gillenator

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.

Hey Robert,

Some good reflection on life my friend! You know, I used to think am I the only one who feels naked without my hair? Are we concerned about what others think of us especially our appearance? The answer is yes on both points for many of us.

There seem to be two classes we can fall into that society tends to view as something abnormal. That is over-weight people and those missing their hair. Many over-weight folks feel less worth than those who are thin and eating disorders run rampant in our society. And some will nearly starve themselves to death desperate to be thin. They even start seeing things in the mirror that others do not see. Some end up in fatal situations. And when we hear about them or see their photos we think, my word that person was skinny as a rail! But the victim did not perceive themself that way. When I was diffusing badly and at times asked for opinions, some would say "you have lots of hair left, you're just thinning a little bit". Maybe that was their opinion, maybe they were just being kind to me. Either way, what I saw in the mirror was a dilemma I was desperate to change, even to the point of wearing hair systems for 11 years. Still I did not feel complete until I was able to obtain some decent coverage in three procedures to where I now enjoy a restored look unless my hair is wet. I can deal with that!

The young attorney you mentioned is probably somewhat affected by his hairloss which is probably why he wears his hair cut so short. Yet he may think well there's not much hope in getting his hair back to where it used to be so he may choose to just cut it all off. And why not, he has a beautiful supportive wife who may be rubbing his head in a sort of intimate way which subtlely shows her support of his balding. And it sounds like he has alot going for himself and to be thankful for, but I bet deep down inside he would like to have his hair back. None of us want to openly admit that our hairloss makes us feel less than complete. And the fella with a full head of hair probably takes his hair for granted.

Sometimes it takes a loss of something near and dear to us before we can really appreciate what it is like to lose it. This is true in many other aspects of life. It's a real personal issue. But if hair restoration causes or helps us to grow individually including our confidence, than it can be a good thing. Although hair restoration can never replace that special character inside, it can indeed help open the social doors that we felt were once closed because of how society views appearances. Robert, maybe this guy had a full head of hair when he met his wife who was his girlfriend at that time. Now for the magic question. Would she have still been attracted to him had she met him when he was already bald? It is something we will never know. Would he have the same confidence level to have approached her without hair? It is very interesting to see how dramatic our view-point can change with just a little turn of events. Many of us are subject to changes in our social status with divorce unfortunately ranking high. Hair restoration provides many folks a new lease on life socially speaking, AS LONG as we understand that our inter-action with others is still based on our character and our inter-personal skills because hair can never replace good character.

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.