FUE and patchwork

[Guest]

I have read a lot about not doing patch work, or should I say small sessions at a young age because you waste donor hair, and you obviously will have one more scar to deal with. Well with FUE on the horizon, does that not take away the deterant of small session patch work. Due to the way in which it heals and leaves minor to no visible scarring, wouldn't it be safe to say if you only need small session maintenance work done, go for it. Now by patchwork I'm talkin guys who might not be far along their balding. I for example have been on Propecia a year. I'm sticking at around a N2 or N3. However there are patches in the front of my hairline which are obviously not gonna grow. I am very reluctant to get a FU strip procedure due to the extra scar it would create knowing that somewhere down the line, barring break thru drugs, I'm gonna need plenty of scalp for strip. So doesn't FUE kinda dismiss this concern.

 

 

Matt 6: 25-34

[Guest]

I have read a lot about not doing patch work, or should I say small sessions at a young age because you waste donor hair, and you obviously will have one more scar to deal with. Well with FUE on the horizon, does that not take away the deterant of small session patch work. Due to the way in which it heals and leaves minor to no visible scarring, wouldn't it be safe to say if you only need small session maintenance work done, go for it. Now by patchwork I'm talkin guys who might not be far along their balding. I for example have been on Propecia a year. I'm sticking at around a N2 or N3. However there are patches in the front of my hairline which are obviously not gonna grow. I am very reluctant to get a FU strip procedure due to the extra scar it would create knowing that somewhere down the line, barring break thru drugs, I'm gonna need plenty of scalp for strip. So doesn't FUE kinda dismiss this concern.

 

 

Matt 6: 25-34

[arfy]

Are you asking if you are an appropriate candidate for FUE, even if you aren't appropriate for strip excision?

 

There are a couple of posters around the net who seem to think FUE has changed all the rules about who is a good candidate, what is an appropriate hairline, how young can you be, etc. I pretty much disagree with those folks on these issues.

 

FUE is a method of harvesting, that's it. In my opinion a guy who is not bald enough to get a strip excision is also not bald enough to get a FUE procedure. A correct FUE hairline is still mature, with some recession, to look correct later in life. The common-sense "rules" have not changed about hair transplants, just because of FUE.

 

Now I will say that in the right hands, it is possible for FUE to be less of a commitment than a strip excision, if it is done well and handled responsibly, on the right patient at the right time, etc. Just as far as being committed to the process, it is easier to change your mind and walk away, with no linear scar, should you decide not to follow up with additional sessions. This is a small point, however, and it doesn't seem to be what you are asking about.

 

I don't remember seeing your pics offhand, so maybe you are a good candidate, maybe not.

 

But the need to:

-think things over and research different options, including waiting

-plan for the long term with hairline placement and donor area use,

-not rely on drugs or cloning to "rescue" poor planning,

-to proceed cautiously

-only get a hair transplant when other approaches have been tried, and failed

-stop the progression of hair loss with medications, if possible

-be bald enough that a hair transplant makes sense

-not get a hair transplant as your first reaction to hair loss...

 

None of these things have changed just because there is a new and different way to harvest follicles, in my opinion. FUE only means a less-invasive way to harvest grafts. If you look at the doctors who have been performing FUE the longest (Woods), they still turn patients down for being too young, or not bald enough, and they still give patients mature hairlines, instead of restoring patients to adolescent or young-adult levels.

 

However, if your question is "can an appropriate candidate get an FUE transplant by doing it in small steps, I think the answer is yes.

[Manko]

JRod,

 

The only thing I would add to Arfy's post is that a transplant does potentially bring about shock loss. You may wind up losing more than you gain.

 

Good luck.

 

Manko

[Guest]

The two main reasons I see for postponing a HT cause of age are:

 

1. Can't predict future loss, and don't wanna waste donor hair

 

2. Don't want excessive scarring if you happen to need more procedures

 

With FUE it just seems that both of these issues would be in a way taken care of with the right approach.

 

1. if you get the transplant conservatively, then future loss is accounted for because you would need it in that place eventually anyway, so why not now, seems to become a now or later debate

 

2. from what I understand, FUE doesn't scar nearly as bad, if at all, so to carefully select the donor area would seem to have no bearing on having too much scarring later if a strip is necessary

 

Thanks to both you guys for your responses, greatly appreciated, just thought I would kinda elaborate on exactly what I was getting at, I think Arfy, you mentioned I was a bit unclear, hope this clarifies.

 

 

Matt 6: 25-34

[Guest]

I haven't put my pics up yet, my girl has got my, well I guess her (I gave it to her as a gift) digital camera. So I'll have to wait till she gets back from her trip to Europe to post. I am almost embarressed to post them though, after seeing and hearing some of the other posters and their truly severe stories I will feel almost petty with the small amount of loss I have by comparison. I mean I am only 24 and I will be in their shoes at some point, but my pics might seem almost disrespectful to those with real and severe loss. Nevertheless I will post as soon as I can. I guess I am just concerned with never letting it get that far. A luxury I have with the recent technology and future progression of procedures. Thanks again for your posts, you seem to be one of the few truely impartial posters (in respect to certain doctors) I have read, so I respect your opinion highly.

 

 

Matt 6: 24-34

[Son of a Plug]

JRod,

 

Any amount of hairloss is reason to come here to read and exchange experiences.

 

If you are 16 or 70 and concerned about hairloss it's better to visit here and get involved than to feel you are too early or too late.

 

At 24 you would be well served to read, ask questions, and post photos in order to gain an objective point of view of what degree hairloss constitutes needing a HT. No one said that in order to gather info here you need to have already put a down deposit on a HT.

 

The fact that you have concern that posting photos of a NW 2 and being "disrespectful" to those with "real hairloss" is silly. If you have no hair where you used to have hair, you do have "real hairloss". The only difference is the degree of loss. So, by getting advice now at 24 on how to slow your hairloss, without surgery, you may be able to avoid doubling your loss in 10 years.

 

Following the advice of people here who know what they are talking about actually shows respect.

[arfy]

I agree with Son of a Plug, it's not 'disrespectful' to ask questions. There are a lot of things about HT the average person doesn't realize, and the only way to figure things out is to read and ask a lot of questions.

 

Also, I agree with the comment that shock loss is one of the negatives you need to weigh out, if you still have a decent amount of hair remaining, or you are putting grafts into an area where there is still hair.

[Guest]

I am a bit confused about Shock loss. Does it occur only within the area of the HT, or does it branch out a bit. For example, if you had a perfectly circular recipient area, would the only shock loss occur within that circumference of HT, or would it kinda branch out, like a ripple effect in a pond. Reason is, the spots I'm losing are losing heavily, its like a recession almost, but just moving into the center of my head. I've got that look like someone put a donut up on your hairline and left the spot in the middle. Its really thinning up the power alleys and up into the center of my head. More so on one side than the other, but common sense tells me the other side will soon be following suit. All that to say if it(shock loss) only effects the HT area, I think I would be well served with a small FUE procedure. Asthetically that is, now as far as future planning and loss that is a different concern.

 

 

Matt 6: 25-34

[arfy]

That's a tough question. I don't know if there is a definite answer. Shock loss is not something that is completely predictable or even completely understood, to my knowledge.

 

Some people say shock loss can happen anywhere on your head where you have "at risk" hair, not just where the grafts get placed. Some people say the general risks of shock loss are lessened with a less-invasive FUE, but that isn't guaranteed. I would assume that transplanting directly into any area would increase the odds of shock loss there, if all things are equal. The "at-risk hair" factor may be the biggest variable. Some guys have very strong hair remaining hairs, and might suffer no shock loss. Or they have 'some' shock loss and it all returns. Whereas if the hair is less hardy, it may not return. Or it may. This is one of those questions that can't be answered definitively over the 'net, you need to discuss this with a doctor. Even then, there's no doctor who will guarantee "no shock loss" that I know of.

 

This is why many folks (like me for instance) think you need to have enough hair loss to make getting a transplant make sense. (Some say to be at least Norwood 3 before considering HT, I might even say higher than that). It is possible to end up with a net loss after a hair transplant, if you do a small session, you still have a lot of remaining hair at the time, and you end up having shock loss. If you are at risk for shock loss, it makes more sense o do a large enough session (or multiple FUE sessions) to ensure a net gain, even if there is some shock loss.

 

All of this needs to be weighed out if you are a borderline candidate for a transplant. Some guys are definitely good candidates, some guys are bad candidates, and a lot of guys are somewhere in between. Those borderline guys need to be more careful about choosing to have surgery.

 

By the way, have you stopped the hair loss from progressing with Propecia? It's better if you are not in a hair loss free-fall at the time of surgery.

 

I should point out that there are some doctors who might say that shock loss is not permanent, or is not a big worry. (I don't know why they say that, but I've heard that before. Maybe these doctors were talking only about one specific patient at that time? Because you can find reports of shock loss from patients here in the forums, so that tells me it IS a problem).

[Son of a Plug]

Arfy,

 

I thought I'd try to be an optomist regarding the net effect after a HT due to potential shock.

 

I do believe that the hairs that have miniaturized are at great risk of being loss for good after HT but that the healthy ones do have a good chance of returning.

 

Once hairs start to miniaturize you're always going to be at risk of losing them for good as a result of a HT resulting in a net loss/gain.

 

But remember, the coverage that 15 FU per cm/2 of miniaturized hair is not going to give as good an illusion of coverage as 15 FU per cm/2 of genetically strong hair. Don't forget, the miniaturized hairs are whispy, lighter in color, and have less texture.

 

Plus the transplanted hairs are there for good and likely to survive the next HT.

[Guest]

Speaking from personal experience only, but it's been 1.5 months since my HT, and I haven't noticed any shockloss yet. There must be something to it, because I've talked to another person who also got 500 FUE's, but experienced shockloss shortly afterwards, mostly in the crown area. This would lead me to believe, that if you're not balding in the first place, you are unlikely to experience shockloss, after an HT.

 

"Any sufficiently advanced technology is indistinguishable from magic''. Arthur C. Clarke

[Guest]

As far as the Propecia, it has haulted the loss in back (crown), although the front (power alleys in particular) keep creeping in towards the center of my head. I should mention that I just switched from a half dose of Propecia to a whole dose. I have been so broke I had to split the freakin pills. Hopefully the whole pill will kinda help me out even more in front. The consult I went to said that unlike Rogaine, Propecia should promote growth over your entire head, not just crown. I hope he was right. Makes sense definitely, although logic and hairloss seem to be at a loss for each other.

 

To everyone else who has responded thanks, and lets keep this one going this is very interesting.

 

 

Matt 6: 25-34