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  1. 3 points
    "pseudo wet hair" This is underestimated and not well considered enough. In Couto's case (and I'm not bashing him as a surgeon) there is a conscious decision to mislead. The damp hair in his cases will show virtually no more information than dry hair and they clearly aren't stupid enough to not understand this. 90% of even top surgeons do similar things but inexperienced noobs like Wally (which is the vast majority of those who haven't had transplants) can't understand this sort of thing.
  2. 3 points
    Cheap does not equal poor result. Expensive does not equal great result. There are no guarantees in surgery so there are no guarantees in price. Anything can happen All that matters is High ethics and standards of care and patient satisfaction.
  3. 3 points
    While everyone here has focused on the problems of bargain shopping for a HT, paying extra doesn't necessarily insulate you from a bad result either. I went to a supposed “top tier” doctor in Belgium that ended up charging me an extra 3-4k more for my surgery (he decided to expand the operation when I was unconscious and exceed our agreed upon graft count, only then to have his financial secretary awkwardly tell me the next day how much more I would be paying for the honour). Not only did I end up with a bad result from that surgery, but then I had to turn around and spend another 12k with another surgeon just to fix it. All in all I spent around 28k (including flights accomodations etc) and had to go into debt over what should have been a straightforward surgical experience from an award winning veteran of this industry - so no, not happy about the price and regret getting a HT in the first place. I've also seen enough bad results (even botched results) from prominent doctors that price isn't really a good gauge of quality in this industry either - all that matters is patient verified results.
  4. 2 points
    Right, lets look at my result then: The reality is there isn't a single person on the forum or on the planet with my previous hair situation who wouldn't be happy with these results. To add to that, Erdogan has and continues to have among the most impressive high norwood results on this and the international forum. Certainly the most impressive of FUE. You're obsessing over Couto purely off the basis of Youtube videos, I doubt you've seen a single patient posted result from him. You literally were praising an Erdogan result as "One of the best jobs I've ever seen." a few days ago. "Of course obtuse and uneducated guys like jayldd dont know hair while stuck with shitty transplants." You know as well as I do that this comment is false so why say it? I've had multiple transplants, I've seen multiple people with transplants in person including people who had previously been to American and Canadian clinics at ASMED and I've been on this forum for longer than you have and engaged more significantly. Same situation with Gas and same situation with Melvin who has been here for years and years. You've never had surgery, the current state of your hair is terrible and you're jerking over a surgeon who again, I am 99% sure you've never seen a patient posted result from. You refuse to understand that it is impossible to achieve natural density on the top of the head by taking from a donor with less hair than ever originally existed on top. Its the equivalent of a child believing in magic. I feel bad for you in a way because its clear your own hair situation is terrible and you're looking for a magic bullet so badly you've decided wizardry is a real thing. Wake up and stop acting like a child. "Dude youre overreaching and getting angry af. Its not that serious if youre wrong. Take a water break you need it" Proof you're deluded? I strongly recommend you read and reflect on this comment you wrote, specifically how hypocritical it is and the projection involved in case you're beyond figuring that out.
  5. 2 points
    I agree, in Turkey anyone can claim to be a hair surgeon, just open a site, upload photos of amazing results, perhaps stolen by other surgeons and passed off for them, photographing large hospitals even made to look like owners, and who doesn't ago nothing is known about the hair transplants being deceived, all because there is no control in Turkey. We find ourselves managed by young people who were perhaps the waiters the day before or who know what other job they did. It is indeed very dangerous.
  6. 2 points
    @duchaine my friend Goncalo had his appointment today with @Dr. Bruno Ferreira Dr. Bruno analyzed his hair under the microscope and said that my friend`s miniturized hairs are not impeditive of him having a hair transplant and that he has treated many patients with DUPA so he can safely confirm that Goncalo does not have DUPA Dr. Bruno measured a total area of 226cm2 to implant and believes that it will be difficult to achieve a good density because my friend has very thin hair. Dr. Bruno reccomended Goncalo to have two surgeries the first with 3500 grafts and the second with 3000/3500. Regarding the beard, Dr. Bruno said that its darker and thicker with a tendency to curl so he won`t use any beard grafts. The only comments Dr. Bruno made about the 270 grafts implanted by Dr. Pekiner was that the punch size he used seemed a bit too big and that he doesn`t understand why the surgery was stopped. Goncalo is now booking his two hair transplant surgeries with Dr. Bruno Ferreira. So far I am very happy with my surgery experience and the 16 day results from Dr. Kaan Pekiner but after the feedback from Dr. Bruno Ferreira, I am inclined to agree with you that Dr. Kaan seems to be filtering his patients so he only does surgery on patients he believes will achieve amazing results. I do feel somewhat responsible for Goncalo because I advised him Dr. Pekiner but in fact this Doctor does achieve amazing results and is very affordable for a Doctor that only has 1 patient per day and does the whole surgery (both myself and my other friend Ricardo that also had a HT in December are very happy so far). I advised Goncalo to ask a second opinion to Dr. Bruno Ferreira because he works with the foremost authority for DUPA - Dr. Jose Lorenzo as you can see from Dr. Lorenzo presentation on the link below: Hope my comment has helped you @duchaine and I also hope you can have the same feedback when you ask for a second opinion. I do reccomend that you to chose the Doctor you will ask this second opinion very wisely.
  7. 2 points
    Yeah, I'll be posting a detailed update in a few weeks time. Since my last update, there has been further thickening and growth and all seems to be heading in a very positive direction. Thus far, I'm very happy with the outcome of the surgery - well worth the cost and effort.
  8. 2 points
    What? Are? You? Talking? About? This is a great result and on top a rare 1 out of 100 cases without big shedding...the yeti exist! There is one very small area with less than optimal growth. This is a <50 FU unshaven touch up away from a 10/10 result. By the way: When going thorugh this thread it appeared that there was some crust? in this area? Maybe a small infection or fungi?
  9. 2 points
    I do not what happened with your second HT. 11 months post 2HT, you look worst that you looked before getting it. The doctor should answer here and explain why a such poor result.
  10. 2 points
    I just found this thread. Im interested to know why the photos have been removed. @transplantedphil did you remove them? and if so why?
  11. 1 point
    Should you name the clinic, because either way, if it is a success people should know, and if it is a failure people should know. Try to post without agenda, simply share your experience and allow the community to make the judgement. This way you're not necessarily naming and shaming, you're simply sharing your genuine experience.
  12. 1 point
    George....IMHO, this is an infection called Follicularitis...and I highly recommend that you contact your surgeon immediately so they can start treating this a.s.a.p.
  13. 1 point
    A lad who went to demirsoy the week before says you don’t see the hairs before you remove the scabs so you don’t know wether they have not grown bud until you remove the scabs hope this helps 👍
  14. 1 point
    I was reading some papers about type II diabetes and metformin when I read some interesting researches about autopaghy and hair loss. Autophagy is the natural, regulated mechanism of the cell that removes unnecessary or dysfunctional components, allowing the orderly degradation and recycling of cellular component. during the last decades, we have had several researches on AF and the benefits correlated to AF (on this topic, I suggest to read the book written by David Sinclair where he explain the results of his decennial research on this topic at Harvard University). In 2016, Matsumura et al. demonstrated that "that hair follicle stem cell aging causes the stepwise miniaturization of hair follicles and eventual hair loss in a process that that depended on the proteolysis of type XVII collagen. The cyclic growth and shedding of hair requires a complex communication between epithelial and mesenchymal cells. While autophagy is active in hair keratinocytes and mesenchymal cells surrounding hair follicles. A 2018 research (Parodi et Al.) showed that "genetic inhibition of follicular autophagy induces premature catagen and enhances hair matrix keratinocyte apoptosis, suggesting that autophagic flux in the anagen hair matrix is important for the maintenance of this stage. Indeed, we find that the principal ingredients of a product used to treat hair loss induces autophagy in organ-cultured human scalp HFs and promotes anagen. We conclude that organ-cultured human HFs are a suitable (mini-)organ system to study both the role of autophagy in human physiology ex vivo and to test candidate agents that modulate autophagy under clinically relevant conditions". So, the interesting question was, "if we do activate autophagy, can we stimulate anagen?" In 2019, Chin et al answered to this question "quiescent (telogen) hair follicles can be stimulated to initiate anagen and hair growth by small molecules that activate autophagy, including the metabolites α-ketoglutarate (α-KG) and α-ketobutyrate (α-KB), and the prescription drugs rapamycin and metformin, which impinge on mTOR and AMPK signaling. Stimulation of hair growth by these agents is blocked by specific autophagy inhibitors, suggesting a mechanistic link between autophagy and hair regeneration. Consistently, increased autophagy is detected upon anagen entry during the natural hair follicle cycle, and oral α-KB prevents hair loss in aged mice". Unluckily, the last research was conducted on aged mice. Can we stimulate hair growth taking metformin? Or, considering that fasting stimulates AF, can it be a weapon to fight hair loss?
  15. 1 point
    During a transplant procedure the doctor will carefully select the "hair" he needs. Hairline hair, for example, will be finer in caliber than the hair located in the mid scalp. Finer hair is typically harvested from behind the ear. Some will have one hair, some two and so on. If a 2 hair graft is selected and planted as such, it will grow as a 2 hair graft. That specific graft will not grow additional hair. But this does bring up a question. Say that two hair graft is split into 2) 1 hair graft. Would that 1 hair graft grow additional hair? I doubt it. What is transplanted is what will grow. So the site is made and the graft implanted. A crust forms. 7 or so many days later, the hair that came with the graft - along with the crust - will fall off. 3-4 months later the new hair will start coming in. The hair will be very fine and will continue improving. Matured results take 12-18 months. At that point the caliber of the hair will match that of the donor. The follicle still "thinks" it is in the donor area and will behave a such.
  16. 1 point
    Post-surgery photos After the surgery when Dr. Koray came to see me at my room to do a post-surgery inspection, he told me something about that my scalp had felt very tight during the incisions. I am not sure what exactly he meant. What I noticed is that the grafts don't seem to have been placed as deep as I have normally seen on post-surgery photos, as I noticed (if you look closer) that the transplanted hairs are sticking out much longer from the incisions. Could this have anything to do with it what he was saying? If that's the case, does anyone know if there any risks with this, like cobblestoning/ridging?
  17. 1 point
    Look's great Matt! Glad we both got our crown's done around the same time to watch each other's progress. It never ceases to amaze me how clean the postop work is.Here's to hoping the third time is a charm for you!
  18. 1 point
    Yes If you take a hd photo with flash you will observe many native hairs along side transplanted ones, but they are weak and dying Reviving them would boost density for sure
  19. 1 point
    Quite possibly, though even if they are not damaged, the temporary loss of blood supply may cause them to die off if they were already weak and affected by DHT. Strong hair should come back hopefully. Stick and place is a good way of minimising damage compared to slits, but since you are completely blind you never know if there's a dormant follicle beneath the surface.
  20. 1 point
    @karatekid both Bruno Pinto and @Dr. Bruno Ferreira are located in Porto / Portugal not Spain. Dr. Bruno Ferreira also works in Madrid at Dr. Jose Lorenzo clinic but that amazing clinic charges 5€graft. I believe Dr. De Freitas has truly great results but be prepared for a long wait list and similar price to Lorenzo. You are not being petty, research as much as you can before booking the surgery!
  21. 1 point
  22. 1 point
    Hello everyone. In this post I am going to give an overview about my prosedure which was on January 9th,2020. I have been waiting for that day for a long period of time. Before giving an idea about my prosedure I would like to describe why I selected doctor Tejinder bhatti. First of all, Dr. Bhatti's huge experience in this field. Secondly, I found no secrecy in the cost of ht procedure. I tried to contact with other ht clinic in India. But they were somehow trying to avoid that, was was asking my phone number so that they can call me and let me know. Thirdly, Dr bhatti has settled darling buds clinic in Chandigarh. This clinic is built with all the modern equipments which are required.Compared to other cities in India Chandigarh is very relaxing. Post operation is more smooth. The time when I book my procedure in August 2019, I contacted with Shera Who is the patient advisor of Dr.bhatti . He has been absolutely helpful from booking the procedure, then sending the confirmation message. And also all the hotel arrangements. I am staying at the first hotel. Which is quite close to the near market, airport and also to the clinic Pre op- 8th January 2019 On 8th January, I had my consultation with doctor bhatti. Dr told me that he will be recreating the hairline, and will address frontal part only.He draw the hairlineband I was okay with that. Clinic manager Shalini gave the medicines which I took in the dinner. Operation day - 9th January 2019 Driver picked me up at 7 o'clock from the hotel. My procedure is started approximately at 8:15. The process itself was absolutely smooth. The time when the anaesthesia was injecting, I felt pain apart from that there wasn't any pain I felt. My procedure was completed at 3:00 p.m. Total 2243 grafts were planted. They also provided lunch. What I liked was everyone basically knows what they are supposed to do. They knows their role properly. reason why I am not writing much about the procedure day because for me it was a very smooth experience. The next day driver took me the clinic again to change the dressing. And medicines and instructions were provided on that day. Today I went to the clinic again to change the dressing again. Single Graft- 343 Double grafts- 1013 Triple grafts - 887 Any thoughts ???
  23. 1 point
  24. 1 point
    Aloe Vera gel will cool the scalp, help to reduce the redness and even help with inflammation. The rest of the grafts will eventually shed once they go into their respective resting phase, and the timetable can vary.
  25. 1 point
    congrats Craig. ASMED killed it. I got 3600 grafts from ASMED 23 October, so I'm almost 3 months post op... got a lot of thin hairs coming thru... ughhhhh the wait is killing me.. spending way too much time in front of the mirror looking for new growth... were u doing the same thing at 3 months? or did you somehow just not think about it ?
  26. 1 point
    I would recommend NOT going to Turkey. There is a difference between implanting into a wide donor scar versus an area that was peppered with incisions. You need a considered approach where a modest density is attempted first, to see how well the growth pans out. If that works out well you can boost the density another time. In Turkey you run the risk of the doc just pushing maximum grafts and profit.
  27. 1 point
    Wow that's horrible. Forget turkey. You should be looking at top doctors only who will do a small session first to see how the scarred area will react to transplants. No doubt you will have a lot of scar tissue in the hairline area after what happened the first time.
  28. 1 point
    There were some studies which showed that it blocks DHT from destroying hair follicles. And I'm sure that for some people, in smaller quantities, it does. But desperate people always think its a magic shampoo or something and use it everyday, and even if it works in blocking DHT in small quantities once or twice per week, when u use it every day, it's abrasive and harsh on your scalp and hair follicles and destroys your hair and does more damage than help.
  29. 1 point
    I stopped feeling self-conscious about my hair loss. I gained a passion. I felt victorious. I truly felt like I overcame something that was really detrimental to my self-esteem. I feel like I will be prepared to tackle other things in my life because of it- great topic by the way. Check out this vid
  30. 1 point
    Good morning everyone, I’m 12 days post-op and yesterday returned to work. Everyone was commenting on my new look (still have many scabs on the midscalp) so I openly spoke about my hair transplant with my colleagues and they praised me for having the courage to travel alone to Turkey to get this done. Below are pictures with hair wet and dry. Would really appreciate your comments. Thank you.
  31. 1 point
    Well I did say “3 results off the top of my head”. Here are a few I can think of from memory (and one might assume a proper search would deliver even more); https://www.hairrestorationnetwork.com/topic/53183-how-to-undo-a-hair-transplant-asap/ https://www.hairrestorationnetwork.com/topic/55750-dr-tejinder-bhatti-2-bad-hair-transplants/ https://www.hairrestorationnetwork.com/topic/51278-possible-repair-or-fix-after-bad-hairline-ht/ https://www.hairrestorationnetwork.com/topic/54387-hair-transplant-surgery-2376-fue-graft-with-darling-buds-tejinder-bhatti/ https://www.hairrestorationnetwork.com/topic/52551-2476-grafts-fue-with-drbhatti-at-darling-buds/https://www.hairrestorationnetwork.com/topic/53183-how-to-undo-a-hair-transplant-asap/ Since I’ve been on this network I have noticed that Dr Bhatti delivers utterly mediocre to outright terrible results with more consistency than other clinic here (with the fact that Dr Bhatti apparently does all the extractions and incisions himself meaning we can hold him personally responsible for the quality of the work). Looking4HTInshallah originally asked for someone who could “deliver perfect results” and I responded. Dr Bhatti does not even come close to this. So I do not believe I was being "very harsh" in my statement about Dr Bhatti's clinic, (especially in light of the links I provided) and I would never suggest him as a viable option when there are so many better and equally affordable clinics elsewhere. While you might disagree with me, others are free to search through his results and make up their own minds.
  32. 1 point
  33. 1 point
    @duchaine con Pekiner vai sul sicuro...vedrai 👍
  34. 1 point
    @karatekid You are not in such a bad way, do not exclude completely the Turkey, I recommend that you also look at Dr. Pekiner, who except the unfortunate member Dred77, I have not seen any threads that went wrong around the forums.
  35. 1 point
    @baldlivesmatter awesome journey man. Im just finished 7 months and quite pleased with my results as well. If i may ask, did you notice any changes in density or texture or growth of your hair after month 7? Just wondering what to expect for the next 5 months, thanks!
  36. 1 point
    @Zoomster and @Looking for HT Thanks for your great information and tips to help anyone through the airport ,and best seating areas on the flights and lots of other advice. There is some great information there thank you. I wish you both well on your own HT journeys , and HAPPY NEW HAIR ....................Paddy.......... .
  37. 1 point
    Sorry about that I was talking about something closer to the end result. At 6 months you should at least see the promise of what is to come.
  38. 1 point
    What I've had a good experience with is nioxin shampoo and conditioner, and then I switched to bosley shampoo and conditioner. But the best change happened when I stopped washing hair every day, and just rinsed it with water. But even better still is: when you wash your hair, massage in coconut oil on your scalp and leave it in for an hour. Then do a regular wash and condition, but with more massaging than usual, to get the coconut oil out.
  39. 1 point
    @Loadrunner my doner was good after 9 or 10 day. I had to put an antiseptic liquid and antiseptic ointment for the first 7 days. Then I had to do the first headwash to remove the crusts. After I done this I didnt have any crusts showing which is a big help . After doing this your recipent will still be quite red. Mine was red for 3 weeks and started to die down after that and is only really back to normal in appearance after a month. The doner area is still tender after 10 days, but not as red as the recipent. It wont be as noticable as the recipent in terms of redness, your hair that grows on your doner will help to disguise it somewhat. So all in all make sure you have all the crusts off , or as many as possible without forcing them very much. Then speak to your doctor about what you can use to calm down the redness, but you should be fine without people asking questions. You could say that your scalp got irritated by a shampoo or something that caused the redness. If any other guys reading this and has other ideas please feel free to share. ......................Paddy...............
  40. 1 point
    More information is needed to answer your questions. What are you trying to achieve? Are you trying to lower your hairline? Add overall density? If you are trying to lower your hairline and rebuild your hairline I would say 2,500. However, if you are simply trying to reinforce and strengthen your existing hairline I would say around 1,500. I wouldn't touch the crown or midscalp, you have enough density, and you would be a better candidate for hair fibers.
  41. 1 point
  42. 1 point
  43. 1 point
    Hairline and density is exceptionally well crafted , totally natural. Congratulations to Dr @Arika and@DrPradeep and all the team @eugenix.
  44. 1 point
    I agree, I suggest spending some time and researching real patient posted reviews on our website before choosing a surgeon. Remember, money comes and goes but your results stay with you forever.
  45. 1 point
    Hahaha Yeah, I am not a dentist, and the doctors in the quote I brought aren't a dentist, and your dentist who tells you it is safe isn't a dentist. And everyone who doesn't validate your concern isn't a dentist. I mean, hey. Let's assume I am a troll and not a dentist as you claim (I can confirm my degrees to melvin btw), but what about your dentist? And the names I brought? Some of those are known worldwide in the field. Read the quote I brought, google the names of those Dentist and try for once to understand what they are saying. I mean if you think standard is safe, why did you even make this thread? if 18 is standard then it is safe by your logic? And just for the record, I didn't say standard isn't safe but again you fail to understand that. Do the math, you get exposed to radiation on daily basis equal to 1 periapical X-ray mate. And everyone in this forum told you they have never heard of 16-18 X-Ray being standard, even those in USA. And it is the country that is well known for overdoing tests. Thing being safe doesn't warrant its overuse. As health practitioner you always prefer to be conservative as much as you can. If you can 5 instead on 10 you do that. No, it means if you didn't ask a question don't complain about not getting an answer. It means if you don't say your health issue don't complain that I didn't take them into account. It means you need to ask the right question to get the right answer. I am not a Nostradamus to know your health issue if you don't tell them in advance. You call me crazy for not taking into your account a health issue you didn't say? By what logic is that? There is no suggestive evidence of hair loss due to dental X-Rays. You are making a claim without evidence. There is neither a suggestive evidence of its effect on nerves. There is a weak -albeit significant- correlation of it in cases of overuse (like if you are doing your 18 x-rays on annual/biannual basis for long time) with some oral cancers like salivary gland cancer. If you are smoking, drinking, having HPV or eat spicy foods you will have more important factors to worry than this repeated xrays. In general X-Ray are avoidable in any dose with woman as precautionary, there are 100 of other things that we take exception to pregnant women and we deem it safe But you won't even try to even process this information , so do whatever makes you feel comfortable. This is my last post in this thread, I came here with good intentions but you don't want to listen and obviously my advice isn't welcome. The one last thing I would say, and I would say it as an honest advice: There is an actual strong evidence of correlation between Psychological factors and oral cancer/ cancer in general (this was actually my master thesis, done in prestigious UK university) among infinite number of health issues. You are obviously dealing with some stress/anxiety that I hope you will try to tackle, I know it is easier said than done. So at the end I can only wish you luck with your teeth and hair
  46. 1 point
    Thank you for your thought provoking comment Toubey! Even though I have thought about why I want an HT many times over the years, your question still got me thinking; why do I want a HT? To be honest, this would be the first time I share the reasons why I want an HT now even though I have been considering it for the last 10 years or so. My wife loved the buzz-cut style when I started doing it more than 8 years ago. She had always assured me that I look good and discouraged me from going for HT. For me I was fine with it, If my wife was happy I was happy. But, tragedy struck my life 2 years ago, my wife of 22 years died of a heart failure. As you can imagine, this changed everything about my life. I went into some kind of hibernation and withdrew myself from social life for more than a year. Now for the last one year or so, I am trying to become active by going out with friends and participating more and more in social activities. I also realized this incident also brought out all of my insecurities including being bald. Even though I am more active than before, I tend to shy away from activities that require close contact with women who are not my friends. I believe this may have something to do with my level of confidence and any improvement in my appearance may give me a confidence boost in general. I could be completely wrong here, but with my current life situation I am willing to take that chance even though I am afraid of any kind of surgery. So there you go I said it. BTW, I red your HT story and I hope things are a lot better for you now. -Josh
  47. 1 point
    We should remember that the goal is to achieve a visual appearance of restoration, not necessarily a defined level of density.
  48. 1 point
    The SMP industry has evolved and is booming right now. I also have had 2100 FUE by Dr Feriduni to the frontal area. I do not have enough donor hair to transplant the crown, and I have slight diffuse thinning in the middle. This was a bad procedure by a company that produces constant bad results. I fell in to their marketing trap as they 'innovated' SMP. We all make mistakes. Now back so SMP. There has always been, or certainly used to be a belief that SMP was garbage, waste of time etc. Not the case now days. The very best SMP artists can produce 3d effect SMP, natural results. Just look at the before and after pics of Paul Clark and Jonathan Gerow. When combined, SMP/FUE combo looks very good, providing one can rock a short hair style. Results undetectable when done by the right practitioners and docs. The best artists now use vegan ink, no additives that can cause the head to turn blue and no longer dish out goofy hairlines. Best artists will measure a hairline properly according to clients face, raising of the eyebrows etc, to determine what hairline to go with. I do not think there is an argument for anything being 'fake' providing one goes with the best SMP practitioners out there. SMP is essentially doing what a hair transplant does, restoring what was once there, albeit with a short buzzed/shaven look but it frames the face. For clients that do not have enough donor hair for whole head FUE, SMP if done correctly, is a fantastic option. Permanent SMP is now as good as temporary, due to the evolution of the procedure and quality of ink used by the best artists out there. Furthermore, lots of people are now choosing SMP over a hair transplant. There are pitfalls to HT's as you're always chasing the hairloss. Lots if people are also using SMP to thicken a HT. I had a bad SMP. By a crooked clinic. And I advise anyone considering SMP to stay away from that clinic. My rework plan involves one of the best SMP practitioners in the world. I will be posting progress of laser fading, and new SMP once laser has faded the awful procedure I had. Some people with hair transplants get all grandiose and disregard SMP. But SMP has now exploded onto the scene and is now a first choice option for many. Not everyone wants a slick back HT look. Some people like low maintenance short hair.
  49. 1 point
    Hi PA, So just to be clear: you started 1mg finasteride in July of 2018, and seemingly did not see any sort of initial shedding phase? By around 4.5 months post-op (November), your hair looked great and you appeared to be an excellent responder to finasteride. Then from November until now, you experienced gradual and worsening thinning to the point where you believe you have pretty much lost all gains? Typically people experience a shedding phase for the first 3-4 months; the follicles are somewhat "shocked" into a telogen phase (which lasts around 3-4) and then wake up and begin functioning better -- and growing stronger, healthier terminal hair as a result. If we presume that you did not experience an initial shedding phase but did experience one starting in November, it would likely end around March or so and should start exhibiting noticeable improvement by June or July. If you were my patient, I would probably tell you to wait 6 months from when the transition from Telogen (rest) to Anagen (growth) occurred. If we say the resting cycle ended in March, you would maybe want to wait until September before declaring that you have experienced no benefit from the finasteride. Now, how likely do I think this is? Probably not too likely. However, I have seen stranger things when it comes androgenic alopecia. I also think there is another possibility; and fair warning here: I do not think my experience and opinions when it comes to finasteride are necessarily as "main stream," but I feel pretty confident in what I have seen thus far interacting with thousands of hair loss patients over the past 5 years. I personally believe finasteride is a "kick the can down the road" type medication. In the end, androgenic alopecia is genetic. It is like your height, eye color, or any other inevitable physical trait based upon your genetic code. In the end, your genes are going to win out. You take a drug like finasteride and put someone on it while they still have a lot of their own native hair, and it may help them hold on to this hair or hold on to a greater portion of the hair for a longer period. In the end, however, they are still going to get to the same point. It just may take a little longer on finasteride. When you get to a certain point where you have already lost a good portion of hair or maybe the "horse is out of the barn" a bit, the drug tends to do less. You specifically may have been further along in the process, and there was just simply less that the drug could do. Maybe an initial "bump" was all that was possible before your body started making more DHT or expressing more DHT receptors in the follicles because that is its coded mission and there was not much you could do to slow it at this point in the mission. I know this is not the rosiest of theories, but I often find it holds water. While preventive medications are great and I always have a detailed discuss about using them with patients, they do have limitations and they cannot overcome what is hard-coded in your programming. Does this mean you should give up on it if you are not experiencing side effects? No, not necessarily. But it may be time to research other adjuncts (surgery possibly being one of them) to help. Just remember to play it safe and try to stick to tested and approved treatments. Again, the above is my educated opinion based upon my experience with the medication and hair loss patients. Other doctors may feel differently and they are absolutely entitled to their own conclusions based upon their experiences. I also say the above not to discourage anyone from using preventive medications; I do think they are useful adjuncts and recommend that all hair loss patients research and consider them.
  50. 1 point