gillenator

Nile, There is a thread in this same forum category entitled "Dr. A, respectively Dr. AP/India. HTN forum member Mathew posted a comment on his recent BHT procedure with Dr. Arvind and his upcoming BHT procedure with him. You can probaby private message him for more details. Most of Dr. Arvind's work is showcased at Hairsite which includes a fair amount of repair cases like yours. There is a section at his website providing the protocol for enrollment, travel, etc.

Pat, The recipient area looks very clean and the grafts impeded into the neighboring vertex, lateral humps, and coronet area of the crown will make for a nice acclamation into your existing hair. You should get a very nice result and coverage so keep the pics coming. Happy growth!

HBT, I am with you all the way! The best gift in life is giving to another in need!

Hi Powerplay, The average natural surface density equates to approximately 80 hairs per cm2. The average graft carries 2.15 hairs within it. 400 X 2.15 = 860 hairs. Then divide 860 by 50 and you will get 17.2 cm2 of coverage on a bald surface area. I used the number 50 for two reasons. The first is that you only need to restore half of original density to gain the illusion of coverage, so you won't need 80 hairs per cm2. The second reason is that whenever working the hairline where there is no natural hair left, a fair amount of single hair grafts will be used or better yet, should be used. That will bring down the average hair per graft. Keep in mind, these numbers are for the "average" patient so your own density and hair characteristics like coarseness may vary. Best wishes to you.

Justin, Wow! I definitely agree your pics make you look younger. It is a very nice result for 1609 grafts. You can really slow future loss in the vertex and crown areas with finasteride as you probably already know so glad to see you are on it. Although your color contrast is wide, you appear to have ideal hair characteristics and your hair does look good short in the after pics. We will all look forward to your one year pics!

HBT, No, I in fact did see your location a long time ago and that's why I mentioned the Vikings, no pun intended. Would the record between the Vikings and Lions have anything to do with it? Just kidding and happy growth to you, can't wait to see your progression. Take care HBT!

Bill, Thanks for the comments. No, I do not recognize anyone who is a past patient of Dr. Katz on the forum. Most of his past patients came to him from high-powered infomercials when he was at Bosley and then subsequently MHR. He never exposed himself to the internet until very recently. Because I am based out of the greater Wash DC area, I had lots of occaision to cross paths with his patients. I simply was not impressed with his techs clinical knowledge and professionalism. The very best in this industry "LOVE" their work, the rest seem to view it as a ordinary job. The best techs and "docs" have a passion for improving techniques and skills, they do each procedure as if it were a gold medal event. They continue to educate themselves and contribute to making the procedure a better one. That's the type that impresses me. Also glad to hear you are giving your first procedure time to mature.

I think Dr. Sharon Keene was formerly with MHR for a very short time. I heard she is very ethical but never had any contact with her. I also know of Dr. Grant Koher in North Carolina who left MHR and heard of some violations he had in Pennsylvania and elsewhere. I tried to contact him to discuss these issues but he never returned my many messages so I gave up trying to communicate with him. I really do not know the specifics but I heard that they are of public record. I do agree with 99.99% of what Arfy stated and have posted similar caution to patients. There are many long-time ethical independents to chose from so why take the risk. In most cases they are cheaper in graft prices than the mills so it's a no brainer.

You can read more about Dr. AP's comments regarding the difference of his approach in FUSE vs FUE at his website. FUSE stands for Follicular Unit Seperation Extraction which is a technique that seperates the graft safely upon extraction by cutting it rather than the 'pulling' of the tissue that FUE employs. It decreases transection and has less damage potential for the grafts. It helps to prevent the crimping of grafts. FUE does involve the employment of a punch to make the initial incisions for extraction. Dr. Poswal has become so efficient in his "feel" of the instrumentation based on the many cases he has done to date. He is very skilled at following the angulation of the hair sheath. Most FUE surgeons are using the 1mm punch.

Dear FS, Consumption of caffeine products is a definite no-no prior and during surgery. It does indeed raise blood presuure just like nicotene and it is highly recommended to abstain from both prior to surgery and shortly thereafter. Alot of doctors have and still do administer valium, some ambien to relax the patient and to stabilize blood-pressure. I have even heard of Vioxx being utilized! It is possible that you experienced nausea from the side-effects and/or the interaction of the other medications employed. Any of these meds have nausea as a reported side-effect. Did the surgical staff include a nurse or trained medical assistant who took your vitals before administering anesthesia? In addition your medical history and meds should be screened at the time of enrollment and there should be questions asking about your potential negative re-actions or allergies to any known meds. My premonition is that the food and drink you were given did raise your sugar levels to snap you out of the lathargic state but also to get something in your system to counter-act the full effects of the meds. On your next procedure be sure to eat a good hearty breakfast and try some bagels or something high in carbs to sustain you until lunch. Take care!

Hey Brando and HBT, Don't forget about the Vikings! Can't wait to see your growth progression guys so glad to hear of the good results to date.

Bill, I always encourage patients to wait at least one year for their next procedure. As Hugh mentioned, six months out from surgery you will notice lots of growth coming in and there can still be some coming in as late as 9 months post-op. The "full maturation" level includes optimal caliper development so the transplanted hair should also gain full coarseness by one year. That is when you will be able to evaluate the full effects of coverage from the 1600 grafts. I read some of the comments regarding Dr. Katz not wanting to do more than 1600 in a single session. My opnion is that is due to the fact that 1600 grafts is a "big day" for him and his staff. Back in 2001, 2002 I heard he did not want to do more than approximately 1200 grafts. I think he is somewhat set in his ways from the ole' Bosley and MHR days. I have seen a fair amount of his work since he left Bosley and I have to say that it all looked good. These were basically patients from Philadelphia and the East Coast. I have met Dr. Katz in person but not as a prospective patient. I asked him a fair amount of questions regarding FU procedures mostly because I heard his training was in micro-mini graft procedures that Bosley was doing. He also claims he was personally trained by Dr. Bosley which may be true. He was somewhat evasive in his answers but stated he likes moving hair in groupings of mostly ones and twos and some threes. Possibly he is doing FUT procedures now. I was not that impressed with his staff but that is my opinion for whatever it's worth. Still his work looked okay on the patients I had seen that had work done by him since 2001. I think you will be happy with the results. Thanks for all the pics and happy growth!

Qvarnis, My guess would be that your buds simply have MPB and I bet if you could research it further it would show up somewhere in their genetic history. I occaisionally watch the Tonight Show on NBC and both Jay Leno and the bandleader Kevin are supposedly big-time potheads. They joke each other about this and there are other rumors about Leno's heavy pot-smoking. Whether it's true or not, who knows. But take a closer look at Leno's hair. He has a thick youthful hairline and density that won't quit! Kevin? Class 7 all the way. See what I mean? Any chemical based drug will deposit residuals in our bodies which all vary in how long they linger in our blood, tissue and organs. All medications have side-effects including homeo-pathic meds. They have varying interactions within our bodies as well. I am not directing this to you but let me generally state that anyone who would consume a recreational or black-market drug should be more concerned about loss of their life than loss of their hair.

Shaggy26, Yes adequate scalp laxity is imperative to sustain any strip procedure(s), but not the case with FUSE/FUE/FIT technology. Preservation and on-going management of the donor areas are also critical in determining potential procedures. Transection can vary between doctors and their respective levels of expertise. Proper closure of the donor area goes along with this to minimize the linear scar so hopefully it can be taken out in any subsequent strip procedure(s). Permanent shockloss in the donor is yet another consideration for those who sustain it. Thankfully this does not happen to many patients, but obviously could affect future procedures. Trauma is caused to any recipient area from the recipient incisions and many patients and doctors will tell you that the best yield comes from the first procedure in most cases. This is due to the permanent affects in scarring and compromision of blood flow to the recipient area post-operatively speaking. Many will advise to do as large of a session on your first procedure for these reasons although I am not an advocate of mega-sessions. Yes there are some financial benefits with lower graft prices for huge sessions but there also are some potential drawbacks concerning overall yield. I have yet to see published clinical findings concerning yields on mega-session procedures. Lastly, your overall general health is of utmost consideration and any prudent ethical clinic will "clear" your current medical condition and history.

AB, Dr. Shapiro did my first HT in 1996 and started the most natural hairline for me. This first procedure released me from wearing hair systems for 11 years prior to that. I am from Minnesota originally. I was so self-concious about my privacy as public opinion was still somewhat poor regarding HTs. In addition, I did not want anyone and especially my ex-wife at that time to know I had done a HT, but when it grew in she simply stated, "oh, your hair is growing back!" That was the best compliment I could have heard and it certainly was a compliment to Dr. Shapiro!

Gerry, As Hugh mentioned, caliper (coarseness or thickness) of the hair cylinder is very important in gaining the appearance of coverage. Caliper in fact is the single most critical factor in gaining coverage. I have seen patients with thin caliper but yet had great donor density which helped in making them good candidates so hopefully this will be the case for you. As was mentioned, get your donor density calculated by a competent surgeon. I do not agree necessarily that thin caliper makes a more natural appearing hairline. I believe if the type and correct size grafts are utilized, along with natural angulation of the recipient sites, the hairline will look perfectly natural, whether thin or coarse hair. Best wishes to you.

MG, I hope you had a chance to see some of the other relpies to this same thread on the "Hair Restoration Experiences" category of this forum. Best wishes to you.

MG, I think you will see noticable improvement in 6 months post-op and it can also take up to one year for the redness to resume the color of your scalp. It can also take that long for numbness and a feeling of a tight scalp to dissipate. Best wishes on healing and growth. Possibly you can post some pics as your new hair grows in.

Hi Wantitback, Yes losing a few grafts post-op is typical although none of us want to lose any of them. No one retains 100% of the grafts placed whether the patient realizes it or not. What happens post-op is that we are told for the most part to wash our hair every day following the procedure. The grafts become soft again from the warm water so even gentle washing and rinsing can cause a graft to dislodge. The graft you noticed six days out was probably loose long before now and probably just rinsed out. Many of us here are advocates of utilizing post-op wound care topical treatments like Graftcyte which advance the healing process and possibly you have been using something like this. Either way, you are now far enough out from surgery that you should not lose any more. The best way to shampoo the recipient area post-op is to establish the shampoo lather on either the side of your scalp (rim hair), or other location of the body where there is lots of hair to create and establish suds. Then cup one hand and scoop the suds and then place the suds over the recipient area without scrubbing the area. Just pat the suds very gently onto the recipient area, no scrubbing. After the suds start melting away, apply a second scoop of suds and repeat. Then simply rinse off using a receptacle of some kind and gently pour the water over your scalp to rinse off. Use lukewarm water, not hot, not cold. "Do not allow the rinse directly from the shower head as the pressure can dislodge wet grafts in the first several days following surgery. Let your hair "air dry" and do not pat your head with a towel to dry off. After 8-10 days post-op, the crusts are ready to come off and then and only then can you begin to get more aggressive in massaging the recipient area with your fingertips while shampooing. The crusts will come off and there should not be any other complications. After the healing of the surface of your scalp (epidermis), you may begin to see some effects of shockloss. Hopefully it will be minimal and not very noticeable. Most of the hairs within the grafts will come out with the crusts and a smaller percentage will just take off and grow. In time, alll of the hair follicules that were transplanted will cycle through their phases and behave like they did before your procedure. Best wishes to you!

Jr1, The surgeon featured was Dr. Allan Baumann based out of Boca Raton. FL. There have been other national programs that have featured him. He is also doing some FUE procedures although I do not think he has been doing FUE for very long. The examples I have seen of his work looked really good and I did have the opportunity to speak with him about a month ago. My impression is he is a leader in applying and making available all treatment options including the laser therapy. He is someone coming up in the ranks, and my guess is that we will be hearing more about him. I believe Pat knows of Dr. Baumann too and he does have a very comprehensive website. Smoothy, I believe the hair dryer was briefly utilized to minimize the "glare" of the scalp when the scalp was wet and being filmed. I saw this before during a live surgery workshop. I do not believe any damage was done because once the grafts are placed, the clotting process begins immediately and holds the grafts in place until healing of the dermis layer begins. Then the tranplanted follicules will re-establish their blood supply. I suppose too much drying could eventually dry out the top of the grafts but the follicules are imbedded into the soft tissue in the dermis layer. Keeping the epidermis in a moist environment for three days post-op is good as you suggested for the purpose of minimizing scar matter formation, but I believe the follicules themselves are not affected once placed and held by clotting. In other words that brief drying should not affect the yield. Personally, I do not think I would want a hair drier utilized during my procedure. I mean the tissue that remains above the scalpline will dry out soon enough and turn into crusts, but I think I would prefer them to do this after applying Graftcyte in the first week following the procedure.

Fabe, Was the area of additional balding as you stated a "blothcy" or "patchy" spot? Or did you notice from a year ago that the "area" of balding widened into the coronet area? That area is the lowest point below the crown. It often distinguishes men between a class 6 and class 7 potential.

Nile, Any reason why you would not consider FIT, FUSE/FUE extractions to thin the plugs? That way you can have those grafts extracted re-implanted in the recipient areas and gain some more coverage. Why have them destroyed? If you are going to pay to have your plugs thinned out, why not do it in a way that would bring you additional benefit? Just some food for thought.

Hi Neutronman, Welcome to this forum! Alot of information provided here in this thread however I want to offer you a comment that you probably are already aware of and probably have heard from your doctors. Long-term steroid use in any form is ill advised and can have grave consequences in the long run. I did note that you are a "professional" and so this may be hard for you to compromise at present, especially involving your occupation. The production of testosterone really dips down in men reaching post 30's in age. It may not show up initially but as you get older, your body will need all that much more to maintain the muscle mass. I don't know how old you are nor how long you have been maintaining this regimen, but for whatever it's worth, at some point you will have to cease it or they will take their toll. Possibly you have plans to be a trainer in the coming years. Please understand I am not trying to tell you how to live your life, it's just that I have seen some men very adversly affected by steroid use including terminal situations. Best wishes to you.

JacobS, Did your doctor prescribe or provide you with a steroid known as Prednisone? This really can help with swelling along with the ice packs. The effects of gravity also pull down the solutions that were injected into the scalp and usually noticed 2-3 days post-op and then lingers another 2-3 days until it subsides. Those are the averages and so don't worry, things should subside very soon. There was one individual in this forum who recently posted about some dramatic swelling, but it is the exception and not the rule.

Vocor, Glad to hear of your research, the right decisions, and now the benefit. Keep on living brother, life can be good!