TomA

I just finished a touch up session with Dr. Madhu in Hyderabad. Everything went well. He transplanted 320 grafts into the area around my scar line via FUE. He didn't charge me for the session as he considered it to be an extension of the previous work. Amazing customer service there. As usual, everyone at the office was wonderful. I did get a bit of bad news, however. He said that my donor area is probably too sparse for any more work.

Thanks for your replies! Sorry, I've been out of the country (and still am) for work. I posted this just two days before I left and only now had the time to come back. I will try to answer all of the above questions in this one post. I took these photos with my iPhone. I will post some better photos later, but I think these are fairly representative of the 9 month result at a normal distance, I can say that my hairline is EXCELLENT. I couldn't be happier with it. I no longer have an issue with scalp show through anywhere along the hairline when my hair is parted on the left. You cannot detect any problems along the hairline even at point blank range. My concern is not so much the shock loss behind the ears. I did have extensive shock loss after my first transplant, but it corrected itself by the eighth month. This time it didn't. It's not that I am happy about it, of course, but it is what it is--correct me if I am wrong, but I don't think that has much to do with any specific physician. In any event, the area could be viewed as naturally thinning. I do think this means a third strip surgery is out of the question though--correct? My pressing concern is the visible lines above the thinning areas. They can be noticed quite easily even when my hair is fairly long--and the thinning begins right at the line, it is not gradual. Dr. Madhu has emailed me noting that the scarline issue can be corrected with FUE, and I will write back as soon as I finish here. I'm guessing you could remove grafts via FUE above the line and place them in the scar or below the line to even things out.

These are my 9 month results. The front looks great, but the scar line area looks like a problem to me. This is is freshly cut with a number 7 guard. Some of the problem is that the hair below the scar line is very thin, but the other issue is that the scar line itself is quite visible.

Your hairline is a lot better, and good enough now to use a concealer. I think you will be very happy with something like Dermmatch at this point.

Agree about the Dermmatch and the fibers. The fibers make a huge mess and don't seem to add that much.

Strange. Maybe your email is going to their spam box? I set it up while I was in Bangkok by phone. I wired the money and then called immediately afterward ant they confirmed having received it.

I have been wondering about three questions that I have not seen answered elsewhere: 1. When, if ever, is it too late to start using treatments like minoxodil/dutasteride/finasteride? In other words can an NW5 or 6 start using these meds at age 60 and see an improvement? 2. I remember that Rogaine had a drawing of a guy with different levels of hair loss and it said that if your hair loss was worse than this, it may not work. Is this due to the LENGTH of time someone has been losing hair, OR is it referring to the person's genetic NW destiny? 3. I know that minoxidil is only for the crown. If someone has more hair loss than that, again say NW 5 or 6, would it still work in the crown area? 4. Finally, the drawing seems to indicate that it may work on a completely bald crown, which I didn't think was the case.

Where did you get Dutasteride?

Why would he have lines? I think the way that is should be done would be to simply darken an entire area evenly and fade the color to the edge of the area. In addition, I would think that this would be a more effective solution AFTER a transplant IN THE TRANSPLANTED AREA. Therefore you would not lose the hair when you get older. Any comments?

I have noticed that my hair is better when I use two different types of shampoo and rotate them. I typically shampoo once with a creamy shampoo and once with a clear one (like Nioxin). This leaves my hair very clean and tends to work a lot better than just using one shampoo over and over again.

It's true about the closure method, but that has nothing to do with the shockloss--they are totally separate isues. The "shocked" hair will start to grow back in 6-8 weeks. You (and I) are going to look bad until then.

Oh, hell.... I guess that means I need to post some pix soon... :mad: :rolleyes: I was hoping to wait until the shockloss was gone...

I had VERY bad shock loss just behind and above both ears after BOTH transplants. I'm about two months out and look normal EXCEPT for that--and it is quite obvious. Since I had two different docs, this is something that it probably just related to my specific scalp. I doubt that it could have been prevented with current technology Honestly, when I go in for a third surgery one day I am considering asking the doc not to cut above the ears and to limit the donor region to the back of my head. Is this possible? I know that this would result in a lower graft count...

I actually wondered about that before and it seems logical, but I too have never heard it mentioned before. Are you sure it's new hair and not just normal MPB shedding?

I live in Bangkok 3-4 months per year and have an apartment on Ratchada Rd. I'll actually be in Hong Kong at the end of November, so I won't be in town when you are there. I can't really give you advice about a hotel as you haven't specified a price range. With no limits, for example, I am likely to recommend the Mandarin Oriental, Dusit Thani, or JW Marriott...

That's better than average, though. Most of mine still seems to be growing it--and I'm almost at six weeks. I won't say there has been NO shedding, but a LOT has begun to grow.

Well that's the third case of this that I have seen from Dr. Madhu. Yeah, wb280, they may still shed, but mine shed completely after one month the first time and I had growth beginning at around three months--which I think is a typical pattern. Actually,1966kph, for ME the worst part is the shockloss behind the ears which I had with BOTH transplants. If it wasn't for the shockloss, I would look normal at this point except for the slight, (but noticeable if you look) disturbance in the hair along the scar area. I have no hope of looking normal for at least another month to 6 weeks. Luckily I'm on a sabbatical this semester! I might go back and ask him at some point, but I didn't really think much about it.

Definitely.

Wow... 4 weeks. I removed mine after 9 days if that makes you feel any better about it. Don't know about the Gym, but after a month it doesn't seem like it would be a problem.

I will say that I don't think the Western clinics are ripping people off--their costs are MUCH higher. (Especially their malpractice insurance!) I don't begrudge them one penny of whatever they make. And the vast majority of people are not going to leave their country to have surgery. That's fine, too. But some people, like me, don't mind having surgery at a good clinic in Asia (or Eastern Europe) for whatever reason. Some may need to save money. Others may prefer to spend their money on other things. To each his own. The Western clinics have furthered HT research and have graciously shared that information with others around the world. Dr. Path, I believe, trained with Blufford Stough at Stough Medical Associates in Hot Spring, Arkansas, one of the hair transplant pioneers. Everyone has a place at this table.

I will only comment that a lot of these young guys pressure the docs to do this. If the doc refuses, they complain, "He wouldn't listen to what I wanted." Hey, how many people on this board smoke, because they get pleasure from it NOW, all the while knowing what is likely to happen in the future. Same same.

Clinic: lower real estate and construction costs abroad. Anesthetization (heck, all meds): generally MUCH MUCH cheaper abroad. I buy the same meds in Thailand for less than my $15 deductible back home. Punches, microscopes: might be the same price, but this is a SMALL part of the price Blades/needles, bandages, tape, garbage bags, ALL cheaper abroad. The fact is, for something labor intensive like hair surgery, the VAST, VAST majority of the cost comes from labor. If we were talking about something like LASIK, which is not as labor intensive, I could agree more. A huge part of the cost of LASIK is the licensing of the LASIK machine software which costs the same everywhere.

I realize that I am responding to an old thread, but I have to strongly disagree with your statement. You are failing to acknowledge the lower wages and exchange rate differences in other countries. Dr. Madhu (who is recommended here) charges even less that ?1 per graft for strip and I was his only surgical patient on the day I visited (though he had lots of visitors for consults).

The vast majority of the new hairs have not shed! My wife says that they appear to be about 1 cm longer now. I'm cautiously optimistic that they are not going to fall out at this point. This got me thinking about what would have been different this time around (because the hairs did shed with the scabs after my first transplant). I remember Dr. Madhu's staff spraying my head continuously during the procedure with some type of liquid, and I do not remember that happening the first time around. Dr. Madhu also gave me a bottle of liquid to spray my head with every 1-2 hours for the first day after the transplant. He said that it would help with the survival rate of the grafts. The bottle was marked with a tag that said only, "Dr. Madhu's Advanced Hair Transplant Center." I remember that the other guy here that posted a lot of pics from Dr. Madhu got immediate growth as well. I'm starting to wonder whether this spray is the reason. Has Dr. Madhu solved the shedding problem? Garet: Dr. Madhu had trouble finding the scar from Dr. Path, if that helps. He said that in many areas it was completely invisible and he was unable to follow it. When a top HT surgeon cannot find your scar at point blank range under bright surgical lighting, I guess that's pretty good.

Update: Oddly, though the scabs are long gone, almost none of the transplanted hairs have fallen out yet. I do have the same horrible shock loss behind the ears that I had the first time, though. At least this time I am not worried about it, but I hate having to wear a hat everywhere I go. I will post a one month update in my weblog in about a week.