TheHairLossCure

It is very common to see guys strip-out and then opt for FIT/FUE, either for necessity or because only a touch-up is needed. For those worried about the strip scar showing, consider FIT/FUE grafts into the scar area. If strategically placed, even a small number of grafts can help to blend away strip scarring.

He does solid work and is one of the few docs that I consider to be in the same league as Dr. Rose as far as surgical skill.

It should be noted that scratching your scalp at this point is NOT a bad thing. You will not harm any grafts that have begun to grow, and it may well help remove any lingering dead skin, scabs, and/or hair fragments.

I noticed your donor incision is temple to temple for the last session. Do you know the length of the strip? Surely it is well longer than 30 cm, yes? Sorry if you addressed this already, but we are working on a mighty long thread here

Thanx Bill!

Thicker,

Your doubts are certainly reasonable. HTs will not give a full head of hair. Today's refined procedures are very effective in the right hands, though.

Strip excision CAN provide enough hair to treat baldness, but there will need to be a balance between density, coverage, and the limited donor supply. Consider these reasonable dimensions for a single strip: 25cm by 1.25cm. That is 31.25cm2 of hair bearing scalp that can be dissected and transplanted (should give you 2500-3000 fu grafts). Certainly this will NOT cure a Norwood 6-7, but it can make a great impact on the frontal 1/3 or frontal ?? of a moderately bald patient. A second similar sized session can be considered for added coverage over the top or crown.

At age 21, odds are that you are a med therapy candidate and NOT a surgery candidate.

With undetectable hair work people will notice your looks gradually improve. The beautiful thing is that the process is incremental and subtle so people (even your friends and family) usually do not attribute the change to surgery. You simply look better to them.

Dr. Beehner is upstate. He is a well-published hair doc and has a rep for being a good guy. I cannot say I have seen any of his work in person though.

Having worked for many doctors, many of whom are recommended by this community (Rose, Deyroye, Cooley), it would seem you have a somewhat interesting perspective on post-op care. Have you discussed the rational for the various approaches with any of the doctors that employ them? Do you find that adherence to one approach over the other seems to be based on personal experience, independent studies, suitability based on the sort of procedure being done, etc?

Side effects with Propecia occur in less that 1% of patients. If you have used the drug for as long as you have and not experienced any side effects I think you are OK. You still may wish to check in with you doctor though.

You are not alone with the minox. Many men and women have compliance issues with this topical. It can leave the scalp greasy and in other cases, flaky. For those who do not have a problem with the minox, it is a good therapy to use, particularly in conjunction with Propecia. See how you like the foam. I am hearing pretty good things about it.

There is some anecdotal data that would suggestion that Propecia and Minox together can work better than either therapy alone.

Bobby Limmer is often sited as the father of follicular unit transplantation. There was a time when he was very cutting edge and, when a mega-session was 1000+ grafts, he did do the mega HT.

Honestly, I do not hear much either about Dr. Limmer or his son these days. I would be interested to see what sort of work they are doing.

I feel FUE surgery can greatly benefit certain hair loss patients. I worry that hyped-up adverts such as the one in the thread will give the procedure a bad name. Very unfortunate.

When a person expresses that their hair loss is disabling to them in some way, I think that is a good time to at least consider hair restoration. With that said, I do not think a patient should good forward with a procedure if they are feeling uncomfortable about surgery. Through research on this board you should get a better sense about what options are best for you.

You also mentioned a concern about surgery cost. Keep in mind, if you can find the right medical therapy to stabilize or improve your hair loss, meds are usually far more cost effective that surgery. Of course, there are contexts where in HTs are totally necessary, but meds are good to check out.

Jimmy,

What sort of HT did you do to treat your burns scar? Was it a strip harvest or FIT/FUE?

It is good to know you have limited MPB in your family. That is one indicator of your potential for hair loss. Ultimately, the genetics of hair loss is unpredictable and we cannot use family history as the sole indictor.

I know that Dr. Rose will build and/or reinforce more aggressive hair lines on certain candidates. Then again, I also know that he very much keeps the long term well-being of the patient in mind. I think you need a particularly skilled but also a very ethical physician to determine what is possible for you as well as advisable.

dbk,

I strongly discourage patients from making their hair restoration decisions based on price alone. You are paying for results. If your result is less than natural, is it not worth much. If you do not get good growth, the per graft savings mean very little.

Find the doctors that are doing the very top work with the most natural hairlines and best overall results. Then, as a secondary concern, think about price. Considering that most of the elite docs charge within a similar range, I think you are doing yourself a huge disservice by focusing on the per graft charge.

Good advice.

The top physicians in the field will take great pains to maximize the naturalness and fullness of a hair transplant result. Results are possible today that were unheard of 10 and 20 years ago. A factor remains though ??“even a great HT doc cannot make a bad HT candidate a good one.

I am a great advocate for hair restoration surgery as a solution for people who are bothered by hair loss. Although this is the case, I believe hair transplantation a poor idea for ill-suited patients. Moreover I think HTs can be disastrous in some very young patients and in individuals rapidly losing hair without medical therapy.

Understanding what make a good candidate has (at least) two advantages. 1) It help the patient set his/her expectations for a possible hair transplant procedure and 2) it helps patients identify the unscrupulous clinics that might mislead patients about there suitability for a proceedure with financial gain in mind.

Chicksdig,

You look as though you have good hair characteristics for transplant surgery. The minimal contrast between your hair color and skin tone is sure plus. It also looks as though you have a slight waviness to your hair. Is that accurate?

Good luck and enjoy the watching the new hairs coming in over the next year. I echo the sentiments of some of the other posters who suggested you get on some medical therapy for hair loss if you are not already.

Bayscholar,

You truly have come along a long way. And, at 10 months, the results stand to improve somewhat more. I am happy for you

When strip-free donor harvesting initially appeared on the "internet scene", I think traditional strip surgery was unfairly criticized. There seemed to be a suggestion by some people that strip harvesting was bad on the donor area, wasted graphs, and generally harmed the patient. Sure, strip surgery CAN be bad, as can any surgery in the wrong hands. However, it can work beautifully in the hands of a skilled practitioner. Similarly, FUE/FIT was too quickly panned by some in the early days. In truth, the FUE/FIT's effectiveness is very much doctor dependant.

Strip harvesting and FUE/FIT have both progressed greatly over the past several years, and patients should understand the benefits of both when choosing a hair restoration strategy. All hair transplant procedures scar, but expertly performed strip and extraction transplants can deliver natural and satisfying results to patients. I have never seen hard evidence that would suggest that strip surgery yields better than FUE/FIT, although there is soft evidence from different sources that would both corroborate and refute this. Dr. Rose, who I believe is in a unique position to assess the merits of both techniques, has never indicated any significant difference in growth between the two harvesting methods to my knowledge. Growth can be affected by how the grafts are handled, stored, cut, trimmed and placed, among other things. Patients should therefore seek out a qualified doctor with a qualified team to handle ALL aspects of the procedure with great attention to detail.

The donor area is a precious and limited resource. Physicians and patients are lucky to have two methods that can be used separately or in conjunction to deliver the best surgical outcome.

Prospective patients often look for the techniques and technology when checking out different doctors. B Spot brought something up that we do not hear about as much ??“ size of staff and experience.

You can have the best doctor in the world but without a great staff, all bets are off. A properly-sized and highly experienced staff will contribute greatly to a patient's experience and final result.

You forgot one...less healing, waiting, and growing...and less SCARRING.

Markky,

Have you been able to talk to any patients on the phone from Keene or Alexander? Have you met any patients?

If you have not already, see if you can check in with some folks one-on-one. Often times it helps with the decision. Seeing work up close can be a great help.

Patients can do well with multiple strips. To me, there is a point where the surgery is inefficient though. Usually you can get the most tissue, and the most hair, out from the first session. For the second procedure you are probably not going to get as much tissue. Furthermore, less of that tissue will be hair-bearing as a scar will be running through it.

If you look a Bill' surgical history, it almost reads backwards as the graft yield with each of his sessions gets greater and greater. Most of the time we see mega-session candidates get a big first pass followed by progressively smaller sessions.

With FIT/FUE working in conjunction with strip excision, I believe fewer patients will need 4-6 strip session these days. You can move a lot of hair with 1-3 strip harvests and then touch-up/finish off with FIT/FUE as needed. I feel the combination approach will limit scarring potential, avoid tightness, and deliver a good number of grafts.

I'm being a little tangential here, but I think technology is such now that patients do not need to do that many sessions.

By the way, you might want to check out some medical therapy, even though your loss seems stable. You still have the potential to lose more hair near the lateral humps and the crown area.

Since hair transplantation is very much an issue of supply and demand, patients with limited and stable loss tend to be the best candidates. Young patients with limited loss are not the best surgical candidates, simply because it is difficult to see how far baldness will progress for 20-something patients. In your case, there is not a lot of mystery about where you loss can go. So, while your pattern is advanced, it is well-defined and can be planned for without having to heavily speculate.

In some ways this may go against conventional wisdom, but I feel you may be a good candidate. While you will never get a full head of hair, you will certainly be able to improve coverage and density.

I did say that you "may" be a good candidate for a reason though. Perhaps it is the lighting of some the photos, but your donor hair are looks a little weak. I know you indicated that you donor is dense, but how would you characterize the actually quality of the shaft? It your hair on the fine side? Is it straight or curly when you grow it out a bit more?

Lighting can be tough, since you donor resources look just fine in other photos.