propecia_pillPropecia (1mg finasteride) is arguably the most effective medical hair loss treatment currently available. Though not a hair loss cure, countless men have used the drug to effectively slow the progression of balding and regrow hair since its approval for the treatment of androgenic alopecia (male pattern baldness) by the FDA in 1997.

Propecia works by inhibiting the conversion of testosterone to Dihydrotestosterone (DHT). Studies conducted by pharmaceutical manufacturer Merck & Co showed that almost 80% of men using Propecia stopped or even reversed their hair loss to some degree, while fewer than 2% exhibited “Drug-Related Adverse Experiences” or side effects. These side effects were said to be temporary and to subside upon discontinuation of the drug.

However, in the years since Propecia first entered the market as a hair loss treatment, numerous complaints have arisen from men who claim to have suffered severe and irreversible sexual side effects attributed to finasteride use. This has come to be known as “Post Finasteride Syndrome” or “PFS”.

Side Effects

As a result of these complaints, in April of 2012, the FDA mandated labeling changes to finasteride related products. Labeling changes to Propecia include “libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug”. Labeling changes to Proscar include “decreased libido that continued after discontinuation of the drug”. Labeling changes to both Propecia and Proscar include “reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation”

I won’t use names of any hair restoration surgeons but I am trying to get some information. I have done research and hair transplant is the way I will go. I have had consultations with doctors in Turkey, Seattle and in New York. I have been given $13,000, $11,000, and $2,500 dollar choices as far as price.

The general consensus is that I need around 3,000 to 5,000 grafts. The thing that worries me is the drastic price variations: $2,500 in Turkey and $13,000 here in the states. I guess the big question is, the way I’m leaning is Turkey so I guess I’d like more information from others regarding Turkey specific to prices.

I saved up $5,500 for surgery including airfare. I have been to 36 countries so I’m not afraid to travel. I’m looking for quality at the best price. Please help.

CashCost vs. quality is a common concern and frequent topic of discussion on our hair loss forum. What you’ll find is that the most expensive hair transplant surgeon is not necessarily the best and the least expensive is not necessarily the worst.

Being well-traveled, I’m sure you’re aware that factors regarding cost like average wage, insurance, rent, training, etc. vary widely from country to country. Thus, patients willing to travel can find exceptional work at appealing prices, even when factoring in travel expenses.

The below question was asked by a member of our Hair Loss Social Community and Discussion Forums and answered by Janna, the lead medical technician for Coalition hair restoration surgeons Dr. Ron Shapiro and Dr. Paul Shapiro.

I am 52, with dark hair and very light skin Caucasian. My Norwood Scale 4V hair loss started to show when i was around 39. Will I be candidate for slow hair growth if getting a hair transplant?

growthThe growth rate seems more dependent upon an individual’s physiology than age in my opinion. Another factor may be the hair restoration clinic’s protocol and techniques, such as the type of holding solutions used and how quickly the follicular unit grafts are planted.

Regenerating therapies like ACell to help repair the follicles could also play a part in growth rates.

Janna
Lead Medical Tech and Surgical Manager
Shapiro Medical Group

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

To share ideas with other hair loss sufferers visit the hair loss forum and social community.

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This below question was asked by a member of our Hair Loss Social Community and Discussion Forums and answered by recommended hair restoration surgeon Dr. Tejinder Bhatti:

I was just curious to hear from a hair restoration physician on what their theory is on why a small number of people won’t ever shed the newly transplanted hairs. I figured it has to do with genetics and the way the hairs were handled after cut.

Dr-Bhatti-photoAn ideal hair transplant procedure involves relocation of follicular unit grafts from the donor area to the recipient area with minimal trauma, in the shortest time possible, while stored in an optimal storage solution while the grafts are out of the body. These are 3 variables to the technique. The 4th variable is the patient’s age and general health.

Due to so many variables at work, it cannot be predicted which patient will shed and which will not. Even the same clinic will not be able to produce non-shedders consistently.

In my practice I have clinically experienced that the average amount of hair shed after the procedure is 65%.
1% of patients do not shed hair at all.

Honestly, there is no scientific basis on why one patient will shed and another will not.

Dr. Tejinder Bhatti
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeon Dr. Alan Feller:

What are the side effects of follicular unit extraction (FUE) hair transplant surgery?

Dr_Feller_photoThe thing you are probably concerned about is the side effect of FUE that can be rightfully called FUE Donor Area Neuralgia. Also known simply as FUE Neuralgia as you almost never see it’s counterpart in follicular unit strip surgery (FUSS) surgery.

This is a condition that occurs after the donor area is harvested with a great number of FUE grafts. It’s symptoms are a persistent and deep burning sensation in parts of, or throughout, the donor scalp that is not relieved with pain tablets. This condition can last for weeks, months, or even years.

The other concerns you may have read about are:
1. Lower and inconsistent hair growth yields compared to FUSS
2. More damage to the donor area resulting in fewer harvestable grafts in the future if needed
3. Donor area shock loss which appears as a moth eaten look or patches of thinning hair.

FUE is a good procedure for smaller cases. If you need greater than 1000 grafts -now or in the future- you would be better served going with a strip procedure.

Dr. Alan Feller
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

The below question was asked by a member of our Hair Loss Social Community and Discussion Forums and answered by “California”, patient advisor for recommended hair restoration surgeon Dr.Tejinder Bhatti:

Can body hair from the stomach area be transplanted to the scalp? What other sources have hair transplant surgeons had success with aside from beard and chest (both of which I have little of)?

LOGODr. Tejinder Bhatti believes that when it comes to body hair transplantation (BHT), “only ABC is GOOD!”. (A- Axillary, B- Beard, C-Chest). He is not fond of using any hair other than beard, chest and axilla (armpit) in this order of preference since leg, arm, belly hair, in his experience, take a long time to grow, if at all.

In darker racial groups he does not venture outside the ‘shadow area’ of the beard which lies on and behind the jawline and above the Adam’s apple due to the possible risk of visible scarring.

“California”
North America Representative and Patient Advisor for Dr. Tejinder Bhatti.
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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It’s been over 3 months since my follicular unit extraction (FUE) hair transplant. I’m now getting some red bumps in the recipient area. Is this some sort of infection? Will they go away on their own or do I need to treat them?

PimpleThis sounds perfectly normal. You have reached the stage when a lot of new hair growth is stirring below the surface of the scalp. These hairs sometimes fail to exit the skin initially and that results in ingrown hairs. It may also be due to folliculitis or inflammation of the hair follicles. These can become large and quite painful and may even burst and bleed.

Typically, it’s not necessary to treat them. You can simply leave them alone and allow them to resolve themselves. If you feel the need to relieve the pressure, you should follow the advice of your hair transplant surgeon. Some may suggest squeezing them while others recommend only lancing them with a sterilized needle

If the condition should worsen, contact your hair restoration physician or regular doctor immediately. You may require medication to treat the infection.

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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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The following thorough response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member “Gillenator”.

I’ve read that you should not overexpose a new hair transplant to the sun. I’ve also read that glass stops UVB but not UVA. Which is the most harmful to the grafts?

summertime-clipart-sun-wearing-sunglassesGraft survival is dependent on the transplanted follicles getting established to a new source of blood supply. Without that occurring, whether from damage from UVA or not, they will perish.

So the risk of UVA rays is the potential of sunburn and/or exposure beneath the outer layer of scalp tissue damaging both the graft tissue as well as the underlying follicles.

My understanding is that the healing process in the deeper layers of scalp (dermis) are slower than the epidermis outer layer.

This is why wearing a cap or hat that fully covers the hair transplant recipient area is recommended when exposed to the UVA rays for more than 10 minutes in duration. The higher the UVA rating implies a quicker burn ratio yet a full cover with a cap/hat prevents this potential damage from occurring.

Most hair restoration physicians will want their patients to avoid direct exposure to UVA rays for at least 3 months post-op, some feel 6 months and still others 9 months.

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Mike Vories:

What is the advantage of using implanter pens in follicular unit extraction (FUE) hair transplant surgery?

Dr_VorriesAtraumatic placing of FUE grafts is the most important topic, in my opinion, in all of surgical hair restoration. It is the reason I use implanter pens, and the reason I place all grafts myself.

I use technicians, and I could easily delegate this part of the procedure to them. I choose to do this myself not because I do not trust them, but because I believe I owe this to my patients. When they sign up for surgery with me, I should perform this most critical part of the procedure myself. I do not think most patients understand how easy it is to crush FUE grafts with forceps. Even the most gentle placer can injure the bulb with forceps.

So while it is true that FUE grafts can be injured with implanter pens, they are much less likely to be injured than by forceps placement. To explain this with words is one thing, to see it is another. That is why I welcome any hair restoration physician to my clinic to observe the procedure at anytime, at no cost. (With patient approval).

Dr. Michael Vories
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

I’m 33 years old and I am thinking about hair transplantation, but I am confused in choosing between FUE and strip and also would like to know if there are any serious side effects in the future after hair transplant surgery.

questionFollicular unit extraction and follicular unit strip surgery (FUSS) are both excellent procedures the can produce natural and undetectable results. However, each procedure has its pros and cons. There is not one that is better than the other in all circumstances.

Volumes can and have been written regarding these two techniques. But, in a nutshell, Strip surgery can typically yield more grafts in a single session and offer a higher average success rate in terms of the number of grafts that survive and grow. The downside for some guys is that it results in a linear scar often stretching from ear to ear that requires hair to be a bit longer for concealment purposes.

With FUE, follicular unit grafts are harvested individually using a small punch. This is much more labor intensive. Depending upon the tools used and the expertise of the hair restoration physician and staff, maximum grafts per session may vary from as low as 1,000 grafts to as high as 3,500 with a very high rate of success.

Due to the method of harvesting, scarring from FUE is in the form of very tiny dots that may be virtually invisible even when the hair is buzzed very short. This appeals to many younger men who like to wear their hair short.

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