MattJosh

How soon after a HT can someone sunbath to get a tan with a backwards baseball cap on in a way that it covers the hairline but the face gets the sun exposure? 

This would involve sweating

Of course you can my friend, you might want to ask the nurses for help while you're at it...

Is the row implantation of De Freitas a big negative?

His results are excellent of the most part and come to think of it it seems that Couto also kind of implants in rows

What are the main problems with this?

I'd go with either De Freitas or Couto, although Couto's waiting time is too long

30 minutes ago, lunch_owl said:

I have a solution that im currently working very hard on to make into reality. I am too very selfconcious about walking through airports with my head exposed  and having  people stare at me and might possibly even take pics. Also obviously i dont want sun exposure as well so I can do some sightseeing or go outside instead of locking myself inside all the time 🙂 i wont be getting my own ht until I solved this. When I do solve it, I will let you know.

The best thing to do if this is a concern is to rent the hotel or airbnb for 2 weeks at the city where you get your surgery, arrive a day before surgery and have the place loaded with food for the upcoming 2 weeks, do your surgery and then stay indoors for a couple of weeks and then travel with a cap on since then it won't be a problem.

If you are very self conscious about this the sight seeing won't be a priority.

9 hours ago, Jayson1361 said:

I don’t see the doubt. Don’t transplant hair into an area of active inflammation regardless of the root cause🤷‍♂️. But that’s not the question or doubt I have. I don’t think it’s right to assume that if your scalp itches etc… that LPP/FAA is the first place your mind should go. 

Doesn't almost everyone has some inflammation to one degree or another? Even just basic dandruff or those with seborrheic dermatitis who have successful transplants and there are plenty would be considered to have inflammation

How would you define inflammation in the scalp?

16 hours ago, Jayson1361 said:

I’ve looked into this before. Posting twice in this thread I wanted to say I think it’s important to keep things in perspective. LPP with associated FFA is rather rare even for those who have an auto immune disorder like lichen planus or perceived symptoms that coincide with mpb. To say that allot more people have it than has been reported or diagnosed is a stretch I feel. Almost all of the normal symptoms of MPB can be associated with LPP and FFA or a patterned form of fibrosis. Itching, receding hairline, change in hair texture… thinning eyebrows, or sideburns would probably be more indicative of something but itching…meh that can be caused by so much, including folliculitis or any number of things. Discoloration on a small scale occurs in almost all skin types as well. That was my conclusion originally when looking  into this and it remains the same. Further, having dealt with lichen planus it’s not permanent on any part of the body in my experience and can flare up or not. If indeed there is hairloss due to LPP I would think that might even be a better diagnosis than MPB as symptoms can be controlled and eventually eliminated even. Further HT can take in areas where there is scar tissue as that resides on the top of skin. But, that being said Hair loss due to scar tissue is very permanent and destruction of stem cells in the bulb is also, at least for now. Healthy grafts finding a blood supply would take quite some time to be impacted by LPP as they were not impacted most likely prior to the HT on the back of the head. Obviously LPP can be localized but usually does fade with time to virtually non existent. I had an injury a scrap that was fell on my hands due to moving heavy furniture during a move. I had what I think was a version of LP that existed for 2.5 years before disappearing. Super dry skin, perceived eczema or something. Eventually it subsided to let’s say a .5 vs a 10 and has remained as such. JAK inhibitors have been shown to significantly improve LP and LPP as well…. which means that dealing with hairloss outside of androgens could have a higher probability of success when associated with HT. Personally I think drugs associated AA vs MPB have a higher chance of success of coming to market much sooner. Whose to say really, but it’s important to keep things in perspective. Sure the OP has a biopsy and diagnosis, but I bet with treatment if indeed that was the only form of hairloss… 1) The LPP will eventually subside and 2) drug intervention has a higher chance of success vs MPB drugs over time. Sure not knowing ahead of time and getting a HT without treatment of an underlying condition is alarming, but knowing ahead of time and treating and with time, and assuming that were the only cause of hair loss…I might take that over MPB. I bet treatment of LPP and another pass via HT would yield positive results. Curious as to what an ANA blood test reveals for the OP? That’s standard ops for a blood test when getting a yearly physical. 
 

There is a pub med study that shows LPP causes a positive ANA test in 84% + patients. 
 

https://pubmed.ncbi.nlm.nih.gov/30810113/

 

Further, when it comes to speculation on hairloss, this site is more prone to speculation vs empirical observation or evidence due to the personal nature of hair loss.  Based on that I think it would be safe to assume in the absence of  a positive ANA test or positive biopsy HT would still be the gold standard in dealing with hair loss even if LPP or FFA is suspected or even found. Obviously if either were found treatment associated with HT would be the obvious course. 
 

I think it’s also fair to note that fibrotic tissue regardless of scarring is also prevalent in MPB as well as FFA. The obvious difference being that FFA can have a skin level scarring bulb and in extreme cases a keloid that grows to be much much larger although very rare and even more so in men. Point being just because LPP is present doesn’t mean time and circumstance associated with treatment and HT can’t yield a positive result. The crux of this being that it may take longer and or preserving donors for a later date. 
 

Lets also not forget there have been many post on scar tissue from FUT being repaired as well in this forum. Which I bet is much more fibrotic than an unnoticed form of FFA associated with LPP. 

Very astute observations and I would tend to agree with the overall conclusion

I have to mention that the event of skin discoloration takes place quite often to one degree or another in the case of the recipient area in hair transplantation, specially when  the patient gets plenty of sun exposure before a few months go by

Biopsies are very important to detect these things but let's not rule out the human element and the different interpretations by different Dr's of the same results, as has happened far too many times, unless in cases that are extremely clear and straightforward

11 hours ago, mcr7777 said:

I may have misunderstood the question.... if the area is scarred ie there are no stem cells left, the hair won't grow back. 

 

This can be a long or short process to happen.  And sometimes goes through more than 1 hair cycle to scar from LPP

ie not every hair shed won't grow back if you have LPP....but it's a progressive condition that tends to spread, especially if left untreated.

Ok it makes sense now

Since you had it, how did you treated it? Any success?

On 3/23/2023 at 3:37 PM, mcr7777 said:

They can grow keep growing back  but with different texture and not as long as before....it depends how much activity there is....LPP can be slow moving or more agressive.

 

Interesting, where did you get this from? From what I read in various sources, it seems that one of the main elements of scarring alopecias is that in the vast majority of cases once the hair falls it never grows back

3 hours ago, mcr7777 said:

LPP is poorly understood -and I'm guessing way underdiagnosed in males.   Not everyone gets thinning/eyebrows or side burns - but the majority do have itching. 

There  is an overlap LPP/MBP condition called FAPD (Fibrosing alopecia in a pattern distribution). 

With LPP and hair transplants there are no certainties - for some they take but eventually fall out a few years later for examples.  For others they get very poor growth - or some combination of the above. I believe some may do well over time but I struggle to find lots of examples as case studies seem to stop after a few years.

There is no 'cure' for autoimmune - this or others - but there are many treatments. It's a difficult condition to treat but many people get in under control after treatment starts. My symptoms have gotten away better but it still flares from time to time.

Check out Dr. Donovan's hair pages on LPP  - loads of information on it.

 

 

 

This is very interesting

Let me ask you something, do the hairs that fall because of LPP regrow a few months later??? Or once hairs fall because of LPP they never come back?

What is your experience and opinion on this?

5 minutes ago, Melvin- Moderator said:

I’ve always thought there’s some correlation to how much hair you have as a baby vs. when you get older. Again, a Native American baby full head of hair. Hairline quite low.

 

When I was a baby I was a Norwood 4. Hairline looked like Sting, and my forehead you could project a kids TV show on. 

 

I have a theory that the pattern we have as newborns is the one after many years we are going to have as adults( after mpb kicks in or not)

In a full circle kind of way

2 minutes ago, NegativeNorwood said:

 

They have the same hair, just different lighting and wet vs dry hair in Cruise's pictures. Pitt shaved the temples for a movie role. Cavill didn't have a hair transplant. Tremendous straw grasping you did there, you truly are clueless if you don't understand how lighting can influence the perception of hair. That's why there are so many bad doctors out there, because they use favorable lighting and low resolution pictures to show their results as better than they actually are. You are doing the opposite and showing pictures with bad lighting to prove your crazy theory.

 

 

You need to be a happy man accepting that there's people out there with better genetics than you, delusion is not happiness. Many people in Hollywood had hair transplants, just not Brad Pitt, Tom Cruise or Henry Cavill.

James Franco is a good example of a celebrity with minimal hair loss that got a hair transplant, and the change is pretty evident:

 

He has unlimited money, same Hollywood friend's circle and connections...yet the small change is noticeable when you compare pictures with the same lighting. Do you really think Tom Cruise or Brad Pitt can get away with it and he can't? Non sense, all of them have the same amount resources, just Cruise and Pitt didn't have a hair transplant.

Thank you for proving my point, completely clueless you are buddy

it appears that you have certain people you admire on a pedestal and refuse to think otherwise , whatever makes you happy :)

the OP is clueless

Tom Cruise had a HT in 2006 , he had a bowl cut the whole year and you can see in 2007-8 the change see pic, and another after 2015

Despite his extreme self care, he's losing something as in the pic from 2 years ago below

Henry Cavill had a HT in between 2020/21, here is a pic of him in 2019 and that's for a photoshoot(where they make everything look much better), look back over a decade and you see his recession growing, he's made a great choice by doing it

Brad Pitt might had a very small one in the 2012/13 years when he was shaving his temporal points and having a middle part for a year or so, look at his brother, great hair but some minor recession

As for meds, they are all on meds

On 5/1/2022 at 3:40 AM, Surfarosa said:

That's what I had always believed. It's hard to see that the back of your head (donor area) is also slowly thinning but in my case I think it is and if I look at my father, his certianly has.

Let me ask you something

As the years went by and you lost the transplanted hairs, how was the process of losing them?

a) Did the hairs suddenly fall and never grew back

b) Did the hairs suddenly fall/grow/fall/grow/fall while getting thinner and miniaturized over many hair cycles over years until they stopped growing

c)or did it happen in any other way?

17 hours ago, NARMAK said:

But you kinda just hit the nail too. 

Go back to your first post and look at the Tag Heur photo then look at the yellow jacket picture which shows what you say is Gosling at an event for it. 

If his hairlines been done, how come it looks impeccable in the marketing shot then suddenly higher and whatnot with less density around the same time? The only explanation for that is photoshop imo. 

As for the movie screenshot again there's a strong possibility that the camera lens is also causing a distortion making his hairline appear higher. 

Compare the Tag Heur marketing photo and then The Grey screenshot you posted. They look the same yet the yellow jacket picture then matches more with the top picture in your first post. 

So, i am not convinced he has had a hair transplant but i wouldn't be surprised if its hair concealer and the focal length of the lens causing the disparity. 

If you look at Bradley Cooper for example, it's much more obvious his temporal areas were brought down and closed off. With Gosling, it's difficult to say but sure, he could have had a reinforcement of the hairline but the hairline looks lower in the pictures too from the Tag marketing and The Grey screenshot. 

 I see a clear HT on Gosling, a bit on the hairline but still keeping it basically high as it was, but noticeable clear work on the temples/sides that make a big difference

What you are saying is true regarding the light in movies and photoshoots making hair look much better in general as well as making a face look better hence why they spend millions on doing so and why in real life they never look like in movies/commercials , it's all heightened

4 hours ago, follically challenged said:

To me, the temples definitely seem filled in, alongside his temple points looking thicker and more aggressive than before.

If I had to decide, gun to the head,....he had a HT

Yes I agree that's what it looks like

21 minutes ago, NARMAK said:

Don't be so sure its a hair transplant. One reason. Photoshop. 

It's become very common practice in post to edit and refine hair in the adverts to give a thicker denser look and really make us mere mortals feel inferior lol. 

The height, temple points etc. are all possible to reinforce via a hair transplant but i don't think this is more than a retouching on a marketing image which is par for the course. 

While what you say its very true oftentimes when it comes to marketing and photo alterations ,it does’t seem so in this case regarding the hairline

Here is a snapshot of his last movie The Grey man and one of the tag heuer event, the hairline change is clearly is there 

Ryan Gosling had a Hair Transplant 

the first pic is from lala land and the second one is from recent a tag heuer commercial while he was filming the grey man(hetook a “break” from acting in 2018)

He had a higher hairline but good hair it’s the type of work that no one would notice as he has done it before hairloss was an issue

On 5/6/2022 at 8:37 AM, MattJosh said:

Thank You for the response

That's what perhaps is happening, I was on Finasteride A for years before the transplant and during and  2 years after having done the transplant and everything worked perfectly

2 years after the HT or so I switched to Finasteride B and everything went down(only the transplanted hairs) for close to 2 years I've been on it

I am just back with Finasteride A and just suffered a shed of some HT hairs that were growing back, we'll see what happens

While I intend to be on Fin for good, How long would you give it to see if this was the cause?

Bump for Rahal Representative

5 hours ago, general-etwan said:

I'm not convinced JD had anything done the way some are. That's not the first time but sometimes people seem to be convinced that a celeb had a HT when it's impossible to know for sure. Knowing some of how JD was living now, and not to disrespectfully get into it...but with how much he seemed to abuse and neglect himself, I very much doubt he had a HT. Wouldn't be like him. I think it's most likely he just has a maturing hairline, and obviously no diffuse thinning at all.

He sure has, many others with self destructing habits of booze and alcohol got a HT, it is both vanity and required for his profession and type of actor he is, Johnny Depp bald would have a very different career

It seems like when you say him getting a HT “wouldn’t be like him” because it would imply self care and vanity, looks like he cares enough to always have his hair perfectly dyed and not showcasing a single gray hair being close to 60 whether he is working or not and keeps care of his van dyke goatee all the time besides staying at a certain weight range give or take

Not bothering is Marlon Brando later on when he became a whale and had bad habits all around 

11 hours ago, NARMAK said:

Do you have pictures though? It's hard to know without them. 

Gordon Ramsey for example has some out there you can find. Elon has the scars. Franco has the obvious recession to comeback as does Bradley Cooper and even Machine Gun Kelly has the obvious recovery stuff shown and FUT scars. I just haven't really seen anything on Brad. 

I do know that sometimes for roles they can end up screwing them. Like in that gangster movie, they completely shaved his temple points. 

Your first pic is from 2019 or so

The time i’m referring as to when he did it was sometime in 2013-2014

While it is very subtle you will see him with long hair and something slightly off at the hairline for his standards in sone pics and you’ll see as well the temple points shaven two years after having filmed killing them softly as per your second pic

As far as a clear sign such as ramsey, musk etc, pitt is extremely image conscious and is never seen unless while promoting something, he covered it up with the long middle parted hair

5 hours ago, NARMAK said:

It would be interesting to see if you can post some comparison pictures. 

Brad Pitt's hair is solid even now. The only slight thing about him though is his temple point narrow in a fair bit over the brow and then swing back a bit more sharper than probably aesthetically ideal. 

BP did his transplant before the Fury movie, he had great hair still but I guess slight maturing of the hairline wasn't acceptable, he was shaving his temple points for a good year or more before, and he was wearing long hair with a middle part for the time he was recovering

1 hour ago, Rahal Hair Transplant said:

MattJosh,

There have been discussions about generic finasteride and certain brands that are less effective than others. In my opinion, if you switched brands and are experiencing side effects or other symptoms such as a loss of transplanted hair or natural hair, I recommend switching back ASAP.  This of course is assuming that the original brand was working for you in a positive way.

Far be it for me to draw any conclusions or suggest that the brand you have switched to is less effective however, it’s obvious that changing brands affected things in some way and not in a desirable way.  And because of discussions I’ve seen about generic finasteride and certain brands, I think it’s worth exploring the possibilities here. 

Now, transplanted hair should not be permanently affected by using finasteride or switching brands, etc. If anything, you may be experiencing an initial shedding as if you just started finasteride for the first time.

Here’s the other possibility - 

One might actually even suggest that the previous brand you were using wasn’t as potent as the brand you switched to given that it seems to be causing side effects that are possible in some men who use finasteride and it seems like you are experiencing an initial shedding which is typical when starting to use finasteride.

Thar said, if the previous brand was working for you and you were happy with it, I still suggest going back to the original brand because the changes you are experiencing aren’t desirable. However, if the previous brand was not working for you, you may want to continue with this brand for a little while to see if it actually does work for you.

Any hair shedding is temporary and side effects often go away with continued use of medication. And if they don’t, you can always stop or switch back in which case, side effects should go away.

That said, I do want to point out that there are some men who have stated they have experienced ongoing side effects even after stopping use of finasteride.

At the end of the day, you need to do what works for you. I suspect that you felt the previous brand was working in which case I would stick with my original advice and switch back to the brand that was working for you without any negative effects. On the other hand, if it wasn’t working for you, you could continue with this brand and see if it does work and ride it out to see if the side effects go away  

best wishes,

Rahal Hair Transplant

 

 

 

 

 

Thank You for the response

That's what perhaps is happening, I was on Finasteride A for years before the transplant and during and  2 years after having done the transplant and everything worked perfectly

2 years after the HT or so I switched to Finasteride B and everything went down(only the transplanted hairs) for close to 2 years I've been on it

I am just back with Finasteride A and just suffered a shed of some HT hairs that were growing back, we'll see what happens

While I intend to be on Fin for good, How long would you give it to see if this was the cause?

Yeah you are correct, he was 41 and 42 in the pics I posted, he had the transplant later than I thought age wise

Here is JD at 31 and 32 years old, he had a transplant years later keeping his natural high hairline, while very natural you can see the sharp design over the last decade 

12 hours ago, J.A.C said:

Transplanted hair should remain regardless if you take Fin or not, that’s been taken from your so called “safe Zone” 

Where do you have the work done ? Can you give some more details ? Pics if possible.. thanks 🙏 

That is the way it should be as per the donor dominance theory, which is not black and white, albeit not being the norm, countless of people have lost transplanted hair over years, specially the ones not medicated there are plenty of users on the spanish forum recuperar pelo an others mentioning it.

I am all for hair transplants but this happens more than it thought of

12 hours ago, MAIZE1694 said:

 

What is the name of the manufacturer of this suspicious finasteride?

Let's put that aside an imagine I'm right, would this situation be possible?