29 Yr old male

[rlucas]

Rather than posting a new thread, I assumed posting in this one would be more appropriate since I had posted pictures, even though it has been about a year. I still do not take propecia and only use rogaine. Propecia had previously given me sexual side effects and I had read some troubling things about it in the past couple of years, which I realize is a concern if I would want to get the surgery.

Over this past summer I went for a consultation (prefer not to say the name of the doctor) and discussed my options. He was a very nice, easy to talk to and very receptive and understanding about my hesitations regarding the procedure.

He stated that he would work on my front and do about 1500 grafts on both temples and fill in the thinness in the middle. He said he would not do anything with the crown, which I can't say I was too pleased about. He seemed as if he was saying there wouldn't be enough transplant hair.

My main concern, and why I am posting, is he seemed to be pushing me toward the strip rather than the FUE, which were both the same price per graft. He claimed that the FUE actually created more scarring compared to the strip. I was curious as to whether others here feel the same given their experience and in depth knowledge of the two?

I am going to get another consultation with a different surgeon in NYC and discuss this and other questions with him, but I would appreciate an impartial view and maybe some suggestions as to what other questions I could ask at the upcoming consultation.

Thank you in advance, it is greatly appreciated.

[Tracy C]

He stated that he would work on my front and do about 1500 grafts on both temples and fill in the thinness in the middle. He said he would not do anything with the crown, which I can't say I was too pleased about. He seemed as if he was saying there wouldn't be enough transplant hair.

It is reasonable to assume that the doctor is a little more reluctant to work on the crown area because you are not willing to take Propecia (1mg Finasteride) to stabilize the area. If a doctor would work on the crown of a patient who will not take Propecia, that patient can possibly find themselves with an island of hair surrounded by a ring of no hair as the crown continues to thin - and the crown will very likely continue to thin.

The crown and mid anterior are the two areas most likely to respond and stabilize with medications. This takes a long time - a very long time. These areas are not likely to stabilize if you are unwilling to take the medication needed to stabilize them.

I cannot relate to concerns about possible negative side effects of Propecia because they do not apply to me. But I do wonder if these negative side effects are actually as bad or as frequent as you have read. My hair restoration doctor has been using Propecia for over ten years. He says he has not experienced any negative side effects. I know a few other men who are taking Propecia, they tell me they have not experienced negative side effects either.

My main concern, and why I am posting, is he seemed to be pushing me toward the strip rather than the FUE, which were both the same price per graft. He claimed that the FUE actually created more scarring compared to the strip. I was curious as to whether others here feel the same given their experience and in depth knowledge of the two?

I do not have in depth knowledge of both. I have read that FUE can create more scarring - though they are tiny dots instead of a line. I have also read that doctors can achieve a better cosmetic result in lesser time with the strip method, then save FUE for future procedures as needed to avoid tightening your scalp. This seems like a reasonable plan to me.

BTW, from your pictures you don't look so bad. I know some women who have it much worse.

[rlucas]

So I recently went for a second consultation with a different, and also very reputable surgeon, and he sent me a notice of our consultation indicating the following:


Pattern of Loss
Classification:
Present: . . . . . . . . . . . . . Norwood Class 3
Character:
Hair Thickness. . . . . . . . Fine

"I suggest restoring your frontal hairline and adding coverage to the front and top of your scalp. I recommend transplanting approximately 2,500 follicular unit grafts. We will reassess the need for additional grafts after we have seen the results of the first session. It generally takes about one year to see full growth from the procedure."

He was, more or less, there addressing my concerns and, as discussed in this thread, my hesitation to do go back on propecia. He stated that, while propecia is recommended, it is not a prerequisite for surgery and that a successful surgery can still be had. Being that it has been 2 yrs since I have started this thread, I don't believe I have lost too much in that span, but he did indicate that I obviously will down the road. I am happy to post more pics if anyone is that interested.

I am fairly certain I will see him again and schedule the surgery, but would like to know what the typical time frame for the post surgery redness, scabbing, etc? I, like I'm sure many here have dealt with, would like to take some time off work to avoid any indication that I have had surgery, which I realize is difficult, but I just wanted some insight as to what the time frame is/was for individuals who have had a similar number of grafts.

Again, any feedback is greatly appreciated.

[mattj]

The scabbing should be gone in around two weeks. Two weeks is when it's safe to actively remove any scabbing which hasn't already fallen off by itself. (This is according to Dr Rahal's post-op instructions; other doctors are often less cautious and allow the washing away of scabs sooner).

Redness (fading to pinkness) can linger around for longer - maybe months. The worst of it should have faded within a few weeks to a month.

How large is the area to be covered by those 2500 grafts? I ask this because the smaller the area the easier it can be to hide it by brushing hair forward over the recipient area. This is assuming that you are having frontal work done and have enough native hair behind this area to style forward, which I realise might not be the case.

[ryan555]

Go see Dr. Feller in Great Neck. He's one of the best in the world and definitely the best in the NYC area. Bernstein is very good too but I think he is too conservative. All of his work looks too thin for my taste.

[rlucas]

Go see Dr. Feller in Great Neck. He's one of the best in the world and definitely the best in the NYC area. Bernstein is very good too but I think he is too conservative. All of his work looks too thin for my taste.

Those are the two I've seen and it was Dr. Feller who seemed to be more conservative, in that he didn't want to go back to the crown of my head, whereas that was what Dr. Bernstein suggested when I saw him.

I assume if I meet with Dr. Feller again and tell him what Dr. Bernstein suggested, I'm sure he would say the same.

I read much more about Dr. Feller on this forum, but I saw two people in person at Dr. Bernstein's office, who were in for follow ups, and they both looked good. Though I hadn't seen them prior to their respective surgeries.