MCS

After yesterday's consultation with my long-standing surgeon and from what I've briefly researched, FUE transection rates vary widely, and are not just reliant on the skill of the surgeon but, as he explained, on the mechanics of harvesting the grafts themselves. Thus, there looks to be a lot of mistruths and outright lies being touted by those who say "oh, FUT is obsolete now, we do nothing but FUE, and our transection rate is only 2%." The reality, he claims, is more like 20-30%. Furthermore, the automated robot machines that some are using for FUE don't get the same yield as what some of the FUE surgeons are charging their patients for and the grafts are shot into a tube and into a glass, further subjecting them to unnecessary stress. Bottom line is that my doc does FUE, but was very transparent in educating me on the risks. He still feels that the best yield still results from FUT, hands down. I can at least attest to that firsthand, having had three HTs now, with a total of nearly 10K grafts total to my credit, with minimal scarring as a result. I just had more loss than we had donor hair for, and still do. I have not consulted other docs in my area (Las Vegas), but leave that option open, though my level of trust and comfort have are still with him. Recommendations to me: Although my laxity has improved markedly since he last did a post-op follow-up on me 09-12, he still would like to see increased laxity and suggested scalp exercises as a pre-op prep. He now feels we can get a pretty good yield of grafts, somewhere around 2000, using mostly FUT and combining it with FUE, especially in the scar area (which are not visible with my current hair length). This would get as close as possible to achieving the density I desire, especially in the crown. This was just not a possibility 4 years back.

Not on any DHT-blocking meds, no.

Here's one of my original threads: http://www.hairrestorationnetwork.com/eve/169274-1-year-post-op.html I am now 56.

My previous thread on my visit to Dr. Umar back in 2013: http://www.hairrestorationnetwork.com/eve/170516-consultation-dr-umar-need-help.html

No, and now that you and ontop have mentioned it, perhaps it's time for a re-evaluation with my doc. Any thoughts on SMP?

Beard hair is all white now, so wouldn't match. My doc that did the previous HTs had added FUE soon after my last (3rd) procedure: FUE | Follicular Unit Extraction His site pretty much spells out the risks of FUE. I trust his expertise more than anyone else's. He is a coalition member: http://www.hairrestorationnetwork.com/JosephWilliamsMD Maybe I should re-consult him since it's been over 4 years since my last procedure (I did all 3 HTs with him starting in 2006). I am on blood pressure and blood thinner meds; would have to stop the thinner for a couple days, but that's no big deal, as I had a surgery 2 years ago and zero problems.

Have not done anything since HT #3, but re-evaluating & still looking for "filler" solutions. Just wanted to see what's changed, if anything, in the last 3 years since I last posted. Latest pics attached. As I mentioned in my past threads, another procedure whether FUT or FUE is not an option since I've already done 3 HTs and my scalp laxity is almost null. Anything other than SMP, BHT? Or should I just wait for Shiseido, RepliCell, etc. to come thru with multiplication/cloning?

Could you post the link to the other website?

Thanks. Again, can you post some of your befores & afters from Dr. Umar?

I'm sure you mean to say "FUT has taken you as far as it will go." And that would be correct, yes. The only other option would be for me to keep making the Toppik guys rich until replication or cloning is available. Do I want to keep smudging up pillows with black soot and not being able to swim in public pool for another 5-10 years? I don't think so. Would you be willing to please post some of your befores & afters? How long ago was your procedure done? My job would be in "icing on the cake" or fine-tuning my thinning areas, as I;ve already had 3 transplants already.

Dr. Williams - which I put in the post when I first made reference to him

I would not be doing anything in the front, only the crown, back and sides. He did mention the possibility of using some scalp hair along with beard. No, I didn't get a lot of confidence to be honest, but I see he is recommended here. Strangely, I got more from his online consultation than in person. He basically said that using his methods, he has not found the scarring to constitute a long term cosmetically significant problem in the hundreds of surgeries he's done over the past 6 years. Who's the other guy you mentioned that charges $12 out of curiosity? Last resort, I could just wait it out until hair cloning is finally available.

I just recently completed a consultation with Dr. Umar and need help here in making a difficult decision. As a fourth and final solution to the lack of density and scar having stretched from my third HT procedure as I've posted here: [ http://www.hairrestorationnetwork.com/eve/169274-1-year-post-op.html ], I am seriously considering FUE using beard (and possibly scalp) donor hair to fill in the crown and sides. While Umar's many online advertised results speak for themselves, it was important for me to get a feel for him personally. The doc that did my prior three procedures is Dr. Williams and my first choice would always be to go to him. This is the first time ever consulting with another HT doc. Dr. W brought it to the absolute max that conventional FUT could ever go. I am very pleased with the top notch work of Dr. W. But I want that extra density that FUT can no longer provide due to reduced laxity, previous scars, and continued shock loss that comes with the territory. It would be a dream if Dr. W could be the one to do #4, as I've developed complete confidence and an unsurpassed comfort level all these years with him that I do not have with anyone else. Whether it matters or not at the end of the day, Umar was rather despondent during my consultation and didn't really seem too enthusiastic about meeting me or doing my hair, but that just could've been that it was at the end of the day and I'm not anywhere as bad a shape as most of his clients. Umar recommended the following: 800 grafts for the scar restoration, 1500 grafts to add density to the crown area and 600 grafts to add density to the left and right side of your head. Total grafts: 2900. This would be a 2-day procedure @ $7/graft (his usual price is $8/graft and his clinic is running a special this summer). Thinking back to Dr. W - I know that he CAN do FUE now [ http://www.hairrestorationnetwork.com/eve/167889-dr-joseph-williams-now-performing-fue.html ], however, BHT FUE requires a certain skillset that from everything I've researched develops over time and this would naturally be my concern. Thoughts here? Also, some cons over BHT, as top HT docs like Rassman advise against all forms of BHT: Hair Loss Information 1) Scarring (especially for beard donor hair) - For me, beard hair may be a safe and yield a better cosmetic results, however, I fear the risk that transplanting beard hair may leave visible facial scarring. 2) BHT inconsistency with scalp hair. 3) BHT requires a greater donor yield to accomplish what scalp hair can since body hair growth cycles are shorter. Whereas only 10% of scalp hair isn't visible due to being in telogen (shedding) and catagen (resting), up to 40% or more of body hair isn't visible on your scalp at one time. So, I remain somewhat skeptical as to whether BHT is the best approach in my particular situation. Umar is closest to me, but any thoughts as to Jeffrey Epstein who also does BHT/FUE? Thoughts??? I know it sounds silly, but I feel like I'm cheating on Dr. W.

Looks like Rassman's SMP clinic is the best one in the states?

Anyone seen this before? Just would like to get some feedback: **outside link removed by mod**

Another option would be a beard hair transplant. Thoughts? Maybe a combo of both?

SMP. Never thought of that. Definitely the least invasive at this point. I've only seen pics used for bald guys who want to give that shaved look. Can you post some before and after links showing for guys with thinning hair or strip scar lines that need to camouflage and touch up their scalp? I guess it's no different than permanent makeup. In fact, that may be a suitable "patch" or bridge for where I'm at before the next generation in hair replacement (i.e. replication/cloning) becomes available. Anything to replace the concealers! Thanks.

Has anyone tried a beard hair transplant? This was suggested as a solution to my issues on another forum. Only thing is that my doc doesn't do those.

Well, had my follow-up, and the upshot: I agree with the doc that further procedures would just cause more visible scarring regardless whether FUE or strip, as my scalp has much reduced laxity from the three prior procedures. Prior thread that shows my pre & post-op pics: http://www.hairrestorationnetwork.com/eve/167505-transplant-3-8-mos-post-op.html Only options at this point: - wait for more growth (the ProScope did again show some weaker hairs popping out) - wait for the next generation of HT (stem cells, cloning, regeneration, etc.) - continue to use concealers in the meantime. - body hair transplant to touch up the residual thinning Speaking of concealers, I still have been using two: Couvre (for sides, rear hairline, and sideburns) and Toppik (for vertex, crown), neither of which are ideal options, but I have no choice if I want to look "restored". The biggest disappointment is that even after three procedures, I still have to use them.But I REALLY hate resorting to concealers. They are messy, potentially toxic, get on pillows and clothes, and consume application time, but I have no choice if I want to achieve the look I feel good about. My doc takes great pride in his work and has done everything that is currently available today. He was disappointed and almost offended that I have to resort to using concealers. His rationale is that because I'm in my 50s, I should accept my hair as-is and that it looks good enough. But that is not what I paid for and is not my desired outcome. I wear it pretty short which I realize is challenging for anyone who has had a good deal of loss even with multiple procedures (10K grafts combined total) as in my case. But I prefer it short and it looks markedly better with the concealers which means I still am LACKING DENSITY! As you can see, using concealers vs. not (click the link above for past pics) is a huge improvement: http://i57.photobucket.com/albums/g207/CS2006/image_zpsf09d9a39.jpg http://i57.photobucket.com/albums/g207/CS2006/image_zpse468e4b1.jpg Doc argued with me to wear it longer, but I emphasized that even longer, you can still see thinning throughout the crown and rear. At this point, I have no other options except the above ones unless anyone can share something I'm unaware of or missed.

If you click the link in my post, you can see all the pics. Let me know.

Now going on 10 mos. post-op, the results of the transplant continue to be anything but satisfactory. The scar line is now clearly visible in this third procedure which was never visible in the first two. Again, doc confirmed he used a trico closure as he did on the first two, so I cannot understand what happened here. In addition, I have seen no improvement thus far in the areas on my scalp which had the most transplanted hairs despite the small hairs that showed up on the ProScope: http://www.hairrestorationnetwork.com/eve/167505-transplant-3-8-mos-post-op-2.html I am due to come in after the first of the year (12-mo. follow-up), but I don't see how there will be any improvement as I haven't seen any up to this point. Certainly not to the scar line. I hate to think I'd need a scar revision and a fourth "patch-up" because the third didn't come out as planned. Until follicular replication or stem cell is available, do you think something like FUE would help in this regard? My scalp is a battlefield and I think I can no longer count on yet another future FUT strip excision. I still have to use so much Toppik and Couvre that I need to clean the sink and vacuum the floor every day. Will that ever stop? I stumbled across this vid that may explain that even trico closure may not work in cases like mine of multiple procedures and that FUE is best: http://www.youtube.com/watch?v=tu0datWla5c Perhaps FUE could remedy the residual thinning areas?

Had follow-up appt. w/ doc today to address the above concerns: - he did agree that the scar line widened for some reason on procedure #3, despite using the tricho closure method, although I still retain scalp laxity. - he did use epinephrine with the local anesthetic (this is reported to help reduce shock loss and bleeding). - he did agree that the scalp trauma of multiple procedures most likely has retarded growth. - he advised to check back in 4 mos. (1-year follow-up) to evaluate further growth. I am not as concerned about the scar line, as even with the cut I just got (the shortest AI would eve wear my hair), you cannot see any scar. My main concern is the remaining thin crown and side areas. Has anyone heard of this new hair replication method, RepliCell: http://www.youtube.com/watch?v=lnZ6OJagUN8&feature=plcp http://www.youtube.com/watch?v=gG4Jz88IuB8&feature=relmfu

Here are my latest post-op photos as compared to pre-op taken in the doc's office. I still get shocked and say where are my grafts??? Tell me what you think based on my concerns.

Post-op 8mos. - Using the ProScope @ 50X we can see the smaller diameter hairs now just starting to sprout.

FYI - the name of the device is ProScope http://www.bodelin.com/proscopehr