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There are a couple of different situations, that can get confused: The dormant phase- this is when the transplanted grafts shed their hairs, and stay dormant for about three months. (After surgery, it seems like your transplanted hair is growing... a week or a few weeks later it will usually go dormant and shed). Then after about 3 months the transplanted hairs will begin to emerge and begin growing at the normal rate... about a half-inch a month. Shock loss- when the surgery causes non-transplanted hair to be lost. This can hit right away, or have a few weeks lag time. Usually if you do not have shock loss in the first month or two, you are out of the woods. It's good to be using meds like Propecia as far in advance of your surgery as possible, as it not only helps prevent hair loss, it may also help prevent shock loss. Sometimes the shocked hair returns, and sometimes it doesn't. No guarantees and no rules, but generally the sturdier hairs will return, the weaker hairs do not. Normal hair loss- after surgery you will still have male pattern baldness. A hair transplant doesn't prevent your hair loss from continuing. That's why I think it is important to stop hair loss from progressing first, before you even go in for surgery. Sometimes guys are losing hair after surgery... is it shock loss or is it just the normal progreession of hair loss, because a guy is still losing hair? If a guy didn't stop the progression with meds first, it could be hard to tell... maybe even a combination of both. The worst possible situation is that you go in for a transplant, then you lose a lot of hair because of shock loss, and end up with LESS hair after the surgery. A transplant is supposed to give you a net gain, not a net loss. There is also a situation where some grafts just don't grow. I believe this is referred to as the X factor. It is rare but some guys just lose their transplanted grafts. Maybe they don't have a stable donor area, or there may be some other reason. If you are past the 7 month mark (if I read your post right) then your hair should be growing and improving. If not, it could be doctor error, or it could be something unknown. You are entitled to a refund if the grafts don't grow. However that's only half of the problem. Everybody has a very limited donor supply, so wasting grafts is a big problem that you don't want to have... you need every graft to grow, for best long term results.

I think it's hype. You are already doing the right thing by using Propecia (and Minoxidil too). If you have a few hundred bucks to blow, you can try a laser comb or laser therapy but DO NOT stop your cornerstone treatments. You can get used Laser Combs on eBay, from guys who tried it. Maybe it only works for some guys, or maybe these guys only used the laser comb and nothing else. Or maybe they didn't use it correctly or give it a fair chance (a year of use). But I suspect it's baloney. Who knows? There are no real studies showing it works.

I think the totally undetectable hair transplant is VERY rare. I'd say probably 5% of transplants could be called undetectable, and they are usually on a guy who still has a lot of hair left. If one of your main concerns is "nobody can know" then DO NOT get a hair transplant. NOBODY can guarantee that, and if you don't believe me ask any doctor if he will guarantee it in writing. See what they say. If you are just 19 you are too young to get a hair transplant: You think a transplant can erase any signs of hair loss. They can't! That's not what transplants do. You need to get a handle on what transplants can do, they have definite limitations. If they actually were a type of cure for hair loss, then everybody would have them, and nobody would be bald. Goal number one is to stop the hair loss from getting worse. Go see a dermatologist and get on a prescription for Propecia, and give that a year to judge the results. Getting a transplant now would be jumping the gun. Getting a hairpiece was probably jumping the gun at your age, too. Some guys are so freaked out by any signs of hair loss that they panic and lose their common sense. Do not panic!!!! You're going to live. Correct long term planning is crucial to success when getting a transplant. You only have a limited amount of donor hair so you have to use it wisely. One of the big problems with young guys getting a transplant, is that young guys are at a high risk of losing a LOT of hair. But the young guys are trying to restore their hair to "no hair loss" appearance, which is unrealistic. They "stake out a line in the sand" that they can't defend, by putting grafts into a low hairline. Remember what I said about long term planning being crucial? Well these guys have started out from the beginning, with bad planning. They have planned their hair transplant as if they will only need a little "touch up" when they actually have full blown hair loss. This can be a HUGE problem.

Avoid the big franchises, they are usually not the best. Find someone who you could consider the 'worlds best' otherwise you could wind up with mediocre results. It sucks to have a sub-par transplant, it's worse than just being bald. Try to maximize your odds of satisfaction, by searching out (and travelling to see, if necessary) a top doctor. You will be happier in the end. (Lots of guys travel to get their transplants, most guys are not lucky enough to live near a top doctor.)

Fabe, you look to be headed to Norwood 6 if you don't stop your hair loss. Getting a transplant without stopping your hair loss first, is like trying to bail water out of a leaky rowboat. You can't just let your hair fall out and expect to replace everything with grafts. There isn't enough donor hair to do that. The more existing hair you can keep, the better. Are you still losing hair? Guys with extensive hair loss (Norwood 5, 6 , 7) can often lose hair in the donor area. Look at any guy who has full-blown baldness. His donor area is often thinned out too. If that guy would have moved that donor hair up top, it would have thinned out there too. In guys with serious hair loss, the donor area may not be permanent! I recommend that guys who want hair transplants try to SAVE as much of their pre-existing hair as possible! Your hair transplant will look a LOT better. That is "Hair Transplant 101" Ask Dr Feller if he guarantees that your donor hair will be permanent?

I've been reading these forums for a while. I have never heard a positive report about Dr Sword's clinics, only complaints. I've heard that Dr Zierring has some okay skills but maybe falls short as far as ethics (?) because when he was the medical director at a big franchise just a couple of years ago, he would sometimes do as many as 10 patients per day. That is outrageous if it is true (and the office records would be the evidence of it). You want a doctor who concentrates on one patient per day (or two AT MOST. One patient per day is better.) Would you rather have the doctor's full attention, or share it with a bunch of other guys who are also getting hair transplants that day? My advice is to keep looking!

ISHRS membership is not a guarantee of quality (it even says that, on their website). Do some research on your doc. (What we call 'doing your homework'). If you don't want to get screwed up, you have to "be your own expert". Read up on what makes the best procedures "the best". Then ask your doctor what procedures he uses... here are a couple of hints, to jumpstart you: The clinic must use binocular microscopes to dissect the donor strip. This increases graft yield and prevents waste. NO LOOPS for dissection. Avoid clinics who use multi-bladed knives for removing the donor strip. A single bladed knife creates less damage and wastes fewer grafts. Avoid clinics that use a "Mixed Graft" approach (sometimes called Varigrafting, or Micro/Minigrafting). What you want is microscopically dissected, individual Follicular Unit grafts. The so-called "All-FU" procedure is 'the gold standard' but most clinics don't use it. Mixed grafting is faster and more profitable for them and they figure that the results of Mixed Grafts is "good enough". Don't settle for less, get an all-FU transplant from an experienced clinic (one that has been doing this technique for a while). Use a clinic where you will be the only patient that day, and get the doctor's full attention. Choose a clinic that doesn't use pressure to sell you on a transplant. You might not be able to get a transplant like that, at a local clinic. You may have to make an effort to travel. IT'S WELL WORTH TRAVELLING (sorry about the caps) to see a doc who is considered ONE OF THE BEST (not because he says he's the best, but because real patients say so). Don't cut corners when it comes to permanently altering your appearance! Does Dr Gizburg have a website?

FUE does work. There are only a few doctors doing it. Some doctors do both Strip and FUE, and have a valuable perespective on the pros and cons. NO hair transplant is perfect or without limitations. FUE does work but ultimately it is still a hair transplant with all the same issues that all hair transplants have... You still have to be careful and think it over carefully... be a good candidate first. Pick a good doctor. Know the limitations. Have a long term sensible plan. And so on. If a doctor doesn't offer FUE then it isn't realistic to expect them to recommend it. To put it nicely, don't look to Pepsi for accurate information about Coke.

Fabe Are you using Propecia? Propecia should help retain your existing hair, and also help retain hair in the donor area. Is it a slam dunk to do that, no it is not. If you have stablized your hair loss already with Propecia then that is hopeful. If not, be careful. The bad news is that your crown will have to get short shrift. You need the grafts to build up the front, more than the back. The crown uses up a ton of grafts, you could blow an entire donor area on the crown and still want more (and then have no more grats, to even touch the front). You may have to be satisfied with a bare crown, or a very lightly grafted crown (see through). Nice to finally get a scalp to see, to associate with the voice. Keep posting if you get something done, you are a straight shooter and your feedback is valuable.

Lots of doctors are not up to speed on Propecia yet. And some doctors are concerned with long term medications. Nobody should take Propecia lightly, just for the heck of it... it is a serious drug. My feeling is that if your hair loss bothers you enough to think about surgery (hair transplants) then using Propecia is certainly a reasonable step to take. Propecia does work very well for some guys, pretty good for some guys, and for a few guys it doesn't work (about 1 in 5 get no reults, but 4 out of 5 do! Not bad odds.) Don't hold it against your regular doc, go see the dermatologist, who specializes in Skin and Hair.

If you're really a true Class 2, you should probably hold off on surgery for now. I would not get a linear scar for that small number of grafts (strip excision). FUE does work however it is not very common and only a few doctors do it. There is still a lot of misinformation about it, out there. In general, a Norwood class 2 is advised to hold off on surgery, and use preventative medicine instead.

If you are one of the unlucky few who get side effects from Propecia, lots of guys say they go away after a little while. Sometimes you can ride it out. Another option is to lower your dose... take a half Propecia every day, or take a whole one every other day. Or even a half, on every other day. Benfits from Propecia are still seen at lower doses, and there is some evidence that side effects are lower at lower doses. Really the thing to do is talk about this with your doctor, but reducing the dose has reportedly worked for lots of guys who got side effects.

If you are donor depleted then you should look into the FUE technique, that can harvest hair from "non-traditional" zones. This method does not require a donor strip, as each tiny graft is harvested individually.

Agree with Robert. Not everybody is a good candidate for a hair transplant... it's not a one-size fits all surgery. Even a bad candidate can still get a transplant (and there is no shortage of clinics who will welcome you with open arms). But the odds you will be disappointed in the end, are higher. If your odds of disappointment are high, then it's probably best that you accept that, and not forge ahead anyway. Some of the factors that contribute to making you a less-than-ideal candidate: poor donor supply very fine hair large balding area (now or in your future) diffuse all-over thinning crown loss only scar easily or poor healer you want all your hair back (as if you don't have male pattern baldness) you can't really afford multiple surgeries you are young and are just beginning to lose hair None of these have to be 'deal killers' on their own (okay maybe a few of them might be). When you start adding these factors up, they should combine to make a red light for some guys. Best to accept that and move on, sometimes. There are always exceptions, but most guys are going to be average and not exceptional.

Billy Bob Thornton: One day he's bald, then you see him in a movie with a full head of hair. Then you see him bald again. Conclusion: hairpiece Nic Cage: Saw him on the Tonight Show with obvious plugs and concealor. He appears in movies with obvious hairpieces. Conclusion: Hair Transplants with a hairpiece for acting roles. Also, Dr Kasimir of NYC apparently tells people that Nic Cage and Sly Stallone were his clients. Sly Stallone: Obvious hairpiece over alleged hair transplant. The story as it was told to me, is that a few years ago Sly heard Nic Cage had a hair transplant, so he called him up and asked who did his work. Sly didn't realize (like a lot of guys online) that Nic Cage does have a transplant, but always wears a 'piece in his movies. Stallone thought that Nic Cage's hairpiece was a fantastic hair transplant. Nic Cage told Stallone that Dr Kasimir did his transplant, however he neglected to warn him that he didn't do a very good job. Why not? Maybe the competitive nature of professional actors? So now Stallone has a HT from Dr Kasimir too... a bad one. At least that's what I heard, but maybe I'm wrong. I don't know why you are resorting to petty digs at me. Maybe you could grow up a little? You're supposed to be the forum moderator and set the tone for everyone else. I'd like to see you comment on the TOPIC and not spend your time critiquing me and what I say in my posts. Have your own opinion, rather than just taking potshots at what I say.

Hi Robert. My posts are not any more skewed than your posts. I write from my perspective and you write from yours. As far as scaring guys, look at the title of the website you work for!!! "Hair Transplant? Be careful! A Hair Transplant can be great if you find the right doctor for your hair transplants. MY message is also BE CAREFUL. If you think that is "scare tactics" then maybe you should bring this up with your employer. The simple fact is that MOST hair transplants are not that great. If every doctor was doing great transplants then there would be little reason to BE CAREFUL. If most doctors were doing great work then the list of "recommended" doctors on this website, would be a lot longer. I did a quick count and it looks like the Hair Transplant Network endorses about 51 doctors. But there are about 700 doctors in the International Society of Hair Restoration Surgeons (ISHRS) and hundreds of non-ISHRS doctors who do transplants. With such a small number of recommended doctors, it's not hard to guess that the MAJORITY of transplants being done, aren't worth crap. Maybe you want to belabor this point, and we can discuss the merits of the HTN list. It seems to me that you just want to argue with me. Instead of me saying my opinion on the topic and you saying your opinion on the topic, you want to focus your comments on ME. That's fine with me, I don't mind a good discussion. I read everything I can get my hands on regarding hair transplants, and I've had over 15 procedures with 5 different doctors. I'm confident in my knowledge about HTs. If you only want Hair Transplant cheerleaders on this website, then that would be too bad.

I hope it works out for you. Shock loss of existing hair can be caused by direct trauma when the new grafts are placed, but it can also be caused by indirect trauma too. Even if your doctor is careful not to directly damage your existing hair, shock loss can be a problem. Guys can even have shock loss in a completely different area than where grafts were placed. That's according to Dr Bernstein and other doctors, and also what patients sometimes report they experienced. Stay on your preventative regimine if you have one (Finasteride or whatever you use) and hopefully things will work out in the end.

Robert said Your graft claculator is hypothetical too. You also said my estimate of 5500 grafts being available for the average patient, was wrong. You said that 7000 was average. I think that is wrong, Robert OIf 7000 grafts were average, then that means that some guys have 5000 available while other guys have 9000 grafts availabe. I have NEVER heard of a patient who had 9000 grafts available (maybe one... Jotronic? He has exceptional scalp laxity). However I believe that having 5000 grafts (max) is common. I did make a mistake though. Here's what I meant to say: So Robert thinks that an average guy has 7000 grafts, okay lets say that he does. So he has 7000 grafts available to address an area that potentially needs 10 or 12 thousand grafts, just to have "the appearance" of fullness (not actually a full head of hair). My point is that for many guys, the numbers do not add up, especially not in the way they hoped they'd add up at the beginning of hair transplant surgery.

Mederma just makes a scar blend in better, it doesn't shrink a scar. To Harve, you should be trying to retain your existing hair. Ive you had 300, 300 and 1250 grafts, and you los all your hair, those grafts aren't going to do all that much good. I think you may be underestimating how much hair you have left. As far as your plan, most doctors do add density in key areas so you can get a combover effect. A typical pattern is the "hockey stick" which runs along the part and into and along the hairline (soft "L" shape). So when you comb your hair, you get a little eextra combover. Your idea is not far fetched. However you may be underestimating how many grafts it takes to do your crown (it takes a LOT. You could use your entire donor supply just in the crown). The best idea is to run your ideas past Dr Keene, who already worked on you and can examine you in person.

Great thread. There is a balance between "density" and "area covered" and you CAN'T have a lot of "both"... There's just not enough donor supply. This is something that the newer patients need to totally understand. Lots of guys get "starry eyed" when certain doctors hype their ability to do "high density". They don't realize that the doctor may be burning up a lot of their limited donor supply, and the patient will end up shortchanged elsewhere on their scalp, as they continue to lose hair. This kind of high density "show boating" indicates a blatant disregard for the patient and their future.

Do you realize that a transplant will cause scabs and redness, and that a lot of guys will take 2 weeks off from work, in order to hide out and recuperate? I totally agree that having the doc look at your head is the way to go. Read up about transplants before you go to a consultation, so you can ask smart, specific questions. Realize that there are only a small handfull of docs doing consistently great work, and it's likely that you might need to travel to see somebody good. There's probably not one conveneintly located, unless by coincidence you are lucky. Just like you would be willing to travel to see a great heart transplant surgeon, you should be willing to travel for a hair transplant... the doctors who are worth picking are few and far between. Watch out for Dr. Puig in Dallas and Austin, he lacks ethics and he lacks artistic ability.

Some guys had Minis and Micros and actually don't look too bad, it really depends on the guy. Some guys have a lot of remaining hair which helps their HT look good. Some guys have certain hair characteristics, that a Mini-Micro approach doesn't look radically different than an all-FU approach. Some guys styled their hair a certain way, that it didn't matter that the grafts weren't as natural looking. You'd have to see these guys standing in the rain, maybe, to tell the difference. I can tell you that the all-FU approach will look more natural on MORE guys, than the Mini-Micro (aka mixed grafts aka Vari-grafting) approach. A real "all FU" approach is also a more efficient use of donor hair, so your limited donor will go further. With all-FU grafts there are less problems with pitting and cobblestoning. Not every guy who gets Minigrafts has problems with pitting or cobblestoning. But a LOT of guys do, and it's a TERRIBLE problem to have. Getting a transplant is a gamble to some extent, there is really no such thing as a perfect transplant. So what you want to do is maximize your odds for success, by picking a consistent doctor who gets good results, who uses the best possible techniques, by being a good candidate (not that you can really change that, very much) and so on. You DO raise a good question. "My" doctor Carlos Puig would advertise that his transplants looked totally natural, even when he was doing plugs. Then in each new brochure it would say he was using the new improved techniques, whose results were "natural" and undetectable. BOTH THOSE CLAIMS made at different times cannot be true! If something actually "duplicates" your hairline, then it can't be made "even more natural" later. Short answer: some of these hair transplant doctors like Carlos Puig are con men, who are willing to say anything to make a buck.

A hair transplant is not going to solve your problems, or address a flaw in your personality or confidence. If you are really self-conscious about your hair loss, then odds are pretty good that you'll feel self-conscious about your transplant too. Some guys think that getting a transplant means "no more hair worries". In my experience, I have rarely seen this to be true. Pretty much every patient runs out of donor hair before accomplishing everything he wanted to accomplish. Lots of guys are still concerned about getting caught in the wind or rain, or don't want to go swimming etc. Lots of guys still feel the need to use Couvre or Toppik or other concealers, after their transplant is "finished". Probably the best situation is when a guy isn't self conscious about having hair loss OR a hair transplant (some guys are fine with other people knowing, as long as they feel like they look good). Other guys don't want ANYONE to know they had a transplant... these guys better think twice about getting a hair transplant, because that is a tall order that is rarely filled. If you doubt it, ask your doctor to give you a double-your-money-back guarantee that your transplant will be totally undetectable, and see what he says.

I hate to argue with the website's "Graft Calculator" but according to that, a totally bald guy only needs 8000 grafts for "full density (whatever that's supposed to mean). The fact is that OFTEN TIMES the math involved for guys who want a transplant, doesn't "add up". A guy who is totally bald has lost about half of the total hair on his head. Most guys have about 100,000 hairs on their head average (some more, some less). So a Norwood 7 has about 50,000 hairs left in the "permanent zone" and is missing about 50,000 hairs. (again, that is hairs not "grafts"). We'll call that "half-density" for now, okay? According to one study that everuyone seems to agree with, you can lose half of the hair in any area, and still have the visual appearance of "no hair loss". So to replace half of the missing hair, you need about 25,000 hairs. The average FU graft has 2.5 hairs. To replace 25,000 hairs, you need about 10,000 FU grafts. In fact according to one chart I've seen, they estimate 10,000 to 12,000 grafts for a full restoration (not a full head of hair, but "half-density" over the entire head). Okay, here's the important part: Most guys have about 5,500 FU grafts available, on average. (Some guys more... some guys less. That's what average means). In other words, 5 or 6 thousand hairs available, for a potential area that could need 10 or 12 thousand hairs. As you can see, there is a major flaw in the logic of hair transplants, when it comes to supply and demand... they don't even come close to matching up, for some guys. Now what if you aren't totally bald? Well then you are better off. You need less grafts for now. However, hair loss is progressive. That means it never stops! You may be able to put the brakes on it, or slow it way way down with Propecia. But pretty much every guy with hairloss will eventually become Norwood 7, "if he lives long enough" as one doctor put it so delicately. Until we find a cure for hair loss, and right now we do not have a cure. All the more reason to try to halt hair loss as much as possible, before even considering surgery. The more hair you keep, the better any transplant will look. And the more hair you lose, the worse your numbers look. That doesn't mean getting a transplant sooner, is better than getting it later. In fact just the opposite. Hair transplants can accelerate hair loss via "shock loss"... surgery can cause borderline (at risk) hair to die sooner than it would have otherwise. And it's better to plan your first transplant with a full understanding of how much hair you will lose, so that you don't attempt an "unrealistic area of coverage."

Hair loss is a TRAIT, just like freckles, or being short. Getting a hair tranplant to try to address a trait is an extreme step that MOST guys are not willing to do. Think about it! Only a small percentage of guys with hair loss or baldness, will resort to surgery. What I got out of the first post was her surprise, that it mattered that much. The fact is that NOBODY CARES about your hair loss, nearly as much as we do. Oh sure, maybe there is some a-hole at work who ribs you about it. Maybe there is some shallow girl who only dates guys with Brad Pitt- hair. Maybe if you are very very young and losing hair, it can be hard because it is less common. But nobody really cares all that much, guys. And the fact is that the OLDER you get, the even-more LESS other people care about hair loss, because the more common it is. That a-hole at work who ribs you, will start losing a little eventually. Most of the shallow girls grow up, and wind up dating guys who have some amount of hair loss. When you are older, it's a lot easier to be more philosophical about hair loss, and it no longer seems like the end of the world for some guys, who thought it was the end of the world at first. If hair loss is the worst thing that happens to you in life, then count yourself lucky. Really!!! It's VERY possible that some of us are TOO neurotic about our hair. I know this is true when I see guys say things like "Joe Rogan (Fear Factor guy) or Conan Obrien is going bald!!!" I can undertand that guys want to keep their hair because I certainly did. At the same time, lets keep things in perspective!