SorleyBoy

Never brilliant at maths - but if he works 5 days a week - by my reckoning the bold doc would have to perform over 2 procedures a day . . . So, either: - a) He never sleeps. b) the procedures are extremely small. c) he has an army of technicians doing most of the work on 2 - 3 patients a day . . . and I think the (disturbing?) implications of this latter scenario have been well discussed on this forum. SorleyBoy

Chris Hello and welcome. If you use the 'Find' facility (tab towards the top left of your screen) and enter (for example) < price range graft > . . . you should find all the info you need. I'm sure that you'll find everyone on this network most helpful in providing the guidance you need . . . stay in touch. Regards, Sorleyboy

PB . . . I think we've all mentioned it before at some time, the psychological exhillaration of stepping out of the top flight surgery that you've just chosen - and being able to 'throw your crutches away' is priceless -(well . . . a price of $10,000 at least!). You'll be on a daily 'high' knowing that in just a few months you can deliver that lecture - without the podium lights blinding everyone as they reflect off your gleaming dome! As you say - it's one step closer - but a giant step nonetheless. When you consider the time, trouble and expense you went to in avoiding any situation that might compromise your confidence - I would estimate that 'after the scars have healed' you won't give a damn about public opinion - you'll be so full of yourself knowing that you've had some of that 'warrior beauty' restored. Good Luck . . . Sorleyboy

PB . . . Jetfly - and the majority of other Minox defaulters are unfortunately dead right about 'time catching up' once you stop the regular application. I used it from 2000 to 2003 and successfully slowed down or even halted hairloss at a diffuse NW4 stage. I got lazy and thought maybe it was my extreme age (52) that had stabilised things - and stopped using it . . . how wrong can you be! - In just 3-4 months I was a NW5 and an avid reader of the Hair Transplant Network! Rogaine, concealers, hair colourants, mega thickening styling gels etc. are the perpetual 'monkey on your back' . . . you can't do jack in life for being concerned about wind and weather and being 'presentable' to people - for whatever reason. I binned the lot and went for a 'strip' in Arizona. Ahhh! - what a relief. Regards

Joey . . . Yer healing process (from Birmingham Uni. 'Medweb' (UK)) . . . Wound healing. The time course of healing by repair and the amount of scar tissue formed depend on factors such as the extent of tissue damage, presence of persisting infection, inflammation, etc. The relatively simple, rapid proces of healing in a clean skin wound which has been closed promptly and where tissue damage is minimal (e.g. a surgical incision) is termed healing by primary intention. In this situation the epidermis regenerates across the gap quickly and successfully,the volume of tissue into which granulation tissue has to grow is small, and the amount of fibrous scar produced is minimal. Healing of an open wound where there is significant tissue loss, or where there is ongoing tissue damage from infection is termed healing by secondary intention. In this situation the amount of granulation tissue formed may be sustantial, scar contraction much greater, and re-epithelialisation less complete. Factors influencing healing: - The rate of healing and the success of formation of scar tissue can be limited by many adverse factors. Some of the local and systemic factors which are of importance clinically are as follows: Local: Persisting infection, foreign material or other stimulus to inflammation Inadequate blood supply Excessive movement Irradiation Locally applied drugs, e.g. corticosteroids Systemic: Age: the healing process becomes slower and less effective with increasing age. Nutritional deficiencies, e.g. vitamin C, zinc, protein Metabolic diseases, e.g. renal failure, diabetes mellitus Catabolic state associated with malignancies Systemic drugs, e.g. corticosteroids . . . If you've ever played contact sports (and at our age!!) you'll know what I mean about recovery time . . . and what to expect. Best regards - Sorleyboy

Joey . . . and in 9-12 months - when the 'frontal area' is more luxuriant than the armpit of an Oran-utan . . . what are you going to tell your pals then? You are about to have your genetic disfigurement (considerably) reversed - you should feel totally LIBERATED by the experience (and future expectancy) the moment you leave the surgery. My advice would be to grasp the nettle, sod what anyone else 'might' notice and get your life back at the earliest opportunity. My ploy was to get a change of hairstyle the day before surgery (you can try almost anything from highlights to binning the combover - but keep it longish at the back). You'll have a week or two of saline solution, hairwash 'n' gauze treatment to get rid of the encrustation and any colouration, as mentioned in previous posts (you're 44 - so it takes a little longer to heal than a 20 year old, right?) . . . but then just get out there and mix it with everyone. With the all-over changes to your hair's appearance ( - any significant re-style will do) - I'll guarantee no-one will notice the 'stubble' at the front. . . . If they do, I'll give you your money back. Take a short 'post HT' holiday Joey - Give it a week or two, then throw your self-consciousness in the bin - together with your baseball cap! . . . I did - and I was a Norwood 5 !! Regards, Sorleyboy

Kev . . . Of course at 23 years of age you will be a highly paid business exec? . . . because you'll need a fair wedge of cash (and not a little luck) to get hold of generic Minoxodil and Finasteride/Propecia this side of the Atlantic. I assume the Republic suffers the same malaise as Britain in that you can add 50% over and above USA prices . . . and how would you get hold of Propecia? I understand that you would need a very compliant GP to swing a regular supply. . . Anyway, sound ideas from Arfy, Brando et al - so good luck. Sorleyboy

Mr Invisible . . . Try the next forum down (H.T. Experiences . . .). The topic "4+ months ... still waiting" from 'goinbaldn20s' seems to be generating considerable concern and interest. Regards, Sorleyboy

Completely O.T. . . . . . . Shouldn't that read Cat Stevens (the songwriter). . . Don't you just hate me - or did somebody else pick up on it months ago? Sorry shipmate, but I had sod all else to do for once and couldn't resist it . . . and anyway, Mr Stevens would be upset. Sorleyboy

Kes . . . Don't get too concerned about this - your freedom of speech has always been safe. Unless you are thinking about a massive leaflet campaign that results in a second 'Kristalnacht' - the law won't be picking you up for satire, jokes or critical debate. If you check out the Home Office guidelines on the new Bill [link to outside website removed by forum moderator; contents transcribed below - Robert] - I think you'll find that it's only the likes of extremist Nationalist parties that will have to be more careful. . . . (Go on! - tell me that you're a member of the BNP!) . . . and the law will even protect me - as a Godless heathen . . . ('ere, now where did I put that volume by Neitzche?) Sorleyboy

Kes "Law against inciting religious hatred" . . . "people could insult the church any way they wanted"? - Are you talking about heresy? The "thousand years of Christianity" as you put it, was responsible for enough judicial murder (of people insulting the Church) to put 'Christianity' in the same league as Mao, Uncle Joe, and Adolph! . . . no freedom of speech back then my son. You have right to be critical of Islam (inciting violence is the 'sin' per se). You have to be above that - you wouldn't want to be like them. . . . it could potentially ruin your HT! Sorleyboy.

Robert In response to your question of "what kind of articles . . . etc" - it seems to me, looking at each topic in the 5 most popular forums - that the most viewed and replied to topics are (generally): - i) 'Just before and after' photos or articles ii) 'Hard luck' stories iii) Bad Surgeons. Although by no means a comprehensive list, it gives an insight into the psychologically damaged nature of the readership out there. (I include myself of course). My preference would have been for topics along the lines of 'Latest developments in HT techniques' or 'physiology and body chemistry issues'. But it is noticeable that postings on purely technical themes like this usually elicit a small fraction of interest (by more than a factor of 10 in some cases - and over similar time periods). Unfortunately this phenomenon does tend to keep my active participation in the HTN down to a minimum. . . But hey, it wouldn't do if we were all the same now would it? . . . Peace. Regards, Sorleyboy

Smoothy I'd have to concur with your 'graft packing' statement. I had 2,500 grafts placed throughout front AND crown (By Dr Keene by strange co-incidence) this should give a relatively low/moderate density at maturity, BUT . . . in terms of graft survival I would have to say that, almost a month after the procedure - I 'guestimate' that only 8 - 10% of the hair implanted has so far been shed. The remainder has continued to grow and is now some 3/8" long in most areas. . . . Possibly an argument for less dense coverage? Nonetheless this phenomenon might re-inforce your 'blood supply' theory (not to say of course that it's just a physiological function peculiar to me). Sorleyboy

Dear readers . . . Another query to baffle and amuse. I can find no reference to atrophy Pathology: - A wasting or decrease in size of a body organ, tissue, or part - when doing a search - but which seems to be a fundamental issue with all MPB follicles and the subsequent way our hair appears to become finer through time. I'm trying to establish whether the hair shaft diameter, 'strip excised' from the usual donor area 'improves' or indeed continues to deteriorate in quality as a function of being implanted in what was an MPB susceptible area of the scalp. The reason I ask is that, over the last 25 years of hair thinning, the wavy 'donor' hair that I would have had in 1980 has gradually become finer and somewhat slower growing through time. Although still suitable for an FU procedure a few weeks ago, I'm trying to envisage whether this biological slow-down will continue - for life? My guess would be that the genetic signature in each follicle will remain and thus ensure that the hair growth characteristics 'perform' in their predetermined way - with a gradually decelerating growth cycle over the decades and a tendency towards a slightly sparser coverage. Regards

Dear readers . . . Another query to baffle and amuse. I can find no reference to atrophy Pathology: - A wasting or decrease in size of a body organ, tissue, or part - when doing a search - but which seems to be a fundamental issue with all MPB follicles and the subsequent way our hair appears to become finer through time. I'm trying to establish whether the hair shaft diameter, 'strip excised' from the usual donor area 'improves' or indeed continues to deteriorate in quality as a function of being implanted in what was an MPB susceptible area of the scalp. The reason I ask is that, over the last 25 years of hair thinning, the wavy 'donor' hair that I would have had in 1980 has gradually become finer and somewhat slower growing through time. Although still suitable for an FU procedure a few weeks ago, I'm trying to envisage whether this biological slow-down will continue - for life? My guess would be that the genetic signature in each follicle will remain and thus ensure that the hair growth characteristics 'perform' in their predetermined way - with a gradually decelerating growth cycle over the decades and a tendency towards a slightly sparser coverage. Regards

arfy Thanks for that.

Dear all Transplant hair density (as a function of growing hair shafts) - and graft numbers per cm2 are subtly different aspects of gauging the final outcome of of any individual's procedure - complicated by variable aspects of each individual's hair type. Often it seems that, when discussing procedures, much emphasis is placed on 'quantity' of grafts whilst overlooking some of the more fundamental characteristics of hair quality and morphology - which would seem to be equally, if not more important in determining '12 month post-HT' coverage or density. Simplisticly and given the same hair strand type/diameter etc. between 2 people - the individual who had only 1 hair shaft per follicular unit is likely to need 3 times as many grafts as that person who has 3 hairs rooted in each F/U? I appreciate that we all have a scatter of anywhere from 1 to 4 (or more) hair shafts per unit BUT - I've searched all forum threads and can find only limited information on the combinations that have been identified (or subsequently used) for transplantation. My guess is that there is no 'typical' ratio for male or female but I would be interested to know if there have been any studies that might have explored, say, the average yield of each type from 'strip' surgery and whether this can impinge on subsequent waste of F/U's, or whether it explains why mature HT densities can be so variable between individuals who perhaps had elected to have an identical number of grafts each. I imagine we'd all like a shed load of groups of 3 or 4 follicles per F/U, but has anyone come across a breakdown of what might be regarded as typical? - if in fact 'typical' does exist. Regards, Sorleyboy

Dear all Transplant hair density (as a function of growing hair shafts) - and graft numbers per cm2 are subtly different aspects of gauging the final outcome of of any individual's procedure - complicated by variable aspects of each individual's hair type. Often it seems that, when discussing procedures, much emphasis is placed on 'quantity' of grafts whilst overlooking some of the more fundamental characteristics of hair quality and morphology - which would seem to be equally, if not more important in determining '12 month post-HT' coverage or density. Simplisticly and given the same hair strand type/diameter etc. between 2 people - the individual who had only 1 hair shaft per follicular unit is likely to need 3 times as many grafts as that person who has 3 hairs rooted in each F/U? I appreciate that we all have a scatter of anywhere from 1 to 4 (or more) hair shafts per unit BUT - I've searched all forum threads and can find only limited information on the combinations that have been identified (or subsequently used) for transplantation. My guess is that there is no 'typical' ratio for male or female but I would be interested to know if there have been any studies that might have explored, say, the average yield of each type from 'strip' surgery and whether this can impinge on subsequent waste of F/U's, or whether it explains why mature HT densities can be so variable between individuals who perhaps had elected to have an identical number of grafts each. I imagine we'd all like a shed load of groups of 3 or 4 follicles per F/U, but has anyone come across a breakdown of what might be regarded as typical? - if in fact 'typical' does exist. Regards, Sorleyboy

. . . All my whisker hair is IN my ears. Leave it grow for a couple of months and its like a goatskin rug! . . . ('ere where's that Remington nose hair trimmer!) Sorleyboy

Justyour(good)luck to find this site! It's that bloody Dermatch that has created your shock-horror depression. You'll find a wealth of good advice and first hand experience on this forum which will snap you out of this frame of mind you are in and quickly give you renewed hope - and scope. . . because it did for me when I first discovered this network of dozens of folks, all sharing differing degrees of the same problem - available day and night to bounce your problems off. And yes my son, I was a 55 year old NW5 with what I thought was limited donor hair (a 'band' of less than 2" of useable FU's) . . . turned out to be more than enough for the surgeon I chose - she just recently covered my entire crown and front (but not temples) with over 2,600 grafts (harvested from an 'ear to ear' strip, but which only needed to be approx. 1 cm deep). Yes I know the hair density will only be about half of the currently suggested optimum, but, in 9 months to a year I'll have wavy hair (diffuse though it may be) everywhere, where I've never had that much hair for 2 decades! . . . and I'll end with a postscript which you can make of what you like. 4th August, I hadn't seen my regular friends for over 2 weeks (I'd been away having my H/T) so last night I decided not to refuse the invitation of a chat and a few beers with good company . . . but I had to face that demon - would they notice what I'd had done? I decided to smarten myself up and caught the bus into town. I showed up at 8pm and put on a brave face as I went across to meet everyone . . . you could have knocked me down with a feather. Dave, who I'd worked with for the last 15 years said "Hi Tone, nice to see you again - good, holiday? . . . you're looking well - have you lost a lot of weight or somethin' " . . . It's difficult to explain the relief and exhuberance that I felt at that moment. . . . and I hadn't been on any sort of diet! (Q. - Do bald people tend to project an impression of being fat(ter) than people with hair?) I can only surmise that the transplanted 'all over stubble', (blended in with what threadbare but now neatly trimmed original was left from forelock and median) - had looked convincing enough after only 8 days! to create some sort of deceptive and new demeanour - I'm conviced now that even minimal but well executed H/T's can have the most profound effect on your appearance. Needless to say, it was a massive boost to my confidence (I can tell you) - and that's coming from someone who only a week or so before, was in exactly the same situation as you. So my point is simply this, that you are not alone by any means; you will find the very best of help from this community and in all probability, quickly find the right professionals who are capable of resolving your problem - if you set yourself measured, realistic and achievable goals. Best regards, don't despair - help is at hand . . . and go easy on that Dermatch! Sorleyboy (UK)

Strawperson The Shapiro MG gave me DIAZEPAM (Generic Vallium) sedative . . . 2 purple tablets at extended intervals through an 11 hour procedure. It rapidly brings your pre-op. blood pressure down and yes, you can (and probably will) eventually drift off to sleep. Walking to the restroom is best accomplished with an arm to rest on - and you definitely won't be driving home! I wouldn't relate the feeling to a beer scale (some folks get aggressive, right?) - But you will, as Robert has described, feel amazingly calm and totally carefree . . . makes for a totally relaxed procedure as I remember. Sorleyboy

Dear All . . . The HIV and Hep C Pre-Op lab work requests. Is this all that the majority of previous patients (subscribing to this thread) have been asked for? I note that, in addition to the above, the Shapiro MG also request haemogram (White blood cell and platelet count) and what is effectively Urea, electrolytes and liver function tests (presumably to ensure post-op medication compatibility). I can only surmise that, because H/T is an invasive procedure and will always involve some risk, giving your surgeon this information could help reduce complications at the operative and post-operative stages? I think I'd be more concerned with the outfit that wasn't interested in any diagnostics - before letting them take a scalpel to my head. Regards, Sorleyboy

Hairworthy I'm sure what I said was . . . "Particularly (i.e. not exclusively) from folks (I didn't say 'guys' (as in male?) - in the UK". . . . It frightens me no end the number of UK querents who because of distance/cost/time/travel/lack of options - or whatever - still keep asking if anyone has opinions on the plethora of slaughter houses we over here still have to consider (as a matter of convenience) - for procedures. If I can guide or re-assure just one person that it is worth going that extra mile (well 5 -6,000 actually!) . . . surely it has to be its own reward. Both you and I can speak from experience? Somebody from your or my home county might feel more comfortable talking to another Brit, wouldn't you say? . . . and there aren't that many UK forum members. No, Dr Keene doesn't work in the UK. - I did say in the first instance that I'd travelled to Tucson. Peace . . . T.P.

Gorpy . . . Hair distribution will be between you and Dr Keene and what you envisage between yourselves as your achievable longer term goals. Whatever you see as your priority with regard to area density and coverage, be assured that Dr Keene will make carefully considered suggestions with regard to hair re-distribution, such that you have the outcome that you would prefer. However, in answer to your question; at 55 years of age I had an established MPB (NW5) with diffuse wavy hair (~10-20 per cm2) at the median of the vertex (utilised as the inevitably ill-conceived 'comb-over') augmented with (generally) <5 per cm2 coarse hairs over the rest of the affected area. I'd bleached this some 18 months ago to reduce the contrast between hair and pate! (works - to an extent). My 'predicament' was that, after consultation with the Shapiro Medical Group, there was a likelihood that donor hair would not be 'over-abundant' - and so the prospect of a second procedure in the future would have to be carefully assessed. (The point being - it doesn't get any better, the older you get! - but at least you know what you've got left to work with). I wanted reasonable coverage of the crown area and wasn't concerned at all about the temples; a younger person may have wanted the opposite. A naked pate has for centuries been a distinguishing mark of humility and I was hoping that Dr Keene could suggest a procedural plan to counter this 'humiliating' disfigurement. From 8.30am. to 19.00pm. Dr Keene and her team worked at 2,500 grafts (and an extra 100 or more that were part of the original excision) to distribute the grafts approx. 50/50 front and crown. Having initially trimmed away the 'comb-over' and longer existing hairs, and having "only a half gallon to paint the house, when we need a gallon" - the front grafts were positioned and worked into the existing coverage with a view to establishing (in about 9-12 months) a high, natural parting line running forward to a front 'peak'. Assessing how the implants would grow out, Dr Keene could maximise graft distribution by (for instance) reducing grafts on the side that would be overlain by new hair and by the meticulous angling of each implanted hair shaft. Given that I am (was?) a NW5 - Hair density on both front and crown transplant areas, should resolve to at least 20-25 per cm2 for the one procedure - but given its wavy characteristic and the well considered placement of grafts we are confident of a sucessful outcome. As a postscript: - with the hideous comb-over gone and all the grafts still in place (7 days post-op) the change in appearance, even with a relatively low/med. density is quite remarkable - establishing the peak at the front has taken years off me! I'm as happy as a sand-boy and I can tell you Gorpy - that you will have a VERY positive time at Dr Keene's surgery. . . Best regards . . . T.P. (UK.)

Just to thank the veterans, et al, from this community who provided such valuable information prior to a 2,500+ graft procedure with Dr Keene on 27th July, 2005 in Tucson. I'll be putting an album together in the fullness of time to illustrate H/T growth progress. Most people should be aware of the excellent reputation that Dr Keene has cultivated over the years but I'd be willing to answer on this forum, any questions (based on my recent experience) - particularly from folks in the U.K., who are contemplating a procedure with Dr Keene of the SMG Regards, thanks, and good luck to you all . . . Sorleyboy