*PHOTOS* Is there something wrong here? Feller and Bloxham, Great Neck, NY

[KO]

Nice. Hair loss is unpredictable for sure.

[Spanker]

Is it just me or is 10 months a ridiculously short period of time to go from a very strong core lock to heavy loss? I know it happens but it is very infrequent and I've never seen it in any person that I knew "in real life."

 

What was this gentlemen's age and was he on fin?

[Dr. Alan Feller]

Is it just me or is 10 months a ridiculously short period of time to go from a very strong core lock to heavy loss? I know it happens but it is very infrequent and I've never seen it in any person that I knew "in real life."

 

What was this gentlemen's age and was he on fin?

 

Sure you have, you just don't think about it. Most people lose their hair in spurts, this was his time. To lose a small section after already having lost the rest of the top is more the norm than anything else.

 

He is in his early thirties and is not on Fin due to side effects.

[fortune11]

Spanker - I strongly believe that hair transplants by themselves " pull forward " any pending hair loss in patients that have new grafts placed between or around existing hair . It has happened to me twice now . While I am happy with the transplanted hair , I certainly lost a lot of hair around it . Now mind you the transplanted hair quality (donor hair) is much better than the thinning native hair that was limpy and hard to style so the net effect is a +ve enhancement to appearance.

[Matt27]

First time I've ever seen a NW5A with a forelock like that. So I'm not surprised he finally lost it.

 

Mind you, non-Europeans' hair loss patterns can strongly deviate from the European norms we're used to.

[Dr. Alan Feller]

Spanker - I strongly believe that hair transplants by themselves " pull forward " any pending hair loss in patients that have new grafts placed between or around existing hair . It has happened to me twice now . While I am happy with the transplanted hair , I certainly lost a lot of hair around it . Now mind you the transplanted hair quality (donor hair) is much better than the thinning native hair that was limpy and hard to style so the net effect is a +ve enhancement to appearance.

 

VERY popular misconception. It is tempting to think this, and it may even be true in cases where the transplants are placed right into very thinning areas. But what people forget is that by the time a patient has actually gone out of his way to seek out HT help he is already well on his way down the hair loss road. By the time he has an HT he has lost an alarming amount of hair. And by the time an HT starts growing its another 8 months down the road as well. All that time the genetic balding has been at work doing it's dastardly thing. In a case like the one I presented here it is just a matter of time that the forelock would be targeted and eaten away "pac man" style. Usually a bit longer, but perfectly within the norm. Hair loss is progressive and that needs to be taken into account in each and every patient which is why I usually opt for more conservative hairlines. More forward hairlines are very appealing to young men, but doesn't serve them well as they get older and lose more hair. Also, when hair is lost behind the transplanted front line, the front line looks a bit thinner. Better to keep the hairline a bit high and have the grafts necessary to "back fill" if necessary. That's what we did with this patient and why he is signed up for another small procedure.

 

Thanks for playing. More coming...

[destorius]

In a case like the one I presented here it is just a matter of time that the forelock would be targeted and eaten away "pac man" style.

.

 

Dr. F, I'm not looking to pick holes at this (interesting case), but this is different to what you said in one of your recent videos where you highlights a NW5 with a forelock which you said he was very unlikely to lose.

 

The point I'm making is, as a HT doctor how difficult is it to make a solid judgement call on where someone's hairloss will go? To me, this is the million $ question which drives everything - technique used, density planted and hairline design.

 

I find this stuff fascinating, I should have studied medicine at college instead of computing & maths!

[newbie33]

OK, eyes on the prize. My final shot - is it a young Harry Belafonte?

[Dr Blake Bloxham]

Guys,

 

Yes, we were surprised at how much he thinned in 10 months. Unfortunately, this demonstrates how unpredictable androgenic alopecia can be. ESPECIALLY in younger guys.

[Dr Blake Bloxham]

Dest,

 

I know! Fun, it's it?

 

I think the difference in what Dr Feller said in another video has to do with the patient's age. If you have a 55 year old gentleman with a NW V pattern but a persistent forelock, there is a pretty good chance that this will be fairly stable. In this instance, you may be able to "count on it" somewhat and include it in the surgical plan. However, this is a very different story in a late 20s, early 30s patient. And this situation is a perfect example. These guys have very active hair loss, and it's very difficult to count on anything. And this was all discussed, in detail, with the patient while we created the surgical plan.

 

So, how difficult is it for an HT surgeon to predict how someone's hair loss will progress?

 

Honestly? Quite difficult. In my humble opinion, at least. However, we're not completely "shooting in the dark." You can always bust out the magnifiers and really do a miniaturization analysis of the hairs along the fringe and in the middle of the areas in question. You can also take things like the patient's age, medication regimen, and pattern along the rest of the scalp into account. Even with all this, however, it's still tough. And we have to plan accordingly!

[destorius]

Dest,

 

I know! Fun, it's it?

 

I think the difference in what Dr Feller said in another video has to do with the patient's age. If you have a 55 year old gentleman with a NW V pattern but a persistent forelock, there is a pretty good chance that this will be fairly stable. In this instance, you may be able to "count on it" somewhat and include it in the surgical plan. However, this is a very different story in a late 20s, early 30s patient. And this situation is a perfect example. These guys have very active hair loss, and it's very difficult to count on anything. And this was all discussed, in detail, with the patient while we created the surgical plan.

 

So, how difficult is it for an HT surgeon to predict how someone's hair loss will progress?

 

Honestly? Quite difficult. In my humble opinion, at least. However, we're not completely "shooting in the dark." You can always bust out the magnifiers and really do a miniaturization analysis of the hairs along the fringe and in the middle of the areas in question. You can also take things like the patient's age, medication regimen, and pattern along the rest of the scalp into account. Even with all this, however, it's still tough. And we have to plan accordingly!

 

Thank you for such an informative reply. Now I just need to find someone who can check mine to check for miniaturisation!

[john2223]

I agree with fortune11 in that hair transplants normally pull forward any hair loss that's pending. Androgenic alopecia is not predictable.

Edited September 19, 2015 by Admin
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[fortune11]

VERY popular misconception. It is tempting to think this, and it may even be true in cases where the transplants are placed right into very thinning areas. But what people forget is that by the time a patient has actually gone out of his way to seek out HT help he is already well on his way down the hair loss road. By the time he has an HT he has lost an alarming amount of hair. And by the time an HT starts growing its another 8 months down the road as well. All that time the genetic balding has been at work doing it's dastardly thing. In a case like the one I presented here it is just a matter of time that the forelock would be targeted and eaten away "pac man" style. Usually a bit longer, but perfectly within the norm. Hair loss is progressive and that needs to be taken into account in each and every patient which is why I usually opt for more conservative hairlines. More forward hairlines are very appealing to young men, but doesn't serve them well as they get older and lose more hair. Also, when hair is lost behind the transplanted front line, the front line looks a bit thinner. Better to keep the hairline a bit high and have the grafts necessary to "back fill" if necessary. That's what we did with this patient and why he is signed up for another small procedure.

 

Thanks for playing. More coming...

 

I respectfully disagree. I am speaking from personal experience , having been through transplants 3 times , first time in 2004 ,then again in 2011 and now in 2015 . All FUTs .

 

My speed of native hair loss picked up dramatically during the 1 year after surgery than the 1 year before it , and then it again somewhat slowed down after year 1 post op (or thereabouts) .

 

I did not think much of it back in 2005 until the same pattern repeated again around 2011 (2nd HT). Now granted , I did not conduct a scientific study and measure rate of change of hair density before and after . However, the optics of it , looking in the mirror and my prior photographs (since memory can be fickle) , convinced me that this actually happened .

 

It is always possible that even without the hair transplant , my hair loss progression would have picked up at around those times in 2004 and 2011, but why those two specific years as opposed to all the others. I think there is something to it ,

 

As I said before , the overall visual enhancement with the transplanted hair is much better since they are thicker and more lustrous than my thinning native hair so I am pleased with the overall results . Personally I don't care if the weak hair fell out in year 1 , 2 or 3 since they had to go at some pt anyways but hair transplant process did accelerate their demise , in my opinion.

[KO]

I respectfully disagree. I am speaking from personal experience , having been through transplants 3 times , first time in 2004 ,then again in 2011 and now in 2015 . All FUTs .

 

My speed of native hair loss picked up dramatically during the 1 year after surgery than the 1 year before it , and then it again somewhat slowed down after year 1 post op (or thereabouts) .

 

I did not think much of it back in 2005 until the same pattern repeated again around 2011 (2nd HT). Now granted , I did not conduct a scientific study and measure rate of change of hair density before and after . However, the optics of it , looking in the mirror and my prior photographs (since memory can be fickle) , convinced me that this actually happened .

 

It is always possible that even without the hair transplant , my hair loss progression would have picked up at around those times in 2004 and 2011, but why those two specific years as opposed to all the others. I think there is something to it ,

 

As I said before , the overall visual enhancement with the transplanted hair is much better since they are thicker and more lustrous than my thinning native hair so I am pleased with the overall results . Personally I don't care if the weak hair fell out in year 1 , 2 or 3 since they had to go at some pt anyways but hair transplant process did accelerate their demise , in my opinion.

Are you on fin? One thing that happens after an HT is that a bunch of hairs go into telogen. This is the stage in which androgens are supposed to be the most active...

[fortune11]

Are you on fin? One thing that happens after an HT is that a bunch of hairs go into telogen. This is the stage in which androgens are supposed to be the most active...

 

KO - I was not on fin the whole time (I have only started recently 6 mos ago, after my HT #3). fin I think does help on the margin here.

[Dr Blake Bloxham]

Androgenic alopecia is such an unpredictable process!