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Best Surgeons for FUE in the US?

Hello,

I apologise if this question has been asked and answered previously, but who would you recommend as the more accomplished surgeons performing FUE in the US. Kind regards

There are a handful of hair transplant surgeons who claim expertise in follicular unit extraction (FUE) in the U.S. You should visit the International Society of Hair Restoration Surgery (ISHRS) for a listing of qualified surgeons and there is a sub-group from this list that do this procedure. Some good hair transplant doctors do not do this procedure, by choice. At NHI, we created the FUE technique and published it in medical journals. There are a few doctors with publication credentials, but many claim expertise. Unfortunately, I have heard about many failures by some of the doctors who claim expertise so you need to do the research yourself and meet with the surgeons on your list (who claim FUE expertise). Ask to meet some of their patients so that you know what the surgeon is capable of doing. I realize this may not be the answer you are looking for, but there is some work required on your part to assure yourself of a good result. Even for me, sorting out the doctors who can perform successful FUE procedures is very difficult as there are so many who claim such expertise and just can’t cut it.

For more, please see:


2007-11-23 09:23:09Best Surgeons for FUE in the US?

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Bilateral Varicocele and Propecia

Yes, another Propecia question for you. Sorry 🙂 I am 37 and have a bi-lateral varocele, grade 2 on the left and grade 1 on the right. If I started on propecia, could its side effects be more potent or affect my condition? From what I remember, the Merck studies did not get into the issue of results or drawbacks of people with Varocle.

This is a question you must ask the doctor who is following your problem. There is no obvious answer, other than you cannot just correlate any medical issue with a side effect. I am not a urologist nor do I treat varicoceles, so I am probably not the one to answer the question.

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Mom’s Male Family Is Bald — Dad’s Family Has Hair

if my mom’s father and brothers are all bald and my dad’s family including my dad all have hair, where does that leave me in the genetic mix?

Balding genes can be inherited through the mother or father’s family line (54% may be the maternal side connection). Even if you have the gene, there must be environmental influence to express it and for men it is hormones, time, and stress. The balding genes are not fully understood and there is what is called “expression” of the gene, which means that having it and showing it are two separate things. In other words, you may or may not have the gene and if you do, you may or may not show the gene with genetic balding in your lifetime, yet you can still pass that down to your children or children’s children who may then show it with balding in their lifetime. You won’t know until you begin to lose hair and then you will have to be examined thoroughly.

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Bleeding with Microneedling

When you bleed with microneedling, it shows you are at the correct depth. From a numbers perspective, I recommend a 1.25 mm depth. I particularly like the “Dr Pen” device because you can hold it over each area and deliver an effective injury to induce the healing cascade. Once per week is adequate; more frequent use is unnecessary. The photograph shows that you are using it where you want your hairline to return. I can see that clearly by the bleeding that shows in the photo.

 

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More Opinions About Finasteride and Prostate Cancer Risk

This post is in reference to an increased prostate cancer risk from finasteride and dutasteride (see here).

E. Antonio Mangubat, MD wrote an interesting metaphor to help some of his patients and colleagues understand the many discussions on cancer risks in association with taking finasteride. He writes:

“It is sad that the number of lives saved [who have not developed prostate cancer] has been discounted because of the words used …. [in the opinions drawn].

In my opinion their conclusion [New England Journal of Medicine] is like saying seat belts should not be used because it increases the chances of dying if the car ignites on fire. While the caution is true, the conclusion ignores the lives saved if the car does not incinerate.”

We both agree that the conclusions in this NEJM article introduce a fear factor that people with hair loss will now have to consider cancer risks and even death from prostate cancer if they choose to take this drug. The study that is referenced was performed on 20,000+ men over 55 years old in a classic double blind methodology and it showed that the cancer risk was reduced by 25% for those men who took the drug when compared to the control group.

The fear was generated from the observations that there was a higher risk of high grade tumors in those men who took the drug, but there was no study of death rates on the men with higher grade tumors despite the high numbers of men studied. For those readers who are still confused, the pathologists who reviewed the ‘slides’ of the tumors felt that the tumors looked ‘meaner’ (my words), but if these meaner tumors did not kill the men who had that diagnosis made, then it seems almost meaningless, an exercise of intellectualization.

I am angry about these conclusions to two reasons: (1) I must notify patients of these recommendations since they come from the FDA and the NEJM journal, because this has now become the standard of care, and (2) patients who are balding and could be helped with a simple daily finasteride pill may be frightened into the hair transplant surgery route. Yes, I would make money from the transplant, but I prefer that patients simply take a pill rather than have surgery that could perhaps otherwise be avoided.

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Body Hair Transplant for Alopecia Sufferers?

Hello Dr. Rasman
I have Norwood class 7 diffuse ‘patterened’ alopecia. I am 26. You have seen my scalp and said I am definitely not a candidate for hair transplant because my donor density is poor and I have ‘see through scalp.’ I have been on propecia since then for almost one year. My question is: what is the current success rate of using non-scalp hair for a donor region, such as chest. Do you do these procedures for people with poor donor density? Last question: When will hair cloning become available w/Aderans?
Thank you very much.

Body hair is not the solution you are looking for. I do not expect to see hair cloning for at least 5 years or more. For the moment, if I saw you only once, then you should have a yearly visit with me to follow what is happening to you. There is not much to offer other than Propecia and possibly Avodart (something that I might consider using in your case).


2006-09-15 12:49:41Body Hair Transplant for Alopecia Sufferers?

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Born Without Pubic Hair!

I was born without pubic or underarm hair, I have eyebrows but they never grow long. The hair on my head is thick and lustrous – other body hair sparse. What causes this?

There are genetic patterns that each of us inherit associated with both our heritage and our ancestry. American Indians, like their Asian ancestors, have very little body or facial hair. Many Asians do not have pubic or under arm hair. We have transplanted many Asian women who want pubic hair, but it will grow like your head hair, a bit more curly, so you will have to cut it to keep it short.

For your eyebrows, it sounds like you have very short hair cycles there, which means that the eyebrow hair may only be there for a very short time when it falls out and eventually gets replaced by other hairs. When this happens, the length is usually very short and the growth rate is always slow in the eyebrow, possibly slower on you then in many other people of similar ethnic background.


2006-06-22 10:51:01Born Without Pubic Hair!

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My friends (26, and 27) who are balding are making fun of my hairline

You have kept your 5 year-old hairline. Don’t feel bad, assuming you are the same age as they are, you will be in the category of people like Bill Clinton who kept his 5 year-old hairline into his early presidency. The juvenile hairline is rounded, concave in shape. All boys and girls at the age of 4-6 have this hairline and you were fortunate to keep it. Maybe you will become president one day. Tell anyone that makes fun of you that you and Bill Clinton share the same hairline, that should be on-up for you.


2020-08-18 06:59:42My friends (26, and 27) who are balding are making fun of my hairline