GoliGoliGoli

One final question: Where do you guys think I fall on the Norwood scale? 

On 6/23/2022 at 3:20 AM, Gatsby said:

I think you will be fine as long as you stick with the anti biotics. A lot of clinics prescribe anti biotics immediately after surgery regardless to avoid infections. All the best!

This is something I've been wondering about. It sounds like some but not all clinics prescribe antibiotics post HT? I would prefer to avoid having to take antibiotics if not 100% necessary, so I'm hoping it's true that not everyone takes them post HT? 

20 minutes ago, pidds said:

1. I started 1mg of Fin and Minoxidil Foam about two years before my first transplant which stabilized my hair loss.   

2.  I assumed I would need a second transplant to get more density. Additionally, one of temples lost more original hair after the first transplant so I had that restored. I’ve lost more natural hair in the last few years so I’ll have a third transplant in the next two to five years.

3. I haven’t shared any pics.

Final q: Where were you on the Norwood scale prior to the 1st ht?

4 minutes ago, pidds said:

I had the transplants 23 months apart from each other.

In 2016 I had 3,584 grafts over two days.

In 2018 I had 1,930 grafts over one day. 

Let me know if you have any other questions.

A few if you don't mind:

1. Were you on Fin/Min/Nizoral/Anything else? If so how long before or after the first HT did you start

2. Did you go in knowing you would probably need 2? Or was the 2nd somewhat of a surprise? 

3. Do you have any before/after pics from one or both surgeries?

3 minutes ago, Gramatik said:

2.5 k grafts for front and 2k grafts for crown. Total 4500+ grafts you need for both Parts. 

Do you think I could get away with 2k front and 2k crown? Like I said I'm limited to 4k grafts per procedure 

4 minutes ago, civic said:

You mentioned cap of 4k grafts, usualy when donor is limited in some way,  pro FUT surgens would recomend strip to not deplete donor. Was your donor examined in person? 

If anything I think I have a pretty strong donor, but I have never had it examined in person. But I have always had very thick hair, and my hair in the donor area feels super thick to me just like it did when I was 16. 

Regardless, I thought 4k was the max grafts for any procedure just because you don't want swelling to be too brutal and follices to be competing for blood supply? I don't think the 4k max is lifetime, just per surgery

8 minutes ago, civic said:

Are you going for FUE or FUT? 

FUE. Curious as to why this would impact graft # needed? 

6 minutes ago, Buck Naked said:

I think the hands of a great surgeon about 1,500 for the crown can be down. The 2,500-3,000 grafts for the front makes sense. Yeah, oral minoxidil is better. Have you tried finasteride? If not, get on finasteride ASAP.

TBH I'm really not interested in trying oral or topical fin. I don't like taking any medicines really if I can avoid it, and generally don't trust the pharmaceutical industry (Despite working in it). I'm also ok with getting a 2nd HT if/when needed and would rather do that than get on fin

Since I'm capped at 4000 grafts, I might go for 2000 on crown and 2000 on hairline. Does this seem like a decent enough plan? @Melvin- Moderator   @Buck Naked

I should say, despite how the picture looks I don't think I need to lower my hairline very much. My forehead looks huge in original picture, but isn't so bad with how I wear my hair. Here is another pic of me with it styled to cover it up. 

2 minutes ago, Buck Naked said:

To fill in the sides and front and to advance the hairline a little is about 2,500 grafts. I think the crown needs about 2,000 grafts. Have you had any consults yet? If so, what did the surgeons say? Are you on oral minoxidil? How about finasteride?

I've had a few consults. The only one I remember is with Nader and was told 2500-3000 for the hairline and 1000-1500 for the crown. But I'm worried this wont give me the coverage I want on the crown. 

I am on liquid min for 1 month and not on fin at all. Is the oral min supposed to work better? 

Awesome thanks for the answer.

When you say "reinforce" versus "lower", reinforce would basically mean filling in the recessed areas in the corners? My goal is to go as long as possible before needing a 2nd HT  so I think reinforcing would better in this regard? 

Hi all, just seeing what you folks think in terms of graft number needed. I'm fine with being conservative on the hairline as long as I get the crown covered. 3rd pic is fresh out of the shower and hair pushed down. I figure I will need a 2nd HT at some point to cover the area between the crown and hairline, but for now it's fine. Been on Min for 1 month so hoping that will help too. 

Hi all, I searched the forum but wasn't able to find a straight answer. Is scalp laxity only a concern with FUT? Is it essentially irrelevant with FUE? 

34 minutes ago, MachoVato said:

That's all in range, although a little low. You could also look at your estrogen levels, as it impacts stress/anxiety.  My test was over 800 a few months ago without any TRT and I'm 51. Today I'm on TRT and my test is over 1200. 💪

Genetics are stubborn. Finasteride/dutasteride are not perfect but they are the best chance at keeping your hair. My transplants have been the biggest improvement to my life in many years. I'm still on meds and will be for the rest of my life. And probably testosterone, too. 

 

Sorry to derail the thread.

How did you get prescribed TRT at 800? And why did you want TRT at 800? Due to also wanting to take Fin? Won't the fin and TRT kind of counteract one another? 

45 minutes ago, pidds said:

When I went for my first transplant with Dr. Nader I asked him about his track record and he told me that overall he’s had great patient results. However, he did tell me about a failed transplant that believed was the result of a very stressful event the patient went through after his transplant. Dr. Nader told me he gave that patient a second transplant for for free which had a very good outcome. IMHO, Dr. Nader is class act who really cares about his patients! 
 

I’ve been very happy with my results from two Nader transplants. If I ever need a third I will gladly go with Dr. Nader again. 

How far apart were the two transplants? And how many grafts each? 

1 hour ago, MachoVato said:

Ok. Have you taken a blood test to check your test levels?  I doubt DHEA is increasing your test levels enough to make a difference. 

Yes I was at 510 or 590 (Cant remember which) when I tested about a year ago. So basically totally normal amount, maybe slightly low for my age (33 years old). DHEA was recommended by a doctor along with a few other supplements. I noticed a genuine improvement on DHEA but never got my bloodwork done after having been on it so can't say whether it raised my testosterone or by how much. 

Nevertheless, I am off of it now for fear that it will speed up my hair loss. 

28 minutes ago, MachoVato said:

You're taking testosterone injections?

No no, it's DHEA. It's a supplement in pill form, you let it dissolve under your tongue. You can buy it in any vitamin store. 

4 minutes ago, eb21007 said:

I will be very transparent with you .. do not take the  steroid tren . It will wreck your hair. I got big on it but paid for it with hairloss . Like I said , had I not taken it 2015 ... I would not have needed a 3rd touch up 

Oh trust me I'd never take steroids. I was on DHEA which is an over the counter non prescription supplement. Basically a precursor to testosterone. 

3 hours ago, Raphael84 said:

It really depends on many factors specific to the patient and therefore why a unique surgery approach for each patient is essential.
Donor density is obviously an influential factor. Patients with significantly above average density may be able to achieve higher graft counts providing their donor is healthy.
Density however is not the only consideration.
FUE takes from surface area and therefore patients who may have a dipping or drop in the lower crown or potential retrograde alopecia with thinning from the nape of the neck moving upwards and possibly weakness above and around the ears, may mean that despite a natively higher density, weaker areas limit the surface area viable for FUE extraction.

4000 is pushing the average donor. We would personally prefer to see the patient in person for consultation before recommending or considering a 4000 graft surgery and much more commonly a patient may safely reach 3500 grafts for example. 

If the donor is pushed too much, then due to the overall negative effect that this can have on untouched grafts as detailed in my above post, this would mean that less grafts would be available in subsequent procedures due to a decline in general health of the donor and that is never the preference.

If you have no concerns with dipping in the crown or retrograde alopecia and density is high, then 4000 grafts can be achieved, but again this is not every patient.

The following case is a good example of higher graft counts being suitable.

You can see the patients rear donor has great height. No signs of decline in the lower crown or anywhere within the rear occipital, and you can see the strength and density moving toward the nape which is not so common.

This patient had an average density of 82.5 follicles per cm2 (70 - 75 is an average patient) so he was above average and his donor allowed a "safe" zone of 8cm in height and 32 in length, providing a surface area of 256cm2.
Another patient may only be able to consider a surface area of donor of 180cm2 for example, and therefore density is not the only consideration.
 

 

So I guess one concern I had with doing 4000 grafts is that it would potentially risk the newly implanted grafts due to swelling/inflammation. Is that not a concern? Reading the above two posts it sounds like the concern is more with regards to the donor area than the implant zone?

I started taking a Testosterone supplement 6 months ago (Not thinking how it would effect my hair) and it definitely seemed not to help at the very least... So I know the struggle

Interesting. First time I've heard of a bad result coming out of Nader's clinic. Was the guys 3rd HT so maybe that has something to do with it? It's also still very early, people say 12 months wait period for a reason 

Look forward to hearing further updates. I'm booked with Nader for November. Has anyone else ever heard of a bad result coming out of Naders clinic?

Dr Nader is just south of the border (Like literally 10 mins south of the border). From everything I've heard he is just as good as any US doctor for a fraction of the price. I am going to him for my HT in November

23 hours ago, Raphael84 said:

In regard to over harvesting, obviously it is the amount of grafts that are extracted that creates the main issue. But the problems created, do not stop there.

In most cases, it is due the very large graft numbers being taken in single procedure, which is more than the donor can safely provide. In other cases, graft numbers can be more conservative, but when focus is only in the richer occipital rear donor for example and therefore surface area of donor utilised is much smaller, then if not optimally managed, the obvious moth eaten appearance can still occur.

In the punching and extraction process and as follicles are essentially cut from the surrounding tissue, the scalp experiences a level of trauma. The more extraction sites in any cm2 of donor, the more blood vessels below the scalp are disrupted and the more extreme the "trauma".

Due to the "over-disruption" of these blood vessels which are responsible for healing and providing "nutrients" to the follicles that are untouched, healing in these areas can be sub optimal meaning not only have too many grafts been taken from a particular area, but the follicles left in tact also experience decline in terms of potential miniaturisation and thinning of the structure of the hair due to such disruption.

Below I share two videos with Dr. Bisanga explaining these concerns further. The second video due to some blood being visible means it is only available on the YouTube platform, but it is well worth the watch.

 

 

Thank you for the very detailed answer. I am currently scheduled to get 4000 grafts with a reputable Dr in November. This will be to cover my hairline and scalp. Do you think 4000 over two day session is risky for these reasons you explained? I know 4000 is the maximum most reputable Dr's will do, but is 4000 even pushing it? Asking @Eugenix Hair Science@Eugenix Hair Sciencesas well, thanks!

13 hours ago, PeppaFrog said:

Damn, December you talking about actual appt., or just email respond by December 🤣, is there any other ways besides his website and email I can in touch with him? 
I’ll keep trying ofc. See what FUEcapillar will say. But Dr. Nader seems very good according to this forum’s reviews, I haven’t seen bad ones, besides guy who has almost 0 visible results after 7 months post-op. If anybody else have experience bad or good with Dr. Nader please share it here so I can make right no-biased choice. 

Also can you link to the thread of the guy who has seen no growth by month 7?