Rahal Hair Transplant

@YesorNo,

Well it’s not surprising that you are confused because you’re talking to so many different doctors with varying philosophies, experience and skill. All of them probably have a different thought on how to tackle your hair loss and hair restoration treatment plan, if they even feel that you are a candidate.

in all honesty, sometimes less is more. Now, I do suggest that you do a lot of research. But I don’t suggest that you consult every doctor you come across.

Most of your beginning work should be spent online learning about the procedure, reading patient reviews, getting involved in discussion, asking your own questions and learning about who the best doctors in the industry are.

Then, once you finally feel you have a handle on how the procedure works, you feel that you have a good grasp of the advantages, disadvantages, benefits and limitations associated with surgery and you have learned what separates the best doctors from the rest, it’s then time to narrow your physician selection down to about 3 to 5 doctors and then start consulting.

I’m going to tell you now, with all of the confusion you’re feeling, coming to the forum and then asking for everybody’s opinion on whether or not they think you’re a candidate when we don’t have enough information to make that call, nor are we doctors… might confuse you further.

Below, I’m going to present some information on how to start your research, narrow your surgeon selection down and then ultimately how to select the best surgeon for you, assuming that you are a good candidate.

Rahal Hair Transplant 

How to Select an outstanding hair transplant surgeon. 

—-

1.  Start by looking at the surgeons recommended by this community, in particular the Coalition of Independent Hair Restoration Physicians.  Surgeons recommended by this community have met a demanding set of standards and are approved based on meeting those high standards.  Many online hair surgeon memberships don’t have any criteria other than to pay a membership fee.  Furthermore, physician members of the coalition have met an even higher and more demanding set of standards and have proven to be amongst the best of the best in the profession.

2. Now even amongst a list of outstanding surgeons, not all surgeons are created equally. Therefore, while it’s tempting to select a surgeon based on price or location, try to avoid this as many individuals travel great distances to undergo surgery with an elite surgeon they are most impressed with. Thus choose a surgeon based on their proven ability to produce outstanding results rather than because of cost or location.

3. Narrow your selection down to 3 to 5 surgeons you are most impressed with.  You can do this by using this discussion forum and others to view examples of patient results posted by both the clinic and their patients.  Speak with and meet with real patients in person if possible. If not, video chat works pretty well.

4. Come up with a list of consult questions to ask each surgeon/clinic you are considering. I’ve created several different posts on this forum with good questions to ask doctors.  If you need help coming up with a list of good questions, please let me know.

5. Consult with each doctor you are considering and ultimately, choose the surgeon you feel can best meet your goals.

I hope this helps  

Rahal Hair Transplant 

@DaniBr,

You can cut your hair as early as one week after your FUE hair transplant. Technically, you can probably cut it before that but it’s better to err on the side of caution and not do anything that could potentially damage the newly transplanted hairs.

I hope this helps 

Rahal Hair Transplant

Example 1 - Post-Op

Example 1 - 2 Weeks

Example 2 - Post-Op

Example 2 - 6 Weeks

Example 3 - Post-Op

Example 3 - 1 Month

Example 4 - Post-Op

Example 4 - 9 Days

Rahal Hair Transplant

@coolbreeze

I don’t know if you’ve had a hair transplant or you are just considering it at this point. But have you undergone FUT or FUE?  Same question if you are considering it… Which one are you considering?

now, having undergone all FUT procedures, my last one being almost 15 years ago, I can still wear my hair on the side the back of my head at a number three clip without showing any real signs of scarring.

Had I undergone FUE with Dr. Rahal for example today, I feel confident that I’d be able to support a one clip without showing any signs of scarring.

Now every patient is different and every patient’s physiology is different so I’m just guessing based on what I know about his skill and experience in my donor hair.  After all, I’ve seen and presented several examples of donor areas from Dr. Rahal that are shaved down quite short after every surgery and there’s no signs of scarring.  I will present a few in a few minutes.

Best wishes,

Rahal Hair Transplant

@Recession1,

One thing you need to understand is that everybody responds differently to medication. While there may not be an exact such thing as stabilization of hair loss, you can slow it down, stop it or even possibly reverse it to some degree. Now does that last forever? Most likely not.  But then again, we also don’t live forever.

Hair restoration is about minimizing risks and giving you your natural hair back as long as possible.  In my opinion, it is still a good idea to consider non-surgical solutions such as fenestrate  and minoxidil if you are still in the early stages of hair loss or even if you have any natural hair that is prone to androgenetic alopecia.

I also advise speaking to a doctor about any non-surgical solutions before getting on them as every medication comes with a possibility of side effects.

I hope this helps.

Rahal Hair Transplant

@mr_peanutbutter,

Graft survival doesn’t depend on any use of non-surgical solutions, whether it be finasteride or minoxidil, taken orally or topically.   Graft survival has to do with the skill and experience of the surgeon and clinic operating on you. And, of course, there are a number of variables during surgery that will impact graft, survival and growth.  This includes how the follicular units are extracted, how long the graft are outside of the body, the type of holding solution, and how the freshly extracted follicles and hairs are implanted into recipient, incisions, and the level of care that goes into all these moving parts of the hair transplant, which comes from experience and skill, etc.   

nonsurgical solutions, such as minoxidil and finasteride health, especially with maintaining one’s existing natural hair, and even possibly reversing some of the effects of genetic hair loss. If someone is a good responder to finasteride or minoxidil, for example, one might reverse some of the effects of male pattern baldness, increasing the amount of terminal hair they have, and then in conjunction, with a hair transplant, their results will likely look phenomenal.

I hope this helps.

Rahal Hair Transplant

@T218HT,

While the transplanted hair is perfectly safe and deeply rooted 10 days or so, after your hair transplant, I agree that it’s probably best to wait until after the hair shedding to shave the recipient area down.

That said, some hair transplant patients may choose to shave the rest of their donor area to match the recipient area, 7 to 10 days after the date of the procedure.  But since the recipient area is usually shaved prior to surgery anyway, I do think it’s probably a good idea to wait until after the shedding of the transplanted which occurs typically between 4 to 6 weeks to shave the recipient area again.

I hope this helps.

Rahal Hair Transplant

@OverharvestedAndSad,

In my opinion, it’s very premature to panic and worry since you only just had surgery and shock loss can occur anytime over the first couple of weeks to the first couple of months. It can take up to six months or even longer for any shocked hair to return.

So while I understand a patient’s tendency to panic and worry when something looks worse than it did prior to surgery,I suggest that you don’t draw any conclusions until everything heals and grows in which can take up to 12 months.   

Best wishes,

Rahal Hair Transplant 

@chris71080,

I agree that everything looks pretty normal at just only 11 weeks. Most people don’t start seeing new signs of growth until 3 to 5 months, so I agree that any signs of growth at this point shows that you are already ahead of schedule.

i’m assuming you’ve started another topic sharing your hair restoration details.  us who aren’t familiar with your case, I suggest presenting your details on each new thread you create for linking to the original on each new thread, so that we can comment and encourage you further.

All the Best and happy growing,

Rahal Hair Transplant

@Recession1,

As far as I can tell by the photos, your donor area looks good. Thankfully, you also seem to have a great deal of your natural hair as well.

You haven’t presented too many photos of your hairline, but you have stated that it has recessed and thinned out a bit.  Given your age of 35, you are likely a good candidate for surgery assuming that all of the other variables makes sense as well.

I trust that you’re going through with an actual information session with a qualified doctor would provide you with the information you need to determine whether or not you’re a good candidate and if so, how many grafts would be recommended.

Best wishes,

Rahal Hair Transplant

@Searching4truth,

i’m a little unclear about what you’re asking.  Transection could occur at two potential places during an FUE hair transplant procedure.

The first one would be when the follicles are being harvested from the donor area during extraction.  if a surgeon isn’t careful and or is inexperienced, irreparable damage could occur to the follicles being harvests and 

The second time could be while the surgeon is making tiny incisions in the recipient area.  If done incorrectly, natural hair follicles should be transected by the blade entering into the scalp in preparation for the transplanted hair. Clearly, this would be highly undesirable as you would simply be exchanging natural hair for transplanted hairs as the natural hairs would be permanently shocked, due to trauma.

I’ll keep in mind that trauma to the scalp occurs during her transplant surgery just because it’s surgery. But on necessary trauma occurs if a surgeon does something wrong, uses inferior, or outdated tools, or techniques, etc. 

I hope this helps.

Rahal Hair Transplant

@JoeD,

Risks of significant scar stretching are always a rare possibility.  That said, the chances that this will happen on the second procedure under the same surgeon is also rare.

That said the more you undergo strip surgery, if you were about to undergo your fifth hair transplant, for example, the risk factors may be a bit higher than if it was on his second procedure.  This is because the skin on your scalp only has so much elasticity - and while time and healing can improve upon it, full elasticity never returns.

Of course, some patients undergoing multiple strip procedures, and still end up with pencil, thin scars that are easily camouflaged bye surrounding hair 

The alternative (if you are concerned about the possibility of scar stretching associated) would be to consider FUE, which today, in the right hands is just as viable as FUT in terms of growth and zzz possesses other benefits, such as no linear, scar and or no scar stretching.  

I hope this helps.

Rahal Hair Transplant

 @JCPS,

Surgeons typically advise patients to stop using minoxidil a week or two before surgery.  Minoxidil in the bloodstream can thin out the blood making surgery more difficult.  Therefore, if you are going to use minoxidil, I would be sure to speak with your surgeon about whether or not lhe requires you to stop taking. Prior to surgery and then when he feels to see if you start up again after surgery.

I hope this helps 

Rahal Hair Transplant

@Realism,

I think in order to answer your question, we really need to discuss what you mean by “candidate“.  If you’re asking if it’s possible to restore a full looking head of hair over in Norwood six or seven area with hair transplant surgery (regardless of whether it’s FUE or FUT), then the answer is no. You’re not an ideal candidate for surgery.

If you’re asking if a qualified FUE surgeon can re-create a conservative, looking hairline with some coverage in the first couple zones behind the hairline… possibly even into the mid scalp depending on your donor availability while leaving your crown bald, then, yes, this may be possible 

That said, I do agree that we would need to see some current photos that are of better quality… Including pictures of your toner area.

I hope this helps.

Rahal Hair transplant

@MyKindaMoves

To answer your initial question, there are benefits of using finasteride for a year prior to undergoing her transplant surgery for some patients.  Examples of patients that could benefit from this will include diffuse thinners and or anyone that has a good amount of natural hair left in an area that’s being transplanted into.

The reason this is beneficial is because it takes up to a year for finasteride to reach its capacity for efficacy. In other words, if finasteride is going to work for you, and you have an area of thinning hair that’s about to be transplanted into, giving finasteride a year before your transplant could be beneficial because some of those thinning or miniaturizing hairs may thicken up.  As a result, transplanting into this area, may minimize or even illuminate the potential for permanent shock loss which typically occurs to natural hairs that are miniaturizing when hair is transplanted in between or around it 

To sum up the above, taking finasteride a year prior to surgery, may minimize or illuminate, permanent shock loss, resulting in a gain of hair over those who started finasteride on the day of surgery or didn’t start at all.

I hope this makes sense and helps.

Rahal Hair Transplant
 

@booyaka7777,

Hair loss medication, such as finasteride do a pretty good job of slowing down, stopping, or even reversing some of the effects of androgenetic alopecia.  However, it is advised to be on finasteride for at least one year to determine its efficacy.

In situations like yours where the patient still has a lot of natural hair, but has a pretty advanced looking hair loss pattern, some physicians/clinics may suggest considering finasteride and then wait to see what the effects will be before operating on the patient.

Now, some patients may choose not to use a finasteride because of the potential of side effects, which is why it’s always good to consult a physician prior to using it.  On the other hand, without its use, your hair loss will continue to progress as far as long as your genetics dictate.

I don’t know how much donor hair you have available over the course of your lifetime… Dr. Rahal uses a formula to determine this for his patients.  But, in order to determine whether or not you’re a good candidate for hair restoration.surgery, one would have to consider how much available donor hair you have over your lifetime versus how much hair you will likely lose based on your genetics with or without hair loss medication.  In other words, it’s a matter of supply and demand.

Now, given the extent of your hair loss, I trust you have spoken to your surgeon about realistic expectations, and what can and cannot be accomplished with surgery with or without medication.  There are worst and best case scenarios and it’s important that you are familiar with both of them in your case we should be discussed with your hair physician.

For example, how many grafts have been suggested for your first procedure with the doctor that’s willing to operate?  And what is the surgical plan at this point?

Just know that it will take a large number of grafts to give you full coverage and even more full coverage plus density.  In all actuality, you will likely only have enough donor hair for one or the other.  Note that this is not necessarily Dr. Rahal’s opinion, this is just my opinion as an educated patient and advocate.  Just make sure you speak to whichever surgeons you are considering about what your goals are, and what can realistically be achieved in your case.  Be sure to discuss the differences between using medication and not and then you can make an informed decision which is best for you.

I hope this helps 

Rahal Hair Transplant

@Henry,

If you’ve only had your hair transplant 3 months ago, I would definitely give it more time. There are some hairs that will essentially not shed, and they will essentially not grow either for several months, but then, eventually, they will start growing.  Since new hair growth from a hair transplant typically starts between 3 to 5 months post-op, I would give it several more months before determining what’s going to happen.

I hope this helps 

Rahal Hair Transplant 

@Esten,

I’ll be honest with you, it’s really not easy to give you feedback from photos alone especially since you are still quite young and as far as I can tell, Still possess a lot of your natural hair. But, the fact that you think that you are heading towards a Norwood 7 pattern, tells me that you’ve had an assessment where a surgeon or two has told you that.  Can you confirm this? 

If that’s the case and you are heading towards a higher Norwood level, then I don’t know if I’m going for a hair transplant surgery at this point would be wise. are you currently on any non-surgical treatments such as finasteride or minoxidil? If not, I suggest speaking to a physician about the possibility, evaluating the potential side effects versus the benefits and then make a decision. Non-surgical solutions could really help you keep the existing hair you have and make hair restoration a real possibility in the next couple of years.

I hope this helps.

Rahal Hair Transplant 

@thr0waway,

I don’t know what the family history of hair loss looks like for you however, if you are sure that your hairline has moved, and you may be already experiencing early onset of androgenetic alopecia or male pattern baldness.  Ultimately, at 17 years of age, you’re far too young to be considered for a hair transplant and more so, because of the fact that your hair loss is minimal at this point.

That said, I do suggest consulting a dermatologist/hair restoration specialist about potentially getting on finasteride and minoxidil. It’s especially crucial at your age to speak to a doctor about finasteride because of the potential of side effects.  And at your age there may be some extra precautions or steps to consider, etc. 

I hope this helps.

Rahal Hair Transplant

@Big Rome,

I understand where you’re coming from for sure. You read a lot more reports about side effects on discussion forums and it seems like it’s way more than 2 or 4% of individuals taking finasteride that are experiencing side effects.

Now, I’m not a doctor nor am I a scientist but we do need to remember a couple things. When percentages are given, they are provided based on scientific studies that are conducted on a certain number of individuals and groups. It is not a scientific study conducted on all finasteride users in the world.

Therefore, in real life, we don’t really know for sure exactly what percentage of Finasteride users are actually experiencing side effects. But we do know that based on the study that was conducted, that only a small percent of those involved in the study experienced side effects.

So the question becomes, can you trust the study enough to believe that only a small percentage of those who take finasteride will experience side effects? Or do you believe there was a margin of error in the study? Was the sample size big enough or diverse enough? Did it take into account real world situations?

When I was younger, I used to hear studies and percentages, especially about risks of side effects in medication based commercials and would immediately question it making statements like, “well, I was never tested”.

Or even when statements like “4 out of 5 dentists recommend…(a certain type of toothpaste)” but yet I went to several different dentists at different points, and they all told me that it didn’t matter which toothpaste I used.

The point I’m making is, some studies are just plain bogus, and other studies are more trustworthy. But at the same time, no study can account for every real world situation and give you accurate percentages of all people in the entire world as it applies to that product.

Long story short, I do believe that only a small percentage of those who take finasteride actually experience side effects. As to risk factors, and whether a particular person is more susceptible, then another, I don’t know. I suggest speaking to a doctor and then making a decision as to whether or not finasteride is right for you.

I hope this helps 

Rahal Hair Transplant

@Ralph kaka,

To be honest, it just looks like a new transplanted hair that may be starting to break out through the scalp, which is going to be sensitive for a couple of months after the procedure.  I don't see any signs of concern as there only appears to be one or two at the moment.  Seeing a few of these or even several starting around month 3 is quite normal.  It's only if it becomes extreme that it's usually a problem.  Just keep your eye on it and use your judgment.  When it doubt, contact your surgeon and garner his or her opinion.

I hope this helps.

Rahal Hair Transplant

I agree that Toronto Man's results are phenomenal...very typical of Dr. Rahal's results in my opinion.  Obviously, results vary even at our clinic as each patient's circumstances and physiology varies.  But one thing remains true for sure.  Dr. Rahal's skill and experience can't be beat, either can his results.

As for why Toronto Man didn't undergo any temple work, I'll let him chime in as I wasn't directly involved in the discussion of his procedure.  My guess is that he chose to use what donor hair he had available at the time of the procedure for density.  If he has the donor for it, he can always go back for temple work if he wants it, but i agree he certainly doesn't need it.

Best wishes,

Rahal Hair Transplant

@Rogith,

Honestly, everybody is different. But on average, it is said that patients typically experience approximately 60% of their growth by around six months. But keep in mind, that “Growth” only means that the hair has broken through the surface of the scalp. Most transplanted hairs, when they start growing, throw in thin, fine and colorless to the point where you can barely see them.  Because of this, many patients will see Most of their cosmetic  improvements between 6 and 12 months rather than 1 to 6 months.

As I said however, everybody is different so early growers may experience substantial growth between 3 and 5 months and see maybe 80% of their growth in the later months.

I hope this helps.

Rahal Hair Transplant

@Jb4458,

personally, I’m a firm believer in “if it’s not broken, don’t fix it”. For starters, non-surgical treatments aren’t necessary for your hair transplant to grow. As long as you selected an excellent surgeon, your results should grow in as expected with time. Time is your best friend and make sure you also follow your doctors postoperative instructions.

Nonsurgical solutions, however, are great at slowing down, stopping, or even potentially reversing, some of the effects of androgenetic alopecia a.k.a. male pattern baldness. So my question to you is, has your hair loss treatment regimen, been working for you in terms of helping to keep your existing hair? If so, then I’m not so sure there’s any need to mess with it or change it.

Now you could increase your finasteride those from .5 mg a day to 1 mg a day because that is the recommended dose. That said, more finasteride in your system means a higher possibility of potential side effects. Therefore, before messing with your toes in anyway, I suggest speaking to a physician.

As far as Biden, I’m not convinced it really does anything for hair loss, but I don’t believe it’s harmful in any way so again, I would consult a physician. But if you feel that’s helping you, and it’s not hurting you in anyway, then you could probably keep taking it.

I hope this helps.

Rahal Hair Transplant

@xcactus,

I totally understand being concerned about your temples.

When I was 21, I first started losing my hair and started developing the smallest thinning/balding spot in the crown and I was mortified.  I did just about everything I could to fill in the area with my real hair. When minoxidil didn’t seem to be working, I tried every lotion and potion in the book and my hair only started getting worse.

Maybe if I had done proper research when I was 21, I would have tried finasteride early and it may have helped me keep my existing hair (or at least show down my hair loss) but I doubt it would have brought every bit of hair back that I wanted.

Why? Because I was young and didn’t understand what could realistically be achieved versus what I desperately wanted.

Had I found a hair transplant doctor back then that was willing to fill in that small area, I would have been ecstatic at the time but long-term, I would have been mortified because it would have been totally inappropriate and unethical for a doctor to touch my scalp at that early stage.

Long story short, hair transplant surgery is not something you should be considering at this point.

I understand how bad you want your temples back right now but this is likely an early sign of a more progressive condition a.k.a. androgenetic alopecia that will likely bring a lot more thinning and hair loss over the years.

Hair transplant surgery is not a miracle cure and is limited in what it can achieve.

Moreover, an ethical surgeon will look at a prospective patient through the hourglass of time and do what’s best for them over the long term.

Since the degree of hair loss cannot be predicted especially at early ages, hair restoration physicians and representatives alike should really be suggesting that young hair loss sufferers talk to a doctor about proven non-surgical solutions such as finasteride and minoxidil.

To date, these are still the most effective non-surgical solutions and while they will likely not grow your hair back in your temples, they might help slow down the progression of hair loss to come if you start taking it at an early age and continue with it.

I hope this helps.

Rahal Hair Transplant