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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.

Both and it all depends on the size of the practice. Consider a practice that does several cases per day with only one doctor. So as to save time a doctor may do sites first on one patient while extractions are being done on another case simultaneously. Trust is a big component in the overall scheme of things. Why choose a particular clinic? Do your research and view photos of results, particularly of cases similar to your own. There are a couple of ways you can determine what was harvested. If FUT, by the size of the segment. With FUE, did they just harvest a bit from the sides? Or sides and entire back area? Ask. Eventually the overall result will also provide a clue. 2000-2500 grafts will typically provide coverage to the front and area behind it, unless the grafts were placed diffusely throughout the entire area.

There are two times when you can experience these bumps. Right after the procedure and as the new hair is coming in. Let's address the latter as this is what you're concerned about. The follicle comes with the gland. The gland blocks the hair. It will turn into a bump. Use warm compresses and, when ready, treat it like a zit. Clean it. The hair will then grow normally. A dozen of these is normal. It truly takes 12+ months to mature results. If you're a slow grower, it might even take 18+ months. Patience.

It all begins with understanding the limitations we face, how best to proceed, and the overall goal. The basis of it all is donor limitation. There's just not enough to allow for full density to the front, top and crown. It's for this reason most ethical doctors will concentrate their efforts towards the front. It's the area you see when looking at yourself. It's also the area others see when they interact with you. Now the crown. In simplest terms, 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've created a target area and an unnatural pattern. Retention of the native hair becomes imperative. 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. Let me illustrate. Grab a piece of paper and a pencil. Draw a dot. Draw an intersecting cross on the point. Turn the paper ever so slightly in either direction and draw another cross. Do this until you get tired. How many crosses would it take to fill the area? We refer to the crown as the black hole of hair restoration. You'll end up putting all your donor in the crown. You then lose the front. I can almost hear you ask, "Why did you put all my donor in the crown when I now have nothing left and still look bald? It's important to keep in mind it's the front people see when they converse with you. Review the Norwood chart and notice the progression. It's perfectly natural to have hair in the front and have a thinning or empty crown. To have a "dusting" back there is normal.

"What a great looking transplant!" comes to mind. I'd be horrified. There are reasons for "irregularly irregular." Staggering, blunting corners. using the caliber that most match the area. A random placement. The basis of it all is you! If you look carefully at yourself, can you see rows? Can you see coarse hair in the front? How about your temporal points? There's a reason for things. A doctor who can match and mimic is the true artist. This is far more complicated than just saving grafts. You have to consider both offense and defense. If you've shown the propensity to lose, you'll continue losing. Getting on some sort of regiment to halt the loss is part of the equation. Donor limitation is another. Research. Review photos of results, particularly of those close to your own case.

It's difficult to tell given the length of the hair, if you're experiencing any hair loss. The crown is the weakest point we all share due to the whirl. It's the point from which the hair stems. That is, the hair grows outwards from the point, exposing the area. The contrast between the color of the hair and that of the scalp is not helping you either. But it does seem this is slightly larger than just a point. So, my first inclination, would be for you to visit with a dermatologist or a hair transplant specialist just to confirm. Since you do have family history, I would start doing research on all non surgical options. Discuss with the physician and decide the best course of action. It's important to understand, if you've shown the propensity to lose, you'll continue losing. There are two types of loss. The type you can see, (shedding), and the type you can't see, (true hair loss). What you do see in the sink, pillowcase, brush, is normal. The follicle gets tired of producing and goes into a dormant period of 3-4 months. The hair then resumes growing. 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. Start by looking at the hair in your temporal areas and pay particular attention to the caliber. Some thick and some much finer. We refer to this process as miniaturization. Eventually the hair dissipates and disappears. Once gone, the hair will not return.

It's typically recommended you use a modified version when washing your hair for 7 days. You can return to normalcy after that. It's also recommended you sleep at a 90 degree angle for the first 7 days. You can also return to normal after 7. (I gather you did FUE). The follicular units are secure under the scalp. The first three days are the most critical, but for the sake of conservatism, most clinics will tell you 7-10 days. Washing daily and keeping the area clean is important. Infections are rare but can happen. Use the cup method for 7 days. Washing does not cause effluvium. You can pat dry. Normal after 7 days. You can typically wear a cap after the procedure. You can wear a cap all you want. Restrictive diets normally have no effect on hair unless it's extreme. As long as you're getting your daily nutrients, you should be fine. With regards to drinking, return to normalcy after 7 days. Pimples right after the procedure are likely localized infections. This is a clean but not a sterile procedure. Bacteria can crawl into the aperture. If this happens, return to the clinic and have the doctor prescribe what he deems appropriate to address the issue. This can also happen 3-4 months later. A dozen of them is common. The follicle comes with a gland. The gland does not know what to do and blocks the hair. A pimple will form. Treat it like a zit and clean it. The hair will then start growing and the pimple will resolve itself. Rogaine is a vasodilator. It's likely they'll ask you to stop using it a week prior to the procedure. If you flood the field, the doctor will not be able to see what he's doing. You can resume 10-12 days after the procedure. You don't want to put this on open wounds - otherwise you'll feel the stinging sensation.

There surely are great misconceptions about what true hair loss really is. There are two types. The type you can see and the type you can't see at all. What you do see in the sink, shower stall, brush, is normal. We refer to it as shedding. The follicle gets tired of producing hair and goes into a dormant period of 3-4 months. The hair then resumes growing. This will happen randomly to all the hair in your had and not all at the same time. 100 hairs a day is considered normal. Hair loss is different. You don't see it. Under a bright light start by looking at the hair in your temporal areas. Look at each strand and pay attention to the caliber of the hair. Some thick and some much finer. This is the miniaturization process. Eventually the hair dissipates and disappears. Once gone, the hair will not return. Nothing regrows hair. Something is not going to come from nothing. If and when you see a visual change, it's enhancement of miniaturized hairs. It looks like regrowth but it isn't. Propecia and Rogaine are considered to be the best meds for retention the crown. They do work in different ways and there's synergism when combined. The problem is a year later when most 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. From time to time we hear of patients who do experience enhancement. If so, they'd be classified as positive responders. When this happens it's imperative they continue with the regimen. Similarly, a very small percentage do not respond. If that's the case, stop the meds and invest the money elsewhere.

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, floor, brush, is normal. The follicle gets tired of producing hair and goes into a dormant phase for 3-4 months. The hair will then resume growing. 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. Under a bright light start looking at the temporal areas. Look at each strand and pay particular attention to the caliber. Some thick and some much finer. This is the miniaturization process. Eventually the hair dissipates and disappears. Once gone, the hair will not return. Hair loss is a hereditary condition that can come from both sides and even skip generations. And just because a sibling is experiencing the condition, it doesn't necessarily mean you will as well and vice versa. No rhyme or reason. Thus, if there's history, that's a good time to visit with a dermatologist or a hair transplant specialist and learn about the non surgical options available to you. Why? The donor area, most times, dictates how to approach the case. This is particularly true when dealing with an advanced pattern. There's not enough har available to allow for density through the front, top and back. It's for this reason most ethical doctors will concentrate their efforts 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 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. You've now created a target and an unnatural pattern. It's imperative you be on some sort of regimen to help you retain the native hair. Propecia and Rogaine are considered to be the best meds for retention, particularly towards the crown. The mechanism of action of each is totally different and there's synergism when combined. The problem is a year later when patients see not visual change. Most do not understand, the meds are not intended for you to grow anything. They're to help you not lose more. If you look the same a year later, the meds did what they were intended to do. Research PRP and Laser. The done correctly, these can help reverse miniaturized hairs. Much has been written about potential side effects. Discuss with your doctor. Some patients may choose to ease into the med by taking it every other day or every third day. Be under the guidance of a physician so they can follow your progress.

No restrictions after 7 days. Playing is not the issue. It's the sun. You need to keep the area protected from the sun for for 4 months. If you burn each of the incisions, you'll freckle permanently. After 7 days you can use sunscreen and a cap and your can play all you want.

Lots of great information has been given to you so far. I'd like to add my $0.05 cents. The procedure is done exactly the same way - regardless of the harvesting method. FUT, a segment of about 9mm, (size of your pinky), will be removed. Typically a segment ear to ear will yield about 2400-2500 grafts. That is, a segment starting behind one ear to about 1/2 way it's what would be required for 1200 grafts. The area is then sutured close hair to hair - leaving a linear scar which will not be visible provided you keep the hair in the donor long enough. It's typically recommended you avoid weightlifting that affects the neck for 6 months to avoid widening of the scar. The segment is then divided and separated into individual grafts. The follicular unit will have lots of substance. Consider a unit can have from 1-5 hairs. You typically get better yield with this type procedure. Why? The whole purpose of FUE is to avoid the linear scar. This is meant for guys that keep their hair shaven. And, to allow for micro-scars which are not detectable by the eye, the instrumentation needs to be smaller than .9mm. The issue is the fact that the instrument is very small, so will the graft. Not a lot of substance nor hair. Thus, if you keep a high and tight haircut, FUE is for you. Similarly, if you are a weightlifter, choose FUE. Otherwise you can do whatever you prefer. FUE will typically be more expensive than FUT. But you can return to normal a lot quicker. With FUT you'll have sutures that will be self absorbable or can be removed in 10-14 days. If you have an advanced pattern, it would be worthwhile considering both procedures. Exhaust all FUT first. You can then move to FUE - and can actually put FUE grafts on to the scar. With regards to numbers, a lot will depend on hairline design. There are engineering principles that apply to all of us universally. Research the Rule of Thirds. This will give a decent idea where your hairline ought to be. The lower you go, the more grafts will be needed. And, just for reference, an eyebrow takes about 500 grafts. Do you think two eyebrows worth of hair is going to address the area you want to fill? Lastly, if you've shown the propensity to lose, you'll continue losing. What are you doing to mitigate the progressive nature of this condition?

It's typically requested you stop using it for a week prior to the procedure to minimize bleeding at the time of the intervention. If you flood the field, the doctor will not be able to see what he's doing. Resuming the use of it will depend on the type. Rogaine foam contains alcohol and will sting if you put it on top of open wounds immediately after the procedure. I would give it 3-4 days before doing so. The other types you can use right away.

It depends on the harvesting method. If FUT, you want to wait until the sutures are gone. If FUE, no restrictions after 7 days. I would start washing normally and then get to it. But, some clinics are more conservative than others. Check with the clinic you worked with and ask for their input. There's a reason why you chose that particular group to begin with. Why not follow their protocol?

Travel light. If you get too active after the procedure, it's likely you'll swell. This typically happens on or about the third day. It will travel down your face and drain at the neck. You may also want to consider checking the bag. The clinic will probably give you a post op kit - the last thing you want is for TSA to take these things away from you. Peace and quiet. That's what I would want. The farther up you are, the less people you'll see. Get there early and tell the attendant you just had a medical procedure and see if they can help you. Hopefully then can give you a row all to yourself. Also sit in isle if possible so you can easily go to the restroom without having to ask others to get out of the way. Keep things as easy as possible. Take a travel pillow and carry some pain meds with you in case you need to take some. You can also wear a loose-fitting cap which will help for you to avoid touching anything. Try wearing a button down shirt. This will help you avoid having to pull anything over the head.

Continue Fin, stop Min for a week or two prior to the procedure. If you flood the field, the doctor can't see what he's doing. You can resume right after.

No exercise a week before and a week after. If you flood the field, the doctor can't see what he's doing. Avoid anything that will make you bleed. It's likely the clinic will give you some sort of post op kit for the after care. Check in the bag so TSA doesn't take them. Get a travel pillow Good idea to take before procedure photos and update every 3 months to keep track of the progress. What are you doing to mitigate the progressive nature of this condition? Discuss with the doctor as needed. I gather you're doing FUE? What type, What's the size of the punch? If smaller than a .9mm it will leave a micro-scar which will not be detectable. It is a robotic system or a manual one? What will the doctor be doing during the procedure? What will the techs do? Travel light. If you exert yourself you can swell on or about the 3rd day. This typically lasts a day or two. Edema will travel down your face and drain at the neck. What area(s) will they be working? Do you know the graft count? Do you know what pattern you're thinning into?

A few things to consider. If you had an issue the first time, for whatever reason, why would you go back to the same group? That would be my first inclination. But you also have to consider what exactly the issue is. Lack of density? Too low a hairline? If it's a minor issue - sure. It's likely you will not be charged for the service. Going to someone new will surely cost more. And there's more than goes into this. If you go to a new group, they are now involved and somewhat responsible. The patient could very well blame this new doctor as well. It's up to that particular doctor to agree or not to.

It is always about results. Visit the Hair Restoration Network . There are 83 pages, (20-30 photos per page) of Dr. Arocha's work. https://hairtransplantnetwork.com/dr-bernardino-arocha/patients

No, you're not crazy. And I truly empathize. It all boils down to - who do you trust? Research, look at photos of results, particularly of those completed in a single visit. Consider, most practitioners are under the impression grafts compete for blood supply. They feel the need to leave a separation in between grafts and will ask you to return a year later to work around the separations and add density. They'll explain they're placing a foundation to which you can add density down the road. You might even require a third visit to add density. This work in progress approach will have you questioning results for years. Undoubtedly, if you've shown the propensity to lose, you'll continue losing hair. What are you currently doing to mitigate the progressive nature of this condition?

Based on your explanation, we can assume you did experience a visual change. If so, you'd be classified as a positive responder. Please continue and don't stop. I'm surprised given the results anyone would suggest you modify the regimen. What, to confirm what med did what? Truly makes no sense. While unlikely - but let's play the game - let's assume it's Rogaine that helped the most...Why would you get off of it?

The medication is now available in pill form which is less labor intensive. Most consider the combo of Fin/Min to be the most beneficial when it comes to hair retention, particularly towards the crown. The problem, in my view, is one of expectations. Most people expect. If I do something, I expect something in return. I think we can agree most people retain and see no visual change. A small percentage will experience enhancement, and a very small percentage don't respond to the regimen. I'd encourage you, if you been on the meds for years, to continue and don't stop, particularly if you look the same as you always did. If, on the other hand, you're losing hair despite the use of the meds, get off of them because they're doing nothing for you. Just let nature take its course. You remind me of a patient I visited with some 15 years ago. He'd been a long time user of Fin. Decided to get off of it just to check what would happen. Within a year he lost all his hair. And, once gone, it will not return. These are very inexpensive meds - why play with fire?

Pre op, and it's not so much for improving the conditions for the grafts to grow, but for the overall success of the procedure. No exercise a week prior. This will cause you to bleed. If you flood the field, the doctor can't see what he's doing. Avoid all vitamins, including fish oil. Simple things, such as onions, garlic, turmeric can also cause you to bleed. What's more worry-some however, is the fact you're not doing any sort of regimen to help you retain the native hair. Let me give you some basics which hopefully will help you. Donor limitation often drives this industry, particularly when you're dealing with an advanced pattern. There's typically not enough available to allow for density throughout the entire pattern. It's for this reason most ethical doctors will concentrate their effort, at least initially, to the front. It's the area you see when looking at yourself. 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 everything around the island worth of hair and now you've created a target area and an unnatural pattern. Retention of the native hair becomes imperative. Finasteride and Miinoxidil are considered to be the best meds for retention towards the crown. The problem is a year later when people 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 a year later you look the same, the meds did what they were intended to do. Research PRP and Laser. When done correctly, these can help reverse miniaturization. If you're concerned with potential side effects of any modality, do the others. With regards to Fin, it's also now available as a topical solution - by the way. If you end up not doing anything to help you retain, avoid working the crown. You can have the doctor work the horizontal plane. The farther back he works, the smaller the size of the crown. Having hair in the front will always serve you well. It'll frame your face and give you styling options. Lastly, be pattern appropriate. Bringing attention to yourself with an unnatural result is not a good thing. A class 6, for example would never have a hairline in the middle of the forehead. What number of grafts will you be doing? It's uncanny how many posts I read about this. 4K, 5K, 6K grafts. Most believe 2000-2500 grafts in a single procedure is fairly standard. So, how do you get to much greater numbers? You could do FUT and FUE, (2 consecutive days), or split grafts. Consider, a follicular unit can have 1-5 hairs. You could take a 5-hair graft and convert into 5) 1-hair grafts. You would achieve the number but not the density. A diffused result - unnatural. Who will be doing the procedure? So many things can have an impact on the overall result. Research.

Donor limitation often drives this industry, particularly when dealing with an advanced pattern. There's typically not enough available to allow for density through the front, top and back. It's for this reason most ethical doctors will concentrate their efforts towards the front. 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 always serve you well. It'll help frame you and give you styling options. Now the crown. Think of the crown as a circle. You fill it. Because you've lost, you'll continue losing. You go on to lose everything around the island worth of hair. You'll have created a target and an unnatural pattern. Retention of the native hair is imperative. What are you currently doing to mitigate the progressive nature of this condition? In cases similar to your own, 2000-2500 grafts. Start in the front and go back until the doctor runs out of grafts. Allow the non surgical modalities to help you retain towards the crown, where they tend to be the most effective. A year later you can decide if you'd like to work farther back so as to minimize the size of the crown. So, how do you get from these numbers to 5K - 6K? You can either do FUT and FUE at the same time, (typically a 2 day procedure), or split grafts. A follicular unit can have from 1-5 hairs. You could take a 5-hair graft and convert into 5) 1-hair grafts. You would get the higher count, but lose density. If you end up placing 1 hair grafts throughout, it would yield a diffused look, (and an unnatural one). Always be pattern appropriate. Bringing attention to yourself is not a good thing.

It's difficult to tell, based on the photos you've provided, what pattern of loss you're dealing with. It does seem you're not dipping very much in the donor. That is, you would not be classified as a 7 just yet. So perhaps somewhere between a 5-6. Undoubtedly an advanced pattern. Donor limitation often drives this industry, particularly when dealing with an advanced pattern. There's typically not enough available to allow for density throughout the entire pattern. It's for this reason most ethical doctors will concentrate their efforts, at least initially, to the frontal area. 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. 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 he native hair around the island worth of hair. You've now created a target and an unnatural pattern. Retention of the native hair becomes imperative. What, if anything, are you doing to help mitigate the progressive nature of this condition? Fortunately, your loss seems to be on the horizontal plane and not so much the vertical. That is, you can have the doctor work as far back as he can, in U fashion, so at to minimize the size of the crown. If you did have more density, how would you style your hair? If long, you would have the access to both FUT and FUE. If you're going to keep a high and tight haircut, FUE. this is important as it can give you access to your entire donor area.

My understanding, Min is a vasodilator. It's typically suggested you stop it a week before the procedure. If you flood the field, the doctor can't see what he's doing. You can resume a week post procedure.