LaserCaps

1 minute ago, Revale said:

Yeah, that is my concern, too.

Agree.  Most clinics do not know how to do this.  If you hear the word "sessions," run in the opposite direction.  This till typically involves doing a syringe size worth of PRP, a few shots and that's it.  Not even a local is used.  Not good.

37 minutes ago, Revale said:

Hi,

I'd like to get some advice for hair restoration.

I'm now 33 years old and noticed hair loss for the first time when I was 26/27.

My temple area is receding and my crown area has thinned a lot.

I have scalp psoriasis. I got treatment for it but as soon as the treatment stops it comes back. Only the part with hair is affected. Not everywhere though.

Until now, I have visited 3 hair transplant clinics in Tokyo for consultation.

The first one said, that they can transplant 3,000 grafts for about 25.000 USD.

The second clinic said that they don't recommend so many grafts because they're unsure how my scalp condition would affect the result. Instead, they would transplant some graft in my temple area (where I have no skin issue) and a few hundred (not sure if I remember that correctly) in the crown area to see what the result would look like.

The third clinic advised me against a transplant because I would still have too much hair on the crown and therefore no space to plant the grafts (and maybe they also considered the skin issue - I don't remember well).

I also contacted a Turkish clinic. We had a very short video call. They would transplant 4,000 grafts, but I would have to count for 7 days how many hairs I'm losing per day. If it's less than 100, I could do the surgery. If it's more, not. 

Honestly, I didn't know how to count that. I counted in the morning the hair I could see in the bed. It were between 30-50. Therefore, my estimation was, that I'd lose about 80-100 per day. 

2 of the clinics mentioned Finasteride and Minoxidil, but I declined, because I'm unsure about the potential side effects.

The thinning on my scalp keeps progressing and I feel that I need to do something about it. 

What would you guys do if you were in my position?

It is truly amazing what curly hair can do.  It gives you more lateral coverage.  The photo you've shared with us does show diffused thinning throughout.  If you were to shave, it is likely it would show a very advanced pattern with a lot of miniaturized hair.  

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

Under a bright light look at the hair in your hairline and corners.  Notice some strands are really thick and some not.  Some seem so thin you can't hardly see them.  We refer to this process as miniaturization.  Eventually the hair dissipates and disappears.  Once gone, it will never return.

Propecia/Rogaine/PRP/Laser are the modalities we typically refer to when dealing with this condition.  The mechanism of action of each is totally different and are thus synergistic when used simultaneously.  Try them all and give them a year.  Below are some issues to be aware of.  

Propecia and Rogaine are considered to be the best medications for retention in the crown.  The problem is one of expectations.  Eventually people become frustrated when they see no visual change not understanding the medications are not meant for you to grow anything. Rather, they are intended for you not to lose any more.  So, if a year later you look the same, the meds did what they were intended to do. You can achieve a visual change with PRP/Laser.

Two things can happen with PRP and Laser combination.  (It typically takes 12+months to see the results of a transplant procedure.  When you add PRP/Laser, we typically see the same result in 6 months).  The combo can also help reverse the miniaturization.  The key here is to find a provider that knows how to do the PRP.  Not all PRP's are created equal.

It is important to recognize the donor area is limited and finite.  Be judicious with your grafts.  Any benefit you can get from the medical modalities could have an impact in the overall approach and number of grafts.  It would be in your best interest to do the meds and give them a year.  Move forward based on what you achieve.  

34 minutes ago, SeanToman said:

Hi,
I'm one week off from reaching the 7 month post operation milestone, it's exciting!

However (like many clients), one side of my transplanted area is much thinner than the other.
I was wondering what your thoughts are if we should expect much density improvements or are we close to the final results?

When reviewing other users journeys, it appears that the hair only gets longer rather than denser from the 7 month mark.

Thanks.

(Left - fuller/denser | Right - thinner/less dense)

It can take 12 months, sometimes longer, to see a matured result.  When the hair first starts growing, it is vellus-like. It takes time for the caliber to improve.  Eventually it will be the same as the hair you have in the donor - since it is from where it was harvested.  Be patient.

11 hours ago, AlteredEg0l said:

Hello all! I've been looking into FUE for a few months now, and recently got a consultation from Hair Center Mexico. They recommended 2200-2400 grafts for my crown and another 2300-2500 to restore my hairline and add density across the top.

1. Do these numbers sound accurate? (Refer to my photo album for more historical pictures.)
2. They said they can't do it all in one go; I'd have to come back after the first procedure had time to heal up before addressing whatever is left. What's the max number of grafts people can get in one procedure?
3. Is quality as necessary with less prominent areas like the crown or simply restoring density? (I'm basically wondering if I can save some money on the less obvious areas, in order to splurge a bit on the ever-important hairline.)
4. I live in midwest US (Ohio), so I'm thinking around September is a good time of year to get this done: truly cold hat-wearing weather doesn't set it for a few months, but it's not the absolute middle of summer when sweat and sun will be at their worst. What do y'all think?
5. My budget is around $6000, all-inclusive. I'm in the US, but expecting to travel outside the country to get the work done. Doctor recommendations?

Thanks everyone!

Forget the money aspect for a minute.  Unrealistic expectations? Perhaps. Let's return to basics.

If you've shown the propensity to lose, you will continue losing hair.  The photo you've shown of the top of your head shows diffused thinning. All that hair is at risk and it's likely you'll lose it if you don't do something about it.  Are you doing anything to help you with retention of the native hair?  Propecia, Rogaine, PRP and Laser are the modalities we typically refer to when dealing with this debilitating condition.  

You've drawn a hairline in a very aggressive position.  This only increases the size of the canvas.  Not only will you create a hairline of a teenager, you'll be limiting your donor and the amount of hair that can be placed farther back in the pattern - which seems to be important to you.  The farther back you work the farther back the doctor can take the grafts.  This would help to minimize the size of the crown.  

Donor limitation.  No one with an advanced pattern has enough donor to allow for a full set of hair in the front, middle and back.  So, if there is a limitation, where do we want to put it so that it makes the most benefit for the patient?  The front.  It is the area you see when looking at yourself.  It is also the area others see when they interact with you. And, what about the crown? You might ask.

We all share the whirl.  There is a point in the crown area from which the hair stems.  No hair is coming into the area. Rather, the hair grows outwards from the point.  It's a sphere and it can take all your donor. So, say you fill the crown and you have no donor left.  You will then be asking "why did you put all my hair in the crown? Now I have nothing left for the front." You will always look bald.

Now the money.  You may want to consider getting on all modalities and give then a year.  Who is not to say a lot of the miniaturized hair you have can be reversed with the PRP and the Laser.  If much of what you have is improved, including the crown, would then open up many more options.  

Finally, as part of your research, find out where the doctors you are considering learned to do hair.  Do they have a Fellowship in hair?

Hard to say, it's only been 14 days.  I am curious.  Typically, when this type of procedure is done, the area is shaven.  Not sure why there is still hair there.  And, I gather by the photo you've posted, they only harvested from the right side.  Why not from the whole head?  If you distribute the harvesting throughout, theoretically, you would leave more native hair in between to cover, (say every 8th). 

Can you post photos of the area you did? It would be interesting to see what they did with the 1400.

Now you have no option but to wait to see if there is enough native hair in and around what was taken to cover.  Do you know what instrument they used? How about the size of the punch? Did the doctor do the work? or was it technicians? Who was the Doctor?

What part of the Country are you in?

How many grafts are harvested at any one time is a function of many factors including the size of your head, the density in the donor, etc.  Even the way you style your hair can have an impact.  Say you keep your hair long in the back, you could do both FUT and FUE at the same time.  This would allow for a greater number of grafts.  

Normal.  The concern, however, is why wait 14 days to start washing normally? Get in the shower, let them soak in the warm water and start massaging with your fingertips and shampoo.  Get these things out of there. You can't hurt anything.  You do not want to get an infection.

After 3 days, most believe, you cannot dislodge a graft.  They do recommend however, you start massaging the area with your fingertips on day 7th.  You also need to keep the donor area clean.  Read the instructions given to you by the clinic.  10-13 days seems a bit long.  Perhaps other can chime in. 

First thing I would so is post some photos.

So, you are either a candidate or you're not.  Having thin hair is fine.  It typically allows for a very natural result.  Thinning hair, if that's what you mean to say, is an issue.  You then refer to the donor.  The concern here is thinning of the donor.  If you are experiencing global thinning, potentially you lose the grafts transplanted. 

The doctor recommended 2500 grafts.  Is he not concerned? 

I gather you are a young individual.  If you are experiencing this aggressive loss at this age, it is likely it will continue.  Are you doing anything to help you with retention of the native hair? Some type of medical regimen may not only help you halt the loss, you might even enhance the hair that's dissipating.  

On 3/21/2022 at 10:15 PM, sr1486 said:

I had a 2500 graft FUT transplant in 2017. Unfortunately, I later realized my scar was "raised" and pretty noticeable. I had about six sessions of SMP, and it didn't stay at all. That was a waste of money. I'm pretty sure the reason it didn't stick was due to the keloid scar being different than regular skin.

What are my options for this? Would FUE grafts stay put if placed in a keloid? May just wait to see if Verteporfin works on humans. That seems very promising. Then I could have this scar removed and let it heal with Verteporfin

 

 

 

 

 

 

 

 

 

It is very hard to tell if this is a true keloid.  I would do an in person evaluation to confirm.  

How you heal is a function of wound physiology.  This looks more like a scar that widened.  Did you start lifting weights right after the procedure? In what position did you sleep? There are a number of things that could have had an effect.  What to do?

Since you already have a scar, the first thought, is to re-excise the scar and replace with a new one.  Hopefully there'll be an improvement.  Like others have mentioned, there are a number of things, (injections for example) the doctor can do to help minimize the risk of a keloid.  SMP can help but, as you know, the body will metabolize the organic ink and you may have to continue doing this for years to come.  Can you FUE and put hair into the scalp? Guess you could but, if you do have the propensity for keloids, you could actually keloid each of the incisions, (both at the time of the harvesting and at the time of the placing). Again, I think your best bet is to do an in person evaluation and find out what exactly you're dealing with before doing anything.  Do you have other keloidal type scars in your body?

Are you doing anything, by the way, to help you with hair retention? You do need to try to keep and enhance as much as you can to avoid dealing with this.

1 hour ago, Melvin- Moderator said:

I had my surgery on New Years eve and New Year. Did it matter? No. Many world renowned surgeons operate on weekends. 

This is a free market, which means supply and demand. If there’s a high demand for surgeries on weekends, then the surgeons must supply. Why on earth would this be an issue, seriously sometimes these threads get ridiculous. 

You do what you have to do for a patient.  The patient is the reason for our work.  Convenience is only the tip of the iceberg.  This should be a non issue as Melvin indicates.  And this, in now way, reflects on the talent nor experience of the surgeon. 

Young, diffused thinning and demarcating down on the donor. This is yet another example of not understanding what the meds can do.  Wrong expectations.  Fin and Min are considered the best meds out there for retention in the crown.  Many however, get frustrated when they see no visual change - not understanding the med is not intended for you to regrow anything.  Rather, it is to help you from getting worse.  Thus, if you look the same a year later, the meds did what they were intended to do.  I would encourage you to resume the meds and stay on them.  You may want to add PRP and Laser.  These two can help reverse the thinning.

There are two types of loss.  They type you see, and they type you don't.  The type you see is normal.  Hair in the shower, brush, pillowcase, etc.  The follicle gets tired of producing and takes a vacation for about 3 months.  The hair then returns.  This will happen randomly to all the hair in your head.  Hair loss is different, you don't see it.

Go under a bright light and notice the hair in your temporal areas.  You'll notice some very thick strands while others are thinning.  We refer to this as miniaturization.  The hair will eventually dissipate and wither away.  Once gone, it will not return.  

I would encourage you to get on the meds and give them a year.  Not only to see if the meds will help, but to confirm you can stay on them.  You may end up having more options down the road, including transplants.

$10,000 is a decent amount to invest.  Save it and keep saving.  Do the research.  Ask doctors where they learned to do this.  Do they have a Fellowship? Are they Board certified? Photos of results? etc.....

10 hours ago, JoDimaggio22 said:

Very curious here from any of you who have had fue. I have sensitive skin and seem to scar easily. Of course I don’t ever want to go bald but if my donor area was shaved after an fue years down the line would it be obvious scarring? I guess what would it look like or would someone have to look close to see it? You always see so many clinics call it a “scarless” procedure but how close from the truth is that?

I've had multiple procedures, both FUT and FUE.  Regardless, if you have sensitive skin or not, every time you invade the skin, you will get a scar.  

How obvious are the scars will depend on a number of factors, including the size of the punch and your wound physiology.  

I do agree, the term scarless - is used to differentiate FUE from FUT.  It is incorrect nomenclature, however. Micro-scars will be difficult to detect if the punch is smaller than a .9mm. 

Are you doing any type of medical therapy to help you with retention of the native hair?

Nice and cleaned up.  I would add PRP and Laser categories to the Non-Surgical options.  

Yes, it is possible.  A lot will depend on the donor and how exactly they harvested the two previous times.  Make sure you schedule an in-person evaluation and you get to meet with the doctor so he can check your overall density and elasticity.

On 3/13/2022 at 3:17 PM, Ant763 said:

Hello all. My temples are the main problem. They have been receding for a few years. I have been using rogaine for a few years. I was wonder if I can get a small FUE to bring back my temple area and corners of Hairline. If so how many grafts do you think I would need? I am 31 years old and my father and his brothers are all bald. Do you also think I’m losing any density at the top of my hair. I posted a pic of where my temples used to be in high school. Lol thanks

It seems you truly understand what's coming down the pike.  The temporal areas should be the least of your concerns.  Rogaine, in my view, is like using a band-aid.  I would consider adding Propecia, PRP and Laser.  The mechanism of action of each of these is totally different and are thus synergistic when used simultaneously.  And once started, do not stop.

Prefer the black over the red for a number of reasons.  1st. guys recede on the corners. It is also designed a bit farther back which better matches the pattern that you have.  Guys with advanced patterns do not have hairlines in the middle of the forehead.  

What you've drawn is similar to a teenage hairline/female-like.  By doing this you have expanded the size of the canvas which will directly impact your donor.  

I think it is important to understand hair in the front grows forward at an angle.  So as the hair grows, and gives you bangs, you'll end up having hair right about where you drew the red line.  

Last thing to consider....Think of yourself retired, in a happy home, with a hairline of a 17 year old.  Everyone will be asking why you don't age.  You will then be wishing you had not done such thing.  

It is always easy to add grafts.  It is impossible to remove.  Go with the doctor's recommended plan.  Let it grow in.  If meds work and you end up enhancing some of the native hair, you will then have options to make adjustments and to add grafts, lower hairline, etc.  Be cautious and judicious with your grafts, we only have so much to work with.  

Not the best set of photos, but it sure looks as if you are still in the process of expanding the pattern.  (If you've shown the propensity to lose, you will continue losing).  Are you doing any type of medical therapy to help you with retention?

One of the basic concepts I like to share with patients is the fact it is the front you see when you look at yourself in the mirror.  It is also the area others see when they interact with you.  So, place more importance to the frontal area.  

Propecia/Rogaine are considered to be the best meds out there for retention in the crown.  Something to keep in mind is the fact that these meds are not intended to regrow anything.  They are to keep you from losing more.  Thus, if you look the same a year later, the meds did what they were intended to do.  PRP and Laser can actually help reverse thinning.  I would encourage you to consider these for a good year.  It is likely your crown can improve as there is a lot of miniaturized hair.  

The other thing you can also do is work as far back horizontally on the pattern as you can.  This would help to minimize the size of the crown.  

Given your family history and think it's smart to start - or be on - a medical regimen.  Propecia/Rogaine, most believe, are the best meds out there for retention in the crown.  The problem is expectation.  Most people become frustrated when they see no visual change - not understanding - the meds are not intended for you to grow anything.  Rather, they are to help you retain.  If a year later you look the same, the meds did what they were intended to do.

As you know, there are two types of loss. The type you see and the type you don't.  The hair you see on the pillowcase, sink, etc. Normal.  The follicle gets tired of producing hair, and it goes into a resting period.  3-4 months later the hair returns.  This will happen randomly to all the hair in your head.  Hair loss is different, you don't see it.

Go under a bright light and start looking at the hair in your temporal areas.  You'll notice some thick strands.  Others not so much.  The caliber of the hair is so fine in some - eventually the hair withers away and disappears.  That's hair loss.  PRP/Laser can help reverse the thinning. Perhaps adding these modalities would not be a bad idea. All modalities work in different ways and are thus synergistic when used simultaneously.

Give yourself time.  Give the meds time.  With the hair you currently have, I would hold off doing any transplants.

Diffused thinning, some retrograde.  

One of the first concepts I like to cover with patients is donor limitation.  Typically, there is not enough to provide full density in the front, top and back. Thus, if we have a limitation, where do we need to put the hair so that it serves you well now and in the future?  When you look at yourself in the mirror - what do you see? How about when others interact with you? It is for these reasons that we give the front a bit more value. Eventually, as you let the hair grow, it will allow you to cover the back.  

Medical therapies tend to be far more effective in the crown.  And, considering the whirl, it's ok to be thinner in that area. 

It is likely both FUT and FUE will be available to you.  Considering both would allow you to have access to your entire donor.

Given your pattern, I would encourage you to visit with a doctor for an in-person evaluation.  Try to do as many grafts as you can afford.

On 3/13/2022 at 6:52 AM, RecedingSebs said:

Hi everyone I'm about to pull the trigger and book my transplant for next week with Dr Turan (FUE Capilar) - £2500 for around 2500 grafts to front and 500 to crown. This isn't a last minute decision - I have done a lot of research over the last couple of months and he seems to have very good results for a great price. The main concern I have is that I will need another transplant in the future but I am taking Fin without experiencing sides so hopefully if I do need another one it won't be for a good few years.

I've been agonosing over this for quite a long time but I'm still hesitating because no matter how much research you do there are still unknowns - eg How good will the surgery be? Will I need a transplant in the future when native hairs fall out? etc. I think I am confident as I can be because of the research that I have done.

I guess that I am looking for some final reassurance/comments before I do pull the trigger (which I AM GOING TO DO unless anyone convinces me otherwise). I think this is just cold feet and I would be stupid not to be concerned about risks right?

By the way I'd like to say thanks to everyone who contributes to this website as I have found it so useful and I may well have gone to a cheap hair mill if it didn't exist...!

I will be posting my experience to hopefully help others (BECAUSE I AM GOING TO BITE THE BULLET AND BOOK THIS....!)

I am curious about a couple of things.  First, what research did you do? This is concerning when you are planning on doing 500 for the crown.  (500 is typically what's used on an eyebrow.  Putting that number in the crown will make no visual change when you consider the whirl.  With all the miniaturized hair you have, it makes more sense to add all medical therapies to the mix.  (Fin, Min, PRP, Laser).  Since you're holding off, I would just do those and give them a year.  You can then concentrate ALL the grafts the doctor can harvest towards the front and blend to that mid-scalp.  This is the area you see when looking in the mirror, it is also the area others see when they interact with you.

The images you've provided, is this the way you typically wear your hair?  Why not consider FUT? Once you exhaust FUT, (no more elasticity), you can then do FUE. This way you take advantage of all that is available in the donor - if needed.

11 hours ago, JoDimaggio22 said:

Wait so laser cap is the best hair laser on market? If so I will buy

Dr Arocha is a provider.  

So then all modalities can have an impact.  If the hair in the donor is improved, it will ultimately impact the grafts harvested from exactly "the area" harvested. Off hand it would be the hair higher up on the donor, the area by the nape (thinning due to traction). 

52 minutes ago, Mike10 said:

To me this was not the question. Fin has no impact on the result of a HT. If we are talking non-transplanted, a case by case assessment is in my opinioon to deterimine whether Finansteride is necessary. 

Wait.....Yes, Fin can have an impact on a hair transplant procedure.  Say the patient is dipping in the back and the doctor harvests grafts from the area that's thinning. Eventually this would lead to the thinning of the grafts, wherever they're transplanted. But say the patient in on Fin and the donor improves.  Theoretically the grafts will remain for as long as the patient continues the med, provided it is working for him.  But that was not the original question. 

"Hello, does taking Finasteride impact the growth of new transplant hair grafts or does it only impact your native hairs? I have a twin and he was on propecia and had sides. Being a twin, we have the same DNA so probably mean I'll have sides. But I heard fin doesn't have any impact on transplant grafts and just wanted to see if that's true"

So the answer remains Yes but only in very specific cases. 

The other way to look at this....Fin will have an overall effect on the results - if it works. Transplants + Native hair = total result.  

32 minutes ago, Reatz said:

Yeah indeed. I live in Europe and sadly we do not have minoxidil/rogaine in foam form where i live.

I am able to travel.

Regarding minoxidil though, it seems like the worse version of finasteride If you stop using it.

I gather, by your comment, that you experienced some positive results with Rogaine? If so, pls get back on it and stay on it.