gillenator

Yes indeed, “In the right hands”.

It never ceases to surprise me how some of the younger men think that surgery in itself will solve their genetic hair loss without the use of effective hair loss meds…the bottom line is that if you have native hair that is DHT receptive, low dose finasteride, minoxidil, will help you hold on to it.

They can call it a hundred different things but trust me, after all the hype, it’s a binding contract which releases the doctor and or clinic from any and all liability…and they typically do not have the patient sign it until after they collect 100% of the money on the morning of surgery.

I would wait a minimum of 12 full months before starting scalp stretching providing your strip scar healed completely without any complications…and I agree to confide with your surgeon.

Hands down, I could not agree more!

If you have native hair that can be lost to DHT, you will continue to lose that hair if you discontinue finasteride and minoxidil.

It would be helpful to receive an update.

It’s all a matter of what cannot be seen under the surface of the scalp…why would the risk of transection in a previously grafted area be higher you ask?…it’s because the surgeon cannot see under the surface, he can transect what he cannot see and you paid lots of money for those grafts which are close to sprouting the surface, why would you risk damaging/losing some of them?…also, the outer surface of the scalp can look completely healed at 4 1/2 months post-up however what we cannot see is the level of trauma and inflammation under the surface and remember, it’s trauma and inflammation that induces shock loss…realistically, it takes a solid year for the entire head to recover.

Trauma from the surgery causes many hair follicles to retreat into the resting phase…transection is something totally different.

MMM, Please allow me to provide some feedback to your concerns with a second surgery and how shock loss could be a factor. First let me make a distinction between 2 totally separate things: shock loss and transection…transection is the underlying damage to follicles that are caused by new incisions…these follicles under the surface cannot be seen by the surgeon and this is why doing a follow-up procedure too early carries the risk of transection…is 7 1/2 months too early?…yes it is…but you stated that there would be minimal overlap of the previous grafts, still if it were me, I would insist on no overlap. Now lets discuss shock loss…while there is no damage to the follicles, this momentary cyclical loss of hair is caused by the related high level of trauma to the scalp caused by the surgery, mostly attributed to the recipient incisions and also injected fluids, etc…the traumatized follicles simply retreat into a resting phase for approximately 3-4 months and then enter a new growth phase…hair that is in an advanced state of diffusion and very weak usually is permanently shocked…hope this makes some sense.

Starting the initial use of finasteride can and many times will induce shedding, and so can minoxidil although finasteride is often times more prone to induce shedding…and it is highly advisable to wait until a new complete growth phase has occurred because the risk is a high rate of transection especially with 5500 new recipient incisions!…the shed hair follicles will on average rest in a dormant stage for approximately 3-4 months before entering a new growth phase!…so if you do the math, yes, November 7th is too early…if it were me, I would re-schedule for after the new year, like sometime in February which will give your hair a chance for a complete regrowth cycle.

I have read and evaluated literally dozens of these contracts including other forms of cosmetic surgery…these contracts primarily serve the interests of the clinics that perform the procedures and 99.99% of them will not provide their services unless the patient/client signs them.

It would be better if your hair was much shorter to evaluate your case.

I remember when you posted some pics several months ago and your recipient area was thinner in visual density…it’s looking much better however IMHO, another pass would look better and more natural instead of lowering it.

There are in fact several ways to test for MPB and then arrive at a formal diagnosis…the good news is how you have progressed in a positive way and your journey to happiness my friend.

I agree that density is an issue but I also noticed a lack of hair shaft maturity (caliber)…having said that, I would give it several more months and consider taking oral minoxidil or even topical to potentially strengthen the development of your hair shafts…you would be amazed at what a difference an increase in hair caliber will do!

On the surface, most donors are going to look good when we are young…however you are definitely headed for class 7 so it is imperative that you have your donor microscopically examined to see if your donor is suitable for transplantation.

The most long term established surgeons with proven talent will have the most experience in cases with diffused thinning patterns…ask these doctors for examples you can see online and also ask them how they treat diffused cases differently…do their answers make sense?

IMHO, you are not wrong…it would be a good idea however to get another in person exam to rule out MPB which would include a microscopic exam of your scalp and formal diagnosis to see whether or not you have MPB…if you do not have genetic hair loss, obviously there is no reason to take finasteride…and IMHO taking finasteride for the first time post-op may initiate an acute shed which would be counter-productive.

There are a small number of well known/established/reputable surgeons who were more known for their top quality FUT work that was being performed several decades ago…they were the surgeons who developed the lateral slit technique to utilize acutely sized coronal recipient incisions thereby accommodating high levels of dense-packing giving birth to the mega-session approach that allowed much larger procedures into upper level numbers well over 3,000 per session…this was before FUE ever hit North America.

Well said!

I agree Gats, whether topical or oral, the growth phase can be effectively extended with Minoxidil.

As long as the area is healed, no more scabbing or bleeding, Toppik can be applied.

IMHO the pics seem to validate more shock loss than over-harvesting though it is way too early to tell…only time will tell…it’s best to allow the scalp to heal and repair itself.

IMHO, you would need considerably more than 800 grafts to fill in the proposed area, and especially considering the high amount of single hair grafts that would be needed.