JakeVig

I agree, Dr Alexander that is some fine crown work you have on display there. It doesn't get any better than that, keep up the good work!

I am very happy with my HT. Though, before I had my HT I shaved my head slick bald just to see if I could accept the shaved look. Unfortunately I am unlucky and I do not look good bald so a HT was the only option I had to get back to a satisfactory appearance. If you have a HT than you can pretty much rule out ever shaving your head in the future. As for shockloss it is a very *real* phenomenon, do not listen to a doctor who says it doesnt affect his patients. As I mentioned previously you only want to go to a doctor who is experienced in minimally invasive surgery.

Well I can say if your only an NW1 at 32 then you sound like you are in pretty good shape. I was a NW3 at 27 when I had my HT done. I am now using meds dilligently to maintain as much of my existing hair as possible. Though even at NW1 it sounds like you have diffuse thinning, i.e. thinning evenly on top of your head. Im guessing that when the doctor says you have 50% hairloss it sounds like it means that your density is 50% of what it used to be. The thing about thinning hair is that you don't notice it until it gets below 50% of normal density. So normal density is around 80-100cm2 (which is usually the density of your donor area). A similar illusion of density can be achieved with just 50cm2. Its only once you get below that will you notice your hair thinning. I would post some pics of your hair so you can get more informed advice. The problem with thinning hair as opposed to a receeded hairline is that with your HT you are looking to add density amongst existing hair rather than filling in 'bald spots'. Transplanting amongst existing hair will cause 'shockloss', where the trauma of the surgery can cause your existing hair to fall out. Most of this shockloss is temporary i.e. it will grow back in the next hair cycle in about 6 months. But for hair that is about to fall out anyway some of this shockloss can be permanant. Effectively this means for the first 2-3 months post op your hair may look worse than what it was pre op. For examples of shockloss I would look at the photo gallery of Bill and Bushy. The best way to minimize the amount of shockloss is to get on the meds to strengthen your existing hair. I would recommend that you at least get on Propecia and use Nizoral Shampoo 3 times a week. If you are obsessing over your hairloss (like me) than I would also add Minioxidil to your regimen, only if your prepared to stay on it indefinately. Note: Propecia and Minioxidil are the only FDA approved meds available for hair loss. Nizoral provides a healthy scalp for your meds to work the best. So if you get on Propecia/Nizoral and Minioxidil than you can take comfort in that you are taking the most effective treatments for hairloss. Also going to an excellent doctor who can do minimally invasive incisions is crucial in minimizing shock loss. Generally adding density will mean that you will have to cut your hair short. I had my density added by Dr Ron Shapiro who used state of the art 10x magification and tiny custom blades to place grafts in between my existing hair. I had minimal shockloss as a result although your mileage will vary. Hope this helps!

m32, Excellent doctors today use the trychophytic donor closure technique which allows you to have a nearly undetectable donor even with short hair, for more info on the technique checkout: http://www.regrowhair.com/hair-transplant-surgery/donor...richophytic-closure/ It still varies for each patient but many patients are able buzz there hair short without the scar being noticeable.

m32, A HT is not a cure for hairloss, granted the transplanted hair is permanent but your native hair surrounding your HT will continue to receed as it did before your hairloss. Personally if I were you I will get back on and stay on Propecia for up to 6-12 months. If you do not get the desired results with Propecia you can add Minoxidil (Rogaine) to your hairline. The problem with each of these treatments is that you have to use them indefinately if you want to keep the hair that you have regained or maintained with them. Minioxidil is a messy regimen so I would only recommend it if you are prepared to stay on it indefinately. Note: it is recommended to get on Propecia at least 3-6 months before your HT as it will strengthen your existing hair minimizing the amount of shockloss. Basically the above treatments work best on the crown however some people have gotten regrowth on the hairline especially with Minioxidil. Whatever you do, do not jump into getting a HT without doing your research. A HT is a lifelong comittment, after you have a HT you wont be able to shave your head bald without the donor scar being visible. If you are young chances are that you will require further HT's in the future. After you have a HT most of your transplanted hair will fall out (70-90%) and will only start to grow back slowly after 3-6 months after. If after your research you do decide you want to have a HT then the most important thing is that you pick an excellent doctor. A HT is not like other plastic surgery, only the best HT doctors in the world can ensure you get an excellent and totally natural result. Some of the best doctors in the world are listed in the Coalition of Independent Hair Restoration Physicians: http://www.hairtransplantnetwork.com/coalition-physicians.asp Whatever you do do *NOT* go to a hairmill like Bosley, or MHR, etc. They have ruined the lives of many of their patients. Hope this helps!

Hi jame61, Well that would explain it, being 45 with just a little loss on your hairline makes you an ideal candidate for a HT as it looks like there will be no chance you will run out of your donor anytime soon - you can pretty much decide on the hairline you want. Yeah I've only read a little about Dr Griffin's work (from what I know he regarded as an excellent doc) but have not seen too many pictures. Yeah Im very happy about my procedure with Ron Shapiro, Im at the 2 month mark so my results are just starting to come in, next month will be an interesting one for me.

alexander seriously you're getting your info from a personal blog? If you need anything over and above Finasteride/Minoxidil/Nizoral I would consider Xandros (as a replacement for Minoxidil) from http://www.minoxidil.com Dr Lee has been openly researching hair loss and hair loss treatments for years, at least with his products you are going to get the benefit from his years of research. Xandros contains Minoxidil and Azelic acid (which should eliminate the formation of DHT where applied). Apart from having the highest concentration of Minox around he also has spironolactone lotion which is a powerful anti-androgen that can be added to your regime.

jagdish, I have to agree. You have been on this forum for a long time and have gone through a lot with your first HT, why would you risk another bad HT? If its cost, a lot of doctors will give you a reduced price if you have to travel overseas. There is so much risk with a HT to not go with the best, i.e. best use of limited donor supply, size of donor scar, naturalness, yield, transection, shockloss, etc. Remember you only have one head and a limited donor supply. IMHO if you cannot afford a good HT, you cannot afford to have a HT.

jame61 congrats, Only 700 grafts? usually that is too few to consider a HT for, where a lot of doctors will consider you to wait. How old are you? also Im guessing you are at most an NW2, is this correct? We would also like to see your results as there aren't many results from Dr Griffin or people undergoing a small HT.

Just to shed some further light on the topic you should read the article on propecia at: http://www.hairlosstalk.com/productreviews/men/propecia/ I will include an excerpt about shedding:

Rashomon, The only follow up you need a nurse or doctor for is to remove your sutures at 10-12 days post HT. All the post op instructions are given to you before the procedure so you can have a good read through it, then they will go through it with you again after your HT. It basically says to lightly shampoo your recipient area every day with a non-chemical shampoo, avoid direct sunlight, etc. If you have further questions you can shoot them off an email at anytime.

Kane, I've never heard of Dr Harris on this forum. Im just curious with all the great doctors mentioned on this forum why would you take the risk with a relatively unknown doc? Not that you should let geography be a factor for you in deciding which doc to go to but where do you live? As people may be able to recommend good doctors near your area.

Hi Midiman, My experience in detail and my photos immediately post op is here: http://hair-restoration-info.com/eve/forums/a/tpc/f/746...701005542#6701005542 I do not have any recent photos (Im currently at 2 months post op) because there has not been much growth. I will post some more pics starting at 3 months. I got dense packing between 50-55cm2 on my hairline and increased density on the thinning area behind my front tuff.

Propecia is definately the #1 treatment for hair loss. If you stopped it because it was too expensive I would get a prescription for Proscar which contains 5mg of the active ingredient Finasteride (Propecia contains 1mg - the recomended growth) and cut them in 1/4's, it works out much cheaper in the long run. I would also use Nizoral as well especially if you have dandruff.

Hi Rashomon, Crown work is rare because it is not the most efficient place to put grafts as you would get a better cosmetic appearance if you place most of the grafts in your hairline and midscalp area. Its only if you have enough donor hair would they recommend placement in the crown. Having said that all the docs you mentioned have done 1000's of HT's they would definately have also done a lot of crown work. I know that SMG have more pics than whats on their website and this forum, if you ask Matt Zupan from SMG he might be able to provide you some before and afters.

Hi Rashomon, I flew all the way from the UK for my HT. I stayed an extra few days at a nearby hotel for a quick recovery. I also had a great experience with Ron Shapiro, He is definately one of the worlds best. Though you wont go wrong with Dr Rose either who also used to work at Shapiro Medical Group. Ron also provided me a prescription of Avodart on request, I imagine most HT docs would if you ask them.

Well I'm very happy with my experience with SMG. Apart from being one of the worlds best, Ron really has your long term interests at heart and will let you know what can be achived with your limited donor now and in the future. Im only 2 months out so I can only see some peach fuzz which doesn't really make a cosmetic difference at the moment. I am using Minioxidil and MSM to speed up growth so your mileage will vary at the 2 month mark. But I was happy with my hairline immediately post-op so if it all comes through like its supposed to I stand to be one happy kid in the future!!! My recipient area lost its redness within the first week and I didn't experience any shockloss that I can tell, though most of transplanted hairs did shed (around 85-90% I believe) by the 3 week mark. As for the donor, I had to use dermatch for the first couple of weeks after my HT because my donor hair was short and so couldnt conceal the shaved area on its own. At this time my donor scar is completely flat and is very hard to locate by touch. I just had my first haircut yesterday since my HT and even though my donor is shorter than when I had a HT, you cannot see the donor scar which im pretty happy about. Other side effects after the HT were that my recipient area was a little numb after my HT but is now almost back to normal. Also for about 1 1/2 months I could feel tightness in the donor area when sleeping on it, though that has pretty much gone now aswell. I will still be careful about not lifting heavy weights and avoid doing anything that can stretch the scar (like crunches, etc) for another month or so. Overall I had a positive experience at SMG I believe my surgery was world class and am happy I took the flight over from the UK rather than settling with a doctor here. I took the advice from the forums and went to who I thought the best doctor in the world for me, regardles of location. If you live close I would definately add them to your list of consulting doctors.

so tired, I don't think transection amongst top doctors is as common as you think. You should be expecting nearly 100% growth rate from your HT which effictively means that minimal grafts (if any) will be lost because of transection. I believe going to a top doctor is important for a high yield as they use small custom blades, high magnification and the appropriate incision for the appropriate location. But yeah I wouldnt worry about it too much as all you can do is to chose the best doc and sit dead still when they are making the incisions

Mark, that is most likely because people who sign up on this board may use a 'private' internet email address, so when they stop visiting the forums they would probably have no use for their internet email and discard it. In that case we will probably have lost them forever

Well some people experience an initial shedding when starting Propecia. The shedding is usually when removal of DHT from the follicles (the cause of hairloss) it can shock a number of follicles to enter into the 'resting' phase. You shouldn't worry about the shedding as it usually means that you are responding to the treatment. You should expect to see these hairs (and hopefully some new ones) within 4-6 months. I know it is tough to see some shedding but it is generally a good sign, and you will most likely be better off in the longterm with Propecia.

There is a good chance that he has stopped being a regular viewer of the forums. The good thing about PM'ing, is that it will send them an email, which will be the best chance you have to get a response.

Hi suntop, Well the #1 recommended treatment for hairloss is Finasteride. This is comercially known as Propecia which contains 1mg of Finasteride (the recommended dosage). To save money a lot of people by Proscar (which is 5mg of finasteride) and cut it into 1/4's - it works out much cheaper in the long run. You will need a prescription to get either. Finasteride works by inhibiting DHT, the cause of MPB. There is some evidence that Minoxidil (Rogaine) works better when used together with Finasteride. You may want to try them both for a while to see if you can conjure up some regrowth. Although unless you have lost your hair within the last few years it will probably be unlikely to expect any regrowth with Minoxidil - you can try it for 4-6 months just to make sure. In most cases Finasteride will slow/halt your hairloss, though it is still recommended to begin treatment before your HT as it will strengthen your existing hair and limit the amount of 'shockloss' you will have after your HT.

Bob C, this may be obvious but have you tried sending him a PM yourself?

Midiman, I know exactly how you feel. I was on a high for the first month as well without having any results, but by the time you reach 2 months the high dies down and you will be anxious to see some resutls.

Gorpy is right. Apart from being more expensive, FUE is only suitable for minor sessions and touch-ups of up to around 1200 grafts. If you need more than that you will most likely be doing FUT. Unfortunately with your level of hairloss to get a satisfactory result your going to need the max no of grafts. If I were you I would strive for the max no of grafts in each of your HT's. Get on the Meds now if your not on them already and start doing some scalp excercises to improve your donor laxity. Good luck suntop, you have a long journey ahead of you.