HI ! Being a person who had hairtransplants starting in the early 70′s(Old Punch style) How effective would be the new
FUE procedure filling in the spaces along side the old, with limited donor
area?

There are a few different options when it comes to plug repair: you can have them removed entirely, you can break them down and redistribute the smaller follicular units for a more natural look, or you can have additional hair transplanted around them to conceal the “pluggy” appearance.

Unfortunately, a depleted donor supply will limit your options somewhat, as it could require a significant number of grafts to sufficiently conceal the
existing plugs. Similarly, if your prior procedure(s) created a very low hairline, a FUE surgeon might be reluctant to place additional grafts below
the existing plugs, as it will be very difficult to achieve natural-looking results this way.

To determine the best option for you personally, I would suggest that you schedule an in-person consult or submit detailed photos, of both your donor
and recipient regions, for an experienced FUE surgeon to review. This way, the physician can evaluate the extent of work needed, the donor supply
available, and your expectations, to help you determine the best way to proceed.

It is always exciting to read about advancements in the hair restoration industry.  The field has come a very long way since the days of plugs and scalp reductions.  It is the belief of the editors on this blog that we are on the verge of a new revolution in hair transplantation: one that will mark an official departure from the prominence of strip surgery.

Strip surgery has remained popular, while FUE is only now being more widely adopted, for a number of reasons.  For one thing, physicians who have mastered a particular method (strip) tend to be change adverse when it comes to learning a new, more challenging technique.  Physicians who have not received proper training, or put in sufficient time learning the technique, can find FUE, and the skill required, frustrating.  Many physicians have therefore been quick to dismiss the technique as being unsuccessful or limiting despite their own inadequate knowledge of it.  Strip surgery has also traditionally been a faster procedure, as the physician only needs to excise the strip of tissue and can then pass the dissection work to a team of surgical technicians.  FUE is a more labor-intensive process for the actual physician, who must do all of the extractions himself.  Finally, some patients continue to turn to strip, despite the linear scar it leaves, because the procedure is less expensive than FUE.

Dr. Cole, however, is preparing to release a new motorized extraction instrument for FUE which will make the safe extraction of follicular units faster than ever before.  This instrument also allows physicians to use smaller punches to safely and effectively remove grafts.  With this device, Dr. Cole can successfully remove over 2000 grafts an hour (minus donor site preparation time).  One must understand that strip surgery requires the precise extraction of a portion of scalp tissue, the careful suturing of the wound, and 3 to 5 man hours for every 1000 grafts that are cut by technicians.  Dr. Cole’s new instrument substantially undercuts the time it takes to harvest an equal number of grafts using strip methodology.  We anticipate that the ability to perform top quality FUE procedures in far less time will translate to the ability to lower prices and take on more patients- allowing more hair loss sufferers than ever to achieve their hair restoration goals.  The era of the strip scar in hair transplantation may very well be on its way out!

Click on the “play now” to watch Dr. Cole using the new CIT Power tool on patient’s beard hair and scalp

There is an abundance of hair transplant ‘before and after’ photos at the fingertips of anyone interested enough to perform a search online.  However, educated consumers need to understand that certain clinics and physicians will deliberately publish misleading photos that do not accurately depict the true quality of their transplant outcomes.

When basing a hair restoration surgery decision on a physician’s photos, make sure the images are large, clear and very detailed.  Doctors who are proud of their work will have nothing to hide and no qualms about posting high-quality images, showing details such as the patient’s hairline.  Excellent hairline work should have a gradual “feathering” effect and a natural look.  Look for consistent lighting in before and after photos; overexposure of the results photos can be misleading.  There should also be consistency in hair styling (whether hair is wet, dry, gelled, styled, etc.) and the angles from which the patient is photographed.

Some doctors’ websites provide only small, dimly lit images, in an effort to disguise details that may detract from the results they wish to convey.  Some photos may even be deliberately out-of-focus or blurred.  Doctors who are trying to disguise the lackluster quality of their work will avoid showing detailed hairlines in their patient galleries, or will style the patient’s hair so as to conceal the hairline.  Some doctors will even digitally alter images, using software such as Photoshop, to blur hairlines.  One way to detect whether the images have been altered is to look carefully for detail; watch out for ‘blobs’ (where an editor may have tried to smooth the hairline appearance) and a lack of individual discernable hairs.  Beware of doctors who hide behind poor quality images in hopes that prospective patients will not notice the lack of clarity or detail in their results images.  A top quality physician will have nothing to hide.

I am now 29 and have been using propecia for around 6 years and my hair sitution has now got worse.
I was wondering With your expertise and vast knowledge if you would recommend me trying avodart to help my situation alongside propecia or take it by itself?

The studies that have been performed show that Avodart does work better than Propecia. The only problem is that we don’t know the long term consequences of taking it. You are blocking both forms of 5 alpha reductase. We don’t know if this will produce problems later on such as depression.

The other problem is we don’t know the proper dose because it has not been studied. People take it once a day or as little as once a week because it has a long half life. There are many patients on it because it works better than Propecia, but I’ve heard a few say that the Propecia worked better than the Avodart.

Shedding probably means it is working for you because hair shedding occurs when resting hairs return to the growing phase and push the old resting hair out. This means that the drug is stimulating growth or Anagen. Of course it could take up to one year before you see a noticable improvement. I think it will always work best when you have some existing hair. If your hair line is bald, don’t expect much benefit. If the hair line still has hair, then the Avodart could stimulate new growth. The main thing all these products do is prolong the life of hair. It is actually rare to see a significant improvement in coverage, but when it occurs, it can be amazing.

My dermatologist just recommended me to take accutane for my acne. I’ve been doing some research and I read somewhere that one should be off of accutane for atleast 6 months before having a cosmetic surgery, because of scarring reasons

No one really knows for sure. Accutane is supposed to affect the sebaceous glands and as such it had an affect on skin resurfacing. It has not been studied in hair transplant surgery, but the general rule of thumb is that you should be off Accutane for 6 months prior to a hair transplant. I’ve done a strip on a patient who did not tell me he was taking Accutane until after his surgery. He healed just fine. Patients on Accutane probably respond well to FUE. Going with the general rule though, you should wait 6 months after stopping Accutane prior to having a hair transplant.

There are also a few reports of hair loss on Accutane.

You can probably have a hair transplant and safely start Accutane a month later, but this has not been studied either.

.