arfy

to Vocor It's a problem that young women prefer guys with hair. My experience is that it matters less in your 30s and even less in your 40s, if that helps at all. There is one big issue with your post though. A good HT will plan for the future, and will not give you a 20 year-old's hairline, because that will look strange when you are in your 50s. I know it can be hard to think that far ahead. But I know many ethical doctors will resist giving guys a low hairline just to satisfy them for the short-term. Besides the issue of having too low of a hairline as an older man, there is the issue of limited donor hair. The lower your hairline, the larger the potential area you will need to cover with grafts eventually. I know that with drugs like Propecia there is some hope that you won't become become completely bald. But a responsible doctor will plan with the "worst case scenario" in mind, so you don't get stuck later with a "ronald reagan hairline" and a huge bald area behind it, that you can't cover with grafts. This has been discussed before, so I won't drag it out. But the correct hairline in a transplant will be mature and recessed. Look at Pat's hairline in the "My Recovery Story" part of this site. Pat was an excellent candidate for surgery: over Norwood 3 level of baldness, with a well-defined bald area. I'm sure Pat would have enjoyed having an even lower hairline, but that would have been a mistake. Pat's doctor (Shapiro) is considered one of the best (if not the best) when it it comes to hairlines. Use Pat as an example of a good candidate with a great HT hairline. So the question is really, will it make a difference to these 20 year old women, if you remove your ballcap and have a mature recessed hairline. I don't know the answer to that. But I caution you against getting a low hairline put in now, as it can be a recipe for future disaster. Also, in everyone in general...If you are self-concious about your hair loss, there is no gaurantee you won't feel self-concious about having a hair transplant! Many guys become obsessed about being "spotted" as a HT, having to constantly check their hair, arrange it "just so", etc. Getting a HT does not always mean the end of worrying about your hair! Just the opposite sometimes. As many of us know, getting "only" microscopically-dissected FU grafts means that your transplant will look natural, "no matter which way the wind blows". As far as getting a HT to make yourself more attractive to women...I think the most important things are to pick a world-class doctor, to be a great candidate for surgery (and not every balding guy is!), and to be satisfied having a bald crown and "a lttle coverage" (realistic expectations). After that it's less important what motivates you. Looking better to attract a partner, is kind of a "given".

I agree completely. With drugs like Propecia, supposedly 80% of users can halt their hair loss, so they might never need a HT in the first place. I believe it was Dr. Parsley who wrote an excellent post on this topic. He compared hair loss to tooth decay. Nobody reasonable will let all their teeth rot out, and then go to a dentist to have them all replaced. Instead, people use toothpaste to prevent tooth-decay. Propecia is like toothpaste that prevents "hair-decay". Use Propecia and don't let your hair "rot". Also, hair transplants do not "prevent" baldness. So you need to get on Propecia and stay on it, even after a hair transplant, to save whatever remaining natural hair you still have. There is simply NOT enough donor hair to "replace everything".

Propecia stops progression of hair loss in over 80% of the guys who use it. Side effects are seen in 1-2% of users and are temporary. Those are good odds. If you get started on Propecia soon enough, you might never need a hair transplant. In my opinion, transplants are a last resort when treatments like Propecia haven't worked. You shouldn't get a transplant until you are at least a Norwood 3 or higher. Look at "My Recovery Story" and compare yourself to Pat (he was a good candidate). Lucky for you, you are not bald enough to need a hair transplant yet. If you start with Propecia, you hopefully never will be.

Hi Jebster Please state the name of your doctor who you say dissected Minigrafts with a microscope? Maybe you are confusing "magnification" with a microscope? Any old doctor can divide grafts with magnification. It might enlarge the view "3 times". Very few doctors use microscopes, they enlarge the view up to 10-20 times. Please clarify your statement? I am unaware of any Mingraft doctors using microscopes. jebster said "I had 5 mini/micro HT procedures in the late 80's and early 90's by a surgeon that did an excellent job with microscopically prepared small mini/micro grafts. "

Hi Augustart I'm glad you are happy so far. But I really am baffled when I read that guys are willing to have cosmetic surgery, but not willing to take any medications like Propecia. I know you are on Proscar now. If guys would start on Propecia earlier, and not wait until they had major hair loss, they might be able to skip the surgery altogether. Also, you said "girls like hair". This is true. They also like guys who are comfortable with themselves, and guys who are natural. Bottom line, if a guy gets a HT with "girls" in mind, he is probably making a mistake. Again, I'm truly glad you're happy. I particularly admire that you flew cross-country because you wanted to use a specific doc. I think more guys should follow your example. Keep us posted and "speedy healing" to you.

I agree with Pat. It sounds like you are shedding. At this point in time everything is already "set" in your scalp. You are not affecting the follicle. Be gentle with your grafts anyway, though.

I like to compare hair transplants to a "heart" transplant. If you needed a heart transplant, you'd fly around the globe to get one from "the best". You wouldn't take any extra chances on anyone else but the #1 guy. A hair transplant should be no different. You really have one "best shot" at getting it right the first time. HT is a specialty, and it is highly unlikely that one of the "worlds' best" is located in your town. Do yourselves a favor and chip in an extra few bucks for a plane ticket and an overnight stay. You won't regret using the best, and in most cases they are cheaper than the big "hair mills". If I was starting over, I would do the research, to try to decide "who is the world's best". Every guy deserves an AWESOME looking HT, and nobody should settle for an "okay" one. Don't sell yourself short. And as already said, many of the giants in the industry are relatively inexpensive. Who is convenient, or who did your friends, or who is cheapest, should not be a factor. Good luck Foxworth, and keep us posted on what happens.

I see that the Norwood Lehr Hair Transplant Clinic is a recommended clinic in Oklahoma. Look at the recommended surgeons list and check out their website, they look good.

You should be using Propecia already. Most good doctors will recommend it BEFORE surgery, to try to prevent shock loss. Does the doctor use microscopically-dissected FU grafts? There is never any penalty for waiting, when it comes to HT. Your deposit should be refundable, if you give the doctor enough notice. I would think one or two weeks notice. Even then, you may still be able to get your deposit. I don't think anyone should get any HT if they have any doubts in their mind about their doctor, or any doubts that they are making a good decision. In those cases, you are better off waiting, and thinking about your options some more. It's natural to be nervous before a HT, but you should have 100% confidence in your doctor and your outcome. Even if you lose the money, it is better to have peace of mind. the other option would be to try to reschedule, and give yourself another month or two to keep rersearching. Getting a HT is like buying a house, don't just buy the first one you see, shop around, think things over, see other options...

There are some different possibilities. I believe if the grafts are distorted, they can grow a little kinky. This happened to me. However if you used a recommended doc, this distortion should be unlikely. Hopefully this is a temporary "in-between" phase and your hair will grow out normally. Regarding your hairline, is it possible you are losing some of your original hair, which is resulting in the thinning look? You should be using Propecia to maintain any remaining original hair you have. HT do not prevent baldness. Also, your hair should continue to thicken as it comes in. Hair shaft thickness actually does account for a lot, regarding coverage. I believe around the one-year mark, thickness should be around "normal". Also, depending on your Norwood level, having one 2000 graft session will only get you so far. I believe most doctors need more than one pass to really build a good hairline, depending on how much needs to be done. For more info on that, look at the articles on "hairlines" in the "Research Library" here.

Speaking as a "repair patient" who has had to live with the devastating effects of an unnatural-looking hair transplant for many years, I can report that "naturalness" (or "undetectabilty") is my primary goal. I would be willing to bet that the vast majority of patients both new and old agree with me. The issues of "coverage" and "density" become practically worthless when you have a 'detectable' transplant. Dr. Beehner alluded to older patients championing the "smallest possible grafts" and that is definitely my perspective.

Dr Beehner After re-reading your post, I see you have already addressed my second question about mixed grafts vs. FUs and why you say that many all-FUs don't have as dense a result as a mixed graft approach. (I was asking you to compare coverage of an all-FU approach with a mixed graft approach hypothetically, in the "same patient".) Dr Beehner already said<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR> I would certainly grant that a small number of doctors, with highly trained and motivated staffs, and in patients with a high average number of hairs per FU, can achieve density equal to what I am describing above - namely a result that, when viewed from above, does not allow the observer to see the scalp at all. I am simply saying that, in my opinion, that is not the majority of patients, and most of the patients I have seen who had exclusive FU work look sparser than my typical results. When you put into the mix a doctor or chain of clinics that is not focused on quality and has a high staff turnover rate, then I believe the fragility of handling high numbers of FU's which are "dense packed" can be a nightmare and can yield poor growth due to the drying of grafts and trauma. It is no coincidence that the handful of doctors who do excellent all-FU work have staff assistants who have been with them for many years and are just as motivated toward great patient results as they are. That seems to make sense. I wasn't taking into account the variable of "skill and experience" of the surgeon and his techs in using FUs. Since FUs are more delicate, it seems reasonable that experienced surgeons (and staff) will have better (denser) results with an all-FU approach. I absolutely believe that there are a limited number of excellent "all-FU surgeons". It also partly explains the reluctance of big chains like Bosley and MHR (and small chains too )to switch over to an all-FU procedure. The learning curve is steep with FUs, not just for the doctors but for the techs too. Switching your practice to one which uses a high percentage of FU grafts is not just a simple matter of buying a bunch of microscopes. Thank you! [This message was edited by arfy on April 18, 2002 at 07:59 PM.]

Dr. Beehner Thank you for you reply. If I understand you correctly, it seems like two-thirds of the grafts you use will typically be FU grafts, and one-third of the grafts you use will be Minigrafts. This seems to be different than what clinics like MHR typically do... I estimate that they do the opposite: one-third Micrografts and two-thirds Minigrafts. I say "estimate" because I have been unable to engage anyone from MHR in a serious discussion about techniques and philosophies. It seems like they are unintersted in disclosing their methods or educating the public. Although I would choose only FUs grafts for myself (undetectabilty is absolutely my top priority) I respect your candor in discussing your typical strategy. And if I understand you correctly, you are "willing" to do an all-FU procedure. One thing I don't understand about your answer. Lets compare an all-FU procedure with a mixed graft procedure hypothetically, in the "same patient". Patients have a fixed amount of donor hair, of course. If the "maximum amount" of grafts are moved for a given patient, and a "fixed" or limited area is covered, how could Minigrafts achieve "more density" than FU grafts? Since the same amount of hairs are moved (the "maximum", whatever that number might be) I don't understand why one technique would provide "more coverage" and the other "a more see-through look". Again, the area covered would be "fixed" or constant in both hypothetical procedures, and the amount of grafts or follicles would be considered maximum. Any comments are appreciated.

Dr Beehner Thank you for your input. Could you estimate a rough breakdown of the percentages of different graft sizes, when you do decide to mix grafts? I realize that patients are different, so if you could estimate a range... For example, what is the largest percentage of Minigrafts you would consider using on a patient? The reason I ask is because there are many many clinics that use Micrografts (or sometimes FU grafts) only in the frontal hairline, and a majority (or all) of the grafts placed behind the hairline are Minigrafts. Based on what I have read and seen, that approach is considered outdated by the most skilled surgeons. If I read your statement correcetly, that does not describe your approach. If you could be more specific about how big a role Minigrafts play in your overall approach, that would be appreciated. Also, you alluded to the use of Minigrafts for economic reasons. Do you think it is acceptable to give a patient a less-natural or less-pleasing transplant in the interest of saving some money? Would you consent to doing "lesser" surgeries in order to appeal to a patient's "thriftier" side? If so, can you estimate how much money these patients might have typically saved by "cutting corners"? I'm not discussing "what the patient wants" here, because I'm sure you realize the patient considers you the "expert" in the relationship, and the "final word"... Patients expect that you will not do anything that is not in their best interest. For example, I am sure you are regularly refusing to give patients a hairline which is too low, for example. Do you think it is ultimately worth it for a patient, to save (fill in the blank____ ) dollars, but not get the best possible result you are capable of delivering to him? At what point is "saving money" not considered worth it, in relation to cosmetic results? In other words, how much money does a patient need to save, in order to make a less natural result "worth it"? In your opinion, would it be ethical to design a cosmetic surgery based on a patient's pocketbook, and not on what their needs are? [This message was edited by arfy on April 17, 2002 at 12:21 AM.]

I don't have any personal experience with California doctors. I don't even recommend that guys should get a hair transplant, unless nothing else has worked, and they have a complete understanding of all the drawbacks and limitations involved. HT is not the "miracle cure" to baldness, and it is not for everybody. That said, I suggest you research the doctors you may be interested in, read up about them, and contact them. Many doctors will do an email "consultation". Other than that, I can't advise you. HT are a bit of a gamble, there is no "sure thing" or perfect doctor.

I believe women who have diffuse hairloss, are not good candidates. Actually, this is probably true of the majority of women with hairloss, if I am not mistaken. The reason they are not good candidates is because their donor hair is just as likely to fall out as any of their other hair. The donor area is not considered stable. I believe there are some women who have male pattern baldness, who have stable donor areas. Even so, women can use more drugs to battle hairloss than men can. Some hairloss drugs are feminizing and are off-limits to guys. Hair transplants should always be considered a last resort, when drugs like Propecia or Minoxidil have not been effective, whether you are male or female. Good luck, "Toofunnyman".

Not all surgeons use the densitometer. I suspect that the best doctors will be able to give you a fairly close estimate on grafts. I am going to take a wild guess and suggest that if your doc said 3000 grafts as an estimate, it would be sensible to "give or take" 500 grafts either way. So you may wind up with as many as 3500 or as few as 2500. If your original question was regarding how precisely can a doctor predict how many grafts a patient has available, I will guess it is a "ballpark estimate". Like I said, scalp laxity is intangible (not measurable, in other words). If a doctor suggests you have 3000 grafts, that is realtively limited, as some guys can have 4500 or more. Did your doctor estimate 3000 grafts for the 'first surgery' only (meaning follow-up surgeries would harvest more)? Also, one other factor to keep in mind is hair quality. Coarse hair can provide more coverage per graft than fine hair. Apparently this is an important variable in final coverage. By the way, when you look at a doctor's before and after photos, notice how many guys have coarse or wirey hair. Those guys tend to get a fuller looking result. You may need to pose more specific questions directly to an actual surgeon in the forum called "Post your questions for Hair Transplant Surgeons here".

Hi Pehrl Good luck with whatever you decide to do. But try to find a clinic or doctor who uses microscopically-dissected Follicular Unit grafts, because they are the most natural looking. Read "The Best Procedure" on this website, if you haven't already. When the microscope is used, the resulting graft yield can be be increased by up to 20%, from what I understand. If you can't find an Asian clinic who is using microscopes to dissect grafts, it would be worth travelling to the US.

There is a finite amount of donor hair, and if your doc is worth using, he will be able to give you an accurate estimate on how many grafts he will be able to harvest. Some surgeons use a densitometer (I believe that is the name) to decide what a patient's donor density is. There should be no real surprises when you discuss your strategy with a prospective surgeon... They should be able to tell you what kind of coverage you will have, over how big of an area, in how many sessions. Of course the exact number of grafts is impossible to predict, but they should be able to come quite close. (One variable would be scalp density, which is relatively intangible). Check out Dr. McAndrew's website for a breakdown of density vs. graft number: www.hairgrowthdoctor.com/Pages/translim.html I was botched by an "old-school" incompetent doctor, who was unable or uninterested in planning for a patient's future. For many years this "running out of grafts" was a common result of hair transplants, and it still happens with some of the inferior doctors. (The patient being told "I'm sorry if you're not satisfied, but that's as far as we can go. You're out of donor hair.") A good doctor will be able to get specific about how many grafts you will have, and what that will look like.

I think it does both, but I'm not sure. It seemed to help me, but then I had nothing to compare it to. (I didn't test it on only one side, or anything). click for Mederma website I can't make a direct link, but find the Media Info section, and look at the articles in the print media section. The article in Pharmacy Times called " Scars: Do They Have to be the Center of Attention?" says that Mederma seems to block a substance that makes up scars (making them smaller/smoother). It also says that massaging the scar helps.

PDM68 I thought that was what you meant about hairlines. That is not such a bad approach (placing them a little high)...It is obviously easier to add some grafts in front to modify your hairline, rather than vice-versa. Also, I think some docs build the hairline gradually. If you go back to Dr. Limmer, you might find he is planning on adding some additional frontal grafts. I believe many doctors build the hairline over multiple sessions. Dr. Shapiro has an article about creating hairlines in the Research Library section- check it out. Once you have lived with this hairline for a few months, by the time your grafts grow out, maybe you may find that you've grown to like it. Otherwise, I think you mentioned going to Dr. Shapiro next time. I think that makes sense...if you don't care for a doc's style choices or agree on an approach, use someone else instead. Good luck.

You should check out the website www.BosleymedicalViolations.com and maybe contact them. You should also consider filing a complaint with your state medical board. Maybe you can help stop this from happening to other people. Which Bosley franchise did you go to? How many grafts? When did you have the work done? Where are you located? It is possible to have the grafts removed, and just be a "regular bald guy", but if you have a lot of grafts, you will have to accept that there will be some scars in plain view. This may or may not be acceptable. Hair transplants can also be successfully improved ("repaired"), but it is more complicated than just getting a good hair transplant in the first place. How extensive and how bad your Bosley work is, will determine how successful you can be with repair work. It is absolutely crucial to find a top-notch doctor to do any further transplant work. Otherwise you are just going from the frying pan into the fire. Check out the Bosley Medical Violations site, and consider your legal options. If you are considering "repair", you should look at the "Find a Great Surgeon" list. You should visit and read the websites of all of the surgeons on the list. You will learn a lot about what hair transplants "can" be, when they are performed using state-of-the-art methods. It's important for you to inform yourself about the latest methods, so you can understand what happened to you, and to also figure out what you should do next.

PDM68 When you Dr. Limmer is "conservative" with the hairline, what exactly does that mean? I'm not sure how to interpret that. Thanks.

I believe 10 weeks has been mentioned as a ballpark figure for regrowth. At twelve weeks, you are still in the ballpark. I hope your grafts kick in soon, so you can ease your mind. Hang in there.

I believe Dr. Baumann uses only Follicular Unit grafts- is that correct? Maybe you can send some photos to the site, so we can see how you look in a "before" and "after"? That would be appreciated.