Maxxy

Hey Clint69, I can't advise you on where to buy Nizoral as here in the UK both the 1% and 2% can be purchased from stores without prescription. There has been studies done that shown the 1% is almost as effective as the 2% when it comes to hair-loss (here in the uk the 1% version is called Nizorelle) You sould read up on the product before deciding to use it post-op, some guys have a had a negative responce from it. Here's a link to get you started Nizoral Transplant I was using the 1% version pre-op but have not used it post-op, I'm going to wait until I'm fully grown before restarting.

Interesting, does anyone have anymore info on this? and maybe some photos of the mature scars after recieve grafts during closure.

Hey Mmhce, As the scar is not formed until the wound has healed where would they put grafts? The only place I could think is around the wound area, not having much benifit or right on the edge of the cuts - which I can't see happening and I don't think would very beneficial either. Edit: Or after closure, placing grafts between the cut skin? I don't think they would do that either for all kinds of reasons.

Calv, I'm sure everyone who has had a transplant worries about future loss and if you are in the lower numbers on the NW scale it's actually highly likely we will progess in loss at some point in the future. It's important to get on the meds and and draw up plans for the future. In some cases, the loss can be stopped or at least slowed for some time. While nobody can be certain of future loss, by looking at certain factors it's possible to get a good idea of where you may progess to. My reason for having a transplant was because I had been on the meds already, my hair-loss had stabilised and not progressed for some years. I'm fully aware that I will most-likely need another hair transplant in the future but I'd rather do it in stages as I need it than walk around bald until I knew I could lose no more before going ahead. If a transplant is done right even if you progress to a NW6 it should stand up on it's own. I also have high hopes for future treatments such as Follica.

Brady1212, You won't get a single visible scab for every graft, it wouldn't even be possible in the space transplanted unless the scabs were minute. I recieved 2300 grafts, I didn't count the scabs but for sure there wasn't anywhere near 2300 scabs.

Wantego, Have you considered using the foam only once a day? I read recently that due to the half life of Minoxidil that once a day will give you the same benifits of a twice a day application, maybe this will reduce shedding if this is what you are suffering from?

Yeah it's just a annoying its thin but hopefully the transplanted hair with fix that. I really liked the foam it was so quick and easy to apply, had it not been for the reaction I had I would have continued to use it through out transplant.

Well in my mind I'm certain it was the foam, my surgeon had his doubts, he believes it may have been case of Alopecia areata. I respect my doctors views but this only happened after starting the foam and only in the area around where the foam was applied, coincidence? We transplant into the area as the hair had started to come back but was thinner then it was previous, the hair I have in the area now is not transplant hair as yet, or atleast not the vast majority of it as the hair is over 3 inches in length. Edit: I'm currently not using any Rogaine, I wanted to see how the transplant comes in first but I will not be returning to the foam.

I think I was on the foam for 5-6 months total, I can't remember the exact timelines now. I did write about it at the time but I forget if it was on this site or another. Again, I can't remember the timelines but I had a bad shed - an area went totally bald then the hair started to grow back, it got to maybe an inch in length then fell out again. I continued with the foam and the hair came back, however, yet again it fell out before getting any real length to it so I stopped, and since stopping the foam - the area that kept shedding has continued to grow but yes, the area is thinner. It was scary at the time and still causes me some concern, the hair had just started growing back when I recieved my transplant. So I had a lot of worry over whether or not to transplant hair into that area. When I had my transplant the doctor gave me a steriod shot into the area that had shedded, if that had any bearing on the hair not falling at a short length again, I don't know.

Thanks again for the replies everyone. Haha yeah, still here Mr. GQ. I've been busy with work lately so not had much time come on. I actually bought some light brown Nanogen last week, I tried to apply it to the transplanted area and it was a disaster, haha. It fell straight to the scalp and looked as though I had emptied an ashtray on my head. I then applied it to the crown area where I really don't need it but just to see what would happen... it did thicken the area and when I asked my partner to rub it in as I was holding the mirror - they said "Where is it? Have you put it on yet?" so atleast I know I have found a very good colour match. I mustn't have enough hair in the receipt for the stuff to cling to yet. I will buy a UV light when I get the chance and test if the light brown Nanogen shows up, will let you all know.

Wantego, May I ask if you are using Rogaine foam? I had a massive shed on foam, it actually caused around a square inch of hair bearing skin to become completely bald. It has been maybe 5-6 months since I stopped using the foam and a lot of the hair in the area has returned, however, It is still a fair bit thinner than it was, prior to the foam.

P.S. As I'd rather not discuss this matter anymore unless directly asked, could I just point out to anyone reading that I am not doubting Dr. Mohmand as an excellent surgeon, my issue is that I personally don't agree with his teaching methods and feel problems could and should have been avoided regarding the aforementioned trainee surgeon.

Dr. Lindsey, Thank you for your response. The way you were taught sounds like good practise and I'm sure it benefited you and your patients, being taught in that manner. Dr. Mohmand, Again, thank you for your response but for myself - I see little point continuing with this discussion - which is a shame, but as you feel you have did nothing wrong and mistakes were not made by yourself, maybe it's time to agree to disagree as this will go no where, as you feel no need to change. I agree with most of the above which is why you should have been there for every surgery until the trainee was ready to be alone. It took Dr. Lindsey (with considerable experience) 1 year of training before his mentor allowed him to do facial plastic surgery alone, and even then it was only when his mentor believed he was ready to do so. Your trainee was not ready. You certainly can and should stop them operating on patients when they are not getting it right. I realise the imitation skin I linked to is basic and cheap but without trying it can you be so sure it won't be beneficial? It's better to fail on fake skin then a live scalp, and I'm sure there will be much better products on the market. You will never know, as you seem unsure about how many patients this trainee treated and even if you know the exact number now, you were not at every surgery he performed so you can't possibly know on all the occasions when and where he went wrong. But a good way to limit "less than perfect scars" would be to change your teaching methods. They were not less then perfect scars they were, as you have stated in previous posts bad scars - and I know you said you have high standards, but these scars were bad enough for the patients to complain and bad enough for you to put them under the knife again, resulting in discomfort, hassle, downtime and possibly a tighter scalp aswell as the possibility of shock-loss. I assume and hope you wouldn't put a patient through all that if it wasn't warranted. My final thoughts on the matter are: Where you present during the surgeries performed by the trainee which resulted in bad scars, you should have been able to spot the mistakes being made and corrected them at the time. If the bad closures happened without your presence, and you have admitted surgeries were done by your trainee without your peresence, then these bad closures are a direct result of your training and lack of supervision and should not have happened (in my opinion). I find it disappointing that you can't see mistakes might have been made and have chosen not to change anything in your practise/teaching methods. Let's all hope this trainee has bettered his skills since leaving your clinic and is no longer producing bad results on patients in his own clinic. I also hope that your next trainee has more skill so the problems won't be repeated, as you seem unwilling to change your teaching procedure. Again, I apologise to Jazz and the readers for getting this post so off track.

Dr. Lindsey, Thank you for sharing your training process. I agree that sounds like a very good a thorough way for teaching/learning. I may be wrong here, but I assume if you were having trouble during your training and having difficulties with a particular aspect which you had moved on to that you would be took back a step, and only when you were ready would you be moved on to the next stage of training again or would you have carried on with the part you were having trouble with until you got it right?

Dr M Humayun Mohmand, Again, I appreciate that you have took the time to reply, however, I don't think we are ever going see eye to eye on this matter. The fact that the patient is aware the surgeon is a trainee and because of that he pays less is a fair point, but I still feel this trainee should not have been left alone at anytime - especially when he was having difficulties. I also understand the trainee needs hands-on training, and you're correct... I'm not sure how the training process works, but my views stand: I believe the surgeon should train on animal or some other form of skin when he is having problems, before being let loose on the scalp, especially without supervision. I wasn't referring to a live animal and wasn't suggesting an animal be killed for the purpose of training the surgeon. Maybe this is not how surgeons train but if your trainee cant get it right he shouldn't be allowed to keep trying on patients heads in my personal opinion - and this will never change no matter how you try to justify it. I don't need to consult any other doctor on this matter, it will never change my views that a trainee surgeon should never be left alone until his training is complete, or at the very least you are 100% confident that he is safe to be alone. I also believe, as I've already stated that he should train on something other then the scalp until he's getting it right. I understood what you were saying when you refer to the issues as teething problems, but you have to understand that statement is insulting to some. I thank you for being so honest, but you should have been present for every single surgery - this may have saved a lot of people unnecessary scarring, discomfort, hassle, shock-loss, and downtime to name a few. He was still producing bad results towards the end of his time at your clinic, so why would you leave him alone? 60 to 100 is a big difference, you should know the numbers, but lets take your higher number to be safe... that's 10 and maybe another 4 that needed/will need revised out of 100. To me that's a high percentage and shouldn't have happened. You keep contradicting yourself, you did leave him on his own - you have already admitted that. This is the main problem being discussed, and the problems were not detected and corrected at the time of surgery - this is the other problem. I'm not sure that you understand the question. You should be taking steps and making changes to your training procedure to stop these problems happening again. At the very least, 10% of patients treated by this trainee were left with bad results, this is just not good enough in my opinion. I don't believe this has ever been questioned, at least not in this thread and certainly not by me. On photo you attached... if there is a scar there then on that example you have produced an excellent result as I can't see one, thank you for sharing. As you pointed out, the photo may cause confusion, so it may be benificial to show another example. Edit: I've just had a quick look and as I suspected, there does seem to be products on the market to aid learning. I realise the skills learned on the imitation skin can only go so far, but I'm sure it could only help aid in your teaching when trainees are having the aforementioned difficulties. Here's the link Suture Kit I realise it may all seem to be a bit basic but I'm sure there will be better products on the market and it has to be benificial to the students and future patients.

Could I just point that out I did not just write the post attacking Dr M Humayun Mohmand, I also thought this may have been a language barrier concern. You will notice on page two that I wrote the following to Dr. Mohmand, in regards to his first post in this thread: Which is what he stated in the first post on this thread, but before I posted my concerns I wanted to make sure I understood what he was saying. In response, Dr M Humayun Mohmand wrote: This clarifies what he said was not just bad English. Now, lets not get confused - the bad closures did happen at the hands of his trainee and Dr M Humayun Mohmand, this I am sure of. Now, did it happen with Dr M Humayun Mohmand allowing this trainee perform the closures knowing he couldn't do a good job? I personally believe this is the case. It is not one or two occasions that this trainee made a mistake, it is at least 12 so far which have required scar revisions. If these closures were under your supervision you should have been able to spot the closures were not going correctly and took over. These are not small, "school boy" errors which needed a word from you to your trainee on how to improve.. these are 12 so far that were bad enough to justify revisions, the fact that you say "so far" also concerns me, that statement suggests you may expect more - though, that may just be your English. This is misguided, it should not have happened in the first place, you say free of charge as if you should be praised for being so fair - this is the absolute minimum that should be done. It is a damn disgrace. Don't try to brush this off as "your" high standards not being met, these scars were not simply due to you having high standards which weren't met, these were scars that patients had major concerns about, which you agreed to the extent that you have revised 12 of them. Also the above would mean you are revising 10 scars in every 100 patients you treat, if this is the case perhaps it is you who needs more training. As you stated, you treat 5 patients per day - that's a lot of scars that don't meet your standards (if you perform 5 surgeries per day and let's say you are open 5 days per week, then that's 10 patients every month with scars that don't meet your "high" standards). You are really annoying me, these are not 12 scars that have turned out bad because anything the patient has done they are a direct result of yourself and your trainee. Referring to them as "teething problems" is insulting to me, so god knows how it comes across the the guys who were actually affected. Your trainee hasn't learned the hard way, your patients have, and it is a disgrace. I do not know how doctors learn to perform closures but if your trainee could not get it right you should have had him watch you longer and had him practise on animal or some other type of skin before letting him perform on patients again. This should have been done in the first place, not after the fact. The above statement suggest to me that you were not present during every closure, or you would have been showing him how to do it right at the time. I have given thought to your English difficulties but I don't believe that is the problem here. I would also like to apologise to everyone for this thread going off-track but I believe these concerns need to be pointed out.

Dr M Humayun Mohmand, Surely this cannot be the case? Doctors allowing their trainees to keep hacking away at patients heads until they get it right? So, you allowed your trainee to try and perform a scar closure technique for 18 months, knowing that he hadn't mastered the technique and not only had he not mastered it but he screwed them up so bad that 12 to date have needed you to revise the bad scar. This you say is normal practise and: Well I'm sorry, and I don't care who disagrees with me - that is a bloody disgrace. If I was one of the guys with bad scars left by your trainee, I'd hold you personally responable. You allowed him to perform these closures knowing that: I hope some of the badly scarred patients that suffered at the hands of you and your trainee read this, and come looking for you. Come on, 12 so far with bad scars and you brush it off as teething problems, utterly unacceptable. What is meant by the above quote? If he hadn't have ran off, you would have left him to deal with the bad scars he produced?

lokingforsolution, My post-op instructions state not to colour dye hair for 3-4 weeks, not sure what other kind of dye there is lol.

Bllorayne, Thanks for editing your post - but by editing and deleting what you have said, it makes threads impossible to follow or understand. I don't mean to get on at you but can you also please stop deleting your posts? Now that you have deleted one of the posts and edited the other in the thread it makes it look as if I and Dakkota were bitching over nothing.

Bllorayne, I personally wont be replying to anymore of your posts until you lay off the damn CAPS, its getting really annoying now and people keep asking you to stop. On a seperate note, we all know H&W are good - you don't need to keep referring to them as "gods" and "the best in the industry", they are good but so are a lot of doctors in the coalition who people have chosen to go with.

Welcome Hairseekerusa, After 2 weeks your donor and receipt area will be very red still, of course this is not always the case and changes from guy to guy but at 2 weeks in general things are still very noticeable, without picturs it's hard to tell. Growing your hair out will help, this is some what futile if you choose a doctor which shaves the receipt area, but it will help hide the donor area in either case. Doctors have different opinions on dissolvable stitches, normal sutures and staples, which are used may be decided by your choice of surgeon. (I'm not sure they will let you choose which are used)I had dissolvable stitches with 10 normal sutures for tension stitches, the tension stitches were removed on the 6th day and the rest were totally gone in around a month. The price is going to differ from doctor to doctor, you could start sending your pictures to some of the coalition doctors for quotes.

Dr M Humayun Mohmand, are you saying you were training a surgeon for 18 months in your clinic who couldn't master the technique and then ran off leaving your practice with patients who had bad scars as a result of this surgeon (which you are repairing)? Correct me if I'm wrong.

It's good that you have such faith in your choice of doctor. What got people's backs up, well, mine at least - is your title is so dramatic and attention grabbing, resulting in people taking time to read your post and the post that you referred to which really isn't relevant today. Also, as hairthere was saying... by bringing attention to that thread could do nothing but damage H&W (I'm sure it won't), all the regulars and people who have done their research know H&W are among the best, but all you have done is point out someone who was unhappy with H&W, which may affect a future patient's decision all for a 7 year old post.

GTL, As Bill, mentioned above it is highly recommened that you try the meds Rogaine, Proscar and maybe Nizoral before considering a transplant. (for atleast 1 year) The above will likely slow down your loss, stabilise your loss and may even regrow some of your lost hair.

Bllorayne, The post your referring to is almost 7 years old, if you're going go back that far, you'll find bad comments on every doctor out there.