Category: Uncategorized

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I Thought Miniaturization Analysis Was the Best Test for Balding!

After my visit to your office today, I was more confused because your miniaturization analysis showed no miniaturization and your bulk analysis seemed to contradict the finding by identifying early balding. I thought that miniaturization was the most important test a doctor could do to determine balding. Please help me understand what appears to be a discrepancy.

I am sorry that I confused you. Before the Haircheck bulk measuring device was invented by a Florida hair transplant surgeon, the only way one could tell if hair loss was occurring was:

  1. Seeing excess hair falling out (very early and not conclusive)
  2. Seeing a balding pattern developing (maybe too late)
  3. Looking for miniaturization (does not always appear, especially when hair loss is slow)
  4. Taking photographs and comparing them (often too late)

By doing bulk measurements, it is a very sensitive way of understanding hair loss with a metric that is replicable once the measurements are repeated and compared over time. In your case, the metrics showed early hair loss, but there was no miniaturization present in the area of concern. Based upon this, the drug finasteride was recommended. By repeating this test in a year, you will know if the hair loss is stable or reversing, and if you are progressing in both anatomic areas as well as local measurements to see the state compared to what was done today.

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I Want a Hair Transplant, But I’m Prone to Forming Keloids

i’m an 19 year old girl suffering from androgenetic alopecia. i’ve been losing much hair and tried everything(rogain 2%, hormone therapy) but didn’t see any major results. i’m considering of having FUE on my frontal hairline, the problem is, my skin is prone to forming keloids. I know that keloid will probably form on the donor area but is there any possibility at all that keloids will grow on my hairline??

Yes, you are at risk of forming keloids on your recipient area (frontal hairline), but the risk is low. In all of my years, I have never seen a keloid in the recipient area. At a medical meeting some years ago, we polled the audience of about 300 hair transplant doctors to ask them to raise their hands and tell us if anyone ever saw a keloid in the recipient area. No one raised their hands.

You must also consider that androgenic alopecia in a 19 year old female is very rare and make sure that you have the correct diagnosis along with realistic expectation of what you are trying to accomplish and the fullness that you are going to have from a transplant. In other words, you must weigh the risks versus the benefits and you absolutely need a diagnosis by a competent doctor.


2007-09-14 14:03:41I Want a Hair Transplant, But I’m Prone to Forming Keloids

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I’m Worried About My DHT Levels with heavy exercise

I wana go back to the gym. Im 3.5 month on fin with super awesome results. I talked with my friend about it he said when u start to lift ur body produce more Test. More Test mean more dht even on fin. So how do i go back to gym?

Don’t worry about DHT when you lift weights. Just work out. The finasteride will hopefully take care of your hair loss and your work-out will not raise your DHT levels, causing more hair loss.


2020-01-06 08:19:34I’m Worried About My DHT Levels with heavy exercise

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I Want to Transplant a Slight Widow’s Peak to Frame My Face

I am 29 with a stable NW 2 after taking Propecia for a year now. I’ve always had a high forehead and have always wondered if it is possible to have a small hair transplant to create a slight V in the middle of my hairline like Keanu Reeves, Leonardo Dicaprio or Johnny Depp. I feel like if you took that part of their hairline away, their hair wouldn’t frame their face right and I feel like if I had that bit of hair there, it would frame my face better.

The slight V you’re talking about is a widow’s peak.

Beauty is in the eye of the beholder, as the expression goes. If someone wants a different hairline, that is what we do. This is cosmetic surgery, after all. Meet with a hair transplant surgeon to go over your options.

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I Was Disappointed With My Doctor With My Surgery. What Do you Think My Results Will Be?

Had, what I feel was very successful strip surgery graft to frontal area at beginning of year. Full natural hairline . In light of this, pursued transplant to crown at different center (for geographical/practical reasons) Was disappointed that rather than 1,500 or so grafts promised only 900 were done. Reason given was lack of scalp laxity. Multi unit hair grafts were used for a total of 4,500 hairs. Crown area is question was about 14 sq in (35 sq cm) My hair is somewhat coarse, not particularly fine. I’m not fair skinned. Was interested in your opinion as to what your best guess would be in terms of final density.

math

I am not here to “guess”. You have specific numbers and it is merely about doing the math.

It is worrisome how 900 grafts will total 4500 hairs. This equals 5 hairs per graft. This is highly suspicious since most people have an average of 2 hairs per graft.

Your 900 grafts in a 35 sq cm equals 26 grafts per sq cm. If you really have 4500 hairs in a 35 sq cm that would be 129 hairs per sq cm.

An average non balding scalp may have 100 grafts (200 hairs) per sq cm.

If you had a successful surgery with one doctor and had a disappointing experience with the second doctor, maybe you should follow up with the first doctor.

 

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Ibuprofen to Prevent Shock Loss?

Since shock loss is caused by inflamation and swelling, do you think ibuprofen (600 – 800 mg doses) could be as effective at preventing shock loss as propecia?

Do you think that there is any adverse interaction between ibuprofen and propecia? Thanks.

There is no connection between ibuprofen and preventing shock loss after hair transplantation. To my knowledge there is no connection between Propecia and ibuprofen either.


2007-10-11 09:36:45Ibuprofen to Prevent Shock Loss?

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If I Get a Hair Transplant, Will the Volume of My Long Hair Be Noticably Thinner?

I am a 42 y/o male,(Norwood 3)no “V” as of yet and I have long hair that reaches past the middle of my back. Should I ever require a transplant procedure will the volume of hair that flows down my back be noticibly reduced since follicles must be harvested from the back of the head? BTW, I have taken Avodart for 2 years with great success. I was getting a little thin in the crown area and now the crown has filled in very nicely, however, no such luck with the receding hairline.

Thanks

There should be a minimal reduction of hair volume from one hair transplant. I am curious to know why you are not taking Propecia (finasteride 1mg). Stronger medicine does not necessarily mean it works better. You may have had the same impact from Propecia alone.


2007-09-19 12:33:56If I Get a Hair Transplant, Will the Volume of My Long Hair Be Noticably Thinner?

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If I See White Bulb on the End of Falling Hair, Does That Mean It Is Lost Forever?

I am a 22 year old male. I have noticed more shedding than usual in the past months. When I look at the individual hairs, there is definitely a tiny white follicle on the end of each one. My question is, since there is a follicle on the end of the hair that has fallen out, does that mean more hair can never grow back from the location it fell out in? Thank you for your time.

The white dots you see at the end of the hair shaft do not necessarily mean your hair will never grow back. That is not the way we diagnose hair loss. When you pull on normal hairs, some will come out with a white dot on the end. This is normal, but the key is how many hairs came out with such a pull. More than 10% would be abnormal, requiring an expert to evaluate you (see FPNotebook.com – Hair Pull Test).


2006-08-08 08:41:40If I See White Bulb on the End of Falling Hair, Does That Mean It Is Lost Forever?

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If I’m Splitting the 5mg Finasteride Pills, Are the Side Effect Risks Greater?

I’m turning 26 years old soon and been on Propecia for 4 years now starting in mid July. For over 2 years I been cutting generic fin in 4 pieces and have saved tons of money. If you are cutting fin you are taking a slightly higher dose can it give you side effects? Because when cutting those pills the dose can be sometimes from like 1mg to maybe 1.5mg it’s hard to cut it accurately! And even if you do you be still taking 1.25mg!

Unless the pieces are perfectly symmetrical and you didn’t lose any crumbs in the cutting process, you probably aren’t getting a full 1.25mg finasteride dose — and like you said, splitting it accurately is difficult.

But let’s assume you’re getting an average of 1.25mg per day. I suppose taking that dose by cutting a 5mg tablet can theoretically give you a slightly higher risk of side effects than taking a premade 1mg finasteride pill (Propecia)… but in practice, we have not seen this.


2012-07-02 11:39:24If I’m Splitting the 5mg Finasteride Pills, Are the Side Effect Risks Greater?

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If Propecia Only Slows MPB, What Eventually Happens?

I was curious, if drugs like propecia only slow mpb and genes usually overcome them after time and you get hair transplants, what do you do later on when the drugs looses it’s effect and you loose hair in the non transplanted areas, and by chance you don’t have the donor hair to compensate. Thank you for your time.

Norwood Class 7Great question! The treatment of male pattern baldness with drugs and possible transplants requires a good Master Plan with your doctor. The Master Plan will balance the eventual worst case scenario for your balding pattern (only 7% of men go all the way to a Norwood Class 7 pattern — see illustration at right), the donor supply, and the reconstruction. For example, a person who has a Class 3A balding pattern at 35 years old, has a worst case scenario of a Class 5A pattern, but probably wont get there if he is treated with Propecia (finasteride 1mg) and is a good responder. I find that I can restore almost all Class 5A patterns with reasonable hair density, good laxity and average or better than average hair weight. When you discuss your balding problem with your doctor, this should become the central focus on your consultation.

Like you suggest, going into transplants blindly could not work in your favor if your hair loss pattern eventually works to a Class 7 pattern. With that said, people who may evolve into a Class 7 pattern could accept coverage in the front and top, leaving the crown out of the reconstruction if their pattern goes too far. A frontal reconstruction with a Class 7 pattern looks great in the mirror and is a reasonable option for the worst of the balding patients.