gillenator

Hey Damo, WOW! You must be very excited! You are in great hands with Dr. Martinick and am confident you will have another fine result. Best wishes to you and let us know how things turn out.

Hey Rob, Well it certainly does not surprise me that you received the "red carpet" treatment from Dr. Alexander. He is very sincere in his care of his patients and his actions and that of his staff really reflect it. I have often said, "as the doctor goes, so does the staff". That can be good or bad as we all know! Dr. A is also very meticulous in 'everything" he does from A to Z which I'm sure was evident to to you and your wife. His hairline design is very natural and the "blades" you referred to are probably his own improvised to accomodate the most least invasive recipient site as possible. This should result in quicker healing, less swelling, and ultimately less trauma. So yeah Rob, congrats to you, and very sorry to hear of the loss of your father. That can be really tough but man you seem to be always thinking of others first, something I have a tremendous amount of respect for. Get some rest my friend and let us all know how things turn out. Can't wait to see the pics. Oh, make sure that dear wife of yours gets some needed rest too! Best wishes to you and your family Rob.

I would never recommend Dr. Larry Shapiro in Miami if it's the same one Pat mentioned. I spent some time in Miami in 2001 and a patient asked me to sit in on his consult with him. I found him to be arrogant, not a good listener, non-attentive, and VERY aggressive in trying to get a deposit for a procedure. He appeared very frustrated when this patient told him he was going to talk with a few other docs like Dr. Glenn Charles and Dr. Jeff Epstein. He suddenly had no more time to answer any questions. He then asked us if we were with the State Board of Medical Examiners and seemed kind of paranoid. We both had a bad feeling about the appointment and that's my opinion for whatever it's worth. This is clearly not the Dr. Ron Shapiro in MPLS!

Hi there Eddie, WOW! You are coming down home stretch brother! YEAH, you should start seeing the growth "any day"! Keep looking because the new cylinders will break scalp and have thinner caliper until they fully mature. If you have coarse hair, they will be fatter and easier to see. Many forum members here will also advise you that minoxidil applications and ingestion of MSM will help facilitate and even jump start the growth. BTW, if you had some of the grafts placed in the crown, they can take longer to break through. Hey, let us know how things progress for you especially in the next couple of months and care to post any before and after pics? Best wishes to you Eddie!

BAL, Both Brando and Robert are absolutely correct in their advice to you considering you are at the 17 day post-op mark. How will anyone know if they have popped a graft? You will know because there will be a stream or steady trickle of blood that will ooze out of the recipient site. The stream will typically run down the scalp from the effects of gravity. Also one may find a few grafts on their pillow case the next morning or two after surgery. But if you do find a few on the pillow, they will be dried up and useless at that point. Don't worry BAL, "everyone" loses a few grafts and those few should not have any bearing on the overall aesthetic aapearance when everything grows out. It will be great to see the new growth come in man!

DIT, Sorry it took a little while to get back to you and let me propose that the information is not contradictory at all. Normal activity is most often considered "just that" like normal walking, sitting, resume sleeping in a normal position vs that of an angle, etc. In addition, most post-op instructions are addressing the healing period of the outside scalp (micro-incisions and crusts). That's why most clinics will state that it's okay to resume "normal" activity after roughly 7 to 10 days because they know the epidermis is healed. So my friend "head bumping", long exposure to intense and damaging ulta-violet rays are not considered that of normal activity. Now please don't get me wrong, some folks have activities and even occupations that require long periods outside in the elements and "they" may consider that normal. But within the realm of post-op activity from a HT procedure which requires a fair amount of healing in both layers of tissue, extra precaution should be taken. That's the consensus of most HT doctors which I am not. An occasional head bump won't present any threat unless you break open the sutures or something like that. BTW, should that ever happen to anyone, go directly to the ER room or after hours care facility "if" you do not have immediate access to your HT surgeon. Further, I agree with you in that there can be some variation of oral and written post-op instructions between clinics and yes at times it can be confusing. Half of the post-op instructions I have perused do not even cover post-op exposure to the sun! I have always advocated that the clinic goes over the post-op instructions when they "check out" the patient after surgery. It is also a good time to go over post-op healing products and how to use them so the patients have a thorough understanding of how to care for themselves when they leave and also to provide the patients the opportunity to ask any questions just like the ones you are asking now. Post-op pain medications and potential swelling should also be addressed. Yes it's okay to use the cosmetic products you mentioned because you are sixteen days post-op, your epidermis is completely healed by now so you are correct in that they will not interfere including the new growth. Just make sure you are cleansing your scalp routinely as you stated earlier. Hope this has been a little more helpful DIT, and will close with this advice to you and any others reading. If ever in question, "ask your doctor directly" for his/her advice. After all, you are their patient. Take care.

DIT, Again it would be nice to hear a physicians' response to this ever important issue. Since I am not a doctor, I will offer you my layman's response. After the initial placement of grafts, the blood begins to clot in the sites and works somewhat like glue to hold them in place. This serves well while we go about our "normal" activity post-operatively. Yet most docs/clinics wiil advise the patient to sleep with their head elevated to preferably at least a 45 degree angle such as a recliner, etc for at least three days following the procedure. Within the first 48-72 hours post-op the tissue of the graft is "attaching" or "mending" to the tissue in the recipient site. As we know the "graft" is the tissue that carries or transports the hair follicules for implantation. It is during this period that the grafts have their highest potential of popping out especially caused by heavy cardiovascular activity too early. This includes intense sexual and masturbation activity post-op. Keep in mind that the inner layer of tissue is "soft" and with blood supply and has no external air flow around it like the outer layer (epidermis) during the healing process. The epidermis works like an orange peel, a protective cover for what is inside. Sorry if that was poor analogy but I think you get what I am saying here. So the inside tissue in the dermis layer can take up to 60 days to heal. Severed nerves take longer to repair themselves and re-grow. Finally there's the issue of the transplanted hair follicules getting their blood supply re-established. As you may have already researched, a good percentage of those transplanted follicules go into the dormant phase (telogen) so the concern of exposure to the sun is really the potential damage to the follicules caused by the high ultra-violet rays and subsequent potential to "toast" your transplanted follicules. Once the blood supply is established and flowing to the follicules, they won't be subject to that type of ultra-violet damage. A good recommendation is to cover your head if out in the direct sun exposure for at least six months post-op. Some docs will advise after three months is fine. Hope this has been helpful.

BAL, Well I was hoping one of the docs was going to address your questions and possibly one of them will. Hopefully the following will be of some help to you and others. PRE-OP: Refrain from activity that "leaves you breathless" such as any high level of sexual activity and/or cardiovascular activity for at least 5-7 days pre-op. This refrain will help to keep your blood from getting too thin. POST-OP: Sexual activity and/or heavy cardiovascular activity can potentially "pop" some grafts out from the undue pressure created in the scalp. It can also affect the sutures and subsequent stretching in the donor zone. The next issue which any patient may want to consider is the private one nobody wants to discuss, post-op masturbation. It's a no-no because again of the possibility of grafts popping out. My recommendation would be 7-10 days abstention. Sometimes good things are worth waiting for at least for a little while, unless one can get really creative!

Taoofjord, WAIT on a HT procedure. If you are 23 you need to start on Propecia first and I am not a doctor but any prudent one will inform you to do the same. At 23 and with the early signs of MPB you need to get a better handle on slowing down the loss before you would ever consider HT surgery. I mean what happens if Propecia (finasteride) does not work for you? If there are advanced levels of MPB in your family history you need to take extreme caution in not using up all of your available donor too early. Make an appointment with a competent HT doctor or dermatologist who treats hairloss as soon as you can if you are serious about slowing down the effects of MPB. You can then go back for follow-up evaluations to see if Propecia is working for you as it does for the 90% of men who ingest it. Best wishes.

Kez, Yes my friend I think it's probably very possible for a competent HT surgeon to achieve more density with a subsequent procedure, but please allow me to qualify that statement first. It all depends on how many grafts will be added to what specific surface area of the recipient site. In other words if your zone of demarkation for a Norwood class 5a is roughly 15 X 12 cm or roughly 180 cm2, you'll need more grafts per cm2 than if the recipient area were somewhat compromised by placing the grafts closer within a smaller surface area. More grafts in itself does not always imply a higher illusion of density, the recipient area has to be considered in conjunction with the added graft count. A very competent surgeon will evaluate your specific goals (level of density). The doctor will also evaluate the level of density you currently have in the recipient area i.e. 30 grafts per cm2 for example. After also considering your color contrast, hair charateristics including degree of coarseness, you should get an idea of how many grafts per cm2 that the doctor would recommend to achieve your desired level of density. The surgeon will also take into consideration any prior procedures, current angulation of the grafts from prior procedure(s) and adequate blood flow to the recipient site. Transection of existing grafts is always an issue when creating subsequent recipient sites. Certainly they will again pre-screen your current medical condition including meds. Then the doctor will evaluate how much donor reserves are available while considering any future potential hairloss since MPB is progressive in its nature. Alot for any of us to consider but again I think there's alot of potential for you to add to what you got at present. Take care. Best advice would be to utilize digital quality pics including donor and e-mail them to several good docs and then evaluate their opinions. They will be able to fine-tune your graft count on the day of your procedure if you are traveling abroad.

Taoofjord, The pictures are always going to look nicer than how most systems look face-to-face. Try going in one of their centers and see if you can hang around for awhile to see different clients in person. Although the quality of hair systems have improved greatly especially from the time I wore them, they are for the most part pretty detectable. Most guys are very challenged in styling and grooming the system to get it as natural appearing as possible. It took me close to six months before I felt somewhat able to do it. And unless you have a perm put into it, you'll spend literally hours trying to get it to look just right and then you have to use gels and maximum hold hairsprays etc, etc, etc. For me, I hated it the whole ten years! There's guys out there that can really relate to what I am saying here. Somee other issues with hair systems are fine tuning the density levels, keeping the color right because ultra-violet light especially in the summer months will change the color. And depending on the competence of the center, they may not get the color right. Don't forget about "hair-adds" that your system(s) will need unless you enroll in their most expensive program where you get a new system every month. $$$$$$$$$$!!!!!! The BIGGEST drawback is the expense, both for your systems and "the on-going maintenance". That's where they really get you over the long haul. Just be sure to add up "everything" and you'll see over time that a HT is not only the best option aesthetically speaking and providing you have a competent HT surgeon, but a much better value over time. So why pay all your hard earned money for something superficial when you can have your own transplanted hair instead. Let me also be very careful to not completely shun hair systems. They can be the most pratical resolve for those individuals who are not candidates for HT surgery or not the best candidates when equating donor limitations to those with extensive or very advanced forms of alopecia. Really do your research on this one guys.

Teddw2ds, Every now and then I hear someone say "oh, a hair transplant is just being vain"! Yet it never seems to amaze me that the folks who state this are not suffering from hairloss. Even spouses, significant others, friends may just accept our hairloss and may imply that we hairloss sufferers are just overly concerned or even just being vain. I could not disagree more. I remember years ago when I used to wear hair systems, my father used to tell me "there's nothing wrong with being bald, just be proud of your Irish heritage". Yet my dad had a full head of hair all his life, so thick and red that his nickname at work was "Red". I got so tired of him joking me that I was supposedly going through mid-life crisis that I finally pulled him in front of a mirror with my system off. I said to him "the difference between you and me" is that you still have what I lost. People do not stare at your forehead but they stare at mine! We were given hair by mother nature (avoiding any religious implications), so when we lose it, we experience a real sense of loss and it can be as tangible as a broken leg. Now here's the kicker. Like Pat being a former Minnesotan and when I finally found the right talented surgeon (Dr. Ron Shapiro) and my first procedure grew in, I was freed from wearing the hair systems! I never told my dad about my HT with Dr. Shapiro but I did confide in my mother who suffers from hairloss for over 60 years now. BTW, my mother has been my best support through this dilemma. None of my siblings suffered from genetic hairloss. I remember the holidays of 1996 and sitting next to my father at the dinner table. Out of nowhere he said "well what do you know you're hair is growing back". "It looks very nice". My ex-wife never knew I had the HT and she too thought my hair was growing back by some miraculous occurance. Yeah, there was a miraculous occurance alright, I found Dr. Shapiro! I felt much better about myself even though I needed and wanted more done, I just could not afford it at the time. Since then I had two more procedures over the years and now am very happy with my coverage. Yet sometimes I think I still want more, I am just happy to have back a nicely restored look. So is a HT really vanity or is it gaining back what once was lost? I guess that depends on who you ask, a person who never lost their hair or other hairloss sufferers like us.

Kez, Sometimes and even possibly most times we are our own biggest critic especially for those of us that have suffered hairloss. I can relate. You mentioned you were a Norwood 5, is that class 5v or class 5a? I got the impression of class 5a when you stated you were completely bald there. I was a Norwood 5v and have had 4400 grafts to date. Still I can see the difference in density or better yet "illusional volume" compared to the rim or donor areas. In additon I have a wide contrast but mid-coarse hair with a mild wave. Not sure of your hair chararcteristics but my wife tells me the same thing your girlfriend tells you yet I continually wonder if I should do another small procedure. Also not sure of your total area of demarkation as measured by sq cm but I definitely agree that more than the 3500 grafts you had to really get you where you want to be. It sounds like you desire more than just coverage, yet like you, I am also very blessed to have coverage again. Take care.

Mr. I, From what I have been informed, loss of pigmentation of hair also carries a pre-disposed genetic trait. Possibly you know of some folks that had what is called "pre-matured greying", loss of pigmentation very early in life and tends to occur with other family members as well within the blood line. The only other consideration or caution would be to consider where one's loss of pigmetation first occurs again based on family history. Take care.

P.S. The corporate merger of Procyte with PhotoMedex was approved March 18, this year. FYI in case the labeling changes, etc. P.S.S. I too echo thanks to Dr. Charles' participation!

Hi BAL, Hey, welcome to this forum! Wow, I just received an e-mail from someone in Toronto asking me the same thing. Here's the deal. Several years ago there were some changes at the executive level of Procyte and then some subsequent changes in how they distribute their products. They used to retail the product to the public online but now "only" distibute through their network of approved Physicians and some third parties. Here's my suggestion. Go to www.procyte.com and click on the Physician Products folder. Then click on Physicians' Links and there you will find their US network. The HT doctors are listed at the bottom of the page. You can contact one of them and see if they will ship to you if you pre-pay them the shipping charges. There's a clinic in Canada also. You can also check www.bizrate.com for online Procyte product orders and surf www.skinplanet.com which carries every Procyte HT post-op related product. All Tricomin shampoos too! Best wishes to you.

Hi Cat, Welcome to this community! It is true that scalp follicules will grow to the same length as to the area from where they were harvested, as long as the recipient site is the head and not the body. Dr. Woods has done a fair amount of research in this area and no doubt has been doing this technique longer and is more experienced at isolated extraction than anyone else I know. I believe he found that when scalp follicules were placed in the body (chest) as the recipient site, they did not grow to the length that they did in their original virgin territory. On the other hand, and in response to your question, follicules extracted from the chest and placed in the scalp grew up to and documented at around six inches. This finding I believe presented more hope and potential resolve for those past multiple procedure patients who basically "ran out of donor". And at the same time proved useful for repair. His (Woods) continued research also ascertained the slower cycling of follicule growth stages utilizing chest to scalp trials. It probably would best serve you to write to him or Dr. Angela Campbell directly for exact findings on their research. There is little research data available (published) however FYI Dr. Poswal is extensively documenting his findings on the many BHT procedures he performs with patient consent of course. You may want to consider contacting him as well for the clinical feedback. Lastly, surf a few of the other forums that address BHTs more extensively. Best wishes to you.

Hey Guys, Very happy to hear of the nice results with Dr. Keene!

Mr. I, One thing I have and continue to mention to every patient is that genetic hairloss is "progressive". Androgenetic alopecia is evidence of a genetic predisposition that we can never change. For now, prudence calls for life-time planning goals which almost always implies more than one procedure. That is on the basis that one's goal of coverage does not change. Hopefully better medicinal products will emerge in the future and even more so hair multiplication.

Unless I totally misunderstood Wallywonka, I believe he is referring to the hair "within" his grafts that are growing, not shockloss to his natural hair in the recipient area. These are totally two different issues so Wally correct me if necessary. Yes it is quite exceptional to have that many grafts just take off and start growing. Wally, you mentioned that the crusts came off but the stubbles did not come off with the crusts. So the crusts came off but the hair stayed and now is growing right? If yes, that is evidence that those hairs are still in the growing (anagen) phase. As I mentioned before they will eventually cycle through like all of the other follicules. You are the first that I have heard have so many take off and start growing above 70% which is great and that's probably why your family has noticed the recipient area filling in so soon. I am sure you are pleased with the result. What type of post-op product did you use to facilitate the healing process? Who was your surgeon? I bet they are as amazed as we are. Back to the issues of shockloss. Mr. I, the only way a patient would not experience any shockloss in the recipient area is if that area was 100% bald to begin with no natural or diffused hair there. Of course there is always the risk of shockloss in the donor region where the strip is taken. Most everyone will experience shocking out of natural hair to some degree. It can be rated on a bell-curve with the majority at 15-20%. The more natural and/or diffused hair in the recipient area, the greater potential to lose that natural hair which in most cases will grow back unless the natural hair was so diffused to begin with. Those fine, thin, wispier hairs typically do not come back however chances are very high that they would be lost in the near future from the disseminating effects of DHT anyway. Sooner or later they will have to be replaced "if" the patient desires coverage in that area. I hope this helped to clarify some questions and best wishes to all.

Wallywonka, The answer is yes to both questions. Yes some of the hair from the grafts are going to continue to grow and yes you will also lose some of them. Hopefully that did not sound too crazy but please allow me to explain. On average, a higher percent of your transplanted hair will fall out with the crusts. That could be 60 to 70% with the remaining 30 to 40% that remain growing in the anagen phase in the recipient area. We never really know when those growing stubbles are going to go dormant and they could grow up to one inch or so and maybe even three inches before they enter into the resting and shedding phases. What we do know is that the average time period for the growth (anagen) phase is approximately six years for most people. So mother nature seems to do this cycling of phases in our hair follicules throughout our scalps. There are on average about 100 to 150 hairs shedded per day but when we look in the mirror, we do not notice the day-to-day changes of shedded hair because there are always new ones coming out of dormancy. That's what replaces the many we lose each day. It is when we are losing far more than the average that we begin to notice the hairloss. Unfortunately that is the ultimate effect of MPB so thank goodness there are options for resolve for us hairloss sufferers! Oh, before I forget, congrats on some good healing brother! Sounds like everything is going "right on track" so keep us posted of your continued progress.

Hussain, Welcome to this forum and hope you are finding it a helpful site. One would think that Wash DC would have several great if not good HT doctors especially with the demographics it has. But that is clearly not the case. There are two doctors that come to my mind that I would highly recommend however neither of them are in the immediate DC metropolitan area, but both are "drivable" The first is Dr. Ed Epstein and he is the only doctor recommended in Virginia. He has two clinics, one located in Richmond and the main clinic in Virginia Beach. The other is Dr. James Vogel in Baltimore, MD and also be advised that he is a plastic surgeon and affiliated with John Hopkins Institute. So he does not do HTs full-time however since I live in the DC area myself, I have seen a fair amount of his work which looked pretty good and can say that I have never seen any bad work by him, never heard a patient complain about him either. One more thing. There is an up and coming FUE surgeon based out of Gaithersburg, MD by the name of Dr. Christian Bisanga who does his cases over-seas. He is completing his resindency at John Hopkins so soon he will be doing both strip and FUE out of Maryland. Both Dr.s Epstein and Vogel are recommended on this site as well. Stay away from the "chains" including HRG in northern Virginia. Best wishes to you!

Nile, It's under Hair Transplant Experiences section and the thread was "Got my HT".

KG007, Yes indeed for some reason transplanted follicules in the crown appear to remain in the telogen phase longer and no one seems to know why. Might it be the level of blood supply compared to the frontal and vertex areas? It will come so as you get closer to the 6-9 month post-op mark, you will begin to see the changes that Pat is experiencing. To clear up some possible questions of losing your transplanted hair, the ones that have not fallen or come out are probably still in the anagen (growth) phase. They will cycle eventually, meaning you will lose them but after an average of four months to six months, you will undoubtedly see further growth. These hair follicules enter and exit their respective phases randomly, especially transplanted ones. Utilizing post-op products with copper-peptide can actually facilitate more transplanted hairs remaining in anagen with fewer going into telogen. Also speak with your HT doctor regarding utilizing minoxidil to facilitate the new growth. The best is yet to come to you! P.S. You can apply these cosmetic products like Dermatch, Prothik, Toppik, etc once the epidermis is "completely" healed and free from all scabbing or crusts.

Neil, Hey it's great to hear that everything is getting back on track! It's waiting for the shockloss area to grow back in that can be the hardest thing. Dr. Epstein was a good choice on your part and you can bet he utilized the double-closure technique to close the area. My guess is that your linear scar will fade even further especially one year out post-op. Best wishes to you and happy growth!