gillenator

Every patient should be checked for areas of miniturization before surgery. Some patients may show miniturization in the occipital zone where most strips are excised. They may not be losing hair in the parietal zones where possibly some FUE extractions could potentially be made. This may greatly reduce the souce of donor supply but at the same time avoid taking a strip where miniturization may be taking place. It would be ideal to have every patient physically examined by the doctor "in the consultation". That way every patient receives a formal diagnosis for their type of hairloss and where their candidacy for the procedure is established because some people are not candidates for HT surgery or make poor candidates at best. It gives the patient and doctor an idea of how much surgical restoration can be done based on available donor. That way there are no surprises on the day of surgery. And some patients (primarily men) do in fact have retro-alopcia whereby strip may not be the way to take donor for them. This is where FUE may again enter the equation. The FUE surgeon can then cherry pick where the grafts can be extracted in other regions of the scalp where terminal hair can be harvested. This can be expalined in the consult as the doctor examines the patient's hairloss and donor supply.

IMHO, the bent hair happens as the new regrown hair shafts travel through several layers of soft tissue that are new pathways to the surface.

It is always possible that some of the new light colored finer hair growth is some of the exisitng natural hair that was there before surgery and may have been shocked out. It may be coming back with the transplanted hair.

IMHO, you are right at the period post-op where most of the transplanted hair is coming through. You still have some to come, but it is right now say through the next two months that most patients will notice new growth. The rest is caliber maturation up until the 12-18 month mark post-op. That's been my observation for the average patient with average hair characterisitcs. Remember, hair caliber is the single most critical factor considered in achieving the "illusion of coverage". It is more important than density!

Nick, Well that's the whole purpose of why you are taking finasteride and appropriately so. You are putting everything on your side. Not sure if you are using minoxidil, but both Propecia and Rogaine are the only two FDA approved meds for treating MPB. Chances are, your uncle and grandfather who became NW 6s never took Propecia nor used Rogaine and probably were not even aware of it. And even if they were aware of it, some guys are just not interested in taking Propecia due to the potential side effects. Part of the risk in HT surgery is not knowing for sure how extensive our hairloss will be over a lifetime. That needs to be understood by all patients "prior" to surgery along with the other apparent and even not so apparent risks. Those of us who have completed our homework and subsequently moved ahead with HT surgery are doing so on an informed basis, yet without any guarantees. And most of those individuals who are moving forward with HT surgery have noticed the meds greatly slowing or even stabilizing their progression of loss. I for example discourage young men who do not respond favorably to Propecia "to not have procedure done". At present, you have so much exisitng hair, and at your young age, it would only be a wild guess at how you will end up. I would put more attention on the rate you are losing your hair. Then again, that's where Propecia will help. The other thing is that we never know how long the meds will be effective for us over a lifetime. That also varies between patients. Best wishes to you on your journey my friend.

At this point in time post-op, you are fine to use a blow dryer IMHO. Best wishes to you on your regrowth!

Have you tried the new product yet? If yes, how were the results?

Do you have older men in your family history on either side that have the same type of loss pattern, meaning, it started in the crown?

The publication is from a group of psychologists. I still have a hard time believing the two are connected. In over 30 years of observations, I still see the people who lose hair to MPB are genetic.

After reading many of the responses, one thing we can conclude for sure; everyone responds diffrently to pain and anaesthesia. Even the discomfort post-op can vary between patients.

I forgot to mention, ask your chosen doctor what he recommends.

You might want to present your question on (Edited by moderator)

IMHO, you should not apply minoxidil, the active ingredient in Rogaine to your scalp post-op until your epidermis is completely healed. Many HT docs would recommend waiting two weeks before applying minoxidil. But that is for the purpose of jump starting the new growth in your grafts, not for healing purposes. Minoxidil is not a post-op healing med. The only one I would recommend is copper peptide on your list.

Yes, you heard correctly, $10.00 per graft! That's more than straight FUE or even BH. This sounds so much like what the hair mills charge. Remember, Dr. Ziering is one of the former medical directors for Medical Hair Restoration which was officially acquired by Bosley last year. Is Dr. Craig Ziering a recommended doctor in this community?

multiplier, One of my four strip procedures was with an MHR doctor. Big mistake. My other three were with talented docs so my final result is good. FYI, MHR got officially acquired by Bosley last year. Many former MHR offices were closed because the two giant chains competed against each other in many larger cities in the US. MHR no longer exists! How old are you? And what extent of hairloss are there in both sides of your family history? IMO, it appears that you could end up in a more advanced class on the Norwood scale. If you are still slowly losing hair and still on both hairloss meds (finasteride, minoxidil), than you must plan the placement/distribution of the new grafts in a way that will take into account further thinning and loss, "based on the pattern of loss" that you have. The doctor should also be able to inspect your scalp for the areas that have active miniturization going on. Those areas of hair are DHT receptive and can be lost in the future even though there is some visible growth at present. Basically the doctor is looking for areas that have decreases in hair shaft diameter due to the miniturization process from MPB. Just don't get overly aggressive with density in any area. Most of us only need 50% of original density to attain "the illusion of coverage". You can get by with less to look natural, even if you thin further. If you hit your maximum harvest from strip methods, I agree, you can consider FUE extractions which can also be harvested from some of the parietal areas. Most strips are excised from the occipital zone. But you need a full physical exam and assesment of every donor area. Best wishes to you friend...

Anyone can purchase a magnifying glass at the dollar store and begin to compare hair shaft diameter in any area of the scalp. Simply take a sample from the area that you believe or suspect that miniturization is taking place. Take several terminal hair samples from the donor zone by just plucking them. Then lay down the miniturized hair samples next to the terminal hair and tape to a white sheet of paper and start comparing over future time periods.

Did you experience some shockloss or thinning in the area where the strip was taken? That area can take up to six to eight weeks to heal to the point where the scabbing is gone. If you do have some thinning on either side of the linear scar, it can take three to six months for that area to thicken up completely.

If you did not experience any lingering redness or unusual facial/forehead swelling, then you should look pretty normal by day 17. That's better than two weeks to heal. Your crusts should be gone by then as well.

How often are you using the Nizoral? My guess is that it is not the Proscar that is causing the itching. And you are cutting the Proscar tablets right? Regardless of the shampoo, if you do it everyday or even every other day, it can dry out the scalp and cause itching. If the condition persists, you may want to consult with a derm.

After 8-10 days post-op, I prefer to just allow the high pressure of the shower head to beat down on the recipient area to start removing the crusting. There are always a few that are stubborn that will need to be dislodged by rubbing them loose.

It is sort of along the same dilemma as to MPB in family history but not hitting all of the men. For example my two brothers and I are all within several years of age from one anothe yet I am the only one who is affected by MPB. My two brothers have no hairloss nor does my sister.

What happened with the dutasteride if you don't mind my asking?

pavlov, The problem with the crown area (post-terior) is that the surface area is large demanding lots of donor hair. From your words, it sounds like it still appears thinner than you want to see it. But to provide coverage even at 50% of original density will demand lots of grafts. Were you completely bald in the crown before surgery? How much of the existing crown is natural thinning hair that is not transplanted? If it is less than 25%, minoxidil may not do much to make a visual difference. IMHO, minoxidil increases hair shaft diameter so it can potentially improve the "appearance of coverage" in hair that is losing caliber. But if your crown is more than 25% natural non-transplant hair, than I think the minoxodil can improve the appearance of coverage.

From what I have observed, most HT docs recommend that the epidermis is completely healed before applying minoxidil to the grafted area. Ane yes, the idea is to "jump start the grafts" so that the resting phase is reduced once the hair is shed.