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

As a young person (24) who is contemplating a hair transplant within the next 12-18 months, I have a few questions that I am hoping some experienced individuals can help me with.

As all of us here can relate, I would love to return my hairline to its teenage years. However, I understand that it is just not possible, considering the fact that I need to account for future hair loss. My goal is to lower my hairline by about 3/4 cm to 1 cm in the middle and about 1.5 cm at the temples. I am currently about a 2.5 on the Norwood Scale.

I have measured the area that I would like the new hairline to be placed. My rough estimate is about 23 sq cm. How many grafts per cm on average would be needed to give the illusion of a thick/natural hairline?

Is lowering the center of the hairline a bad idea? Would you suggest follicular unit extraction (FUE) or follicular unit strip surgery (FUSS) for this type of procedure?

Dr. CharlesYou need to use all available information to create a plan. One that will make a nice improvement now while you are young and will also take into consideration the possibility of additional hair loss with aging.

The following hair transplant question was answered by recommended hair restoration surgeon Dr. Tejinder Bhatti:

Dr. Bhatti, I can only reach the clinic on the morning of my hair transplant. Is that okay?

Dr-Bhatti-photoThat will not be possible since your counseling has to be done, blood tests have to be carried out and you are to be given medication the night before the procedure. We would also like you to digest overnight the points discussed during the pre-consultation so the next day there are no surprises.

Also, I have seen that some clients who come in the same day have anxiety due to which we have had to, on occasion, cancel the hair transplant due to elevated blood pressure.

One gets surgical hair restoration done once or twice in a lifetime and so I do not wish that you spoil your best chance for a great result by being careless with timings wherein if you arrive late due to a traffic jam (or any other reason) we rush to finish your case against a time deadline.

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.

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

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Today’s state of the art hair transplants provide many men with the opportunity to restore a full and natural looking head of hair. However, since donor hair is limited, those with larger balding areas may have to settle for lower densities or less coverage. This is why many have considered maximizing their donor area by undergoing follicular unit hair transplantation (FUT) first followed by follicular unit extraction (FUE) to add density and coverage. Additionally, some patients with wider “smiley face” scars left by FUT use FUE to fill-in and minimize the appearance of the scar.

Recently, forum member “nsuede” started a topic to discuss the advantages of using both FUT and FUE to maximize his donor area and minimize the appearance of the scar. You are encouraged to visit “FUT/FUE Combo? Scar Donor Area” to discuss the advantages and disadvantages of both techniques and how they can be used in conjunction with one another to garner the best hair transplant results.

Bill Seemiller
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeon Dr. David Josephitis

Should a person hold off having a hair transplant if they seem to be getting good results from medical hair loss treatments? Meds won’t bring my hairline back but the thing is I can see a lot of small hairs coming on my mid-scalp and I already seen hair growth in the crown.

I remember about 4 months ago I posted that I could see more and more scalp. Well now I can see less and less scalp. How much will these miniature hairs grow and can they get like normal hairs?

Dr_Josephitas_protrait
The answer to this question will vary from one person to another. Some people get on meds and it adds very little density or helps only a small amount in regrowing some of those smaller miniaturized hairs. These people still may benefit from the meds as they most likely are helping to prevent more hair loss. Other people, like yourself, see some excellent improvement on meds and a slight reversal of the finer hairs.
For many of my hair restoration patients, I ask how conservative they want to be. If they want to wait and see what the meds do first and then after a year, go ahead with the surgery, that is perfectly acceptable. For others, they don’t want to wait that long as the hair transplant can take up to a year to come in. It really depends on how quickly they want to see changes.

For you though, you have a tougher decision. It appears that you are actively seeing improvement. You might want to wait the full 9 -12 months prior to undergoing a procedure. That way the hair transplant surgeon can you can see where you would most benefit from adding more hair (It might be different from where you were before meds). Also, it helps the surgeon avoid damaging hair follicles during the transplanting process that may not yet be visible.

This question, from a member of our hair loss social community and discussion forums, was answered by a staff physician from Coalition hair transplant clinic Feller Medical:

First of all, I had a hair transplant of 5130 grafts in Germany exactly 14 days ago. All scabs and crusts were gone by day 8 and 9.

Now I’ve ordered Revita Shampoo and conditioner and I would like to know if I’m allowed to use such hair loss shampoos and conditioners 2 weeks post-operative. The lotion and shampoo the clinic has given to me is almost empty. I’m not going to use any cheap crap shampoos again and I’m a bit afraid and confused about what I’m going to use due all of these shampoos and conditioners available on the market.

RevitaYou should be able to use pretty much any kind of shampoo you like 2 weeks after the procedure. However, check with your hair restoration clinic before using anything. They may have some post-operative restrictions, and you always want to follow the post-surgical instructions as closely as possible.

Keep in mind that Revita does have a small amount of ketoconazole in it, and this has been associated with some initial sheds when starting to use the product. This means that you may see 3-4 months of increased shedding or hair loss before it starts actually coming back healthier.

This shouldn’t affect the transplant itself at all, but just something to keep in mind. The fact that it has this active ingredient is all the more reason to speak with your clinic before using it as well.

Dr_Josephitas_protraitOnly an elite group of surgeons are considered and approved for the Coalition of Independent Hair Restoration Physicians. Thus, we are pleased to announce that Dr. David Josephitis has been approved for Coalition membership. To learn how we prescreen and recommend hair transplant surgeons, click here. To see our standards for Coalition membership, click here.

Dr. Josephitis, his technique and results were carefully reviewed by our hair restoration forum and social community in consideration for Coalition membership. Patients and physicians alike have given him accolades. To see what our members are saying, visit the “Potential Coalition Membership for Dr. David Josephitis of Bloomington, MN“.

Given the exceptional feedback we received from patients, physicians and forum members and his dedication to providing ultra refined hair transplant surgery (both FUSS and FUE), Dr. Josephitis has been approved for Coalition membership. To view Dr. Josephitis’ Coalition profile, click here.

Thanks to everyone who provided their valuable input regarding Dr. Josephitis’ potential Coalition membership. You are encouraged to congratulate him by clicking on his featured potential inclusion topic above.

For hair loss sufferers considering hair restoration surgery in Minnesota and beyond, we strongly encourage you to consult with and consider Dr. David Josephitis and Shapiro Medical Group for your procedure.

Pat, Bill and Dave – The Hair Restoration Team for the Hair Transplant Network, the Coalition Hair Loss Learning Center, the Hair Loss Q & A Blog and the Hair Restoration Forum and Social Community

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As part of a holistic approach to treating male pattern baldness, proven and FDA-approved hair loss medications such as Propecia (finasteride) and Rogaine Foam (minoxidil) may be employed in conjunction with a hair transplant or used on their own. Combining these two treatments is said to have a synergistic effect that could promote new hair growth; however, most users consider them maintenance drugs that primarily stop or delay the progression of hair loss.

Toppik and Nanogen are topical concealers composed of microfibers (organic keratin protein) that coat your existing hair upon application, making it appear denser instantly as the fibers magnetically bond to each strand. You generally need to have a minimal to moderate amount of hair to work with, though.

There are several additional topical concealers available on the market. These include, but are not limited to, DermMatch, which coats the scalp and expands each hair; Prothik, an aerosol hair thickening system; and Couvre, another lotion-compound that can reduce scalp contrast. Some brands are more durable than others, and each has its own benefits and limitations. Finding the right color and mastering the application process is usually the key to success with most concealers.

The quality of hair replacement systems has also improved dramatically over the last decade. Contemporary hair pieces are often designed with a sophisticated blend of real and synthetic hair fibers, and can be worn for extended periods of time without being removed. While this option isn’t for everyone, hair systems can restore an appearance of full density nearly instantaneously on balding individuals who are prepared to deal with the relatively high cost and regular maintenance.

This question, from a member of our hair loss social community and discussion forums, was answered by a staff physician from Coalition hair transplant clinic Feller Medical:

I have a strange situation – or hopefully it isn’t. I had a follicular unit extraction (FUE) done almost 13 months ago. I didn’t see much progress until after the 6 month mark but then it grew in really thick (this is on the forehead not the crown – that’s another story). But after about the 10th-11th month it’s been getting thinner and thinner – even the guy who cuts my hair has said that it’s thinner than it was. Has anybody experienced this? Is this unusual?

questionThe thinner appearance could be due to a number of things: a seasonal shed, reaction to any new preventive medications (not sure if you started any), or, most likely, continued hair loss of your native hair. This is the most common reason, in my opinion, for hair transplants appearing “thinner” at a later date.

The only caveat here would be if follicular unit grafts were extracted outside the safe donor region during the FUE procedure. However, my guess is that you’re experiencing a reversible and temporary shed or you’ve simply continued to lose some of your native hairs around the transplants.

Feller Medical
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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.

Selecting a quality hair restoration physician is crucial in getting the best hair transplant results. And while we prescreen and recommend quality surgeons who have proven to meet our high standards all over the world, some hair loss sufferers may consider traveling abroad to undergo surgery with their physician of choice.

Forum member “Balding_Male36” is so impressed with recommended hair transplant physician Dr. Pathomvanich that he’s decided to fly to Thailand to have his procedure. Visit and join “Getting Hair Transplant Surgery Abroad” to discuss travel tips for getting your hair replacement procedure done overseas.

Bill Seemiller
Managing Publisher of 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 hair transplant question was answered by recommended hair restoration surgeon Dr. Tejinder Bhatti:

I had a 2000 graft follicular unit strip surgery (FUSS) done in Australia. My hair transplant surgeon advised that after 2 weeks I actively scrub off the remaining hair instead of letting it fall off, to avoid foreign body reaction/folliculitis. So I gently tugged on them day 14 post op and they all slid off easily without any resistance or bleeding.

Now I am a little paranoid whether I did the right thing, as even though most hair restoration websites and research articles suggest day 9 and day 10 to be the day when you can pull or scrub without actually dislodging the follicle or papilla, there are so few research articles about it. Also very few have advised to actively scrub away any remaining hair after 2 weeks instead of letting it fall off.

Dr-Bhatti-photoQuite often between 5th & 10th post procedure days, one notices black scabs falling out from the hair. Sometimes this is accompanied by a small planted hair adherent to the scab. You will naturally worry and feel the planted hair has come out and have lost one root. In reality one can compare hair roots with ice candy where the stick of candy is hair & ice-cream attached to the stick can be compared with soft tissue of hair root with stem cells attached to hair.

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