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Dr. Arvind

Homepage E-mail

New Delhi, India,
25.08.2010, 15:47
 

Hair transplant education for prospective patients (Hair Transplant)

Dear forum readers,
I find that the forum is sometimes divided between people who have extensive knowledge about transplants v/s others (many, I suspect lurkers), with limited information.

I hope, with your help, to compile a basic knowledge database for new readers.

It should be simple to grasp, logical and something the people can carry in their mind when they go for a consult/research.

-------------------------------------------------------

For sake of simplicity, I shall divide it into
1. The science behind hair transplant
2. The mathematics behind hair graft estimates
3. The art behind hair transplants
4. The pitfalls and some litmus tests before going for a transplant

Active participation from veterans as well as new readers will be most welcome.
Do not hesitate to voice your enquiries but do keep in mind that this thread is devoted to compiling a basic database, not specific philosophies of different good HT doctors (who may all be correct in their contrary views).

Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
25.08.2010, 16:15

@ Dr. Arvind

The science

This section shall include the basic definitions in easy to understand language.
Please feel free to add or question.

1. Hair Transplant - The surgical relocation of hair roots from one part of the body to the other. Usually, the hair roots to be transplanted are taken from areas of the scalp/body that retain hair growth till ripe old age.

2. Follicular units - Hair grows in form of groups of 1, 2, 3 or 4 hair follicles. This group alongwith its sebaceous gland is called a follicular unit (also referred to as a pilo sebaceous unit)
The picture below shows the hairof the scalp buzzcut. On close inspection, you can see the groupings/follicular units.
[image]


3. Types of modern hair transplants - 2 main type of hair transplants are considered the accepted standard at present.
The difference between both has to do with the method of extraction of the donor hair.
a). The strip FUHT/FUT method - This involves taking a hair bearing strip of scalp skin from the donor area. The resultant wound is closed with sutures or staples
b). The stitchless FUSE/fue method - Hair follicular units are extracted individually in a random manner

Pictures of the donor area immediately after extraction is shown in the pictures below
The strip FUHT donor area
[image]

The stitchless FUSE donor area (scalp)
[image]


Please note - The difference is in the extraction method only. The graft placement method is the same in both the methods. In strip FUHT, the strip is dissected into individual follicular unit grafts before placement.

For those desirous of reading more on the topic and viewing additional pictures can visit the following link
http://www.fusehair.com/node/566




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
25.08.2010, 16:48

@ Dr. Arvind

Hair follicle v/s follicular unit graft

This is another topic that sometimes confuses the new readers.

Simply put, a follicular unit is a group of hair follicles as they grow in nature.
True! hair does not always grow as 1 hair per place.
In majority of instances, especially, in the scalp, it grows in groups of 2 or 3 hair per place. (refer picture above).
The picture below is a random example illustrating the concept of follicular units. Notice how even though the hair follicles splay as they go down, on the skin surface they grow close together in form of a unit.
Yes, right! a follicular unit.
[image]


Hair follicle per follicular unit differs in
- different races
- different areas of the body
- different areas of the scalp

However, as a basic thumbrule, for scalp, 1 follicular unit graft is atleast equal to 2 hair on average.

Therefore, if someone tries to con you by telling prices per follicle, take care and look closely. Most reputed HT doctors/clinics worldwide will always mention the fee per follicular unit graft (NOT per hair follicle).

For those desirous of seeing more detailed pictures and commentary, the following link is useful
http://www.fusehair.com/node/567




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
25.08.2010, 17:09

@ Dr. Arvind

Who was this Norwood?

Well, long time ago, before anyone had thought to differentiate the people going bald from "just balding" to "stark bald", there was this respected Dr. Tar'O Norwood.
He brought about the notion of classifying the extent of hairloss.
And believe me, he did a good job of it.
Even though most people will either -
a) feel their level of hairloss is not correctly reflected in the classification,
b) feel they are being classified in the wrong category by their HT doctors,

this classification brought about one of the first scientific steps in the field.And a reasonably accurate one.

Sorry, no pictures. A man has to do his own legwork at times.
This time I will not help you. If you want to read more about Norwood classification, go ahead, use google, and punch in the words.
When I did, I got 391,000 results.

Come on, give Dr. Norwood his due. Dont expect me to make a simile of his chart on my website. The man deserves better. He made bald men realize they could be classified.
(I hope you are not Norwood 7 and angry on me. :-( Blame it on Norwood, I say).




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
marco

U.K,
25.08.2010, 17:59

@ Dr. Arvind

Who was this Norwood?

Here is a template for the structure of a review / Knowledge pack.

General
Anatomy of hair
Anatomy of scalp
hair density
temporal progression of MPB (beyond norward)

Extraction
FUE Blunt / sharp dissection Techniques and depths; limitations
Strip Laxity / undermining; Dissection techniques;Closure techniques

Graft Dissection
Storage media / temperature
Techniques

Placement
Holes / slits / depth etc
Angulation
Coverage philosophy



marco has 3 Personal Journal(s). Click here to view
marco is located in U.K and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
26.08.2010, 09:44

@ marco

Who was this Norwood?

» Here is a template for the structure of a review / Knowledge pack.
»
» General
» Anatomy of hair
» Anatomy of scalp
» hair density
» temporal progression of MPB (beyond norward)
»
» Extraction
» FUE Blunt / sharp dissection Techniques and depths;
» limitations

» Strip Laxity / undermining; Dissection techniques;Closure
» techniques

»
» Graft Dissection
» Storage media / temperature
» Techniques
»
» Placement
» Holes / slits / depth etc
» Angulation
» Coverage philosophy

Yes, that is also a good template. Care to elaborate?!




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
26.08.2010, 15:57

@ Dr. Arvind

Is my hairloss genetic?

This is another oft asked question.
Many people want to believe that their hairloss is due to a disease and will be reversed completely by curing the disease.

That may be the case in some. Unfortunately, not in all.

I have found an easy way to help differentiate and explain the type of hairloss is by understanding the concept of pattern hairloss .

Androgenic alopecia, or the commonest form of balding follows a pattern.
The hairloss starts in the temples, hairline and/or the crown. There will be variations, but it almost never effects the sides and the back of the scalp

Diseases usually do not follow the same pattern.

Some diseases where you may experience hairloss but which are not androgenic alopecia are -
* Alopecia areata, globalis and universalis . For further reading see this link
http://en.wikipedia.org/wiki/Alopecia_areata

* Psoriasis . Additional pictures and information is available at
http://www.fusehair.com/node/570
http://www.psoriasis.org/home/

* Hormonal imbalances (especially thyroid).

* Lichen planus. Additional information and pictures available at http://www.dermnet.org.nz/scaly/lichen-planus.html

* Post chemotherapy, or due to injury (burn, surgical or accidental)

* Trichotillomania . Additional information about this unusual condition can be found at http://en.wikipedia.org/wiki/Trichotillomania

* Traction alopecia (due to sustained and long term traction on the hair roots). Two commonest sub groups affected by this are Black women wearing tight braids and Sikh gentlemen wearing hair tightly under their turban.

There are many more rarer causes and maybe veteran readers will be able to add them to this thread. But to keep this short, I will desist. Sufficient that you get a brief idea of the types of hairloss.


A good first step is to contact your family physician as the first step. He should be able to rule out or advise tests for hairloss due to reasons other then androgenic alopecia.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
27.08.2010, 09:31

@ Dr. Arvind

Anesthesia, bandages and the post operative look

All this means a lot for the patients. The appearance especially can have a serious impact on the planning of the vacation post HT.

Anesthesia - Hair transplant is an out patient procedure, does not require overnight admission and is performed under local anesthesia. The area to be operated upon is numbed and the patient is conscious through most of the procedure.

Bandage - This varies. There are some clinics that do not apply any bandage and others that leave the bandage on for a couple of days. My personal preference is to apply a light bandage (it usually goes around the head) overnight. The bandage can be removed by the patient himself, the next morning. There is no need for repeated bandaging.

The post operative look - Its best explained by pictures.
This link shows what the scalp looks like from just before, during, just after the hair transplant procedure as well as how it looks 7 days after.
http://www.fusehair.com/node/573


This link shows what the recipient area looks before, immediately after and then at intervals of 1 month, upto 8 months after hair transplant. Pictures courtesy of the patient available at
http://www.fusehair.com/image/tid/111


Let me know if you need additional inputs on this topic.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
furious

29.08.2010, 08:19

@ Dr. Arvind

Hair transplant education for prospective patients

Good stuff, thanks for doing that,.




furious is located in [NA] and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
30.08.2010, 08:51

@ Dr. Arvind

Body hair to scalp

I meet many who have lots of body hair as well as extensive hairloss.
The question uppermost in their mind - If hair can be transplanted, why not transplants the thousands, even millions of hair some have, on their body, to the scalp and finish the problem once for all.

After having spent years researching this special field, I have found the answers that are clear when viewed from my side. But for someone to understand from the other side, it may take an effort.

Before I try to explain, just keep in mind "Nature kept it simple".Whether we understand the simple is up to us.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
30.08.2010, 14:16

@ Dr. Arvind

Body hair to scalp

Hair, even though they look similar whether on scalp, beard or body, differ greatly in their characteristics.

A few of them that impact greatly on the coverage provided per transplanted graft are :

1. The %age of hair in active growth phase (Anagen)

2. The duration of the anagen/growth phase of the hair

3. The physical characteristics of the hair (diameter, color, curl, length etc.)

The scalp hair has the longest period of anagen (3 to 4 years) and a high %age of hair that are in anagen stage at any one time (aproximately 85%).

Compared to this, the body hair growth phase is very short (4 to 6 months) and a huge %age of the hair are often in the resting/telogen phase.

In addition, the body hair have more singles/graft, a thinner diameter, shorter length.

Thus, in most cases, they provide less coverage per graft when compared to the scalp donor hair.

-------------------------------------------------------

However, that does not mean body hair can not be used for transplant. We have often used robust body and beard hair in suitable cases.

For those desirous of reading more about body hair transplantation (including guidelines to BHT ), visit this link
http://www.fusehair.com/body_hair_transplant




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
30.08.2010, 15:43

@ Dr. Arvind

Body hair to scalp

This link shows pictures comparing the hair grafts of the same person taken from scalp, body and beard donor areas.

http://www.fusehair.com/node/567

[image]




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
nitesh

Homepage E-mail

INDIA,
30.08.2010, 16:54

@ Dr. Arvind

Is my hairloss genetic?

Sir i discussed on this website about "safe donor area"

But i also want to know more detail about "safe Donor Area" with sketch ,pics and mathematical calculation for any person head.




nitesh is located in INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Nitesh HT results
First Surgery Dr Charu Sharma
Second Surgery Dr Arvind Poswal


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
30.08.2010, 17:30

@ nitesh

Is my hairloss genetic?

» Sir i discussed on this website about "safe donor area"
»
» But i also want to know more detail about "safe Donor Area" with sketch
» ,pics and mathematical calculation for any person head.

Dear Nitesh,
I will try to make an easy to understand yet comprehensive, short article about that.
Let me make the necessary accompanaying diagrams, I believe, will best explain the safe donor area.

Regards,
Dr. A

P. S. - Meantime, if anyone wants to chime in to answer the question, they are most welcome. This is an interesting topic.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
johnp

E-mail

New Jersey,
01.09.2010, 15:46

@ Dr. Arvind

Hair transplant education for prospective patients

Dr. Arvind I guess this falls under the placement category, what exactly is lateral slits? It was explained to me before but frankly I never fully understand how that works.



johnp has 1 Personal Journal(s). Click here to view
johnp is located in NEW JERSEY and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
02.09.2010, 05:49

@ johnp

Lateral slits

» Dr. Arvind I guess this falls under the placement category, what exactly is
» lateral slits? It was explained to me before but frankly I never fully
» understand how that works.

Dear johnp,
I will explain lateral slits. For that, I will classify slits as
- sagittal slits
- coronal slits, and,
- lateral slits.

Lateral slits are not necessarily sagital or coronal. Their direction is not related to the skull but to the direction of growth of the emerging hair follicular unit/ hair follicle.

But before I do, I will upload a close up picture of a non balding scalp.


[image]


At this close up, you can not and need not worry about the sagital and coronal planes.
What you see is
1. The direction of the hair follicles as they emerge from the skin.
2. The alignment of the hair in the individual follicular unit

The picture below shows
1. Lateral slits in blue and, for sake of comparison,
2. Sagital slits in red.


[image]

Please note that the lateral slits and sagital slits appear perpendicular to each other, but that may not always be the case.
For example, in the crown swirl area, where the direction of hair growth changes constantly, the direction of the lateral slits will change accordingly. The direction of the sagital slits will not.

Let me know if you have any questions/doubts.
Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
02.09.2010, 07:10

@ Dr. Arvind

safe donor area

Following are some pictures that give an idea of the safe donor area.

[image]


[image]

I will explain about them shortly.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
hairlove

U.S.A,
02.09.2010, 07:30

@ Dr. Arvind

safe donor area

» Following are some pictures that give an idea of the safe donor area.
»
» [image]
»
»
» [image]
»
» I will explain about them shortly.

dear dr.arvind,
looking at the pics of safe donor area,why is that lot of clinics doing fue now a days seem to go beyond,(read higher up), than the safe donor area to harvest the grafts????
this is usually not the case with strips!!

regards,
hairlove



hairlove has 4 Personal Journal(s). Click here to view
hairlove is located in U.S.A and he is available to meet: NO

---
Minoxidil 2%<2ml daily,
Finpecia 1mg daily,
Multivitamins specifically biotin and multiminerals occasionally.


FIRST HT- not happy with results

SECOND HT-Repair with Dr.Arvind...very satisfied with results as well as personal attitude of the clinic....TWO THUMBS UP!!


Post reply
marco

U.K,
02.09.2010, 11:16

@ Dr. Arvind

Lateral slits

My own opinion is that the use of "straight" slits (preferably lateral) are important but not because they improve the illusion of coverage which is often stated as their advantage. In contrast to the "elliptical slits" produced by a needle, I feel that the contraction of the straight slit during healing is less likely to result in compression of a graft due to primary intention compared with the elliptical slit produced by a needle. As a consequence the final angulation is more predictable and the graft better spread. Just my two pennies worth!



marco has 3 Personal Journal(s). Click here to view
marco is located in U.K and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
02.09.2010, 13:11

@ hairlove

safe donor area

» dear dr.arvind,
» looking at the pics of safe donor area,why is that lot of clinics doing
» fue now a days seem to go beyond,(read higher up), than the safe donor area
» to harvest the grafts????
» this is usually not the case with strips!!
»
» regards,
» hairlove

Dear Hairlove,
It is not advisable to transplant hair outside the safe donor area.
In case hair are being extracted from above the safe donor area, it is possible that the transplanted hair will also be lost with the progression of Male pattern hairloss.
Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
nitesh

Homepage E-mail

INDIA,
02.09.2010, 19:23

@ Dr. Arvind

safe donor area

Sir

As i was searching answer about safe donor area since a long time.....and if this is the range of safe donor area mention by you in above pictures,then i got my answer and can say that my strip is taken from unsafe donor area from first surgery.

First HT surgery strip pic is attached here....

[image]

Regards
Nitesh




nitesh is located in INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Nitesh HT results
First Surgery Dr Charu Sharma
Second Surgery Dr Arvind Poswal


Post reply
Ahab

02.09.2010, 19:42

@ Dr. Arvind

Body hair to scalp

» I meet many who have lots of body hair as well as extensive hairloss.
» The question uppermost in their mind - If hair can be transplanted, why
» not transplants the thousands, even millions of hair some have, on their
» body, to the scalp and finish the problem once for all.
»
» After having spent years researching this special field, I have found the
» answers that are clear when viewed from my side. But for someone to
» understand from the other side, it may take an effort.
»
» Before I try to explain, just keep in mind "Nature kept it simple".Whether
» we understand the simple is up to us.

Since I've been taking DHT inhibitors (propecia, proscar, avodart), I've lost most of my body hair.

So if I had body hair transplants before I started DHT inhibitors, I would think I'd have slowed continued fallout of original scalp hairs, at the expense of losing the body hair transplants.

Seems like a wash to me.

Furthermore, should anyone decide to not take propecia/proscar/avodart in any case, and therefor would believe themselves removed from those drugs causing them to lose body hair--there's always the chance they may one day need to take those drugs because of a swollen prostate, and then possibly find their body hair transplants falling out.

By the way, these drugs seem to have little or not effect on my beard hairs.




Ahab is located in [NA] and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
03.09.2010, 15:15

@ Ahab

Body hair to scalp

»
» Since I've been taking DHT inhibitors (propecia, proscar, avodart), I've
» lost most of my body hair.
»
» So if I had body hair transplants before I started DHT inhibitors, I would
» think I'd have slowed continued fallout of original scalp hairs, at the
» expense of losing the body hair transplants.
»
» Seems like a wash to me.
»
» Furthermore, should anyone decide to not take propecia/proscar/avodart in
» any case, and therefor would believe themselves removed from those drugs
» causing them to lose body hair--there's always the chance they may one day
» need to take those drugs because of a swollen prostate, and then possibly
» find their body hair transplants falling out.
»
» By the way, these drugs seem to have little or not effect on my beard
» hairs.

Dear Ahab,
Those are very important observations.
Prospective non beard BHT patients are well advised to stay on Finasteride for a period of 8 to 12 months and observe any decrease in the proposed body donor hair before they decide to go ahead with using body hair as a donor source.

In some people, continued use of Finasteride can reduce body hair growth.

At the same time, it is well worth mentioning that Finasteride does not negatively effect the beard/facial hair.

Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Ahab

03.09.2010, 20:02

@ Dr. Arvind

Body hair to scalp

» »
» » Since I've been taking DHT inhibitors (propecia, proscar, avodart),
» I've
» » lost most of my body hair.
» »
» » So if I had body hair transplants before I started DHT inhibitors, I
» would
» » think I'd have slowed continued fallout of original scalp hairs, at the
» » expense of losing the body hair transplants.
» »
» » Seems like a wash to me.
» »
» » Furthermore, should anyone decide to not take propecia/proscar/avodart
» in
» » any case, and therefor would believe themselves removed from those
» drugs
» » causing them to lose body hair--there's always the chance they may one
» day
» » need to take those drugs because of a swollen prostate, and then
» possibly
» » find their body hair transplants falling out.
» »
» » By the way, these drugs seem to have little or not effect on my beard
» » hairs.
»
» Dear Ahab,
» Those are very important observations.
» Prospective non beard BHT patients are well advised to stay on Finasteride
» for a period of 8 to 12 months and observe any decrease in the proposed
» body donor hair before they decide to go ahead with using body hair as a
» donor source.
»
» In some people, continued use of Finasteride can reduce body hair growth.
»
» At the same time, it is well worth mentioning that Finasteride does not
» negatively effect the beard/facial hair.
»
» Regards,
» Dr. A

Interesting and a good precaution to test effects of DHT blockers on body hair in potential BHT patients before proceeding.

Also interesting that as I personally observed, DHT blockers seems to have little or no effect on beard hair.




Ahab is located in [NA] and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
05.09.2010, 08:44

@ Dr. Arvind

What is BHT? - all input welcome

Simply put, BHT stands for Body hair to scalp transplants.
No! it does not mean transplanting hair to various assorted body areas.

The idea is to use the hair growing on the body as an additional donor supply. The hope is to get rid of "donor limitation". Atleast, in suitably hirsute patients.
-------------------------------------------------------

Does it work?

Maybe, I should first allow 24 hours for all else to speak.

I hope to get all contradicting views in one place. That is a good way to get to the real truth.
At the end of that we can sift and get to the bottom of this. No pun intended.

Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
nitesh

Homepage E-mail

INDIA,
06.09.2010, 08:45

@ Dr. Arvind

Scalp Exercise

Sir

If a patient goes strip surgery and he/she is not doing scalp exercise,then what would be the effect on scar.Or this exercise necessary for second surgery for more yield HT.

Up to how much time or months scalp exercise is necessary.

Regards
Nitesh




nitesh is located in INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Nitesh HT results
First Surgery Dr Charu Sharma
Second Surgery Dr Arvind Poswal


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
06.09.2010, 15:06

@ nitesh

Scalp donor area stretching exercises

» Sir
»
» If a patient goes strip surgery and he/she is not doing scalp
» exercise,then what would be the effect on scar.Or this exercise necessary
» for second surgery for more yield HT.
»
» Up to how much time or months scalp exercise is necessary.
»
» Regards
» Nitesh

Dear Nitesh,
Scalp donor area stretching exercises is a very important topic.

The part of the scalp considered safe for donor harvesting by strip has numerous connective tissue attachments to the aponeurosis below it.
These attachments do not permit the scalp skin to slide over the underlying tissue and skull.

To compare, try pinching the skin over the back of your wrist. You will notice it is very easy to do so.

Try doing the same on the scalp skin at the back of the head. You will find it much more difficult.

----------------------------------------------------

Scalp donor area stretching exercises aim to loosen the connective tissue attachments of the scalp skin to the underlying tissue.

This helps :
1. Hasten healing as there is less stetch on the suture line,
2. Minimizes the chances of post HT scar widening,
3. Maximizes the grafts that can be extracted in a single strip FUHT procedure.


------------------------------------------------------

Scalp donor area stretching exercises would be beneficial to all. Whether going for the first procedure, or a subsequent one.

Let me know if you have further queries.
Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
marco

U.K,
06.09.2010, 17:49

@ Dr. Arvind

Scalp donor area stretching exercises

»
» Scalp donor area stretching exercises aim to loosen the connective tissue
» attachments of the scalp skin to the underlying tissue.
»
» This helps :
» 1. Hasten healing as there is less stetch on the suture line,
» 2. Minimizes the chances of post HT scar widening,
» 3. Maximizes the grafts that can be extracted in a single strip FUHT
» procedure.
»
»
» ------------------------------------------------------
»
» Scalp donor area stretching exercises would be beneficial to all. Whether
» going for the first procedure, or a subsequent one.


Do you think this could equally be achieved by undermining the galea local to the donor incision?



marco has 3 Personal Journal(s). Click here to view
marco is located in U.K and he is available to meet: NO


Post reply
nitesh

Homepage E-mail

INDIA,
06.09.2010, 18:29

@ Dr. Arvind

Scalp donor area stretching exercises

Sir
After surgery for how much months it is good .I mean to say 2 months or 8 months or more...

And is there limit of time period after that there is negligible impact of doing scalp exercise .Example doing exercise up to three years ,then it is beneficial or time wasting on scalp exercise???

Or effective in first year after surgery????????

Regards
Nitesh




nitesh is located in INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Nitesh HT results
First Surgery Dr Charu Sharma
Second Surgery Dr Arvind Poswal


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
07.09.2010, 07:59

@ marco

Scalp donor area stretching exercises

»
»
» Do you think this could equally be achieved by undermining the galea local
» to the donor incision?

Dear Marco,
Undermining the galea followed by intraoperative traction is a known method.
However, in my opinion, even though technically feasible, it is more invasive.
Especially, in terms of the additional trauma to the neurovasculature of the undermined area.

I would rather advocate the pre operative, non invasive, scalp donor area stretching exercises.
Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
topcat611

E-mail

07.09.2010, 21:39

@ Dr. Arvind

What is BHT? - all input welcome

I think over the years we have seen body hair to be hit or miss. Since I need to use body and beard hair to help with my repair it’s always been of interest to me. My own recent experience with body and beard hair has been very good so far, but I do have a long way to go.

Since I have been on the forums for a very, very long time I have been able to develop many friendships over the years and I still maintain contact with many of the forum members who no longer post.

Let me say that I have no problem in a failed result with a hair transplant, and especially when using body or beard hair. If the clinic and doctor did the best that they could that’s all one could really ask for. Sometimes things don’t go well, and it could very well be the patient’s own physiology or just the fact that the person is a repair. It’s put a greater burden on the clinic so repair patients in general should be grateful that clinics will even accept them.

You have a patient in your repair gallery that had bht work done a long time ago, but after a year it all fell out, never to grow back again. Obviously this was a failure, but judging from your website one would not get that impression. I spoke to this same patient a few weeks ago to let them know of my progress. He is happy for me, and is just resigned to shaving the rest of his head and being done with it, scars and all.
Surely you are aware of this failed result. I don’t think it’s anything of which to be ashamed. But I also think it’s better for the prospective patient to know that this particular person had a failed procedure and this is possible. It gives one the ability to make a more informed decision.



topcat611 has 1 Personal Journal(s). Click here to view
topcat611 is located in [NA] and he is available to meet: NO

---
I have been posting for well over 14 years because I feel the need to help others avoid the mistakes I have made and want to help others make better decisions and avoid being deceived. I would be happy to speak to anyone at anytime in person or on the phone. There are some out there that wish I would go away, but I don't have any plans on going anywhere. I believe the small amount of effort I make can make a big difference in someone else's life and it's well worth my time.

Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.


http://hairsite.com/serendipity/authors/19-Topcat611
http://hairtransplantrepair.blogspot.com/

My experience can be read on my blogspot and a complete pictorial history of my repair procedure is available at:

http://tinyurl.com/y8m256z


Post reply
johnp

E-mail

New Jersey,
08.09.2010, 00:48

@ Dr. Arvind

Lateral slits

Dr Arvind this is the best illustration ever, I finally understand what lateral slits mean, thank you.



johnp has 1 Personal Journal(s). Click here to view
johnp is located in NEW JERSEY and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.


Post reply
Gunther

09.09.2010, 05:47

@ topcat611

What is BHT? - all input welcome

TopCat,

Do you have an email address at which I may contact you? I would like to discuss your recent procedure with Bisanga but was unable to find any contact information for you at any of the links you have attached to your profile.

Thanks




Gunther is located in [NA] and he is available to meet: NO


Post reply
topcat611

E-mail

09.09.2010, 14:12

@ Gunther

What is BHT? - all input welcome

You can e-mail me at htrepair1@yahoo.com



topcat611 has 1 Personal Journal(s). Click here to view
topcat611 is located in [NA] and he is available to meet: NO

---
I have been posting for well over 14 years because I feel the need to help others avoid the mistakes I have made and want to help others make better decisions and avoid being deceived. I would be happy to speak to anyone at anytime in person or on the phone. There are some out there that wish I would go away, but I don't have any plans on going anywhere. I believe the small amount of effort I make can make a big difference in someone else's life and it's well worth my time.

Stay away from doctors who perform mega sessions, have posts deleted, attack posters, sue patients & forum owners, use power drills or robots. I recommend fue with hand punches in the .70-.85 range. I consulted with dozens of clinics over the years and there was a recurring theme regarding FUE among some employees of those other clinics. I was told Bisanga was the man my research told me the same and my experience validated my own research.


http://hairsite.com/serendipity/authors/19-Topcat611
http://hairtransplantrepair.blogspot.com/

My experience can be read on my blogspot and a complete pictorial history of my repair procedure is available at:

http://tinyurl.com/y8m256z


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
09.09.2010, 16:03

@ Dr. Arvind

Body Donor Hair - additional v/s alternate donor source

Dear forum readers,
The first and foremost thing to remember about Body donor hair is that it is an additional donor, not an alternate donor source.

Body and beard hair have different characteristics then scalp hair.
They have different -
1. Length,
2. Calibre/diameter,
3. Curl,
4. Sheen and texture,
5. %age of hair in anagen/growth phase,
6. Duration of Anagen/growth phase,
7. Predisposition to greying, etc...

Assume that the transplanted body and beard hair will retain their original characteristics after transplant.

The doctor and the prospective patient should plan their HT based on the above.

Additional information about BHT and some case studies can be found at
http://www.fusehair.com/body_hair_transplant

We have formulated Guidelines for BHT that we advise prospective patients to follow.

Guidelines for BHT -
These guidelines are based on our follow up observations in patients.

1. Preshave the body donor areas 3 to 5 days before the extraction. It is a simple step and very helpful to pinpoint the actively growing hair that need to be used.

2. Use only the body donor hair in active growing phase for purpose of transplant. Do not use telogen hair.

3. Assume the transplanted body hair will retain their original characteristics (length, calibre, color, predisposition to greying, curl, anagen/telogen %ages and hair growth cycles).

4. Factor in the impact of growth cycles and characteristics of the body donor hair proposed to be transplanted.

5. Mix the various body as well as scalp donor hair in any particular area of scalp.

Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
09.09.2010, 16:35

@ Dr. Arvind

BHT - the preshaving protocol

A larger %age of hair follicles are in resting/non growing phase on the body donor areas.

It is advisable to use only the actively growing hair for transplant.

Preshaving the body donor areas is a simple, non invasive method to locate the actively growing hair.

Please note - The body donor areas should be wet shaved with a razor (trimming with a hair trimmer alone will not suffice), 3 to 5 days before the procedure.

If you have very dense and long hair growth, you may first buzz cut the hair with a trimmer, followed by shaving the hair flush with the skin using a razor.

The duration of the anagen/telogen phase plays an important part overall, while the %age of hair in telogen gains increasing importance with each passing hair cycle.

Talking of durations -
Following is an extract


--------------------------------------
Hair Growth Tables
There are many factors that affect individual hair growth. These growth tables should only be used as a very generalized guide.

Telogen (%) Anagen (%) Duration of Activity

Scalp 15/ 85/ 2-6 years
Eye Brows 90/ 10/ 4 - 8 weeks
Cheeks 40 - 50/ 50 - 60/
Beard (Chin) 40/ 60/ 1 year
Moustache 45/ 55/ 16 weeks
Arm Pit 70/ 30/ 16 weeks
Pubic Area 70/ 30/ months
Arms 80/ 20/ 13 weeks
Legs & Thighs 80/ 20/ 16 weeks

Carl W. Bushong, Ph.D., LMFT
Richard A. Martin, Jr., M.D., FACEP
Kimberly L. Westwood, CPE, CCE
et al.

--------------------------------------

While the scalp donor hair have a growth phase of, an average, 3 years, most body hair have a growth phase lasting approximately 4 to 5 months.


Therefore, unlike scalp to scalp transplants, BHTs will show a marked cyclic variation.

Also while 85% of the scalp hair are in growth phase at any particular time, 40 to 80% of the body hair may be in telogen (non growth phase).

Thus, the significance of the Preshaving protocol.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
11.09.2010, 16:19

@ Dr. Arvind

Graft estimates

Dear forum readers,
Graft estimates is another important topic for patients researching HT options for themselves.

How does the doctor give graft estimates for a patient?

The wrong way to do this is to limit the graft estimates to the number of grafts the doctor/clinic can perform e.g., I have come across Norwood 6 level of baldness patient given graft estimates of 2500 grafts at some clinic.

What is happening in this scenario?
At best, there is a miscommunication. The doctor maybe telling the patient that 2500 grafts is the total number of donor grafts he can perform for the patient. The patient on the other hand may tend to believe that 2500 grafts will give him good coverage (maybe even a full head of hair).


So for the prospective patient it is important to keep the following information in mind -

The full non balding adult scalp has average 100,000 hair follicles (or 40,000 follicular unit grafts).

The numbers may differ among different races. The blond Caucasian have higher number of total follicular unit grafts while on the other extreme are the negroid and the Oriental/fast east people.

Nevertheless, one gets a base idea.

Now, if you look in the mirror and see that half the original hair have succumbed to the effects of male pattern hairloss (hair have vanished/miniaturised); you would realize that the number of follicular units lost is approximately 20,000 (half of the original 40,000).


2500 or even 5000 follicular unit grafts are not going to return the original head of hair back to you.

What you will need to do is sit down with your doctor and devise the sort of hair restoration you plan. Depending on the HT doctor's philosophy and capability, he should let you know the total number of fu grafts available for transplant at his hands.
Then he will let you know what he can accomplish with the said number of grafts.

If what he can accomplish is alright with your expectations, go ahead.

Else, you will atleast be clearly in the picture and may decide that HT is not worth the trouble for you.

There is more on this topic but that for later.

Regards,
Dr. A

P.S. - meantime, you may like to research about how much total donor fu grafts YOU have available for use.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
HanginInThere

Manila(UwishUrHere),
12.09.2010, 03:02

@ nitesh

safe donor area seems to me

It seems to me that the safe donor area used by Dr A
is the ultimate extreme safe area

I think many patients, will not lose hair in the area way above that "safe" area
for the rest of their life, so for them the area for "safe" is much larger,

but since the docs have no way of knowing which patient will lost hair so low on the sides as Dr A safe area guidelines, that sure if you use that as a guide almost no patients will recede below that area. But its an extremely cautious
map if you ask me




HanginInThere is located in MANILA(UWISHURHERE) and he is available to meet: YES
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---
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Maxi Hair by Country Life 2/day
Saw Palmetto 320mg/day
Beta Sitosterol 125mcg/day
Pygeum 500/day
Nettles 500/day
Kal Amino Max 2/day


Post reply
nitesh

Homepage E-mail

INDIA,
12.09.2010, 17:32

@ HanginInThere

safe donor area seems to me

» It seems to me that the safe donor area used by Dr A
» is the ultimate extreme safe area
»
» I think many patients, will not lose hair in the area way above that
» "safe" area
» for the rest of their life, so for them the area for "safe" is much
» larger,
»
» but since the docs have no way of knowing which patient will lost hair so
» low on the sides as Dr A safe area guidelines, that sure if you use that as
» a guide almost no patients will recede below that area. But its an
» extremely cautious
» map if you ask me



As Dr A explained from their side about safe donor area, which i m understood at present from pics boundary provided by Dr A.

I also had seen article on Dr Coel website ,but i didn't able to understood clearly

forhair . com /donor_harvesting . htm

Can you explain Dr Coel article about safe donor area range.

what would you suggest in my case by seeing my progressive baldness and strip position from where it is taken(as shown in pic above).




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---
Nitesh HT results
First Surgery Dr Charu Sharma
Second Surgery Dr Arvind Poswal


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
14.09.2010, 17:10

@ Dr. Arvind

How much is the available scalp donor grafts

There may be differences in this based on
- race,
- size of the head
- scalp donor area laxity
- donor area follicular unit density

But, we will talk about average case.

Option 1-
Strip FUHT - With multiple strip procedures (I do not advise more then 2 full length procedures in a person's life), most people can give 5500 to 7000 FU grafts.

FUSE/fue after strip excision - 1000 to 1500 grafts from scalp safe donor area.

Option 2-
Only FUSE/fue method extraction - 3500 to 5000 grafts.

---------------------------------------------------------------

In addition to the above, we have beard donor area. The beard donor varies widely from person to person and it is not possible to hazard an average guess.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
chris

18.09.2010, 05:50

@ Dr. Arvind

Hair transplant education for prospective patients

I want to know on a scale 1 to 10, how painful is hair transplant with 10 being the most painful? The pictures I see on this board look horrifying as if someone is being stabbed thousands times in the head.




chris is located in [NA] and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
19.09.2010, 04:48

@ chris

Pain in hair transplants

» I want to know on a scale 1 to 10, how painful is hair transplant with 10
» being the most painful? The pictures I see on this board look horrifying
» as if someone is being stabbed thousands times in the head.

I think this question would be best answered by patients who have already got the procedure done.

However, in brief -

1. Injections of local anesthesia are given in the donor and recipient areas to render them numb/pain free. So, the actual surgical procedure itself is pain free (even though it may look messy or horrifying in the pictures).

2. In strip FUHT, the sutured donor area will be tender after the effect of anesthesia wears off at the end of the procedure. Pain killers are prescribed for the same for 5 days.

3. The recipient area is usually pain free at the end of the procedure.

4. The donor area of FUSE/fue is usually pain free even after effect of anesthesia wears off. There may be minor discomfort or soreness for a couple of days. Most patients do not feel the need of pain killers after a FUSE/fue procedure.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
20.09.2010, 13:25

@ Dr. Arvind

Coverage v/s density

Many a times, patients having extensive hairloss (Norwood 5 or above) are faced with a delimma.
If they are going in a multiple stage HT, should the grafts be transplanted to
- acheive the final desired density for a particular area, or,
- should the grafts be transplanted at a lower density to cover most, if not all areas of hairloss with some hair

Following are a few examples of patients with extensive hairloss choosing different options.
I do not advocate one option over the other.
Nor will any 2 patients necessarily be identical in their hairloss patterns (even if they are classified at similar levels on the Norwood scale)

Choice 1 - (addressing one/few areas at a time)
http://www.hairsite.com/hair-loss/board_entry-id-72880.html

http://fusehair.com/image/tid/14

http://fusehair.com/image/tid/117

http://fusehair.com/image/tid/199

http://fusehair.com/image/tid/99

http://fusehair.com/image/tid/192

http://fusehair.com/image/tid/94

http://fusehair.com/image/tid/260






Choice 2 - (addressing all/most areas of hairloss albeit at a lower density)
http://fusehair.com/image/tid/204

http://fusehair.com/image/tid/261

---------------------------------------------------------------------



Of course, the third option of going for larger number of grafts to finish the procedure in one go is always there.
Example - http://fusehair.com/image/tid/124




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
28.09.2010, 16:31

@ Dr. Arvind

The significance of beard/facial donor hair in hair restoration

I would prefer that the facial hair not be clubbed with body hair as they differ in many aspects, including, most importantly, their growth cycles and the possible adverse effect of finasteride on them.

As per my knowledge, the first ever documented case of beard hair to scalp by fue was performed at our clinic in Feb 2006.

Beard hair is a very viable source for augmenting the donor supply. In most cases, however, it can not be used in the hairline and temple points.

Its advisable to use it mixed with other scalp hair to help in easier blending once the hair grow.

Following are a few documented examples of patients who had very robust and well endowed beard and utilized the same for their hair restoration

6873 beard (including 207 moustache grafts).
Argentine is happy with the results.
http://www.fusehair.com/image/tid/124

http://www.hairsite.com/hair-loss/forum_entry-id-53760.html


Please note that most people may not have such prolific beard as Argentine's.

Zayden's case
http://www.hairsite.com/hair-loss/forum_entry-id-51738.html
This was considered the "impossible repair" by many. Beard donor hair was greatly instrumental in Zayden's repair.


Francis' case
http://www.hairsite.com/hair-loss/forum_entry-id-46014.html

Pop's case
http://www.hairsite.com/hair-loss/forum_entry-id-49928.html
I found Pop's case to be an equally challenging case as Zayden's and its successful outcome was very satisfying for me.

Vineet's case
http://www.fusehair.com/image/tid/204
http://www.hairsite.com/hair-loss/board_entry-id-51031-page-0-order-time-category-0.html

Veer's case - 2850 beard grafts
http://www.fusehair.com/image/tid/206
http://www.hairsite.com/hair-loss/board_entry-id-62514.html

Veer and Vineet's case were examples of extensive hairloss for which the patient would have had to settle for much lower expectations without the use of beard donor hair. Both are happy with their progress.

Arjun's case
http://www.hairsite.com/hair-loss/board_entry-id-33703-page-0-order-time-category-0.html

http://www.fusehair.com/image/tid/20

Arjun's was an extraordinary case that showcased the use of the "less is more approach". Again beard donor hair played an important part.

There are more documented cases, but offhand, these come to mind.

Facial hair, including hair from the cheek and the moustache hair have been used in the above cases.



Please note: Not all facial hair are the same. The chin hair, cheek hair, moustache hair or the hair low down on the neck all differ.
They differ in terms of their length, speed of growth, coarseness etc. You just have to examine a person with a grown out, untrimmed beard to understand what I mean.
The hair from different parts of the face would be suitable for different purposes. For example - hair from the edges of the beard (low down on the neck or high up on the cheek) do not grow very long. They would be better used for areas that do not require long hair length (previous strip scars would be the ideal place for them). Chin hair and hair towards the central parts of the beard grow longer. They would be suitable for adding bulk in the vertex areas.

Regards,
Dr. A




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
stitchmeup

29.09.2010, 01:27

@ chris

Hair transplant education for prospective patients

» I want to know on a scale 1 to 10, how painful is hair transplant with 10
» being the most painful? The pictures I see on this board look horrifying
» as if someone is being stabbed thousands times in the head.

I didn't have fue but I can tell you strip is a solid 8 on a scale from 1 to 10, it would be nice to hear from those who had both fue and strip.




stitchmeup is located in [NA] and he is available to meet: NO


Post reply
Duck

30.09.2010, 15:49

@ Dr. Arvind

The significance of beard/facial donor hair in hair restoration

"In most cases, however, it can not be used in the hairline and temple points" 100% agree!




Duck is located in [NA] and he is available to meet: NO


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
02.10.2010, 07:59

@ Dr. Arvind

How far will my hairloss progress?

Another oft asked question and one that has significant impact on the decision of whether to and when to go for hair transplants.

Recent advances suggest availability of successful genetic testing to predict future hairloss.
Helpful information for the same is given at the following link
http://www.hairdx.com/nioxin/FAQs.aspx

----------------------------------------------
Other measures -
1. Familial tendency to hairloss (both on the maternal and paternal sides),
2. The age at which hairloss started. Though there are no definite medical studies that have documented this, the layman perception is that the younger age at which hairloss starts, the more severe/extensive it is likely to be.

Though not fool proof, the above 2 parameters can be used to try to predict the extent of hairloss that would occur if left untreated.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
08.10.2010, 14:45

@ Dr. Arvind

Some necessary definitions patients should know (Anagen, categen and telogen)

Anagen, categen and telogen
Hair growth cycle is divided into 3 phases. Anagen, catagen and telogen.

Recent advances have added more stages/phases but for ease of understanding, I am limiting this discussion to easy to understand, simple stages.


The active growth phase is called anagen. During anagen, cells in the root/hair buld divide mitotically to add to the hair shaft.
During catagen, the hair bulb ceases to divide and starts involuting and regressing. Catagen phase starts at the beginning of involution and ceases when the involuting bulb reached the level of the bulge.
Telogen is the resting phase of the hair. The hair ceases all activity and stays as a club hair. It may shed at any time from the beginning of the telogen to the time new angen phase commences.
The event at which the telogen hair sheds is called exogen.
Exogen need not be at the time of the start of the next anagen. Effects like traction, trauma may bring it earlier on in telogen.
The various phases of hair growth cycle differ in different hair (scalp, nape, body, beard hair etc. have different duration of the various phases).

For present, we concentrate on the scalp hair.
Anagen lasts for anywhere between 2 to 6 years. Catagen for 2 to 4 weeks and telogen for 3 to 5 months.
As a thumb rule, we can say A:C:T is 3yrs:3weeks:3months.
In scalp hair approximately 85% hair are in anagen, 12 to 14% hair are in telogen and 2 to 4% hair in catagen.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
08.10.2010, 17:11

@ Dr. Arvind

2 effluviums - a must read

There is Anagen effluvium and telogen effluvium.
Both of these are not classic male pattern baldness. However, its very important to understand about them.

A lot of hairloss happenings/coincidences can be explained if these 2 are understood.

First, we shall talk about telogen effluvium

Telogen effluvium (TE) – In animals, hair/fur goes into synchronized telogen and are shed. This is called telogen effluvium. It occurs in humans during phases of extreme stress, malnutrition, post pregnancy or when under certain drug therapy. For telogen effluvium to occur a significant proportion of hair have to switch from anagen to telogen at the same time. The hair are shed 2 to 3 months later.
Telogen effluvium may be acute or chronic. When hair sheds persistently for more then 6 months, its termed chronic. Chronic telogen effluvium is more common in females.
Acute Telogen effluvium is seen in many infants as a band of hairloss around the occiput that occurs 2 to 3 months after birth.
In order for a large number of hair to simultaneously switch from the anagen phase into the telogen phase, the body has to undergo some systemic injury.
There is usually a lapse of 2 to 3 months between the inciting cause and the hair shed. Therefore, it is often difficult to identify the exact cause in many cases.
A telogen effluvium is not caused by topical medications. But because there is a required time lapse of several months between the inciting cause and the excessive shedding of hair, the exact cause of the telogen effluvium is often not positively identified.

Hair shed is known to occur 2 to 4 months after pregnancy. This can be considered a classic example of telogen effluvium.

Other suspected causes of telogen effluvium include menopause, severe illness, job change, crash diets, major surgery, severe bloodloss, heavy metal poisoning etc. Hyper and hypothyroidism, SLE, end stage renal disease are other reasons. Medications, including anticoagulants, anti inflammatory agents, retinoids, calcium channel blockers etc. are some known causative factors of TE.
In all cases, the common factor is some form of physiologic stress several months before the hair shed.

Diagnosis – 1. Hair pull test : Hold a bunch of hair between the thumb and fingers and pull firmly. Unlike in normal conditions, where 2 to 4 hair may shed, one notices a high number of hair coming out. Usually between 20 to 30. This test will be positive even in the scalp areas resistant to pattern hairloss, like the occiput area. At the same time, note that there are no slick bald patches like in alopecia areata.
The hair that get pulled out in the test will be club hair.
An obvious history of an inciting cause and the time frame between the physiological insult and the actual hair shed is usually sufficient to clinch the diagnosis.
A biopsy is usually not required.

Treatment – Telogen is actually a variation of a normal hair shedding process, which occurs prematurely and in a synchronized manner in TE. Therefore, there is little in way of treatment except reassurance.
One must eliminate or treat the inciting physiologic event. Assuming there is no repeat of the physiologic insult, the hair should get replaced in 6 to 12 months.
In certain cases, telogen effluvium can coincide with early stages of Male pattern hairloss. In such cases, the hair that replace the shed hair may be miniaturized, giving the impression that the inciting physiologic event gave rise to male pattern hair loss.
Hair transplant is not recommended treatment for Telogen Effluvium.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Dr. Arvind

Homepage E-mail

New Delhi, India,
09.10.2010, 15:47

@ Dr. Arvind

Anagen effluvium, chemotherapy, radiotherapy

Anagen effluvium (AE) – unlike telogen effluvium, anagen effluvium is not a normal process. Simply put, it is the loss of hair in its active growth phase, which is not a normal event.
AE is extensive hairloss caused due to sudden damage to the growing stem cells of the hair follicle.
The commonest cause is following chemo or radiotherapy administration for treating tumors.
The hair do not get shed like in TE. Instead, the hair shaft gets fractured and the hair falls.
Hair growth occurs due to rapid mitotic division of the cells in the hair matrix. The hair grows on the scalp at an average 1 cm per month. Following an injury to these rapidly dividing hair matrix cells/keratinocytes, the cell division stops or is greatly reduced.
The stoppage of cell division results in a greatly weakened hair shaft that breaks the moment it reaches the skin surface.
Thus, hair in AE typically occurs 1 to 3 weeks after the inciting injury/cause.
Since 85 to 90% of the scalp hair are in anagen at any one time, AE can influence 90% of the hair.
The telogen hair, since their keratinocytes are not multiplying, are spared.
If the chemotherapy and/or radiation is discontinued, regrowth of hair from an anagen effluvium can be expected within weeks, since matrix cell division has only been temporarily disrupted. The hair that grows back may show a change in the texture and color. These changes may persist for years because the chemotherapeutic drugs and/or the radiation has produced changes in the surviving hair matrix cells that persist for the entire anagen phase
of the hair follicle (nearly 2 to 5 years). In occasional cases, insults to the hair matrix are severe enough to cause a premature termination of the anagen phase and the start
of catagen. If catagen occurs, recovery of hair will not be seen until the
end of the next telogen phase, which is 2 to 4 months.
Topical minoxidil has been shown to shorten the duration of hair loss due to
chemotherapy and/or radiotherapy by approximately 45 to 55 days, but it is unable to
totally prevent hair loss due to chemotherapy or radiotherapy.




Dr. Arvind is located in NEW DELHI, INDIA and he is available to meet: YES
email hairsite@aol.com to arrange a meeting.

---
Dr.(Capt) Arvind Poswal
A-9,First Floor,
C.R. Park, (Near Nehru Place),
New Delhi-110019, India. www.fusehair.com
e-mail: fusehair1@gmail.com
Ph- 91-011-26274368,91-098-101-78062
Hours-10a.m.to 5p.m
Scalp & Body hair transplants
facebook - arvind poswal
Results- www.fusehair.com/image
===
Dr. Arvind Poswal is a sponsor of HairSite. Rankings on HairSite are based on # of successful patient results posted and not affected by sponsorship. Any clinic or doctor can post their patient results in HairSite forum and earn a point for every successful result posted. It is not the mandate of HairSite to track failed or unsuccessful results, readers are advised to do their own research carefully before making a decision about hair transplant and not rely solely on our ranking system.


Post reply
Lucky

10.10.2010, 20:22

@ Dr. Arvind

2 effluviums - a must read

» There is Anagen effluvium and telogen effluvium.
» Both of these are not classic male pattern baldness. However, its very
» important to understand about them.
»
» A lot of hairloss happenings/coincidences can be explained if these 2 are
» understood.
»
» First, we shall talk about telogen effluvium
»
» Telogen effluvium (TE) – In animals, hair/fur goes into
» synchronized telogen and are shed. This is called telogen effluvium. It
» occurs in humans during phases of extreme stress, malnutrition, post
» pregnancy or when under certain drug therapy. For telogen effluvium to
» occur a significant proportion of hair have to switch from anagen to
» telogen at the same time. The hair are shed 2 to 3 months later.
» Telogen effluvium may be acute or chronic. When hair sheds persistently
» for more then 6 months, its termed chronic. Chronic telogen effluvium is
» more common in females.
» Acute Telogen effluvium is seen in many infants as a band of hairloss
» around the occiput that occurs 2 to 3 months after birth.
» In order for a large number of hair to simultaneously switch from the
» anagen phase into the telogen phase, the body has to undergo some
» systemic injury.
» There is usually a lapse of 2 to 3 months between the inciting cause and
» the hair shed. Therefore, it is often difficult to identify the exact cause
» in many cases.
» A telogen effluvium is not caused by topical medications. But
» because there is a required time lapse of several months between the
» inciting cause and the excessive shedding of hair, the exact cause of the
» telogen effluvium is often not positively identified.
»
» Hair shed is known to occur 2 to 4 months after pregnancy. This can be
» considered a classic example of telogen effluvium.
»
» Other suspected causes of telogen effluvium include menopause, severe
» illness, job change, crash diets, major surgery, severe bloodloss, heavy
» metal poisoning etc. Hyper and hypothyroidism, SLE, end stage renal disease
» are other reasons. Medications, including anticoagulants, anti inflammatory
» agents, retinoids, calcium channel blockers etc. are some known causative
» factors of TE.
» In all cases, the common factor is some form of physiologic stress
» several months before the hair shed.

»
» Diagnosis – 1. Hair pull test : Hold a bunch of hair between the thumb and
» fingers and pull firmly. Unlike in normal conditions, where 2 to 4 hair may
» shed, one notices a high number of hair coming out. Usually between 20 to
» 30. This test will be positive even in the scalp areas resistant to pattern
» hairloss, like the occiput area. At the same time, note that there are no
» slick bald patches like in alopecia areata.
» The hair that get pulled out in the test will be club hair.
» An obvious history of an inciting cause and the time frame between the
» physiological insult and the actual hair shed is usually sufficient to
» clinch the diagnosis.
» A biopsy is usually not required.
»
» Treatment – Telogen is actually a variation of a normal hair
» shedding process, which occurs prematurely and in a synchronized manner in
» TE. Therefore, there is little in way of treatment except reassurance.
» One must eliminate or treat the inciting physiologic event. Assuming there
» is no repeat of the physiologic insult, the hair should get replaced in 6
» to 12 months.
» In certain cases, telogen effluvium can coincide with early stages of Male
» pattern hairloss. In such cases, the hair that replace the shed hair may be
» miniaturized, giving the impression that the inciting physiologic event
» gave rise to male pattern hair loss.
» Hair transplant is not recommended treatment for Telogen Effluvium.

Dr. Arvind, I am new to this board, thank you for the telogen effluvium information, I am starting to think (or hope) that it is the reason I am losing my hair so rapidly this year. It all started earlier this year probably around March or April and since then the shed has been frightening, I must have lost 1/3 of my original density already, so depressed.

Do you advise your telogen effluvium patients to go on minoxidil ? I started using Rogain foam a few months ago and added Revivogen later on, would this help or this is not a good idea?

Should I just stop all treatments and let my hair grow back on its own?




Lucky is located in [NA] and he is available to meet: NO


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