N-6

Feller, Ron and Paul Shapiro and Rahal are well reputed on this site for FUE. I think its impossible to reliably accept "best doctor" answers to your questions for the categories you mentioned. Maybe other than yield percentages, there is no objective way to provide you with accurate answers. You might get a few opinions about a patients experience with a doc with lets say scarring but given the volume of patients a doc sees I don't see how this can show you who's better. I would research docs, discuss at length, meet with them, see patients, and make a decision. Remember that results, in terms of yield, scarring, shock loss, is very patient specific and just because one patient had an extraordinary result doesn't mean you will have the same result.

This is a medical question, why don't u talk to your doc?

Congrats, sounds like it went great.

Hariri/Bill, I understand the concern that Hariri initially mentioned 3 NY docs and then narrowed that list down to 2 NY docs whom he assumed performed this "very bad HT". I don't know why he pointed out those 2 docs out of the 3 as potentially responsible. Hariri never explained why he assumed it was either T&D or Bernstein out of the initial 3. Maybe he doesn't like their work but I think he's entitled to share that opinion even if they are coalition doctors. Also, isnt it his right to say that this was a poor HT especially given the reason this thread was created, ie to get opinions about whether the patient received adequate growth, and the differing opinions in this thread on whether he received appropriate growth?

Its hard to tell from your pre-op and post-op photos, including lighting and angles, but it looks like you've had decent yield for that little amount of grafts over such a large area. The area behind your hairline looks thicker and so does your hairline. How many further grafts do you need? I think the question is how many grafts do you actually have left. As a norwood 6, you need as many grafts as possible. I personally would target my hairline/frontal third for my next session and start hitting the crown area as well. So if doc tells you, they can do 2500 grafts at the next session, I would do something like 75% of that for the front/hairline and 25% for crown. Treatment plan is dependent on how much you have left overall, what you think should be a priority and what the doc feels in his experience will optimize your grafts so discuss with your doc and try to hash out something. Good luck.

Ive never heard that it can cause prostate cancer. A lab test called PSA is used to help diagnose prostate cancer. The higher the PSA level the more concerning. Propecia can suppress the PSA level therefore making it more difficult for a doctor to know what your actual PSA level is. This is my understanding. Do know however that PSA tests are controversial because they lead to many unnecessary biopsies. Since you have a family history, make sure to discuss this risk and whether taking propecia is a good idea in your case.

In nyc its about 250 for a 3 month supply. I echo what futurehair said, get a prescription. I don't know why anyone would mess around with nonprescription "propecia". How do you even what you're getting without a script is even propecia?

Hariri makes a good point. Clinics ( I don't know what H&W does) do split follicular units which results in more grafts so I'm not impressed by the sheer number of "grafts" a clinic says they put out. Count the number of hairs that are transplanted and not the grafts. Pt A undergoes 1 HT session - 3000 grafts which contain 5000 hairs. Pt B undergoes 1 HT session - 2500 grafts which contain 5000 hairs. Each patient is getting the same exact number of hairs but patient A is shelling more $$ for the same number of hairs. Clinics sometimes have a legitimate reason to do this, sometimes there are not enough 1 hair grafts for the hairline so they split 2 hair grafts into 1 hair grafts. Its when they do this just to drive up the price that it becomes unethical. Unfortunately, as a patient, I don't think we will ever know for sure what's being done and why. We have to take the doc's word so its important you get someone with an ethical reputation.

I like the idea but not sure if results are consistent. Scars have less blood flow than other parts of scalp and blood flow is needed for growth. Therefore, yield is an issue with FUE into scar. I'm curious about micropigmentation or tattoo into scar to preserve precious donor hair for future loss.

HT is an individual decision; some people will choose to shave, others want to restore their hair. Just be sure that if you do go the surgical route, you thoroughly research the different procedures available and choose a quality doc. If you come up with an appropriate plan, then there shouldnt be a need to shave your head off even if hair loss progresses.

I found Couvre easier to apply to conceal scar and shockloss but Dermamatch works very well too.

Looks really good . . . how close can you go on the sides before scar or any thinning in that area shows? Also is your scar or any line noticeable when your hair is wet?

I would consult with the docs mentioned above, both T&D and Bernstein may be conservative but I don't think this is a bad thing at all. I actually prefer this approach for certain patients because of the unpredictability of hair loss patterns.

Wooly, some choose to do FUE at the end because they have no more donor left via strip. FUE is not as efficient as getting grafts as FUT so it would be interesting to see where the doc can possibly get 7500 grafts via that method. Ive never heard of a doc doing that many grafts via FUE and I suspect that's the case because its an impossibility for most patients. FUE is not always taken from the safe permanent zone so the more grafts you try to obtain via FUE to satisfy a patient's thirst for hair, the higher the risk that the doc will be extracting those grafts from fringe areas or areas of the scalp where hairs may not be permanent. If you have discussed this risk with your doc and are willing to transplant a boatload of hairs which may fall out anyway, then that's your choice of course. I've attached some links authored by medical professionals which support this. The last one is from a pioneer in HTs. Medscape: Medscape Access Welcome to Dr. Walter Unger | The Procedure

I went extra hard weight wise up until I was supposed to stop prior to my HT. Everyone heals differently but I did cardio/no weights beginning at about 2 weeks post-op and only today (almost 6 weeks post-op) resumed some very light weights (low weight, high reps). Its always good to change up your workouts and the time off from weights was a nice rest and repair for me.

If you have credit cards, I would also check with them to see what promotional offers they have and check your mail to see if you have any promotional offers coming in. I got approval from Chase Advance but opted to place mine on a miles accruing credit card at 0% for 12 months which aint bad. Figure I could get a favorable interest rate and get miles at the same time. And I don't think I've ever heard of anyone getting 7500 grafts (especially by FUE) in one procedure. That's a lot of $$ at once, even for FUE.

Good thread. Here's article about Latisse from May 2011, interesting. Also discusses cloning. http://www.nytimes.com/2011/05/05/fashion/05SKIN.html

The nape issue via FUE probably varies from patient to patient. I have heard nape can thin over time but I don't know if this is necessarily the case in every patient. In my opinion, FUE from any area outside of the FUT safe zone is a better bet in an older patient whose hair loss pattern is fairly well-established. Definitely wold like to hear Dr. Umar's thoughts about his reasoning for using nape.

Good question. The idea of using nape hair for the hairline is great because the doctor doesn't have to split grafts into 1 hair grafts if he needs them for the hairline, therefore saving you some money and maintaining the follicular unit intact. I really like the results of Dr. Umar's nape to the hairline procedures. They look very natural. My only concern (as it is with certain FUE procedures) is the longevity of that hair. Is it in the safe zone? I certainly don't know. It is below the area where strip is usually taken (which is what traditionally has been the safe zone) so maybe it can be permanent, although I've heard the nape can thin out over time. That said, I probably would feel more secure using nape hair for a transplant than using hair above the strip area as we see in some FUE procedures. It would suck for a patient to transplant hair that will fall out in time anyway. I don't want temporary hair but hair that has the best chance of staying permanent. Maybe Dr. Umar himself can comment.

As the links demonstrate, splitting grafts seems to be fairly common. Whether Dr. Rahal does or not I don't know but it would not be surprising if he does. It is not unethical to do so if its part of a treatment plan for the hairline. It is unethical if the doctor does it to make more $$ off you. As a patient, unfortunately, I really don't think there's a way to know whether a doc is splitting grafts unnecessarily. At the end of day, as people have said over and over, its hairs that count. Assuming there's no need to split grafts, the patient who gets 4000 grafts/9000 hairs is better off than the one who gets 5000 grafts/9000 hairs. The latter patient gets swindled in this case.

Here are some links discussing the topic: Should Hair Transplant Surgeons “Split” Follicular Unit Grafts During Follicular Unit Transplantation (FUT)? | Hair Loss Q & A Why Cutting True Follicular Unit Grafts in a Hair Transplant May Be “Splitting Hairs” | Hair Loss Q & A

Yes I believe they take the follicular unit of lets say 3 hairs and can create 3 separate 1 hair grafts, for example, to give the hairline a more natural appearance. At the end of the day, its hairs that count not grafts. That's why I'm usually not impressed with these mega mega sessions.

At 7 months, there is an improvement of your hair overall. The hairline is less recessed and the crown has filled a little so far. I still think you will have some more growing to do and the hairs that have grown should mature into thicker hairs. By the look of the hairline, it doesnt look like it was densely packed so I wouldnt expect to see night and day density in the front even after it is fully grown out. I also wouldnt expect dense packing in your situation because it appears that the plan you agreed to was to use about 2900 grafts to address virtually every zone of your scalp. 2900 grafts spread out like this won't give you lots of density but it should result in a nice balanced cosmetic difference all over. I definitely think another procedure should be done.

This depends a lot on the type of procedure you undergo, whether or not the doc shaved the recipient area and how you recover as an individual. I had a strip procedure (where recipient area was trimmed) with staples and was back at work in 16 days. I work at an office, have lots of personal interaction with people and don't think anyone noticed.

At what age would it be fairly safe to get a hair transplant? Maybe mid-20s but a doc would know better. How much could this potentially cost? Cost depends on how much work or grafts you need as well as the type of HT procedure you undergo. The price per graft for a Strip procedure can be anywhere from $3 to $5 per graft. So a patient undergoing a small strip procedure of 1000 grafts could pay up to 5K. There is also an FUE procedure and this is sometimes double the price per graft than a strip procedure. Also keep in mind that many patients need multiple procedures over their lifetime. I personally have undergone 4 strip procedures over a 15 year period and invested a little over 20K over that time. Could I maintain a hairline that resembles a Norwood 2 (my current position)? This may or may not be possible depending on the ultimate progression of your hair loss. You could be a NW2 now but could progress to a NW 6 or NW 7 with time. In that case, you might b able to keep a NW2 hairline but have less coverage in the crown. It is also possible, however, that you won't progress that far and could remain where you're at now. Docs will have to analyze your scalp and elicit a complete personal and family history. They can provide you with an educated guess but know that they cannot reliably predict where you'll end up eventually especially when you're a 20s-something patient. From your experience what would you recommend? We could chime in on some photos and/or you could just consult a reputable HT doc.