2nd HT. Need Advice...

[SV_08]

Looking to get my second HT done in the near future and could use some advice on how to approach it.

 

First HT was in 2006. Approx 900 grafts into the hairline.

Here is a link to my pics from that procedure:

 

Hair Restoration Social Network - Hair Loss and Transplant Photos

 

I have already had consultations with 2 different coalition Dr.'s here LA....

Dr. Meshkin and Dr. Siporin.

 

Both told me basically the same thing: About 2000 - 2500 grafts. From hairline to about half way back/vertex. Leaving the crown for a 3rd procedure in the future.

 

I've been on this forum for a long time and have done a lot of research. But of course, I still have concerns/hesitations.

 

1-Based off my pictures, do you guys think it is a good time for a 2nd procedure?

2-Can I transplant through this much native hair?

3-Also, what are peoples take on doing the points right above the sideburns?

 

Any help or advice that I can get would be greatly appreciated.

 

 

 

 

 

Pics attached. First one is natural. The others are with water and hair gel.

[Blake Bloxham]

Hi Spiral,

 

Let me see what I can do to address some of your questions:

 

First, and foremost, let me begin by stating that Dr. Meshkin and Siporin are both great, and it looks like you're completing thorough research and undergoing helpful consultations.

 

1. Since it has been 6 years since your last hair transplant procedure, it seems like a good time to proceed. Are you currently taking any preventive medications, or have you been since your last procedure?

 

2. Although it is technically the surgeon's judgment call, it seems like your current density (in certain areas) would still allow for further transplantation.

 

3. Reconstructing the temple points basically comes down to two variables (in my opinion): preference and allocation of grafts. In most cases, it is really surgeon or patient preference as to whether or not restoring the temple points is important. Furthermore, keep in mind that any grafts allocated to restoring temple points will deduct from the amount available for the frontal region and hairline.

 

I hope this helps! Feel free to ask any additional questions.

[SV_08]

Hi Spiral,

 

Let me see what I can do to address some of your questions:

 

First, and foremost, let me begin by stating that Dr. Meshkin and Siporin are both great, and it looks like you're completing thorough research and undergoing helpful consultations.

 

1. Since it has been 6 years since your last hair transplant procedure, it seems like a good time to proceed. Are you currently taking any preventive medications, or have you been since your last procedure?

 

2. Although it is technically the surgeon's judgment call, it seems like your current density (in certain areas) would still allow for further transplantation.

 

3. Reconstructing the temple points basically comes down to two variables (in my opinion): preference and allocation of grafts. In most cases, it is really surgeon or patient preference as to whether or not restoring the temple points is important. Furthermore, keep in mind that any grafts allocated to restoring temple points will deduct from the amount available for the frontal region and hairline.

 

I hope this helps! Feel free to ask any additional questions.

 

 

Thanks for the feedback.

 

I use rogaine, twice a day. I used to be on finasteride as well, but decided to discontinue.

 

Would you recommend more grafts? Do you think I can achieve good density with the amount I plan on getting?

[SV_08]

Any more opinions/feedback???

[gillenator]

Spiral,

 

I read that you stopped finasteride and obviously that is a personal decision.

 

You are diffusing throughout the entire top of your scalp and I would not recommend a higher graft count until you see how much and where you will recede the most in the future.

 

You are still young so the progression of your hairloss will continue without finasteride. Your crown would benefit the most from finasteride and that would leave you more future donor for the higher visual impact areas.

 

Have you tried skipping a day or reducing the level of finasteride under your dcotor's advice?

[Shampoo]

I've been on this forum for a long time

 

Spirall08....how old are you?

[SV_08]

Spiral,

 

I read that you stopped finasteride and obviously that is a personal decision.

 

You are diffusing throughout the entire top of your scalp and I would not recommend a higher graft count until you see how much and where you will recede the most in the future.

 

You are still young so the progression of your hairloss will continue without finasteride. Your crown would benefit the most from finasteride and that would leave you more future donor for the higher visual impact areas.

 

Have you tried skipping a day or reducing the level of finasteride under your dcotor's advice?

 

I only stopped it a few months ago. I might start it again at a low dose, say EOD.

 

 

 

Spirall08....how old are you?

 

I'm 31

 

 

Problem now is that my old hair transplant is starting to become more obvious. Not because it was a bad job, but because the hair around it is thinning out, leaving kind of an awkward look near the temple/hairline.

[SV_08]

My major concern is doing more harm than good.

 

I've read:

1: Transplanting among native hair puts you at greater risk for shock loss.

 

2: Being my 2nd procedure, I may yield a lower % of grafts that actually grow. It may also result in a worse scar than I currently have.

 

3-Lastly, there are a lot of stories of people 8,10,12 months post op and seeing little to no growth at all.

 

I was spoiled my first time around. Got excellent growth that began about 4 months post op. 7 years later and I am completely happy with the results, my only regret is that I did not do more.

[josh333]

Spirall08,

 

We seem to be in similar situations. I just had my second HT five weeks ago after my first one 7 years ago which was for my hairline. I had a little more hair then you have now (before the 2nd HT) and transplanted around the front and crown area. Although there was some shock loss it was not so bad and I feel I would have been at this point in another year or two anyway if I did nothing. I never heard a that a 2nd procedure would have less yield, I hope not at this point.

[SV_08]

Spirall08,

 

We seem to be in similar situations. I just had my second HT five weeks ago after my first one 7 years ago which was for my hairline. I had a little more hair then you have now (before the 2nd HT) and transplanted around the front and crown area. Although there was some shock loss it was not so bad and I feel I would have been at this point in another year or two anyway if I did nothing. I never heard a that a 2nd procedure would have less yield, I hope not at this point.

 

 

Josh,

 

Thanks for the feedback man.

 

How old were you when you got your HT's? How many grafts?

 

Do you have any pics?

[gillenator]

Spiral,

 

Gald to read that you are considering starting finasteride again and EOD will IMHO still work well in inhibiting that cilprit DHT.

 

I truly believe in the long run that finasteride will be the biggest single factor for you in slowing down the rate of progression of MPB for you.

 

IMHO it is even more critical than adding more surgery in your overall plan.

[SV_08]

Any more thoughts or feedback?

 

This is obviously a huuuuuge decision and I want to make sure I have all of the information I need.

 

-Opinion on graft count?

-Dr. Siporin?

-Transplanting into native hair?

 

Goal at this point is to do it within the next 3 or 4 months.

 

Thanks.

[MTL30]

I can clearly see that you have transplanted hair when your hair is not wet on the hairline.I guess transplanted hair does not look the same wich to me sucks,for the price you pay..