think of the FUE manufacturer. Their job is to sell equipment. Do you think they care who they sell the equipment to? And not only will they sell the equipment, they'll send techs with it. People with no medical experience. A disaster waiting to happen. It's not uncommon to hear, "the techs did the work, the doctor was nowhere to be seen." Perhaps that was a good thing, he has no experience either! So, who do you trust? Review the list of suggested surgeons and do your research. 3. It's important you keep the area clean. Post op instructions will be given to you outlining a modified washing technique. Get baby shampoo which contains no alcohol. Put in on the tips of your fingers. Tap the area gently, not rubbing. Get a cup of water and pour to the back of the hand and let the water trickle down. Others will suggest pouring shampoo and water on a cup, mix, and pour unto the area. Do not let the water from the shower hit the transplanted area. This could dislodge the grafts. (Visit with your favorite hair dresser. They can help you address the greasy look issue). 4. Unfortunately you're holding the hair up with your hand and it's impossible to tell what pattern you're thinning into. It does seem, however, you've receded the hairline, the temporal areas, and the area behind the hairline. How far back? difficult to tell by the angle of the photo you've submitted. Review the Norwood chart and notice the progression. The important thing to understand, you can identify a pattern by the way the hair is being lost. Take a pattern 5a for example. Grab a pencil and cover the figure. You can have hair but, if you can see through, you should be able to idenfity the pattern you're thinning into. Always be pattern appropriate. A class 6 would never have a hairline in the middle of the forehead. (There are engineering principles that apply to all of us universally. Research the Rule of Thirds. This should give you a basic idea where your hairline ought to be). You can also think about it this way....18 is long gone, 80 is coming. Imagine being 80 YO in a happy home with a hairline of an 18 year old. Not good. In regards to numbers, 1500-2000 follicular units is a common range for a case similar to your own. A lot will depend on how far down you come. Bringing hairlines down take many, many grafts. (Keep in mind, hair typically grows forward at an angle. You'll now have bangs which will make it look as if you have a much lower hairline. Stay conservative. You can always add and tweak. You can't ever remove. Well, you could - but it would leave scars in the middle of the forehead. 5. Has been addressed. 6. Testosterone is what drives guys. This gets broken down to DHT which we know is an irritant to the follicle. This affects the horizontal area but not the vertical. If we know the hair in the donor is permanent, it'll be permanent wherever it's placed. It's the best hair you have! But this does not preclude you from losing more native hair. If you've shown the propensity to lose, you'll continue losing. What are you currently doing to mitigate the progressive nature of this condition? 7. Propecia, Rogaine, PRP and Laser are the modalities we typically refer to when dealing with this debilitating condition. The mechanism of action of each is totally different and there's synergy when combined. Propecia and Rogaine are considered to be the best meds for retention towards the crown. PRP and Laser, when done correctly, can help reverse miniaturization. Just be under the supervision of a physician.

Forget the crown. Concentrate your grafts in the front and area right behind the front. If you're going to be thin, be thin back in the crown. (The meds tend to be more effective in that area. And, it's normal to have hair in the front with a thinning or even an empty crown. The crown can truly eat your lunch. We refer to this area as the black hole of hair restoration. It all has to do with the whirl. Let me illustrate. Grab a piece of paper and a pencil. Draw a dot. Draw an intersecting cross right on the point. Let's assume this is procedure #1. Turn the paper ever so slightly in either direction and draw another cross. How many crosses would you need to fill the entire circle? You could actually put your entire donor in the crown and still look thin. You then go on to lose all the hair in the front and you'll have nothing to fix it with. What's worse, you'll be questioning the doctor, "Why did you put all my donor in the crown when now have nothing left for the front and still look bald?" Remember, it's the front people see when they converse with you. You also have to deal with the doctor. How was he trained? Where did he learn to do this? Many doctors are under the impression grafts compete for blood supply and feel the need to leave a separation in between grafts. They'll explain they're placing a foundation to which you can add grafts in the future. So, you do the first procedure and it leaves you with a thin result. You return a year later to do more grafts and achieve a bit more density. You might even require a third and a fourth visit to achieve desired density. Eventually you run out of donor. My suggestion to you is to rely on a medical regimen to help you retain as much of the native hair as you can. Do all modalities and give them a year. Based on the results you can then decide how best to deal with the situation.

It takes 3-4 months for the new hair to come in. Vellus-like at first. It'll then take the ensuing 8 months to mature the results. The next day the doctor will typically call to check up on you, make sure you slept well, and to learn if you experienced something during the night. Never heard of a doctor asking you not to share your opinion with others. Post photos of your donor. There are plenty of people in this platform that can share their opinion with you. There's a lot of communal experience. At 6 months all will be out but it'll truly take a full year, (and sometimes even longer), to achieve a matured result. Remember, the quality of the hair will be the same as what you currently enjoy in the donor, the area from which the hair was harvested. For the doctor to ask you to give it time - is not unreasonable. (What I like is the fact you've kept an open line of communication with the doctor. I would take photos and share them with the clinic. The worse thing that can happen a year later is for the doctor to blame you for the poor result, "you never came to any of your scheduled post up visits." Negative reviews are not good for a clinic. If he already suspects that eventually that's exactly what you intend to do - I'm not surprised he's asking you to keep it quiet.

The beauty of having hair is the fact you now have the freedom to style it the way you want. In this particular case the patient opted to use some gel and to spike the hair up. The patient is so thrilled with the result, he's now considering doing another procedure. Hair grows at a certain angle and direction. At the time of the procedure the doctor will make sites in the angle and direction to match that of the native hair. If you look carefully, you can actually see the hair, from back to front, it is combed forward. It's only the front the patient spiked up using gel.

No. I do agree patients tend to question the results of the second procedure a lot more than the first. Particularly for patients that start with nothing. It might be due to the fact that on the first one you go from nothing to something. Once there's hair in the area, the second one will not be as dramatic.

Wait, what? Let me see if I understand. If you've never tried anything, I would encourage you to do all modalities and give them a year. You can then decide if the time, effort and expense are worth continuing. (It does take a year to confirm what exactly the meds will do. It also takes a whole other year to mature the results of a procedure - so you're now two years into this. Why not do both transplants and meds at the same time? A year from now you'll have more density in the front because of the procedure, but perhaps more in the mid-scalp and crown because of the meds). It also seems you have realistic expectations - which is a good thing. Now, let me see if I can decipher what you mean by what you wrote in the second sentence. Is having hair in the sides and back important to you? If your ultimate goal is to keep those areas tightly shaven, you could contemplate the idea of moving all the hair you have in those areas and move them to the top. Growing the hair in the donor.....how does that compensate loss? Pls clarify.

No family history of hair loss? But all have receded temporal areas? That's a component of hair loss. Gradual, it seems. Will you go on to thin more? A true enigma. The fact remains, if you've shown the propensity to lose, you'll continue losing. Wish we had a hair crystal ball from time to time. Consider the non surgical program. Propecia and Rogaine are considered to be the best meds for retention, particularly towards the crown. They do work in different ways and there's synergy when combined. The problem is a year later when patients see no visual change - and stop all together. The meds are not intended for you to grow anything. They're to keep you from losing more. If you look the same a year later, the meds did what they were intended to do. Research PRP and Laser. When done correctly, these can help reverse miniaturization. Testosterone is what drives guys. This gets broken down to DHT which we know is an irritant to the follicle - in the horizontal plane, not the vertical one. If the hair is permanent in the donor area, it'll be permanent wherever it's placed - meds are typically not needed unless the patient is experiencing global thinning, (thinning in the sides and back). (Starting and stopping the medication is a waste of time, effort and expense. Not only will you go on to lose what you would have lost had you not been on the med(s), you'll resume losing hair). If you decide to start some sort of regimen, stay on it. (The cost of Propecia - the lowest price I found so far - is $27 for the entire year. So, why not)? Understanding meds tend to be more effective towards the back, I'd be one to transplant the front and keep an eye on things. If you start noticing ongoing miniaturization, consider getting on meds. Be under the supervision of a physician and take photos to keep track of things.

A couple of concerns, Looking at the last photo, it sure seems you're still expanding the pattern. Just look at what's happening in the perimeter and how far you're dipping. My first question, what are you doing to mitigate the progressive nature of this condition? It's important to recognize, if you've shown the propensity to lose, you'll continue losing. I once worked with a doctor who used to say, "It makes no difference where the hairline is as long as there is one." The farther back you go, the farther back the doctor can work so as to minimize the size of the crown. You can always add a tweak at a later time. The second thing that goes hand and hand with this being pattern appropriate. Review the Norwood chart and notice the progression. The key here is to understand how each pattern is identified. An advanced pattern, for example, would never have a juvenile hairline. (Research the Rule of Thirds. This should give you a decent idea where your hairline ought to be. Be conservative). Everyone'an expert. I often chuckle when I read recommendations in the 4K - 6K per procedure. There's only so much you can harvest per time. Why is that? As long as the punch is smaller than a .9mm, it'll leave a micro-scar which will not be visible to the naked eye. The punch is so small, however, so will the graft. Not a lot of substance nor hair. And while this has improved greatly, the fact is, you can get more with "O" than you can with "o." Larger punches will leave circular type scars - which defeats the whole purpose of FUE. You typically want to spread the harvest to avoid over harvesting. Taking every 7th, for example, would perhaps allow a second procedure down the road. You can typically harvest 2000-2500 grafts at any one time. So, how do you get from this to 4K+? You could do both FUT and FUE procedures, (2 day procedure). You can split grafts, or you can over harvest. (Follicular units can come with 1-5 hairs. You could take a 5-hair graft and convert into 5) 1 hair grafts. While you get the numbers, you lose the density. Placing one hair grafts throughout would yield a diffused and an unnatural look). Given the way you style your hair, it's likely you would consider FUE. Over harvesting...hmmm. This is something to consider. If the doctor removes all your donor and places it on top - would that be a consideration? If you plan on always keeping your hair in a high and tight on the sides and back, why not? I would, at least, have that conversation with the surgeon. Lastly, donor limitation often guides the approach. There's typically not enough available to allow for density in the front, top and back. It's for this reason most doctors will suggest working the front first. It's the area you see when you look at yourself. It's also the area others see when they interact with you. (Having hair in the front will alway serve you well. It'll help frame your face and give you styling options).

An experienced doctor will work with magnification. He'll work in and around the native hair. The instruments are very sharp and, inadvertently, can give you a haircut. These hairs will eventually come in along with the transplanted hair. It's very difficult to damage a follicular unit. By "can not take medication..." I gather you're referring to Finasteride? Why can't you take it? The medication, by the way, is now available as a topical solution. And, there are other modalities other than Fin, that are available to you. The mechanism of action of each is totally different and there's synergy when combined. You truly need to consider doing something. Why? Donor limitation often drives this industry. There's typically not enough hair available to allow for density throughout the entire pattern. This is the reason why most doctors will suggest concentrating in the front to begin. It's the area you see when you look at yourself, it's also the area others see when they interact with you. But let's consider the area behind the front, which is what's likely concerning you. Let's assume you fill the area. Because you've shown the propensity to lose, you'll continue losing. You go on to loose all the native hair around the "island" worth of permanent hair. You'll have created a target area and an unnatural pattern. And, if the pattern progresses forward, which is what it seems is happening, you may be left with no donor to address the front and still look bald. It's the front people see when they converse with you. It sure seems a new hair transplant outfit comes up every day. I'm sure you'd get thousands of different answers when it comes to "who is the best." If you know how to do hair restoration, you'll know what do do regardless of what the case is. There's no such thing as a "specialty" in this industry. The issue however is the fact this is not a regulated industry. Any doctor can do this. All they have to do is read up on the subject and be in business the very next day with zero experience. Do your research and watch out for fake reviews which seem to be rampant. Glad you're getting advice from this community.

Review the Norwood chart and notice the progression. As patterns advance a number of things happen. The hairline recedes. The corners become deeply recessed. The crown begins to expand. When you get to a class 5, the only thing left is a bridge. When that's gone you're a 6. The donor then dips and you've arrived at a 7. What's your family history like? Are there males with very advanced patterns? Donor limitation often drives this industry, particularly when dealing with an advanced pattern. There's typically not enough to allow for density in the front, top and crown. It's for this reason most doctors will suggest working the frontal area first. It's the area you see when you look at yourself. It's also the area others see when they interact with you. Now the crown and the reason for your post. In the most basic of concepts, I'd like you to think of the crown as a circular area. You fill it. Because you've shown the propensity to lose, you'll continue losing. You go on to lose all the native hair around the island of permanent hair and now you've created a target area and an unnatural pattern. Retention of the native hair is imperative. Also consider the whirl. The crown is the weakest point we all share due to the whirl. It's the point from which the hair stems. That is, no hair is coming into the area to provide any sort of shingling. The hair grows away from the point exposing the area. It would take many, many procedures and many grafts to achieve density. We refer to this area as the black hole of hair restoration. The crown can eat all your donor. If you ever lose the front, you'll have nothing to work with and still look bald. I can almost hear you ask "why did you put all my donor in the crown when I now have nothing left for the front and still look bald?" Remember, it's the front people see when they converse with you. Propecia and Rogaine are considered to be the best meds for retention in the crown. The problem, is a year later when people see no visual change. Most do not understand, the meds are not intended for you to grow anything. They're to keep you from losing more. If you look the same a year later, the meds did what they were intended to do. (A small percentage do get to enhance the native hair. A very small percentage similarly, do not respond to the treatment). Research PRP and Laser. When done correctly, these can help reverse miniaturization. If the crown is the main priority, I'd be one to do all modalities and give them a year. You still have a lot of miniaturized hairs that have not left the building. These could possible enhance which, in the end, would add density to whatever you end up doing. And, if they're successful, it's critical you continue the regimen. If you stop, not only will you go on to lose what you would have lost had you not been on the meds, you'll resume losing hair.

Your hair is long enough on the sides but you can still see through and see scalp. That's concerning. The crown is the weakest point we all share due to the whirl. The hair grows away from the point exposing the area. Rely on a medical regimen to help you retain. If you end up with a thinning crow, that's perfectly normal. Yes, I think moving to oral Min would be a great idea. Take a pill and walk out the door. Less labor intensive. It's often not what you need but what the doctor estimates he can harvest from the donor at any one time. In a case similar to your own, 2000-2500 grafts. So, how do you get from this to 3500? You could do a max procedure, (FUT and FUE over two days), or you can split grafts. A follicular until can have from 1-5 hairs. You could take a 5-hair graft and convert into 5) 1-hair grafts. This would result in a diffused and unnatural look. Lastly, you could over harvest. You typically want to take every 7th. Take one, you have the other 6 to cover. If you take every other one, you'd be left empty areas. And while I am exaggerating, spreading the harvest is a much better approach. This would allow for you to return for additional procedures if need be.

There are several issues you're dealing with....And they're all concerning. First, fine hair does allow for the most natural results. It does take, however, many more grafts than someone with coarse hair. Dark hair, light scalp results in tons of contrast. You don't have that issue - so that's a good thing. Whatever you add will give the illusion of more density. Review the Norwood pattern and notice the progression. As patterns advance, a number of things happen. The hairline recedes, the corners become deeply recessed, the crown begins to expand. Unfortunately the quality of the photos is not very good. It's difficult to tell what exactly is happening behind the front. There seems to be miniaturization throughout, including the sides. This could be a function of your hair being too short and exposing the scalp. You were on Rogaine but stopped due to getting tired of the regimen? What's going to happen when you get tired of using Propecia? My friend, you're playing with fire. Donor limitation often drives this industry. There's typically not enough hair available to allow for fullness in the front, top and crown. It's for this reason most doctors would consider working the frontal area to start with. It's the area you see when you see yourself in the mirror. It's also the area others see when they interact with you. Now the crown. Think of the crown as a circle. You fill it. Because you've shown the propensity to lose, you'll continue losing. You go on to lose all the hair around the island worth of hair and now you'll have created a target area and an unnatural pattern. When you look at this from the back, it looks like a "happy face." We refer to this as "chasing the pattern." Now you have to waste more grafts to keep that area looking natural while we could have been using those grafts in the very front, the most prominent area. Retention of the native hair, in the overall scheme of things, is HUGE. Propecia and Rogaine are considered to be the best meds for retention in the crown. The problem, is a year later when patients see no visual change - not understanding - the meds are not intended for you to grow anything. They're to keep you from losing more. If you look the same a year later, the meds did what they were intended to do. Research PRP and Laser. When done correctly, these can help reverse miniaturization. I'd encourage you to do all modalities and stay on them for a good year. First to confirm you'll stay on them and second to assess their effectiveness. It truly takes a full yer to confirm what exactly they'll accomplish. A year later, based on the results, you can decide if the effort, time and expense are worth continuing. Lastly, be age and pattern appropriate. Advanced patterns do not have a hairline in the middle of their forehead.

There are two types of loss. The type you can attest to and the type you can't see at all. What you do see in the sink, brush, shower stall, is normal. The follicle gets tired of producing hair and goest into a dormant period, (resting phase) of 3-4 months. The hair then resumes growing. We refer to this as shedding. This will happen randomly to all the hair in your head and not all at the same time. 100 hairs a day is considered normal. Hair loss is different, you don't see it. Have someone help you. Take (sharp) photos of the crown. Notice the caliber. Some thick and some much finer. As the follicle atrophies, the hair becomes progressively thinner until it dissipates and disappears. This is the miniaturization process. Once gone, it will not return. Propecia, Rogaine, PRP and Laser are the modalities we refer to when dealing with this debilitating condition. The mechanism of action of each is totally different and there's synergism when combined. Talk to your dermatologist or a hair transplant specialist, research, and decide what's best for you. The meds do take year to confirm what exactly they'll accomplish. The majority retain. Some enhance, and some just do not respond to the treatment. Take photos and keep track of the progress. A year later you can decide if the time, effort and expense are worth continuing.

It's typically suggested you wait 6 months before you start weightlifting that affects the neck. No shoulder shrugs, no squats. You can do push-ups, leg presses, etc. You then did a revision. And each time you do this, less elasticity. How you heal is mostly a function of wound healing. The doctor will do all he can to keep it to a minimum, (deep suture, continuous, interrupted). The concern, if the scar widened the first time, and you had nothing to do with it, it's likely it'll happen again. The first thing I would do is have the doctor check how loose your scalp is. I would then get an orthopedic pillow that conforms to your neck. Even the pulling of the neck when you seep on your side, can have an effect on the wound margins. Ultimately, if there's no elasticity left or you decide not to move fwd, you could do FUE and put FUE grafts on the scar. You can also SMP. You seem to be thinning in the donor. Was there shock loss involved? Did the doctor make reference to this? What are you doing to mitigate the progressive nature of this condition?

Dryness of the scalp is typically the result of alcohol content in the shampoo. Try using baby shampoo. There are no restrictions after 7 days, you can now return to normal washing.

It's so irritating to hear about cases like this one. I almost feel the need to apologize to the patient - industry wise. Donor limitation often drives this industry, particularly when dealing with an advanced pattern. So many things to consider. There's typically not enough donor to allow for density throughout the whole head. It's for this reason most ethical doctors will concentrate their grafts towards the front. It's the area you see when you look at yourself in the mirror. It's also the area others see when they converse with you. Review the Norwood chart and notice the progression. A number of things occur as patterns develop. The hairline recedes. The corners become deeply recessed. The crown begins to expand. Eventually there's only a bridge left, (class 5). You lose the bridge and you're a 6. The donor then dips and you've arrived at a 7. The point here is to realize each pattern has a certain look. Being age and pattern appropriate just adds naturalness in the overall scheme of things. Follicular units can come in groupings of 1-5 hairs. This is commonly harvested in an FUT procedure. The whole point of FUE is not to have visible scars. To achieve this, the punch needs to be smaller than a .9mm. This leaves a micro-scar which is not detectable to the naked eye. But, if you think about it, because of the size of the punch, the follicular unit is just as small. Not a lot of substance nor hair. Could you get a 5 hair graft during an FUE procedure? Doubtful. You can typically harvest 2000-2500 in any given procedure. How do you then get to 4K, 5K, 6K grafts in a single procedure? Are they talking about hairs and not grafts? Perhaps. You could do both an FUT and an FUE procedure at the same time, (2 day procedure) to harvest as much as possible. You could also split grafts. You could take a 5-hair graft and convert them into 5) 1-hair grafts. Yes, you would get the numbers, but you would lose the density. This would yield a diffused and an unnatural look. People do not lose hair this way. The only other way to achieve numbers is to over harvest the donor. While there doesn't seem to be a lot of native hair left, I would encourage you to consider some sort of regimen to help the overall look. If there's any native hair left, retention and enhancement of it might just add to the overall density. I sure hope this happens. Give the meds a year. A year later you can decide if the outcome is worth the time, effort and expense. I do have a question. Was any of this discussed with you during the initial consultation? Who did the work, the doctor or the techs?

During the procedure the doctor uses very sharp instruments and inadvertently can give you a "haircut." Could be a simple as just that. Other times you can experience shock loss from the mere fact the doctor is working in and around the native hair. The tendency is for that hair to return on or about the same time the new hair comes in, (3-4 months). Lastly, and based on the caliber, it could be hair that's miniaturized and on its way out. What are you currently doing to mitigate the progressive nature of this condition?

If it happened the first time, why would you think it wouldn't happen the 2nd? That would be the first concern. How patients heal is more of a function of wound physiology. Doctors will do all they can to keep the scar to a minimum. A deep suture for example, the type of closure he chooses to do, etc. But he can not keep you from doing things that eventually can lead to a wide scar. If you go to the gym and start doing squats, for example, that will surely result in a wide scar. (It's typically recommended you avoid weightlifting that affects the neck for 6 months. No squats, no shoulder shrugs). Even the wrong type pillow that pulls on the neck can lead to a wide scar. Get yourself an orthopedic pillow that conforms to your neck to avoid tension. Have you visited with them to check your elasticity? Assurances and guarantees....hmmm. Get something in writing. There are too many variables involved - many which are out of the control of the doctor.

If you've been a long time user of the medication and you stop, not only will you go on to lose what you would have lost had you not been on the medication, you'll resume losing hair.

Minoxidil, oral or topical, is one of only a handful of modalities available to us to help with retention of the native hair. It's typically suggested a patient stop the use of the medication a week before the procedure to minimize bleeding. If you flood the field, the doctor would not be able to see what he's doing. Testosterone is what drives guys. This gets broken down to DHT which we know is an irritant to the follicle. If you get DHT, you get hair loss. This will effect the horizontal part of the head but not the vertical one. If the hair is permanent in the donor area, it'll be permanent wherever it's placed. Medical modalities, including Rogaine, are normally not used to improve the donor. (Women tend to be global thinners. That is, they tend to thin the sides and the back. If the hair is thinning in the donor, it would subsequently thin regardless of where it's placed. A doctor might suggest the use of Rogaine, and other modalities, to help strengthen the donor area). Rogaine can help the overall result, however. If you can retain the native hair because of the medication, this will end up adding density to whatever you accomplish surgically.