Long-haired balding men often brush their hair. It often takes more force to brush long hair so that miniaturized hairs and the hairs that are due to fall out that day (between 100-150) are easily pulled out with vigorous brushing. If you don’t have significant miniaturization in the long hair, then having it long will be okay. I advise all men who are losing their hair to use a wide-comb brush which doesn’t pull the hair out.
SMP doesn’t last very long in scar tissue. Scar tissue turns over quickly, being replaced every 90 days or so. Depending on how deep the ink was placed and how thin the scar is dictates how long it lasts.
Nothing like sticking to the plan you created!
I have had a bad SMP, and I need to shave down my hair. Can you point out a few clinics that have been consistently doing a good job at SMP?
I know we do a great job. I published almost all of the reference articles on SMP and showed many great results. When checking out SMP clinics, it is best to ask to meet a few of their patients with the type of work you want to do. You’ll know good work when you see it.
That is a very impressive result. The microneedling was the key here; once a week, the 1.5mm needles helped it along nicely. The long-term becomes an issue; in other words, what must you do to maintain your final result when you get there? I am almost sure that if you don’t maintain some microneedling, even every month, these hairs, when they go through their next cycle, may not go into anagen (the growth phase) without the stimulus of the micro-needling. This could happen even earlier than the next hair cycle. We just don’t have the information we need to answer that question. You would find out the answer to that question if you did follow-up repeating the microneedling. If the hair starts falling out again, pick up the microneeding and write to me.
This is a remarkable injury from a car accident where this woman lost most of her scalp. The initial surgery to address the loss of her scalp was with the use of split-thickness skin grafts (left photo), probably taken from her thigh or abdomen. The grafts covered the skull so that the skull didn’t die off; however, her look was clearly abnormal as you can tell in the middle photo. You can see the brusing of the split-thickness grafts. I imagine she probably used a wig to cover the deformity shown below.
Dr. Felix Popescu, from Bucharest, did approximately 3500 grafts to cover the deformity and give her back her hair. The photos below only show before and after extending 2 days, but the skin looks viable, suggesting this surgery might work. The zoomed-in view shows that a good blood supply is available to the grafts. Split-thickness skin grafts don’t have an infrastructure to support much beyond the skin grafts. I hope he will send me follow-up photos over the next few days and eventually of the final results. I greatly admire his skill and courage in tackling such a difficult case.
Surgery performed by Felix Popescu, M.D.
Dr. Felix Hair Implant
Soseaua Nordului, No. 98 G
Bucharest, Romania, 14104
Does finasteride only prevent more terminal hairs from miniaturizing? Does it thicken existing miniaturized hairs? Does it help regrow hairs from follicles that stopped growing?
Terminal hairs do not respond in any way to finasteride. It does thicken existing miniaturized hairs and may induce hairs that have failed to regrow if it is recent hair loss. Finasteride works by blocking the hormone DHT, which prevents the genes from kicking in to cause the loss in men that have the genes for hair loss.
Yes, some people get changes in mood on finasteride. That is a problem for men with depression as it could exacerbate it.
This is a case of necrosis. I don’t understand why it keeps happening in Turkey. In my 33 years in practice, as the first surgeon to do 5000 grafts and as the pioneer of FUE, I have never seen this complication. These three pictures show the progression of the necrosis over time and the final scarring that resulted. I see other areas where there is a suggestion of further compromise. These scars will not grow the transplanted hair. Another hair transplant by a competent surgeon may fix this problem.
So I had my hair transplant done on Jan 2nd. I had virtually no shedding in the past 1 months but I started using topical Minoxidil a week ago and all of a sudden got dandruff in the transplanted area. My doctor told me to scrub it off and I did and gave him some after pictures with some hair down the drain. My questions:
I did this after 4 weeks. I was told it takes 2 weeks for the hair to root. Did I accidentally peel off some hair or was the shedding at the same time?
How do confirm what I shed was legit or I accidentally messed up transplant?
I’m worried. I have had no problems so far and was going so far with maybe a hair or two in the drain. Pictures attached! If it’s just shedding it couldn’t have been timed worse. Stats: 2100 transplant count Age: 36
Scrubbing your transplanted area after 12 days will not cause loss of the implanted hair stem cells that, I expect, will eventually grow. Starting minoxidil could induce some shedding, which tells you that the drug may be working to develop new hair in the non-transplanted areas. I believe that you don’t really have a problem.
4000 grafts are likely 60% or more of your donor supply. Have you considered what you would do if your hair loss pattern evolved into a more advanced balding pattern? If you are under 26, this is a significant question; however, if you are over 35, the risk of developing a more advanced pattern may not be substantial unless some male in your family line developed a later pattern of advanced balding. Who do you take after in your family line? Do you have a worst-case plan? I think 4000 grafts for a balding Class 3 pattern male is mal-practice.
Do hairs like this stand a change with medication? Is a HT even a viable option to increase density?
Because of the possibility of diffuse unpatterned hair loss, I would want to look carefully at your donor area with a hand microscope to make sure you don’t have DUPA, which will rule out a hair transplant that probably would fail if you have DUPA. Medications may work well but have the medications managed by a good, caring, competent doctor
Finasteride can positively impact a swollen prostate and is typically used in men with prostatic hypertrophy, commonly over the age of 50. Also, in men who used it for a long time, it reduces the risk of prostate cancer by 25%. The recommended dose, however, is 5mg, in the form of Proscar.
I think that 23 years of age is too early because your final balding pattern doesn’t usually show up until you are 25-26 years of age, and even at 26, it may not show up. When I do a hair transplant, I prefer men over 25. The number of grafts depends on four factors: (1) the size of the area being transplanted, (2) the location of the transplant (frontal hairline or not?), (3) your donor density, and (4) your hair mass per unit hair. With that, I can build a personalized Master Plan for any patient, which will consider what might happen to them as they continue to bald (as every man who is balding does).
The doctor should discuss a plan when he/she intends to harvest hair outside of the donor area, as shown in this picture. A procedure with 4500 grafts and the harvesting FUE patterns shown demonstrate the problem. If his balding pattern increases, many transplanted hairs will fall out because many hairs/grafts were taken outside the safe donor area. FYI: The safe donor area is a 2 1/2 – 3-inch high area from the base of the skull around the side of the head above the ears to the temple peaks.
