alopeciaphobia

It may significantly impact whom they go to, because a botch job may no longer be a death sentence. So the allure of saving money by going with a cheaper surgeon may be harder to resist.

People who got botched by a hair mill may not be screwed for life if existing scars can be regenerated. That is certainly not nothing.

Looks like you're the kind of candidate for whom verteporfin could make a massive difference. That is if you have the funds and patience for getting several large procedures 😁.

This is exactly how I feel too. And anyone who wears their hair really long, say shoulder length or more, would benefit hugely from verteporfin. Mainly because verteporfin may allow for much higher densities in the recipient area, instead of the illusion of density at 40-50% native density. The illusion of density only holds up with short or slicked back hair. If you wear your hair really long, it doesn't look very good unless you're reasonably close to native density. The parting would be too see-through, and the tresses that frame your face too thin. If verteporfin HTs really do allow for unlimited donor, and become available, I'll take out a second mortgage on my house and not stop getting HTs until my hair looks like one of the members of Rust in Peace era Megadeth:

I can see the expensive Visudyne work for plastic surgery where it's injected along a line. But for a full FUE, you'll need so many bottles of Visudyne, you'll easily get into the 5-figure price territory. I'm going to imagine that surgeons would rather use a generic and put the verteporfin surcharge in their own pocket.

Yeah no doubt they'll make bank from it initially. But if we can really make verteporfin mainstream in cosmetic surgery as a whole, it's all but certain that generics show up.

For all we know, maybe you can use an FUE punch to excise existing scars, inject them with verteporfin, and get the donor back?

Well, it's normal in a strip procedure that there is (temporary) shock loss in areas adjacent to the wound. Maybe that shock loss is caused by the Engrailed-1 expression that verteporfin inhibits? I find it very implausible that a hair follicle can grow in a matter of weeks, and start growing fully terminal hair at a normal rate immediately after. Both in babies starting to develop scalp hair, as well as people partially reversing MPB through medication, follicles slowly start producing velluslike hairs and gradually transition to growing terminal hair normally. This is why I can't imagine the increased hairiness in the control sites to be regrowth. The hairs are too long and too thick for how young they would be if they had regrown.

Once its fully healed, shave the donor area and take close up shots and compare test to control.

Very interesting results from Dr. Bloxham, but I believe the conclusions drawn here regarding regrowth are premature. Hair follicles don't grow from scratch within a month usually. The injected areas looking hairier is likely to be due to less shock loss, especially considering the length of the hair, as Dr. Bloxham mentions in the video.

Interesting. In light of this I wonder if regrowth potential would be affected by FUE punch size. I noticed from @DrTBarghouthis work and his results that he's very specialized with very small punch sizes. No doubt this is perfect for reducing scarring, but perhaps excising more skin could be more condicive to follicle regeneration?

True, although in the case of FUT the entire wound is sutured, so we can't assess regrowth potential. Of course reduced scarring is also a very interesting outcome, but it's not nearly as much of a potential breakthrough as donor regeneration.

It's beyond fantastic that we have two full FUE case studies coming up, and that these are with even higher dosages, and an improved injection technique. These should really be able to give us a much better idea of whether HT+verteporfin is or isn't the world's first procedure that can effectively multiply hair follicles. By summertime next year, we may finally have a decent indication of whether this may be the major breakthrough that many of us hoped it would be ever since the first animal study. It's really really cool to be following this. Thank you @DrTBarghouthi.

@DrTBarghouthi Just out of excitement and curiosity, have you had an opportunity yet to set another date with the patient?

Maybe you were onto something. He canceled so many times, it's rather odd. Maybe he's reading this thread and having a laugh lol. Nevertheless it was a good idea to try. But glad that Melvin and Dr. Bargouthi realized it was going nowhere and we're going ahead anyway.

@DrTBarghouthi Couldn't be more excited about the upcoming trial, and also super happy to hear that you're so positive about the trial, and the community!

Now that the call with Dr. Longaker has been canceled again, are you planning on setting another date for the trial?

There are so many factors to consider: Optimal dosage of verteporfin per cm² Best technique for injecting it at exactly the right depth, every time Getting enough horizontal coverage across the entire surface of the donor area. How many injections does the full amount need to be divided into for it to be evenly distributed across all follicles? How not to let light break it down while still retaining enough visibility for the surgeon to inject accurately How much time can be between extracting a graft and injecting verteporfin? For a full-day FUE, do we need to split up the donor area into multiple areas and do extraction + injection in phases so that extraction sites don't sit without verteporfin for too long? If we take the verteporfin dosage per cm² from these small experiments and do a full FUE across the whole donor area, how many bottles does it take, what does that cost, is it feasible to source this much, and is there any risk when a person has this much total verteporfin injected? And that's just when using it in the donor area. There may be countless more questions in future trials using it directly in the balding areas.

Great! Using verteporfin in FUE megasessions would be an incredible step forward. However, it's not clear to me if Dr. Pittella is just interested in doing verteporfin trials at some point, or is he looking to do it soon? At any rate, I really hope future trials on donor regeneration will use a temporary tattoo, such that we can actually get some meaning metrics on whether it's actually doing anything.

I'd be really interested in hearing how much verteporfin that would require if done all over the donor in a full FUE. Wouldn't that be quite a bunch of visudyne bottles, which go for well over a thousand bucks each? Maybe we would have to find the support of a synthesis chemist to keep that feasible 😅.

@DrTBarghouthi Thank you so much for responding. You're one of the, if not the most, well intended hair transplantation surgeons that I've ever seen. It's incredible that you're regularly updating the community, and responding personally to comments from some balding internet strangers who are just looking for hope. I must say it felt incredible that a world class hair surgeon who may be on the cusp of a medical breakthrough personally responded to several of my comments. I agree that it's unfairly held against you. I think we should all be more thoughtful before publicly sharing impatience and negativity regarding these trials. Especially myself, because regretfully I contributed to it. We should all remember that these are our personal emotions, based on our personal shimmers of hope that these trials give us, and publicly posting these personal matters do not contribute posively to these trials, quite the opposite in fact. Sharing thankfulness and scientifically relevant concerns or suggestions does. So thank you, and my apologies. Best of wishes from a fine-haired diffusely thinning NW3 who just wants to one day proudly grow dense shoulder length hair again without irresponsibly depleting their donor. Even though it's all still uncertain, you give me hope.

I agree that it's not likely that he'll want to take on responsibility by recommending dosage. While his comments will without a doubt be very insightful, it may not be worth postponing the trial by more than a few weeks.

I'm sad to admit that I'm also struggling not to lose faith in a second FUE trial happening anytime soon. Looking at how many times something caused it to have been postponed since the original goal date of August/September 2022, and even after the incredible $15k donation, it's hard not to see a never ending pattern.

My guess would be that Dr. Longaker may have advised against human experimentation completely. He has expressed in articles before that he doesn't want surgeons to just start trying to use it on people.