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Hi, 

This patient contacted us at his early 20s asking for a hair transplant. At that moment Dr. Alcaide advised him to wait and start the use of medication for hair loss. 

After 3 years, and with good results using finasteride 1mg., we proposed a surgery using 1800 FU to restore the hair line and temples, but being conservative at the same time thinking of possible loss in the future. 

 

Here the data: 

Dr. Antonio ALCAIDE

BHR Clinic Spain

Age: 25

Technique: FUE

Medication: Finasteride before-after the procedure

Hair Caliber: Medium

Previous procedures: No

Total FU used:- 1809

 

* FU breakdown:-             

1s 522

2s 852

3s 430

TOTAL: 1809

 

That means 1809 FU = 3526 Hairs. Average = 1,95 hairs/FU. 

 

Pictures show the result at 8 months. 

 

Pre-Post Surgery

 

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00.%20Pre-Post%2014_zpsnzncdl16.jpg

 

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00.%20Pre-Post%2015_zps6tnbvgwa.jpg

 

 

4 Months 

 

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01.%204%20Meses%206_zpsur9ki8ri.jpg

 

01.%204%20Meses%207_zpsdi6wvjdj.jpg

 

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01.%204%20Meses%2011_zpsbbulqu0w.jpg

 

01.%204%20Meses%2010_zpsydsy4u5x.jpg

 

01.%204%20Meses%2012_zpsvt01bmcx.jpg

 

 

8 Months

 

02.%208%20Meses%201_zpsymdn4nng.jpg

 

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02.%208%20Meses%206_zpslpiwwuwa.jpg

 

02.%208%20Meses%205_zpsfx2ggfir.jpg 

 

02.%208%20Meses%2011_zpsxnyi5tco.jpg

 

02.%208%20Meses%2012_zpsv3eoxgap.jpg

 

02.%208%20Meses%2013_zpsyskvmjw7.jpg

 

02.%208%20Meses%2014_zpszpq0888a.jpg

 

02.%208%20Meses%208_zpsiqr2hzks.jpg

 

02.%208%20Meses%209_zpsclib9epv.jpg

 

02.%208%20Meses%2010_zpsm1jb1gx8.jpg

 

 

Comparison 0-8 Months

 

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09.%200-8%20Comp.%202_zpsvuyva216.jpg

Edited by BHRClinicSpain

Daniel - Dr. ALCAIDE Advisor

www.bhrclinicspain.com

daniel@bhrclinicspain.com

Whatssapp: +34 626 350 698

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In one of the photos showcasing the extraction pattern of the right side of the patient's scalp, extractions were made right above the ear. Seeing as the patient is in his early to mid 20s, how can you be sure that the patient won't develop retrograde alopecia later on in his life and thus lose the transplanted hair that was taken from this area? 


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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Hi delancey,

Thanks for your comments.

I understand that those follicles around the ear were fine for the procedure, and not everyone has to develop a retrograde alopecia. Also the amount of grafts extracted there was relatively small.

Kind regards,


Daniel - Dr. ALCAIDE Advisor

www.bhrclinicspain.com

daniel@bhrclinicspain.com

Whatssapp: +34 626 350 698

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Hi BHRClinic, 

Thank you for your response. It's an interesting extraction pattern removing follicles so close to an area that is susceptible to retrograde alopecia, especially in a younger patient who is only in his mid 20s. Just because "everyone" does not develop retrograde alopecia does not mean that some do not. 


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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Thank you for your comments baldlivesmatter.

Kind regards,

 


Daniel - Dr. ALCAIDE Advisor

www.bhrclinicspain.com

daniel@bhrclinicspain.com

Whatssapp: +34 626 350 698

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23 hours ago, delancey said:

In one of the photos showcasing the extraction pattern of the right side of the patient's scalp, extractions were made right above the ear. Seeing as the patient is in his early to mid 20s, how can you be sure that the patient won't develop retrograde alopecia later on in his life and thus lose the transplanted hair that was taken from this area? 

Hey delancey,

what do you mean about extraction above the ear?

doesn't everyone do it?, i'm kinda freaking out now, despite the fact i'm almost 11 months post op.

i'm over 41, this is my picture.

 

7.jpg

 

 

 

 

 

Edited by wheretogo

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Hi WheretoGo, 

I cannot comment on extraction patterns used by the industry as a whole as each clinic implements its own protocol, which has resulted in extraction patterns varying to a large degree across the industry. Retrograde alopecia is however not uncommon, although not spoken of as much on the forums as it perhaps should be - especially now that FUE has really taken off. My personal viewpoint is that hair loss is unpredictable, including retrograde alopecia, especially on a patient who is as young as the aforementioned case. When grafts are taken right above the ear, it always leaves the possibility that these grafts may fall out later on in life. This is not to say that everyone develops retrograde alopecia, but the risk is always there. I started developing retrograde alopecia, albeit rather mild, in my late 20s. 

As each case is unique with its own set of advantages and challenges, perhaps your Doctor felt that your donor region right above the ear had few signs of thinning. This coupled with your age may have led the clinic to extract grafts in this region to get at thinner grafts for the hairline (i.e., to make it appear more natural), but this is really a question for your Doctor to answer. 


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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Ok, so you don't mean regular hair loss but Retrograde alopecia which is a special condition. got it.

thank you.

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1 minute ago, wheretogo said:

Ok, so you don't mean regular hair loss but Retrograde alopecia which is a special condition. got it.

thank you.

Exactly! :)


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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Great work 🙌🏼 

Also, there is nothing universal about a donor area. I think many viable grafts are not transplanted by strictly sticking to a Norwood 7 pattern. In fact, most men are more likely to end up Norwood 5 at the end of their lives than they are Norwood 7. I really think each patient should follow a planned procedure individually rather than some cookie cutter area that may not benefit them as much. 


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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5 hours ago, Melvin-Moderator said:

Great work 🙌🏼 

Also, there is nothing universal about a donor area. I think many viable grafts are not transplanted by strictly sticking to a Norwood 7 pattern. In fact, most men are more likely to end up Norwood 5 at the end of their lives than they are Norwood 7. I really think each patient should follow a planned procedure individually rather than some cookie cutter area that may not benefit them as much. 

Millions of Norwood 5s have retrograde alopecia. This is the reason why there is a universal safe donor zone to begin with; there is no way of telling whether a 20 something year old will end up with retrograde alopecia later on in his life. 


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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5 hours ago, delancey said:

Millions of Norwood 5s have retrograde alopecia. This is the reason why there is a universal safe donor zone to begin with; there is no way of telling whether a 20 something year old will end up with retrograde alopecia later on in his life. 

Millions don’t have retrograde alopecia,  there is no “one size fits all” for hair loss. Not every person will bald/thin in the same pattern. In fact, some men never  progress past a norwood 4. Surgical plans should be carried out in accordance with the specific individuals “predicted” pattern and personal goals.

Unfortunately, there’s no crystal ball to predict with certainty the patients future hair loss pattern, but there are some good indicators that can provide surgeons with enough information to take a calculated risk.

At worst some of the transplanted hair may thin over time. At best, you have a fuller head of hair that you enjoy for many years, important years of your youth. As someone who’s been a Norwood 6 at a young age. I can personally say that if some of my transplanted hair thins over time it’s worth it, because I’m living some of the best years of my life. Enjoying my youth as it should’ve been. I understand being cautious, but I think taking a calculated risk is more than worth it.

Many have complained about H&W taking strips high up the sides where hair could potentially thin. Those are calculated risks and so far it’s worked out for many like Bill, who’s turning 42, doesn’t take finasteride and still has a good head of hair.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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First of all, it is estimated that approximately two thirds of those who are losing their hair experience some level of retrograde alopecia. This is consequently the reason why many doctors avoid the areas commonly affected by retrograde alopecia. Second of all, indications allow professionals to draw educated conclusions, this is true. However, many times indications first present themselves beyond the age of twenty five - hence, there is no educated conclusion to make. It can be unpredictable, similar to regular male pattern baldness. Thirdly, I am of the philosophy that it is better to extract grafts inside the safe donor zone first and then reassess.  

 

 


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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Hi,

Thank you all for your comments.

@ BjornBorg, no, not Ivan Rakitic, hehe ☺️.

As said, this patient was monitored by Dr. Alcaide during 3 years before the surgery. He was under medication and there were no signs of miniaturized hair / retrograde alopecia during those years and of course at the moment of the surgery.

What can happen in the future? That is a question which can be asked to any single patient, but from our side we always try to manage donor area in the best possible way getting grafts only from the safe zone, after a detailed exam of the area.

Kind regards,

 

 


Daniel - Dr. ALCAIDE Advisor

www.bhrclinicspain.com

daniel@bhrclinicspain.com

Whatssapp: +34 626 350 698

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