gillenator

Guys, It's not that I was implying that an antiseptic would necessarily impair the regrowth of the grafts, It's more of the "why" issue for me. Possibly there is a superseding medical condition or concern that would precipitate the use of it and unless we have more information, it's hard to know. And at the same time doctors will vary in their post-op care and recommendations for their own patients. Typically an anti-biotic would be used to dispel an infection or the stronger probability or suspicion of post-op infection based on the individuals current and even past medical history. Some individuals can be more prone to infections. And there are factors involved. Pimples from the regrowth of grafts in themselves are not an issue. However if there is evidence of puss, swelling, inflammation, acute redness, etc., then yes that can be a sign of infection, folliculitis, and the like, and would call for further treatment at the doctor's own discretion. And speaking for myself, I may at times overstep my bounds to question a medical directive since I am not the professional and know nothing of the details involving that particular case being discussed.

Dr. Drake, I agree and why I was wondering if his reference was to individual hairs or FUs.

Graft survival is dependent on the transplanted follicles getting established to a new source of blood supply. Without that occurring, whether from damage from UVA or not, they will perish. So the risk of UVA rays is the potential of sun burn and/or exposure beneath the outer layer of scalp tissue and damaging both the graft tissue as well as the underlying follicles. My understanding is that the healing process in the deeper layers of scalp (dermis) are slower than the epidermis outer layer. This is why wearing a cap or hat that fully covers the recipient area is recommended when exposed to the UVA rays for more than 10 minutes in duration. The higher the UVA rating implies a quicker burn ratio yet a full cover with a cap/hat prevents this potential damage from occurring. Most docs will want their patients to avoid direct exposure to UVA rays for at least 3 months post-op, some feel 6 months and still others 9 months. I believe this is due to giving the transplanted follicles enough time to fulfill a complete resting cycle and enough time for all of the follicles to manifest into an ongoing growth cycle that produces full regrowth of the hair shafts.

chad, If the hair shafts are regrown hair grafts but just never continued to grow in length, I highly doubt that they are dead hair shafts. They would pull out rather easily if they were dead hair. It is hard to say what the issue may be. It is possible that they may grow longer in the next full growth cycle period. But this could take some time for the current anagen growth cycle to move into the next resting phase. These hair shafts would have to shed, rest, and grow another hair shaft. Possibly they are stunted from being placed in a DHT enriched zone. I would not pull them out but instead wait it out to see what happens in the next full growth cycle. The hard thing is waiting it out...:confused: Hope you see some positive changes in the future months chad.

Hey Guys, Thanks for all of the kind words and responses. It means a lot to me. Anytime we can help out our fellow men is very meaningful. We all have our moments walking in the valleys of life and yet with faith, we can be overcomers. Wishing you all the very best in this life...

My premonition is that there are other NW 7s in your family history such as father, grandfather, uncles, brothers, etc. If so, that's a good indicator of future hair loss and without meds, changes the equation dramatically.

The transplanted hairs shed intermittently because the follicles that are imbedded are cycling on the same basis. In other words they are cycling into the telogen (resting), shedding, and growth phase at different time intervals.

Minoxidil does not inhibit DHT but low dose finasteride does and for most men, effectively. Yet any of the hair loss meds are an elective decision. They are recommended because of the fact that MPB is progressive over a lifetime. Low dose finasteride can potentially slow down that progression and buy us more time.

That was good sense on your part. Are you happy with your results so far?

Whether its a single hair graft or a multiple hair graft, it's the graft hair that sheds, and nothing else...

Mike, I think we can be our own biggest critics and many of us with hair loss can relate to that. Currently you look like you have some mild recession around the temporal areas and a tad higher hair line yet I agree with many others that it looks good considering where you started. A change in perspective? You bet. It happened to me when I was diagnosed with terminal stage lung cancer in 2009 and lost my right lung. I went through very extensive chemotherapy treatments, lost 65 pounds and 100% of all my hair including the private areas if you know what I mean. So in a very short time, my focus was diverted from dealing with hair loss to a real chance of losing my life. Funny thing how that changes perspective on life. Well as the story goes, I defeated all odds and survived the cancer albeit am living with one lung now and have other permanent limitations with my health. Yet I am still alive and truly enjoining the real important things in life such as family, faith, and purpose. Only life is much different now. I care much more about each day that I have instead of each hair that I have lost. After chemo, my hair did grow back but not as robust that it was from having 4 separate HT procedures for a grand total of 6917 grafts. I don't care. And I don't find myself looking in the mirror at every hair like I used to. Instead I am inspired to look at the people around me in my life that I care so very much about such as my wife and my family and a few close friends who stuck by me through the hardest times in my life. Maybe that's also a part of maturing and getting older but for me one thing is for sure...we may lose our hair but love and family is what matters more than anything and life is better than ever whether I have hair or not my friend... Whatever you do, system or not, surgery or not, I wish you the best in this life!

Good points by David. How are old are you usmn-m? You are already in the Norwood class 7 stage so any meaningful coverage would not be possible and this is where David makes an important point in that one's goals and expectations need to be realistic and in accordance with one's limitations. It does appear that there is some retro-alopecia going on and the three doctors may have examined your donor and considered it not suitable for surgical hair restoration if the donor hair is diffusing and showing signs of miniaturization. This would imply that your donor hair is DHT receptive and that you would lose that hair in the future or a significant amount of it. I am not stating that this was the case but usually when several doctors state the same thing referring to not being a candidate, there is usually donor suitability issues that they clearly see. So at least they did not take advantage of you and take your money. If you must have hair, there are upper end quality full hair systems as an option. They have come a long way over the years. And you get what you pay for so you want to stay away from cheap systems.

Shedding and shock loss are two different issues. Shock loss is more related to the level of trauma from the procedure and shedding can be attributed to a number of reasons. Yet if the recent loss is within the recipient area or adjacent to it, then it's probably shock loss and like David stated will undoubtedly grow back unless those shed hair shafts were very diffused and weak.

It's best not to rush into things and really take the time to research and compare all of the options and doctors...

I think you're going to be just fine and happy growth to you!

The front view photo was helpful. Obviously an adequate number of the grafts will be used to fill in the temporal recession areas to blend in with the front forelock. As those temporal areas are brought forward, a fair number of single hair grafts will be necessary at the base of where everything blends in, and if you plan to lower your existing hairline a little bit, then even more single hair grafts will be needed. So you may find that your estimate will be higher towards the 4,000 mark and maybe a tad bit higher if you are filling in the crown. Another consideration would be to maintain the level of density in your crown at 40 FU cm2 or lower so it does not look barren but yet you would be wisely managing your donor reserves as you need more work in the future. Because MPB is progressive over a lifetime, your temporal zones can recede further and the crown can open up to a wider zone of loss. You would not want to be left with an island of hair where the grafts are presently going to be placed and then have a ring of thinning all around those grafts in the years ahead. Are you taking low dose finasteride? That can potentially keep your crown from expanding with more loss. Let us know how everything turns out because I think you are going to like your final result from this upcoming procedure.

And at this point in time post-op, all of the crusts should also be removed in the shower with the shampoo suds and using your fingertips to remove them.

herroprease, Did you by chance remove a photo of yourself as I see your past post was edited by yourself. After reading your initial post, my first thought was to see some pics of you. That would help greatly. Even without pics, I highly doubt that 6,000 grafts would cover both the frontal zone and crown area. It could be possible if you were to lower the density level throughout the entire recipient area, however the degree of visible coverage would be compromised. So it depends on what you are willing to accept in expectations as it related to your donor limitations. My concern for you is more related to the confined area of your donor being a more permanent zone. In other words, could the area under your crown in the back have any miniaturization and/or diffusion going on?

Your grafts should be fine as any shedding whether by rubbing on the pillow or from the procedure itself will not hurt your grafts...

You're welcome my friend and it never hurts to err on the side of caution...

Some very good advice provided... And I agree that first and foremost, consider the docs that you believe do the best work and would give you the best result. And if it were me in your location, definitely consider your choices in Europe as you would be able to take the train to various clinics in Belgium very economically and quickly to be evaluated in person. That way you get to meet each recommended doctor in person and may be able to see some of their patients face-to-face. The closer these European clinics are to one another, the more competitive they are going to be to each other, generally speaking. This gives you the opportunity to really fine tune your choice which will be more related to the skill of the doctor rather than choosing one because of the price being cheaper.

RR, It never hurts to send your surgeon the same photos for evaluation. Normally the staples should not create a red line like that but it could be just from the tension that the staples created. Staples enable a tight closure to prevent scar stretching. The effect could just be from the tension of the closure. The good thing is that the area and scar does not appear raised or problematic at this point in time post-op. Personally, I think you will see improvement as the area begins to relax from the staples being removed. One thing that will help in the short term (30 days) is to apply a rich aloe vera cream to the entire scar and the area just above and below the scar. This will help relax the scalp tissue and help to reduce the redness and inflammation. Possibly your doctor may suggest something as well to facilitate the healing and reduce the inflammation. If you are a good healer, you should notice a significant improvement in the next three weeks or so. Congrats on your recent procedure RR...

MrMatt, The 6,000 figure that you are referring to is approximately the average number of "harvestable" FUHT grafts for an average level of donor density. Obviously this will vary between individuals. The only way to know your own donor density is to have it evaluated and calculated by a reputable surgeon. There are other factors that can impact the numbers such as how your scar heals, future scalp elasticity, whether you have FUHT or FUE, and the skill of the surgeon. You do appear to have good hair quality regarding the degree of coarseness to your hair and you do not appear to have a diffused thinning pattern. Are your grafts going in the frontal zone or are you wanting to restore the area in your crown? You will undoubtedly experience further loss in your crown as the years go by. Crown loss can demand as much as 60% of one's available scalp donor which is significant so careful and prudent management of our limited donor is critical.

RR, It looks like two scars...was this a second procedure? At 18 days post-op, this could just be some inflammation which should subside over the next several months.

TL7, You stated that 9,000 hairs were extracted... wondering how many grafts did this equate to?