Balding Blog

The issue is the doctor not the machine that does the surgery. Is the doctor really an expert in this field? Make sure that the doctor has his own staff and doesn’t bring in hired staff to do the surgery for him/her which is not only illegal but common with some of these systems (see: https://baldingblog.com/death-during-hair-transplant-surgery/). Too many doctors are just in this business for the money and don’t take training on their own. They buy a ‘Machine’ and then hire out the entire surgery team and often don’t participate in it, pocketing a fair amount of the money collected from you. I had seen situation where the doctor left the surgery with technicians who did the surgery. What would happen if something went wrong, could you die? If happened before and you wouldn’t want to be the next.

For the bald man that wants hair cover, he should let the side hair grow long enough to be able to sweep the hair from one side to the other. Once that is done, the center part of the long hair is pulled forward to the eyebrows. The final product is the last picture, a damn good covered hairline very common in many men who slowly bald over time. The problems occur when the bald area becomes too large and the amount of hair that is grown from the sides is both too low on the fringe area and too short, and you get the failed comb-over shown in the last picture. Note that the comb-over just doesn’t last as you can see in the gray hair suggesting that this man let his comb-over go on too long. The last set of photos I found on Google images which shows how creative some people can be to get their hair covering their bald area. This photos is not as outlandish as it may appear as this is called a Bouffant and is not infrequently built from scalp hair. In my 29 years of practice, I have seen such Bouffants on a number of men. I remember one man who got up at 2:30 am every morning to build the Bouffant hair by hair (a three hour process). His Bouffant looked good enough to fool me when we first met, but when I unwound his hair, he was fairly bald. He had two hair transplants and told me that these transplants changed his life. He now slept to as long at 7:00 am without worrying about his hair and was able to engage in activities with his children, including swimming and vacations in places that he never thought he would travel to.

It should be clear from this schematic that to make a single hair, requires the use of epithelial stem cells with a lot of coaxing (click to enlarge).

Author’s Conclusion about Hair: “Because hair follicle stem cells are the only adult stem cells possessing organ-inductive potential that can be transplanted autogenously, the first human clinical trial of organ regenerative therapy will undoubtedly investigate hair follicle regeneration. The regeneration of hair follicles using our organ germ method is now being investigated in a pre-clinical study to cure patients suffering from androgenic alopecia, with an aim of conducting clinical trials in 2020. This hair follicle regenerative therapy will be a milestone in organ regenerative therapies and will lead to the development of material and responsive infrastructure to realize organ regenerative medicine. Applying knowledge of hair follicle regeneration and expertise obtained from clinical trials to other organ germs or organoids will enable the regeneration of other organs from pluripotent and tissue stem cells in combination with organoid technologies in the next few decades.”

Any hair transplant should be treated the same with regard to the recipient area, but if the donor area has open wounds (FUE), it requires daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish. The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply our patients with a surgical sponge to fill with soapy water (we supply the shampoo) and press on the recipient area daily in a rolling motion, never rubbing it. By repeating this daily, all crusts can be washed off without any fear of losing grafts from day one forward. If any crust are present, use a Q tip and dip it into soapy water or shampoo and roll it on the crusts and that will lift them off without dislodging them, but never rub them, just roll the Q tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area gone in the first day with daily washing and stay that way. Here is an example of the way is should look like in 12 days with before and after pictures:

https://baldingblog.com/2007/12/14/12-days-after-hair-transplant-with-photos/

The following is an example of one of the worst crusting I have seen in a picture:

https://baldingblog.com/2015/06/04/fue-from-turkey-help/

The problem with this type of crusting, the grafts get pulled out as the crusts come off. We wrote about this in a medical journal here:

https://baldingblog.com/wp-content/uploads/pdf/mp-2006-graft-anchoring.pdf

The key is good washing starting from day one.

They say you can get a transplant once you’ve stabilized your hairloss with Fin – but how reliable is it actually? I’m not sure how accurate this is, but I often read that Fin doesn’t really halt your hairloss, it slowns it down a lot but your hairline is still receding. And who’s to say that you get you a transplant and, 3 years later, Fin starts losing effectiveness and you end up looking even worse before? Do you just have to gamble on this, or am I missing something? Or is the transplant a commitment in the sense that you’ll eventually need more to “recorrect” everything?

What are you realistically getting in the long term with a hair transplant?

I have been doing hair transplants for 28 years and started the trend with small follicular units used for the hair transplants. Many of my patients from 28 years ago, come and visit me and a few came back for more hair transplants as they continued to lose hair. In good hands, hair transplants work and in 99% of people, the results are permanent. That is good and bad because if it is done well, you will look good, but it is done poorly, you will always look freaky.

The science papers suggest that the sexual side effect (the focus of most men on this site) are less than 2% and are reversible if stopped early. The nocebo effect is much higher as young men bring on their sexual side effects by obsessing over taking the drug, and reading forums that suggest that this is a common occurrence. The greatest concern of most young men is the condition called Post Finasteride Syndrome which if real, may reflect a 1% risk at most. There is controversy over the existence of this condition within the medical community, but it is nevertheless important for any man considering this drug