Dr. Lindsey 10 months out from 600 FUEs to frontal triangles McLean VA

[Dr. William Lindsey]

This fellow had 615 FUE’s late last summer to address his fronto-temporal recession. He’s likely to lose a little more, but hopefully not a lot of additional hair as he ages. After a long discussion over FUE vs strip, particularly with his fine hairs, he chose FUE. Either he or I posted his case back then but I can’t find it easily, so some readers may recognize these pictures.

 

Shown are day of surgery, about a week and now at 10 months. Both of us think he’s gotten a pretty decent result, but they’re a few thinner areas from either poor growth or additional loss, or both. We’re planning a 200 FUE session in mid September.

 

Dr. Lindsey McLean VA

[haircut]

Wow, that looks great!

[Motoro]

I'm the guy in these pictures. A big thanks to Dr. L. and his team. Here are some quick comments and observations:

 

I started noticing hair loss when I was 19 years old. When I was 20 I started on Propecia. When I turned 22 I transitioned from Propecia to Avodart (0.5 mg). Im 33 now and have been on an oral 5-alpha reductase inhibitor for 13 years (2 on finasteride, 11 on dutasteride). For the last 2 years I've also used liquid minoxidil, which may or may not be doing anything. To the extent that I'm still actively losing hair, it's happening at a very slow pace, mainly around the hairline. When I look at pictures of myself from 5 or 10 years ago, there's not a tremendously noticeable difference in my appearance. I attribute this to dutasteride, from which I've had no side effects at all (that I know of).

 

Now, as for my HT case, the thing I want to drive home is how slow regrowth has been for me. It took months before my transplanted grafts fell out and nearly 6 months before I had any new minor regrowth. I'm closing in on a year now and I'm still seeing new hairs pop up (not a lot of them at this point, but I had at least a few brand new ones at month 11). What I've also noticed is that the hair that first regrew months ago is now, after many months of growth, really starting to thicken and darken up. I knew going in that regrowth happens at different rates for different people, and it turns out it doesn't happen very quickly for me. Like Dr. L. said, I'm going back for some additional work in September, mainly to fill in areas that need thickening.

 

The bottom line for me is that this game requires a lot of patience. That's true of both medical and surgical hair loss treatments. You need to think in years and decades, not weeks and months.

[Spanker]

Man you are really lucky to have hair like that at 33 after starting fin at 19. Good for you.

 

So do you take .5 avadart a day? Also, what does it run you a month?

[Motoro]

Thanks man. There's no doubt I'm extremely lucky to have kept most of my hair. In an odd way, I'm lucky I started to lose my hair and got on Propecia and then Avodart before the Internet hair loss forums blew up in size and filled up with people paralyzed by fear of the potential side effects of the oral 5-alpha reductase inhibitors. Those concerns, which didn't exist when I started all this, may have frightened me away when I was 19/20 years old and kept me from the things that allowed me to get to 33 with most of my hair intact.

 

I pay about $130 per month for 30 0.5 mg Avodart pills, from my local pharmacy. I was put on Propecia and then Avodart by my dermatologist, so I've always had a legit prescription and haven't messed with the online pharmacies, where I'm sure I could probably find a better deal.

[Spanker]

Man, you would think that you would be able to find something that you could cut to reduce the price.

 

Have you read about the daily finasteride plus .5 dut weekly regime? That will be my next step.

 

If you don't mind me asking. what prompted the switch?

[Motoro]

No doubt I could cut the price by buying online or using generics from India. I could cut the price a lot, I think. The thing is, I've been doing the exact same thing for over a decade and I'm pretty happy with where I'm at. I don't want to mess with online pharmacies or drugs from India. I have little doubt that these meds are probably just as good as what I get in the local pharmacy, but buying what I've always bought from the place I've always bought it gives me piece of mind, which is worth a lot to me. It's certainly worth $4 a day.

 

I actually don't spend much time on the hair loss forums, as I've found it plays into my OCD and I don't want to spend too much time thinking (even more) about hair loss, but I have read about daily fin plus a 0.5 weekly dose of dut. If that's working for people, I think that's fantastic. As for me, I'm going to stick with what I've been doing for the last 11 years.

 

I switched from fin to dut not because fin wasn't working, but because dut was new on the market (this was way back in 2002) and my dermatologist suggested it might be even better than fin. So I made the switch and have been using everyday since.

[nathaniel]

After a long discussion over FUE vs strip, particularly with his fine hairs, he chose FUE.

 

Motoro, what did the "long discussion" over FUE vs. strip entail, and why did you choose FUE? And how did "fine hairs" factor into all of it?

 

Your pre-op pics look pretty good, so you are fortunate to have started on meds so early so that your transplant procedure was minimized!

 

- Nathaniel

[Motoro]

I was never going to go with FUT. I had my mind set on FUE from the beginning, as I didn't want any sort of linear scar, however minimal, and also because I wasn't looking for a large number of grafts. If I needed or wanted more grafts, I may have proceeded differently.

 

As for the discussion about FUE vs. FUT, if I remember correctly, it was what you might guess. We covered the issues one needs to be aware of when considering FUE, namely yield and the issues that can affect yield, like follicle transection. Dr. L. left the choice to me. The issue of the diameter of my hair shafts isn't related to FUE or FUT, except to the extent that FUT often produces more consistent, healthy grafts, which is desirable when you have fine hair and may need more grafts to achieve the illusion of natural density.

 

Like you said, I was fortunate to have had great success with the meds. If that hadn't been going as well and I needed more hair, I may have proceeded with FUT. As it is, I'm just using small HTs to even out my mature hairline. As I approach my mid-30s, that seems an appropriate goal. Fingers crossed that things proceed the way they have been proceeding for the last 14 years. If so, my plan is solid.

[Dr. William Lindsey]

Nathaniel,

 

Let me add clarification on long discussion...

 

At consultations, and then again when people come in for consent signing, I ALWAYS go over a bunch of things that include 4 options. 1. do nothing 2. wear a wig 3. medical therapy and 4. surgery. In the surgery part we discuss the pros and cons of strip vs fue, the cost vs success consistency and linear scar issues.

 

I also push my conservative approach overall and go over the potential for future hairloss and that a person may need much more hair in the future.

 

Additionally I go over what I think the three potential mistakes with hair work are: 1. big scar 2. hairline too low 3. too little hair over too much bald head. And I have a couple of videos on the web that show this talk as well.

 

In some people, who have done a lot of research before they come in, this takes 10 minutes. In others, it takes 30 minutes and a followup meeting or 2. And some people never can either accept what I'm saying to justify my plan or they simply can't make up there mind. Its ok, there is not a rush or emergency to get a hair transplant. And there are plenty of people to consult with and forums to do research on.

 

I never call patients to tell them to move forward and we really don't do any sort of sales tactic to get people to commit. My feeling is that this is all a big decision for people, take your time and let me know when you are ready to proceed. An educated person in general makes a better decision whether its hair, car buying, spouse picking...

 

This particular man is really quite sharp, and I'm certain he was as educated as any potential patient the day he showed up. For guys like that its mainly going over the details, particular issues related to their decision tree, and expectation management.

 

I hope this adds to your understanding of our general way of talking to prospective and decided patients.

 

Thanks

 

Dr. Lindsey

[nathaniel]

Dr. Lindsey, I think it's really great that you provide so much information and various options to potential patients without any sales tactics. If you were a little bit closer to me I'm sure I would have already popped in for a consultation

 

I also like that you emphasize that there is no rush - hair loss is not a life threatening medical condition.

 

I am still curious about the reference to "fine hairs" and how they factor in to it - you mentioned them in a previous posting a couple of weeks ago and I had questions about them then and was hoping to hear you elaborate a bit more on them.

 

Thank you!

 

- Nathaniel

[Nick153452]

Congrats man. May the stay with you!

 

Horrible Star Wars pun?

[Dr. William Lindsey]

Nathaniel

 

All this hair work is very similar to moving and planting real trees. I've planted more than 1000 trees so hence I'm familiar with the analogy.

 

If you dig up a big beefy rooted evergreen and you're halfway careful...and you plant it elsewhere and water it a few months, they ALL grow. Or at least almost all.

 

If you dig up a scrawny rooted arbor vitae and you're not really delicate with it, or even if you are, half the dirt falls off the root ball, and the thing dies.

 

Same with hair essentially. I find that thick rooted middle eastern hair grows better than thin Vietnamese hair for example. And with FUE, there is more trauma to the root than with strip. So I suggest FUE is more likely to be highly variable in results in thinner rooted hairs.

 

I hope this helps clarify my thinking on this matter.

 

Thanks

[Dr. William Lindsey]

Bump.

 

Another thread had led to a question on this one so I'm bumping to make it easier for that fellow to review.

 

Next case in 3 days. Updates to follow.

 

Dr. Lindsey

[Motoro]

Ok, quick update. I had a small followup FUE session on 9/20/13 with Dr. Lindsey. The goal was to thicken up the previous work and fill in a few problem areas from last time. Dr. Lindsey removed around 340 grafts using a 1 mm Feller punch (Dr. L., please correct me if I'm off on this). Most of the grafts in my 2012 session were singles, but there were a higher percentage of multiples (doubles and triples) this time around, which Dr. Lindsey strategically placed behind the front of my hairline. I'm hopeful the illusion of the transplanted hair will be augmented by the multiples, particularly because my hair is of a finer caliber. Not surprisingly, areas containing multiples from last year's session look significantly thicker than areas made up exclusively of singles.

 

As was the case last year, everything went very smoothly and Dr. Lindsey, Wendy and the rest of the team were both professional and a lot of fun to talk to while the procedure was underway. In terms of recovery time, everything is pretty much back to normal a week out. All the "after" pictures were taken exactly a week after the procedure. There's not a lot of evidence that any work was done at all, which was one of the goals.

 

Thanks again Dr. L.

[Dr. William Lindsey]

Thanks for the post. You know, sometimes FUE is easy, usually though its pretty hard. But as you know from the case, your scalp just cooperated. Now its the waiting part. Stop by sometime in January.

 

Thanks

 

Dr. Lindsey McLean VA

[LongApple]

Ok, quick update. I had a small followup FUE session on 9/20/13 with Dr. Lindsey. The goal was to thicken up the previous work and fill in a few problem areas from last time. Dr. Lindsey removed around 340 grafts using a 1 mm Feller punch (Dr. L., please correct me if I'm off on this). Most of the grafts in my 2012 session were singles, but there were a higher percentage of multiples (doubles and triples) this time around, which Dr. Lindsey strategically placed behind the front of my hairline. I'm hopeful the illusion of the transplanted hair will be augmented by the multiples, particularly because my hair is of a finer caliber. Not surprisingly, areas containing multiples from last year's session look significantly thicker than areas made up exclusively of singles.

 

As was the case last year, everything went very smoothly and Dr. Lindsey, Wendy and the rest of the team were both professional and a lot of fun to talk to while the procedure was underway. In terms of recovery time, everything is pretty much back to normal a week out. All the "after" pictures were taken exactly a week after the procedure. There's not a lot of evidence that any work was done at all, which was one of the goals.

 

Thanks again Dr. L.

 

Hi,

I am a 21 year old who lives in the Northern Virginia area currently on propecia and have had no side effects. I think this patient mentioned that he switched to avodart with no side effects and I am looking to do the same.

 

I was wondering if Dr. Lindsey or other doctors in the northern VA area have ever prescribed avodart for young men.

 

How do you private message on this forum?

 

When I click the "send private message to ______" off a user, I see a window pop up saying Welcome Back "LongApple". We’ve noticed that you have yet to:.

Where on the screen is the compose private message button?

Edited December 15, 2014 by LongApple