This common question comes from a member of our hair loss social community and discussion forums

I want to undergo hair transplant surgery. I can only undergo surgery once, however, so it must be with the best. So, who is the best hair transplant surgeon practicing today? Help me find the “best” hair transplant surgeon.

first place ribbonMembers frequently ask this question at our hair loss discussion forums. We pride ourselves on researching, reviewing, and recommending the most talented hair restoration surgeons practicing today; however, identifying one surgeon as the “best” practicing today is difficult. This is true for several reasons:

First, surgeons specialize in different aspects of hair restoration surgery. For example, say a surgeon specializes in follicular unit extraction (FUE). He may be considered the “best” FUE surgeon practicing today, but he wouldn’t be the first name mentioned for a female hair loss sufferer seeking strip surgery (Follicular Unit Strip Surgery).

Second, terms like “the best” are subjective. Hair transplant surgery is as much an art as it is a science. Many patients desire a specific hairline design or reconstructed whorl pattern in the crown, and connect with a surgeon using these designs. This surgeon may be the “best” for this patient. Another, however, may find this doctor’s hairline and crown design too aggressive and desire a different approach. For this patient, the second surgeon may be “the best.”

I am 31, and I have been experiencing steady hair loss for about 6-8 years. Using the Norwood Scale I would say I am about a 3 to a 3 vertex right now. I have seen and read about hair transplant surgery and looked at some reviews for surgeons in my state but I don’t think I want to go with a full surgery right now.

If I could maintain and maybe regrow hair, I think I can live with that. That may change, but I’d rather try non-surgical hair restoration methods for now.

My questions are:

  1. Should I seek out a hair loss professional first for consultation to see what they recommend for meds or topical solutions? Are they more prone to just suggest surgery since that’s where they are going to make their money?
  2. From my research, the first options are usually Rogaine and Propecia. Is it a good idea to go with the brand name stuff or are the generic brands I have read about just as good?

I have been going back and forth on this hair loss issue for years and I have done research on and off but the time has come for me to finally make a move on this. So any help and suggestions are very appreciated.

Dr_Harris_photoEach year, the International Society of Hair Restoration Surgeons (ISHRS) honors a member who has made outstanding and significant clinical contributions related to the field of hair restoration surgery, with the Golden Follicle Award. This year, we’re proud to announce that recommended hair transplant surgeon Dr. James Harris was presented this prestigious award.

Dr. Harris is one of the earliest pioneers in performing follicular unit extraction {FUE}. He is devoted exclusively to doing high quality all microscopically dissected follicular unit hair transplantation with special emphasis on FUE.

A clinical instructor at the University of Colorado’s School of Medicine in Denver, Dr. Harris has lectured extensively around the world and co-authored a textbook, “The Hair Replacement Revolution: A Consumer’s Guide to Effective Hair Replacement Techniques.” A Fellow of the ISHRS, Dr. Harris currently serves on the Society’s Board of Governors

We congratulation Dr. Harris on this well-deserved honor.

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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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My hair transplant surgeon is recommending me to have 1500 follicular unit grafts (I have hair loss between a 2 and 2A on the Norwood Scale). However, since that clinic is new and the only one in my area, I am a little scared and considering to ask for only  850 grafts to be transplanted. And then, if surgery is successful, I will go for the second surgery after a year.

Has anyone done anything like this? What did your doctor sacrifice – density or hairline length? Any other complications after such a choice? Why you would or wouldn’t you ask your hair restoration physician to do this?

indexThere is nothing wrong with taking a more cautious, conservative approach. Just be aware that the placement may need to be a bit higher and the density will be lower so don’t expect miracles. In addition, I would seriously consider the fact that the hair transplant surgeon is new and you should realize that you are, in essence, a guinea pig. Every doctor has to start out new at some point and there is nothing wrong with that, but you have to ask yourself if you want to put yourself in that position.

If you haven’t already, ask the following questions…

1. Who trained him?
2. What method is he using?
3. If follicular unit strip surgery (FUSS), is it single blade or mult-blade?
4. If follicular unit extraction (FUE) is it robotic, manual or motorized punch?
5. What size punch if FUE?
6. Who will be doing placement of grafts?
7. Who will be doing extraction of grafts?

Overview of the 2014 ISHRS Meeting

ISHRS MayalsiaEach year, the International Society of Hair Restoration Surgery (ISHRS) holds its annual scientific meeting to discuss hair loss and advancements in medical and surgical hair restoration. This year, the ISHRS meeting was held in Kuala Lumpur, Malaysia and discussion topics focused predominantly on Follicular Unit Extraction (FUE) and future hair loss treatments. This is in stark contrast to past meetings, where FUE was rarely discussed or mentioned as a “novel” or “adjunct” procedure to the then gold standard Follicular Unit Strip Surgery (FUSS).

FUE-related presentations included: a discussion of FUE-based Body Hair Transplantation (BHT) from Coalition hair transplant surgeon Dr. Robert True and recommended hair restoration physician Dr. Sanusi Umar; an overview of “treading the FUE path” – or FUE pearls and pitfalls – by recommended physician Dr. Tejinder Bhatti; a presentation on beard hair FUE (a specific type of Body Hair Transplantation) again by Dr. True; a discussion regarding the role of the dull punch in Follicular Unit Extraction given by FUE pioneer and recommended physician Dr. James Harris; a presentation on the challenges of performing FUE in African American patients by Dr. Umar; a discussion about selecting the “right” FUE tool and avoiding graft transection by Coalition physician Dr. Jean Devroye; and an exciting course on the use of manual FUE extraction tools taught by Dr. Jose Lorenzo.

This question comes from a member of our hair loss social community and discussion forums

I’m going to see a doctor about my hair loss. I think I suffer from androgenic alopecia or male pattern hair loss; however, I want an evaluation to see if something else is causing the thinning. Should this work up include blood testing? If so, what type of blood work should I get to evaluate the hair loss?

blood workGenerally, male pattern hair loss is a clinical diagnosis made by closely examining the scalp. Furthermore, there is really no defined “hair loss” blood panel. However, some cases of alopecia – especially in female patients – aren’t as obvious, and many doctors check blood levels of: thyroid stimulating hormone (TSH) , total and free testosterone, estradiol, DHEA(S), hemoglobin (a complete blood count to assess anemia), vitamin D, iron, and maybe DHT, ANA (autoimmune), and prolactin. Some of these blood tests are more specific than others, and doctors will chose which are best for each individual patient.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

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I’ve had 5 hair transplants over the last 15 years with the last one 2 years ago with a total of more than 4500 grafts, all in the frontal part of the head. The problem is the new hair only lasts a certain amount of time and then it starts falling out. It used to last longer in the past but now it doesn’t seem to last more than a year before thinning starts all over. I’m now a 2 or 3 on the Norwood Scale for hair loss as if I’ve never had any hair transplants done. At this point, more procedures aren’t an option, knowing that I’ll end up losing that hair too.

I’m now living a nightmare and suffer from deep depression and anxiety with the likelihood that I’ll end up losing all my transplanted hair. I’ve talked to my doctor – who’s a very reputable and well known hair transplant doctor in Canada- and he’s telling me this is a very rare case (2%) where the body ends up rejecting the transplanted hairs due to some kind of an autoimmune problem and told me there was nothing that could be done in this case.

Is there anything anyone can tell me about this? Is this really it for me?

hairloss11-150x150In virtually all men, if hair is harvested from the “permanent” zone at the rear and sides of the head to balding regions of the scalp, the hair will continue to grow for a lifetime, just as it did in its native location.

I had hair transplant surgery 7 months ago. I am not seeing good results on both sides of my head. Though I can see hairs growing in frontal area, density is not that good. I had 4500 grafts.

I also want to know what kind of effects excessive sexual activities like sex or masturbation cause on hair transplant growth.

One-year-Celebration-ImageAt 7 months post-op, you have probably only seen about 70% of your final hair growth. It’s common for initial regrowth to be uneven during this time. You’ll need to wait the full one year before assessing the full extent of your results. However, I recommend that you discuss your concerns with your hair transplant surgeon and find out what your options are in the event that your final yield is less than expected.

It’s often recommended that patients refrain from sexual activity for about 10 days after surgery. This is the time it takes for the follicular unit grafts to heal. After that, sexual activity will have no effect on the outcome of hair restoration surgery.

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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 question comes from a member of our hair loss social community and discussion forums

I want to start Propecia (finasteride), but I’m worried about the side effects. How common are these side effects? Do they resolve after stopping the medication?

Propecia BoxThe manufacturers of Propecia claim 2% of patients experience sexual side effects. These side effects include: decreased libido, erectile dysfunction, and decreased semen volume. Allegedly, these issues resolve spontaneously after stopping the medication. Another large study in Japan noted side effects in 0.2% of patients. They claim the problems resolve after stopping the medication as well.

However, many finasteride users disagree. These individuals claim a much higher rate of sexual dysfunction and believe some of these side effects can be persistent or even permanent. Frankly, I try to stick with the objective evidence – which show a small number of patients experience temporary  side effects. However, all hair loss sufferers should be aware of the potential for side effects and discuss these issues with a trained hair loss physician before starting finasteride.
________________
Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

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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”.

Can you get scars in the hair transplant recipient area from the incisions when they plant the grafts? I know there’s tiny scars in the back with follicular unit extraction (FUE) due to harvesting the grafts. I was wondering if the same principle applies when the grafts are inserted.

step_13Yes it’s possible however unlikely especially if the hair restoration surgeon uses the least invasive instruments, like blades for example, to create the coronal incisions. Some hair transplant surgeons may choose to use needles to create recipient incisions. Some use a combination of both instruments depending on the variance of graft sizes.

The key is that the size of the corresponding recipient incisions accommodates the peripheral sizes of the grafts that are placed within them. If the incision site is too large, there can potentially be some pitting at the base of the implanted graft when it heals. Sometimes that can be slightly noticeable.

And of course, if you are a good healer, that makes a difference as well.

Gillenator
Supporting Hair Restoration Physicians: Dr. Glenn Charles, Boca Raton, FL – Dr. Jerry Cooley, Charlotte, NC – Dr. Jim Harris, Denver, CO – Dr. Robert True & Dr. Robert Dorin, New York, NY

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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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