redkun9

I'm also very interested in Asian Player's results. His hair loss situation is very similar to mine, and I'd like to see how things turned out.

Looking great - and its only 5 months! The difference is already significant; I'm excited for your next few months...

Hey everyone, Thanks for the responses! I've had about 3 online consultations, from recommended doctors to the generally accepted elite doctors on this forum. I've had estimates from 2,000 to 3,000, but personally, I'm more comfortable with the 3,000 number. While being on finasteride for about a year and a half has slowed down the crown loss, I feel most of the frontal third is in varying states of miniaturization, so I feel the 3,000 figure should compensate for any imminent future loss. I appreciate your comments, Dr. Feller. Actually, I remember seeing your Chinese patient's results on the forum while I was researching Asian patients. It was one of the first Asian patients where I was like, "Okay, so this HT thing could work for me". If you don't mind, could you provide your professional opinion on my situation (on the forum or PM). I sent some pics for a consultation a while back, but I think they got lost somewhere in the interweb tubes. Cheers

Hey Ronny, I've still in the "thinking about it" stage, but I'm leaning towards Dr. Rahal. Could you describe your experience with McGrath? If you could be so kind as to post some pics of McGrath's work, that'd be wonderful. Thanks!

I like how things are looking, and glad that you feel the same. Best wishes on future growth! Also, I was curious what your density figures were (eg FU's per sq. cm) and how they were distributed (crown vs. frontal third)? Cheers.

JustCurious - actually, from what I understand from my own hair research, a unique attribute of Asian hair is that there is a higher percentage of single and double follicular units and less 3 and 4 groupings than Caucasians.

Being Asian myself and with a similar hair loss pattern, I'm very excited to see your future results. Best of luck on the regrowth; the work looks fantastic. Out of curiosity, do you know what your density numbers are in the transplanted areas? I also noticed that it's hard to make out your scar in your post op pics. Is your scar even visible from behind? If not, how short is your hair to effectively hide the scar? Cheers!

Hey everyone, I'm curious about the current consensus regarding graft rate survival for strip procedures. By this, I mean the survival rate of implanted grafts, as opposed to the harvest yield (survival of grafts excised from the donor area). I feel this is immensely important for this community in that it has a direct bearing on one's aesthetic results and expectations. If you implant at 40 FU/cm2, but only achieve 90% survival, you're only getting 36 FU/cm2. Does that mean you should aim for an implanted density higher than 40 FU/cm2 to achieve an actual density of 40 FU/cm2? To answer this question requires an appreciation of the difference between implanted and achieved density, and how that difference may change at higher densities. For example, does implanting at higher densities reduce graft survival? I've read in several posts that this is probably the case, but I'd like to know what evidence supports this probabilistic assessment and how much do survival rates drop at higher densities? Doing a few searches, I've uncovered informative discussions that I'll be referencing below. To all the doctors out there, I'd love to hear your thoughts and any updated research studies that have been released. In 2005, Dr. Beehner discussed how FU graft surival "has varied all over the board...mostly averaging around 90% survival" while also noting that implanting into virgin scalp has better survival rates than subsequent sessions. In a set of posts during 2008 (which I strongly suggest you read for yourself), Dr. Beehner writes, "In two recent studies I conducted, the follicles contained within 2-hair FU's survived in the mid 90% range, whereas 1-hair FU's survived between 65-75%. The 2-hair FU's were placed in 19g needle sites and the 1-hair FU's into 20g sites." He suspects that "the lack of protection and physical buffering around a skinny 1-hair FU makes it far more vulnerable to both trauma and drying". He also notes that these studies have been performed in conditions that are more likely ideal and in areas that don't have to share blood supply with thousands of other implanted grafts. He writes, to my lament, that "no one as yet has studied growth of FU's in the midst of such dense, large sessions" (large sessions referring to 3,000 - 7,000 FU grafts). There is also an interesting conversation between Jotronic and Dr. Carman in 2008 about the survival rate of grafts above 40 grafts/cm2. Dr. Carman writes, "It has been demonstrated that a density of 40grafts per square cm will give near 100% graft survival, all other things being equal. It has also been observed that when grafting at higher densities than this, the survival rates of the grafts decreases. So, while it may be technically possible to make and place 60 grafts per square cm, the survival rate is in the low 90-93% range." Dr. Carman makes an interesting point about the relationship between the number of insertion sites into an area and the implanted graft's hair count in terms of density. Jotronic argues that these studies aren't methodologically rigorous and also weren't performed by individuals who necessarily have the experience of dense packing or megasessions. He claims the studies "cannot simply be thought of, executed, then have the data be considered valid if the proper experience to perform the studies to begin with is absent". I've tried to summarize these posts to revive discussion about these issues, and any misrepresentation of the author's opinions is my fault alone. Likewise, I strongly suggest you read these posts yourself. My particular comments are: has a consensus been established within the Coalition doctors about the estimated survival rate of grafts at various density levels? For example, what should the expected graft survival rate be for a Coalition doctor at 40 FU/cm2? 50 FU/cm2? 60 FU/cm2? What are the results of any new research? Given that this is the terrain of hair transplant surgeons, their comments would be particularly salient. Cheers

Hey everyone, I'm curious about the current consensus regarding graft rate survival for strip procedures. By this, I mean the survival rate of implanted grafts, as opposed to the harvest yield (survival of grafts excised from the donor area). I feel this is immensely important for this community in that it has a direct bearing on one's aesthetic results and expectations. If you implant at 40 FU/cm2, but only achieve 90% survival, you're only getting 36 FU/cm2. Does that mean you should aim for an implanted density higher than 40 FU/cm2 to achieve an actual density of 40 FU/cm2? To answer this question requires an appreciation of the difference between implanted and achieved density, and how that difference may change at higher densities. For example, does implanting at higher densities reduce graft survival? I've read in several posts that this is probably the case, but I'd like to know what evidence supports this probabilistic assessment and how much do survival rates drop at higher densities? Doing a few searches, I've uncovered informative discussions that I'll be referencing below. To all the doctors out there, I'd love to hear your thoughts and any updated research studies that have been released. In 2005, Dr. Beehner discussed how FU graft surival "has varied all over the board...mostly averaging around 90% survival" while also noting that implanting into virgin scalp has better survival rates than subsequent sessions. In a set of posts during 2008 (which I strongly suggest you read for yourself), Dr. Beehner writes, "In two recent studies I conducted, the follicles contained within 2-hair FU's survived in the mid 90% range, whereas 1-hair FU's survived between 65-75%. The 2-hair FU's were placed in 19g needle sites and the 1-hair FU's into 20g sites." He suspects that "the lack of protection and physical buffering around a skinny 1-hair FU makes it far more vulnerable to both trauma and drying". He also notes that these studies have been performed in conditions that are more likely ideal and in areas that don't have to share blood supply with thousands of other implanted grafts. He writes, to my lament, that "no one as yet has studied growth of FU's in the midst of such dense, large sessions" (large sessions referring to 3,000 - 7,000 FU grafts). There is also an interesting conversation between Jotronic and Dr. Carman in 2008 about the survival rate of grafts above 40 grafts/cm2. Dr. Carman writes, "It has been demonstrated that a density of 40grafts per square cm will give near 100% graft survival, all other things being equal. It has also been observed that when grafting at higher densities than this, the survival rates of the grafts decreases. So, while it may be technically possible to make and place 60 grafts per square cm, the survival rate is in the low 90-93% range." Dr. Carman makes an interesting point about the relationship between the number of insertion sites into an area and the implanted graft's hair count in terms of density. Jotronic argues that these studies aren't methodologically rigorous and also weren't performed by individuals who necessarily have the experience of dense packing or megasessions. He claims the studies "cannot simply be thought of, executed, then have the data be considered valid if the proper experience to perform the studies to begin with is absent". I've tried to summarize these posts to revive discussion about these issues, and any misrepresentation of the author's opinions is my fault alone. Likewise, I strongly suggest you read these posts yourself. My particular comments are: has a consensus been established within the Coalition doctors about the estimated survival rate of grafts at various density levels? For example, what should the expected graft survival rate be for a Coalition doctor at 40 FU/cm2? 50 FU/cm2? 60 FU/cm2? What are the results of any new research? Given that this is the terrain of hair transplant surgeons, their comments would be particularly salient. Cheers

Mochi, Thanks so much for sharing your pictures. I genuinely hope you'll continue to provide updates to chronicle your transformation, especially since we have very similar hair characteristics. Just curious, but do you know your original hair density? What is your new density? Best of luck with healing and (re)growth.

Mochi, I share many of the same sentiments over a HT, especially the unique value of having hair while you're young (I'm 24). From your description, I think we have similar hair situations. If you search for my pics, you can judge for yourself. From my consultations, I've received estimates from 1500 - 2000. One thing to keep in mind about Asian hair is that while the density is lower, the follicular width tends to be thicker. I'm not sure if this offsets for the lower density, but it should be taken into account. Another thing you might want to think about is shock loss. My HT would be lots of grafting into existing hair in my frontal area, which poses a shock loss risk that I'm concerned about. Regarding the lifetime of HTs, I think I'd be up for another HT for the future when my age calls for it. Although one HT would be ideal (actually zero really), two would most likely be my limit. Ideally, that would be enough. You may want to realistically consider your willingness for another HT. What did your doctors say about your donor potential for future HTs? Looking at your relatives also might help in determining the extent of your future hair loss and donor need.

Woah - being numb, "strange sensations" for a year?! Even the idea of losing sensation for an area on your head for a few months seems somewhat terrifying. Is this numbness typical for HT patients? For those who experience this, how long did it last? If anyone could shed some more light on this, that'd be great. Cheers,

Hey everyone, just wondering if anyone has had any HT experiences with James Harris in Colorado. I've read a few posts that he's recommended, but I was curious if there were any more opinions out there. Cheers,

Hey everyone, just wondering if anyone has had any HT experiences with James Harris in Colorado. I've read a few posts that he's recommended, but I was curious if there were any more opinions out there. Cheers,

You should just ask your personal doctor - they should be able to hook you up. That's what mine did.

Dedred, You appear to have thoughtfully explored your options and that should reassure you of whatever decision(s) you ultimately make. However, I had some additional thoughts that you may want to consider regarding your hair loss strategy. Your analysis of the Propecia option may be too black and white, whereas I see shades of gray. You state that if you "experience no (major) side effects: Success" and that if you have side effects that you can't live with, If I'm interpreting what you wrote correctly, then you seem to be saying: if I don't take Propecia, then I shouldn't get a HT because I'd be wasting my money since there would be future hair loss, hence the wasted money. But that line of thinking assumes Propecia works for you. If Propecia doesn't stop your hair loss, then that may be the same as you not taking the medicine. Would you still think that the HT is a waste of money? Or what if Propecia merely slows your hair loss, does that negate the value of a HT? What if Propecia stops further loss, but doesn't promote any regrowth? Would you be happy with your current head of hair? Does your decision calculus of undergoing a HT entirely depend on Propecia's success? That's something you may want to think about more. From my standpoint, I think that a HT could still be valuable by giving someone a desired appearance of hair, even if that overall appearance may be temporary in the long run. If you get a HT and Propecia slows your hair loss, then that just buys you more time to have the hair you want. The question becomes: is it worth it to have this particular amount of hair even though in the future you may succumb to further hair loss or require further HTs to maintain your appearance? Which leads to the other consideration of your willingness to have further HTs to replace potential future hair loss, that is either delayed by Propecia or the natural consequence of DHT. Just some thoughts to reflect on, that hopefully are helpful.

Thanks for the info, Latinlotus. I really appreciate your opinion based upon the unique aspects of Asian hair. Would you remind linking to some of that research? My preliminary research lends me to believe that Asians in general would also require a lesser number of grafts, all things being equal vis a vis other Caucasians. Have you read this by any chance? The study claims that "n normal Chinese scalp, an average 71.78 FUs/cm(2) and 137.08 hairs/cm(2) were calculated with a follicular density of 1.91 hairs/FU." and continues to say that "[t]he average density of 30 FUs/cm(2) implanted was suitable to reconstruct a natural frontal hairline in bald Chinese patients, which can achieve about 40% of normal hair density." I didn't purchase the article online, but I was curious how you felt about the 30 FU/cm2 number. I realize this is only the number for the hairline, and who knows how they define "suitable". If you don't mind me asking, are there any doctors you've run across that do impressive "Asian" work?

Dhoose and indian, thanks for the suggestions. Indian, what number are you planning on going with? I've been on finasteride for about a year, on and off, now. Would 2500+ be too aggressive since I have existing hair in the frontal 1/3 area? It's sparse bc of a combination of thinning and loss, but there are still native hairs there. As Indian mentioned, that existing hair still does it's coverage thing (kinda), and I'm concerned that going with too many grafts could backfire. Would shock loss risk be a reason to go with around 1500? I'm kinda confused with all the divergent numbers thrown out, and the "unique" issues/obstacles of asian hair compound those worries. I'm not lowering my hairline radically since I've always had a high hairline. I just want enough grafts to lower the hairline and fill in the front. Are there any docs who "specialize" in asian hair? cheers

profile

right temple

Left temple

top down - with flash

Top down view

View from the front

I don't style my hair this way (clearly), but hopefully this shows the degree of my hair loss.