A graft calculator (there are many) doesn’t take into account such things as hair mass index, a critical element for determining how many grafts one needs for a given bald area. To make my point clearer, image a fine hair (equal of a 1 by 1 piece of wood) or a 4 by 4 piece of wood). The 4 by 4 would have four times the mass of the 1 by 1. Then assume that the analogy is that a 1 by 1 is equal of a fine hair, but a 4 by 4 is equal to a coarse hair. The number of hairs (or grafts which contain hair) required will be significantly different so it is not just a number calculation as these Graft Calculators show. Then there is the ‘ART’ that allows an experienced surgeon to blend the numbers and the hair mass of the hairs and grafts into a plan. At the time this plan is built, the surgeon must take into account the donor supply (is it high or low). High density people with coarse her can do more to cover their balding area than fine hair low density people. To make maters even more complicated, imagine that you continue to bald even after the hair transplant. Most people are somewhere in-between low and high densities and that is why an experienced hair transplant surgeon is critical to the entire process. I am not easily replaced by a calculator.
Taken from Wikipedia:
Trichotillomania (TTM), also known as hair pulling disorder, is a mental disorder characterised by a long term urge that results in the pulling out of one’s hair. This occurs to such a degree that hair losscan be seen. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress.
The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair. On examination broken hairs may be seen. Other conditions that may present similarly include body dysmorphic disorder, however in that condition people remove hair to try to improve what they see as a problem in how they look.
Dr. Nghi, a surgeon in South Vietnam worked with me as I volunteered to assist South Vietnamese Civilians and wounded soldiers while I was in Vietnam. He was fortunate to be evacuated and ended up in Camp Pendelton when I was able to connect with him in 1975. I sponsored him and his family of 8 others including his wife and two children, plus other relatives including his wife’s father and mother. He joined me in my Surgical practice in Vermont, working as a physician assistant while studying for his examinations to get a license to practice medicine in the United States. After 9 months, he took the examination and passed it on the first round. With some help by me, he went onto to Dartmouth in Hanover New Hampshire and studied Anesthesiology for 3 years. When he left Dartmouth, a special award was created for him to recognize outstanding service while he was there and was offered a faculty appointment. He decided not to take the appointment and moved to Pittsburgh where he has been practicing anesthesiology every since. He has been active in helping Vietnamese refugees resettle and has been invited to the white house twice to be recognized as an outstanding community contributor. His family now extends to more than 40, all highly successful and integrated into American life. He has four children, an OBGYN doctor, a PhD researcher, a district attorney and a pharmaceutical Vice President. He told me that America gave him and his entire family the opportunity to succeed through hard work. He loves America. Below is this presentation posted by the History Museum in Pittsburgh just this week to honor Dr. Nghi and his family.
All I can say is “Don’t hold your breadth!”
I’m a gym bro, have healthy testosterone levels and considering fin. As I understand it. Fin increases testosterone, increases estrogen and decreased DHT, it’s the last two I’m worried about. Talks about ED and gyno, although rare, make me worry for my “manliness”. Can anyone speak to muscle building, voice tone, behavior/deamenor while on fin?
No, the dose of finasteride is far too small to overcome the impact of all of your male hormones.
If you take a photo of your cut hairs like this with either a hand video microscope (available on Amazon) or a good camera with a zoom in feature, you will see the follicular groups. The average Caucasian density averages 2.1 hairs per Follicular Group so if you count the number of groups and the number of hairs, you can know for certainty what your donor density is. In these pictures, the circles in C and D have higher than normal donor densities as the average number of hair in each Follicular Unit averages significantly above 2.1 hairs per Follicular Unit. That means that the person who has the higher donor density has more hair to transplant and if they want to do FUE, can do certainly more grafts based upon the chart here: https://newhair.com/resources/#tab-id-4
Like it or not, this has been the benchmark approach to learning about new treatments for disease; but it doesn’t always relate to the human diseases it mimics.
My dermatologist said he “isn’t convinced” I’m balding (fingers crossed), sees no miniaturization and said if it is MPB it’s very early, but because I’m still shedding hair he’s told me to start using an ointment with minoxidil/finasteride and see how it goes.
One of the side effects of minoxidil is increased body hair and I’ve read stories of people getting huge amounts of (possible permanent?) back hair and so on which for me would be equally as bad as balding. How common is it? Should I just go back and ask for finasteride only?
It is common in women who use it. My best friend’s wife used it and shortly stopped taking it because it produced facial hair that she did not like. I can’t advise you on the finasteride as that is between you and your dermatologist
As the doctor who pioneered the FUE, I can tell you with authority that 6000 FUE grafts will deplete your donor area and produce a see-through donor area. This is not a fixable situation as once the hair is moved, it will not regrow there. What is the doctor’s plan other than to get your money? What happens if you continue to bald over time, what then? Have you thought through this process?? If you are under 25, then you are about to make a terrible mistake.
You can have a second hair transplant if the donor area has a reasonable amount of hair left. Failures are usually the result of technical problems at the time of the surgery. If the first surgery was with FUE, the second surgery should not use FUE or you will have balding in the donor area. Your available donor area depends upon your original donor density that you had prior to the first hair transplant. Did your doctor measure it?
Is there a way to tell the difference between a standard min/fin shed cycle and min/fin no longer being effective? I’ve lost a ton in the past 3-4 weeks after being on fin and min for over 14 months, and am terrified min/fin are no longer effective and that this shedding won’t stop.
If you have been on finasteride and minoxidil for 14 months are are now seeing shedding, you most likely are experiencing an acceleration of your balding. You might want to see your doctor and get an opinion. If you were my patient, I would have had a HAIRCHECK test done on you a year ago and would repeat the test to confirm new hair loss and to what degree. That is the value of the HAIRCHECK test when you start treatment.
This is not uncommon, an increased sex drive and water semen. Most of the guys have a focus on loss of libido, not what you are getting.