a common question from a young guy

drcole

i think this is the most difficult situation in hair restoration surgery. first, we don't know the future and we cannot ever predict how much hair anyone will loose.

the most important criteria in assessing a patient is to have an undestanding of the donor density and the hair characteristics. is the hair coarse, fine, curly, blonde, black, etc. what is the follicular density and what is the hair density.

now we must look at the degree of loss you have now. if it is advanced and you are under age 26, we can expect much more loss over the remainder of you life. if you are under 26 and the degree of loss is minimal, then you can expect much less hair loss during your life time.

in your case you are 25 and you are a class 3A. you can expect much more loss.

what is you hair shaft diameter. what is your hair density, and what is your follicular density?

frankly, you might be a good candidate for the less is more. i truely think that this might be the best option for many young guys who have hair loss. if your density is the same in the donor area as it is in the recipeint area, you will not see a contrast. if you create a strip scar, you eliminate the option to cut the hair short.

i agree, one of the problems with shaving the head when you have advanced degrees of hair loss is that the top appears completely different from the back and sides. this is contrast.

therefore, adding hair that has more color and diameter to the top gives the illusion of fullness becasue it elimates the contrast. adding hair gradually to the top using fit or fue is the same as gradually removing hair from the back and sides with fit or fue. equal density in the top and donor area can give the illusion of no hair loss when the hair is short. the one thing we cannot predict is the degree of loss you wil have later on. you still run the risk later on that you will not have enough donor area to treat the entire area of hair loss. even if you have an advanced degree of loss that cannot be completely treated with fue or fit, the result will still be much better than if you had a strip. with the strip, you will not be able to shave your head, especially if you have over 5000 grafts done over the course of your hair restoration process.

thanks for this interesting question on our hair loss forum.

forhair

It is always better in your age to wait as much as you can before you will rush into a surgery, and stabilize your hair loss at list one year.
Yet, with FIT it is safer to do a hair transplant then strip if it is done in the right hands.
Dr. Cole answered your question very well, but to really evaluate your
possibilities, you will need to either upload a photo to this thread or come to one of the
Seminars in your area for a consultation. can you also tell us more on your family hair loss history?
If you don't know how to upload a photo please send me to :
webmaster@forhair.com
Thank you.

Michelle

For a photo consult please email your photos to Michelle@forhair.com.
Thanks and I will be looking for the photos. Smile

drcole

you have done a fabulous job of evaluating your family's history of hair loss. this is often quite important since it could predict the course your hair loss will take. sometimes it does not though. i have always felt that it is very important to compare the degree of hair loss you currently have to the degree of hair loss your relatives had at the same age. if your hair loss it much greater than that of your father when he was your age, this implies you are following a different course than you father did. if it is the same degree, it implies you are following the same course of hair loss. check on your grandfather, as well. was his hair loss the same degree when he was your father's age. old photos of the family are often of tremendous value.

if the patterns are all similar, this is a very good indication that hair restoration surgery may be of great value to you. we must always be careful with the younger patient though. a conservative hair line is a very good idea when you are young though i feel very good about the capacity of our FIT procedure to elevate the hair line at an older age if needed. this is a significant advantage of FUE extractions (FIT) over prior technology.

your medication regimen sounds fine. a new product that seems of value is the hair max laser comb. some initial studies suggest it may help retard hair loss though the studies to date are not conclusive in my mind. the other device you have quoted has not been reported to the medical community to the best of my knowledge and may not be of value. if it is not expensive or harmful to your health (or hair), I see no reason for you to discontinue it though.

we will be holding another seminar in London in July- we hope. please stay tunned. we hope to post the date in the latter half of July next week some time. in the interim, thanks for your interest in IHTI and our hair loss forum.

drcole

We are planning a trip to London in July. I cannot state the specific dates at this time. We hope to identify them next week.

Shock loss can affect pre-existing hairs. It only affects the hairs in the grafted area. it does not affect hairs next to the grafted area. If we do not place grafts into an area, you will not experience shock loss in that area.

Shock loss can affect transplanted grafted hairs also. This is uncommon from a hair transplant procedure though. I have seen it happen only a few times.

Hairs that fall out due to shock will regrow. The problem is that they do not grow back as strong as they were before they fell out. This is the natural progression of hair loss. Every hair has only so many cycles of growing, resting, and falling out. Once they hit the critical number of cycles, they do not grow as long (duration), they do not grow the same length (shorter length), and they do not contain as much pigment (less color). These finer, shorter hairs do not cover as much scalp and therefore, produce a thinner look. This is why we try to prevent shock loss. we do not want you to take two steps forward and one backward.

Shock loss of transplanted hairs grow back to their original length and color. they are typically not affected the same way as hairs sensitive to circulating androgens and male pattern baldness.

One way to avoid shock loss is to avoid hair transplantation in an area of pre-existing hair. if the hairs are long, darkly colored, and provide good coverage their may be no reason to transplant hairs into this area. if the hairs are finer, they may not be providing adequate coverage. in the latter instance it may be a good idea to add some transplanted grafts into this area. another way to minimize shock loss is to limit the density of grafts we place into an area. if we try to place 40 to 50 (or more) grafts per square cm, the risk of shock loss will be much greater than if we place a much lighter density of 15 to 20 grafts per sq. cm. another way to minimize the risk is to make certain we make incisions parallel to the direction of hair growth. in this way we do not injure the roots of the preexiting hairs. if we cut across the roots, we may damage them and you may see shock loss.

we hope you can be evaluated in London. A diffusely thin area can be a dangerous place to have grafts transplanted. You can get much worse before you get better. In fact you could take two steps forward and five steps back. it definitely is a situation you want to have evaluated carefully prior to embarking on a hair transplant. sometimes it is better to treat the area with concealers and medications.

drcole

i think it is vey important for you to have a consultation. this is exceedingly important for the younger patient.

we will meet with you when we come to London.

3D animation is a fabulous area of study. it is quite difficult to master. you will always have a use for this and can always find good work. of course we understand the passion for hair loss treatment. we have the bug and a tremendous passion for the subject. certainly it is understandable for a young man to prefer having hair.

drcole

there are two schools of thought when grafting into finer, thinner hair. one is to limit the density to prevent shock loss. the other is to go for a higher density so we can get a better result from the grafts in the near term. the theory behind this second approach is that you are going to loose the hair anyway so don't worry about loosing it. either approach is acceptable. many are very concerned about hair loss and will be very angry if you accelerate their hair loss prematurely. therefore, it is important for patients to fully understand the risks and benefits of many approaches. then we can allow them to make the decision with us rather than us making the decision for them and getting a dissappointing complication of surgery - acceleration of hair loss. we see disappointed patients who expereinced this acceleration all the time. it typically results from a physician who attemtps to do more grafts than he should in an effort to do a larger procedure that results in a larger pay day. the patient generally is not told that this action may result in an accelerated hair loss pattern.

Michelle

Dan... we have the photos and you should be hearing something from us within 1-2 weeks. Thanks for getting me the information I needed so quickly. Smile