What The f*** Happened To Me. I Need Some Advice.

[seanvandamme]

The diet thing makes me wonder if you depleted something like magnesium or zink

No sh*t bruh.

Here's a sample or my daily diet back when I was cutting:

Lunch: 400g chicken breast (pan fried)
Broccoli
Dinner: 300g flank steak (pan fried)
500g baked potato wedges

No breakfast because I was doing intermittent fasting.

Last I checked, lacking zinc and magnesium doesn't cause your hairline to recede lolol.

 

[JeanLucBB]

Yeah, after looking at Dr Nakatsui's site, it does seem kind of fishy to me. The fact that it was conducted on 1 person only makes it seem less credible too, though I won't dismiss these sort of cases as impossible. So would you agree that dense packing of up to 70% (70 /cm^2 out of 100/cm^2 original density) is a pretty reasonable amount to shoot for in a small area like the frontal zone?

Eh, are there any Hasson+Wong reps around here who can verify the claim? My impression of H+W is that they are a credible clinic with consistent results. Doctoring numbers aren't something I think they would do. And you could tell that wasn't 90/cm^2 just by eyeballing? Impressive.

What was the degree of your hair loss prior to hair transplant and how many grafts did you got? Seems like you have a hairline you could be rather happy about now.

I'll sit on the medications first. Though I'll definitely keep your recommendation in mind.

Was a NW3 with minor vertex that took 3000 grafts to around a Norwood 1.5, but I'm getting a second procedure for further density particularly towards the back of the frontal third, to close off the temple areas and fill in the crown with a small amount of grafts.

It depends also on hair texture and thickness, but on average 50-55/cm^2 with a high yield in the hairline will look natural and dense enough to convince the world that you don't have hairloss or thinning in that area. Specifically I say it isn't 90/cm^2 firstly because it isn't possible, without clearer before and afters with the hair combed through in those areas I don't know exactly what I'm looking at or where the grafts went but I'm sure it isn't at that level of density. Maximum at around 50 and it looks from the area and density to be less than that. The point on texture, thickness and even colour is another reason why its essentially a moot point. Doctors make up bullshit numbers for ego reasons with everyone wanting to be the highest, and beyond that there are so many more relevant variables to think about.

Simply put, you will be able to achieve a natural looking, youthful and dense hairline that blends with your native hair behind it with a competent doctor. Forget the numbers game though, it ultimately isn't helpful and is too easily manipulated. I agree H+W is a credible clinic and among the most successful in both consistently providing top-standard results for well over a decade and their contributions to the field in general, but the number there is either an ego driven lie or a mistake.

 

[Vanitykills]

When it comes to hair loss, never be in denial or delude yourself.

My old man has a full head of hair, his dad was virtually bald. My mum's dad was cueball, his dad was Norwood 1 in his 80s, go figure. It can go back many generations on either side.

I'm doing well, since I got on Propecia in 2012. I was diffuse, I was losing the lot I reckon. I've virtually, fully recovered everything.

 

[seanvandamme]

Was a NW3 with minor vertex that took 3000 grafts to around a Norwood 1.5, but I'm getting a second procedure for further density particularly towards the back of the frontal third, to close off the temple areas and fill in the crown with a small amount of grafts.

It depends also on hair texture and thickness, but on average 50-55/cm^2 with a high yield in the hairline will look natural and dense enough to convince the world that you don't have hairloss or thinning in that area. Specifically I say it isn't 90/cm^2 firstly because it isn't possible, without clearer before and afters with the hair combed through in those areas I don't know exactly what I'm looking at or where the grafts went but I'm sure it isn't at that level of density. Maximum at around 50 and it looks from the area and density to be less than that. The point on texture, thickness and even colour is another reason why its essentially a moot point. Doctors make up bullshit numbers for ego reasons with everyone wanting to be the highest, and beyond that there are so many more relevant variables to think about.

Simply put, you will be able to achieve a natural looking, youthful and dense hairline that blends with your native hair behind it with a competent doctor. Forget the numbers game though, it ultimately isn't helpful and is too easily manipulated. I agree H+W is a credible clinic and among the most successful in both consistently providing top-standard results for well over a decade and their contributions to the field in general, but the number there is either an ego driven lie or a mistake.

Interesting. So you are going for a touch-up or a correction? Did the first procedure meet your expectations?

Oh yeah, isn't temple hair less dense than hair from the rest of our scalp usually? Could be 90/cm^2 on the rest of scalp and a little less dense (60-70/cm^2) on frontals.

I feel like visiting a doctor who does ultra high density is a deal with the devil. All the glory for 10-15 years, and if you can't outsmart the devil, you get left with a retardedly front-heavy look.

Though, It's a risk I'd be willing to take lol!

 

[seanvandamme]

When it comes to hair loss, never be in denial or delude yourself.

My old man has a full head of hair, his dad was virtually bald. My mum's dad was cueball, his dad was Norwood 1 in his 80s, go figure. It can go back many generations on either side.

I'm doing well, since I got on Propecia in 2012. I was diffuse, I was losing the lot I reckon. I've virtually, fully recovered everything.

Thanks for the advice. It's definitely scary to hear of such cases. I am definitely leaning towards a hair transplant now to restore my hairline. I risk playing catch-up in future, but I'd rather spend the rest of my youth looking youthful than stay my hand because of some complication that might or might not happen.

 

[JeanLucBB]

Interesting. So you are going for a touch-up or a correction? Did the first procedure meet your expectations?

Oh yeah, isn't temple hair less dense than hair from the rest of our scalp usually? Could be 90/cm^2 on the rest of scalp and a little less dense (60-70/cm^2) on frontals.

I feel like visiting a doctor who does ultra high density is a deal with the devil. All the glory for 10-15 years, and if you can't outsmart the devil, you get left with a retardedly front-heavy look.

Though, It's a risk I'd be willing to take lol!

Yes you will never achieve perfection in a single procedure. I didn’t touch he crown on the first run, it wouldn’t have been appropriate in regards to risk to have the hairline where I want it in a first run through and some small spots which didn’t have enough grafts behind the hairline going into the mid scalp.

Most surgeons whatever they tell you don’t go past 55. That’s the honest truth. The frontal area is more dense in a natural hairline but specifically the temple channels have a lower density.

Seriously though, forget the numbers. Keser, hasson and rahal are the three I would think most of in regards to extreme dense packing, however the latter 2 have competence mainly in FUT, not FUE and keser only does 500 grafts per day.

Look up my case, it’s erdogan 3070 on google. Most areas around 30 cm while the front area of the hairline at about 55z

 

[seanvandamme]

Why didn't you opt for 2 consecutive sessions though, or were mega sessions not the trend back then?

We are talking about 55 out of an assumed density of 100 FU's right? I understand that's a number dense enough for good coverage and yield. Are there any doctors who transplant above that safe limit and get consistently good yields?

Yeah I keep seeing Rahal and Hasson around. Hasson seems to be a better choice for my wishes though.

 

[JeanLucBB]

Why didn't you opt for 2 consecutive sessions though, or were mega sessions not the trend back then?

We are talking about 55 out of an assumed density of 100 FU's right? I understand that's a number dense enough for good coverage and yield. Are there any doctors who transplant above that safe limit and get consistently good yields?

Yeah I keep seeing Rahal and Hasson around. Hasson seems to be a better choice for my wishes though.

I meant in regards to grafts per square cm.

It was a 3000 graft session, the next will be a 2500. I’m 23 and no responsible doctor would give me the low hairline I’m after or blow 5500 grafts in a first procedure. You can’t do them consecutively because again they don’t know how the first yield will turn out, they aren’t going to risk a very aggressive approach on a first procedure blowing your donor completely for the future in case it doesn’t turn out well.

 

[JeanLucBB]

Why didn't you opt for 2 consecutive sessions though, or were mega sessions not the trend back then?

We are talking about 55 out of an assumed density of 100 FU's right? I understand that's a number dense enough for good coverage and yield. Are there any doctors who transplant above that safe limit and get consistently good yields?

Yeah I keep seeing Rahal and Hasson around. Hasson seems to be a better choice for my wishes though.

Also forget the grafts per square centimeter issue completely, its the least relevant factor to think about.

 

[seanvandamme]

I meant in regards to grafts per square cm.

It was a 3000 graft session, the next will be a 2500. I’m 23 and no responsible doctor would give me the low hairline I’m after or blow 5500 grafts in a first procedure. You can’t do them consecutively because again they don’t know how the first yield will turn out, they aren’t going to risk a very aggressive approach on a first procedure blowing your donor completely for the future in case it doesn’t turn out well.

Woah, we're the same age. How old were you when you got your transplant done? Which doctor did you go to too? I'd assumed you did not go for an aggressive hairline because your doctor would be concerned about future hair loss.

Also, based on my picture on my first post, how many grafts do you reckon I'd need? The typical numbers I see for Norwood 2A's are 1500-2000. I see a few 2500's and 3000s too.

 

[seanvandamme]

Also forget the grafts per square centimeter issue completely, its the least relevant factor to think about.

You'd go so far as to disregard it completely? I think they have their place in helping potential patients understand the outcome of their transplant. A transplant at 20% of original density would look still look pretty bald for a person with any sort of hair calibre. 50% is the standard but ideally people want to push for as close to native as possible.

Someone hoping for 60-70% of original density probably wants to feel more at ease when their hair is exposed to different conditions (light, wetness, wind). I don't know about you, but I feel these numbers are helpful as long as one doesn't make chasing the highest densities his priority.

 

[seanvandamme]

@Giiizmo
Giiizmo, I've found something that hits the mark for my case. It's a very recent study with evidence that's backed by a scientist who won the Nobel Prize for Medicine. It explains the mechanics behind non-androgenetic factors for hair loss and thinning, focusing mainly on diet and nutritional deficiencies. You seem to like science and research a lot, so here you go.

Could you kindly summarize what you've read for me too? I've read through the article but think a more discerning mind like you will capture its contents better.

EDIT: https://www.omicsonline.org/open-ac...-for-wellness-2155-9600-1000615.php?aid=91441
Another link by the same author. It goes into some nutritional strategies to not only minimize hair loss but also nutrient uptake for people from all walks of life. This is exciting!

 

[JeanLucBB]

Woah, we're the same age. How old were you when you got your transplant done? Which doctor did you go to too? I'd assumed you did not go for an aggressive hairline because your doctor would be concerned about future hair loss.

Also, based on my picture on my first post, how many grafts do you reckon I'd need? The typical numbers I see for Norwood 2A's are 1500-2000. I see a few 2500's and 3000s too.

Was 22, with erdogan. Hard to tell but I think you need around least 2500. If you have diffusing, crown loss and nw3 like I had a doctor won’t go ultra aggressive not necessarily because of future loss, but if they blow 70% of the donor on an ultra aggressive hairline and you’re the 2-3% out of 100 with terrible growth you’re completely fucked at that point. So they will likely advise against it and suggest you do it in a second run through 12 months after the first procedure if you want to.

Your case isn’t as bad as mine I think and you don’t appear to have crown or diffusing issues, but they won’t be prepared to go aggressive unless you’re on finasteride.

The point on the density measurements is that almost no doctors do a strict measurement of this and clearly some doctors overstate things, so for you as a patient you’re comparing against numbers which aren’t consistent or accurate. Also the fact that everyone’s hair texture and thickness is different makes the measurement worthless. A doctor with experience and consistency along with your hair type will know what they’re doing, factor the measurements out of your mind. It over complicates without telling you anything.100% they aren’t worth it because someone in your position that hasn’t done a huge amount of research will believe BS like that that hasson case was 90 fu per
cm^2 when it blatantly wasnt, so you’d be choosing based on false information without knowing it.

What you see is more important than what they tell you, do research beyond what ego driven doctors spoon feed you. Look for yourself at their results and decide. Unless you’re like me and are obsessive with researching transplants you don’t have the knowledge to accurately judge or interpret the raw numbers, but you will have a reasonable sense of what results you find acceptable visibly and which doctors produce them if you look for yourself.

I think you’re better off opting for FUE in which case you should look at keser and erdogan in Turkey, but if you’re fine with FUT then look at hasson, rahal and konior in particular.

 

[Giiizmo]

@Giiizmo
Giiizmo, I've found something that hits the mark for my case. It's a very recent study with evidence that's backed by a scientist who won the Nobel Prize for Medicine. It explains the mechanics behind non-androgenetic factors for hair loss and thinning, focusing mainly on diet and nutritional deficiencies. You seem to like science and research a lot, so here you go.

Could you kindly summarize what you've read for me too? I've read through the article but think a more discerning mind like you will capture its contents better.

EDIT: https://www.omicsonline.org/open-ac...-for-wellness-2155-9600-1000615.php?aid=91441
Another link by the same author. It goes into some nutritional strategies to not only minimize hair loss but also nutrient uptake for people from all walks of life. This is exciting!

Thanks for the link. Here's a brief review of its content.

First of, it's a review of a selected sample of scientific literature - a small meta-analysis. Whether the sources he cites are credible or not is another matter. What's evident is that it is definitely not a scientific study in the proper sense of the word, meaning that he didn't conduct an experiment on a sufficient sample size. He simply came up with a hypothesis and tried to find other studies that helped support his claims. Meta-analyses are sound scientific tools but usually not when it comes to "proving" anything related to a controversial topic, such as the effect of nutrition on male pattern baldness.

Now as for the conclusion of his review, while it is true that nutritional deficiencies have an impact on hair loss, possibly accelerating Androgenetic Alopecia - or, let's entertain the notion here, trigger it -, the solution he suggests is suspect at best.

Consider the following quote:

People today satisfy their hunger with selection of wrong foods
leaving an un-quenched nutritional deficit which research workers
have termed as the ‘hidden hunger’ [70]. Foods with good nutritional
value are affordable only to high income groups. These are termed
as income elastic protective foods [71-74]. Malnutrition is so
common in adult and adolescent population around the world that
an Adult Micronutrient Quality Index (AMQI) has been developed
to study malnutrition in adults [75,76].

Yes, the quality of our food is different, or maybe even not as healthy as the food available a hundred years ago. However, unless a subject suffers from a mental illness (anorexia, bulimia, etc.), no one in the developed world suffers from malnutrition, at least not in the accepted sense of the word. Maybe in India the poor cannot afford proper food but plenty of people can in Europe and in the US.

Here's the thing. Both studies from other scientists and anecdotal reports from hair loss sufferers have tried to affect Androgenetic Alopecia through diet. Several angles of approach have been used - vitamin C, D, selenium, zinc, you name it. None have shown any tangible amount of success in modulating androgenetic alopecia. The conclusion would be, either it doesn't do anything or it's just not enough to stop Androgenetic Alopecia, let alone slow it down.

In conclusion, don't chase windmills by going down the "natural" path to try and treat hair loss. Having a healthy lifestyle probably helps with hair loss but proper exercise and nutrition are sadly no cure for Androgenetic Alopecia.

 

[seanvandamme]

Was 22, with erdogan. Hard to tell but I think you need around least 2500. If you have diffusing, crown loss and nw3 like I had a doctor won’t go ultra aggressive not necessarily because of future loss, but if they blow 70% of the donor on an ultra aggressive hairline and you’re the 2-3% out of 100 with terrible growth you’re completely fucked at that point. So they will likely advise against it and suggest you do it in a second run through 12 months after the first procedure if you want to.

Your case isn’t as bad as mine I think and you don’t appear to have crown or diffusing issues, but they won’t be prepared to go aggressive unless you’re on finasteride.

The point on the density measurements is that almost no doctors do a strict measurement of this and clearly some doctors overstate things, so for you as a patient you’re comparing against numbers which aren’t consistent or accurate. Also the fact that everyone’s hair texture and thickness is different makes the measurement worthless. A doctor with experience and consistency along with your hair type will know what they’re doing, factor the measurements out of your mind. It over complicates without telling you anything.100% they aren’t worth it because someone in your position that hasn’t done a huge amount of research will believe BS like that that hasson case was 90 fu per
cm^2 when it blatantly wasnt, so you’d be choosing based on false information without knowing it.

What you see is more important than what they tell you, do research beyond what ego driven doctors spoon feed you. Look for yourself at their results and decide. Unless you’re like me and are obsessive with researching transplants you don’t have the knowledge to accurately judge or interpret the raw numbers, but you will have a reasonable sense of what results you find acceptable visibly and which doctors produce them if you look for yourself.

I think you’re better off opting for FUE in which case you should look at keser and erdogan in Turkey, but if you’re fine with FUT then look at hasson, rahal and konior in particular.

Jesus. Blow 70% of donor hair on just the hairline? i don't think I have that sparse of a supply. Is this 2-3% statistic of poor yield backed by any study? My primary concern is that my dense packed grafts won't grow due to my blood supply being overwhelmed. I see many good results of dense packing that flies in the face of that 2005 study that claims grafts above 40 grafts/cm^2 will yield poor growth. That is distressing to hear for anyone who desires a dense hairline.

Thank you for your recommendations. Those doctors you recommended have excellent results! What about Dr Armani? He seems to have tons of great looking hairlines done.

 

[JeanLucBB]

Jesus. Blow 70% of donor hair on just the hairline? i don't think I have that sparse of a supply. Is this 2-3% statistic of poor yield backed by any study? My primary concern is that my dense packed grafts won't grow due to my blood supply being overwhelmed. I see many good results of dense packing that flies in the face of that 2005 study that claims grafts above 40 grafts/cm^2 will yield poor growth. That is distressing to hear for anyone who desires a dense hairline.

Not just a hairline, its a full frontal third, some midscalp and crown.

Forget the studies and do your own research. 95% of the results you're looking at aren't as dense as you think and you haven't looked at enough results to understand the numbers. The question is whether or not patient posted results by the surgeons you're researching are pleased, the work looks natural to you in a variety of lightnings and settings and the design has an appealing aesthetic. Studies on yield are borderline meaningless, do you genuinely believe a surgeon conducting a study is going to be honest about their success rate? There's a massive conflict of interest here that can't be resolved, you need to focus on the results of other patients, not numbers.

Doctors aren't measuring the exact density and that is a fact, so stop worrying about a number that isn't anywhere near quoted with consistent measurements from surgeon to surgeon. You need to consult with surgeons on this, at the moment you're worrying about things you haven't done enough research to interpret properly.

 

[JeanLucBB]

Jesus. Blow 70% of donor hair on just the hairline? i don't think I have that sparse of a supply. Is this 2-3% statistic of poor yield backed by any study? My primary concern is that my dense packed grafts won't grow due to my blood supply being overwhelmed. I see many good results of dense packing that flies in the face of that 2005 study that claims grafts above 40 grafts/cm^2 will yield poor growth. That is distressing to hear for anyone who desires a dense hairline.

Thank you for your recommendations. Those doctors you recommended have excellent results! What about Dr Armani? He seems to have tons of great looking hairlines done.

Armani no longer works in the industry it’s a chain clinic now, the doctor running the show is baubac, very impressed with his results and protocol although very expensive. Also endorsed by joe tillman who is worth looking into for info for beginners starting to research

 

[seanvandamme]

Thanks for the link. Here's a brief review of its content.

First of, it's a review of a selected sample of scientific literature - a small meta-analysis. Whether the sources he cites are credible or not is another matter. What's evident is that it is definitely not a scientific study in the proper sense of the word, meaning that he didn't conduct an experiment on a sufficient sample size. He simply came up with a hypothesis and tried to find other studies that helped support his claims. Meta-analyses are sound scientific tools but usually not when it comes to "proving" anything related to a controversial topic, such as the effect of nutrition on male pattern baldness.

Now as for the conclusion of his review, while it is true that nutritional deficiencies have an impact on hair loss, possibly accelerating Androgenetic Alopecia - or, let's entertain the notion here, trigger it -, the solution he suggests is suspect at best.

Consider the following quote:


Yes, the quality of our food is different, or maybe even not as healthy as the food available a hundred years ago. However, unless a subject suffers from a mental illness (anorexia, bulimia, etc.), no one in the developed world suffers from malnutrition, at least not in the accepted sense of the word. Maybe in India the poor cannot afford proper food but plenty of people can in Europe and in the US.

Here's the thing. Both studies from other scientists and anecdotal reports from hair loss sufferers have tried to affect Androgenetic Alopecia through diet. Several angles of approach have been used - vitamin C, D, selenium, zinc, you name it. None have shown any tangible amount of success in modulating androgenetic alopecia. The conclusion would be, either it doesn't do anything or it's just not enough to stop Androgenetic Alopecia, let alone slow it down.

In conclusion, don't chase windmills by going down the "natural" path to try and treat hair loss. Having a healthy lifestyle probably helps with hair loss but proper exercise and nutrition are sadly no cure for Androgenetic Alopecia.

Thank you for the conscientious effort in condensing the information within. I agree with most of what you say. I was excited when I came upon the article because I finally found some scientific evidence of what possibly led to my current plight. You mentioned that you disagree with him that the main cause of diet related alopecia was a reduction of nutritional value in today's food. I think there are several implications that a less nutritive diet entails but don't think he attributed the onset of non-androgenetic alopecia to only that. The main cause he identified was calorie restriction - an eating habit so ingrained in today's culture because of fad diets, uninformed ideas about fat gain, and starvation on purpose. Calorie restriction is problematic on so many levels because when gone far enough:

1. Autophagy takes place
2. Consuming less calories inevitably leads to consuming less micronutrients essential for proper functioning of the body. It doesn't help as well that people often hop on diets that advocate certain macronutrients and demonize others.

All this he mentioned in the article, wreaks havoc on our body's functioning. From my experience, it was the calorie restriction, not the micronutrient deficiency that did it the most. The moment I began eating at baseline calories, any shedding and further thinning halted completely. I really think there are a sizeable amount of people out there that could be exacerbating their hair loss with a poor diet, and the finasteride + minoxidil first approach isn't always right.

 

[seanvandamme]

Not just a hairline, its a full frontal third, some midscalp and crown.

Forget the studies and do your own research. 95% of the results you're looking at aren't as dense as you think and you haven't looked at enough results to understand the numbers. The question is whether or not patient posted results by the surgeons you're researching are pleased, the work looks natural to you in a variety of lightnings and settings and the design has an appealing aesthetic. Studies on yield are borderline meaningless, do you genuinely believe a surgeon conducting a study is going to be honest about their success rate? There's a massive conflict of interest here that can't be resolved, you need to focus on the results of other patients, not numbers.

Doctors aren't measuring the exact density and that is a fact, so stop worrying about a number that isn't anywhere near quoted with consistent measurements from surgeon to surgeon. You need to consult with surgeons on this, at the moment you're worrying about things you haven't done enough research to interpret properly.

Thanks for the advice. I really should start scouring over patient posted results. You mentioned that doctors don't measure the exact density. So how do they work with creating density for their patients then?

 

[JeanLucBB]

Thanks for the advice. I really should start scouring over patient posted results. You mentioned that doctors don't measure the exact density. So how do they work with creating density for their patients then?

On an online consult they will ask for photos and make a rough estimate of graft numbers, then in person they are likely to measure the caliber of your hair, donor density etc along with a rough estimation of the total area on top to be filled. Also photograph the hair and judge miniaturisation, how it looks when wet and design the hairline with you. Once this is done they'll create a decision on graft numbers. For the vast majority of doctors it is very much by feel, with experience and reference to your hair characteristics they'll know what to do according to your expectations and how densely to pack it to achieve natural results. Once they've done it hundreds and thousands of times it becomes second nature. So it isn't all rough estimation, but these things aren't absolute like you might think.

Also on the density point Rahal's rep was on this forum a few months ago and did mention that Rahal used to back around the 70 fu/cm^2 range but dropped it back due to inconsistent results. Aside from the fact that the human eye simply can't distinguish density beyond a certain point, you have to consider that studies showing into these massive ranges are in ultra controlled circumstances, with infinite time to extract the grafts, place them as soon as extracted so they are not out of the body for any time at all with all the time in the world to make sure they are unharmed and then put solely into a singular square 70 fu/cm^2. In reality when looking at cases of 3000 grafts across an entire area and not just a singular cm^2 box with doctors running a schedule and enduring fatigue due to hours of work, you're not going to get the same giant survival rates as are possible in a lab because they aren't working with these controlled conditions.