Dr Lam's Hair Restoration Forum

not necessarily. in about 80% of people, all fall out. in the remaining 20%, the hairs stay and start to grow.

thanks for the reply.
Will you prescribe antiseptic ointment for the grafted area and donor area?if so which ?

no, but i pretreat for 2 days before surgery with Hibliclens for optimal cleaning, then i just have you shampoo twice a day at low pressure for a week.
best,
sml

Dear sir,
Can hair transplantation be done in a 19yr old,with temporal recession?

generally no. bad idea. watch this video to truly understand why:

http://www.youtube.com/watch?v=RExLTUFppBg

thanks for the reply.
May i know at what level in the back is the safe donor area?

safe is a relative term. the younger you are the unsafer is the periphery of it since you could lose hair going down from the crown toward the "safe" area or lose it upwards from the neck going that direction (called retrograde loss). generally i tend to start about at or slightly above the occipital protuberance (the bump in the middle of the back of the head) where the hair is the finest and densest if i am trying to rebuild the hairline and temples. it is ideal hair for that. for the crown i typically go higher up. that is the "safest" of all hair but almost nothing is safe if you are 19, especially the temples. when you build temples up strong you may lose even more hair behind and in the hairline to create more problems down the road. safety is based truly on judgment: age, degree of hair loss, and what is present in the donor area in terms of degree of loss there as well.
best,
sml

thanks for the reply.
I have few questions for clarification.
Is DHI better than strip method.?what medications you prescribe post operatively and for how much period?
What are the probable causes for complete failure of grafts-- not taking up?i have seen post transplantation after 1.5 months,,all the grafts have poped up.
Regarding grafts..How thin we can make?can 19G needle used to make slits for 2 hair follicle units.

Is DHI better than strip method.?
FIRST, DHI IS A MARKETING TERM BY A GROUP OF CLINICS IN THE UK. I HAD NEVER EVEN HEARD OF THAT TERM UNTIL I GOOGLED IT. IT JUST LOOKS LIKE FUE TECHNIQUE. MY OPINION IS THAT GRAFTS TAKEN AS FUE REALLY HAVE MUCH LESS VIABILITY THAN STRIP HARVESTING FOR A HOST OF REASONS:
1. DAMAGE OF THE GRAFTS AS THEY ARE REMOVED (SUCTIONED OUT, TRANSECTED DURING REMOVAL)
2. THE GRAFTS ARE INHERENTLY SKINNY WHICH REDUCES VIABILITY.
IN GENERAL, I BELIEVE STRIP HARVESTING AFFORDS THE LARGEST MOVE OF VIABLE HAIR IN A SINGLE SESSION.

what medications you prescribe post operatively and for how much period?
NOTHING REALLY EXCEPT SOME PAIN MEDS IF YOU NEED THEM.
What are the probable causes for complete failure of grafts-- not taking up?i have seen post transplantation after 1.5 months,,all the grafts have poped up.
YOU ARE SPEAKING OF TWO THINGS. COMPLETE FAILURE OF GRAFTS WOULD BE DEFINED AS AFTER 9 MONTHS TO YEAR THERE IS NO GROWTH OF GRAFTS. AT 1.5 MONTHS THERE IS NOTHING TO BE SEEN. TYPICALLY, THE GRAFTS COME OUT BUT THEY ARE NOT IN EFFECT COMING OUT, THE ROOT IS STILL THERE SO IT IS NORMAL THAT THE GRAFT COMES OUT AT 1 TO 1.5 MONTHS.
Regarding grafts..How thin we can make?can 19G needle used to make slits for 2 hair follicle units. YES, 19G IS WHAT WE USE FOR 2 HAIR GRAFTS IN MOST CASES DEPENDING ON HOW TIGHTLY THE ARRANGEMENT OF 2 HAIR GRAFTS IS. SOMETIMES WE ALSO USE A 19G FOR ONE HAIR GRAFTS. OTHER TIMES WHEN THE HAIRS ARE REALLY FINE, WE CAN GET AS SMALL AS 20 TO 21G. WE REALLY USE MUCH TINIER SITES THAN MOST CLINICS OUT THERE BECAUSE MY GIRLS CAN PLACE INTO THEM. WE BELIEVE THAT ALLOWS US TO PACK SITES IN MORE TIGHTLY AND ALSO CAUSE LESS TISSUE TRAUMA, WHICH CAN INCREASE VIABILITY.
best,
sml

thanks for the reply.
If vellus hairs(which have slow growth and very thin-which does not cover scalp) is present in recepient area,will you dense pack it, or else give importance to it to prevent "shock loss".

more likely than not i will dense pack it especially if it is in an area of critical importance like the hairline and the central forelock even if it engenders shock loss. the reason is that these vellus hairs are on the way out and you need density applied strategically. that being said, i will not injure the vellus hairs as i can skillfully work around them without damaging them. as you rightly point out, that does not mean that they would not be temporarily traumatized with shock loss in the first few months. hope that is clear.
best,
sml

thank you for the reply.
May i know at what point you place 2 hair follicles after hairline(1 hair follicles).Also in case you make slits for two hair follicles and they got to over and still there are some slits for it,can Two(in no)1 hair follicle placed there at once.(holding 2 -1 hair follicle by forceps and placing it like a double hair follicle)

it depends. with fine hairs i can start two hairs right after the first 1 to 2 rows of 1 hairs. with thick coarse hairs i may add another 1 row of 1 hairs. anything more than 3 rows of 1 hairs is unnecessary and makes the hairline look thin. yes, to the second question, i perform follicular pairings to get more density moving 2 1-hair grafts into a single recipient site when called for, like when i get too many 1's that i don't need. i do that very often in the crown where i almost never need 1's.

thanks for the reply.
will you prescribe minoxidil and finasteride after transplantation,if so from when and how long it should be taken and how it helps transplanted hair.

typically in 80% of people the transplanted hairs fall out between 2 weeks and 3 months. in 20%, they stay in and grow. either way they have about the same timetable for growth.
best,
sml