gillenator

Eastcoast, I have formerly used Toppik to disquise my hairloss in the past. It is difficult to utilize on the hairline unless you are very slow applying (tapping) it. It is the most natural appearing cosmetic product I have tried. Have you ever considered FUE/FIT technology to thin out those plugs? Best wishes to you.

Hi Onebaldman, It sounds like you about four months post-op so more should be coming. 40 grafts out of 50 growing is remarkable and by your pic it looks like it is coming along fine for only 50 grafts! That's 80% re-growth. Keep us advised of your progress and we really appreciate the photo. Congratulations!

Corey, I agree with Robert. Give it some more time and more new growth should be coming soon. Keep us advised on your progress and hang in there.

It certainly does not impress me with any credibility. High emotional theme with very little data provided and the ad is structured to produce a high volume of contact. No doctors mentioned, no affiliations, nothing. And chances are that's the value of the ad, nothing. Be very skeptical of this type of advertising.

Dr. Feller is one of those surgeons who gets better and better. Read about some of his clinical findings with FUE and his on-going innovations in FUE instrumentation. He is definitely a top-notch HT surgeon continually trying to improve every aspect of the procedure. I also like his website!

I have been following Dr. AP's work for some time now and he is undoubtedly one of the best FUE surgeons world-wide. A short time ago I received an e-mail from him regarding my posting on the forums and in our continuing communications find him to be a very ethical and genuine individual. I have been very impressed with his passion regarding not only FUE technology, but also his obvious care for his patients. Does this not sound like Dr. Paul Rose? There are many others that I hold this level of respect for in their surgical talents as well as sound character. Thank goodness they are all out there. I just wanted to announce that Dr. Poswal advised me today that he has offered his financial support toward my efforts in the forums to assist and educate patients in general. He has made it clear that he is doing this to make a contribution of informational support to the hairloss community as a whole, not for the purposes of direct advertising, nor the recruitment of patients on any of the forums. Please note that I have added Dr. Poswal to my signature for disclosure purposes, however there are no related links to him nor do I have any to Dr. Rose. Dr. Poswal will be offering informational seminars in the US in the future and I will be assisting him with that when he is ready to visit us. He sincerely appreciates the comments regarding his work and all of the other aspects of hair restoration. Best wishes to all!

I have been following Dr. AP's work for some time now and he is undoubtedly one of the best FUE surgeons world-wide. A short time ago I received an e-mail from him regarding my posting on the forums and in our continuing communications find him to be a very ethical and genuine individual. I have been very impressed with his passion regarding not only FUE technology, but also his obvious care for his patients. Does this not sound like Dr. Paul Rose? There are many others that I hold this level of respect for in their surgical talents as well as sound character. Thank goodness they are all out there. I just wanted to announce that Dr. Poswal advised me today that he has offered his financial support toward my efforts in the forums to assist and educate patients in general. He has made it clear that he is doing this to make a contribution of informational support to the hairloss community as a whole, not for the purposes of direct advertising, nor the recruitment of patients on any of the forums. Please note that I have added Dr. Poswal to my signature for disclosure purposes, however there are no related links to him nor do I have any to Dr. Rose. Dr. Poswal will be offering informational seminars in the US in the future and I will be assisting him with that when he is ready to visit us. He sincerely appreciates the comments regarding his work and all of the other aspects of hair restoration. Best wishes to all!

Smoothy, Staples are being favored more and more over sutures due to the fact that the metal does not allow for stretching generally speaking. It is sometimes viewed as an extra precautionary measure to hold both sections of the scalp togethor after the strip is excised. I knew of one HT surgeon who always used staples on patients who would have more potential for a raised scar or wider scar. Possibly laxity was an issue too. I think alot of folks opt for the sutures or melt-away sutures if they traveled far to get their procedure done or it's just more comforting in one's mind that thread was used to close the area vs metal staples. If staples were used on the traveling patient, they can be removed by another doctor quite easily and it does not have to be another HT surgeon to remove them. I'm with you Smoothy, whatever produces the best result.

Metro, When you say shaved I presume you mean the Michael Jordan look, shaved to the skin. Otherwise there's certainly lots of potential to buzz-cut down to a number two guide once enough healing has taken place. If you think there's a good chance you would shave down to the skin, I would save your money on a HT unless you want the option of having hair and not having it someday. Honestly, I have not seen but a few guys shave their heads after their HT procedures. A very high percentage grow their hair to two inches or more because it's so nice to see what you have just paid so much money for and what's been missing for too long, HAIR.

Mathew, First of all I want to congratulate you on choosing one of the best FUE surgeons in the world, Dr. AP. Dr. Woods did the hard evidence research on chest to scalp BHT procedures whereby he concluded in his case studies that when chest hair was moved to scalp, it grew "longer". The reverse was also true. When scalp hair follicules were moved to the chest, they did not grow to the length that they did in the scalp. Many of the FUE surgeons then preferred the chest because it had the "emperical" data to back it up. Chest hair also parallels scalp hair characteristics better as it is generally more coarse, though not always. I read that you did 100 BHT grafts which would equate to approximately 100 hairs "if" they all survived. Body hair is established primarily in one hair groupings so one of the primary benefits of utilizing your scalp first is that you typically get twice the hair count, if not a little better from scalp grafts. More hair, more coverage. Now Dr. Arvind has probably the cheapest FUE graft pricing and he is a top notch surgeon, however for those of you considering BHTs in the US, the price is as high as $12.00 US per BHT graft. One can get strip done with a good surgeon as cheap as $3.00 to $4.00 per scalp graft and be able to triple or even quadruple their coverage. The thing that gets me is the patient who has done their research very well but "just cannot afford it". Man, I talk to MANY guys who are divorced, supporting their kids first, and never have enough left to save nor the ability to borrow funds for something very important to them. And then there are guys who do most of their coverage by strip and know they can add FUE later and even implant into their scar. So economics does play a major role in their decision even if they would opt for FUE/FIT. Now let's discuss the behavior of a BH follicule. I am happy to hear that alot of your BHT grafts continued growing in anagen. Just know that some of them did enter telogen due to the trauma factor alone. BH follicules can remain in telogen for up to 18 months when they do cycle compared to the average telogen duration of 3 to 4 months with scalp follicules. My heed to you is to use BH as a back-up or reserve as Smoothy so well put. WHY? If too many of your BH follicules go dormant at the same time since they were transplanted at the same time, you could end up with what appears as some uneven density, especially if too many BH grafts are placed in the front forelock. I AM TOTALLY AGAINST USING BH ON THE HAIRLINE. One other thing is that although the BH looks parallel in characteristics at a shorter length, that does not mean it would not "kink" or "curl" once you let it grow longer. I am not saying it would but I have personally seen this happen even when the donor was from the scalp. Possibly you will always wear your hair at two to three inches if you desire to do so. We really have to be careful whenever we imply that there will never be enough scalp donor to satisfy someone because that is simply not true. And 5,000 grafts can work miracles on lots of patients which I am sure Futzy would agree with. It's a matter of hair characteristics, donor density, recipient surface area, and the patient's goals. The avearge individual bears approximately 50,000 hairs on top of their head. If you were completely bald on top, 20,000 grafts at 2.15 hairs per scalp graft average would get you approximately 43,000 hairs IF they all survived and they obviously all do not. However if you utilize a fair amount of BH grafts your total production of hairs will go down significantly. Trust me on this. You won't need that much coverage. Wait and see. Here's the big issue though. 20,000 grafts whether from the body or scalp will create 20,000 incisions in the top of your head. Have you ever heard ethical HT doctors mention that it is virtually impossible to get that level of density? Think about it a minute. How much would the blood supply and flow be compromised to the recipient area? Every time another pass is done through the same recipient area to gain density, some compromision of blood occurs due to the scar matter that is formed in the healing process. The scalp is amassed with a capillary system of blood flow. These capillaries are intregal in delivering blood to the follicule. Although they do heal, it is not and I repeat not the same environment of blood distribution "before" the recipient incisions were made. Create more incisions later, more scar matter develops in addition to what is already there from the previous procedures. If a follicule loses it's blood supply, it will perish. Our bodies do not regrow tissue or flesh when severed or damaged. They formate scar material to fill in what was taken or missing. All I am saying is step back, think about your goals as you age like Smoothy stated and approach your restoration in a methodical way that will produce the results you will be happy with "as they happen." You'll never know until you see it grow! That way you will only sustain whatever trauma and scarring that is minimally necessary and promote the best yield that you can. Best wishes to you Mathew!

Smoothy, Your welcome! Yes, Tricomin is a Procyte product and I use it every other day. It is the Graftcyte spray and shampoo that are utilized for surgical procedures to advance healing. They are two of the components in the kit I referred to. You should be able to purchase their products on-line or from one of the hair clinics. The clinics seem to charge double what Procyte does on-line. Best to you Smoothy! Robert, Thank you for all of that information especially the dietary foods and supplements. I think I will start adding more of the food items into my diet as I always prefer natural supplements. We'll all probably feel heathier too! Take care!

Hi Whoops, First off, great photo quality with adequate lighting. We all appreciate that. And only 7 1/2 months out? That's very good my friend. What a difference in the before and after pics! My guess is it will look even better with a little more time. In average lighting, it will hardly be noticeable and the redness should also improve with time. That can take up to one year or so. By all means keep the pics coming because that is some good work! Are you going to work the other areas of the scar in the future? Best wishes to you!

Anthony, Finasteride, has been applied for treating the prostrate for many years with very little complications. It is this same active ingredient, finasteride, that Propecia contains. The difference is that Proecia was in fact developed for treating MPB and is at a much lower strength of 1 mg per tablet. The reason eithical doctors like Dr. Shapiro recommend Propecia so strongly is because it has and continues to be the most clinically effective medication available for men who wish to slow down their hair loss. It has a 95 - 97% efficiency result in men across all ethnic classes. Potential side-effects though never desirable, are at very low levels with dissepation of those effects in most men who continue with the drug. You can read more about Merck's controlled clinical trials with Propecia at their website. Here's the key to retarding the ill-effects of androgenetic alopecia (MPB). Until one deals with the rampid levels of DHT in our system, we will continue to lose hair. That's what finasteride does, it deals with the main source of the problem. It's pharmacology classification is a specific hormone inhibitor. A very small percent of men have not experienced good resolve with finasteride and have gone to other prostrate medications like dutasteride which effectively blocks both Type I and Type II DHT. There are no FDA approved products which contain dutasteride for treating MPB and the potential side effects can be even less desirable. Hopefully some of the other guys in this forum can comment on Shen Min or Procerin. I personally have never tried them because I do not see the clinical efficacious results nor any emperical data to support their use. A friend of mine who is an MD and researches homeopathic medicine advised me that Rosemary Extract was an herbal method of blocking DHT but again, no clinical conclusions or trials to support it. He also said it was very pungent in odor so again, not an option for me. IF finasteride were a newly discovered medication, I too would probably be more concerned about its long-term use. It's been around for years and considered very safe especially at the lower doses. Either way, I wish you the best!

Smoothy is right on target as usual!!!

Bana, Copper peptide "advances" the healing of the soft tissue in a culminated moist environment which help reduce the formation of scar matter by promoting quicker healing. Copper-peptide is utilized in burn units in hospitals for those very reasons.

Smoothy, Great research and post on this topic. It's so assuring to know there are individuals like you who do your homework and then share it with the rest of us. In my last two procedures I utilized Procyte's post-op wound care treatment which comes in a kit. They are Graftcyte products which promote soft tissue healing in the scalp. There are 3 days supply of moist dressings that are applied to the recipient area twice per day. There is a bottle of Graftcyte spray which is applied to the recipient area between dressing applications. There are shampoo and rinses and even an ointment rich in copper-peptide which is applied to the suture line. It's probably the best post-op package available for HTs. I also use their shampoo product, Tricomin, which is a revitalizing product that contains the essential triamino copper nutritional complex. I first use a cheaper but good quality shampoo to clean the spray and oils in my hair. Then I apply just a small drop of Tricomin in my hands and apply it to my scalp where it suds up tremendously. I allow the suds to sit on my head for 5-7 minutes and rinse off. The complex is absorbed by my hair cylinders and subsequently delivered to the dermal papilla inside the hair follicules. The big difference I notice is my hair cylinders feel "stronger" and look healthier versus the past shampoo products I have used.

Robert, Yes, you indeed are absolutely correct regarding the telogen follicules and you hit on an area that most of us do not think about. Both strip and FUE have their discarded waste and any way you look at it, there is more than 10% waste "thrown" out in the biohazard waste bucket! One of the big issues with strip is "time out of body", whereas the strip specimen is removed and then passed to the surgical team for dissection. A process known as ischemia reprofusion begins whereby free radicals begin to magnetize to the tissue which simply lies in saline to keep them hydrated. All the while and sometimes for hours, the tissue begins to deteriate and reduce potential for survival. The quicker that grafts are placed in the recipient area the better, however I have heard and seen the "assembly lines" where the clinic has multiple procedures that day, but few experienced techs who cut the tissue into grafts. Henceforth they jump from OR to OR and the tissue and cut grafts remain in the dish, sometimes for hours. This is not an ideal scenario so stay away from the assembly lines, and do not enroll with anyone who is more interested in how much revenue they can generate in one day in multiple patients. FUE is supposed to boost the yield because the extracted grafts usually are placed in the recipient area within seconds of extraction "unless" more single hair grafts are needed and then the extracted FU still has to be dissected. Robert, you are also correct in your reference to the angles and "j" formations at the base of the hair sheath in the dermis layer where alot of potential transection can take place. Does everyone see now why the 1mm punch is favored? In addition, the standard stainless steel punch does not allow the graft to slide out very easily so "crimping" of the grafts can take place. Some are so bad that they are often damaged when an attempt is made to remove them from the punch. Dr. Feller's punches have an interior wall which I believe can be removed allowing the graft to easily slide back out of the punch. Dr. Rose' dermal depth analysis allows his punches to precisely set the depth of extraction to minimize transection vertically speaking. I can only speak for myself Fabe, but yes from the many cases I have seen, and in my own personal experience of three strip procedures, cost is favored with strip, transection is far lower providing the surgeon and the techs who cut are good and they are properly staffed. Many FUE docs agree with this assessment as well including Drs. Rose and Feller. Dr. Rose has mentioned to me several times that strip is still the best yield when a patient is in the right competent hands. Most HT patients that I have experience with do not buzz cut their hair once it grows out, including FUE/FIT patients. The fine scar in my donor area does not bother me in the least because it is always covered and I never intend to shave off the hair that I so painstakingly waited to get back! I have had just over 4400 grafts in my lifetime and the last thing I'm going to do is cut it all off. That does not mean what is right for me is right for the next patient who may want the buzz-cut style. Either way, patients must understand that you cannot have your cake and eat it too with hair transplants. When you harvest hair from an area, the outcome is less hair either way you look at it whether there is a strip scar or the dots, spots, whatever. The recipient area gains coverage and looks better and more restored because it is indeed hair that covers the scalp. Most of us if not all of us get hair transplants to improve coverage where there is little to no hair left. That's the premise behind the procedure for most of us. Unfortunately there will be some level of scarring in either approach of harvest so each and every patient must think ahead and then decide which method best serves their goals. Smoothy, there are many, many patients who are on the sidelines with FUE. They just have not seen enough consistent results because as you said, it is still relatively new technology. If it were me as a new patient and needed lots of coverage, there's no question that I would favor strip to get the best yield and corresponding coverage. I could always go back and get hair placed in the linear scar as many FUE doctors claim a strip patient can do right? Still it is a personal decision for every individual. Best wishes to all!

Guys, All of you are right on target! And I do believe that the proliferation of dense packing hype is more marketing driven than clinical based. I have always encouraged patients to initially approach up to 50% density levels for adequate coverage. It is very rare that someone would need more to produce this "illusion" of coverage. Why over commit when the first pass has not even grown out and matured? Density can always be added to in a subsequent procedure. Can too much trauma to the scalp affect yield? YOU BET IT CAN! That's why I am not a big advocate of megasessions.

FUE is the abbreviation for Follicular Unit Extraction and FIT is Follicular Isolation Technique. Both technologies are based on a harvesting method which removes FUs independently from the donor area without utilizing the traditional linear strip harvest method. In other words, this is sutureless technology or so to speak whereas a micro-punch is used for the extractions. The result after post-op healing is supposed to be "no visible" scarring in the donor area. The technology is in some regard like the old punch-out graft approach except the punches are much smaller. Most of the standard punches used by FUE surgeons measure 1mm in diameter which is quite a difference from the larger punches of the stone-age plugs. Some FUE surgeons have tried punches at .75 mm and I even heard of an attempt as micro as .50 mm. I too have been keeping a watchful eye on this technology and I have seen many patients both in pics and in person. I have seen some great results in donor area healing and a few with in my opinion, not very good results or what Smoothy referred to as an over-depleted appearance. Arfy is correct in that the amount of donor rarely meets the demand side, if ever in a lifetime. I believe most FUE/FIT patients choose this technology over strip for the reasons Smoothy mentioned but also for the benefit of not having a strip scar that would show in the donor area if one were to cut their hair very short, number one guide or a shaved look. Anyone who had a bad result resulting in a wide strip scar can relate to this. As many of us know, FUE/FIT technology is being utilized more and more to implant hair into scarred areas where laxity no longer exists. Body hair extractions are being used to fill-in scars and to do other repair work. It seems whenever a FUE/FIT patient posts there pics, there are "varying" opinions. What one sees as magnificent work for post-op healing, another sees spots or redness, over-depleted areas, etc. Just read the comments whenever someone posts their pics and I was not necessarily referring to this forum. FUE/FIT may end up being the answer for the young patient over 25 years old who really has no idea of where his hairloss is headed and may end up buzz-cutting their head someday. Obviously he would not be able to do this with the linear scarring left with strip or could he? Could he later go back and have the linear scar(s) filled in with FUE/FIT? Or could the FUE/FIT patient who had 3,000 to 5,000 scalp grafts extracted and possessing a "wide" color contrast be able to shave their head and not have what appears as a patchy or moth-eaten appearance? Here's the burst in the bubble. Where are the clinical evaluations and findings regarding re-growth?!? Who is tracking the yield with some hard core proven reliable data? The biggest area of risk in FUE/FIT is TRANSECTION! In the hands of an experienced, skilled FUE/FIT surgeon this should be minimal and the good ones claim 10% or less. Based on what? That's the part we never hear or rarely hear about. I CAN tell you that punches under 1mm in diameter have proved to be disasterous regarding transection! Even the most experienced FUE docs like Dr. Feller will advise you that strip harvest WITH dissection of FUs under scope provide the lowest transection rates. And as Arfy pointed out, DONOR IS FINITE. Dr. Feller is continually looking for ways to improve transection and continues to improvise the instrumentation as is Dr. Rose with dermal depth analysis, and Dr. AP with donor area sealing, etc. All three of these FUE/FIT surgeons have produced some phenomenal results (scarring and yield) so like anything else, results speak for themselves. Drs Woods and Campbell also do very good work and pioneered the technology. FUE/FIT is very time intensive and typically costs twice that of strip so one has to really weigh all of the benefits of both approaches, strip or FUE including the cost implications. Dr. Poswal charges as less as $3.00 US per FUE graft and is located in India. He wrote me the other day and would like to do some seminars in the US however that will be some time in the future as more interest manifests in his work. Patients with what is considered as a "mushy" derm, DO NOT make good candidates for FUE/FIT procedures and are better off doing strip. Patients with a "tight" curl characteristic run a high risk of unacceptable transection levels. My advice on BHTs? Doing smaller cases seems to be the prudent approach especially when there is little to no published reliable data in this arena. BHT grafts can cost as much as $12.00 US per graft. OUCH! Can you imagine if the yield was poor? DOUBLE OUCH!! The patients must decide for themselves which approach, that being strip or FUE benefits them the most. I do believe this technology has its merits but so does strip and I do not believe it is a one or the other issue. They both have their place providing the patient chose a competent surgeon.

Some great advice from Smoothy!

Thanks Robert and Kez, I just hope Jenn gets a chance to read everyone's comments. There is a genuine comradre here at HTN that I as well as many of you appreciate. Thanks again.

Texas NW2, Well I am glad to hear that your donor scar is thin! Can you not simply allow adequate length in the back to hide it? If it is that thin, you should be able to get by with a number 2 cutting guide.

Dear Jenn-24, My word. Life is anything but easy. I really appreciate your post and I remember when I was diagnosed with Polycythemia approximately four years ago. When I first received the news and arrived back home, I started with the "why me?" scenario. First I was totally shocked, then angry, then depressed, and that left me afraid and scared of dying. I have so much to live for, my children, my family, my friends, the work I am involved in, and I especially wanted to be there for my only sister who was recently diagnosed with breast cancer. What changed my attitude? This condition I have requires routine therapy and I see ALOT of folks who do not have much time left whenever I have treatments or whenever I go in to see my hemotologist. Although my condition is treatable, it is not curable to date. Still there are so many individuals far worse off than my situation without hope. The key for me is to live my life's purpose and be true to myself. My purpose is to help those I can, be a true friend to those I am in friendship with and to live with the conviction that every human being has feelings and value. Life is very rewarding when we seek the best for others "and" ourselves. As tough as life can be for any of us, please do not feel that you are being selfish for wanting some hair back. And there is only so much we can do for others. Obviously hairloss has bothered and continues to bother many of us. BUT, as long as you are at peace with Jenn, and having the heart of gold that you obviously have, I think it would be great to do something for yourself. WHY? You are worth it because you too my friend are invaluable and so are your feelings. I really do not think people understand the psychological impact hairloss can have on those who lose their hair. My 100% proud Irish father whom I respect to the nth degree would comment to me, "there's nothing wrong with going bald, just be proud you are Irish!" My father of course has a full head of hair. I love him dearly, he just does not understand because he has not walked in my shoes. Many folks think that getting a hair transplant is vanity. I TOTALLY disagree. Why would wanting back what mother nature gave us vanity? We were established with hair and subsequently lost it. There is nothing wrong with wanting it back any more than an individual losing a limb and wanting it back. Jenn, if getting some hair back will make you feel more complete, GO FOR IT providing you are a candidate for the procedure of course. I bet if this man with the terrible burn situation was your friend he would say, Jenn by all means if you can obtain resolve, go for it. He of all people knows what it is like to lose something and I sincerely hope he has more potential for improving his appearance. Just be sure that you have the donor to fulfill your long-term goals. Well Jenn, stay in touch, you have many friends here. My mother had dramatic hairloss from an early adult age and so I can relate. Feel free to e-mail me anytime and I wish you the very best in life.

Hi Black_Hole, It is difficult to give you much feedback without having pics or more details about your case. What Norwood Class are you? What are your hair characteristics and just as important, what are your goals? The surface area you want restored needs to be measured once your new hairline placement is established. You mentioned having a "clean" head so I am assuming you meant no existing hair left on top of your scalp. How much of that area are you seeking to restore? There are many, many single hair grafts utilized in starting a new hairline with the larger grafts placed behind them so if you are in an advanced Norwood Class, count on several sessions providing you are looking for some good coverage. Have you started a medicinal regimen like finasteride to slow down future loss? If you do have some natural hair left in the vertex and crown areas, you may want to consider it otherwise you will undoubtedly need more work as you lose more natural hair in the future. All three doctors you mentioned do very good work so I am sure they would "fine tune" your graft count on the day of your procedure. They would more than likely refund you for any overage of grafts you enrolled for in case the count was too high. Obviously you have been doing your research based on your selection of HT surgeons which I commend you for!

Qvarnis, You mentioned that you had 2800 grafts already and it sounds like you want either additional coverage or more density to what is there now. Futzy has outstanding hair characteristics and remember you are looking at photos vs seeing him in bright light. Either way yes 5,000 grafts can do miracles in providing most folks good coverage. So if you want more, that is your personal decision and it sounds like you have enough donor for it. We can never assume everyone has the density and/or laxity to accomodate 5,000 harvestable grafts however most patients do have that many starting with a virgin scalp and having the work done by a good HT surgeon who will minimize transection. There are patients however who have already progressed to NW6 & NW7 and would potentially need more than 5,000 grafts but lack the donor to fulfill coverage front to back. In other words there are patients who have much larger recipient areas to fill in, but may not have enough donor/density to attain the coverage they would ultimately want. You want to get examined in person, have your donor density re-calculated, laxity re-tested, and then explain your goals to the surgeon. A good experienced HT surgeon will then provide you in what he/she feels is the graft count to achieve your goal based on "your" hair characteristics. And of course providing you have the laxity for it.