GratefulHead

Does anyone know if it is not recomended to take MSM immediately prior to a hair transplant? I'm going for my second procedure next week with Dr. True and his pre-surgery checklist says to stop all vitamins, herbal and other supplements, aspirin, Motrin, etc., 10 days before the procedure (Tylenol is OK). I believe this is to avoid substances that thin out your blood. I wanted to ask him about MSM specifically, but the office is closed for the weekend. Thank you. GratefulHead

Does anyone know if it is not recomended to take MSM immediately prior to a hair transplant? I'm going for my second procedure next week with Dr. True and his pre-surgery checklist says to stop all vitamins, herbal and other supplements, aspirin, Motrin, etc., 10 days before the procedure (Tylenol is OK). I believe this is to avoid substances that thin out your blood. I wanted to ask him about MSM specifically, but the office is closed for the weekend. Thank you. GratefulHead

Corey, Keep the faith -- three months is generally just the beginning of seeing results. You really need to wait a good 7 to 8 months before starting to make judgements. Enjoy your life and the hope/promise of a brighter follicular future while you wait! Fill your time wisely and it will pass quickly as it invariably always does... GratefulHead

MyPrecious, As far as Toppik goes, you should try going to the http://www.regrow.com/toppik.asp website and call the number at the bottom to possibly find a local hair salon that could match you up with the right color and sell you your first container. That is how I got my much needed first batch FAST a few days after my hair transplant! Hope you can do the same in Phoenix. GratefulHead

Gandalf, If you read about some of the really bad hair transplant tragedies involving major shock loss and poor new graft growth, you see a pattern where there were two or more hair transplants performed nine or less months apart. Strip surgery is invasive and takes a good 12 months or more to FULLY heal (like most surgeries). Some people are naturally more resistant to shock loss from close time proximity hair transplants than other people. Why take the chance you are one of the people who is more susceptible to rapid repeat surgery shock loss? My advice is to convince yourself to be patient and wait at least 12 - 15 months between surgeries. Give yourself the best odds possible to avoid this catastrophic type of shock loss... GratefulHead

Hi Mel from NY, I haven't been on the HT forum too much the last couple of months, but here is a better-late-than-never reply. I had 1503 FU grafts (800 in front and 700 in crown/vertex) transplanted with Dr. True in June 2003 and 12+ months out I am very happy with the results. I was progressing toward a Norwood 5A with thin coverage over the whole top of my head (non-uniform 20%-40% my teenage density) and the right-side of my front hair line was super-thin. Since I have dark brown hair and a somewhat fair complexion, I had A LOT of see-thru under good lighting. My donor density was below average, but I have the positive qualities of coarse and wavy hair. Dr. True is a skilled doctor who took the time to answer my MANY technical and clinical questions -- all to my satisfaction. My procedure took a little under 9.5 hours and resulted in hardly any pain. I do like their computerized-wand anesthesia injection system. I took one day off from work and worked from home / remotely for another week. I went to a friend's wedding 8 days after my surgery and with a little help from DermMatch and Toppik to cover the lingering scabs and redness, NO ONE NOTICED A THING! Even more so, I went to a party after the wedding reception with a different circle of friends and they didn't notice either! I WAS STOKED!!! I had my typically short hair-cut at the time (about 3/4 inch) and even the shaved donor area and sutures were unnoticable (dark brown sutures to match my hair). I did get considerable swelling from about day 2 to day 4 post-op. Although I slept with my head elevated and tried to ice twice an hour, I may have slid down too far one night and did wait too long between some ice applications. Since then, I've let my hair grow slightly longer than in recent years and I'm still using Toppik, but my (12 months post-op) hair looks like a good thick head of locks. This is SOOO AWESOME to me because I haven't had that look for a good 7 years!! Dr. True does not dense pack hair and hence I don't expect to have "teen" thick hair after one procedure without any camo. He told me up front a second procedure would be needed to improve density. From everything I've read, this is the standard for hair transplants. Although I've seen some impressive high-density pics, I personally would prefer a non-high density transplant to ease the trauma on all my existing hair. For the first 3-4 months, all you got is your existing hair and you don't want to over-traumatize it into excessive shock. My donor scar is approximately 1 mm at the widest points. Getting a hair transplant is a serious decision and one of the best things you can do to become informed is to read all the forums here on applicable topics, read published hair restoration papers, and look at before/after results for a given number of FU grafts. You will have to weed out some of the hype, but doing this research will help you develop a balanced, realistic set of expectations. I voluntered to attend an Open House Seminar with Dr. True on 3/4/04 (also my 9 month check-up appointment day). There were at least 8 guys there with transplants by Dr. True. All of them looked really good and all of them were very pleased. Incidentally, Dr. True has had two transplants himself to my knowledge. I've gotten considerable positive remarks and inquiries about my hair since about the 4 month mark, but no one knows the real deal (or has even suspected a HT) except one close friend who I decided to tell outright. Overall, it has been a positive experience for me with Dr. True so far. I'm really enjoying my new hair and do not have any regrets at this point. I plan on getting my second transplant for more all-around density with him this coming fall or winter. Given my stated goals at my one year follow-up appointment earlier today, he recommended a comparably sized (1500 FU or so) procedure to my first when I am ready. I wish you the best success with your future hair transplant! GratefulHead

HairQless, What Arfy is saying is sooo true. Don't forget Finesteride is the best defense that YOU can control against shock fall-out! Think about it like this -- if you are planning strip surgery then you are probably paying $4 - $5 per graft (give or take). On average, a graft is 2 hairs. If taking Finesteride has the net aesthetic effect of adding 1000 hairs or 500 grafts (through thickening and regrowth), that has an equivalent hair transplant value of $2000 - $2500. More importantly, each hair that it maintains thick and intact in your scalp in the future is worth $2 - $2.50. As you are now middle-aged, realize age alone can start becoming a major contributor to hair thinning. How many guys do you know in their mid-sixties who have a full good-density head of hair? One general rule of thumb is 30% of guys in their 30's experience hair loss, 40% of guys in their 40's, 50% in their 50's, 60% in their 60's, etc. It sucks Propecia is so expensive, but how much is having/keeping hair worth to you? I would look around for the best deal on Finesteride by shopping around, buying in bulk, looking into Proscar, etc. I hope your research efforts are rewarded with terrific hair improvement. GratefulHead

HairQless, You are correct in that one of the main reasons to take Finesteride prior to a HT is to thicken your existing hairs. Thick terminal hairs are less susceptable to post-transplant shock loss. Another added benefit is any areas with Finesteride induced regrowth will require less of an allocation of your precious donor hair. As for stopping Finesteride after your transplant, I would research that VERY CAREFULLY before making any decision. If you stop, certainly you can expect all of your "in amazement" regrowth that you have experienced to completely disappear. I will never forget a guy I saw at a seminar sponsored by my HT doc few months ago. He was 4 years younger than you if I remember correctly, but he told how he had been on Finesteride for a long time and had a previous transplant. He stopped Finesteride recently for about 6 months, however, and by his account approximately 1/3 of his non-donor region hair fell out! Needless to say, he's back on Finesteride, planning another hair transplant, and is extremely sorry. Take heed to learn from his experience and not make a similar mistake. GratefulHead

Havhairnow, Technically, the follicle is the whole unit they transplanted including the growth center and glands. You are probabably seeing just the hairs come out with the scabs. You can tell the difference because a hair only has a very small light bulb (only slightly thicker than the hair diameter) at its base. This looks the same as a healthy hair that shed because its host follicular unit has gone into the resting phase -- only buried in a scab. It should not have a small rice kernel size base apart from the scab (like Rugger pointed out). I hope this helps put you at ease. Keep up the aftercare and guarded healing... GratefulHead

Forlife, Tony Darrow from the Sopranos, Goodfellas, and Analyze This had a transplant by Dr. True (and Dr. Dorin). Jerry Douglas from the Young n Restless had a transplant by Dr. Elliot. So there it is... GratefulHead

Newby, I've had a very good experience with Dr. True. Click here to see my story... Transplant experience with Dr. True I wish you success in your hair-loss treatment ! Peace out. GratefulHead

CuriousGeorge, If you are only 24, the look of Toppik is acceptable, and you only have been on Finesteride for four months, I think you are VERY smart in your decision to hold off on a hair transplant! I personally would wait until your hair appearance (with Toppik) is COMPETELY UNACEPTABLE before undergoing a transplant! Taking this approach offers the following advantages: 1.) It allows your future hair loss pattern to become more defined. Knowing the final pattern is crucial to optimizing the recipient area distribution and the long-term treatment plan (given a limited donor supply). The result is a future transplant will look better over the long-haul. 2.) Finesteride will thicken up your existing hair and probably grow some new hair after sustained regular use. Certainly this should be given 12 - 18 months MINIMUM to see how it alone will improve your appearance. It is something you want to do anyway no matter what (unless you have serious side effects), and therefore isn't costing you any "extra" money. Finally, the thicker your existing hair the less susceptable it will be to shock-loss after a potential future transplant. 3.) Hair transplants are invasive. Some single-digit percentage of your existing hair will suffer shock-loss after a transplant (assuming you are not transplanting into areas that are completely bald). Although most of this hair should grow back after several months, you will have a thinner look than pre-op during the interim. The really thin vellius type hairs will probably never grow back. Furthermore, some small portion of the normal thickness "shocked" hair will be permanently damaged and will not grow back as well. If you wait longer to have your transplant, you will have less existing hair at risk to these mechanisms and you will see a greater "before/after" improvement to feel good about (assuming a sufficiently large number of FU grafts were transplanted). 4.) Your hairline will recede further and you will age more into the mature look appropriate for the higher hairline. This will allow the (recommended) option of transplanting to a higher hairline and still looking your age -- thereby saving some precious donor hair and minimizing the potential unnatural look from future thinning behind a transplanted hairline. 5.) Once you jump on the hair transplant train, you will most likely ride it for life (or until your donor supply runs out). Boarding the train early will just mean a longer and more unpredictable surgical journey. 6.) At 24 and from what you describe you are near the beginning of the hair-loss curve and on the ramp-up. The further you progress along on that curve before your first transplant, the more likely it is you will need less total surgeries to maintain a natural, asthetically pleasing appearance. This is likely to save you total $$$ and gives you time to increase your earnings and save up money to do it right -- without getting into debt! Less surgeries also means less overall disruption to your life during recovery -- especially while in your prime 20's! 7.) Hair transplant technology and technique will continue to advance as will the number of highly talented doctors. The longer you wait, the more you will benefit from these improvements in the field. Keep it real -- as long as you can... GratefulHead

Hi Truthseeker, I began using Toppik 8 days after my transplant for my friend's wedding. It went undistinguished there and at a different party later that day. I've been using it ever since (9+ months now) and I like it a lot! As far as interferring with growth goes, all of your hair growth takes place in the hair follicles under the skin. Dusting a dry non-chemical fiber above the skin and on the hair is not going to adversely affect hair growth. My hair transplant doctor (True) and Spencer Forrest both approve its use post-op. Click on the index card / little person icon above, select "View Recent Posts", and scroll down to the "Toppik Question" post dated 12/23/03 for some additional information. Best of success with your hair improvement efforts! GratefulHead

Hi Nobel Victim, I can relate to how losing your hair makes one self-conscious. Nine months after my 1503 FU graft hair transplant last June by Dr. True, I can honestly say that self-consciousness has all but completely evaporated. It is a very liberating feeling to once again be able to engage life full-throttle with restored self-esteem! Obviously a hair transplant isn't going to be a "cure-all" if you got other "issues" (which we all do), and it's not going to turn back the calendar years, but it can help immensely if hair-loss happens to be one of your biggest "issues"! Yes, it will be a disruption to your life for a short time -- but within 10 days you can be back to living 90% normal and not long after that you will be reaping huge benefits (assuming a good Doctor). Furthermore, your actions will continue to pay dividends the rest of your life!! Yes, it is rather expensive. I ask one question though: "What material thing can you buy or how else can you spend your money that will improve the quality of your life to the same extent?" You ask for motivation. I don't know your religious standing, but I personally draw much motivation from the bible. As such, here is a passage of scripture for you: "For we know that the whole creation groans and labors with birth pangs together until now. Not only that, but we also who have the firsfruits of the Spirit, even we ourselves groan within ourselves, eagerly waiting for the adoption, the redemption of our body. For we were saved in this hope, but hope that is seen is not hope; for why does one still hope for what he sees? But if we hope for what we do not see, we eagerly wait for it with perseverance. Likewise the Spirit also helps in our weaknesses. For we do not know what we should pray for as we ought, but the Spirit Himself makes intercession for us with groanings which cannot be uttered. Now He who searches the hearts knows what the mind of the Spirit is, because He makes intercession for the saints according to the will of God. And we know that all things work together for good to those who love God, to those who are the called according to His purpose. For whom He foreknew, He also predestined to be conformed to the image of His Son, that He might be the firstborn among many brethren. Moreover whom He predestined, these He also called; whom He called, these He also justified,; and whom He justified, these he also glorified. What then shall we say to these things? If God is for us, who can be against us?" -- Romans 8:22-31 (NKJV) I know this is long, but I hope you draw some inspiration from it. I would ask God to help guide you in making the right decision regarding repair work. You won't regret it! And remember, Nobel Victim -- life goes by, just don't let life pass you by... GratefulHead

Danger, If you have at least decent thin hair coverage, I believe Toppik is the best. It looks incredibly natural (when the color is matched well) and couldn't be faster or easier to apply. As far as being active with Toppik goes, I know there are some who caution about using Toppik while working up a heavy sweat. I was concerned about that myself initially. I haven't found it to be a major issue though. I played spring/summer and fall softball and summer volleyball every week and I never once noticed it run down my skin. I've also worked-out, rode mountain bikes, and rock climbed and it has never been detected. The biggest prob I see is that if you get caught in the rain, it can get displaced by the rain drops on your scalp and result in patchy coverage. Heavy sweating also creates a slightly patchy look. However, if you have at least decent thin hair density (like me), even then it isn't overly obvious unless someone looks real close at the top of your head. The Toppik sales brochure states "It stays on through rain, wind and perspiration, and it can't possibly run, smear or stain." From my experience I would agree with that statement for the most part. Swimming, however, is another matter all together. I would recommend DerMatch for when you plan on swimming or doing water sports. You might just want to practice applying DerMatch several times before the day you actually need it to get the hang of what looks natural. Given your Username, however, maybe this cautious approach doesn't suit you In any event, have fun being more active! GratefulHead

Notsohairy, Since you have two similar threads, I'm appending to both. I am 9 months out with Dr. True (1500 FU grafts) and my improvement is fantastic! My donor scar is approximately 1 mm at the widest points. Select the folder / little person icon above and read one of my November 2003 appends for some details on my story. I second Arfy's advice from his previous append. Arfy, You are so right there is no substitute for seeing real live patient's work with "before" pictures in-hand! By conincidence, I voluntered to attend an Open House Seminar with Dr. True last Thursday (also my 9 month check-up appointment day). There were at least 8 guys there with transplants by Dr. True. All of them looked really good and all of them were very pleased. Talking with them live really provided a depth of understanding behind their aethstetic enhancements that pictures alone just can't do justice to. There is nothing more powerful than genuine personal testimonies! When people don't let their personal bias sway them too strongly, that is the power of this forum! As for me, knowing everything I do about other great Medical Groups, I still plan on getting my second transplant for more density with Dr. True later this year. How is your latest repair work growing in and progressing?? Best regards. GratefulHead

Notsohairy, I am 9 months out with Dr. True (1500 FU grafts) and my improvement is dramatic! Select the folder / little person icon above and read one of my November 2003 appends for some details on my story. I voluntered to attend an Open House Seminar with Dr. True last Thursday (also my 9 month check-up appointment day). There were at least 8 guys there with transplants by Dr. True. All of them looked really good and all of them were very pleased. I plan on getting my second transplant for more density with him later this year. Best wishes for a successful transplant! Robertj, Did you consult with Dr. True as you had planned? Can you share your impressions? You are on the right track by doing lots of research and getting consultations. Micrograft, Your repair work with Dr. True was performed around 6 years ago when the all-follicular unit procedures were in their infancy. Since you didn't receive that type of procedure, it is understandable that your transplant was sub-par when compared to today's standards. Nevertheless, could you be specific in what aspects of your "results" were poor? Likewise, could the others who rated Dr. True negatively please provide some helpful details on their experiences? Thank you. GratefulHead

Justin, You are going to look GREAT man!! My transplanted hairs took about 4 weeks to shed. This is longer than average, however. Best of healing! GratefulHead

Yes, transplanted hairs are still subject to shock loss. Thick terminal hairs (whether transplanted or original) that get shocked out are probably primarily due to the recipient graft site cuts and anesthesia injections being in real close proximity to existing hair follicles. At the same time, individuals vary in the amount of secondary scalp trauma from the overall effects of the anesthesia and donor strip harvesting (and potentially past transplants -- especially ones done single-digit months prior). It is common sense that high-density / high-graft count transplants will result in more shock-loss on a patient with a good amount of existing hair. Some good news is you should experience less shock fall-out on the second transplant, assuming at least a year between transplants, because most of the very fine "vellus" peach-fuzz type hairs typically fall-out after the first transplant. In any event, the majority of the shocked "terminal" hairs (both transplanted and original) should grow back. Although the risk of shock loss is real, the benefits of a quality hair transplant far outweigh them for almost everybody. The most beneficial shock prevention you can control is probably taking Propecia/Proscar for 12 months prior to your transplant to thicken up your existing hair. Peace. GratefulHead

Hi Eastcoast, The answer to your question depends on exactly how big your bald Norwood 6 area is. A Norwood 6 has an elliptical (that is, oval) thinning zone incorporating the front, midscalp, and vertex (a.k.a. crown) areas. The length of the "major" and "minor" bald ellipse (or oval) diameters, d1 and d2, should be measured. Since a radius ® is defined as half a diameter, r1 = d1/2 and r2 = d2/2. Finally, the area ("A") of the bald ellipse (approximating to be planar) is r1 x r2 x Pi = (r1)(r2)(3.14159) = "A" cm^2 (or centimeters squared). Your stated goal of 1 hair every millimeter equates to 100 hairs/cm^2. Hence, multiply the above bald area "A" by 100 to obtain the approximate number of hairs necessary to look follicularly normal. I hope this answers your question. Rugger, Thank you for acting as a positive employment reference! Maybe we can discover hair on Mars??? GratefulHead

Jeffro5422, Welcome to the board! That is great you are on Propecia and Rogaine and are interested in trying Toppik during your early 20's! You are on the right track Bro! I've been using Toppik ever since my hair transplant about 6.5 months ago. Toppik definitely works with long hair... even better than with short in fact. I know there are some who caution about using Toppik while working up a heavy sweat... I was concerned about it myself initially. I haven't found that to be a real issue though. I played spring/summer and fall softball and summer volleyball every week and I never once noticed it run down my skin. I've also worked-out, rode mountain bikes, and rock climbed and it has never been detected. The biggest prob I see is that if you get caught in the rain, it can get displaced by the rain drops on your scalp and result in patchy coverage. However, if you have at least decent thin hair density (like me), even then it won't be so easy to notice. The Toppik sales brochure states "It stays on through rain, wind and perspiration, and it can't possibly run, smear or stain." From my experience I would agree with that statement for the most part. All of your hair growth takes place in the hair follicles under the skin. Placing a dry non-chemical fiber above the skin and on the hair is not going to adversely affect hair growth. One of the most critical factors during initial use is matching the right color. I would have considered my hair medium brown, but a hair salon that sold me my first container of Toppik correctly matched me up to dark brown. I almost direct-ordered the wrong medium brown, but I had a wedding eight days after my hair transplant and I had to seek out a faster way to obtain some (i.e., the local hair salon). Check out the web site http://www.regrow.com/toppik.asp and call their number to possibly find a local hair salon that could match you up with the right color and maybe buy your first container from. I bought a "regular" size from the salon which I thereafter refilled with the more economical "giant" size. You just have to make sure that your shaker-tops fit snug after breaking the seal to refill so they won't fall off and spill during application! Their directions for application are pretty good -- the only thing I would add is to (1) not apply too heavily in the hairline; (2) check your forehead and clothing for off-target fibers and wipe them away with dry fingers; (3) stand away from any sink or countertop while applying so you don't need to dust off excess fall-out; and (4) use a second mirror to check midscalp and vertex/crown area coverage for a while until you get a good feel for how much product to apply. I really like Toppik and I don't know of any faster, easier, or more natural looking way to incredibly camoflague thinning hair. Post an update to let us know your experiences after trying Toppik. Best wishes for a successful hair improvement journey and a blessed Christmas. GratefulHead [This message was edited by GratefulHead on December 23, 2003 at 06:11 PM.]

Figsy, My doctor (True) told me it typically takes 3 - 4 months for stretch-back to occur. My scalp felt tight, especially at the ends of the donor area near the ears or when I moved my head at a certain angle, for about 4 months after my first 1500 FU transplant. I was diagnosed with average scalp laxity. At 6.5 months I essentially don't notice it anymore. A tight scalp is one thing, but having unnatural sensations because the tissues and nerves are not fully healed may be a contributing factor. I wouldn't get too concerned until you achieve full healing, which takes a good year. Our skin has an amazing degree of elasticity given some time to stretch! Think about obese people. Probably the worst long-term outcome will be the donor scar is a little wider, but you are pretty well knit together at this point (3.5 months) and have likely seen most of that effect already. How does your donor scar look? How many grafts did you have for each of your two procedures? May your remaining healing be fast and exactly as you hope. Have a peaceful Christmas. GratefulHead

Dude1, I just realized you asked your question in the Hair Transplant Surgeons forum. I am no doctor. Sorry. I certainly invite any willing doctors to answer Dude1's question. Best regards. GratefulHead

Dude1, Three months out is pretty good, but one of the bigger risks of over-exposure to the sun/UV is permanent discoloration of your healing skin. If you skin still has some pink color, I would lean toward being cautious. Exposing your skin to excessive sun/UV is really bad for it anytime -- the scalp not withstanding (see URL http://www.cnn.com/HEALTH/library/HQ/01462.html). As such, I would stay away from the tanning booths. I don't think the effect of UV on hair folicles is known for sure, but it certainly doesn't help! Wearing a hat part-time (like you plan on) is obviously a great idea -- especially during the strongest UV timeframe of late morning to mid-afternoon. The other preventive measure would simply be applying some good sunscreen to your skull. The UV guard shampoos and hair sprays tend not to provide very much protection (as indicated by their vague ratings information). The trick is to find a sunscreen that protects from both UVA and UVB, leaves minimal residue (i.e., white film) on your hair, and is easy to apply (i.e., spray bottle). I tried several drug store varieties and have not come across any real good ones yet. One would think that with the extensive number of products out there it wouldn't be so difficult to find! Shopping the Internet opens up vastly more options. Some ideas to explore include: Coconut Tree Hair & Scalp Sun Protection Spray SPF15 (see URL http://www.hairsite.com/library/abst-113.htm) and Biotech Shen Min ScalpBlock. There is no reason not to go south and enjoy the warm weather just as you would any other Winter/Spring break -- while at the same time taking these simple precautions to maintain a healthy scalp. May your time off rejuvenate and revitalize you for the year ahead! GratefulHead

Begiumdude, This is so basic I'm sure you already know it, but don't forget that one of the best ways to reduce acne is to simply not to touch your face. Obviously keeping it clean all day goes hand-in-hand with this. My advice is not to give up attempting to control the acne just yet and try to stay on Finesteride. This is the most effective proven hair-loss prevention that is relatively safe. Plus the simplicity of only having to take a pill once a day means you are more likely to stay with it long-term. Peace out. GratefulHead