gillenator

Marcelo, Although there is some clinical evidence supporting higher testosterone levels at night, remember that DHT is produced by conversion of an intracellular enzyme 5a-reductase. The active ingredient in both Propecia and Proscar is finasteride and is a synthetic 4-azasteroid compound functioning as a speciific inhibitor of Type II DHT. Higher testosterone levels do not necessarily imply that there is a "greater" risk of genetic hairloss. And both types of DHT produced do not necessarily behave at the same corresponding levels of testosterone. In fact, testosterone levels begin to drop in men after reaching age 30 or so but that does not imply that genetic hairloss slows down after 30 either. Some men begin to see a dramatic increase in the effects of androgenetic alopecia post 30 years of age. Irregardless, Merck further states that it makes no difference at all which time the tablet is taken each day. The real key is being consistent in ingesting it. The residuals stay in our bodies for an average of eight days so even if you were to miss a day or two, that is not considered to be an issue. Personally I take mine at dinner time with all of the other meds I take daily. I have been "quartering" Proscar for years with absolutely positive effects. I just turned 50 this year and recently had a PSA test done with everything coming out normal. If you do feel more comfortable, confident, or simply prefer to take it at night, by all means do so. As long as it works for you!

Switch, Just read your other thread and glad to hear everything went well. Possibly you can post some before and after pics if possible? Happy growth!

Omar, Have you had prior open-donor procedures or strip and lack donor in the scalp? If so, then BHTs may be your answer although I believe in utilizing scalp donor before going to the body for the obvious reasons. Most of the clinical research and findings for BHTs utilized the chest area. Dr. Woods in particular found that chest hair follicules transplanted to the scalp resulted in longer growth than their original virgin area. The reverse also was true whereby planting scalp follicules to the chest did not grow as long. The resting phase appears longer with BH follicules and the resulting new growth can take as long as 18 months to manifest.

Nile, How many months out is the NHI patient? This is NHI not DHI right? From what I have heard, NHI really does not do many FUE cases and a fair amount of patients do not pass their FOXX test to establish candidacy. Donor sealing is one of the aspects that Dr. Arvind employs to make the extra effort in minimizing visible scarring. The pics are excellent quality (digital).

Phillyboy, Well if you are six weeks post-op we know that your epidermis is healed so possibly what you found was a dried up graft that was maybe stuck to your scalp and finally came off during your patting, etc. Very doubtful that you actually pulled a graft out from the recipient site. When that happens it usually occurs in the first three days or so post-op from overly agressive scrubbing too early, picking, scratching, etc. There is almost always a stream of blood that oozes out from the hole (recipient site) once the graft is pulled out. No one retains 100% of their placed grafts post-op but with proper post-op care, one can help to avoid losing any grafts as much as possible. Best wishes to you!

Mr. I, As long as there is a cut, incision, laceration, whatever, there will be some level of scarring developed by the body to "heal the wound" in spite of what some may claim as "no scarring". I think the term "no scarring" is used too loosely and in my opinion is more a marketing oriented term than actual occurance. The real issue is "visible scarring" and there are many interpretations of that. From what I have researched in these various methods of isolation extraction techniques, Dr. James Harris' Surgically Advanced Follicular Extraction is related more to his patented tool he refers to as Safe Scribe. His basis for claiming it is a "safer" technology is lower transection rates with his tool and those patients who were not good candidates for traditional FUE, are in fact candidates for his SAFE system. He states that everyone could have the candicacy for his technology including African Americans and those patients with white hairs who before-hand were not considered good candidates for traditional FUE methods. I could not find the information as to why his tool reduces transection rates so this is something he would have to explain himself. Dr. Harris and Dr. Rose have exchanged some of their own technology togethor regarding the instrumentation of FUE as recent as last year's ISHRS meeting in Vancouver. I certainly respect their efforts to reduce transection.

Some Dude, Robert covered your shockloss and shedding concerns very well and I agree with his supposition of your situation. It is not unusual for men to experience increased shedding in the third to six month period following ingestion of finasteride which is undoubtedly cyclical behavior of your follicules. So I suppose that along with trauma from the procedure has produced a more than average amount of shedding and shockloss. As mentioned before, the new growth should be coming real soon. Ultra refined dense packing is an approach utilizing the lateral slit technique of creating recipient sites so micro in size that some profound surgeons use improvised blades to create the sites. Because they are so minimally invasive, far more sites can be created to accomodate placement of more FUs within the same surface area (as much as 50 cm2). The primary objective is to gain much higher density levels in one pass compared to what was traditionally done in the past five years or so. Secondary effects are less trauma to the scalp, higher survival rates with a corresponding higher yield. Quicker healing, less post-op swelling, etc. Please keep in mind that this is more prevalent in the hands of very skilled and experienced HT surgeons whereby many of them use customized blading and instrumentation. Their techs are very experienced and skilled at micro-dissection of grafts that identically pare to the recipient site. Take a look at the thread in the Medical & Aesthetics section titled "Examples of Ultra-Refined FU Grafting". This is a thread initiated by Pat and presents a class example of this method as performed by Dr. Ron Shapiro in Minneaplois. I believe this was a case just over 2500 FUs but note the post-op pics and it will blow your mind when you see the precise and close placement of the FUs, little to no swelling, minor if any noticable effects of scalp trauma, etc. Best wishes to you!

Damo, With those type of hair characteristics you should look awesome like you never had any genetic hairloss! Can't wait to see your future pics and don't forget to save some donor for any future procedures you may want, especially for the transition zones.

EG, We will all look forward to your pics! Best wishes to you.

Sounds like you have an ideal situation with a good long-term prognosis!

I caught a glimse of Michael Jackson's father on the news recently. He was in the sun and it almost looked like he had part of his scalp colored with tatoo ink because of the shine that reflected off his scalp. I had assumed he was using Toppik or some other cosmetic application until I noticed the shine when he stood in the sunlight. He really has very little hair left but you do not notice it as much when he stepped into shaded areas as he walked. Robert makes a very good point about chasing recession in the future. I have seen a dozen or so individuals over the years use this "in part" and cannot think of even one that looked favorable. In fact a good deal of them wanted hair transplanted to cover the tatoo! This is especially ill advised for folks with a wide hair to scalp color contrast. Several of these individuals ended up in hair systems to cover the obvious tatooing to hide hairloss that kept on advancing.

Mr. I, I have never seen pitting go away with time (healing). There is also the potential option of extracting the pitted FU altogethor and re-implanting it. This can be especially helpful if the pit is deep and under 1mm in diameter. It is also possible in some cases to have the pitted graft surgically excised and then closed with one suture. Probably a better option for pitted sites larger than 1mm. Only consider surgeons that are very experienced in repair. After narrowing your search, make sure they examine you "in person" and explain all of your options. Best wishes to you.

Scarecrow, Yes, Dr. Rose does work with Dr. Shapiro in Minneapolis. You can also look up Capital One on their website as they offer a formal program entitled "Cosmetic Fee Plan". Interest rates vary quite a bit so your best option is a low rate credit card.

Chucky, Every now and then we hear of a clinic charging by the "hair" and most times it is more of a marketing/promotion than anything else. Within the realm of FUE and other isolated extraction methods, the clinic may argue that there is far more time involved in creating sub-follicular units from larger hair bearing grafts that are almost always done with a 1mm punch, still many singles may need to be cut in creating a new hairline for example. They can then charge ultimately more money for the total procedure. Henceforth, many of us do not support paying by the hair. On the other hand, could a clinic that charges by the graft manipulate the total graft count? I always encourage patients to insist on donor evaluation and ask in the consultation examination, how many singles, doubles, etc does my donor region have and how many natural occuring FUs may need to be cut into sub-follicular units like lots of singles for creating a new hairline, etc. That provides the patient consumer a "rough" idea of the graft count needed and how many will be singles, doubles, etc. Then after surgery, compare the actual numbers placed by graft size and compare with your original notes. It will help ensure that your natural occurring FUs were not over-manipulated and that you were not subsequently over-charged.

Heavy K, I would not coincide with the opinion that shockloss in the donor region is normal for a majority of HT patients, quite the contrary. In fact it is more the exception however it definitely sounds like it happened to you in that area. I never had any shockloss in my donor area in any of my procedures, recipient area, yes of course. Hair follicules fulfill their growth cycles throughout the scalp so it is a matter of time for it to grow back, worst case three to four months. Best wishes to you in your healing and new growth!

Damo, That all depends on what is in the recipient area right now compared to your virgin density levels. Since this will be your second procedure, are you having the same areas worked or are the grafts going intpo a new completely bald surface area? Generally speaking, if your restoration can achieve 50% of original density, you should get good coverage. Possibly you desire higher density levels than that especially if you have straighter hair, not as coarse. Any wave or curl characteristic will help the visual for appearance of density.

Neil, Glad to hear that new growth in the donor near the scar is coming along well. Some things just take time and hopefully Lurker and Eric will see similiar results very soon. It is extremely rare to see permanent shockloss in the donor area so the odds are in your favor guys.

Lightning1, Glad to hear of your great experience with Dr. Rassman and staff. As you probably know, he has been around a very long time and does some very good work. He is credited a great deal for his contributions in FUT technology in the early nineties. Thanks for your input and we will look forward to your results along with you. How many grafts did you have done and did you do a strip excision or FUE? Have a good night's rest and wish you the best in your healing and future GROWTH!

Hi Bluesman, I remember a few of your posts back in 2003, and I must say that the current pics you just submitted this month in March are absolutely awesome!! Everything has filled in very nicely! Just curious why you want to add more to the hairline. Are you trying to lower it a tad, or are you going for more density and definition? Dr. Shapiro was my first HT surgeon which was back in 1996 and my hairline came out so natural that my ex-wife thought my hairline was just growing back, and so did a few others as I kept it very secret. I was a Hair Club for Men client before that. I am 50 years old and had a total of three procedures. I do not know how old you are but your recent pics show your full face and for whatever it's worth, I think the density looks great right now. Once I hit over 40 yrs old, I wanted to be careful not to add too much in the front because I felt that would start to look a little unnatural for my age. But that's me, not necessarily your thoughts. The younger one is, the more critical it is to save donor for any future loss. Also, I have seen men in their late fourties and so begin to lose hair which seemed to be more evident in the crown. Is there any of that in your family history? I do not remember if you are on Propecia or not. From what I recall there is not extensive hairloss for you but feel free to correct me if I am wrong. Hey, I saw that you are a guitarist so with a handle like the "Bluesman", you no longer have to sing the blues regarding hairloss! Best wishes to you.

Rashomon, Whoa!!! Lots of good questions but I would suggest that you do some more reading and research. You mentioned that you do not wish to wait 9 months or a year for results but whether you initially embrace your hairloss with a medicinal approach (Propecia) or consider HT surgery, nothing is an instant fix, anything takes some time. I am not sure how old you are but I do know that it took some time for you to reach Norwwod 5. Propecia (finasteride) takes up to one full year to accurately evaluate its efficiency, and a HT procedure takes up to one full year or so to fully reach maturation. So either way, you have no other options than to wait for results. Neither Propecia or minoxidil will re-grow all of your hair back. You may experience some re-growth but probably would be very little since you are already at a more advanced class of genetic hairloss. And remember, neither medications nor HT surgery will cure hairloss. They simply buy us time since genetic hairloss is progressive in our lifetimes. Also, none of us here in the hairloss community can tell you that yes, you need a HT. No one ever "needs" a HT, but it can be something desired based on making an "informed decision". Now it is not my intention to offend you in any way but rather offer you some helpful insight as I suggested to you on the other thread. You owe it to yourself and only "you" to get your questions answered by reading up on these subjects. Once you have gained enough knowledge concerning the dynamics and implications of hair restoration, you will have the confidence to make the decision that you feel is best for Rashomon, even if it means you decide against the procedure. Take a deep breath and do not try and absorb too much at one time. Many of us here know exactly how you are feeling and yes it can be overwhelming. Start at the beginning, understanding hairloss and then how it can be treated. Best wishes to you!

Smoothy, You may want to read about Dr. Craig Ziering's "whirl" method of restoring the crown. I believe he was awarded recognition for this at one of the annual ISHRS conferences and I think it was the 2002 conference. He does have a relatively new website since he left MHR in 2003 and moved CLEAR across the country from NYC to California. I heard he was doing "tons of cases" in NYC and imagine he was making the big bucks so why he just picked up and left his market in NYC is surprising especially since he has been with MHR from their beginning days. He is NOT anyone I would recommend however possibly there are other HT surgeons who approach crown restoration similiar. My guess is that other attendees at that conference may be able to also get you some information on his method.

You should find lots of answers to your questions just by reading the material. It probably will also generate questions that you may not have thought of. Welcome to this forum and best wishes on your research!

Hi JayJay, Welcome to this forum! At four months you should begin to see the re-growth but it does take up to one year or so for the procedure to reach full maturation including caliper development (diameter thickness of original terminal hair). Sounds like everything is right on track. Not sure how many grafts you had done but you are sure to see more comin!

The desire to wear a short buzz cut is one of the primary reasons why someone would prefer these isolated extraction techniques. Younger patients who do not have a known family history may find this technology helpful in case they realize much more dramatic levels of hairloss as they get older. They may opt out for the buzz cut later in life and not want any detection of a linear scar. Now obviously there is some level of scarring in either method of harvest strip or FUE, but in general FUE/FIT/FUSE leaves less "visible" scarring when done by a talented surgeon. Yes there are cases where the "moth-eaten" or "white dot" appearance is more evident on some patients and not as pronounced as others. How a patient heals can have a bearing on the outcome and there are those types of differences between patients. And the more extractions that are made (larger sessions), the more potential to notice the white dots or spaces where the FUs were taken. I've had many opportubities and still see patients who had basically the same amount of extractions taken from their donor areas, yet one patient may look more depleted than others and/or the visible dots so-to-speak. My perceptions are those differences relate to the size of punch used 1mm and .75mm, how close the extractions were made to each other, how well the patient healed, and even dark coarse hair with a very fair complexion, compared to blonde hair with a very fair complexion which can make the spots or missing FUs less noticable. I've also noticed several patients who had the redness of scalp complexion in the donor area that seemed to linger on for awhile. This redness obviously can happen with strip excisions as well and not uncommon to take as long as a year or so to lighten up. The few patients who displayed these areas of lingering redness were very fair-skinned which was/is something I noticed. Obviously there are exceptions. There are some very fine, barely detectable scars from strip excision and have seen some who buzzed their head and could barely see the scar up close. So FUE/FIT/FUSE may also be great for the patient who desires a small session like mildly touching up the temporal lobe areas and hairlines. But since genetic hairloss is progressive in its nature, most patients will undoubtedly lose more hair and want more work done. Then what, more FUE? Will that not deplete the donor areas further and could it at some point leave a more depleted or moth-eaten look compared to a fine linear scar and wearing one's hair a little bit longer to hide it? And I agree that there are very limited data published on transection and yield. It is not as complicated to monitor as some have suggested on other threads.

Dandare75, Trust me. You were doing the right thing with the right doc which many, many patients can and have attested to. Dr. Shapiro restored most of my front hairline nine years ago and it still is growing and still looks as natural as ever. That was almost a decade ago! His work is simply indisputable and believe me, "you're gonna like what's comin!"