Maxxy

Ahmedabad_guy, If you are traveling on a standard Indian passport, then the above would apply no matter which country you enter by.

darkmanhy, What makes you think Dr. De Reys opened his own clinic? The last I heard, he was retiring from the profession completely.

Welcome, MrBrian! First of all you have came to the right place. The guys on here, doctors included, are very experienced and I'm sure you will get all the help you need. The first thing you need to do is speak to a doctor/dermatologist (preferably the latter as most GP are clueless regarding hair loss) just to make suffer you are suffering from MPB and that there isn't some other underlining cause for your hair loss. As its likely you are suffering MPB there are really only 3 proving forms of treatment: Minoxidil (Rogaine) which is a tropical stimulant. Don't buy this from a UK pharmacy, their prices are extortionate; I use Ebay but there are plenty of sites offering good prices. Personally, I'd go straight for the 5% and give the 2% a miss. I'd also recommend the foam version. Finasteride (Proscar/Propecia) which is a DHT inhibitor taken in tablet form and is currently our best defence. As above, I would avoid the UK pharmacies as its grossly overpriced. Most users including myself buy Proscar (which contains 5mg of Finasteride) and split the pill into 4s or 5s, Propecia is the same medication but only in 1mg doses, splitting Proscar greatly reduces the costs. Ketoconazole (Nizoral, Nizzorelle, Revita) - these are shampoos. Ketoconazole is thought to be a weak DHT inhibitor. You can get Nizoral and Nizzorelle in the UK from most chemists. Nizoral contains 2% ketoconazole and Nizzorelle - 1%. Id stick with the 1% as it's less harsh and studies have shown it to be almost as effective as the 2% version. Revita can be purchased online and contains 1% ketoconazole. All the above should be used for at least 1 year before gauging your response. I'd also recommend visiting a hair transplant clinic just to get there opinion and to monitor your loss. In the UK, I'd personally only visit the Farjo clinic in Manchester. Hope this helps and feel free to ask any questions.

Ahmedabad_guy, Below is visa information for Indian nationals. - According to the Interior Ministerial Announcements, passport holders from 21 countries and territories may apply for visas at the immigration checkpoints for the purpose of tourism for the period of not exceeding 15 days. - The applicant must possess means of living expenses at the amount of 10,000 Baht per person and 20,000 Baht per family accordingly. - The applicant must possess a passport with at least six-month validity and must present full paid ticket which is usable within 15 days since the date of entry - Visa on arrival is provided at 24 designated international checkpoints and applicants should submit the application form duly filled out and to which his/her recent photograph (4 x 6 cm) is attached. The application fee is 1,000 Baht

Bill, I also don't want to speak for Dr. Feller, however, as John was so pleased with his original scar and has spoke of how fine it was - the fact that this was a repair case shouldn't be an issue should it? I mean if John's first scar turned out so good, this wasn't a repair case where the scar is concerned.

Hey Time to do something, Here in the UK we have a TV show called Quite Interesting (QI), it's sort of a comedy/educational show. I remember an episode a while back in which they were discussing hair growth, and the same thing you are wondering came up. It turns out that hair loss in that area is extremely common as men age, I can't remember if they gave a reason for the loss but there is a presenter and 4 guests all of which checked their legs and all noted loss in the area above the ankle.

John Malloy, Without question this should have been discussed. To most patients, any scarring post-op is one of the biggest concerns while going in to surgery, I'd say it is a very close second to yield (at least is and was for me). As Dr. Feller planned to, and ultimately gave you a second scar, your permission to do so should have been given first. Even if you sat down in the chair and said "look, I trust you, do to me what you will" something so important should have been discussed in detail. I recently had a second procedure and taking the donor from a higher location than my first surgery would have resulted in me receiving more grafts, however, the consequences of this were discussed at length and in the end I opted for one scar. Maybe this was the reason behind the doctor's decision? Who knows. It's to late to do much about it now but I would definitely be asking the doctor some questions. Your response to EpilepticSceptic gives the impression that you have not brought up this matter before and I have read in your previous posts of how well your first scar turned out. As such, perhaps the fact that you have two scars isn't an issue to you. Personally, if the first time I knew that I was going to have two scars was when I looked in the mirror after surgery, I'd be furious. Guys, The doctors are the professionals - important aspects of the surgery such as this should be raised by them, however, if they are not you must make sure that you ask questions and be certain that the doctor knows your goals and wishes.

Danielkiwi, Where as I can understand PD's disappointment, 400 grafts isn't a millions miles off the target. Sometimes doctors get it pretty much spot on, sometimes they get more while other times they will fall short. There is many reasons why this may happen and I'm sure Dr. Feller will let us know why this was case with PD. If a patient had an average donor density of 100 grafts per cm2 and had say a 30 cm long strip was removed there may be variations in the density along the strip which prevents the doctors from getting his estimate spot on. For example - even 3 grafts less per cm2 on a 30 cm long strip is a short fall of 90 grafts.

Hey PD, I think you misunderstood me. When I said "graft numbers feather off" I meant maybe less grafts were placed in each zone as the doctor went back, by the time Dr. Feller got to the area where you see the straight line there may only be a few grafts per cm2 matching your native hair in that area. This straight line where the grafts end is obviously now due to the redness, trimmed hair and trauma caused during the surgery. Once the redness fades and the grafts grow the transplanted hair may blend in with your native hair in terms of density and placement.

PD, Have you put your concerns to Dr. Feller? As you know, Dr. Feller is very experienced. I'm sure the donor is in a acceptable position, it's hard to tell by the one photo you supplied. The straight line in the crown area comes right up to the thinning native hair, maybe the graft numbers feather off towards the crown and once the transplanted grafts grow out it will blend in with the native hair in terms of density and the straight line you are seeing now wont be an issue.

Thebutterflycollector, This really annoys me. I was 15 when a first visited the GP regarding my hair loss and like you I was fobbed off. Sadly, back then it wasn't as easy to get the right information as it is now and I just accepted what the GP told me. Within a couple of years I had lost valuable ground which I firmly believe wouldn't have been the case had I been given the right advise and treatment. I'm guessing the GP gave you some crap along the lines of "it's genetics, there's not a lot you can do", "try to come to terms with it", "there're no proven treatments" or "the side effects out way the benefits". Whatever he said, ignore his advice and don't "leave it alone". First off, I recommended you go back to your GP ask, and if necessary, demand a blood test to rule out things like thyroid issues, insist on being referred to dermatologist (ideally a trichologist, though I'm not sure if the NHS will cover this). The dermatologist is covered by the NHS however the doctor will need to refer you. If he refuses, ask for the reason and make sure he knows you will be making a complaint and getting a second opinion (which I suggest you do if he won't take you seriously). You have a genuine concern and the right to an NHS referral. As for the ?300-?400, this is an out right lie. Even if the NHS didn't cover it (which it does) a consult wouldn't come close to that cost. Now the bad news, I have visited 3 NHS dermatologists, the last was a professor and he was useless (they all were). I can honestly say that I knew more regarding MPB than each of them did. The professor even tried to talk me out of Finasteride, stating that he has never seen results from the drug and that I am wasting my money. Don't expect too much from the visit, it's likely you will be in and out the door in 10 mins. Get an appointment at the Farjo clinic. I agree with the others that a transplant is out of the question right now, but they will be able to confirm what's going on, advice you on your options and monitor the situation. Mick, the Farjos' rep/consultant is a good, honest guy and will give it to you straight. There's no way he or either of the Farjos will recommend a transplant giving your loss and age but it's always good to get some professional advise. There is a consult fee but I believe this is only charged for the first visit, at least thats the way it used to work. If you are advised to get on the meds, which I'm pretty sure you will be, I'd recommend you don't buy anything on the day from the clinic. Get prices, but shop around to find somewhere which works best for your budget. Spex, a member of this forum has a good doctor contact for Finasteride (Proscar/Propecia), Minoxidil (Rogaine) and you won't find cheaper than the prices online. I usually use Ebay but there is no end of sites that sell it at good price. Whatever you do don't buy it from a chemist here in the UK (the price of Minoxidil in the UK is astronomical). Ketoconazole (Nizoral/Nizorelle etc) you can get from the chemist, Nizoral you need to buy from behind the counter, however, no prescription is required. If they ask, just tell them you have used it before. Nizorelle you will find on the shelf, both contain the same active ingredient, Ketoconazole. Nizoral contains 2% where as Nizorelle contains 1%. Personally, I'd recommend the 1% version. Sadly none of the above are covered by the NHS, however, if done right you could use all 3 treatments together for around ?10 per month. Going the other way, buying Finasteride and Minoxidil from a UK pharmacy, you are looking at ?80 per month. After you have seen the dermatologist and ideally one of the Farjos, if you have been advised and decide to try Finasteride, let me know (if you like) and I will send you a box of Proscar which will cover you for first 5 months. You are in good hands on this site and will find it hard to get better advice anywhere, I hope you take advantage of this and check with the community before making and big decisions.

Dr Vogel, Thank you for the clarification and for explaining the mechanics behind scalp exercises. I agree with B_Spot, it's great we have someone with your experience and skills willing to take on these difficult cases and offering hope to guys with bad and difficult to treat scarring. When a tissue expander is necessary, does your clinic charge set cost? If so, what is this cost or is the cost dependent on the actual patients scarring, etc?

I've been in two minds over trying a laser comb for sometime and still haven't bitten the bullet. One thing I would suggest is to give the Hairmax Laser Comb a miss - it's ridiculously over priced, you can find far cheaper models online (Ebay), most have the same strength, type, and number (generally more) of diodes.

Wb280, You can find out how to add photos to your album here. For a guide on how to add an image to your post look here.

Dr. Vogel, Thank you for the reply, though I'm not sure I agree. I have read of many patients who have had multiple procedures and been left with bad scarring, some of which have spoke of their worries over the scalp being too tight yet they have later received scar reductions with excellent out-comes. In all my years reading posts from such patients none have used a tissue expander to my knowledge. Of course every case will be different but your statements such as make it sound as if even after 1 or 2 procedures, if you are left with a wide scar then your only option is a tissue expander, which I hope isn't the case for the vast majority of patients. I have also read of patients that have went from having tight-normal laxity to having *too much* after scalp exercises. You say "and in this case probably 2"... I'm not 100% which case you are referring to (Tsakalos?) so maybe I have missed something and you are referring to cases such as his (which I know nothing about)? To be honest I assumed this was the way scalp exercises worked. So unlike the tissue expander that duplicates tissue the scalp exercises are simply loosening and stretching the skin? Not unlike rolling out pastry, it's still the same amount of pastry only thinner and longer due to the rolling process? P.S. I don't mean anything by dissecting your post and quoting you, it's simply easier to ask my questions that way.

Dr. Vogel, I'm sure the expansion won't be as dramatic and it may require more time but in some cases don't you feel scalp exercises can add enough laxity to remove wide scars and aid with tight scalps or do the scalp exercises work in a different way?

Hey hairlossguy222, Again this is just me, you will have your own goals and factors in your life that will determine your decision. I know the down time and everything involved in another surgery is an off putting thought, however, I'd still go with one of the lower estimates. Have the scar addressed and see if you are happy with the density, if not, as Spex has said, there isn't a great deal of difference in *medium* of the quotes (2000 is being mentioned a lot). Personally, I'd book in expecting the lower estimate but understanding that on the day, it may well go above that number. If I wasn't happy with the density after say 1500 grafts, I'd have an FUE session for the other 500 (if this is all that was needed - personally, I wouldn't even consider a strip for anything a great deal under 1000 grafts). This approach would also allow you to evaluate the resulting scar and FUE into it if necessary. The above is what I would do going off your photos.

Personally, I don't think thats a good way to go about it. If you decide on a large FUE session, you may need to continue down that road. Once you have your FUE session the donor is going be depleted and more so with each session, to have a FUT at a later date would mean wider/longer strips being taking than would usually be needed to obtain the desired amount of grafts this brings a lot of problems with it.

I believe you made a good choice in Dr. Charles, I've never heard anything bad about him and his results are good and consistent (from what I've seen); His dedication to this board and helping members has always impressed me. I'm sure you'll have a good out-come. Good Luck!!

Just to echo the others, great news!! I'm glad to hear your daughter is doing so well not only in her recovery but also in other aspects of her life.

Personally, I'd go with Dr. Feller or at least one of the lower estimates. Get the scar addressed and hopefully you'll be happy with the density, if not - you always have the option to add more at a later date, but that's just me.

Welcome, Coltsfan2010! It looks like standard MPB to me, I doubt the bleaching had anything to do with your current loss. The meds should always be your first line of attack, there's no telling what result you will get but at the very least you should try to stabilize your loss before going for a transplant. I know you're reluctant to try Finasteride but you should know this is currently our best shot at saving and regrowing hair. You should also try the Minoxidil you were prescribed, the people saying it doesn't work are simply wrong (this is not in doubt and has been proven), maybe it didn't work for them but it does for the majority of its users -- to what extent is a different a matter. I'd recommend you try the meds for at least a year before considering a transplant, also, if you are concerned that the stress of medical school may make matters worse it may be a good idea to see how things go with that first.

Wb280, You can check out JoTronic's scalp exercise video here - http://www.hassonandwong.com/hair-transplant-videos.php?videoCatID=6&categoryName=Pre-Op+%2F+Post-Op+Instructions To be honest, I very much doubt you will gain much laxity in 6 days though I'd still do it in hope of loosening the scalp.

*I posted the same reply in your other thread* Hi EpilepticSceptic, Like the others have said, try not to stress too much - I'm sure everything is fine and no damage has been done. As for removing the oil, the answer to me seems a simple one, though I have never tried it. Go down to your local health store and buy a basic emulsifier, I'd recommend Polysorbate 80; I have very little experience with Polysorbate but I can assure you it is perfectly safe - many guys in the past used it for oily scalps and treating hair loss (I'm sure some still will); it is also used in some shampoos and foods. Polysorbate 80 shouldn't be too hard to find if you are in the States, though it can be a pain in the arse to get hold of in other countries. Anyway, a few washes *should* bring the oil straight off. P.S. Polysorbate 60 or any emulsifier used in food (as it will be safe) should suffice if you can't find 80. Edit: You could also try craft stores or a natural soap store (the type that make their own shampoos and soaps).

Hi EpilepticSceptic, Like the others have said, try not to stress too much - I'm sure everything is fine and no damage has been done. As for removing the oil, the answer to me seems a simple one, though I have never tried it. Go down to your local health store and buy a basic emulsifier, I'd recommend Polysorbate 80; I have very little experience with Polysorbate but I can assure you it is perfectly safe - many guys in the past used it for oily scalps and treating hair loss (I'm sure some still will); it is also used in some shampoos and foods. Polysorbate 80 shouldn't be too hard to find if you are in the States, though it can be a pain in the arse to get hold of in other countries. Anyway, a few washes *should* bring the oil straight off. P.S. Polysorbate 60 or any emulsifier used in food (as it will be safe) should suffice if you can't find 80. Edit: You could also try craft stores or a natural soap store (the type that make their own shampoos and soaps).