gillenator

Asana, You should start feeling the pain level going down as you get 2-3 weeks post-op. The reduced inflammation is going to make a huge difference. The severed nerve endings will heal soon and regrow but will take some time, 60-90 days or so. I think once you get at least 30 days post-op, you will see more improvement. You might want to ask your doctor for a prescription for a higher strength of ibuprofen in the 600-800 mg range. Or your doc may suggest taking at least 400 mg (two tablets) six hours apart. Have you tried using a larger ice pack that covers the entire donor area? You can use a larger plastic zip lock type of bag and cover it with a thin cloth and lay your head against it lying flat on your back at bedtime. Fifteen minutes on and fifteen minutes off. Hope you get some relief soon my friend...

When you get to the 10-12 day post-op period, most docs will advise their patients to begin massaging the shampoo in the recipient area and start removing the dried-out crusts.

Yeah it was longer than I wanted however my surgeon advised this because again, my laxity was barely adequate for the 2500 graft strip that was taken. So IMHO, it was better that I endured the three weeks and the discomfort of having them removed so i did not have the scar stretch.

This is where the advice of a licensed physician specializing in this field is beneficial. They can potentially adjust both the dosage and frequency accordingly.

IMHO, pain narcotics would not be suitable at this point in time post-op. But analgesics, especially long acting ones like Aleeve may be of benefit since it is a 12 hour reliever. Ibuprofen also has anti-inflammatory properties and may help the inflammation as well. You may even find some pain relief in applying ice to the donor zone before you sleep, 15 minutes on, 15 minutes off. The "electric" sensations are related to the severed nerves from the numerous extractions and should subside soon. Hope the discomfort begins to subside soon and take care...

At this point in time post-op, the saline spray would not be of much benefit however any gentle shampoo would be fine as long as you gently pour a diluted solution over the recipient area and not rub your newly implanted grafts. Congrats on your procedure...

IMHO, it's definitely the crusts with the dead hair shafts attached that were inside the grafts. Nothing abnormal about it. Your transplanted hair follicles have simply gone into the resting dormant phase and as a result, shed the hair shafts. When the crusts are removed, the dead hair shafts come out readily with most of them. But your follicles are imbedded into the dermis layer of your scalp where the blood supply is. After those transplanted follicles have rested for approximately three months, they will re-enter the growth phase and you will start to see the new growth emerge above the scalp line.

Generally speaking, at least 40 FUs per cm2 would be the threshold for most individuals. And as a general rule of thumb, if the restored density is at least 50% of the original density level, then the area should appear restored.

Yes I had one tryclosure yet don't think that was fair to judge the result as my strip scar still came out very thin and it was difficult to tell if much hair was growing through the thin scar. My staples were left in for roughly three weeks and as a result, several of them got buried under scalp tissue as the scar healed. It was very painful having them removed and one got buried and broke when my PCP was trying to remove them. She did not have any local anesthesia to numb the area either...:confused: I would have rather had a double closure technique but not sure if that was possible due to my laxity at the time. So although the staples were a pain, it was better than having a wider than desired scar in the end result.

I cut back my finasteride regimen to every other day and still experience good efficiency. Not an advocate of using dutasteride and it's astounding to read of the various side-effects that some guys experience from it. Some more extreme than others.

I think the other critical factor that you will benefit from is maturation of hair caliber from the grafts. For most individuals, the optimal improvement of visual coverage is seen once 12-15 months pass. IMHO, the degree of hair caliber is more of a factor in gaining the illusion of coverage than density itself. The bottom line is that the benefits of any procedure cannot be fairly assessed until both regrowth and caliber maturation is fulfilled...

Guys, There's no question about differences in individuals' regrowth and the timelines that support them. Parts of the equation are the variances in each individual's auto-immune system, follicle cyclical behaviors, other medical issues, age differences. etc, etc. Those are subjective factors and very difficult to track and/or document, and especially so if labs and biopsies are not used in the evaluation process. So we are left to notice the differences with our naked eyes right? Here's the deal. Regrowth from any HT procedure can potentially be charted and monitored if only the clinics would use the technology that is available today. Even as far back as fifteen years ago when I used to work inside the clinics, we used to take high density digital photos of the patient's recipient area and then downloaded the pics on a hard drive. When thumb drives hit the stores, we offered the photos to our clients so they had them ready and available to view at any time. We took before and after shots from varying angles and then the images can be magnified at any time in the future. We had the patients come back in the clinic at 3 month intervals for follow-ups and more pics. The individual patients could see the results or lack of them directly. It is also possible to note and chart sympathetic shock loss because with digital high density photos, you can distinguish between native hair and the grafts. You can track the regrowth and yield to a high level of accuracy. Yet clinics typically do not offer this type of follow-up service, some do but they are few in number. Some charge for this. Most clinics are too busy doing procedures that they do not have the support to track yields and I suppose it could also present some problems for the clinics when the yields are subpar. Think of what a can of worms that could be for any clinic. But my point is that the technology and/or the means to track and chart these type of things are available today and that would diffuse the ambiguous dialogue.

As long as you have 2-3 inches of hair length in your donor zone, the stitches/staples should not show. Is your present hair length shorter than that? Did you have lingering redness in the recipient area on your first procedure? Were you told that staples would be needed? If not, I would not recommend using staples unless your laxity is not accommodating the size/width of the strip specimen that would be excised. Yet we cannot make that determination since we are not the surgeon. I had staple closure on my last procedure and would never have them again...:confused:

nervous, I encourage you to do more research especially in follicle cycle behavior. If those are dead hair shafts, and they probably are since they are not growing, they will come out rather easily compared to plucking live hair shafts. But if they are dead, they really need to come out because your scalp senses them to be a foreign object and will eventually reject them. Not only is the graft density per cm2 a factor, but also the caliber of your hair shafts. If you have a coarse degree of hair caliber, then visual coverage will appear more pronounced. Yet the thinner degree of hair caliber, the more grafts are needed or a higher level of graft density to achieve decent visual coverage. One other thing. When the regrowth occurs, the hair shafts should be thicker in caliber and enriched with color as they grow in length. Peach fuzz growth is probably not grafts but your diffused native hair growing back in. Take another look at your hairline and you will see dark thick hair shafts which are the grafts. But as several of us have stated, you are still in the beginning stages of regrowth so give it more time and patience.

What I meant by starting minoxidil once daily is to slowly introduce the product into your scalp to try and minimize a significant shed in the area. Then after 10 - 12 days, you can try increasing the application to twice daily. The thing we all have to keep in mind is that we all respond differently to meds. Some guys experience significant shedding when applying minoxidil twice daily, others do not. Yet it's the initial use that can potentially be the most sensitive to the scalp. Only low dose finasteride still proves to be the most efficient medication for treating MPB. And it's the most efficient in the crown... And I also concur to wait on having any HT procedures. The risk of sustaining shock loss is too great for that volume of hair.

There is no clinical evidence to my knowledge that supports the notion that warts or moles, etc., have any negative impact on hair growth or be the source of any type of alopecia. Now your surgeon no doubt would be careful in working around them as not to implant any grafts in them. I have some moles in my scalp but never interfered with any of my grafts.

You have tremendous hair volume and yes there is a spot in your crown that appears to be early signs of MPB but with that large amount of hair volume, you will undoubtedly experience some shedding and the area could end up looking much thinner. Are you prepared for that experience? Because once you start minoxidil, you will be committed to using it every day or you stand to lose any gains. And you may want to consider only use a small amount once per day to start with in the first week of application. That can potentially reduce the effect of massive shedding compared to using it twice per day to start with. Minoxidil does not inhibit DHT so although it can invigorate some new growth and improve hair shaft diameter, it won't stop the DHT from causing future loss. And you may want to consider just buying one bottle of the foam to start with because if you purchase such a large amount of it up front and you don't like the effects of it, your stuck with a case of Rogaine sitting in your attic...:rolleyes:

NervousGuy, I took a peek at your hairline photo and there is new growth there albeit not as robust as you expected. But remember, at four months post-op the new growth is just starting. And your regrowth may not go as quickly as you want it to. You have to give your procedure one full year to even up to 15 months post-op in order to fairly judge the merits of your procedure. If you have grafts that have not shed by now, and they are not growing in length, then they are probably dead hair shafts and should be removed. You can use a tweezers and pull them out. If they come out with ease, then they are dead graft hair. Your crown probably appears thinner because of some shock loss in that area. Be patient my friend and things will happen but don't freak out in the meantime. Get your mind off it the best you can and allow time and patience to work...

Yeah, you could say that I am a real hair junkie... And yes with roughly 6900 grafts total, I am a happy camper. My crown is still a tad bit thin but was not as concerned with crown loss as much as the frontal zone where most of the grafts went. Lessons? I always encourage any individual considering HT surgery to do their research and homework before ever scheduling a procedure. We all must fully understand both the "benefits as well as the risks" of any procedure. And it is only through adequate research that any individual is going to determine their own candidacy for this type of cosmetic surgery and what type of questions to ask. Not everyone is a candidate for this and some can be marginal candidates at best. That's the first phase of homework. Once we understand the risks and benefits and also decide to move forward, then the journey of choosing the right surgeon becomes the challenge especially when there are many to choose from. Eventually, things come together and one's confidence to make that "informed decision" becomes apparent. But this is an elective decision including the choice of using proven hair loss meds. I never took any time off work except the day after in the first procedure and the last one in 2006. I was working inside the clinic for number 2 and 3 procedures so in those cases, I went back to work the following day. Most guys take at least a week off post-op however and many guys use vacation time or personal time off. agentHarley, Do you have challenges in getting time off your job? What do you do and how much time do you plan taking off?

agentHarley, Congrats on your second procedure and I know the feeling well as I had four separate procedures myself...

Hi Jacob, Welcome to this community as it appears that this is your first post... OK, let's see if your questions and concerns can be addressed. 1) Most of the grafts will shed within the 2-4 week post-op period. Will they all shed? No. Some of them will remain growing in the anagen stage however eventually, they all will commence their respective cycle behavior. The transplanted follicles behave intermittently this way and why it takes up to 12 months to fairly judge any result. There is no way to ascertain how many will remain in the growth phase but for most, a majority of the grafts will shed within the period stated. 2) No hair will regrow in a completely extracted site. The goal with FUE is to completely remove/extract the FU in it's entirety. Now, there are a few FUE doctors who have and continue to experiment with what is known as Donor Replacement Therapy (DRT). In simple terms, a small portion of the extracted follicle(s) are re-inserted back into the extraction site. The follicle then is supposed to regenerate and grow new hair shafts. The results to date have been poor at best IMHO. Neither finasteride nor minoxidil will be of any benefit in establishing any new growth in any completely extracted site(s). I assume you were referring to the donor zone where the FUs were taken and not the recipient area. Minoxidil does improve hair shaft diameter (hair caliber) in many individuals and it is possible to have one's donor area appear thicker, visually speaking without actually increasing hair density. 3) There are few and I do mean few cases where Propecia or any other form of low dose finasteride has regrown hair on a completely bald surface area. Regrowth is not typical in the more advanced classes of MPB. Minoxidil is more promising in that regard but again, not very favorable results in the advanced classes as denoted on the Norwood scale. 4) If your proposed 6000 - 8000 grafts are done within the same defined surface area, but split between two separate procedures, then you want to give the initial procedure no less than 10 months if your are a normal bloomer so-to-speak. You want to be sure that all of the first session of grafts have sprouted and are visible above the scalp line otherwise you risk the potential of transection. For most individuals, this will take at least 10 and even up to 12 months post-op. 5) That is only true by defining actual density count/placement, but visual density is a completely different thing because of the two factors of hair caliber and hair shaft length which the initial placement of the grafts does not show. In other words, improved hair caliber and hair length both add to the illusion of coverage of visual density. Visual density and actual density are two different things. It's great to see you doing your homework Jacob and wish you well on all of your decisions. You had some great questions and I hope this response will help others as well. Let me know if you need any further assistance and again, welcome to this community...

LT, Then you definitely want to stay with FUE. FUE extractions can harvest FUs where strip cannot and FUE does not require scalp elasticity like FUHT does. No two opinions will be the same but the point is to make sure you weigh the pros and cons of having any more work done. Then, if you do decide on FUE, choose the best proven FUE surgeon that you can find. Hope everything works out for you.

The newly grown hair shafts will tend to have a thicker degree of caliber and even the color of them can appear more pronounced. The entire procedure takes at least twelve full months to mature so you have lots coming.

LT, BTW, there have been several threads on this subject and try doing a word search on PRP within the larger online communities like this one.

LT, That's why I asked you about your intentions. There really is no clinical substantiation to support that PRP therapy is effective in curbing the effects of MPB or being successful in treating hair loss. Several years ago, PRP was introduced in HT repair procedures and did show some promise in some individuals. Then, it like exploded everywhere and was heavily marketed as the buzz in the hair loss communities and many guys embraced it. It has died down largely due to it not being appropriate for treating MPB. It's also very expensive. PRP was initially used and still is for treating athletic type of injuries, mainly in the joints like a knee or elbow. The doctor or specialist simply draws the individuals' own blood and it is then run through a centrifuge where the blood platelets are separated and condensed. The platelets (PRP) is then injected into the wound site and the rich platelets facilitate the healing process. It is very effective for most athletes and others who sustain wounds. So you can see how it was then introduced in HT repair surgery. But IMHO, save your hard earned money and instead use it on the clinically proven therapies and treatments...