Category: Uncategorized

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MFG, MUG, and FUT

I have been reading about Multiunit Family Groups (MFGs) and Multi Unit Groups (MUGs) which are felt by those who do them to be as good as Follicular Unit Transplants. These claims are very confusing. I met with a doctor last week who does MUGs and he stated that they are essentially the same as Follicular Unit Transplants. Is that true?

The reason that many people use MUGs or MFGs is that they can not or will not put the effort in learning or mastering the Follicular Unit Grafting techniques which are clearly more difficult and more expensive to deliver. There is a great movement to show equality between MUGs and MFGs and the golden standard Follicular Unit Transplants, which is absolutely not the case. At the ISHRS convention these past few years, some doctors showed off patients with MUGs and MFGs. They were at the same session as patients with final results from Follicular Unit Transplants and they are clearly not as good on close inspection. Like the “Emperor’s New Clothes’ , the MUGs and MFGs proponents want to believe that it is something that it is not.

Clearly, the use of MUGs and MFGs are better, much better than the old large plugs of yesterday. But they are just smaller plugs made up of groups of Follicular Units which when placed into MUGs and MFGs, tend to become compressed and look ‘stalky’. Real Follicular Unit Transplants are more difficult to do, but the quality on close inspection with Follicular Unit Transplantation can not be told from God’s work in the best of hands, most of the time.

William Shakespeare said, “A rose by any other name would smell as sweet“, but the MUGs and MFGs doctors might modify this famous quote by declaring that a synthetic paper rose with perfume on it is exactly the same as a real rose for all practical purposes because it may (from a distance) look like a rose.

I think that Shakespeare was talking only about real roses and I am talking only about what God had designed in his original plan for us. We are naturally put together with Follicular Units, not MUGs and MFGs. Sorry if I offended anybody here.

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Microneedling and minoxidil

Do you apply minoxidil right after dermarolling? If so, why? Is it more efficient or just personal preference? Also what is the perfect derma roller size? 1.5mm or less/more. And how do you clean your derma roller? Sorry for all the questions, im just cautious

If you apply the minoxidil immediately after dermarolling, then the medication may go through the skin directly making it more effective

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Bad beard transplant

This young man rushed to get a beard transplant. He should have asked the surgeon to show him other patients who had it done in that surgeon’s hands. Unfortunately, that didn’t happen. Now he work in a public position and every asks him what is wrong with his face? He wants to get rid of the transplants, all 2500 of them. This will possibly produce scarring even when they are out. The use of a very small punch by the surgeon and test removals is the way to go to see what is outcome will be. There is clearly a balancing act, the removal process and the possible scars left behind, or leaving it the way it is.


2020-08-28 12:37:58Bad beard transplant

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Microneedling needle depth

What in your opinion would be the ideal needle depth and frequency? Every two weeks?

I am not an expert on microneedling; however, it makes sense that needle depth should be 1-1.5 mm to reach through the epidermis and impact the stem cells which are found high in the dermis. The frequency is purely an intellectual guess. I am seeing that many of the Reddit posters are doing it weekly which sounds ok to me. I am certain that once a hair cycle has passed, the growth from microneedling will be undone unless more microneedling is performed.

 


2021-01-26 18:01:30Microneedling needle depth

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I have bald patches throughout my scalp from alopecia areata. Can I transplant these bald patches?

We have developed Scalp Micropigmentation and have been using it on men with alopecia areata (aa). Men with aa, can’t have a hair transplant because the disease will reject the hair transplant and the treatments used are not always effective at curing the problem. While you are trying successfully or otherwise, having Scalp Micropigmentation allows you to look normal so that the defects in the skin just don’t show up very well. We did one more session and there was no evidence of the disease after the last session but unfortunately, we did not get photos before he left.

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Miniaturization Mapping vs Pull Test

Dr. Rassman,

I’m going to make an appointment to have the miniaturization test in your office, but someone told me about a “pull-test” which measures the ratio of hairs pulled from a sample area on top of your head to hairs pulled in a sample from the donor area. When compared to the donor area, if significantly more hairs come out from the sample area on the top of your head, then you are balding. Is this test accurate to some extent?

The pull test is not good for diagnosis of miniaturization and genetic hair loss. The degree of shaft thickness change is what mapping will show. Hairs that are in the early phase of miniaturization will not pull out. Those that do pull out, may be the hairs about to go into their telogen cycle.


2006-09-18 09:20:10Miniaturization Mapping vs Pull Test

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Bald Spots in Facial Hair — Doctors Say It Is Alopecia Areata

I am a male of age 33. I have lost hair in three patches at chin and at upper part of neck. The patches have grown a bit in size and looks threatening. I went to a couple of physicians, they called alopecia areata. Now I am being prescribed:

Candid Lotion
Minoxidyl
Nuforce 150 tablets

Please suggest about this. I am losing my confidence everytime I see a mirror. Can I get out of it?

While surgery is never indicated for active alopecia areata, there are some doctors who specialize in this disease. See Alopecia Areata in a Patient with a Miracle Cure for details.


2007-08-23 12:32:49Bald Spots in Facial Hair — Doctors Say It Is Alopecia Areata

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Minoxidil 5% Regrows More Hair than Propecia?

Hello Dr,

I understand that you recommend propecia. Just for the debate i wanted to know does propecia regrow more hair or rogaine in those people these drugs work. I found the below article which shows that minoxidil 5% beats propecia in number of hair regrown hands down. Can you comment on it please.

https://www.haarweb.nl/forum/showthread.php?p=61654
Please scroll down in the thread.

Thank you for the blog

Thanks for the insightful link. I have been swinging to using a combination of minoxidil 5% and Propecia for men. It does appear that both is better than just one. I like Propecia because it ‘hits’ the underlying DHT component for hair loss in men, but one can not deny the building evidence of the value of higher concentrations of minoxidil. Clearly the use of both medications have issues of compliance. Twice a day use of minoxidil is the right approach, but this alone may be a problem for busy men, while Propecia in the morning is easier to use.

In conclusion, I believe that using both is best.

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Balding like my dad? (from Reddit)

23M and am pretty happy with my hair right now and am currently on min(2x a day)+dut(3x week) and fin(4x week). But based on my family history it looks like I have a similar pattern as my pap and will be nw7 by 50/60 and probably an nw4 by 30-40. While I would be completely devastated and depressed to lose my hair right now i know baldness is my inevitable fate and I want to try and gradually shift how much importance I place on my hair. Right now I constantly obsess over it and am frequently checking this subreddit to an almost unhealthy extent. It is understandable to care a lot more right now in my early 20s, but what are some steps that you guys have taken to come to peace and acceptance with hairloss? I will continue to treat it but I want to stop being so damn obsessed with it

Ask your Dad at what age he started balding. Most Class 7 pattern men start in their early 20s so maybe you will not follow his pattern. Age related onset is also inherited but I have seen this happen when it would be inconsistent with inherited timing: See here: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/