I have never had a ht, but Ive been researching them off and on for the past seven years now. I just recently found this forum and have found it to be the most infromational and trustworthy source of knowledge. After researching this forum and chatting with many posters, Im considering going to H&W for a consultation. Yet, I still have a couple points of concern which it seems there are no hard definite answers for; but I would still apreciate your thoughts on. First off, Im 28. My hair loss has been slow and steady begining with a mild "widows peak" when I was about 21. Slowly, but surely the widows peak has extended back in a typical 'v' shape (with hair still in the front middle and thinning on top). Sorry, no pic. I have two worries, the first typical and the second EXTREME:

1. Extent of Future Loss: now I know this is completelly unpredictable and I, in NO way, am looking to have the hairline of an 18 year old. That being said, what if I go through with a ht, and by the time Im 50 I end up becoming a NW7. No one knows if this will or will not happen, but if it does I could end up with a moat of skin wrapping around my head between the top (transplanted hair) and bottom sides; or I might even lose some of the transplanted hair as well.
2. EXTREME WORRY: I recently read a postin on this forum, that stated (although very rare) sometimes ht dont take. That is to say that the transplanted hair NEVER grows in. Has anyone heard of a coalition doctor recommended on this forum EVER having a patient whose ht didn't take? To me, this sounds nuts, but I had to ask as I just read about it on the forum yesterday. Thanks in advance for any thoughts and suggestions. One more thing: no I havent tried any meds yet, but Im considering Rogaine (although seriously doubt it will work) and will probably get on Propecia if I have a ht.

*ONE MORE THOUGHT: does anyone (who is NOT a citizen in Canada) feel somewhat apprehensive about having surgery done in a foreign country? Not that Im looking to sue anyone, but wouldn't you be leaving all of your rights back in your home country?

Damn!
I just dug up my very first post on this forum and realized none of you greedy Ba$tards ever even responded to me!!!
And here I have belabored endlessly on the Balding Blog to help you greedy follicle grubbing Ba$tards! GRRRRRRRrrrrrrrrrrrrrr....

Just kidding, actually I looked this up cuz I decided to look up Pat's *very* FIRST postings to see the history of dA Balding Blog!!!

Wow, have you changes..

Cocky and fell from a N3 to a N5



So cool to see your first post and the WEALTH of info you have obtained here.

Look at your post count as well 1254 at present and only registered 6 months ago.you`re a true hair geek.lol

Hello not going to go bald, I will be happy to touch on these points…in retrospect.


You absolutely need to think ahead about the " what ifs ". First off , the patients that show the great probability to go bald and become a type 6-7 are the ones that start showing signs of thinning early in their lives. The tendency is the younger one starts thinning, the faster their (the) progression and the more extensive their (the) hair loss. Even though an experienced physician can take various things into consideration to predict to some degree how it will progress, we ultimately don’t know…they don’t have a crystal ball to see the future. So, because we are dealing with a limited source and because the hairline that is created will be there forever , it is best to establish the hairline in a manner that is appropriate if the patient does progress to worst- case scenario. Unfortunately, the young patient wants a low, broad, thick hairline, (we understand this and there is nothing more we want to do then satisfy them, unless it could back them into a corner in 10-20years that is difficult to back out of), he wants what he had, he want what his peers have….this all make sense. However, these are ultimately the patients that one should not start aggressive on….in that they have the greatest potential to progress to more extensive hair loss. And, since we do not know (don’t have a crystal ball) and because we are working with a limited source (don’t lose sight of this), moving field (hopefully the products will stop it- but we don’t know, we can hope) and the work needs to look natural now and down the road, it is best to establish the hairline in an appropriate area ... in following the patient, if in time there is indication he is going to” buck the system“ and not progress and go bald (type6-7), we can step in and be more aggressive anteriorly and shift things down, broader, and stronger. We can always lower hairlines but we can not easily raise them.

Hairlines always need to be in sync with the density and coverage behind them. If one establishes a lower, broader, strong hairline on a young patient that has all the potential to progress and go bald and this patient does not " buck the system " and can never establish enough density and coverage behind it, it will look quit peculiar. Generally the only males in nature that have these characteristics of their hairline are adolescent boys and men that maintain a full head of hair their entire lives. This we can not predict with young guys that are thinning. Technically young guys are generally the last patient you want to be anteriorly or posteriorly aggressive on , in that they have the greatest potential to progress to a type 6-7; they would not be thinning at this stage if they were not. I am not saying we need to be ultra ultra conservative, however, add these factors into your planning, establish a natural more then appropriate hairline, get on top of your problem and if in time something indicates you either don’t have a genetic predisposition to progress or the meds are preventing this you can then get more aggressive.



In regard to graft survival, there is no X- factor that affects survival; it is an H- factor. What this means is , if a doctor says everything was perfect and it was a text book procedure…sometimes with no explanation a percentage of grafts just do not grow and no one knows why. Many would say this it not correct…there is no X- factor. It is a n H- factor , a human factor . If something just does not grow it is that something went awry during the procedure, possibly in the dissection, mis handling of grafts, or the incubation of the grafts outside the body. Sometimes inside factors such as cigarette smoking, possibly extreme dense packing, multiple sessions, or scarred tissue can hinder growth , but not prevent it completely. Dr Shapiro has lectured extensively on yield, how to minimize waste and maximize survival.



Hope this helps

Matt Zuapn, Dr Shapior Patient Educator.

Educator,

thanks that was a very elaborate and informative post. I have heard both that cigarette smoking can play a role in hindering yield *AND* that it is really a moot point. If Shapiro feels that it can play a role in hindering yield, then how long does an individual who smokes (uGhuM) need to quit prior to surgery for the internal state to become status qoue, and have blood flow and circulation equivelent to that of a non-smoker?...I previously wondered about this but never got an answer about it...

Regarding the 'H' factor: this is very interesting and it was something Dr. Feller recently discussed on another thread. Dr. Shapiro has also experienced this w/some of his patients? Just how *rare* is it that an individual has, to put it in Feller's terms, "quirky genes," which result in hindered growth?

Smoking- no one really knows how long one needs to stop prior to surgery or when it is ok to start again after the procedure...and how much is too much, if one can not quit all together cut back dramatically around the surgery. After surgery is more of a concern, smoking cuts down the oxygenation in the blood and constricts blood vessel potentially influencing graft survival and proper healing.

H-factor, was not to imply faulty genetic on behalf of the patient…. it is usually a weak link within the surgery, on behalf of the staff or outside factors already mentioned. If very thing is done right, generally everything should "grow".

The 'x' &'h' factors:
So shapiro believes, if any poor yield or growth occurs, it is always attributed to either a human error or those other variables you stated above? The 'x' factor: Feller stated recently that he has had patients, although *extremely* rare, which a few years after the transplant experience some *thinning* of the transplanted hair; which he attributes to 'quirky genes'. Has Shapiro ever experienced this?

Smoking: well, it would be in my best interest to quit altogether, but I would assume a doctor could give me a more decisive answer on a time-line as to when the cadrio-vascular aspects return to/or close to that of a non-smoker...

NG,

8 hours after the blood oxygen returns to normal.

Quitting Smoking Timeline

.

Rambler,
thanks man! That is a fantastic link!

I thought you quick in January NG2GB? I remember reading about Chantix being the best thing since puff wheat and how easy it made quitting. Those little bastards are hard to get rid of I guess.

I like Ramblers icon. Looks like Linus had an HT with a whopping 40-50 grafts over his entire head. Should create some nice density

Flyby---(sighs) yep, I fu$ked up royaly!
I went out for drinks and thought--
"eh, I can have a couple ciggarettes over drinks, no?
Perhaps a *victory* smoke! Yes! Yes, that's it! A victory smoke! Maybe I can *even* be one of those mysterious 'social-smokers', who somehow have the ability to pick-up and put-down smokes on a whim"...

Then, back to base one...
I didn't notice that Rambler! That is cool, how did you add that?

quote:

I like Ramblers icon. Looks like Linus had an HT with a whopping 40-50 grafts over his entire head. Should create some nice density

quote:

I didn't notice that Rambler! That is cool, how did you add that?

Photoshop! Soon he will be sporting his newly sprouted stubbles

.

HAHAHAH!!! What an ingenious idea!
That is cool! Your avatar will directly reflect your noggin's growth...if anyone asks how your growth is coming, simply retort "check Linus!"

Rambler,

That is hilarious my friend! I love your avatar.

Although I have to admit, it seems like the physician made his incisions too large, the grafts are spaced too far apart, and the hairline looks a bit unnatural :P

It's obvious he didn't go to one of our doctors .

Falc

quote:

It's obvious he didn't go to one of our doctors

Dr. Charles Brown isn't in the Coalition? ... uh oh..

.