arfy

It's not retail, as far as I know only Dr. Lee has it (via mailorder). He's got a formula that doesn't feel gritty, and (i think I mentioned this) doesn't irritate me. I don't know the price difference between his 5% and 15% formulas (sorry) but I'm pretty sure it is worth looking into, if you are a Minoxidil user.

Rogaine should help you with the miniaturization, and so should Propecia. What these meds do BEST is to help retain the hair you still have. That's exactly what you seem to need... to save those borderline hairs. I wrote in another thread that there is a 15% minoxidil available. I would look into that. But start with a normal 5% solution, and after a month or two, then bump up to a higher concentration. (I would ease into the stronger version, in your case). Good luck! I hope it works for you. Keep us posted.

I don't think the laser comb will regrow hair. It may do something to strengthen the hair you have (but personally I doubt it). However since you already bought the laser comb, you might as well use it. As far as getting a hair transplant to touch up your hairline, my recommendation is DON'T. I personally think that doing little touch-up jobs for trivial amounts of hair loss can be a big mistake. It is very hard for a transplanted hairline to look perfect... not very many doctors can do it consistently, and even the best doctors can't guarantee complete perfection. But that's exactly what guys want and expect from a hairline touch-up (perfection). I don't think it is realistic! By getting a hair transplant so early, you may be opening up a Pandora's Box. You may be creating more problems for yourself than you already have now. I personally feel that a guy shouldn't get a transplant until he is at least Norwood 3 or HIGHER. (See Norwood Scale ) Hair transplants are not perfect! See this thread about hairlines and how the transplanted hair can sometimes not make a perfect match with the existing hair: http://hair-restoration-info.com/eve/forums?a=tpc&s=5696015661&f=1466060861&m=301107882 My advice: don't get a hair transplant if you only have a minor amount of hair loss. Vitamins and shampoos are probably not going to do anything for your hair loss. You might want to think about getting on something effective like Propecia, which should be able to stop your hair loss from progressing.

There is a 15% Minoxidil available now. The evidence seems to be that the higher the concentration of Minoxidil, the better. I've been using the 15% Minoxidil for a couple of months, and while it is too soon to say anything about results, I can tell you that this formula does not irritate my scalp like other brands did... there is no Propylene Glycol. (PG irritates some people). You're supposed to use it once a day with another application of a lower strength formula (5%) or with another topical, or you can just use it by itself once a day... I just use this once a day, and nothing else (I use it to help my recent grafts grow). You might want to look into a 15% solution. The more recent your hair loss, the better these things tend to work. What the medications work best at seems to be for keeping the hair you still have. That is a strong argument for getting on treatments early, rather than waiting until you are fully bald and then asking "now what?" Do a search on Dr. Lee and 15% Minoxidil to find the source. I'm not suggesting that 15% Minoxidil will regrow anyone's hair, I am just suggesting that you look into it. As far as pricing, it's about 90 bucks with shipping. Used once a day, it lasts about 6 months, I believe.

Maybe she is just the receptionist. She may not be able to answer technical answers because she doesn't know Or she may know the answers to your questions, but she's been told not to get into discussions about things like medical techniques or prices over the phone, with a cold caller. They may be trying to discourage people who shop based on price. Or Epstein may prefer to handle all the medical questions personally (just speculating, obviously). Sorry if I misunderstand the situation, but you may be over reacting. Maybe not though, it's hard to find good help.

If you believe that "follicles never die" then technically yes, you are putting a graft into areas where dormant follicles are slumbering. You could very well be infringing on old follicles when you put new grafts in. A lot of guys don't care because they figure that those older follicles are useless, as far as they are concerned. I'm not sure if this is an issue. If you are asking because you're interested in HM, there should be plenty of old follicles that get "missed" by the new grafts. Hair transplants don't generally recreate your original density, there is not enough of a donor supply to do that.

A lot of how noticeable it is will "depend"... Mostly on your own characteristics, as long as you picked a top doctor (beware there are a lot of mediocre doctors in the field). For example, if you still have a lot of hair remainingm, then your hair transplant has a better chance of passing scrutiny. If however your entire hairline is well gone and needs to be totally re-created, then it will affect your chances of complete undetectability. Another factor is how coarse or fine your hair is. Coarse hair covers your scalp better, but it can be hard to create a soft feathery transition with coarse hair. Fine hair is inferior for covering a lot of scalp but tends to escape detection more easily if it is transplanted in a skillful manner. I am speaking generally here, skill of the surgeon may trump these factors. I would say it is hard to find a hair transplant that fools a trained eye under every condition. Patients and doctors know what to look for, there are tell tale signs. Again, if you still have a lot of your own hair remaining, that can be a factor. I would say that if you are completely opposed to anybody ever knowing you had a hair transplant, under any circumstances, ever, then you should probably not get one. I don't think the odds of that are high enough to make surgery a good idea. Your doctor cannot guarantee that nobody will detect you had a hair transplant. Let me reframe your question. If your results looked great, and most people couldn't tell you had anything done, would you mind that every once in awhile you caught someone looking at your hair and wondering 'hmmm'? That is about as successful as you should hope to get, realistically (in my opinion, of course). My number one advice to you, though, is to beware that quality amongst clinics varies WIDELY and even a smart person may not be able to tell the difference on the surface, between a good clinic and a bad clinic. Research any clinic deeply, and realize that the number of top clinics is tiny. Most clinics will give you a mediocre result, which will (in my opinion) look like an obvious transplant, and is therefore absolutely worthless. Only the very best clinics can do something approaching undetectability, unless of course there is no wind and no rain in New Zealand (?) <BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>I am totally new to the Ht idea but am keen on it. I would say that you should suspend your enthusiasm until you've researched the topic more. Many guys have looked into and then decided against a hair transplant, for a variety of reasons. Don't decide that this is what you want, until you've really got a firm grasp on the pros and cons.

FUE = Follicular Unit Extraction, it is a relatively new and relatively rare way to harvest the grafts. Only a small handful of doctors are currently doing it, but there is a good amount of interest in the technique. Some people think it is an exciting advancement in technique, while some other people are more lukewarm on it. With FUE the grafts (follicular unit micrografts, the most desirable type of graft) are moved one by one, from the donor area. Compare this with the typical way to harvest grafts: by removing a donor strip of scalp, which is divided up into small grafts. FUE does not use a donor strip.

I agree with Rugger in that the patient's characteristics can be a major factor in whether shockloss is a problem. It might even be the #1 factor, as long as the surgery was performed correctly. It seems like there may be 2 different reasons for shock loss... direct surgical damage to the existing hair during the procedure, and the more-vague "general surgical trauma". If the doctor accidently damages pre-existing hair with the placement of new grafts, that is obviously going to cause some hair loss. This could happen out of necessity - the doc has to put the hair where a lot of hair already exists. Maybe that hair is not all that sturdy, but ultimately it all counts. We need every hair, even the wispy ones can contribute something. When guys lose wispy hair to shock loss, it is still an issue to them, even if the hair wasn't that healthy! It all helps! Or the damage could happen accidently. There may be plenty of room around pre-existing hair, but those existing hairs get damaged when the doctor is creating the new recipient sites. Many docs create these sites FAST... two or more every second. It is easy to imagine that existing hair could be damaged accidently. As Rugger said, how much hair is already in that area (and space between hair) will probably be an issue. Another reason for shock loss may be 'general surgical trauma'. Realize that shock loss is not something that is understood, so there is a lot of speculation, especially if the cause isn't something obvious like surgical damage (see above). Some people have speculated that the drugs and saline that get injected into your scalp might be a culprit in shock loss. Other people have said that the surgery itself somehow triggers a response that leads to shock loss. It is not really understood. Some FUE clinics say that shock loss is not a problem during their procedure because there is no donor strip removed, which is easier for the body to cope with. However, there have been some FUE patients who did report shock loss. Maybe the patient's own characteristics made him especially susceptible, maybe this was a case of doctor error, or maybe the alleged lower risk of shock loss with FUE has been exaggerated... I don't know. Shock loss may be less common with FUE, reports from patients seem to suggest that it is true, but this would be pure speculation because nobody keeps track of shock loss statistics. Also, some strip excision surgeons claim that shock loss isn't an issue in their clinic (I believe that Shapiro Group has said this before). There are even some doctors who say that shock loss "doesn't exist" (?) or that it is extremely rare. We can be pretty sure that "general surgical trauma" is a real issue because patients have reported shock loss in areas where they didn't get any surgery. Some doctors would contend that the patient just continued to lose hair. Patients would say in response that their hair loss was accelerated by the surgery (in essence what shock loss does). The best thing you can do is to optimize your own situation with meds like Propecia or Avodart and Minoxidil. You don't want to be in hair loss "free fall" when you are getting your hair trransplant, you should try to have halted your hair loss. The stronger your pre-existing hair is, seems to be the #1 factor in preventing shock loss, that you may be able to have some control over. As far as which procedure causes more shock loss problems, FUE versus strip excision, I would be curious to hear the opinions of the few doctors who practice both methods. They might have the most information on this, based on what they see in their clinics. Hope that helped...

It's hard to tell based on your pics because your hair is wet and some of your hair is shaved. But I would say you are in that gray area where you could go either way (HT or no HT at this time). I would say that if you can control any potential shock loss post-surgery, you could gain some density from a HT. But your hair loss is not as severe as some, and you don't have any real areas of distinct baldness. That means you would be grafting in and around your remaining hair, which can be tricky. Some guys show their pics and I can see how (in the right hands) a HT makes sense for them. I think in your case, you could do it or possibly do without it. I hope you realize that a hair transplant will not match your hairpiece's density. That's one reason I suggested concealors, because you are going to have to compromise on your density even if you do get a HT. I tend to recommend that guys don't do it, if there is any wiggle room. You're already under a hairpiece and unhappy about that, which creates a desire to take action. However when I look at your hair, I think 'not so bad'. Obviously it isn't what you wish it could be, but you still have a good amount of natural hair. Have you even tried things like Propecia yet? You might want to get on Propecia and see where that takes you. Again, just so you know where i'm coming from, if there are doubts about whether a HT is an obviously good move, I tend to tell guys to wait and keep thinking about it. Other guys here are more pro-active and will suggest that you go for it. If I saw you in person, I might have another take on your situation though. I don't know. I'm going to say you are in that gray area, in my opinion.

Most doctors use a 'mixed graft' approach, also known as Minigraft/Micrograft procedure as you referred to it. This approach is over 10 years old though, and is not considered the 'gold standard'. The all-Follicular Unit transplant is considered the best most natural looking approach, but it takes more effort and staff to do this approach, it is more time-consuming, and so it is ultimately less profitable. Let me say this again. Most clinics do not use the gold standard approach (the all-FU transplant) because an older approach is more familiar and more profitable. Only a small minority of clinics use a true "all-FU procedure". Some clinics will try to tell you that you can't get good density using just Follicular Unit grafts. That is not true, today's top doctors can get high density (and a more natural appearance) using only FU grafts. Also, larger grafts like Minigrafts are not as efficient use of your limited donor supply. These grafts are also susceptible to pitting and cobblestoning. (divots and bumps). The terminology can be confusing (probably on purpose I'd suppose). Technnically speaking, a Follicular Unit graft is a type of specially prepared Micrograft. If you aren't clear on the terminology, keep asking questions. A true follicular unit graft ("F.U.") is dissected under a microscope, where excess tissue is trimmed. (Excess tissue can cause a "grafty" look). Look at this page for a condensed explanation: Best_hair_transplant_procedure Also, there are more in-depth articles here: Hair_transplant_news_articles If all that were not enough to take in, in another thread I recommended that you look into Dr Woods in Sydney (because he is near to you). dr. Woods uses only FU grafts, but he has a new way of harvesting the grafts one-by-one, that does not require removing a donor strip. Only a few doctors in the world use this approach, but Dr. Woods is by far the closest to you, as well as the most experienced with the technique (he pioneered it). The technique is generally referred to as FUE: Follicular Unit Extraction. Patients travel from all over the world to see Dr. Woods. Keep in mind that this is a new approach, and has generated some controversy and even resistance among clinics who still use traditional methods. You are bound to encounter some misinformation on the FUE technique from your local clinics. I'd recommend that you give yourself ample time to research all the possibilities, and put off any surgery until you have a grasp on what your options are. But bottom line: Follicular Unit grafts are cosmetically superior to larger grafts. This is true whether the grafts are harvested via strip excision (the way most transplants are done) or via FUE (a new approach to graft harvesting). Keep reading and keep asking questions.

I would look into Dr. Ray Woods in Sydney Australia. That seems like an obvious possibility for a Kiwi. Do a Google search for "the Woods Technique" to find their website.

First, I would suggest NOT choosing a totally inexperienced doctor for FUE (or any other procedure, for that matter). The more experience the doctor has, the less likely you will damage your donor area. If you have FUE done and decide later that you want a strip surgery, it will have a small (small!) impact in your total yield from strip (remember that FUE takes grafts from a large area, not highly concentrated in the strip zone). I'd guess maybe a couple hundred less grafts from a subsequent strip (100 or 200 less). In other words, instead of getting 2000 grafts from your strip, you get 1800 or 1900. That is strictly a wild guess. It's not like you are paying for strip excision grafts you didn't harvest, so there is no financial penalty. (I saw one guy claim you've "paid twice" for your grafts under this scenario... that is not correct). All in all, there is not a big problem with getting FUE and then opting for strip later, in my opinion. I haven't heard any logical reasons why this isn't possible, for those who choose to change directions this way. Discuss this scenario with your FUE doctor and see what he says.

As Smoothy said, the crown can reportedly respond slowerr than other areas. However, depending on the size of the crown area, 1400 grafts may not go very far. The crown can use up a lot of grafts. There is also the possibility that you are not getting a 100% yield on your transplanted grafts (for whatever reason the graft survival was not a perfect 100%, whether it was doctor error, poor healing, etc). Or it could be a combination of things. I would hang tight and hope that things improve, unless you were grafting into a large area. In that case it may not be realistic to expect a lot of coverage from 1400 grafts. You probably know that the front of the head benefits from a "shingle" effect... the grafts all go in the same general direction. The grafts can shingle (overlay) each other and suggest a more impressive coverage. In the crown, there is less shingling: the hair is supposed to go in a swirl pattern, and the roundness of the skull also detracts from the shingle effect. Theoretically you could use up an entire donor supply just grafting into the crown area. So it's probably unrealistic to expect a lot of density after transplanting the crown. However, you may already know all that. Maybe you had realistic expectations, and feel disappointed that your results aren't meeting those expectations...? It's possible that you didn't get a good yield from the grafts that you moved. Since you describe your results from this last session as "horrible" that may be what happened.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Hey Arfy----thanks for putting me on to that website about laser eye surgery. It sure is an eye opener---looks like HTs aren't the only surgery that is full of pitfalls in the hands of the wrong surgeon Sure thing buddy. Really any kind of outpatient surgery that's done in a walk-in clinic should be researched and double-checked. That includes things like liposuction, breast enhancement, facial surgery etc. I've read some disturbing things about all of these various types of clinics. You really have to be extra careful when you're considering any elective surgery. How are you doing re: your recent surgery with Dr. Epstein? I think you are at about 10 weeks now (?) any signs of new growth yet?

When I referred to a hair transplant maybe not being 'necessary' I am talking about cases of mild recession, minor thinning, early stages of hair loss, etc. In my opinion, getting a hair transplant may be premature in those cases (and possibly a mistake). Look at a patient like FUTZYhead for an example of a good candidate. He had an obvious balding area, rather than just needing a little touch-up. If you are using FUE then doing a little touch up "may" be more justifiable, as the cosmetic negative in the donor area may be less significant than a linear scar. I've heard guys argue this point. My opinion is that if you aren't currently a good candidate for a HT, then it probably doesn't matter how the grafts are harvested. It has more to do with your age and current amount of hair loss. I agree with the comments about not lowering your hairline beyond it's original level. I would think twice about creating a hairline lower than you've ever had naturally. In general, if you are not sure if a HT is a good idea or not, I suggest that you wait and continue to weigh the pros and cons, rather than forging ahead into surgery.

I'm not sure but I don't think Bosley does an FU transplant (they have not used the all-FU approach in the past). That was part of the original question. Howard You are on the right track here in looking into the satisfaction rate of the all-FU approach (I believe the satisfaction rate for all-FU transplant is much higher than that of the mixed graft approach aka Minigrafts and Micrografts aka Varigrafting at Bosley). However the use of FU grafts (see the article "Best_hair_transplant_procedure" ) is really just one aspect of being satisfied with your results. Other aspects... Are you a good candidate? There are characteristics that are more desirable than others. The better candidate you are, the more likely you will be satisfied and the more likely your results will be impressive. Is your doctor extremely skilled, experienced and ethical? The FU graft is just the basic building block. The doctor has to know how to use it correctly, to create a natural-looking result. In my opinion the list of doctors who can do consistently excellent work is really small. Many doctors can do enough nice results to put together an impressive portfolio to show vistors. What you want to do is maximize your odds of success by looking for the doctors who do great results consistently, and who can do a good job even if you aren't an ideal candidate in certain areas. Have a sensible long term plan. This is one aspect some guys do not easily understand. Pick a hairline that will look great even whenb you are older. Use your precious donor supply as efficiently as possible. Have an idea of how you will approach additional surgeries, and what you will attempt to accomplish after each step. Have a plan to try to mainatin as much of your original hair as possible... you can't just replace everything with grafts. So I do appplaud the intent of your thread (and it is a good question) remember that not all FU doctors are equal, and not all patients are equal. Figure out where you stand as a surgical candidate, and how good your doc of choice is. Include these factors in your decision-making. I have been on these internet forums for a while now. Every once in a while I do see a post from someone who says "I have a good transplant result. But if I was to do it all over again, I probably would not get a hair transplant". The simple truth is that a hair transplant is not always the right decision for every guy with a hair loss problem.

I am from the school that says do not get a hair transplant unless it's really necessary. Why not? -It's surgery. It's expensive, there is downtime, etc. - A transplant can cause shock loss (as you know) - It can be hard to reproduce a hairline that is 100% effective. It's often not totally perfect. - The most efficient way to use your donor supply is to do fairly large sessions, rather than multiple small sessions. - You are creating scarring in the donor area. The payoff in the recipient area has to be worthwhile. -Some docs say the first transplant often grows best (best yield). So logic would suggest that the first session should be a decent size that accomplishes a lot. (Not all docs agree with this theory). And so on. Many doctors can double the graft estimate you gave, which makes me wonder if you really need a transplant or not (I have no idea). Even if I saw your pics I might not want to give an opinion about how suitable you are as a candidate. All I am saying is do not get the surgery on a casual basis, do it because there is a real need and a clear payoff, with minimal risks. Be sure that 600-800 grafts is worth causing scarring in the donor area.

Dr. Charles has a few people in his "Mentors" section. These are patients who are willing to be contacted privately about their experience. mentors for Dr. Charles The mentor "Tkotko" was pretty active here for a while, do a search on his name to see his posts. Once you find one, click on his name to "read all recent posts". You can probably find his whole story that way. And try contacting him privately too, with more specific questions. (Note- Don't be put off, but it looks like Tkotko filled out his mentor profile early on... he should be able to give you more long-term comments and feedback about his experiences now).

I take fish oil for general health reasons. I would be surprised to hear it has an effect on hair loss, unless your hair loss was pretty mild. I think vitamins and supplements are fine, but I would not expect any dramatic results from them regarding your hair loss.

4 months is too early to really judge the results of Proscar... keep with it and see where you are in another 6 months. Try taking some pics now, that you can compare yourself with later (rather than relying on memory). If you still seem to be losing hair, discuss your concerns with your doctor. He may increase your dosage to every day, or have some other suggestions. Keep your fingers crossed and hope you respond well...

Call the clinic and express some interest in the doc, and ask if they have any recent patients in your area that you could contact. Then try to meet the guys, if at all possible, and check them out in person. Try doing a search on Dr. Charles, he does get mentioned here from time to time. (The Search function has been a bit wonky lately, but give it a shot).

I'm not sure, but I have seen some posts that suggest that swelling tends to be the worst after the first procedure. The whole dang procedure has evolved quite a bit since your first go-round, Altair, so expect a big difference in your next experiences. The procedure you underwent was shockingly crude, compared to what the best guys are doing today.

Dr. Woods charges less for every additional procedure, and it is a per-session charge (not per graft). The reason is that some guys are easier to harvest than other guys, when it comes to FUE. Basically, you are paying for an entire day of the doctor's time. It is admittedly expensive, more expensive than getting a transplant at a clinic that relies on technicians. Woods and Campbell told me that chest is usually the preferred area to harvest body hairs, followed by the back. I was told by Woods that legs are generally not preferred as a source of body hair, because of the nature of the skin tissue of the legas making harvesting difficult. (Other doctors may feel differently).

Well I would stop picking at it, if you can. I'm not sure what it is. It could be folliculitus (inflamed follicle). It could be a cyst that developed where a graft was placed. It could be something totally different. I had a couple of spots on my head that were bothering me... constantly flaking, itchy etc. (It was one or two spots that corresponded with where older grafts were placed.) After my last procedure, I (obviously) stopped touching my head for a while when I was healing. Since leaving the trouble spots alone, they have apparently gotten better. So try to stop touching the bump, you are probably just aggravating it. Go see a dermatologist or contact your HT surgeon if you continue to have a problem. One thing you could try as a home remedy is to soak some hydrogen peroxide on a q-tip, and swab the bump liberally (and gently). The idea being that if it is an infection, that may help. This is just a guess (and something I tried but honestly didn't work for me).