gillenator

Hi Dude1, Body hair has entirely different characteristics than scalp hair. Most BH is extracted primarily from the chest and back as these regions tend to produce characteristics closer in parallel to scalp hair. Still they are not the same. Also, body hair follicules can remain in the telogen (resting) phase for much longer periods than scalp follicules and can in some cases take as long as 18 months to visualize some of the growth. In addition, the emperical evidence for the most part originates from Dr.s Woods and Campbell utilizing chest to scalp cases. Their practice has performed more BHTs than anyone else I am aware of. Most of the remaining surgeons who have done BHTs are more reluctant to utilize leg and arm hair simply because there have not been many cases done from those donor regions. The hair in those regions tend to be of thinner caliper as well. Body hair is established in mostly single and some double hair FUs, so it's tough to get the bang for your buck (coverage)so to speak. There are no long term studies or clinical trials published regarding the survivability of body hair to scalp that I have seen. Generally speaking, BH is considered as a "last" resort of donor supply and utilized in repair work (scars), and fillers to blend in with scalp donor. I would NEVER consider BH in a high visual impact area, like starting one's hairline, etc. But I have myself personally seen blending of BH growth in the crown area. Lastly, consider contacting Dr. Arvind Poswall who has some depth in this area. His FUE work is impeccable and he does have very fair pricing compared to the pricing of BHTs in the US. I believe you would receive a very honest assessment from him. He and I have corresponded on several occasions and quite frankly I have been impressed with his clinical findings and convictions inclusive of donor sealing which minimizes visible scarring. He is also "publishing" his results with pics! Best wishes to you!

Corey, Some folks sprout more early and some are late bloomers so to speak. You should begin to see some new growth any day and into the fourth month, so hang on! Keep us posted on your progress.

Finasteride takes at least 90 days to "effectively" begin the inhibition of Type I DHT. And I agree, stay with it for at least one year to accurately evaluate its efficiency. Finasteride is effective in approximately 95% of the men who ingest it inclusive of all ethnic backgrounds.

Mr. Invisible, Do not take this wrong, but "hearing" and "seeing" are two different issues altogethor. Yes there is much being said and discussed but I for one am waiting for the "proof" in the pudding which I have been waiting for nearly twenty-five years now. I would not bet this to be viable for quite a while yet, and I truly hope I am dead wrong. Do you not have your own donor supply?

That's the dilemma. There are no guarantees about any of this. We do not know what extent our hairloss might be, how we will respond to medications over the long term, etc. That is why initially a more conservative approach is always better. Let me explain. If one's family history depicts let's say mild to medium hairloss in the men, say no one more advanced than a Norwood 4, that is an "indication" and nothing more of another male's potential hairloss within the same family. In other words if no other males within the family had more extensive hairloss why would yours be more? Does that mean it could never happen? NO. As I said it is only an indicator. So it is more advisable for one to conclude that yes hairloss runs in my family, none of the men hit class five through seven, but since there is a chance I could be the first one, I better keep my hairline a little higher, not get too aggressive in the lesser visual impact areas, and always leaving a "reserve" for the just in case later on in life. I have seen men just start to lose hair in their early fifties. Hairloss is unpredictable. So anyone with massive diffused thinning, extensive hairloss earlier in life, less than average denisities, Ludwig pattern of thinning, etc should do some very careful planning for their lifetime appearance. Try to think of the areas of restoration that are most important to you. Most of us start in the front forelock including a frame to our face. Then, if things go well and you seem to continue to respond well to medications, you can always add more later. Also have the sides (lateral hump areas) examined in the future to evaluate just how far miniturization is impeding into those areas. So if the worst should happen, more extensive hairloss than you predicted, at least you have "some" reserves left in case you do sustain more recession in the rim areas or anywhere else later in life. We can still enhance and improve our appearences even if we do not have a home run situation. It is a personal decision we all make for ourselves.

Hey guys, I think the real issue here is "consumer safety". I never have and probably never will purchase medications manufactured overseas. Even if Merck manufactured Propecia overseas, I would not buy it because I do agree with Solid concerning greed. We see it every day. I am not singling out Merck either. I think anytime or any chance to cut corners to make an extra dime, you can bet it will happen. And since the FDA does not regulate outside the US, too much temptation to scam people exists. Oh sure, there are indeed some legitimate drug manufacturers outside the US, but there is an outrageous proliferation of imposter medications being sold worldwide. Who has the time or resources to substantiate verification? Well like anything else, we are all entitled to our own opinions.

Hi Whoops, Yes I can see your reasoning for discontinuing dutasteride since finasteride is working good efficiency for you. Most of the men I have known who decided on using dutasteride did so because finasteride "did not" seem to provide any results and continued to lose their hair. Dutasteride does inhibit both Type I and Type II DHT. Possibly some drug manufacturer will develop a dutasteride product for treating MPB. Glad to hear you're keeping your hair!

Has anyone noticed these pimples at four plus months post-op? I did and these can be ingrown hairs trying to break the surface of our scalp, especially those with curly hair. I would recommend using a clean, warm, wet washcloth and then hold it on the pimple for say a minute or so. This makes it much easier to pop and also keeps the area clean. Try to not use your fingertips when popping them as alot of bacteria and germs collect under our fingernails. Even something as basic as an alchohol pad to wipe the area afterwards works well too.

Hi Tom Hairloss, You have some good questions. I thought to add a comment regarding what is success. Providing the yield was successful, the basis of success can be related to each patient's own individual goals. If you are happy with the aesthetic result then I would conclude that it was successful. You probably are already aware of the fact that hair restoration produces an illusion that can in fact enhance one's appearance. So if your goal was to produce a certain "look" and it was achieved, the result is success. You really, really want to do extensive research on the big chain organizations, especially regarding patient experiences. Best wishes to you!

Hey Smoothy, Sounds interesting. Alot of these advertisements display a toll-free number to call to receive their free literature, dvd, etc. Did you by chance do that to get a better idea of what they are doing?

Big1, Good points by Hugh and Corey. I also would recommend Toppik for the interim period. DO NOT use bleach now or ever on your hair and scalp. There are other cosmetic products like scalp colorations, etc., products that wash right out. Now I would think that the majority of patients including myself are indeed concerned about post-op appearance. We really do not wish others to know for whatever reasons we have. From my own experience if you just go about your business and not react to what others are observing, they will conclude that this is not a big issue to you and not think much thereafter. Remember, you know you just had a HT, they do not. So I often advise patients to act normal, don't go out of your way to avoid others, try to not draw attention to yourself, just be yourself as usual. For the most part others who know us well are more apt to notice a change in our behavior vs a subtle change in our appearance. I think dyeing your hair would be too pronounced of a change which will draw the eye drift to your head. Take care.

Corey, The redness should dissipate over time and be alot less noticable. This does not appear to be an issue with you, so happy growth. You should start seeing the new growth any day now!

FUE also leaves less visible scarring so the extractions on the hairline may not be as noticable, especially in a visually high impact area like the hairline and frontal zone.

Smoothy, I agree totally with you in that it is more probable to "buzz cut" the head after FUE vs the clean shaved look like Michael Jordan. Any incision will form into "some" level of scarring as the tissue repairs itself in the healing process. The question is, how visible is it post op? Patients do heal differently so a buzz cut probably is the best way to go.

Robert, You are so correct in explaining that a HT will not be the savior to life's challenges and shortcomings. We all needed to hear those words. And I agree that although an improved appearance may very well increase one's confidence, we all still face those challenges so it's the internal decisions we make day-to-day in life that helps us determine our own destinies.

Arfy, I certainly did not think you went off on a tangent. You made some very good points. HTs are simply a matter of redistributing one's existing terminal hair. And obviously any of us would want it done in the most aesthetic way possible, to get as much visual bang for our buck. What we cannot change is the fact that once we lose our natural hair, the demand side undermines the supply side. It's a matter of mathematics. If we all start out with approximately 100,000 hairs and then lose say 30,000 to MPB, that only leaves approximately 20,000 for future HTs excluding the donor areas. And that leads to a very critical point that you made. There is "no way" that a HT patient can gain back the original densities they once had. That's why the fully manifested result of "any" HT is an "illusion". EVERY individual considering hair restoration needs to know what the limitations are for them, not someone else. I also agree there are still clinics out there that tell the patient "what they want to hear" realistic or not, truthful or not. That is the number one reason why patients do not return to their original HT clinic for a subsequent procedure. What they were told or sold does not pair up with the results. Or the patient states they want to have their youthful hairline back, a full head of hair back, etc, etc. The clinic knows then that this individual will want more and more and more. The question left unanswered is, "where does this all stop?" Too many times the answer a unsatisfied patient hears is "oh, what you need is another procedure, you need more hair!" (yaddy, yaddy). It can be like like putting out fires on one's scalp yet more future fires ignite up (future hairloss) and then the clinic runs the firehose (more surgery) as the patient continues to lose more hair. Then the dreadful reality finally hits the patient square in the nose. They run out of donor! I have heard too many folks go down this road and end up very angry and regrettful. Moral of the story? Do your research to understand the potential as well as the limitations of hair restoration. Then consider realistically what can be acheived for YOU and if in fact it is acceptable to YOU. I have a fair amount of Norwood 6s and 7s over the years who would comment on wanting a "full" head of hair again with a nice low hairline, etc. But is that reality? I think not. I believe most patients want an honest assessment even if it means they dislike the honest and realistic feedback. Oh sure, maybe they won't end up enrolling based on surgical limitations undermining their unrealistic goals however, better that than having someone's life ruined. I can't emphasize enough that there is NO ROOM for commissioned salespeople in medicine! Yet it still continues on. The burden then falls squarely on each and every patient's shoulders. Get multiple opinions from surgeons with proven aesthetic talents and also proven ethics. Research, research, research.

Robert, For me, every function is going much slower than it was say a week or so ago. FYI. Thanks and I know you are working on it.

Hi Northface, I am very glad to hear there is no real hairloss in the donor areas, still you are young so yes by all means still get some in-person examinations. And yes it is possible to have your entire head examined to evaluate which areas are being affected. Now not all derms are experienced in genetic hairloss but you will find them on the internet by doing a search for derms with clinical depth in this field. Also when you contact HT surgeons, ask them specifically how much experience they have in treating hairloss patients with the ludwig pattern. Do not limit your research with one or the other, get several opinions. Then once you have your situation confirmed, you will have a much better understanding of how to proceed. And yes I would suggest FUE technology just in case you do have more dramatic thinning in the donor areas in the future since you are so young right now. Should that occur later in life, you would be able to buzz-cut your head. Keep us in the loop! Take care.

Hi Otto, Wow, from your foregoing comments maybe you should wait and really take some time and put some thought as to whether or not you want to move forward with another HT procedure. Your comment, "I would pay anything to reverse it" is indicative that you are not sure along with "I don't want to play catchup the rest of my life". Utimately with more strip the incision is going to get longer and potentially more noticable if you do shave your head compared to the scar that is there now. It is very probable that you may end up with as much hairloss as your father, then again maybe not. No one knows for sure. Yes you do have genetic profiles from your mother's side. Any hairloss on the maternal side? Also, you do have finasteride available to slow down the loss in your vertex and crown. If finasteride works efficiently for you, you won't have to chase this around as much as you might think. If you are not willing to consider finasteride or even minoxidil, would you shave your head if you lost as much as your father? Interesting question is it not? Well, if you are concerned that you may one day shave your head yet still want to do some level of hair restoration, stick with good FUE work as a very high percentage of FUE cases do not show "visible" scarring. I know you mentioned in a different thread that FUE was not attractive to you because of the increased cost but better you eventually get yourself restored with time than regretting a situation you "cannot" reverse. You can even consider having FUE done "in the scar" to camaflouge it one day. The outcome does vary. Best wishes!

Northface, Thanks for putting up your photo. I read one of your earlier posts on this thread denoting that you do in fact have the ludwig pattern of hairloss and so does your mother. Are you younger in age, say under 30? Also, do you have any maternal/paternal family members who are male gender with the same pattern of loss, ludwig? Older brothers, maternal uncles, etc? The reason I ask is because it appears that the photo is reflecting lots of light with your darker hair color and it does not appear to be greying. Unless you are coloring your hair, I am presuming that you are a younger man? The critical thing that stuck out in my mind is that you stated this thinning has invaded the sides and back of your scalp which implies your terminal hair typically used for transplatation is being affected. Have you been evaluated for androgenetic alopecia areata? Many female hairloss sufferers sustain this type of loss, and I have noticed approximately 3% of men with alopecia areata. If you are younger, under 30 years old, and do in fact get diagnosed with alopecia areata, I would strongly advise you to wait on doing any HT procedures for now. Why? I have seen too many times alopecia areata patients, both female and male lose substantially more hair both in the donor and recipient zones. Subsequently the multiple incisions from a HT procedure can shock terminal hair that "does not" always grow back. In fact their form of hairloss does not subside at all in most cases I have seen. I have witnessed some resolve with patients utilizing minoxidil but far and few between. Yes there are some exceptions but I hate to see patients chase their hairloss and never really get where they want to be. Along the way you can end up spending thousands of your hard earned money and possibly in the end regret you ever got started in the first place. This can be very difficult to accept if you do have alopecia areata however one should consider both the upside and downside. You really need to get in for an in-person examination by an experienced HT doctor and/or dermatologist experienced in diagnosing various forms of hairloss. Try to get at least three opinions. They can use video telescopic equipment or a simple densomoter to see how much of your entire scalp is being invaded. If other people have advised you that patients with the ludwig patterns of thinning or alopecia areata do not make good candidates for hair restoration, they are probably referring to the fact that your usable donor if any will not be enough to attain adequate coverage in a lifetime. If you are determined a candidate for hair restoration, be sure to consider your future needs since available donor and future affected areas of loss are at question. Then possibly do a "test" procedure to see if the surrounding donor hair shocks out a little or alot. DO NOT do a strip, only consider FUE if you are a HT candidate. My mother has the alopecia areata form of hairloss denoted by the ludwig pattern and she has been in hair systems for over 50 years now. I am so glad that she did not spend her hard earned money on HTs because ultimately she would have still ended up in hair systems. The technology was terrible in the 50's, 60's anyways. My point is to get "diagnosed properly" up front so you have a better understanding of your own situation "before" you start considering your complete options for resolve. Feel free to e-mail me or write me with your phone number if you want to discuss at length. In no way am I trying to sell you anything but I will offer you an open door as I know patients with these types of hairloss can have many questions. Either way I wish you the very best Northface.

Otto, It sounds like the 500 grafts are going behind your hairline into the front forelock area? If so, you should get "some" visual benefit out of it. If the distribution is covering a larger surface area (including vertex), you may not gain as much appearance of added density. That's why it is important for the HT doctor to "measure" any recipient area, determine original density as well as the level of density you are seeking. Then an appropriate graft estimation is more likely to acheive what you are looking for. Let's say for example you have original density of 80 hairs per cm2. Your goal is to acheive the illusion of coverage without noticing scalp. You have approximately 20 hairs there at present. You will need at least another 20 hairs added to that area to acheive the result of coverage, ot half the original density. The more surface area the grafts are spread out, the less density there will be visually speaking. Just trying to save you any possible disappointment and then later concluding that you should have waited or did more than the 500 grafts. Food for thought.

Hey Corey, Thank goodness it was not serious and it could very well be a new and even possibly an ingrown hair coming through. Now the fun begins! New growth! Keep us in the loop and best wishes to you Corey.

Corey, Welcome to this forum! You stated you had a "strip fue" done? Usually one or the other is done. It is a matter of how the follicular units are harvested for implantation. Who was your HT surgeon?

Smoothy, You make a good point about "average" or "light" training. I think the HT docs should be a little more definitive in their post-op instructions so that a distinction is made. And you are absolutely right, people work out at entirely varying levels of intensity. Protect that investment!

I had a very nice chat over the Labor Day weekend with a good friend who is a tech in HT procedures. He sounded tired so I was glad to see he had a day off other than Sunday. He has been in the field for just over 7 years now and is greatly skilled in cutting and placing. Every now and then we hear some words of gratitude and thanksgiving for the surgical staffs of HT doctors and I think that is just great. Yes the good HT surgeons deserve their credit but so do the staffs that take pride in their work and help to make the aesthetic outcome successful. I mean I have worked on the inside before and I know how hard some of these individuals work "every day" and some of their own ideas and clinical contributions that often times go unnoticed. My friend has mentioned to me on occaision that he reads the forums simply to help him gain and appreciate the patient's perspectives and concerns since the patient is on the receiving end of the procedure. To me as a three time HT patient, that is most admirable! Please allow myself and all the recipients of good HT work formerly thank every PA, Nurse, Clinic Coordinator, and Surgical Tech out there who has made a significant contribution in the many, many procedures that have changed so many lives for the better. And let's certainly not forget those important administrative folks either. Although they may not be in the OR, they still are vital members to any successful team. After all, any team is as strong as its weakest link! Many thanks to all involved.