This man will have to take a second pass at the transplant, this time with a better surgeon. 2000 grafts should have filled his frontal hairline reasonably well. Also, note that the hairs are pointing to the sides, like the spokes of a wheel. This is a common mistake made by surgeons that seem to have a problem learning which direction the hair grows. Forward!
The clinics told me that your transplanted hairs are not sensitive to DHT, but I hear everyone here many people saying that these hairs can also fall out, is this correct?
Transplanted hairs from the donor area are protected against DHT and balding; however, your native hair is not and if you have any miniautirzed hairs in your head, they will fall out unless you are on finasteride. In addition, your pattern of balding will advance, so finasteride slows that down.
Is it normal to lose short hairs if you don’t have MPB
If one gets a crew cut, then when the anagen hairs go into telogen, then you will shed the short hairs as that is the only hair that they have. Every hair on your head goes into telogen every 2-3 years and recycles. In women, the cycle may be longer than 2-3 years on average, especially younger women. That means that there is a limit to the length a hair can grow, which is totally dependent on the duration of the anagen component of the hair cycle.
No more panic attacks after starting fin, also testosterone stabilized to higher value
Most men on finasteride find that their testosterone levels rise in the blood tests. The body’s feedback loop responds to a reduced DHT presence from the finasteride.
What you should know about the hair density of a transplanted hairline. The results of the end product depend upon the following:
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The appearance of thickness comparable to where they were before they became bald.
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The color contrast between your hair and scalp color. The closer the match, the better the transplant looks.
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Many transplants from Turkey appear to push graft numbers high. Where I might put 1500-2000 grafts in the first 2 inches of the hairline, many Turkish clinics (with or without a doctor on staff) have technicians or inexperienced doctors deciding graft numbers. They tend to over-shoot the numbers without being able to mechanically place the grafts close enough to get anywhere near their original hairline density without getting necrosis as a complication of the surgery. Good doctors shoot for appearance and fullness; by doing so, they don’t waste the donor hair supply in the first surgery. In my hands, fewer grafts for comparable balding areas than most of the Turkish clinics produce the same appearance of fullness for the area transplanted.
Always remember that Hair Loss is progressive, even after a hair transplant. If you waste your donor hair on the first 2 inches of your hairline with, let’s say 4000 grafts, you have used up more than half of your donor hair supply for the rest of your life.
A classic female hairline is curved, and in the middle, it touches the crease of the furrowed brow. This woman’s hairline receded to the male position and the corners also moved up. This newly drawn hairline will address all of her concerns. Note that the normal female hairline does not have temple peaks present as they are buried inside their concave hairline.
I have seen a similar curve running for 10 years. It shows a similar spread between men who stay on finasteride and those who do not use it. The non-users develop a more advanced pattern of balding. I try to tell every man that is balding that this is a progressive process over the patient’s life, so a hair transplant doesn’t stop the balding in the non-transplanted areas. Today’s young men who head to Turkey or get less reputable surgeons seem to be getting high graft numbers, so the reserves for future balding will not be there.
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This is not an uncommon problem in the hands of less knowledgeable surgeons, assuming, of course, that this was done by a surgeon and not a technician. The Necrosis outlined in the photo by a circle, is probably the effect of improper use of adrenaline (epinephrine) to minimize the bleeding at the time of implantation. In addition, note that all of the grafts are placed in rows. The grafts line up like soldiers. In men with straight hair, these rows will be detectable when and if the hair grows out.
This young man sent these photos to me asking about this area of extreme thinning, which appears in the same place, even on the other side of his head. He said he had this same thin area when he was younger and it is also on the other side of the head, just less prominent. This is often an inherited balding area called triangular alopecia, which is always found in this area. A simple hair transplant can permanently fix it if it is triangular alopecia. It could be alopecia areata, which is rarely in the same place on both sides of your head.
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