Taken4Granted

@yesplease Oh, of course, totally forgot about the donor incision. I’m 34 and was on fin for 6-8 years, ditched it maybe 5 years ago. Tough sides for me. Going back on min next month. From the top last night: Tried to wet down my hair and press it away to show the incision: But it’s not that apparent even with wet hair and minimal effort to cover it up: It’s cleaner and tighter than I expected. Gotta look really close to even see it. I can only make out the stitches usually.

Hey buddy, sorry to hear about your troubles. You def don’t want to keep chasing this with questionable surgeons and finite donor, but I can see how hard it must be to sit and do nothing. Was your first HT strip or FUE?

@home1212 Yes, not spending an hour every damn day on concealer and buzzing techniques to stay presentable is going to be my absolute favorite part of all this. Just shower and go!

Nope, sorry for the suspense @home1212. I hope you understand my withholding the name until I feel this thread represents him fairly. I wouldn’t want ppl searching his name and finding my thread where someone starts a debate about the work or the hair line or something. He’s a top-notch guy who has done well by me. Thanks for the kudos on the hair line. If there’s anything wrong with it, that’s my fault bc I had a lot of influence on it. I drew an awful rendition of what I had in mind, and then he did his best to fix it so it looked as natural as possible. But you’re right, it’s all about the future. I wanted to do something like the line below because I need to conserve donor. I wanted good enough density to style, so I didn’t want to blow a ton of grafts pulling the temples out to connect to a lower hair line. My thinning and family history tell me this is where I’m headed: Unfortunately, some folks back home are puzzled that I didn’t come back with Zack Efron’s hairline. I’ve spent a lot of time explaining about density of grafts and how the hair around the corners will cover up those high arches on the temples a good bit, but oh well.

Also noticed another thread about the yellow discharge, so I’m happy to share this. Just hours after a thorough cleaning on day 2-3 post-op, this stuff starts piling up:

They kept the recipient zone very clean for the first few days, but I popped some bloody spots after my flight home and woke up looking messier today. I figure all the facial/head motion and changing blood pressure kicked off some minor bleeding, but there’s one spot that worries me near the front. Maybe you guys can comment on this. Here it is from several angles in different light and moisture. I think most of it is fine, but it looks like maybe a long double got dislodged. Notice the long two hairs lying flat between the bloodiest spots: A little drier w/ flash: Other side looking good:

Folks, This day’s been coming for many years. I finally got my first HT, and I went to the best. I’ll reveal the name of the clinic later when I’ve had time to judge the content. I’m excited about where I went and have full confidence in the quality of the work, just want to be absolutely sure this thread is fair and accurate before I drop names. I’ll skip the novel (that’s coming) and just post the pre-op (looked even more bald when I grew it out) and post-op. Currently day 6: Pre-op right: Left: Looking to restore this with fair density (just enough to style a bit) and a mature hair line: Immediately post-op: Post-op hair line close-up: This morning (day 6), dry: After a shower (not on the recipient, obv.) and some saline, definitely noticing some bloody spots of concern: Looks like the left side (this is a mirror) is acting up:

Took finasteride for years, suffered severe side effects. It’s true that the internet is full of BS subjective “musings”, but the drug companies are not that reliable either. It’s tricky. The risks with this drug are real, but so are the benefits. @Curious25 said it right. It’s a personal choice every man has to make for himself. Just inform yourself. I went through a lot, but I don’t regret the years I spent on finasteride. It gave me continuity.

That doesn’t look like 3k grafts to me. Anything in the back? If that band in the front is 3k grafts, it must be pretty dense. Looks like you have decent native density right behind it, so maybe that’s the case, but I’d have guessed ~2k.

Hi @Struggle, definitely understand your struggle, if you’ll forgive the pun. Gyno is tricky in the early stages because the first signs are subtle. If you’ll forgive my slow pace, I’d like to discuss these early signs before addressing your question. There are visible changes like more erect nipples, more fullness or swelling, and maybe a puffy look. It’s hard to judge because there’s so much variation (muscle, fat, hydration, fibrous tissue, nipple and areola) from one man to another, from one life stage to another, even from one day or time of day to another for the same man. It also changes depending on your hormonal situation, i.e. how hormones affect you and which hormones are causing the problem, because different hormones affect different tissues, or they may affect the same tissue in different ways (for more on this, look up the effects of progesterone, prolactin and estradiol in breast tissue). Moreover, the earliest signs are aesthetic - in the sense of aesthesia, i.e. sensation - and therefore entirely subjective: tenderness, itching, burning or just increased sensitivity. That being so, physicians may not be in the best position to judge whether you’re showing signs of gyno, even if your uncertainty and psychological fog seem to call for an objectve, professional opinion. It’s just hard to diagnose it in the early stage when your physical presentation falls within the normal range that a doc sees every day. The same occurs to a lesser extent with hormones and other lab results with wide reference ranges. It’s not a classic disease that disrupts critical bodily functions, so there’s a lot of room for “normal”. Okay, the bottom line: You’re dealing with the early signs of a subtle process where psych factors are hard to account for and no one can give you a straight answer until you’re ready for your first trainer bra. Only you can decide whether things look and feel normal. It could be in your head, but the first signs can be as minor as simply noticing your nipples more than usual as the nerves get more sensitive and start sending stronger signals to your brain. The same thing could result from you touching them more - this causes you to make prolactin, so stop doing it - or from just stressing about it. But my rule is “When in doubt, discontinue.” You could be overreacting, but once you get permanent tissue, you’ll always be more prone to issues in the future, it won’t take much to make it worse, only surgery gets rid of it, and you’ll never see your natural chest again. A few things to keep in mind: 1. Don’t scare yourself with pictures on the Internet of crazy gyno on young men with relatively low body fat. That happens to them because they inject enthanated AAS and can’t stop the side effects because the injected drug continues to break down into sex steroids for weeks after it’s injected no matter what you do. Not your situation. 2. You notice more about your breast tissue the more you look. Don’t attribute slight changes (e.g. “they’re puffier today!”) to gyno too hastily. Watch, evaluate critically, take note of the environment (cold, warm), time of day (morning, night) and so forth. 3. Get a baseline blood panel for sex hormones. This includes testosterone, DHT, SHBG, estradiol, estrone, progesterone and prolactin. You can’t do this without dropping the fin for a little while, but it will help immensely if you want objective data down the road and need a baseline for comparison. With hormones, the lab reference ranges aren’t much use. Good luck!

@Curious25 Agree, very hard to make a case for messing with a normal endocrine system. It amazes me that women are so casually expected to take contraceptives. I do understand finasteride for hair, though. For some of us, hair loss can really change life for the worse. It seems so absurd, superficial, petty and vain, which only makes it harder. But the fact is that your face is a big part of who you are to yourself and others, and how you look can profoundly affect your life. It comes down to values and priorities, which we can only judge for ourselves. But yeah, docs hand it out way too readily. Patients should be able to make informed judgments and decide how much they want to risk for their hair. I support fin because I took the risk, paid a high cost and still have no regrets. Best of luck to you, @Hairybiker. We’re all on our own with these hard decisions, so it’s ultimately a tough call you have to make for yourself; but if I were in your shoes, I’d discontinue the fin altogether for a couple months to let the breast tissue go back to normal. Without knowing how much fin it takes to cause that, you might keep fueling the process and end up with permanent tissue. Maybe let your hormones stabilize and try a lower dose when you feel normal again. And hey, maybe try a low buzz if you haven’t yet. It really works for some guys, esp. biker types.

Hey @Curious25, def appreciate that. No, I’m just a damaged internet troll. You learn a lot trying to stop boobs from growing. I’m not totally against finasteride. I took it for years and managed to postpone becoming the bald guy long enough to cope a little, which was prob worth the trade. I do think it’s a lot more serious than many think and say. Do you take it? Sounds like you’ve had occasion to think about these things.

Hey, thanks @Melvin-Moderator. I’m honored if you felt I had anything to contribute. I had exactly the same thought about AIs and SERMs back in the day and did end up trying them out of desperation. I’m happy to share my experience. For everyone else, anti-estrogens come in three main classes: steroidal aromatase inhibitors (AIs), non-steroidal AIs and selective estrogen receptor modulators (SERMs). The first two block the enzyme that breaks a piece off of testosterone to make estrogen, and the other one blocks the effects of estrogen in tissue by competitively binding to E+ receptors in cells. As Melvin pointed out, these drugs may combat estrogen-induced side effects like unwanted breast tissue. They’re extremely popular with AAS users because they are effective when used to prevent these sides while you take them. However, I’d strongly advise against it for anyone considering it on this forum, for the following reasons. 1. No ethical doctor will prescribe these drugs to you unless you have breast cancer or hormone replacement therapy. That means you have to buy them illegally. You will have to break the law and then put unregulated substances in your body. Several years ago, you could buy them legally as “research chemicals”, but that loophole is gone. 2. Anything you do to manipulate your hormones runs the risk of permanently damaging or destabilizing your endocrine system, in particular the hypothalamus-pituitary-testes axis or HPTA. You could very plausibly induce hypogonadism and end up needing HRT. 3. If you’re taking finasteride for hair loss, combating side effects with anti-estrogens defeats the purpose of finasteride. Estrogen is essential for hair and fin works because it makes estrogen a more dominant hormone affecting your hair follicles. It’s essentially a mildly feminizing drug, which is why it has side effects like gyno. Growing hair is just like any side effect in that regard. 4. Even when you use anti-Es very carefully, you still risk estrogen rebound when you discontinue the drug. Your body makes estrogen from testosterone and uses estrogen for negative feedback in the hypothalamus. When E is too high, your body reacts by making less LH and FSH to stimulate your testes, so you make less T and thus bring E back down. When you supress E, your body makes more T. This is the most common mechanism for rebound: you discontinue your drugs while your T is sky high, and then it starts converting to E, resulting in abnormally high E. Gyno city. 5. Suppressing estrogen will stop gyno from getting worse, but it will not get rid of permanent tissue. In summary, the best thing to do is just let your body stabilize on its own. Messing with anti-estrogens can put you in jail with even bigger boobs, lifelong impotence or worse.

As someone who has struggled immensely with fin sides, esp. gyno, I can tell you it’s very real and not something to ignore. HOWEVER, as @LaserCap said, the worst thing you can do is stress out and do something desperate. For some men (def me, maybe you as well), a drop in the ratio of androgens to estrogens in estrogen-receptor-positive (E+) tissue will promote mitosis and growth of new cells, for example fat and glandular tissue in the breast. There are many stages of tissue growth that I don’t understand in much detail, but you should notice sensitivity and swelling in the breast before much new tissue has actually grown, so there’s still time to intervene. If you drop fin and let your hormones normalize, you may see everything return to normal in a few weeks or months. If you decide to do this, remember to give it some time. If you’re prone to gyno, it’s likely that any effective dose of fin will cause this to happen. I was in your shoes and decided the tissue was minor enough to ignore until I could get it surgically removed. I had a lot of success with fin and decided it was worth the trade for a time. Your objective as a man with MPB is the only thing to distinguish “success” from “side effect”, which is why they often go together. I suspect you’ll have good results in the scalp, so you may want to consider the choice I made. I’ve had multiple gyno surgeries, but I’d do it all over again. Couple things: Do not toy with anti-estrogens to control the side effects, and stop probing your breast tissue. Both of those things are very tempting and likely to make your problems worse. “You may even want to discuss dutesteride with your doctor and see how you react.” With respect, I would advise against using dutasteride. It does the same thing as fin and is many times more powerful. Last I heard, dut was the drug of choice for transgender patients on hormone therapy for this reason. Of course, I’m not a doctor and could be misinformed.

Looks great, man. Good for you.

@jmghair Dude, avoiding the linear scar is the #1 reason FUE exists in the first place. When I say it’s less risk, I don’t mean it can’t turn out poorly for some people. Who was your surgeon? FUE leaves scars to be sure, but you should not be so traumatized.

Strange that finasteride didn’t darken your hair. I naturally have medium to light brown hair, but it got very dark on finasteride.

I haven’t looked into this, but my impression is that robotics mostly serve to open the market to less experienced surgeons. Or maybe it helps some clinics manage more volume, but you normally see the quality drop when that happens. Seems many of the best still prefer to do it manually.

@jmghair I mean it’s less cosmetic risk because it doesn’t leave a linear scar on the back of your head. Even if you’ve done FUT, FUE is less risk than a second FUT because the scar can def get worse and more visible. If your hair loss is moderate enough to address with FUE only, speaking long-term, then that’s what an ethical surgeon will usually recommend for precisely this reason. No matter what, you’ll reserve the option of buzzing it down and giving up on hair. With FUT, you have to maintain coverage or accept a George Castanza hair style for the rest of your life - or bare your scar for the world to see.

There’s very little hit or miss when you pick the right surgeon, FUE or FUT.

@karatekid Fair enough. I would say the same in your shoes. I disagree, but I do so with all respect and civility. As someone who’s been watching the industry for about a decade, I would urge you to consider a few things. I’ve learned that’s it important to consider where you’re getting your data, how much a surgeon promotes him/herself, the ethics of the surgeon with respect to long-term outcomes, the demographics of the surgeon’s clientele and the details behind each restoration you see. It looks like Konior has an older, more affluent clientele, which means more space to cover with the same donor, less aggressive hair lines, and most importantly clients who typically don’t engage much online posting pictures and such. Moreover, Konior does virtually zero self-promotion (clearly flipped the middle finger to Yelp, for example). There’s a reason he always has a line out the door despite putting minimal effort into his website and spending nothing on marketing. Finally, the most telling datum IMO is the surgeon’s track record with patients who have multiple HTs. You’ll notice a lot of bouncing around between different surgeons. The ones who are more likely to appear later in the history after patients do better research, and the ones patients keep going back to over many years are the best surgeons. To illustrate with an example, Rahal has tons more amazing patient results on the Internet, but Konior is objectively the better surgeon when you consider the above factors. In fact, I think Rahal even sued HSN to get bad results taken down. Konior doesn’t go around cleaning the Internet of bad photos and puking his best work everywhere. The problem of bad reviews does not even arise for Konior. If you don’t see how good he is, I strongly believe you’re missing something. That’s not to say there aren’t great alternatives in Europe, of course.

@karatekid “About konior, as I said, US is a bit too far for me, and although I would go if I though it is worth the long travel, but from my reviews, those doctors seem like better choice.” I don’t know the European surgeons very well, and I’m sure there are really good ones out there, but it’s hard to see how you could do better than Konior. Trust me, that quality has to be rare in any part of the world. If you have a wish list of 5+ in Europe, he’s easily as good as if not better than most of them. He’s known for being on the expensive side, but it’s really a bargain when you look at his methods and his results. Whatever you pay, you’ll probably walk away feeling indebted.

@JohnAC71 How many of those 5 would you consider successful? What’s your NW rating, how many grafts have you done, how many different doctors have you had, and would you do it differently if you could?

Oh yeah. I need 3k+ grafts to fix my face. I’m not losing sleep over my crown right now.

I’m not as informed as everyone else, but 1k grafts sounds low even if the yield is good, so the density might be an issue, but there’s obviously growth coming in, so it doesn’t look like a botch. I’m gonna be the same way when I get mine, so I’m gonna try to remind myself to stay optimistic. Whatever happens, you got hair still and you went with FUE, so you’re okay. All that said, the thinning in your pics and the modest graft count tell me you’ll be back. If you’re committed to having hair - and luckily this FUE scarring might be subtle enough for you to experiment with a buzzed look - then do pick the next doc very carefully and pay up. Ofc by now you know that as well as the rest of us.