LaserCaps

On 5/3/2022 at 3:57 PM, baldingeagle_ said:

Hi, 

I am starting to research FUE options. I am probably between Norwood 5 and 6. My first question is: is it possible to get FUE and not use finasteride after, without negatively impacting the transplanted hair? I have spent a fair bit of time researching finasteride and have firmly arrived at the conclusion that I would not like to take it. Given this, is it still a good idea to get a transplant? I would really like to have a head full of hair again but certainly not at the risk of the finasteride side effects. For context, I am located in the US (in case that's relevant in terms of the surgical procedure norms here - I read somewhere most surgeons wouldn't do FUE unless the patient agrees to commit to finasteride post-surgery?).

Thanks for any thoughts you might have on this!

Well, before you give up.....

You are thinning diffusely through the pattern.  Lots of miniaturized hair that have not left the building.  Those could be not only kept but also enhanced.  OK, so you do not want to take Fin? Fine.  The med, by the way, is now available as a topical solution. Then you have Rogaine, PRP and Laser.

Fin and Rogaine are considered the best meds for retention in the crown.  The problem is expectations.  Many patients become frustrated a year later when they see no visual change - not understanding, the meds are not intended for you to grow anything.  Rather, they are to help you with retention.  So, if a year later you look the same, the meds did what they were intended to do.  PRP and Laser can help reverse the thinning.

There are two types of loss. The type you see and the type you don't see.  What you see in the comb, shower, sink, etc., is normal.  The follicle gets tired of producing hair and it goes into a dormant period.  3-4 months later the hair will return.  This will happen randomly to all the hair in your head.  Hair loss is different.  You don't see it.

Under a bright light look at each strand.  You'll notice some nice and robust.  Others not so much so.  We refer to this as miniaturization.  Eventually the hair dissipates and disappears.  That's hair loss.  

My suggestion would be to do as many of the modalities as you can, or want to do.  Give them a year.  Takes photos in the interim.  A year later you can decide if the time, effort and cost are worth continuing.  (It truly takes a good year to see what the meds will accomplish). In the meantime, you could start transplanting the front and mid-scalp.  Leave the crown as is for now.  Once happy with the results in the front, and confirm the meds are working, you can then move farther back with transplants.

FUT and FUE are available to you.  Considering both will give you access to your entire donor area.

Now, if you don't want to use any of the meds....Go to the mall and window shop.  Start looking at people, particularly those with an advanced pattern.  Notice they tend to keep a forelock, well receded temporal areas, little to no density in the mid-scalp and an empty crown.  If that's the look you're looking for, you can pursue it.  Just be judicious with your grafts.  Once gone, you'll never get them back.

You can typically return to normal activity 7 days post op.  At 21 days this should not be an issue.

If you did FUT, it is important you avoid weightlifting exercises that affect the neck as this can widen the scar.  

The best way to conceal is to actually just tell everyone you're getting this done.  It will not be a surprise at that point.

20 minutes ago, Euphoria said:

As someone who has used it for more than 6 months consistently, happy I found a nice easy way to save my hair, I have this to say

Youre better off putting a baseball cap on your head and believing you will grow hair or stop hairloss, with the power of placebo you might actually do that.

Seriously. Total waste of money and time. I still have a brand new lasercomb if someone wants to buy it from me cheaper. I bought two, had issues with one being delivered and in the end both got delivered from different sellers online. 

This is sad to hear.  But it's just like anything else.  When something negative happens in the industry, everyone suffers.  A newbie reading this would likely not purchase anything after reading this.  

The laser comb was the first to get the approval.  Everything else falls under the same umbrella so now all laser devices are "released," regardless of their efficacy.  Farther, the comb to be effective, needs to be done properly.  Obviously, it is easier to use a cap - which covers the entire area when put in place.  Now, there are VW's and there are Cadillacs.  There are knock-offs of Knock-offs.  The original LaserCap is by prescription only and does carry a Lifetime warranty.  I don't think there is anything like it out there.  

There are so many people in this Earth, you are bound to find some that will find this to be the most painful thing they ever did.  Others might say it was a walk in the park.  I think most people fall right in between.  

The day of the procedure you will be taking advantage of the local anesthetic.  The key is to stay ahead of the pain.  So, follow the post op instructions given to you by the clinic. If you wait until you're hurting, you will go through some discomfort.  

You do bring up something interesting. Some clinics do offer additional products, sprays, etc., to help heal faster, etc.  IMO these are to be used while you're awake.  I doubt if not doing the spray during sleeping hours is going to make much difference one way or another. Certainly, you will not lose any grafts because of it.  

3 hours ago, Overthinker said:

Hi guys, 

I have a question that hasn’t been answered yet or I missed it somewhere for those who had two or more procedures with different surgeons.

Let’s say someone does the procedure at his frontal third and it’s all good but he wants more and then goes to a different surgeon to add density. Is this considered a repair job by the different surgeon , so you pay it that way , or like the normal HT prices by his clinic ?
I’ve seen that some surgeons charge different and many more for repair jobs , that’s why I’m asking . 
 

thanks in advance ! 

No, it would not be considered a repair job.  The patient is probably looking for either a better price or a better surgeon. 

When things are bad, however, this becomes a much interesting question.  The second doctor is now taking on the responsibility of what the first surgeon did. This is a pandora's box that can go in many directions.

Flakes are typically a result of dryness.  Avoid shampoos that contain alcohol as this dries the scalp. Baby shampoo would work.  Try that out and see how it goes.

Can't tell you the number of patients I've visited with through the years, most questioning the results, soon after the procedure was completed.  I think most do not read pre and post op instructions.  Most see a matured result at 12 months.  Rarely up to 18 months.  Like other have already commented, this can vary from patient to patient. But eventually you will have the same quality you would find in the donor, as it is from there that the hair came from.  Oh but wait!

Experience is HUGE.  If the transplants were placed diffusely throughout the whole head, it would lead to a diffused look.  I'd bet you would be questioning results then.  

How about the patient that's not doing any type of medical therapy to help them with retention of the native hair? This patient would have to continue doing grafts just to replace the ongoing loss.  

So, there are many components involved.

21 minutes ago, kk23 said:

Hi everyone, this is me 27 days post OP. I was expecting some heavy shedding to start by now, is this normal? any way I will not shed? Any input will be greatly appreciated.

 

Sometimes the hair can start growing from the get-go.  Just means you're ahead of everyone else by 3-4 months.  Typically, the hair is shed and the new one will start growing.  Enjoy the early result!

24 minutes ago, Joe2432 said:

Yes 

Just PM you.  

57 minutes ago, Joe2432 said:

The .9mm is great advice.  Thank you. I needed to hear that.   I also do Laser a couple times per week.  Do you have any input on the Doctors below? 

Are you open to traveling to Texas? (Houston).

As part of your research, find out if the doctor has a Fellowship in hair.  

2000-2500 grafts is a typical range for cases similar to your own.  You do keep your hair tightly shaven so FUE is in order.  Just make sure the instrumentation is smaller than .9mm.  This will create a micro-scar which will not be discernable to the eye. 

Glad to hear you are on the medical therapies.  The problem I find with them is one of expectations.  Most people get frustrated when they see no visual change not understanding the meds are not designed for you to grow anything. Rather, they are to help you retain.  Thus, if a year later you look the same, the meds did what they were intended to do.  You could consider PRP/Laser.  If done properly, these can help reverse the thinning.

2 hours ago, Aussie2020 said:

I just had my hair transplant done at Eugenix India and I understand that you have to wait 12 months to get the final result.

 

This is the question I have

Since the transplanted hair is from a part of your head that hasn’t experienced male pattern baldness is will it last a long time, or will it sooner or later succumb to the ravages of the time and hormones and start shrinking and dispersing.

How long does a transplanted hair last?

do you need to take the fin to keep it healthy and for longer?

 

 

 

Testosterone is what drives guys.  There is an ongoing conversion to DHT which most believe is an irritant to the follicle.  This seems to have an effect on the horizontal part of the head, but not the donor.  This is why transplants are normally harvested from that area.  If permanent there, they will be permanent wherever they're placed. 

Finasteride, Rogaine, PRP and Laser are the modalities we refer to when dealing with hair loss.  These can help with retention and enhancement of the native hair, particularly in the front, top and crown.  Not so much the donor. There are exceptions.

There are cases in which the donor can thin.  Global thinning, for example.  If the hair thins in the area, there can be subsequent thinning of the grafts.  

Most believe you cannot hurt anything 3 days post op.  Did the clinic give you written post op instructions?  Most will have you massage the area with the tips of your fingers 7 days after the procedure.  At 9 days you cannot harm anything.  Get in the shower, let everything soak and wash away.  What you're experiencing is normal.

If you are experiencing a dermatological issue in the donor, it can transfer to the recipient area during a transplant procedure.  The doctor or a dermatologist can put you on some steroidal creams/shampoos to help you.  If active, continue medical therapy until resolved.  

Transplanted hair can thin if the hair is thinning in the area where it came from originally.  Get everything under control before moving forward.

12 hours ago, Suda said:

At 14 you should not be worrying about hair loss.  I am impressed, however, that you reached out to the community at this age.  

It is important to recognize the hair in the front grows forward. The hair in the middle also grows forward and it shingles.  In the crown, however, there is a point from which all hair stems. The hair grows outward from the point, so it makes it the weakest area for everyone.  As other have noted, we refer this as the whirl. But there is something else.

Your hair is very curly which gives you more lateral coverage.  There is a lot of contrast between the color of the skin and the color of the hair.  It makes this look worse than what it truly is.  Lastly, the length of the hair.  If too long, the weight of the hair pulls away from an area living it exposed.  There is always the perfect length in which all hairs seem to be working together to allow for the most density. You may want to go to a good barber, stylist and have them cut the hair to the appropriate length.  See if that helps.

23 hours ago, exswimmerD said:

Hello!

Long time lurker, first time poster. I'm a 33 y/o (soon to be 34) male who has been experiencing various degrees of hair loss since my early 20s. I've been on finasteride off and on since then (currently been using standard dose for about 5-6 years) and same with Minoxidil (currently using the foam product from Keeps). It seemed to be much worse than it is in my mid 20s before I was consistently using any medication, and I've been using DermMatch to fill in some of the thin spots for the last couple years. I've been noticing my hairline thinning out a bit more recently and was curious what suggestions anyone might have for where I am. We are our own worst critics so it'll be helpful for me to hear perspective from any of you that wish to share similar experiences. 

If you were in my shoes, would you consider a frontal hair system or am I a good candidate for a transplant? Or is it not bad enough and I should continue with DermMatch (or another product if there's something out there better)?

Any thoughts or feedback is appreciated!

- D

A couple of things I gather from your post.  First, you're not a novice.  You'd been at this for a while and are very aware of all that's going on.  Despite this, you are on and off the meds.  Why? Consider a patient who has been on Propecia for years.  The meds have helped him retain.  He then gets off and loses all that he would have lost.  As soon as it becomes noticeable, he resumes the use of the meds.  At this point he will never recoup what's lost.  And the cycle continues.  If you're going to be on the meds, stay on them.  

You are well demarcated in the crown and does not seem the pattern is expanding.  That's a good thing. 

You seem to be thinning in a class 5 with a stronger forelock and the inverted U.  

I'd like you to consider why we place so much emphasis to the frontal area. It is the area you see when looking at yourself.  It is also the area others see when they interact with you.  Having hair there will always serve you well.  When is the right time to tackle the crown? When you're happy with the results in the front AND confirm the meds are helping retain the native hair.  

The other concept, which we all fail to mention, is enjoying your age.  Sometimes it's OK to wait, mainly because the meds are doing an exceptional job.  Other times it's because the patient is very young, and we have no idea what pattern he'll develop.  At your age, however, why not enjoy the youthful look for as long as you can? In my view, go ahead and get this done, (provided you've done the research). 

With regards to the crow, we all share a whirl.  It is the weakest point for all of us.  Perhaps the only thing you need is a "dusting." Better to look thin than empty.  (Pls don't get off the meds any more).

Who do you trust? A great question which should be on everyone's mind.  Ask doctors where they learned to do hair restoration.  Did they go to their local library to read about the subject? Ask if they have a Fellowship in hair.  Have them show you results of cases similar to your own.  

18 minutes ago, SoSoz said:

If doctor would take a strip with 2500 grafts, compared to doing FUE with 2500 grafts, how many grafts approximately am I going to have left for another FUE procedure in future? Would the difference be big?

If his first procedure is FUT, it is likely he will have at least one more procedure, (or more depending on elasticity). Typically, you lose about 10% on procedure 2 since the scar has no hair.  

FUE area remains intact.  How many grafts can be harvested will depend on the size of your head and the density.  

Years ago most believe patients had 7,000-8000 grafts available.  With FUE also available, it is likely this is even a greater number.  All stars do need to lign up however. Perhaps other can chime in and give their opinion.

2 hours ago, SoSoz said:

Does FUT method allow to save grafts for the future? For e.g If we do a hair transplant on a 25 yo who is already NW4 would the person benefit from this? How many grafts approx. could be saved for the future procedure?

I heard that good surgeon can make the scar barely visible like pencil thin and you can't even see it if you grow your back a little bit.

Typically a patient has multiple FUT procedures available to him.  It all depends on elasticity, donor density, size of head, pattern of loss, etc.  

More likely than not, a doctor will always return to the same scar to keep the donor area as pristine as possible. This process can be done multiple times until the doctor tells you, "the next time will be your last otherwise I will not be able to close the wound." This is due to lack of elasticity. How many grafts you do per procedure can also impact the number of procedures.  

Normally the donor area encompasses the area behind the head, ear to ear and the horizontal area, from the crown down to the nape.  A range commonly discussed is 2000-2500 grafts for a single procedure.  So, if a patient decides to move forward in stages, and start with 1200 grafts, the segment could start from behind the ear and go about 1/2 way.  If he as another procedure with a similar number in the future, the doctor would likely start on the other side and unite the line so as to create only one scar. 

How you scar heals is a result of wound physiology and how closely you follow the doctor's post-op instructions.  For FUT particularly, the doctor is likely to ask you to avoid weightlifting that affects the neck for at least 6 months as this can affect the width of a scar.  Despite verbal and written recommendations patients often disregard instructions, (nor read post op instructions) only to end up with a wide scar.  This is scar tissue which has no hair.  At the time of the second procedure, the yielding area is diminished - and this will have an impact in the number of grafts that are harvested. 

Hair loss patterns can also have an impact on numbers.  Consider a patient with an advanced pattern, dipping in the back and experiencing retrograde alopecia.  This would leave the patient with little to work with.

There are many other factors that are in play, including donor density, size of head, etc.

Going back to the scar.  The doctor has many tricks up his sleeve to help minimize scars and to make them less visible.  A trichophytic closure is one of them. Another is the width he takes in any given procedure.  If he takes a wide scar, this could lead to a wide scar as well.  Make sure to ask during a consultation.

Lastly, FUE is also available and this helps each and every patient take advantage of their entire donor.  This technique can also help patients add grafts to a scar if need be.  With all of these advances, (without putting my foot in my mouth too deep), good time to move forward, provided you find a doctor with experience, etc.

4 minutes ago, Lightmare said:

I wonder if anyone else has this issue where there are a few lone hairs (remnants of my original hairline) that somehow (completely) escaped the miniaturization process?  They are a good centimeter under my transplanted hairline.  I get that miniaturization doesn't affect all hairs at the same time in the same way but these are full thickness and way far down.

 

I knew of these hairs before my HT but didn't think to ask my surgeon to punch them out for me.  They don't bother me too much since I wear my hair down, but I would like to see if this is normal or concerning.  Are they just the chosen ones? 

These are often referred to as stragglers. Since they're your own, (native hair), they tend to add naturalness to the work.  Leave them alone.  They are miniaturized, (not as much as others), and likely will continue that process.  

PRP does work.  The issue however is the fact that not everyone knows how to do it correctly.  If you hear the word "sessions," run in the opposite direction.  By sessions I gather the provider(s) is doing a syringe size worth of PRP and does a few shots, (without using local).  Then he asks you to come back in a few weeks or months to do it again.  This does not work. 

Think of the old west, every man for himself.  You would think an agency, for lack of a better description, like the ISHRS would prompt providers to share information as to what works and what doesn't.  Until this happens, it is truly a crap shoot to find clinics that actually know how to do this properly.  For now, the best way to confirm is to have the clinic show you photos of results.

I am certain in happens.  Consider this,

Most believe grafts compete for blood supply, so a separation is left between grafts.  They'll even explain during a consultation that they'll be creating a base you can then add grafts in the future to add density.  In the meantime, if you do FUT and do weightlifting that affects the neck, the scar will widen.  To avoid this PLS review photos of cases similar to your own, meet with multiple providers, and ask how they learned to do transplants.  Do they have a Fellowship in hair?

Finasteride, (now available as a topical solution), Rogaine, (also available in pill form), PRP and Laser are the modalities we refer to when dealing with this condition.  If you are not considering one, for whatever reason, you can rely on the other ones.  These work in different ways and are thus synergistic when used at the same time.  

If you've lost, you will continue losing and make thing worse.

You may want to consider SMP.  It would help minimize the contrast between the color of the hair and the scalp and it would buy you time to decide what to do.  

19 minutes ago, Ryan Daniel said:

 

 

I have drawn a quick hairline for you appropriate for your hair. I would also add that all the area behind the drawn hairline will be packed with grafts.

I believe you would have a similar result to our friend Ian! @kirkland

 

There are a number of engineering principles that go into designing a hairline.  Once an age and pattern appropriate hairline is designed, then you can add a number of variables that make a hairline look natural.  Staggering, blunting the corners, etc.  Good luck.

As long as it takes for you to confirm the medication is working.  If the med does not work, which does happen in a very small percentage of patients, (and say you worked the crown, for example), you would then end up with an island of hair and nothing around it.  Better to be certain before moving fwd.