gillenator

Obviously Blake did his homework on this drug which is well appreciated by myself and many others. I knew there had to be more to the story. I was not aware that it was a case not involving MPB. Yet this drug could prove to be a cure for AA, AU, DUPA, and the like. After all, hair loss is still hair loss and even if this drug helps a smaller percent of hair loss sufferers, that still a big stride of achievement IMHO...

I took a closer look at your photos and first want to commend you on sharing your story. Just by looking at them, I observed a number of things. First off, if you noticed this progression of loss 4-5 years ago, and you have progressed this much by your mid-twenties, you have the potential of reaching Norwood 7 earlier than you want to see it happen. Without knowing your family history, I already know there men who are Norwood 7s. And you are correct, the degree of diffusion has crept deep into your donor zone, and your rims are already losing. The photo showing the entire top of your scalp tells a lot. You will eventually lose everything of top of your scalp, everything. Your donor zone appears DHT receptive which means it will thin out greatly with time. You may even experience DUPA or advanced generalized loss over your entire scalp and as I said, it's already affecting the sides/rim of your scalp. So in conclusion, I am happy to read that the doctor you saw refused to do a procedure on you. Undoubtedly, he is seeing the same things that your photos show. I know this may be hard to accept, but the last thing you want to do is start having HT procedures because honestly, you are not a candidate for HT surgery. If I were you, then I would only consider buzzing/shaving my head or possibly going with a full hair system, if you have to have hair. Hopefully, there will be a breakthrough in the industry in the future that will grow a full head of hair. I saw on the news last Friday about an arthritis drug that claims it grows a full head of hair. It was not a commercial promotion but a news segment. I was disappointed that they gave very little data and did not even mention the name of the drug. Wishing you the best in your journey.

I saw a brief segment of this claim on NBC Nightly News broadcast last Friday evening. They never stated which arthritis drug was used, provided no clinical information, gave no background on the man they claimed to grow a "full head of hair". They showed his before photo "slick bald", then a pic showing a full head of hair with way above average density. Did you see this too? I am always leery of claims like this when they present the claim like it's sort of private promotion or something. It would also be traveling the world like wildfire if it had any true merit so to me, it appeared more like a scam than anything else. I do hope I am wrong and there is some wonder drug like this to grow hair in massive volumes...:cool:

shikari83, Good to see that you are doing your research. I did not think an individual needed a prescription for minoxidil in the UK. In North America, it can be purchased over-the-counter or online. Potentially minoxidil can help your crown with some possible new growth however the spot is barren of any hair so it's really low dose finasteride that will help your crown from getting larger and broader with loss. The crown can and will demand as much as 60% of one's available limited scalp donor. So I always recommend to keep the density low in the crown because as you already can see, you have broader temporal lobe loss going on and eventually your entire hairline is going to thin out with time. It's tempting to want to address the areas that have no hair however if you use up too much of your donor for the crown, what will you have left for the frontal zone? Something to think about as you plan for future loss as well as current loss. Best wishes to you...

johnny2000, Think of shock loss on a bell curve. It occurs for most patients at around 2-4 weeks post-op and can last for another 2-4 weeks thereafter. So that's a broad window period of roughly 8 weeks. Not many patients experience it beyond 6 weeks post-op but it is certainly not unheard of. In addition, some guys experience a shedding cycle which is different from shock loss. Shock loss is almost always related directly to the level of trauma the scalp is under post-op as a result from the surgery. A shed is simply a time component of the complete growth cycle affecting a larger percent of hair follicles entering the resting phase and thereby losing hair density overall. It generally affects areas outside of the recipient zone. It is usually thought of as generalized thinning throughout the scalp. When the scalp heals and the trauma dissipates, the shocked follicles rest and eventually enter the growth cycle. Hair follicles generally rest for 3-4 months whether they rest from shock loss or a shed cycle. It's the dormant period in the growth cycle. The hardest part is to relax and allow your body to do it's own healing and resting. It's simply takes time and patience, and I know firsthand that it is easier said than done...:rolleyes: Hang in there johnny...you're going to be fine!

Taking any meds for hair loss is certainly not what any of us want however it's the DHT that is the source of the problem. Unless we can inhibit or block the DHT in our hair follicles and the sebum layer of our scalps, the progression of MPB will continue and we will lose more hair as a result. Minoxidil does not inhibit DHT, but it can potentially improve hair shaft diameter and also rejuvenate new growth in some individuals.

I also do not believe that Nizoral does anything to inhibit or block DHT. Nioxin is the one to be careful of and overuse can cause shedding IMHO.

Yes Dr. Frank played in the NFL however most of the pro football players as well as many pro athletes went to college with plans beyond their sports career. So for him, it was something he aspired to go into the medical field and why he chose HT surgery, I really cannot answer. Nothing against him, but I cannot say he would be my first choice however he would not be a recommended surgeon within this community unless he demonstrated the type and quality of standards set forth to be recommended. I have seen only a couple examples of his work and IMHO, it was good. Dr. Konior and Dr. Haber have been doing HTs for a long time, are ethical, and do very good work. The bottom line is, never make your choice based on location or geographical convenience. You have to know what your goals and expectations are working within your own limitations. Then start looking at each surgeon's work on other patients that have similar patterns of your own hair loss as well as your hair characteristics. You need to dialogue with each doctor before you make any final decision. You want to first prepare and have a list of your questions and potential concerns to ask and see how each doctor addresses your concerns. Most of them will be accommodating to do a virtual consultation with you. Max & Erma's is a hot spot, sports club restaurant in the heart of Columbus...:cool:

Harakiri, I took a peak at your profile and only saw 1 pre-op pic and one post-op at 3 months or did I miss something?

Absolutely correct. Scalp excretions, one's lifestyle, personal hygiene, etc all will vary between individuals. I also use water only at high pressure between shampooing and my hair and scalp is much more moistened when doing so, less frizzing, more body. I use a cream rinse to finish off the rinsing and allow it to dry. So I use shampoo twice per week and no more than that. If you read the ingredients on any shampoo bottle, you would be shocked at the volume of inactive additives that are chemical based. Lots of alcohol based additives too which can dry out the hair. You get what you pay for. Most of the cheapest shampoos have artificial chemical additives and many times are the harshest on the hair and scalp. IMHO, best to use a quality product even if it's less frequent.

You mean your grafts right? Or are you seeing some fall out related to shock loss?

Here's the deal. Many men who had HTs comb their hair shafts straight back for several reasons. First, they do it to create more illusionary volume and density. For most individuals, that is not the natural direction of the hair yet if you try it on yourself, you will see what I mean. Brushing the hair from front-to-back creates even more of the illusion versus combing. I do this myself. The secondary reason is that you get more of a comb-over effect when there is thinning or a balding spot in the crown. And the longer you grow the hair shafts, the more coverage you get! Again, I do this myself.

It's probably sympathetic shock loss that is not uncommon. And yes, it most cases, it will thicken with more hair once the shocked follicles grow back. If the thinned area is already diffused, then sometimes it does not grow back depending on the degree of diffusion. Sounds to me like you have nothing to worry about. You can also use a little Toppik to thicken up the area so it is not as noticeable.

Your girlfriend is spot on! We need the natural oils and moisturizers that our bodies produce to keep the hair shafts from drying out and breaking. It also really comes down to the ingredients and quality of the shampoo being used. Some are far more harsh than others.

Possibly some are getting Nizoral confused with Nioxin which are two completely different products. Nizoral is claimed to be a medicated shampoo that has DHT inhibitors but since it is a herbal based product, it is not under the oversight or regulation of the FDA. So its claims are IMHO arbitrary at best without any clinical substantiation through trials. Nioxin is presented as a "scalp therapy" and scalp invigorator/cleanser. They state that it is a conditioner that moisturizes and energizes the scalp. Now the issue of when to use any product is usually related to both the active and inactive ingredients of any product whether herbal based or not. For example, you would not want to use minoxidil if your sutures or recipient sites are not healed. IMHO, Nioxin has many more additives that are chemical based if you ever read the label and why many docs will want their patients to gain complete healing of the outer epidermis layer of the scalp. But opinions do vary and why you are being advised to check with you own doctor...

Hey buddy, is Max & Erma's Grill still alive and well in Columbus?...

I like Dr. Raymond Konior's work and his clinic is drivable in Illinois. He's very ethical and provides good planning over a lifetime. Dr. Robert Haber is in Ohio and also good and reputable. Dr. John Frank is in your backyard in Columbus and one of the recommended surgeons in this community although I don't know much about his work. What I have heard has been good to date. You need to thoroughly research any doctor that is recommended to your own satisfaction and goals. The best docs are worth traveling to...

Toubey, First, please allow me to commend you for your transparency regarding what happened to you. That is also commendable of you to warn others. Trust me, what occurred was an individual who was attempting to learn HT surgery. Who knows what medical training or even background he has. IMHO, he probably attended some weekend workshop and rather than learning the appropriate methodology of HT surgery under the supervision of another surgeon, he decided money was far more important...:confused: The punch sizes he used were very large, way over 1mm in size. They are smaller punch out grafts, nothing more. Will you have growth? Possibly, only time will tell. Since FUE started to become popular just over a decade ago, I have heard from various patients world-wide, a fair number from Greece and Cyprus. My understanding is that doctors have to be licensed but are virtually unregulated. This is true in Europe and the UK as well. North America also does a poor job handling physician misconduct. It is not a rare beast by any means. Just the fact that they offered a complete refund including your travel expenses is an admission of guilt IMHO. But be thankful because that is very rare to see and if I were you, I would get your money back right now and not wait. The longer you wait, the less likely you will get "anything". I know this firsthand after four decades of trying to help patients who were taken advantage of in cases just like yours. It appears that you live in Europe somewhere? There are a number of ethical and talented FUE surgeons there that can do some ethical repair for you and many of us can give you recommendations. How old are you? My concern for you is that you also appear to have a compromised and/or weak donor. What I mean by that is that there are signs of advanced diffusion and a low density. You also have some retro-alopecia going on IMHO. I opened your photos in a much larger frame and really looked them over. My premonition is that you have a form of generalized thinning throughout your scalp. So I would not recommend that you do any large sessions of restoration, but rather get the work that you had done resolved. Your frontal zone is both diffusing and receding and at your young age, probably will be next to go. My guess is that you have men on either side of your family history who are Norwood class 7s right? You really need to have your donor zone microscopically examined to see how much of it is considered terminal hair if any. That is the first step your doctor should have done before ever doing any surgery whatsoever on you. Unless you have any DHT resistant hair, the transplants won't last. That's the scientific truth so don't waste any more money. And I also agree that you are sooooo fortunate that those initial photos were not vertical strip scars. What occurred is that you lost some of the large grafts and that was bleeding that ran downwards from the effects of gravity. Trust me, unless you go to the European and UK forums, this guy who did this to you will do it again to the next guy with money. I have seen it a zillion times. And he is hoping with all of his might that you won't expose him. So get your money now or tell him you will put up your photos and story on every hair loss patient chat forum in the world. You don't have to use defamatory words because your pics tell the story. Just be honest but really, others need to be warned because what this guy did in unconscionable and yes IMHO criminal! I can't even call him a doctor and who knows if he even has a medical license...:eek: Ok, enough of the doom and gloom, let's focus on getting this procedure you had as resolved as possible and move on. I wish you the best and keep doing your online homework. At this point, every decision that you make must be a fully informed one...

Smoking, regardless of the substance causes blood vessels to constrict and promote affixation so that the blood's oxygen level is compromised.

Wow, I had no idea where you started and do you have any photos of your restored look by chance? Just curious of how you were transformed...

Paulygon, Is that really you in the photo?

Laser combs may have some merit regarding the stimulation of native hair follicles from telogen (dormant) to anagen (growth) phase. Or as Paulygon stated, to potentially increase hair shaft diameter. The problem is that there are no empirical data to support that opinion...:confused: And if there were any significant results to a fair number of patients, they would be all over these hair loss online communities praising the laser combs. But there is virtually no one commending their results...:rolleyes:

Newbie, For being 10 weeks post-op, you have significant growth and you may be one of those "early bloomers". Just wait until you get 4-6 months post-op and you definitely should see a very defined new hairline. Nioxin is a scalp cleanser and invigorator. You can purchase it at just about any retailer like Walmart, CVS, or retail beauty supply store like Sally's.

You are welcome Justin, and glad to see you are doing your research. Say hi to everyone at True & Dorin for me and wish you the best...

Justin, Just curious, how old are you? I mean my word, you still have a good head of hair and although many of the men in your family have reached Norwood 5, my guess is none of them took low dose finasteride for MPB? Please allow me to clarify my prior comments about finasteride. What I meant by my statement that "nothing" stops MPB, is that "nothing stops the progression completely" and it is because of the progressive nature and behavior of MPB. That being said, yes indeed low dose finasteride can have a very dramatic effect in slowing the "rate of progression". I started cutting Proscar in four pieces in 1996 shortly after my first HT procedure and it has stabilized my crown very well for 18 years now! My mid-scalp did further lose but at a very slow rate. And as you mentioned, the ongoing clinical trials of Propecia continue to show many guys realizing long term benefit of retaining their native hair. It's more the frontal zone into the midscalp region that finasteride seems to have the least efficiency. And the manufacturer Merck readily notes that in their pharmacology disclosure that accompanies every package of Propecia. It's interesting because minoxidil also does not seem to have much efficiency in the frontal region. Although some docs may recommend the post-op use of minoxidil in the recipient area for the purpose of "jump starting grafts", long term use in the frontal zone for native hair does not work for most men. Like finasteride, minoxidil works the best in the crown for most men. And you will find Dr. Dorin to be honest and forthright with you. Both he and Dr. Robert True have performed some awesome FUE cases for some time now. I have been especially impressed with their hairline work because both yield and artistry have been very consistent. Dr. Wesley appears to be very passionate about FUE and not sure that he has been doing FUE as long as True & Dorin however he joined this community several years ago and put up several threads regarding FUE. There are more docs doing FUE and some really refining their work. The bottom line is to continue to do your due diligence and you will come to terms with what you want. If I were you, and had the family history of MPB at those advanced classes, I would remain on the conservative side to start. In other words, don't drop your hairline too low, keep the density in the recipient area at 50% or less. I sincerely believe you will have an amazing result and transformation and be happy when everything grows out. You always want to be sure that you have some donor reserves as you get older because you will need them as you get older. And remember, you have outstanding hair quality up and above the average individual. In fact, you would be surprised at the result of keeping the overall density at 40% tops to start with because of your coarser degree of hair caliber. If you feel after one year that you want a tad bit more density, you can always go for more. Anyways, I wish you the best Justin in your journey and final results...