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I receive this question daily, I thought I would make a video on the subject. I would love to hear the communities input. How many of you have had successful hair transplant procedures with diffuse hair loss?

 


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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Great post especially for me.....I'm diffused. So far, had consultation with HW and Batti...both said around 3000 FUE should make me look decent. Have another one with Rahal soon.

 

 

Diffused.jpg

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All are excellent surgeons, so you're already ahead of the game by the research you've done.


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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Just now, Melvin-Moderator said:

All are excellent surgeons, so you're already ahead of the game by the research you've done.

Which other surgeons should I look at other than Bhatti/H&W and Rahal.

Infact - another question - who do I chose b/w H & W :) Who has done more diffused surgeries? I was told I would need 3000-3500 over two days....all in one shot...but you had three diff sugeries. So, I'm a little confused. Should I go for 1500 in the hairline and frontal third and then in a year tackle midscalp. I don't think I have enough for crown so I'll just use caboki.

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Posted (edited)

Great topic Melvin.

Yes. Diffuse hairloss can certainly be managed. It is important to be on good maintenance therapy and to tackle the areas wisely. I always opt for a decent number (3500) over two days to cover the front and Mid scalp. How far into the vertex transition zone will depend on the degree of loss. All in all the aim will be to go back to a 3V pattern generally. If donor, age and other factors are favourable, then the crown can be tackled at another stage. With diffuse loss the main issue is to make sure that each graft goes in between the existing hairs so as to get the maximum benefit from the new and native hairs. Hopefully meds will hold as much of the native hair and the overall density looks good. I tend to find that these cases give a nice result as everything is already drawn by nature (I always follow the client’s existing hairline and augment it).

Excellent choices with surgeons. The best of luck to you!

Edited by DrTBarghouthi
Typos

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4 hours ago, Panamera13 said:

Which other surgeons should I look at other than Bhatti/H&W and Rahal.

Infact - another question - who do I chose b/w H & W :) Who has done more diffused surgeries? I was told I would need 3000-3500 over two days....all in one shot...but you had three diff sugeries. So, I'm a little confused. Should I go for 1500 in the hairline and frontal third and then in a year tackle midscalp. I don't think I have enough for crown so I'll just use caboki.

Well I would look at Konoir, Cooley, Gabel, Diep etc. There are tons of surgeons. It may take some research and some consutling with each, but ultimately I don't think you can go wrong.


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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If diffuse Its recommended getting on medical therapy to help strengthen existing situation to provide a stable foundation to build on. With right planning and ethical surgeon who thinks long term all possible but essentially it all boils down to the patients donor supply. Case by case basis and a blanket solution doesn't apply to all. 

Regards

Spex

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Posted (edited)
11 hours ago, Melvin-Moderator said:

I receive this question daily, I thought I would make a video on the subject. I would love to hear the communities input. How many of you have had successful hair transplant procedures with diffuse hair loss?

 

Of course you can have a hair transplant with diffuse hair -loss ,  not the type of diffuse hair -loss which affects the donor as you pointed out ,which is always what I thought the original use of diffuse hair loss meant anyway ,what you refer to as diffuse hair -loss is just classic MPB  where the top  and crown are thinning but the donor remains strong and can be categorised on the NW scale more or less. I had some hair on top before my transplant but not enough for any cosmetic coverage ,not enough to use a comb ,style it etc . I guess what I am trying to say I wouldn't have referred to myself pre-op as a diffuse thinner I would have said I was  NW-5-6 with about 500 hairs stubbornly hanging on ,same as your pics Melvin to me you were quite simply a NW 5-6 balding guy with some miniaturised hair on top on it's last legs  ,not a diffuse thinner as such .

You only have to look at a lot  of the guys who have a transplant with Asmed who to use the term are diffuse  thinners but still have 3-4000 grafts impanted whether that is a wise decision only time will tell.   The term diffuse covers most balding men to one degree or another apart form the lucky guys who are just losing or have lost hair at the front and the mis-scalp and crown are intact . To me as I said as long as the donor is healthy it's all just MPB baldness which of course depending  on the donor -recipient ratio etc someone would be a candidate for a hair transplant. 

Has the original meaning of the word diffused in relation to hair-loss changed ? as i said above I have always thought it meant all of the hair including donor ,and the word miniaturised described the condition of thinning on top through to the crown.   

 

Edited by Mick50

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1 hour ago, Mick50 said:

Of course you can have a hair transplant with diffuse hair -loss ,  not the type of diffuse hair -loss which affects the donor as you pointed out ,which is always what I thought diffuse hair loss meant anyway ,what you refer to as diffuse hair -loss is just classic MPB  where the top  and crown are thinning but the donor remains strong ,I had some hair on top before my transplant but not enough for any cosmetic coverage ,not enough to use a comb ,style it etc . I guess what I am trying to say I wouldn't have referred to myself pre-op as a diffuse thinner I would have said I was  NW-5-6 with about 500 hairs stubbornly hanging on ,same as your pics Melvin to me you were quite simply a NW 5-6 balding guy with some miniaturised hair on top on it's last legs  ,not a diffuse thinner as such .

You only have to look at a lot  of the guys who have a transplant with Asmed who to use the term are diffuse  thinners but still have 3-4000 grafts impanted whether that is a wise decision only time will tell.   The term diffuse covers most balding men to one degree or another apart form the lucky guys who are just losing or have lost hair at the front and the mis-scalp and crown are intact . To me as I said as long as the donor is healthy it's all just MPB baldness which of course depending  on the donor -recipient ratio etc someone would be a candidate for a hair transplant. 

Has the original meaning of the word diffused in relation to hair-loss changed ? as i said above I have always thought it meant all of the hair including donor ,and the word miniaturised described the condition of thinning on top through to the crown.   

 

Absolutely. The photos shown do refer to a MPB with some hair hanging in. We usually refer to the NW scale but then specify that there is a mild, moderate or severe loss in that specific NW pattern. For example a NW6 with mild or moderate loss is what is being referred to here as diffuse thinning. 

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Posted (edited)
3 minutes ago, DrTBarghouthi said:

Absolutely. The photos shown do refer to a MPB with some hair hanging in. We usually refer to the NW scale but then specify that there is a mild, moderate or severe loss in that specific NW pattern. For example a NW6 with mild or moderate loss is what is being referred to here as diffuse thinning. 

Ah OK fair enough so the NW pattern is first identified then how diffuse the loss is in that pattern.

Ha I do have a habit of over complicating things. . well in that case the main thing to take into account with diffuse thinning is shock -loss, so someone would be advised to think carefully before proceeding with a transplant ,myself and Melvin didn't really have that problem as most of the hair on top had waved goodbye  

 

 

Edited by Mick50

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One has to be so careful with diffused hair loss. Even though I have seen many beautiful cases with stunning results, the fact always remains that the pre existing hair have a probability of going away especially in young people.

With diffused hair loss pattern, the surgeons need to be 100% sure of the change in look. Going for a large number of grafts in the absence of Finasteride (for whatever reasons) will facilitate for a probable future procedure. In some cases, even with high survivability of the transplanted grafts, the look change might not be satisfying. The distance between two pre existing grafts may not be sufficient for the doctors to plant new grafts in certain areas. That process tends to be a disaster when patients have unrealistic expectations.

A more concentrated approach in the thinning areas with interventions to prevent any further balding would be appropriate. 

It is crucial that the surrounding grafts in the recipient area are not supposed to be damaged. That goes without saying, of course. 

Going for a hair transplant with diffused hairloss - the patient must be aware of the pros and cons. Now a successful hair transplant (with regards to the patient's perception) depends on his/her expectations being met. Even if from a surgeon's point of view the surgery might be a resounding success, if the patient is unhappy, all seems lost.


Counsellor at Eugenix Hair Sciences

Dr. Arika Bansal & Dr. Pradeep Sethi

https://www.youtube.com/channel/UC5crlGyTac2hlU1gHneADzQ

 

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9 hours ago, Mick50 said:

Ah OK fair enough so the NW pattern is first identified then how diffuse the loss is in that pattern.

Ha I do have a habit of over complicating things. . well in that case the main thing to take into account with diffuse thinning is shock -loss, so someone would be advised to think carefully before proceeding with a transplant ,myself and Melvin didn't really have that problem as most of the hair on top had waved goodbye  

 

 

That's true most of the hair on the top of my hair was waving me bon voyage lol. However, I was considered diffuse because they all waved me bon voyage at the same time. Typically, it goes through a recession. My hairline never receded past a norwood 2.


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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Obviously the number one concern anyone with a diffused loss pattern would have would be shock loss post-op.

Anything that can be incorporated to bring down or minimize the level of trauma to the scalp is critical.  Yet, the native hair that is in an advanced stage of diffusion may not survive post-op.  Still, we have to realize that hair is short lived, surgery or not.

If it were me, I would ask the surgeon(s) what type of recipient incisions would be made and what instrumentation is being considered to create those incisions.

Some docs take a more methodical approach employing several smaller sessions and gradually building the overall density levels.  Many women suffering from MPB like this approach to minimize shock loss as much as possible.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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I’m sure everyone is different is some regard but when might one with diffused thinning expect shock loss to occur after the transplant? Is there a typical timeline when it might begin? I know it could take up to half of the year to grow back in, if is doesn’t become completely shocked out, but when would it start? 

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It can occur anywhere from 2-4 weeks post-op with minor differentials.


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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3 minutes ago, gillenator said:

It can occur anywhere from 2-4 weeks post-op with minor differentials.

Thanks @gillenator, asking for a fr - me...I’m asking for me. 🙂👍🏻

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58 minutes ago, gillenator said:

Obviously the number one concern anyone with a diffused loss pattern would have would be shock loss post-op.

Anything that can be incorporated to bring down or minimize the level of trauma to the scalp is critical.  Yet, the native hair that is in an advanced stage of diffusion may not survive post-op.  Still, we have to realize that hair is short lived, surgery or not.

If it were me, I would ask the surgeon(s) what type of recipient incisions would be made and what instrumentation is being considered to create those incisions.

Some docs take a more methodical approach employing several smaller sessions and gradually building the overall density levels.  Many women suffering from MPB like this approach to minimize shock loss as much as possible.

The best approach is to do smaller sessions in my opinion.


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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Posted (edited)
16 minutes ago, Melvin-Moderator said:

The best approach is to do smaller sessions in my opinion.

I took, what I consider, to be a somewhat smaller session for my first. I have a quite a bit I want to try and save. I also took the FUT route for my first as I’m hoping to maximize my donor that way. If I’m being quite honest I’d have preferred to go down the FUE route completely. I’m not crazy about the idea of having a linear scar but I also want to get the most out of it as I can. There are also ways to conceal it down the road. I typically keep my hair pretty close and tight but I can leave my donor area a little longer for the time being. I’ll never be able to cut it down to a one again but I’m willing to give that for what I’ll hopefully get.

Edited by Steeeve

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2 hours ago, Steeeve said:

I took, what I consider, to be a somewhat smaller session for my first. I have a quite a bit I want to try and save. I also took the FUT route for my first as I’m hoping to maximize my donor that way. If I’m being quite honest I’d have preferred to go down the FUE route completely. I’m not crazy about the idea of having a linear scar but I also want to get the most out of it as I can. There are also ways to conceal it down the road. I typically keep my hair pretty close and tight but I can leave my donor area a little longer for the time being. I’ll never be able to cut it down to a one again but I’m willing to give that for what I’ll hopefully get.

I mean going FUT first is the best way to maximize your donor supply without a doubt. I may even do a small strip procedure down the road. Combining both procedures gives the most grafts hands down.


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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On 4/26/2019 at 12:33 AM, Melvin-Moderator said:

Well I would look at Konoir, Cooley, Gabel, Diep etc. There are tons of surgeons. It may take some research and some consutling with each, but ultimately I don't think you can go wrong.

All the docs I have spoken to say they're very good with diffused and I can get about 2500-3500 grafts. They all have great reputation so how do I differentiate which one to chose other than price/location?

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3 hours ago, Panamera13 said:

All the docs I have spoken to say they're very good with diffused and I can get about 2500-3500 grafts. They all have great reputation so how do I differentiate which one to chose other than price/location?

Hairline design is a big one.


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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On 4/29/2019 at 12:20 PM, Melvin-Moderator said:

Hairline design is a big one.

Is your dad a noorwood 2 with no thinning?

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I think you absolutely can based on my own consultations, but I agree with Spex that an ethical surgeon will insist that you've been on medication for a bit first unless (barring side effects).

I also think, as a patient in this scenario, that you'd want to choose a surgeon with a solid history of working on diffuse thinners. Some surgeons seem to have no issues working with this kind of patient, but I've seen others shy away from diffuse thinning because avoiding transaction makes a difficult procedure that much more complicated.

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i certainly agree with what is being posted here. If the client clearly understands the importance of maintenance therapy and the surgeon is careful with the spacing of grafts then excellent outcomes can be achieved. In some of our post op photos immediately after surgery, the density work looks pretty “horrible” because some grafts are spaced out unevenly and if someone looks at it without knowing the nature of the case, they would think it is amateur work. But it is imprtant that no native hair is damaged.  

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1 hour ago, Phillyman1996 said:

Is your dad a noorwood 2 with no thinning?

I would say he’s a Norwood 3 with no thinning. He’s turning 62 in a few months. I obviously didn’t inherit his hair loss pattern 😕

E53D82D8-3282-4930-8E1A-4363630757B7.jpeg


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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