Royals can have them. Presidents Biden had one, Donald Trump and at least one, Chuck Shumer had one. and many presidents of countries and prime ministers have had them. If they were done prior to 1993, then it was the old technique that produced plugs and a ‘doll head appearance’. Unfortunately Biden and Trumps original surgery did not work out well as their original surgery was prior to 1993, but both found a way to fix the problem. I believe Biden had them surgical repaired with the techniques I defined in my publications, but Trump, I believe, went the hair system route. Trump would have to maintain that particularly unique and very expensive system every two week for the rest of his life.
Logically, the liposomal topical finasteride will only work in the area it is applied, while the oral covers the entire scalp. Just because you may now only have frontal or crown balding, don’t be fooled as the early miniaturization may be all over your scalp including some of the area you do not recognize, The miniaturization elsewhere on your scalp will be less than 50% of the hairy areas but many of these areas will progress to balding unless, of course, you are taking and can tolerate the oral finasteride which definitely slows of stops the progression in many men. Look at this important post: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/
Dr. Dow Stough just published an important article defining the long term risks associated with getting a hair transplant. I always stress the personalized master plan for every patient, laying out a worst-case scenario. Dr. Stough nailed this subject nicely.
Original Article
The Progressive Loss Risk Scale for Hair
Restoration Surgery
Dow B. Stough, MD, CPI*†
BACKGROUND Limited information exists on the long-term risks to individuals undergoing procedures in hair restoration
surgery. The short-term risks are well known and similar to other procedures in dermatologic surgery. The long-term risks
of hair restoration surgery are seldom discussed between the physician and patient.
OBJECTIVE The author sought to describe a classification system that can be used as a communication tool between
physicians and patients to define the long-term risk involved with hair restoration surgery.
METHODS The Progressive Loss (PL) Scale is an attempt at assessing the cosmesis because of future hair loss following
a hair transplant procedure. The PL Risk Scale has designated 5 levels, 1 to 5, with each ascending level representing a
higher level of risk. The PL Risk Scale can be assigned to an individual at the time of the assessment for hair restoration
surgery.
RESULTS Each patient can be assigned a risk level based on how future hair loss may affect the overall cosmetic result of
their hair transplant. This risk is dependent on age, and specific for the area to be transplanted. The younger the age of the
patient, the higher the risk. The larger the area to be transplanted, the higher the risk. It is not a static scale, because it will
be affected by age, donor area, location of transplantation, and other mitigating factors.
CONCLUSION Pattern baldness in men and women is progressive and unrelenting. The dichotomy of hair restoration
surgery is that a satisfactory short-term outcome can evolve to disappointing results because of progressive hair loss. The
PL Risk Scale can be assigned to every individual undergoing a hair restoration procedure. This scale assignment will
convey to the patient their lifetime risk associated with any given surgical hair restoration procedure for that age and the
specific area to be restored.
DERMATOLOGIC SURGERY • July 2022 • Volume 48 • Number 7
I have written about this before. read the follow post: https://baldingblog.com/22-year-old-received-a-hair-transplant-of-2800-grafts-from-reddit/
Dr Rassman has already posted many times links to his articles about the creatine. If you want another anecdote, then I can tell you that my hair loss got drastically worse while on creatine.
I’m a man and I have a naturally high forehead and never had hair loss since I’m only 18 years old, do I have a better option to reduce the size of my forehead than doing a forehead reduction surgery?
A hair transplant is the way to go for men. There is always a risk of balding and that makes a hair transplant reduction the best procedure for men. Women have another option because they don’t have classic patterned balding as men do, so the risks are not high for them to do a forehead reduction surgery.
Can hair start to grow thicker in the current cycle?
Yes, I have seen men grow their hair out and then bring some strands. They can clearly see the hairs at the base of thicker than the hairs at the end showing the miniaturization can be reduced within a single anagen cycle
I was wondering if you had any insight regarding nipple tenderness from finasteride. I began to have bilateral areolar tenderness beginning two days ago. Would this be a precursor to gynecomastia? Should I discontinue the drug altogether or should I just take it at a lower frequency (i.e every other day?)? Thanks so much!
You might try a lower dose and see what happens to the nipple pain. This is a known side effect of finasteride
A recent report out of South Africa showed a healthy woman placed on 0.25mgs of oral minoxidil developed cardiac and other systemic swelling. This situation could have been life threatening, but it was picked up early and the medication was stopped. The problems went away.
Up until this point in time, I, like most of my colleagues believed that dosing oral minoxidil of 2.5 mgs/day or lower did not expose the risk of cardiac complications. This is the first such reported case of what may be thousands of people, but this post is here to let you know if you are on oral minoxidil that this is a risk.
Of significance, this patient had signs of a problem with swelling of the legs, hands and face and her doctor was quick to discontinue the drug with reversal of all side effects , so if you get swelling of your hand, feet face, speak with your doctor and consider stopping the minoxidil.
The effect of the second picture could be the results of longer, curly, coarse hair alone. Such results in 6 months are too quick as normal terminal hairs usually grow at a rate of 1/2 inch/month. Maybe we are seeing a combination with some results from your treatment and a good quality coarse wavy hair. I wouldn’t suggest that you shave your hair, but from such a picture, the results of the treatment would be evident.
If you only had frontal hair loss and used up 5400 grafts, that means that you would have used up 2/3rds of your entire usable donor supply. Did you know that if you progressed to more balding, you may not have enough donor hair to cover the rest of your head? In building a Personalized Master Plan, 5400 grafts doesn’t fit any frontal hair restoration strategy I know of. What it fits is either the ignorance of the surgeon or greed to make more money off of you.
Doses of 1.25 or 2.5mgs have to my knowledge, never seen the severe cardiac effects such as cardiac tamponade. It still is a blood pressure lowering drug but at these doses, lightheadedness and allergies may be the most prominent side effect
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