singh

2 hours ago, BackFromTheBrink said:

I may be misremembering, but doesn't the OP suffer from traction alopecia?

If that's the case, he may well never suffer from male pattern baldness.

My advice would be to ask the clinic about their change in estimated graft count, and their planned density (raising their previous comment about the limitations of hair transplant density).

If you're never going to lose hair, attempting to match native density as much as possible isn't a bad strategy.

What you really want to know is their aimed density and their experience of achieving that in other patients. Hopefully they will be able to share some reference cases.

Yes that's correct. Maybe in my 30s or 40s I will have some recession of my hairline like 99% of men no one in my both sides of my family crossed NW2 before 50.  They just said its gonna be 1000 grafts max so ill probably go ahead with it.

2 hours ago, Emiry said:

You can blame TikTok/social media for this with all these weird hairstyles and trends. These days the trend is to have a bird nest on your head, but what many gullible people don’t realise is some of them wear headpieces/wigs or do trickery with filters etc to look like they have hairs growing down below near their noses 😂 I think it was Logan Paul or his brother what’s his name that was proper NW3 but wore wigs/comb overs and you wouldn’t believe how many foolish people imitated them. 
 

 

Yeah their dad is clearly NW 6+ so I guess theyre making the best out of their genes 

8 hours ago, KSA91 said:

You have to remember that the defining characteristic of a mature man's hairline is that the temporal recession is higher than the mid-frontal point. That's what's going on in this picture. This is normal and natural! It doesn't mean you "need" a transplant! You have thick hair...You aren't suffering from hair loss! This is how a man's hairline is supposed to look like. Unfortunately, modern cultural norms tell us that a "straight" hairline or a "drake" hairline is how a hairline is supposed to look. A straight hairline in a man doesn't exist in nature!

Former US President Ronald Reagen and former football player Steven Gerrard are the only two "men" I know of who maintained a juvenile "straight" hairline naturally. This is incredibly rare and less than 2 percent of men maintain a child's hairline. Your doctor should have informed you and warned you about getting a transplant so early. Do not think about getting a hair transplant in your twenties!

Actually, I'm suffering from traction alopecia, and I'm just looking to reinforce my current hairline. I've had a windows peak since I was a child and women in my family have it too, I think it doesn't have to do much with hair loss but with genetics. My family doesn't have a history of hair loss and I agree my hair loss from traaction alopecia isnt severe but since its not progressive I want to fix it and go on with my life.

When I saw the surgeon in person and asked if I will need  800  grafts as they quoted online by seeing my pictures, but they said ill need 700 only. I asked if I can get 1000 for higher density and they said that wont be possible due to limitations of Hair Transplants

Now I called their assistant to book a slot for a HT and I was sold the doctor said Ill need 1100-1200 grafts?? I dont get it since the doctor in person said it will be 700 and I understand if she went upto 800 or even 900. But isnt 1200 a big leap from 700?

Here's a picture of the initial quote they gave me to add density to my hairline (which is all I want, no lowering). 

 

On 8/20/2023 at 10:39 PM, BackFromTheBrink said:

I say that's an ideal density. Its not so dense that it'll require special treatment to ensure adequate blood flow in the scalp but is high enough to give a good margin of error and ensure a good result.

Now that I told them I wanna proceed the surgeon said its 1100-1200 grafts, i dont get it how will they fit so many in such a small area?

59 minutes ago, BackFromTheBrink said:

Generally I'd say in the region of 50 follicles per square centimetre in the hairline will give the appearance of a full head of hair.

Some surgeons go higher, especially in the hairline. There has been people who got 70-80, but that's relatively unusual and extreme. 

I already have native hair in my hairline and since my issue was traction alopecia, the remaining hair thickness allows a illusion of perfect density when styled right. However a slickback exposes the hair loss. I'm quoted 700 grafts for 12 x 1 cm hairline area between native hair which comes out to 58 FU/per cm. I'm not sure how that will work since its a very high density

2 hours ago, A_4_Archan said:

@singh

What do you mean by "good density" ? Do you mean a density same as someone who doesn't have any hairloss ? If your expectations are as such than you will be disappointed .. HT can give very high density in very very less % of patients where all the factors affecting the outcome of a surgery are extremely favourable..and in rest of the cases HT is an illusion of density and not the actual density...sometimes even giving too much of density proves to be disastrous....

Its not always that only GRAFT COUNT leads to density...graft count is one of the factor but not a singular factor affecting the density..there are many other factors which affects the density of a HT such as

- Hair caliber of donor hairs....this plays an important role to provide density ..even if the number of grafts implanted is less but the thickness of donor hairs is more than you can achieve decent density with less grafts comparatively...

- Hair caliber of native hairs...when there are good amount of hairs already existing in the transplanted area which are thick than the native hairs plus transplanted hairs together can provide decent density even if the amount if transplanted grafts are less

- Number of multiple grafts...average hairs per graft ratio has its role when it comes to density...higher the ratio better the density....more density can be achieved with less number of grafts if donor provides more multiple grafts

- Hair angles....for this surgical skills plays an important role and that's why good surgeons can provide good "ILLUSION" of density with using less amount of grafts comparatively....they can make hairs grow in such an angles where they provide better illusion of density..if the hairs grows in upward direction than they will provide illusion of less density and if they lay flat on the scalp than they provide better illusion of density.

- Survival factor....if a surgeon implants more grafts per sq cm but his transection rate is high than you will achieve less density and if a surgeon implants a bit less per sq cm with more than 95% survival rate will achieve better density..

- Medication..some fortunate people are very good responder to meds and they get some good regrowth as well as their native as well as transplanted hairs really gets fuller and thicker with medication and they achieve good illusion of density with less grafts..

- Hairs-Scalp color contrast...this also plays an important role which people don't consider...if the contrast is low than the illusion of density is high and if the contrast is high than the illusion of density is low.

- Size of the area to be implanted ....sometimes the baldness is extreme but the total area in terms of measurement is less so the number of grafts requirement is low comparatively while in some cases the baldness is not that extreme but the area in terms of measurements is bigger and so more number of grafts are required.

- Individual's response to a surgery....sometimes an individual respond very badly to a surgery and there is a chance that he/she might not get the desired results...

 

Now if i speak about your particular case than i would say there is a good chance that you can get near to native density because as you already mentioned in your other posts that you are not diagnosed with MPB so your surgeon has a freedom to go for a dense packing and use as many grafts as it takes to achieve high density because he/she don't need be conservative in your case....plus the area is small so it won't need too many grafts either to achieve good density...you native hairs also seems to have above average thickness which will help...so if most of the factors affecting the outcome of a surgery is favourable to you than you are likely to achieve good dense outcome..

But if you are asking that if you can get some specific assurances and some calculations about this from someone than my answer would be pretty short and straight -  NO 

i hope this helps you...

By good density I mean, not having my scalp visible when my hair is slicked back. Since I'm only getting the first centimetre of my hairline being done, I believe only singles will be used. But thank you for such a detailed general and a personalized reply. Your assurance means a lot friend!

I was talking to a clinic and I gave them my calculation based on the area of surgery and the number of grafts. I was told that there's no way of calculating post-of density with any calculation and there's no way of knowing what my hair will look like post-op. I'm really confused because how am I supposed to tune my expectations and how am I supposed to know if my surgery went right?

 

9 minutes ago, A_4_Archan said:

@singh

Yeh the same thing i earlier explained in my above post that the shock loss can be contained with medication....but you said that your surgeon told you not to take it so i am not a doctor tht i can counter a doctor's advice...

Yeah same, I think I'll take my doc's advice too. But from what I've read about hair loss I've seen that even the claim that hair fall of after minoxidil is pretty disputed among doctors. Many doctors claim that this only happens in AGA because minox is what maintains your hair, and for example when it is prescribed to women for post partum hair loss or TE, they don't notice a shed after quitting minox. In my experience, I didn't experience a shed either.

And the guys with AGA who noticed this shed on discontinuation of minoxidil don't shed their hair that wasn't falling off either. And most guys on r/minoxbeards also retain their beard from minoxidil since DHT isn't against them in that area.

I think hair loss, just like other fields of medicine has no clear consensus  

7 hours ago, GeneralNorwood said:

Tretinoin is first generation retinoid, so it is the oldest one. Currently we have four generations. 

There is Adapalene - third generation retinoid that is less irritating then tretinoin and can be used safely with benzoyl peroxide. Tretinoin can't be used with benzoyl peroxide, because tretinoin is not so stable. 

You can buy Adapalene and benzoyl peroxide seperately or as a mix - this is called Epiduo. 

I was using tretinoin for half year, but it was to irritating for me and i  recently switched to  Adapalene + benzoyl peroxide. 

 

luckily for me tret 0.05% suits my skin and i can use it every night without irritation. i use a ton of my prescribed moisturizer from my derm. 

i do have genetic acne due to high androgens, so the only way for me to get rid of acne and not have to apply this everyday is by doing a course of accutane

9 hours ago, A_4_Archan said:

@singh

Yeh there are few % of people who don't go through shed ...and if your surgeon told you not to take it than its fine you can skip it...anyhow minoxidil isn't useful in stopping or slowing down hairloss...it is jst helpful to make your hairs fuller and thicker ...

There area surgeons who claim minoxidil eliminates shock loss. I did find a great research journal on this but I can't find it anymore. I remember that it clearly stated that patients on minoxidil post-op pretty much skipped the shock loss stage and the ugly duckling phase. And at 12 the 9 month mark had longer hair than their non minox counterparts.

https://www.hairtransplantfue.org/blog/minoxidil-after-hair-transplant#:~:text=Minoxidil Eliminates Shock Loss&text=Shock loss refers to the,removes the shock loss period.

https://www.dentalhairclinicturkey.com/blog/minoxidil-rogaine-before-and-after-hair-transplant/

 

Really want to move from topical tretinoin to Accutane to permanently get rid of my acne but I’ve read online that accutane must not be taken before skin re grafting or hair transplants. What’s the logic behind this and what’s a safe timeline?

On 8/17/2023 at 5:23 PM, A_4_Archan said:

@singh i am.on oral minoxidil and it seems it helped me...if you are sure of getting a HT thn you should start medication even if you don't have mpb and don't wanna take meds later on..its jst that it can help with permanent shockloss and even shedding...so take start medication and thn you can go for a surgery after 6 to 8 months

Hey man, I was told by the clinic to not take minoxidil post op since I don’t have progressive baldness. But anyway when I tried minox for 3-4 months 2x a day, I didn’t notice a shed or gain of hair. When I quit cold turkey my hair didn’t fall out either 

21 hours ago, A_4_Archan said:

@StillAlive

Imo the logic is when something is so weak and you give shock to this than ofcourse it would damage permanently....when a living thing is too weak at a certain point and thn if it gets sudden high trauma than it dies and when something dies it never lives again...that's what i think it should be and that's how i think nature works...

Damn this confuses me even more. I don't have MPB (have traction instead), and I have some baby hair and some strands of hair of slightly low caliber but I wouldn't call them miniaturised. Makes me scared about permanent shock loss. I can't locate it right now but I found a study which showed that post HT, topical minoxidil pretty much made 90% of patients skip the shock loss stage and almost skip the shedding of most transplanted hair as well. It also showed the new hair achieving way longer lengths than non minox patients. 

I'll link it if i find it again.

On 8/1/2023 at 9:08 AM, gillenator said:

IMHO, you would need considerably more than 800 grafts to fill in the proposed area, and especially considering the high amount of single hair grafts that would be needed.

Hey I read this comment again, I wanted to ask what is your estimate? I measured the area and it is 12cm/square so wouldnt 800 grafts give a  = 65 single grafts per cm square of density? (Second photo)

I'm trying to understand what induces shock loss, and what factors make it temporary or permanent. How does transection of native follicle affect it, and how does implantation between native follicles induce shock loss? Is shock loss simply Telogen Effluvium? 

What ways can be used to reduce shock loss? I've read about topical minoxidil, PRP and finesteride (for AGA cases) not only reducing shock loss but also helping in faster recovery and length.

Those of you who have gotten their HTs, did you guys experience shock loss in recipient area? Was it permanent? 

Here's some studies that touch this topic - 

https://martinelangsam.com/wp-content/uploads/2017/07/Cyclical-Medicine-Article-published-in-Forum-USA.pdf

https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0041-1739247

https://www.ishrs-htforum.org/content/15/6/197

7 hours ago, MildSeven said:

yes 6-7cm from glabella

no asian is 5cm bro

 

i live in asia

 

for eg: andy lau he has 6.5cm

 

 

Takeshi Kaneshiro 6cm

 

 

 

and Jerry yan is 7cm

 

Zayn malik has a very small forehead and a low hairline

bro are you on looks***.org? you dmed me

26 minutes ago, gillenator said:

There are in fact several ways to test for MPB and then arrive at a formal diagnosis…the good news is how you have progressed in a positive way and your journey to happiness my friend.

Thank you! At first I was scared about the potential MPB diagnosis, then I remembered I documented my hair for 2 years already. Will show them to the surgeon for a follow up opintion!

7 hours ago, A_4_Archan said:

@singh

Just keep a check of this and whenever in doubt you can go to a good doctor who has an experience with hairs to get yourself checked again 

Alright, I'm still texting the clinic my doubts about shock loss and the density i can expect post op to see if it's viable. 

1 hour ago, gillenator said:

IMHO, you are not wrong…it would be a good idea however to get another in person exam to rule out MPB which would include a microscopic exam of your scalp and formal diagnosis to see whether or not you have MPB…if you do not have genetic hair loss, obviously there is no reason to take finasteride…and IMHO taking finasteride for the first time post-op may initiate an acute shed which would be counter-productive.

I was told by the clinic that there is no way to do a test for MPB. Would it be a good idea to get the transplant, and keep living my life but get yearly check ups to see signs of MPB and get on finesteride if it is diagnosed? My family doesn't have a history of hair loss and I'm 100% sure I had traction alopecia because I had the early signs of inflammation and stopped my hairloss completely by changing my hair tying habits.

Edit: A year back I showed my scalp to a dermat and he ruled out MPB and said it's traction and he said it won't progress further. And he was right, I took pictures of my hair every now and then and in the 2 years I stopped tying my hair in a turban, my hair didn't deteriorate.  The earliest picture was taken in July 2022

58 minutes ago, HappyMan2021 said:

If OP is indeed 20 (i dont have time atm to read OPs previous posts to confirm), then yes it is silly and impossible to be declared 'MPB-free' at such a young age. 

You easily could still be severely balding at 25... 

20 is a horrible age to predict MPB....

That all being said, sure it does make sense to start Fin now so you can avoid the fates of thw rest of us on here. Why not..

That is my age. I agree, I plan on taking finesteride in the future when I actually have MPB, but I don't see the point starting it before it starts. Why mess with my hormones with no benefit? And I really want good hair in my youth. 

No one in my family has baldness, probably regular recession after the age of 40. So the chances of aggressive hairloss at 25 seems unlikely. 

1 hour ago, shiba1985 said:

Do you want my honest opinion.

You seem to have a lot of anxiety surrounding your mild hairline recession. No one can promise you no shock loss or even guarantee results. You also seem to be fooling yourself into believing you will never have Androgenetic Alopecia. At 20 there is no way to predict the future of your hair genetics. IMO you are too young and not mature or stable enough psychologically to understand the risks benefits of the hair transplant you want. 

Sorry just being honest form the numerous thread you have made on this topic. you may not like it but i think people should be told the truth. 

I don't have anything against finesteride but I don't see a point taking it before I even need it. I know that years down the line it is possible that MPB starts, and in that case I'm okay with getting it. My dad was only NW2 till he was 45 but lost hair from covid.

You are right, I'm affected by my hair loss psychologically which is why I want to fix it and not think about my hair anymore. It is kind of depressing to be worrying about my hair at the age I'm supposed to live life. My apologies if my posts are annoying

In my consultation, I went with a history of traction alopecia but no MPB. Doctor couldn't conclude MPB either, and have no family history of baldness either. But doctor didn't rule it out and suggests finesteride post-op to reduce chances of shock loss. I don't understand how fin would help strengthen my native hair in the affected area if MPB isn't conclusive, I don't feel comfortable taking fin if I don't even have MPB. Am I wrong? Because my hair hasn't changed a bit in the last 2 years of stopping the hairstyle that caused traction alopecia.

I'm wondering if I could take oral minox post-op and quit it. 

4 hours ago, StillAlive said:

If a hair follicle is healthy and does not show miniaturization, the risk of permanent shock loss is minimal, provided that the surgeon knows what they are doing and they don't just plug the graft on top of a healthy hair follicle. 

In general, I caution against messing with healthy hair, as you may end up with a hairline that looks much thinner compared to your native density behind it. 

I have traction alopecia, which thinned my hairline significantly. I'm tired of styling it everyday to look good, my only concern is shock loss in the current hair