Ok so I have a date with facial team in September and I am going back and forth on the hair transplants that they do at the time of surgery. I have had many consults with many surgeons and one well known east coast surgeon was very blunt in his opinion of the transplant technique FT is pitching.

The statement is that the hair will eventually fall out due to the type of folicle and where it was harvested from. He went on to say that if I were to ever discontinue hormones they would fall out. This is obviously a concern for a number of reasons, but what I do not know is if there is truth behind this or if it is fiction. FT charges a lot for this service and the recovery is not trivial, so I am interested in hearing the experiences of others that have done this particular procedure with facial team.

Thanks!

No one?

I've never heard such a thing before and given the large number of women who've been to Facial Team I doubt it's true. Hard to confirm the stopping hrt but since who'd do that, but unless you Dr  had a lot of trans patients he wouldn't know either.

I'm having this procedure at FacialTeam a couple weeks from now.

Quote from: AnonyMs on May 05, 2018, 08:03:03 AM
I've never heard such a thing before and given the large number of women who've been to Facial Team I doubt it's true. Hard to confirm the stopping hrt but since who'd do that, but unless you Dr  had a lot of trans patients he wouldn't know either.

This was from a ffs surgeon on the east coast that is well known and deals mostly with trans patients.

There are many reasons hrt might be paused or stopped. My dosages now ar 1/3 what they were due to other medical concerns.

I am not an expert on hair transplants but am relaying what I have seen elsewhere on the site.

Hair falls out shortly after being transplanted because it goes dormant. A few months after that, it will return to the growth cycle and you will be able to grow it to full length. The hair loss is nothing to worry about as it's normal with transplants.

It's not discontinuing HRT that would cause hair loss but the return of Testosterone. It would be possible to go on a DHT blocker to prevent this from happening should for some reasons your T levels become elevated. Naturally if you expect any changes in your HRT, this should be discussed with your doctor as soon as possible so you have the correct medication when it's needed.

Quote from: jill610 on May 05, 2018, 12:15:01 PM
This was from a ffs surgeon on the east coast that is well known and deals mostly with trans patients.

There are many reasons hrt might be paused or stopped. My dosages now ar 1/3 what they were due to other medical concerns.

If your hair loss was caused by male pattern baldness, and say your uncle on your moms side is a bald Q ball there is cause for concern.. especially if the source of dihydrotestosterone continues unabated.  If you stop HRT and the testosterone starts up again there is a problem most likely.   Though not necessarily true either, sometimes the source is damaged too after being on HRT a while. 

Of course getting an orchi or SRS will stop that MPB from continuing, though sometimes the lack of hormones can also cause hairloss.. severe loss (talking around 0) of testosterone itself can also cause hair loss too, something to be aware of.

Hope this helps

I think my point was missed.

The comment is not a general comment about transplants, but was specifically about the way I. Which FT does it's transplants from the area on top of the head. The statement was that they will eventually fall out due to the type of follicle. The argument was that transplants should only come from the back of the head and neck and any other donor location would be significantly more prone to falling out. Discontinuing hrt is one of the possible causes of them falling out that was pointed out to me.

This is one of those things that is hard to tell fact from a surgeon passively badmouthing the competition.

For the record, I do not have male pattern baldness but do have a high forehead with high peaks, so am currently planning on having the FT transplants. However that's like $7k which is the single biggest line item on my bill, so I want some confidence that it is not a waste of money.

I am aware of the reports that the hair might fall out and then regrow a few months later following the transplantation.

Quote from: Doreen on May 05, 2018, 03:36:47 PM
If your hair loss was caused by male pattern baldness, and say your uncle on your moms side is a bald Q ball there is cause for concern.. especially if the source of dihydrotestosterone continues unabated.  If you stop HRT and the testosterone starts up again there is a problem most likely.   Though not necessarily true either, sometimes the source is damaged too after being on HRT a while. 

Of course getting an orchi or SRS will stop that MPB from continuing, though sometimes the lack of hormones can also cause hairloss.. severe loss (talking around 0) of testosterone itself can also cause hair loss too, something to be aware of.

Hope this helps [emoji4]

I am sure this will be very helpful to someone reading this thread as it is all very factual, but did not address the question I was asking. I am very specifically asking about the technique that FT uses and the long term efficacy relative to more traditional transplant techniques and donor locations.

Why not email Facial Team and ask them about It?

Facial Team can take the hair from the back, but its a longer recovery.

Quote from: AnonyMs on May 05, 2018, 04:32:51 PM
Why not email Facial Team and ask them about It?

Facial Team can take the hair from the back, but its a longer recovery.

I do not trust the surgeon to tell me that his technique is inferior. Looking for something more objective, but I am coming up short.

Trust... but verify .

Living in Bangkok and running a foundation to help tgs, the topic of hair transplant occurs regularly. In addition, I have also assisted some male asian stars who have receeding hairlines. I helped a TV male star from HK with hair transplant for a receeding hairline. Taking hair from the back of the head near the neckline and transplanting infront. The loss rate from this very labour intensive surgery is estimated at 10 to 20pct. They charge by the hair and he had over 2,000 implants. The  surgery lasted 8 hours. Cost around usd 5,000. Now 2.5 years later he looks great and the hair has maintained its volume and other stars are having it done. I also assisted tgs, who after ffs wanted to lower their hairline. My fist assist, 3 years on has great hair.

The experience of the doctor and his team is essential for long term success. It is labor intensive and requires a dedicated team.

Hair loss in older women does occur, presumably because of lower natural hormone blood levels. For us ladies on Estradiol, we almost all have a more youthful appearance, for our age and hair is a big part of this.

For male pattern baldness, the hair loss is primarily on the top and front of the head. Transplanting hair from the back of the head is very effective in restoring hair loss in men who still have the same blood levels of T and DHT as before the transplants. Hair for the back of the head is resistant to MPB due to DHT, but this doesn't mean that everyone will get a fantastic result. A few men become completely bald.

If you have male genitalia and you are still producing T and DHT, an alpha 5 reductase blocker, such as Finasteride is a good drug to take to avoid any further hair loss.

Since we are all individuals, I would recommend getting your blood levels checked for T and DHT to see if you need to take an alpha 5 reductase blocker.

Quote from: jill610 on May 05, 2018, 08:54:53 PM
I do not trust the surgeon to tell me that his technique is inferior. Looking for something more objective, but I am coming up short.

Trust... but verify .

They may be able to refer you to academic papers on the subject.

Quote from: AnonyMs on May 06, 2018, 07:26:17 AM
They may be able to refer you to academic papers on the subject.

They wrote most of the academic papers that address this specific problem.

Quote from: Dani on May 06, 2018, 05:57:46 AM
Hair loss in older women does occur, presumably because of lower natural hormone blood levels. For us ladies on Estradiol, we almost all have a more youthful appearance, for our age and hair is a big part of this.

For male pattern baldness, the hair loss is primarily on the top and front of the head. Transplanting hair from the back of the head is very effective in restoring hair loss in men who still have the same blood levels of T and DHT as before the transplants. Hair for the back of the head is resistant to MPB due to DHT, but this doesn't mean that everyone will get a fantastic result. A few men become completely bald.

If you have male genitalia and you are still producing T and DHT, an alpha 5 reductase blocker, such as Finasteride is a good drug to take to avoid any further hair loss.

Since we are all individuals, I would recommend getting your blood levels checked for T and DHT to see if you need to take an alpha 5 reductase blocker.

My T is <3 and have been on finesteride for over a year. The T and DHT levels are not really the issue as that would effect any transplant.

Question is, is the technique that facial team uses as effective as more traditional methods for long term efficacy, all other variables being equal. I am concerned by the statement that if estrogen goes down, hair will fall out. Personally I think he was making stuff up.

The eventual fate of each transplanted follicle depends on various factors. Observational evidence would seem to indicate that the most important one is whether the follicle is destined to eventually shut down in its original location. That is to say, if the follicle on the crown of the head is destined to eventually atrophy where it was born, it will, all other factors remaining the same, be likely to also do so at the new location.

Thus, if the surgeon meant to say that it is more likely that follicles transplanted from the crown will stop growing hairs, he is absolutely right—male hair usually does thin more on top than the sides or back.

On the other hand, if he told you that all follicles transplanted from the crown of the head will stop growing hairs, I would interpret the statement to be misleading.

If you trust the east coast surgeon, then maybe not do the transplants and let him do them later on. I believe Facialteam FT can do the surgery without cutting too much of a strip of hair that gets thrown away, although it is preferrable to remove some scalp skin to remove the excess caused by bone reduction - and then the hair on that strip go to the bin, which is regrettable.

But consider a number of things - first is, FT do not only have one incision site they always use. If you are concerned about the incision being too high up on the head, they can put it further back. Actually when someone has signs of MPB at the top of the head or is factually thinning there or even bald, they will by default move the incision to the back of the head. So you can just demand that.

The other is, there is no real good reason for the hair from the top of the head to fall out after some time for no reason. Yes of course, they are in the zone that is most prone to hair loss, so those follicles would probably among the first to go if you ever develop hair loss for any reason - be that aborting HRT and return of the tesotsterone/DHT dominated hormone system causing MPB, be that from some sickness that makes you get MPB or even some forms of female type hair loss that thins out mostly at the crown. But honestly you will want to avoid getting into such a situation anyways as what good is it to have your hairline transplants be all good, while you develop a circular hair loss at the crown? I think at that stage you have other problems than additional thinning at the temples.

Personally, I chose to get the transplants done, I did not want them to go to waste and also did not want to get a second scar for transplants elsewhere - or shave my head to get FUE later. I am rather confident they will not fall out, I am post-GRS, testosterone and DHT are low, maybe rather too low actually, so I dont fear MPB much at this stage, even if I had to reduce estradiol.

So I guess as you seem to be very much impressed by that other surgeons opinion, the best choice would be to request FT to do the incision at the back of the head as they do with MPB patients even if you have no loss at the crown, or skip the transplants at this stage, ask FT to minimize the size of the skin strip they have to take out and get it done later - probably you can even save some money if you go to some places.

Quote from: anjaq on May 06, 2018, 04:55:39 PM
If you trust the east coast surgeon, then maybe not do the transplants and let him do them later on. I believe Facialteam FT can do the surgery without cutting too much of a strip of hair that gets thrown away, although it is preferrable to remove some scalp skin to remove the excess caused by bone reduction - and then the hair on that strip go to the bin, which is regrettable.

But consider a number of things - first is, FT do not only have one incision site they always use. If you are concerned about the incision being too high up on the head, they can put it further back. Actually when someone has signs of MPB at the top of the head or is factually thinning there or even bald, they will by default move the incision to the back of the head. So you can just demand that.

The other is, there is no real good reason for the hair from the top of the head to fall out after some time for no reason. Yes of course, they are in the zone that is most prone to hair loss, so those follicles would probably among the first to go if you ever develop hair loss for any reason - be that aborting HRT and return of the tesotsterone/DHT dominated hormone system causing MPB, be that from some sickness that makes you get MPB or even some forms of female type hair loss that thins out mostly at the crown. But honestly you will want to avoid getting into such a situation anyways as what good is it to have your hairline transplants be all good, while you develop a circular hair loss at the crown? I think at that stage you have other problems than additional thinning at the temples.

Personally, I chose to get the transplants done, I did not want them to go to waste and also did not want to get a second scar for transplants elsewhere - or shave my head to get FUE later. I am rather confident they will not fall out, I am post-GRS, testosterone and DHT are low, maybe rather too low actually, so I dont fear MPB much at this stage, even if I had to reduce estradiol.

So I guess as you seem to be very much impressed by that other surgeons opinion, the best choice would be to request FT to do the incision at the back of the head as they do with MPB patients even if you have no loss at the crown, or skip the transplants at this stage, ask FT to minimize the size of the skin strip they have to take out and get it done later - probably you can even save some money if you go to some places.

Exactly what I was looking for and hoping to hear. The east coast surgeon is my "if I can get insurance to cover it, I don't have to go to another country for major surgery, by myself, to a place where I do not speak the language" option. Facial Team is my first choice though I am trying like hell to get insurance to cover them. Being. Out of the country is a problem for that

Anyways, this was the first time I had ever heard that the techniques facials team uses for hair transplants are not as reliable as other methods and the source is well known and respected so I had one of those "I do t want to waste money" moments.

I do not have MPB but do have a high hairline that needs to be fixed. I also have not enough T despite 70% reduction I both estradiol and Spiro, so that's a. It if a mystery, though I plan to have grs within the next 18 months, hopefully.

What do you mean with "I also have not enough T"

See this illustration from the facialteam webiste for the two basic types of incisions they do for the transplants and forehead surgery:


In reality, they put the incision somewhere between those two - depending on your hair health, signs of balding or lack thereof etc. I am sure you can also voice your own preferrences.