gillenator

Hi there Ira, Welcome to the HTN forum! Before you make any decision to move forward, read all you can about FUSE/FUE/FIT technology so you are aware of your "complete" options. This research will also better equip you to know what basic questions to ask the doctors. Only a few of the doctors in this technology have done implants into scar material with documented success as was previewed in the above photo. How wide is your current scar? Do you have adequate scalp laxity? Many times the existing scar can be taken out with the new strip harvested so you only end up with one scar. But you must have adequate scalp laxity to accomodate this. Since you already have a linear scar, you may want to consider your next procedure with strip to move more hair "cheaper", providing you need alot more coverage. Then you can have implants into the final scar to camouflage it. Best wishes to you.

Nile, It sounds like you are a very hairy patient and I am not trying to be funny. Glad to hear of the better quality hair on the thighs, which is an exception to most people. It sounds like you have alot of body hair to work with but I want to caution you about something. Body hair donor has always been proposed as a back-up donor supply for repair in scars, and light blending as mentioned before. If too much is used and if the body hair is visually different in charateristics than the scalp including the existing plugs, it may tend to stand out like a sore thumb. That is why you want to move into that arena with test sessions, allowing the full maturation to take place. No sense in getting too agressive too early and then regretting the full aesthetic result. Our pubic hair is definitely out of the question due to it's curl charateristics unless you have identical scalp hair charateristics. Pubic hair for scar repair? I do not see why not but I doubt that you will find a HT surgeon who has done it before. Your thigh hair sounds like a winner. We may be getting the "cart ahead of the horse" as I wanted to ask you if you ever had or considered having the larger plugs thinned out with FUSE/FUE/FIT extractions, and then having the FUs extracted from the plugs re-implanted in the recipient areas. If you have a wider color contrast, this step would normally precede the adding of body hair to the recipient area, especially considering the frontal hairline. It would also make the most productive use of the FUs within each plug which is scalp hair (same charateristics). By all means post your pics if you like, especially the troubled areas you are concerned with (plugs), etc. Lastly, I have heard from a few BH patients that once the hair grows to maturity, it started to curl acutely, even more so than when it was established in it's original region of body. I have also heard from more than a few HT patients over the years that the transplanted hair taken from the scalp also grew out with a crimped or wavier charateristic. My own transplanted hair in my front forelock grew out with a definite wave that my natural hair never had in the front. It was not a pronounced wave but actually produced a visual of more volume than what is actually there. So for me it was a plus. But if some of the body hair regions produced more of a kinky charateristic, one may end up dissatisfied with the visual result. By the way, my transplanted hair continues to produce this wave and I have had many haircuts since my last procedure so it is without a doubt a permanent effect. So the moral of the story for BH is be very careful on selection of donor regions to help ensure what grows in looks acceptable and does not cause "eye drift". Definitely something to think about.

Low, What you are probably noticing is telogen effluvium which is a condition of hairloss that is more common in the early stages of MPB. It can appear in your late teens, early twenties and you can always read up more on the subject. There can be more than normal shedding and thinning with this condition. As Brando suggested, get in for a formal diagnoses with a dermatologist who treats hairloss, not all of them do. That way you will know for sure and you probably will have to wait until you are at least 18 years old or so before starting Propecia if it is indeed MPB.

You are welcome Nile. It is rather interesting that you asked about the armpit as a donor area because I just counseled a patient who wants to consider it as a possible donor source. Most armpit hair is coarser and can be even more coarse than the chest. It also tends to have a "kink" characteristic for many people that may not be like the charateristics of the chest hair and especially unlike the leg hair. So it probably would be best utilized for repair in scars and/or lightly blending in low visual impact areas. The emperical data is mostly based on chest-to-scalp although you too have probably heard of the few cases of leg, back, and yes even armpit regions. The problem for many is waiting on enough results to either support or negate the notion of utilizing these other regions of potential donor. There just have not been enough of those cases done with documented results good or unfavorable. So my opinion is to approach it with a small test session first before making any serious commitment to a larger procedure. Some doctors may want to confine their extractions only to the chest or back for the reasons I have stated. I am not that big of a proponent for leg and arm donor for three reasons. First, leg hair typically does not have the caliper of other regions. Second, you get pratically all single FUs and considering the BH graft prices, you get less bang for your buck. Thirdly, I personally would favor extractions into my body tissue in locations where there are less nerves and less moving joints. Good luck with your search!

Eastcoast, About a year or so ago I was told by several North American HT surgeons who do BHTs that the extractions from the body go much slower than the scalp due to the angulations of body hair FUs. I was informed that they can take as much as three-fold the amount of time to perform. That was one year to eighteen months ago. I would think that some of them would be a little more proficient with the added experience but their prices have not gone down. The North American doctors may have higher clinical related expenses like insurance and wages as well. Still when you compare the great quality that can be acheived for as low as $3.50 US per BH graft, that's a no brainer. But one has to travel to places like India which I feel is well worth it to get the quality and a good price. Nile, Since one of the best BHT surgeons is one of my contributing doctors, I do not advertise any of his links on these forums. I can in place give you my opinion on who I would personally consider for BHT procedures. Dr. AP, Dr. Ray Woods, Dr. Angela Campbell, Dr. Robert Jones, Dr. Allan Feller, Dr. Paul Rose. You can do a search on any of them for their information and corresponding websites. I hope this is helpful to you as I do not want to violate any of the forum rules. Best wishes!

Hi Nile, Welcome to the HTN forum! Yes BH is a viable option for repair work if you lack the scalp donor. Most HT surgeons who do BHTs prefer to utilize the chest area for donor due to a number of factors. Most of the initial emperical (clinically documented) research has been from chest extractions implanted to the scalp. Alot of patients have most of their body hair established in the chest area making it a useful donor reserve. The chest may have potentially more double FUs compared to primarily single FUs on the legs, arms etc. The chest hair may be more coarse in characteristics to the scalp. An assessment from an experienced FUE/FIT/FUSE surgeon would be best to evaluate your potential BH donor areas. There are not many surgeons in this arena and their BH graft prices have alot of disparity between them. I have seen BH grafts as high as $12 to $14 US in North America and as low as $3.50 US in India. Only a handful of them have posted examples of their work so scrutinize accordingly!

Michiganman, My guess and only a guess is that you are having an acute response to the steroids used and steroids from what I have learned do have a longer residual effect in the body. Saline solutions are often utilized in the injections to create the lift needed and it is the effects of gravity post-op that "pulls" the fluid downward into the facial tissue and eyes. Although you did not have this affect from your first procedure, possibly the one you just had employed higher levels of the steroid. Again I am only guessing. Most doctors I have discussed this issue with state that the typical post-op experience is approximately three days of swelling once it onsets. It should begin to dissipate after that time and as always there are exceptions. I have never heard of of acute swelling that lingered for over a month. I want to encourage you to even go to your PCP for an opnion and/or post your questions on the doctor-to-patient segment of this forum. Let us know how things turn out.

Phl, I agree with the opinion to not utilize any types of oil when you are within 8 - 10 days post-op. It is also important to keep the grafts hydrated or moist as much as possible in that week immediately following the procedure. That's part of the main benefit of copper-peptide, the active ingredient in Graftcyte, not to mention the advancement of healing time. But now you are a month post-op and obviously have a healed epedermis where these crusts remain. The reason they are now stubborn is because they have been there too long. Go ahead and use the oil as was previously suggested and if they are still stubborn, get more aggressive with your fingertips in the shower when your head is wet and suds enriched. Crusts are meant to come off once the epedermis is "healed" and that will make room for the new transplanted hairs to grow in especially after the next couple of months. Best wishes!

Hairboy, Yes the graft prices for BHTs are expensive in the US, Europe and even Australia. And you are correct in that patients who need reserves from the body may have a financial dilemma. Have you done much research on Dr. AP? His BHT procedures are some of the finest I have seen regarding re-growth and healing of the donor area (post-op appearance). FYI, he charges $3.50 US per BH graft right now which is the lowest world-wide that I am aware of. Best wishes in seeking your resolve!

Micga, Is a slower transition in density or new hair growth part of your concern? In other words are you trying to subtlely add more hair a little at a time so no one notices a more dramatic increase in your appearance? I have worked with several patients who held high visual/public positions and insisted on smaller sessions for a more gradual appearance transition. Some of them wanted to spread the sessions out over several years, to insure no detection and I am not referring to post-op redness, swelling, etc. Just appearance in coverage.

Qvarnis, Our donor area has limits in harvesting whether it is done by strip of FUE/FIT. Sooner or later the donor will begin to appear depleted if over-harvesting is done. The main advantage of FUE/FIT is there are no linear scars that show unlike a strip. FUE/FIT extractions can indeed pull additional grafts from above the ears which is typically terminal hair and of course the body. Qvarnis, I think your idea of a conference is a great one! Maybe you can start a thread on the subject to see some feedback. Let me know if you ever are in the US! Take care.

Hi Micga, Welcome to the HTN forum! Well you certainly make some good points about doing smaller sessions. Yes, there are a fair amount of folks who prefer a "slower" transition in their restoration without producing any dramatic changes to their appearance. It is a matter of personal choice. You should not be taking any real risks however if you chose a competent proven HT doctor and you do not have any other medical condition which would preclude you from success. Also, be sure your scalp is always tested for adequate laxity between procedures. What about the potential of future hairloss? Are you on Propecia (finasteride)? If you continue to lose natural hair, you will need more procedures in the future. Best wishes to you!

Kez, Great idea for the stubborn ones!

Eastcoast, I did not know you had the 2K FUE session! That should really help. How many grafts were placed in the front and did Dr. Jones utilize many singles in the hairline area? How long ago was your FUE procedure? I apologize if you already mentioned all of this previously in another thread. Thanks for your participation on this forum and I was wondering if your handle "Eastcoast" has anything to do with where you live. If you ever are in the Wash DC (Northern Virginia) area, give me a shout and feel welcome to stop by and visit anytime. You obviously have alot to share with having 5 procedures in 2.3 years! BTW, that invite extends to anyone else!

Interest, I agree with HBT's comments. Did you use a post-op healing product? BTW, when a graft does pop out, there is usually a small amount of blood that will trickle down showing a tiny "stream". If you did not have any bleeding when you removed the crusts, you should be fine. Best wishes to you and happy growth!

Joe HT, Now that's what I call "prudent planning". You obviously have done your homework very well. You know your limitations and also your resources including BH. Have you ever given thought to doing a "trial" procedure of BH into the crown? And I am referring to a small test session. Since your goals are realistic, and you want to simply add some level of density to the crown, BH may be your best answer and that way you can preserve the scalp donor for the front in the future. Your research surely is paying off for you Joe and best wishes to you. Keep us in the loop!

PHL, Good advice from HBT and Smoothy. At three weeks post-op the scabs are indeed ready to come off. Even as soon as 8 - 10 days post-op they are ready to come off "if" you use a post-op healing advancement product like Graftcyte. The best way to remove them now is by utilizing your fingertip pads and gently rub them loose in the shower while your scalp is enriched with suds. As Smoothy pointed out, allow your scalp to be wet for 5 minutes or so before you apply the shampoo and begin to massage your scalp to remove the crusts. What you are seeing is a combination of dead tissue and blood which appear as scabs. That's what "crusts" are, dead tissue above the scalp line. They are that part of the graft which protrudes above the scalp line after placement, then dries out and becomes quite hard when it is dry. By allowing the crusts to "soften" first in the shower, they should come off quite easily. Use warm water to soak your scalp, this will help the grafts to soften much better. If you had a strip harvest, it is also recommended to "gently" use your fingertips to clean the sutured area to keep it clean. Dried blood can collect between and around the sutures. Do not apply pressure to sutured area, rather massage it very gently with suds. The removal of your crusts will typically remove any dead hairs left in the grafts that have gone into telogen. This is a good thing because once the follicule goes into telogen, it will shed the hair left in the graft. If you do not remove the crusts, the dead hair shaft sometimes remains in the scalp and after healing of the dermis and epedermis, the body recognizes the dead hair as a foreign invasion and sometimes the scalp will begin to fester, develop tiny red bumps and/or pimples. If any hairs remain in your scalp from the grafts and do not come out with the crusts, it is confirmation that those follicules have not gone into telogen and will continue to grow in anagen. Eventually they too will rest and follow into telogen and follow their normal cyclical behavior. Best wishes to you and let us know how things worked out.

Hi Joe HT, Well it looks like you're coming up on your one year anniversary of joining this forum! Hope you have found the HTN as informative as I and many others have found it. How old are you? How long have you been on Propecia (finasteride) and minoxidil and do you feel it has been working efficiently for you, specifically the crown area? I am glad to read that you are waiting for the stabilization in your crown before you move forward. Like mine, your color contrast is wide so the diffused thinning is more noticeable. You also appear younger in your pic (under thirty) and by your established pattern, you appear to be headed for a Norwood 7 especially if you were to stop the meds or if they were not proven efficient for your case. I certainly wish you the best with your medicinal regimen. Did your prior HT procedure place all of the grafts in the front and how many were done? You also mentioned a desire to add to the front again even though your "present" concerns are for the crown. From your one pic, your crown area will demand alot of donor unless your meds keep the loss where it is right now. But that's only part of my concerns for you. My apparent concerns are two-fold. The first is potential shock-loss to the area. If you do permanently lose the diffused natural hair from a procedure, more demand will be placed on your finite donor that is left and there may not be enough for the future, especially the front, where finasteride and minoxidil are not efficient. Though hard to tell from your pic, I presume a fair amount of the hair in the front is still natural but subject to future loss. So if you do lose more in the front in the future, your present concerns could shift dramatically as you get older. Only you can decide for Joe where your ultimate donor reserves will be dedicated and you are correct in not getting too aggressive in the crown. I would just not want to see the shockloss and then have matters worse in your crown area and then having to chase it. My second concern is the thinning in your donor area I observed from the neckline going upwards into the donor zone on the right side. Is this shockloss from your last procedure? I hope it is because it should grow back. I am hoping it is not "retro-alopecia". Retro-alopecia is hairloss that affects the donor zone but commences from the neckline and moves into the donor area. I have observed this on approximately 3% of men, higher in women. Some of the older men (50 and above) that have this condition see it impede above the ears as well. Did you have this thinning before your transplant or did your HT doctor comment on it at all? Again maybe it is shockloss thinning, but either way you want to know for sure before you decide on doing any more procedures, and you will want several opinions which you can probably accomplish by pics. I am hoping for the best in your situation.

Hi Methodical, Welcome to the HTN forum! No one can answer your question "is hair transplant surgery right for me" than you yourself. Please allow me to explain. A decision to undergo a HT procedure can only be made from an "informed" basis. You must be aware of "all" of the options available for treating hairloss including medications. A HT procedure should be your last consideration "after" you have explored what might be best for you and only you. I want to encourage you to first consider your age. If you are 25 years of age or younger, surgery should be out of the question. Why? Men who are that young really have no idea where their hairloss is headed. And many of us have observed over the years that the earlier hairloss starts in men (late teens, early twenties), the more potential for advanced hairloss to occur later in life. Consider your family history in that if there is advanced hairloss on either side of your family, it could very well happen to you. None of us want to experience this level of hairloss, but it is a genetic trait we receive from our blood relatives, something we have no control over. Please understand I am not insisting that you are going to have dramatic hairloss, but family history is part of the facts to consider. Genetic hairloss does not occur all at once. That's why the younger one is, the better chances one has to utilize medications like Propecia (finasteride) to help in slowing down this hairloss. Propecia is effective in approximately 95% of the men who take it for a year or longer and has very little chances of side-effects. It does require a prescription to get started so you will want to see a doctor, ideally a HT doctor or dermatologist, one who is experienced in treating hairloss. The very first step is a clinical diagnosis of your hairloss. Most of us assume that our hairloss is genetic but there are other causes that may not be genetic. It is very important that you know for sure that you have MPB and possibly you have already done this. Hair transplant surgery can be very successful in the hands of a good competent HT surgeon. All of us should know the pros and cons, the benefits as well as the risks associated with it. And we should know what type of candidates we are for a life-time consideration. Remember, the available donor we have is limited yet genetic hairloss is a life-time event. That is why the more natural hair that we can save now, the less surgery we will need in the future, and hopefully have enough donor for the areas that we cannot save. After considering all of the facts along with your own situation, then and only then can you decide if HT surgery is right for you.

Old Baldy, Yes I sure agree with you that there has been far more scientific research done especially in the last three years than ever before and I do feel we are closer to realizing it. You and I are possibly closer in age and it may not be in our lifetime, who knows. It's the younger patient who may be swayed by all of the publicity, get a little too aggressive because he is hanging his hat on HM for future resources and then run out of donor before HM is actually available. Every now and then a younger fella will tell me that he wants to build a thick, dense frontal hairline and forelock. And then he further states he is going to use HM to fill in the mid-section and back. I always ask them if they have their HM session scheduled or who the doctor is that is going to do HM on them. They often look perplexed at that moment and blurt out something like "it's all over the internet". So as you can tell, I am cautioning many folks to wait for the emperical proof "before" they hang their hat on something that has not yet arrived. Mr. Invisible, Yes HM would be most beneficial for those who have the potential for advanced hairloss "including" women, and yet desire "full coverage". It would also be very practical to the patient who "has" the potential to lose alot of hair but has not occured yet. They could do HM along the way so to speak and maybe never have the appearance of any hairloss. It will also be helpful to those with "low" densities.

HairBeThere, Man I wish I had the knowledge back when my hair first started falling out too. I eventually ended up as a Norwood 5 wearing the ole' hair system for a decade or so. The technology just was not any good in my early hairloss days. Hey my friend, things have come a LOOOONG WAY, and now we can help many other hairloss sufferers as we both share our knowledge and experiences with them so hopefully they won't have to go through what you and I did. And obviously we have many friends here in this forum who have walked in our shoes as well and who also have alot of heart for people. So let me thank you personally HBT as I have learned from your posts. I have seen you address some folks here, with a very level head and practical solutions. You seem to relate to peoples' emotions without losing the real issue. Keep up the good work!

Hi Edmond168, Welcome to the forum! After reading your post I was wondering if the hair in your crown area was diffusing and/or thinning. It is not very noticable in the beginning stages and it is very possible that trauma to your scalp resulted in some shock loss to the crown rare as it is. Diffused areas of our scalp are the most sensitive and responsive to trauma caused by the incisions. The fatter less diffused hairs may very well cycle back to the anagen (growth) phase but every time a hair follicule fulfills its three phase cycle, it comes back weaker and more disseminated when subject to DHT. That does not happen to terminal hair. This is where Propecia as HBT pointed out can be of great resolve unless you are already ingesting it. The crown area is that part of the scalp where Propecia (finasteride) is the most efficient. Your HT surgeon can prescribe it for you if he/she has not done so already. Did your HT doctor examine the crown area for possible diffussion?

That's a plan Brando!!!

I say we meet at Robert's for a cookout! I'll do the cooking and maybe the state of West Virginia will grant temporary leave to Martha Stewart who can give us some good tips on which pharmaceutical stocks to buy! Just kidding!

Old Baldy, We all of course hope you are correct about HM being the "norm" of the future, however emperical verification must exist on what scientific studies claim no matter who conducts them. To date we have only heard of claims and some have been promising the moon for decades. So my advice to anyone in the Norwood 6 and 7 categories, and yes maybe even class 5, DO NOT HANG YOUR HAT ON HM OR CLONING. Wait for the proof in the pudding and in the meantime, plan your restoration on the active donor that you have at present, not something you are wishing for. Best wishes to all.