Super negative post (but how much is true?)

[MAGNUMpi]

I just found this post online and was wondering your thoughts on these 5 points.

It's a super negative and I don't want make anyone feel bad, but do wonder if some of these points might be potentially true.

Here is the post...

Hair Transplants are a bad idea. I am a hair transplant veteran/victim (4 procedures) and I am writing this post to help anyone who is considering this procedure to think twice before doing it. In particular, I am addressing the young men around 30, who don't know what they are getting themselves into. My goal is to get a newbie to NOT rush into this as I did and consider the long-term implications of what they are doing.

 

These following points should all be considered:

 

1. There isn't enough hair. If you pour about $40,000 into it, you can get back maximum 25% of your original density. That's it. About 7,500 grafts. It's nothing. Trust me. All you'll be able to do is have a real nice combover. That's about it.

 

2. The hairs are going to thin and age. This will render the cosmetically insignificant. If you transplant them at 30 years of age, they will not have the same cosmetic impact when you are older. They will look like unmanageable weeds.

 

3. The donor area will thin over time. This is the horrible truth hair transplant doctors don't tell you. The hairs in the back of your head will start thinning, too. Eventually, you will have the head of any regular old man - except for the giant strip scar or pock-mark dots of the hair transplants.

 

4. Propecia and other medicines don't work. Don't let the doctors lie to you. Propecia eventually stops working (Merck only ran their studies for five years - the point when they knew it stopped working) and your hair loss will continue. Minoxidil is absolutely worthless. Those are the only "proven" weapons in the arsenal and neither works.

 

5. New procedures like FUE have lower yields than strip and a host of other risks associated with them. You will never get your old hair back, so don't be fooled by the so-called advances in hair restoration surgery.

 

Take these five points, add them together and you'll get the simple fact. There is nothing you can really do about your hair loss. Better to shave your head and accept it.

[ontop]

As much I proberly hate to say this but to a certain point if not all is very true.

If its some method of HT or Meds or even both then all in theory would only buy us time 5/10/20 if your very lucky.

 

I once seen comments from a well known HT surgen that if we all lived to the age 100 we all end up of being full blown NWs even if you had HT / Medication or not.

 

Bottom line is that it buys us some valued time while we are younger I guess.

Unless one day they will crack this with much better less risky meds or cloning.

Edited June 2, 2015 by ontop
edit

[KO]

His comment about Propecia is wrong. There is a 10 yr study on fin just google it.

[thatoldchestnut]

Sounds like a bitter revisionist history to me. Is hair transplantation a "cure"? Of course not. Does it give many men, many years of confidence and happiness? Yes, absolutely. I think as long as you know what you're getting into and select a reputable surgeon then by and large, hair restoration surgery seems a decent solution.

 

1. Everyone knows that which is why you need an appropriate plan. It's also why not everyone is a candidate!

 

2. See 1. Also, thinning over time as you age? How hideously unnatural! Oh, wait.

 

3. True, but not exactly a guarantee of looking like some disfigured wreck. Sounds like the "victim" mentality. Not trying to belittle anyone's plight who's suffered such trauma but there are numerous examples on this forum of similar figures who go to great lengths to disparage certain techniques/surgeons on the basis of their own unfortunate experience.

 

4. They do. There are studies that show it retains efficacy @ 10 years+ at least if memory serves? I'm sure one could easily locate that study if of a mind. Granted that's not a lifetime but it's certainly longer than 5 so that's a willfully ignorant misrepresentation.

 

5. Might be me reading too much into it but again the allusion to "getting your old hair back" is a telltale sign that this person may have had unrealistic expectations. Either that or at the very least they are hypothetically espousing a sentiment that any reputable surgeon would be keen to guard against.

 

(Apologies if any of this is incorrect I do not presume to know more than most about HTs and am sure there are a great many people on this board who are far more knowledgeable than I. That said I felt moved to refute the majority of his points because they're so clearly tainted by experience.)

 

Come on, there will always be people who have had experiences like this; desperate to divulge some "home truths" about HTs, but think about all the positive reviews on here from guys who have literally had their lives changed. It's not a perfect solution but the OP of that post is clearly biased by his own, unfavourable experience.

 

To give such an account too much credit is to deny that which people who diligently and effectively research hair transplants know. There's rationalisation on both sides here but that is natural, I suppose. All that said, the post does raise one issue worth noting I suppose : don't rush into anything!

[hairweare]

I have to agree that at least 50% of HT patients will experience what the poster cites. There are multitude a reasons including, lack of financial resources, late progression to NW7, poor hair characteristics, DHT sensitive transplanted hair among others.

[JoeTillman]

1. There isn't enough hair. If you pour about $40,000 into it, you can get back maximum 25% of your original density. That's it. About 7,500 grafts. It's nothing. Trust me. All you'll be able to do is have a real nice combover. That's about it.

 

This is dependent on the amount of loss that is being addressed and I can only assume the original author of this five point list is referring to to advanced NWs. If the patient is not genetically predispositioned to progress into deep NW terrirtory then the percentage of recoverable density climbs significantly. Regardless, the message is sound, if not a bit short sighted.

 

2. The hairs are going to thin and age. This will render the cosmetically insignificant. If you transplant them at 30 years of age, they will not have the same cosmetic impact when you are older. They will look like unmanageable weeds.

 

This is referring to senile alopecia which does not affect all people. One statistic sets the rate of senile alopecia at 1 in 3 over the age of 70. However, if the work is done naturally and the patient is hit with senile alopecia then it will simply look natual as the condition progresses. This like saying that a face lift won't last you till your're ninety. I think this goes without saying that no treatment will last forever int his regard, for everyone, because then it would no longer be a treatment. It would be a cure. In my case with about 10,000 grafts, my hair may miniaturize with age, but I'll still have far more hair than had I not have surgery and I'm finding that as I get older I have more hair than my friends do when compared to ten years ago when I had little and they had a lot.

 

3. The donor area will thin over time. This is the horrible truth hair transplant doctors don't tell you. The hairs in the back of your head will start thinning, too. Eventually, you will have the head of any regular old man - except for the giant strip scar or pock-mark dots of the hair transplants.

 

See # 2. With regards to the scarring, this may be true for some.

 

4. Propecia and other medicines don't work. Don't let the doctors lie to you. Propecia eventually stops working (Merck only ran their studies for five years - the point when they knew it stopped working) and your hair loss will continue. Minoxidil is absolutely worthless. Those are the only "proven" weapons in the arsenal and neither works.

 

There's a bit of conjecture mixed in with this. Merck didn't stop because they knew the medication was ineffective past five years. How long does one need to test a medication to see how it works. Five years is a pretty good study and in my experience it does not stop working after five years. It is my opinion that this is a myth propagated by various factors.

 

5. New procedures like FUE have lower yields than strip and a host of other risks associated with them. You will never get your old hair back, so don't be fooled by the so-called advances in hair restoration surgery.

 

Yes, and yes, but the differences are negligible for the patient and any minor deficiencies are offset by the lack of a linear scar, which is the whole point of FUE to begin with. In reality, a combination of both techniques will yield the highest number of grafts but few people are in the position to take advantage of both, much less wish to.

[MAGNUMpi]

In my case with about 10,000 grafts, my hair may miniaturize with age, but I'll still have far more hair than had I not have surgery and I'm finding that as I get older I have more hair than my friends do when compared to ten years ago when I had little and they had a lot.

Nice point. Interesting stuff. Thanks guys.

[TakingThePlunge]

There is certainly a lot of truth in this post. However, I believe that a lot of the risk can be mitigated with education, realistic, long-term expectations and careful planning.

 

My dad is a NW Vi at age 84. He's never had a hair transplant but his donor is substantial enough that it could sufficiently hide a strip scar. But, after decades of working as a carpenter in the hot AZ sun, he's got more to worry about in terms of skin issues than trying to hide a surgical scar.

 

My point being that, while very young hair transplant patients need to be counseled about how they'll feel about their appearance at age 40, 50, 60, etc. There is probably a point at which we may not really care that much if a strip scar or FUE scarring is visible. I may be wrong about that. I'll let you all know if another 35 years if I live that long.

 

No, you can't have your natural density back. Yes, it's possible that your scars may become visible in your old age. Medical hair loss treatments are not a hair loss cure and there may be a point at which the progression of androgenic alopecia surpasses the ability of Propecia to slow it.

 

All things considered, the only decision I would have made differently is to have started medical hair loss treatments and undergone surgical hair restoration years earlier than I did. It's had a very positive impact on my self-esteem and confidence.

[Swooping]

Much of what he says holds truth yes, although its clearly not that black & white.

[Motoro]

Everything in this post hinges on point #4, which I consider to be factually incorrect based on my own experience.

 

Two general facts about my hair:

 

1) I began losing my hair when I was 18 years old. I’m 35 years old now and have what most people outside the MPB forum world consider a full head of hair.

 

2) I have aggressive hair loss on both sides of my family. Every single male in my direct bloodline went bald at a young age. To be fair, there are cousins and uncles in my family who are less bald than my father or grandfathers, but my point is still the same: MPB runs very strong in my family. We bald early and aggressively.

 

Like I said, I’m 35 years old now. I have been taking hair loss meds since I was 20. I was on finasteride for two years and then switched to dutasteride when I was 22. I’ve been on Avodart for the past 13 years, which is probably longer than almost anyone who has been taking the drug for hair loss. During that time I have maintained close to all my hair. I’m tempted to say that I haven’t lost any hair at all in the last 15 years, but that’s not entirely true (it’s close though). The point is that with the 5-alpha-reductase inhibitors, the loss has been extremely minimal even though the chances are very, very high that I’d be well on my way to being a NW6 had my genetics been allowed to play themselves out.

 

Having said all that, I admit that the medication could stop working at any time. That’s possible. It has happened to other individuals, although I don't believe this to be the norm. Evidence so far, however, suggests that it’s unlikely to happen to me. In the age of Internet-stoked fears about finasteride, I think we’ve lost some perspective on how effective 5-alpha-reductase inhibitors can be when used consistently after the very first signs of hair loss. There aren’t enough people on these forums who have been in the game long enough and been consistent from the very beginning with finasteride/dutasteride to push back against the anti-finasteride tide. In this sense, these forums aren’t a great place to give someone new to this world a solid sense of perspective.

 

So, having established that point #4 is questionable at best, points #1, #2, #3 begin to fall. Are they true? Yes, but with qualifiers that have already been identified in this thread. The fact is, if you respond well to a 5-alpha-reductase inhibitor over a period of years, you can feel a degree of confidence that you can get a hair transplant that will remain cosmetically sound for a long time. Will touch up jobs be necessary? Yes, probably. But will you be chasing something that’s ultimately unachievable as you age? Personally, even without further advances in treating MPB, I don’t think so.

[pkipling]

Interesting thread. In regards to the medication, isn't it safe to assume that even if Finasteride only works for a certain amount of time, that technology and science will keep improving so that within the next 10-20 years, an even more viable option will be available? It almost seems as if he's speaking like the medication will never improve, and I just don't see how that's possible.

[Spanker]

Interesting thread. In regards to the medication, isn't it safe to assume that even if Finasteride only works for a certain amount of time, that technology and science will keep improving so that within the next 10-20 years, an even more viable option will be available? It almost seems as if he's speaking like the medication will never improve, and I just don't see how that's possible.

 

I don't believe anyone should bank on something that's not here. They've been saying for two decades something better than finasteride would come about within the next five years.

[Spanker]

I think this is a guy that had his expectations extremely high or transplanted extremely aggressive or picked the wrong doctor or a combination of them both. I don't know of I've ever seen a pt that had 7500 grafts from a decent doc that didn't look better afterwards.

 

That said, I think everyone should try a buzzed look for a while before transplanting.

 

Done of what he's saying is true. Donor can and does thin. It's thinner than natural density, and fin can stop working. But also, but everyone will even need 7500 grafts over a life time.

 

Everyone who needs work isn't a nw6 even when they age.

 

This guy seems to be an outlier or the forum would be riddled with posts like these.

[pkipling]

I don't believe anyone should bank on something that's not here. They've been saying for two decades something better than finasteride would come about within the next five years.

 

Good to know. I'm relatively new to the hair restoration world, so am not aware of any unfulfilled promises made over the past 20 years in regards to medication. And you're right that we can't/shouldn't bank on anything that we don't actually have, but I can't help but believe that there has to be some advancement at some point in the relatively near future. Perhaps I'm naive. :cool:

[Motoro]

but I can't help but believe that there has to be some advancement at some point in the relatively near future.

 

Don't count on it! We haven't had a major MPB breakthrough on the medical front in 20 years. Hanging out on the forums, it's easy to get yourself pumped up about things that might be just around the corner, but history suggests these future products:

 

1) Won't work at all.

2) Won't work well enough or better than anything we already have available.

3) Aren't going to be profitable enough for drug companies to bring to market for MPB. The online backlash against fin doesn't help here.

 

At some point we'll see gene therapy address MPB, but probably not for decades. It's not something I'm counting on being available to me. Hair cloning falls into the same "don't hold your breath" category. Based on what I've seen over the last 20 years, I don't believe there will be a major MPB breakthrough brought to market between now and the time decades from now when gene therapy becomes an option. History suggests there may be a MPB product or two that hits the market between now and then, but history also suggests it won't be a breakthrough product that works much better than anything we already have.

 

I'm not trying to be a downer. Quite the opposite, in fact. I believe most men who are starting to bald in 2015 can achieve a great outcome with fin and modern transplants. The trick is to catch the problem early and to remain consistent with the medical treatment. I'd also suggest staying off the forums once you've learned everything there is to learn about hair loss in 2015. Once you've done this, stop by in another 10 to 15 years. You'll likely find there have been advancements on the surgical front but not on the medical front. The forum conversations will all be the same. The old users may be gone, but there will be a new crop (who were young children when you were last on the forums) arguing with religious intensity about one thing or another. But the situation on the ground will be the same. This has been my experience.

[Al - Moderator]

Suppose these things (thinning donor, eventual NW 6 or worse, not enough grafts,etc) happen to only 1% of the patients who have HTs. You may think that shouldn't really deter someone from getting a HT because it's so unlikely. You may even think it's so unlikely that it's not even right to say they are things that can happen.

 

If 10000 people get a HT, 1% is 100 people. For those 100 people that are having these problems, it is most certainly true for them, no matter how many people want to keep saying it's not likely to happen. And that is if the chance is just 1%

 

If something happens even just once in a million times, then it is true that it does happen. It can't ever be false once it is true.

 

If you don't think this stuff happens then take a look at my pictures on my profile. I didn't get a low, aggressive hairline. In fact I still don't even have much of a hairline at all and that's supposedly the most important area to cover. I didn't have unrealistic expectations. How can expecting a high hairline with a decent amount of actual hair be considered an unrealistic expectation? This is a hair transplant after all.

 

Al

[arussell]

Oh My.... this sounds as if unrealistic expectations were set and perhaps the goal of the medications was not fully understood? I have found with some "Veterans" of older transplants that this can often be the case. As it has already been pointed out, the Merck study was not five years but 10 and the take away message is really if you look at the vast difference in the twin studies you see it does work, it just is not a CURE! And it does not totally STOP hair loss, nothing does at least not at this point! Older transplants with larger grafts may become isolated when existing hair continues to thin..... 7500 hairs??? on average there are usually 2 hairs or more per follicle so this would mean that less than 4000 follicles were "rehomed". If done with good technique even with Senile Alopcia they would remain natural in appearance. FUE is not new, it is just refined..... This has to be a procedure that is begun with the knowledge to make informed choices. And there are usually modifications that can be made to help those who started early and didn't preserve their native hair.