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Shifty

Advice por favor: Type of procedure and how many grafts

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12 hours ago, Shifty said:

I literally just purchased this online, waiting for it should arrive today or tomorrow, it has 1% Ketoconazole the active ingrediant in Nizoral. Should i throw it away and just get Nizoral? itam states use basically once every 2 weeks.

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I know nothing about that product there. I got the over the counter 1% Nizoral brand at my grocery store. Twice a week use means you basically can get a year out of one bottle. Has a nice minty smell.

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No one should give you a figure of 2500 grafts to make you think it is even doable with that amount of grafts.  Your in for the long haul and at least looking at 5000 grafts to start off.  Your expected cost should be at least based off of a 5000 graft procedure.

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I would strongly consider Erdogan for FUE as he's suited to 5000 graft megasessions and could comfortably cover both the crown and the frontal area in a single surgery. Alternatively I would request FUT from Diep and look to have the largest session he and your donor can provide. 2500 grafts will cover the frontal area and rebuild the hairline, but you're not going to get both crown and hairline coverage. I would expect that as you lose more hair in the future you are almost certainly going to want a second surgery down the track also (even if its 5-10 years) no matter what you do.

The reality is that you're not far away from being slick bald and its going to take a significantly larger amount of grafts to cover your scalp with than 2500 grafts. Very few men have a thick crown with a completely bald frontal area, so focusing purely on the crown would not look natural, especially as you lose your forelock. I don't believe for a second that your hairloss is stabilised either.  Very obvious norwood 5 pattern, people do not  just stop losing hair indefinitely when they're thinning throughout this area. I suspect that the only reason you're noticing less hair fall because you've already lost 85% of it at this point.

That shampoo you bought should be fine. The active ingredient is obviously the ketoconazole so beyond that it would just be preference in terms of how it makes your hair look.

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Hi,

you talk about laser and derma-roller ? Are these effective in preventing or promoting hair loss.

Laser - I think that is being marketed as a laser comb ? Where does one get it and how often should one use the same?

Also what is a derma-roller ?

Thanks,

S

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9 hours ago, Sean said:

No one should give you a figure of 2500 grafts to make you think it is even doable with that amount of grafts.  Your in for the long haul and at least looking at 5000 grafts to start off.  Your expected cost should be at least based off of a 5000 graft procedure.

No one did, I am basing my thought process on 1) what I have seen done via this forum and the Internet and 2) how I feel about the progression, or lack there of my hair loss. Based of a brief video chat I was told 3-5000. so you are all telling me what is a high probability.

I know I am going against the grain when I say my hair loss has subsided, but honestly know it has, these aren't delusions of grandeur. Everyone is different, much like some peoples hair grows in 4 months some takes 1.5 years after an HT.

 

My head also seems to be reacting well to fin/minox/derma/etc etc and ill be adding Ketoconazole  to the mix. Hairs are growing where it was dead, like 0 hairs, right above my temples. I'm actually pretty surprised because i thought once it was smooth that's it.

 

I am also not 100% against an FUT to get more grafts and having a higher survival rate of the grafts taken. I just prefer to not have a chunk of my head ripped out. But fuckin A I will if I don't have to do this again lol

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7 hours ago, rocketmas said:

Hi,

you talk about laser and derma-roller ? Are these effective in preventing or promoting hair loss.

Laser - I think that is being marketed as a laser comb ? Where does one get it and how often should one use the same?

Also what is a derma-roller ?

Thanks,

S

Not sure of the efficacy of laser caps but I do it anyways. I own an irestore cap  I purchased a year or so ago. Its a few hundred bucks but pretty sure you can go up to a few thousand on these things.

 

Look up the derma roller, very promising. YouTube has plenty of videos as well as some tests that were done. Link n study below.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

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8 hours ago, JeanLDD said:

I would strongly consider Erdogan for FUE as he's suited to 5000 graft megasessions and could comfortably cover both the crown and the frontal area in a single surgery. Alternatively I would request FUT from Diep and look to have the largest session he and your donor can provide. 2500 grafts will cover the frontal area and rebuild the hairline, but you're not going to get both crown and hairline coverage. I would expect that as you lose more hair in the future you are almost certainly going to want a second surgery down the track also (even if its 5-10 years) no matter what you do.

The reality is that you're not far away from being slick bald and its going to take a significantly larger amount of grafts to cover your scalp with than 2500 grafts. Very few men have a thick crown with a completely bald frontal area, so focusing purely on the crown would not look natural, especially as you lose your forelock. I don't believe for a second that your hairloss is stabilised either.  Very obvious norwood 5 pattern, people do not  just stop losing hair indefinitely when they're thinning throughout this area. I suspect that the only reason you're noticing less hair fall because you've already lost 85% of it at this point.

That shampoo you bought should be fine. The active ingredient is obviously the ketoconazole so beyond that it would just be preference in terms of how it makes your hair look.

already booked Dr. Diep. I think I have decent donor so I am hoping, as he has done a few times in the past, he can harvest more than the 2500 spoken about. We shall see, again i am not completely against FUT.

 

Maybe I can be the first guy to rock a thick crown but nothing else?

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1 hour ago, Shifty said:

already booked Dr. Diep. I think I have decent donor so I am hoping, as he has done a few times in the past, he can harvest more than the 2500 spoken about. We shall see, again i am not completely against FUT.

 

Maybe I can be the first guy to rock a thick crown but nothing else?

Ha, well to be honest I suspect Diep has good enough aesthetic sense to avoid filling in the crown with a virtually bald frontal area. Most surgeons would suggest (and I think Diep would similarly) that a first procedure in a case like yours will be dedicated to the hairline, and a subsequent to the crown. Many Diep FUE cases over the 2500 graft mark so certainly possible he will be able to get more grafts.  FUT certainly worth considering if the amount of grafts Diep thinks he can get is considerably above that with FUE.

A thick crown with a frontal area as bald as yours would be immediately strange looking and give away an unnatural appearance to the average person, Ultimately in your case even if it takes a few procedures you likely will have the ability to cover both the crown and hairline. 

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And looking at your photos, I don’t feel that 2500 grafts will be enough to give me that kind of coverage and density that you may be looking for.   That said, there’s always that second procedure but it sounds like you want to get as much done as possible the first time. In my opinion, stripped surgery may be the way to go then but you seem on interested in undergoing that procedure. I assume it’s because you are concerned about a linear scar? 

As a sidenote, but related, I find it interesting how many people today are so concerned about the possibility of a linear scar when my attitude from the very beginning when I underwent all four of my procedures was that I could care less if I had a star on the sides and back of my head as long as I had all my hair back on top.   Yet today, almost all prospective patients are so concerned that they will have a linear scar, even though in most cases it’s very well concealed by the hair on the sides and back of your scalp even at short lengths.   Makes me wonder why there was a shift in attitude over the years, perhaps because of the marketing that FUE is a scarless procedure… Even though that’s not true. 

 Don’t get me wrong, if you could undergo surgery and obtain a full looking head of hair with even less scarring via FUE, then I can understand why people would choose it. However, FUE is still much more expensive  then strip and I personally would rather pay less to get a full walking head of hair with a nominal linear scar that nobody will ever see anyway.   That of course is my personal opinion.

best wishes,

Bill

 

  • Thanks 1

I am the managing publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and this Hair Loss Forum. I am also a 4 time hair transplant patient. View my patient hair loss website to view my entire hair restoration journey with photos.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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On 11/8/2018 at 9:00 AM, Shifty said:

I literally just purchased this online, waiting for it should arrive today or tomorrow, it has 1% Ketoconazole the active ingrediant in Nizoral. Should i throw it away and just get Nizoral? itam states use basically once every 2 weeks.

image.png.ae1bc4914c25c7c543f05d3d1db2914a.png

image.thumb.png.c265b1db20d1da41fa1e012ecbc9bf57.png

 

I have been using this shampoo every day for a little over three months.  I can feel some stubble in my thin spot on my crown. I don't know if the shampoo is having an effect, or because I quit taking my blood pressure medication. (borderline)   But what  I can tell you is, I like that a little bit lathers up a lot, and it does make my hair feel, and appear somewhat thicker.  I was told  three to five months. 

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4 hours ago, Bill - Managing Publisher said:

And looking at your photos, I don’t feel that 2500 grafts will be enough to give me that kind of coverage and density that you may be looking for.   That said, there’s always that second procedure but it sounds like you want to get as much done as possible the first time. In my opinion, stripped surgery may be the way to go then but you seem on interested in undergoing that procedure. I assume it’s because you are concerned about a linear scar? 

As a sidenote, but related, I find it interesting how many people today are so concerned about the possibility of a linear scar when my attitude from the very beginning when I underwent all four of my procedures was that I could care less if I had a star on the sides and back of my head as long as I had all my hair back on top.   Yet today, almost all prospective patients are so concerned that they will have a linear scar, even though in most cases it’s very well concealed by the hair on the sides and back of your scalp even at short lengths.   Makes me wonder why there was a shift in attitude over the years, perhaps because of the marketing that FUE is a scarless procedure… Even though that’s not true. 

 Don’t get me wrong, if you could undergo surgery and obtain a full looking head of hair with even less scarring via FUE, then I can understand why people would choose it. However, FUE is still much more expensive  then strip and I personally would rather pay less to get a full walking head of hair with a nominal linear scar that nobody will ever see anyway.   That of course is my personal opinion.

best wishes,

Bill

 

Its 100% because of the FUE option. Its really the surgery I'm not happy about. I've been lucky enough to have never has to have surgery for anything... 

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53 minutes ago, SWdan said:

I have been using this shampoo every day for a little over three months.  I can feel some stubble in my thin spot on my crown. I don't know if the shampoo is having an effect, or because I quit taking my blood pressure medication. (borderline)   But what  I can tell you is, I like that a little bit lathers up a lot, and it does make my hair feel, and appear somewhat thicker.  I was told  three to five months. 

Awesome! Tomorrow is day 1 using it. I'll use it Thursday and Sundays. How did you come to find it? I found it randomly looking for stuff to help the current situation.

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1 hour ago, Shifty said:

Awesome! Tomorrow is day 1 using it. I'll use it Thursday and Sundays. How did you come to find it? I found it randomly looking for stuff to help the current situation.

Yeah, I was searching on Amazon and came across it. It had a lot of good reviews so I bought the shampoo and conditioner combo, although I haven't been using the conditioner. The shampoo bottle is a PITA  because you have to put channel locks or pliers on the nut and turn it to release the dispenser.  My bottle is only about half gone, so it should last at least six months, possibly more. 
I think they'd prefer you use it every day, but whatever you're comfortable with.
 

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16 hours ago, SWdan said:


I think they'd prefer you use it every day, but whatever you're comfortable with.
 

Just a heads up, the bottle says use 2-3 times a week. 

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Just wanted to keep the updates going on this thread If this works and anyone wants to follow suit.

 

My Regimine:

Started taking Finesteride 1MG September 26th

Started derma roller October 18th (2 times a week Thursdays nights and Sunday nights, no minoxidil on these nights)

started Rogaine foam 2nd week of October (morning and night)

Just started Shampoo Containing  1% Ketoconazole (2-3 nights a week)

currently using PhotoWorx Organic Hair Loss Shampoo w/ plant stem cells for recovery and regrowth (using this for 2-3 months)

will use Photoworx on days I do not use Keto shampoo

Vitamins:

Daily and Nightly (been taking these since 2012) https://bit.ly/2JZ1gQC 

Sr Sports biotin with coconut oil 5000mg https://amzn.to/2FjoiD6 (taking this for last few years)

Viviscal Professional (been taking this for the past few years) https://www.viviscal.com

 

Photos:

Taken October 7th

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Taken October 17th

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Taken November 12th

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Edited by Shifty

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@Shifty

Love the routine...only feedback I have is to keep it simple...so it's part of your daily routine. Keeping it simple is key. Maybe even start with one...make sure your consistent...and move on to the next.

Here's what I do...

  • Propecia
  • Rogaoine 2x (morning/night)
  • Nizoral

It's called the big 3...and combined they work really well. As always, speak to your famly doc before taking. 

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3 hours ago, HairLossMentor said:

 

 

@Shifty Here is what I get. It's cheaper and 2%... Nizoral® Ketoconazole 2% Anti-Dandruff Shampoo

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Once this bottle goes I'll switch to this, any difference between 2% and 1%?

3 hours ago, HairLossMentor said:

@Shifty

Love the routine...only feedback I have is to keep it simple...so it's part of your daily routine. Keeping it simple is key. Maybe even start with one...make sure your consistent...and move on to the next.

Here's what I do...

  • Propecia
  • Rogaoine 2x (morning/night)
  • Nizoral

It's called the big 3...and combined they work really well. As always, speak to your famly doc before taking. 

My regimen is simple for me because it all happens in the morning and night.

 

I have too say, areas above temple are growing hairs, a lot of them! If they grow to full terminal I'll be a happy camper! I cannot tell on the crown as much because of the angle so looking into buying a hair magnifier. If the top looks like the temples I believe this regime is a game changer.

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Anyone can Chime in if 1% Ketoconazole  is any less effective than 2%? I have a large bottle w/1% but am willing to shelve it is 2% has better return.

 

Thanks

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