TheHairLossCure

Growth beginning at the 4 month mark is quite usual and a good sign. You should begin to see some very apparent changes between months 5 and 8. Enjoy!

Growth in scar tissue, recipient or donor, is not always as predictable as we would like. I think most doctors are upfront about this when confronted with repair cases. It is important to note that, at 10 months, we do not always see the final result. A small percentage of patients will experience significant improvement after the 1 year mark. Let's hope this the case.

To keep things in perspective, the scar in the photos resulted from a corrective surgery. In no way, shape, or form does this make the scar the patient's "fault". I am sad to hear it is bothering you M&M. But I suspect that some of the complications might have been, in part, due to the prior work (at the other clinic). I cannot specifically comment on how this might be fixed (don't really know your case). But given your new doc and the other quality resources you have at your disposal, I am quite sure you will find a good way to remedy the situation.

The ISHRS is a non-profit learning organization. Physician membership is not a physician recommendation. The IAHRS is a promotional organization. Physician membership is a physician recommendation. The question is who recommends the doctors? Why? And is this recommendation more objective or informed than any other person's recommendation?

It is pretty darn nice if you "tip" the techs with some sweet treats or whatever. Sometimes doctors are glorified and the techs really do not get recognized for the hard work they do. I think a patient is going to get the same level of care (at a good clinic) whether he treats the techs or not. That said, the assistants are definitely not going to perform worse because of your kind gesture. So, every little bit helps I guess

Mrjb, I think most people that get good work are VERY pleased. I just think that main thing even good work cannot remedy is progressive loss. That is not a big deal for some, but for others it is.

Some people really think that, since transplants are elective surgeries, you should give the patient what they want. You should, within reason. But let's face it - it is pretty darn rare that a 22-year old is going to be a great candidate for surgery.

As far as damaging harvested hair goes... Transection is a product of technique or difficult patient characteristics. It is not related to the size of the surgery unless time constrains are forcing the staff to rush their work. In order words, it is not an issue if you go with a good clinic.

The majority of patients that research transplants on true patient advocate discussion boards are going to get a good result. Sometimes people are disappointment with when hair loss progresses though. I remember talking with a patient who had 2 sessions to build his frontal zone (with another clinic). He expressed some regret over the situation. Interestingly, he has a nice result; the grafts were angled in a natural fashion, the hairline framed the face well, and the scar line was narrow. The problem was that he lost significant hair in the crown area in a few short years. While he had more hair than he would have (had he not done any work), he was pretty bummed about his continue loss. He was level-headed about it though. And, fortunately, he was quite happy with the results of the 3rd surgery for the crown. All is well that ends well. My point is this: research hair loss when you research the best surgeons. A long term perseptive is important.

If you are going to a good clinic, and I think you are, it is pretty unlikely you will have a bad scar on the first pass. 0-2mm is a good strip scar, but I think 3mm is still cosmetically acceptable. "Cosmetic acceptability" is, of course, subjective. How many grafts are you going in for Steve?

BTW, are you thinking of the IAHRS, or the ISHRS?

I think it has been around for about 7 years.

Are you considering flying in for in-person consults before you make your choice? This may be beneficial in itself. Furthermore, I am sure both clinics will be able to arrange for you to meet up with some local patients. Surely both docs have patients in San Fran, just not as many as their local area. You might be able to kill two birds with one stone by doing an in-person consult.

What were the post op directions for larger sessions? I don't know your situation should be any different in terms of post op care.

First of all, I think you should definitely consult your doc about your post-op care. It's beneficial to spray the recipient area and keep the grafts moist. There are differing opinions on the best solutions so, again, I would suggest talking with your doc.

You can actually do FUT and FUE in the same day. FUT is limited more by scalp laxity, where as FUE is limited more in terms of donor density. So, for example, if you require 3,000 grafts to reach your goals, but the strip harvest yields 2,900, I think it is reasonable to do do a 100 graft FUE session in the same day.

Hi Bleach. Typically, you will see initial growth between months 3 and 4. Sometimes it will take longer. The nice thing about (high level) Follicular Unit Grafting is that work looks natural even as the hair is gradually coming in. So, aside from the immediate post-op situation, the growth will look "legit". Cosmetically noticeably results will appear between months 5 and 8, and the final result is usually seen after a year.

A patient who does his research will most likely find a reputable doctor. The research will also help that the patient set proper expectations in advance. If these expectations are satisfied, the patient has good reason to stay with his physician. Certainly, there is nothing wrong with going else where, assuming the same level of research is conducted. One possible reason to see 2 docs is the availability of Strip and FUE. If you are patient with a great strip and 2,500-3,000 or so grafts, you may be delighted with the result and the doc. In fact you may be so pleased that you feel you only need a small 100-250 graft touch up. For me, such as small procedure is ideal for FUE. If the doc that delivered the great Strip result does not do FUE, I think it reasonable to consult a few FUE specialists for a small job.

I believe most physicians use a single layer closure, saving the double layer for special cases.

Hairline density can be hard to determine in terms of grafts per unit area. The area is irregular and, therefore, the density on the leading edge fluctuates. As you correctly mentioned, hair characteristics are a huge factor and greatly effect the appearance of fullness. With average hair quality, patients usually do well with 40-55 grafts per cm2 immediately behind the leading edge. With less than favorable hair quality, grafts may need to be placed closer together for the desired look.

Every case is different and requires a different approach. I think a lot depends on the current condition of your scar. As previously mentioned, scar grafting (via FUE) is a possible option. If the scar is not too wide, grafting can do wonders to blend the area with the rest of the donor. One thing to keep in mind is the likelihood of you needing more hair transplants down the road. It might not be prudent to graft the scar if you or your physician feel you will need to remove that tissue with another strip surgery in the future.

Definitely keep the crew here updated on your procedure. I know Dr. Rose has been complimentary of Dr. Cooley's work on several occasions. That is a good sign. Best wishes.

While it is industry standard to charge by the number of grafts, some doctors do charge per procedure. I don't know that there is necessarily anything wrong with that. I do believe, however, that clinics need to be transparent about what they are doing. So, for instance, even if you are paying a flat rate for a procedure, you should still have an idea of approximate number of grafts to satisfy your needs. In other words, you need to be educated enough about surgery to get a sense of the overall game plan. Part of the research process is talking to patients (online and/or in-person) and getting a sense of the different docs and their reputations. Other part, once you have narrowed your choices down, is building a relationship with your clinic(s). That relationship involves getting all your questions answered completely and to you satisfaction.

A pencil line scar is always the goal. But even in the best hands, strip scars can go a bit wider. I believe you need to give it time. Since you are still healing, the scar may look "angry." It is not uncommon and may not be indicative on the final result. Furthermore, you may have some minor (temporary) shock loss around that scar line. This can magnify your perception of the actual width.

It might be a discouraging to think that after a surgery you will need to stay on medical therapy. The fact is, any investment requires some maintenance and I would encourage you to think of it that way. You can go the generic route to make medical therapy more cost effective you. Hair transplants can be extremely rewarding for patients. But some of the payoff is lost if you acquire hair in one area only to lose hair in another area due to MPB. If meds work for a patient, the synergistic effect of surgery and drug therapy can be fantastic. Still, you may opt not to take meds. They may be inappropriate for your circumstances. But you should know that by not taking measures to halt your hair loss, you increase your chances of needing another surgery.