zenmunk

Been a while, Sean. Just wanted to send best wishes on a brilliant outcome. You've certainly paid your dues and deserve it.

Can anyone else comment on this topic? How common is this sweating complication after HT?

I know the Bisanga case you're referring to, Spanker. That sparse area behind the hairline should have definitely been addressed. I had a consult with Bisanga ready to go in Washington D.C., but had to cancel unfortunately. I'm in no rush, so I'll try to have consultations with all three. I will give extra consideration to Lorenzo.

I'm far from rich, but if I'm gonna do it, I'm gonna do it right. I realize the three docs I'm choosing between are all exceptional. People seem to choose Lorenzo, in part, because of his ability to handle high-Norwood cases. Would you guys say that he also rivals Feriduni and Bisanga in terms of hairline artistry? And, how about Feriduni vs Bisanga in that regard?

The choice comes down to Lorenzo, Bisanga and Feriduni for hairline/frontal third restoration (although if you think someone else would be superior, then please share). Not interested in ultra-high density. Only enough density to produce a stand-alone (no products), convincing blend. Hairline artistry and naturalness are paramount. Also, an intelligent extraction pattern which potentially allows for a number 1 buzz is important. Thanks in-advance for your opinions. 40 year old Caucasian male Fine, straight, medium-brown hair Norwood 3. Persistent forelock. Moderate diffuse thinning around forelock at my right. Mild diffuse thinning around forelock at my left. Strong temple points Estimated grafts needed: 2000 - 2500 (probably closer to 2K) Average donor density On meds Hairline goals: Age-appropriate Norwood 2. Hairline not lowered. Maintain mild recession. Fill-in bald front corners. Transplant into existing diffuse hair. Not excessively aggressive or conservative. $ is not a limiting factor Location is not a limiting factor

Might be worth reading through this thread: http://www.hairrestorationnetwork.com/eve/166975-finasteride-dosage-frequency-conception.html

Might be worth a look: http://www.hairrestorationnetwork.com/eve/166975-finasteride-dosage-frequency-conception.html

BaldEagle1892, I took care of all of the testing through my GP. As long as you have a good relationship with him/her, then s/he will very likely understand your concerns and accommodate you. I think it's very important to establish a baseline for your levels BEFORE you begin with finasteride. That way you have something to compare it to with periodic testing. You'll be able to see how finasteride affects those levels (if at all). Unfortunately, I had no idea to do this way back when I started with Propecia. Keep one thing in mind. You will become a slave to this medication. Once you start you can't stop it if you want to keep whatever hair the meds are preserving. When you're in panic mode and just want to stop or slow MPB, you don't give that much thought. But you may find later on that it really starts bothering you for multiple reasons. No matter how much testing we do, my feeling is we can never know exactly how this medication is affecting us. So, even if all your results come back normal, there may be something bad happening that is not detected. Or, maybe not. It's pretty much a gamble, but with all the testing you can rest a little easier. In the end you have to pay attention to your body. Aside from establishing baseline levels, it may not be a bad idea to keep a finasteride journal for at least the first 6 months of use. This is not about your hair, but your health. How do you feel on it over time? Do you notice any negative changes? You may start detecting symptom patterns which will make you question whether remaining on the meds is a good idea. Or, you may not notice anything which would mean you tolerate the meds well. You can discuss your findings (if any) with your GP or Urologist. Hope this helps and good luck, z

I've used it successfully for a long time. Great product. Never noticed increased hair loss using it.

Your post does not inspire confidence, scar5. lol

Thanks for your reply, Blake. Actually, I was asking about when the follicles are already in the Telogen phase due to the natural hair growth cycle or extreme stress, not shock-loss caused by the trauma of surgery. From Wikipedia: "The catagen phase is a short transition stage that occurs at the end of the anagen phase.It signals the end of the active growth of a hair...A club hair is formed during the catagen phase when the part of the hair follicle in contact with the lower portion of the hair becomes attached to the hair shaft. This process cuts the hair off from its blood supply and from the cells that produce new hair. When a club hair is completely formed, about a 2 week process, the hair follicle enters the telogen phase...the club hair is the final product of a hair follicle in the telogen stage, and is a dead, fully keratinized hair." So, if the club hair is still in the scalp during surgery, then I presume a surgeon can carefully implant around the club hairs. However, if/when the club hair is shed and there is no hair there to indicate the location of the dormant follicle, then what does the surgeon do to avoid implanting directly into a healthy dormant follicle that will grow again? Is the hole through which the hair grows still visible to the surgeon so that s/he may avoid it?

Nope, didn't say that Magnumpi. You didn't include the entire paragraph or the last paragraph in my post: "Regarding the illusion of HT, from what I've learned from this site and other places, unless you have very minimal loss and the surgeon is willing/able to transplant at ultra-high densities successfully (ideal hair characteristics don't hurt, either), you will always be forced to be conscious of environmental factors which may betray the differences between your native and transplanted hair. Even with ultra-high density procedures, you will not achieve the natural density you enjoyed before MPB started. "However, in the above example, I'd venture to say that you could probably have a HT and then not worry too much about environmental factors. I doubt others would be scrutinizing your hair so closely that they'd notice any differences (and, they may not even if they try). The question is how many lucky folks fall into that category?" I believe a HT can be completely undetectable and natural. If I didn't, I wouldn't have spent as much time on this forum as I have. However, what you start with will determine what you end with (as long as you go to an excellent doc with excellent techs and your physiology cooperates). Of course, it's all about the effective blend. If you have a slight recession, but very thick, dense hair otherwise, then that hairline is going to have to be very densely packed to create the effective blend (that's the kinda guy I was talking about in my example). However, if you're a diffuse thinner and you're filling in areas around native hair, you can get away with much less density. In both cases, I believe you can achieve an undetectable and natural result (if lady luck is on your side). You just have to make sure it blends effectively. However, it's probably harder to create the effective blend for a receder with otherwise thick, dense hair, because you simply can't approach what nature provides in a safe manner (imo). But that has nothing to do with what you're willing to accept. If you're the diffuse thinner who wants to look like the guy with thick, dense hair, then you're going to have to use products or SMP to create that illusion. I don't believe a HT alone will cut it. Othersyde was talking about having a stand-alone procedure that requires doing nothing else. I believe that's possible, but it largely depends on one's needs and expectations.

Impressive recovery, especially the FUE donor.

Interesting thoughts. Thanks for sharing. I think everything ultimately boils down to illusion. We all perceive and interpret "reality" through our own lenses or filters. What we believe becomes real to us. Hence the expression, "As you think, so you are." At the end of the day, we have to follow our best instincts with any decision we must make. Do what feels right and makes you happy as long as you aren't infringing on another's life, liberty or property. Regarding the illusion of HT, from what I've learned from this site and other places, unless you have very minimal loss and the surgeon is willing/able to transplant at ultra-high densities successfully (ideal hair characteristics don't hurt, either), you will always be forced to be conscious of environmental factors which may betray the differences between your native and transplanted hair. Even with ultra-high density procedures, you will not achieve the natural density you enjoyed before MPB started. However, in the above example, I'd venture to say that you could probably have a HT and then not worry too much about environmental factors. I doubt others would be scrutinizing your hair so closely that they'd notice any differences (and, they may not even if they try). The question is how many lucky folks fall into that category?

Here's a question for docs and those in-the-know: When one's hair has entered the Telogen phase (usually lasting around 3 months) due to the natural hair growth cycle or due to extreme stress, how does the HT surgeon implant in such a way as to not interfere with the growth of the Telogen follicle once it re-enters the Anagen phase? Is there a way to do that? Obviously this is related to transplanting into and around existing native hair; if one is completely bald in the recipient area (for considerably longer than 3 months), then it's a non-issue. Thanks.

Thanks for your replies, Bill. Excellent list.

I'm sorry, but did you post that pic, Dr. Devroye? Is that pic 4 of 7, or is that a virgin donor?

Sweet! Congratulations on your success! Don't fret tomorrow - live for today!

Just as Gillenator suggested, I was under the impression that non-transplanted, native hairs which are DHT-receptive start out thinner (not thicker) with each new cycle. That's part of the MPB progression. Dr. Charles added an interesting new perspective that it can be hard to tell if what you're seeing is a hair on its way in, or on its way out. As he indicates, time will eventually tell.

Nothing wrong with asking questions, so don't take offense, but I can't see why anyone would want to go through the pain and expense of lasering-off temporary SMP, especially Milena's work. She's really quite good. It's not permanent and will eventually fade to nothing without having to do a thing.

This.

Bravo!

Anyone have experience taking Aurobindo 5mg Finasteride? Aurobindo Pharma is a company based in India. It's a round, blue pill with E 61 written on it. Doc prescribed "5mg Finasteride." Duane Reade Pharmacy (in NYC) gave me the E 61 pills. As it's generic, 30 pills cost me $18 & change. Quarter it, and you're saving a lot of doe. You know the ol' adage, "If it ain't broke, don't fix it." So, I'm hesitant to change from Merck's Propecia to Aurobindo's generic. Anyone on the E 61 pills? What have your results been? Thanks. ____ On a related topic, I read a thread on this forum (circa 2007): http://www.hairrestorationnetwork.com/eve/154062-1mg-propecia-vs-5mg-proscar-2.html Direct your attention to posts #15 & #19. In them, a "Dr. Proctor" claims that finasteride is not recommended for men over 40, with an greater risk of sexual dysfunction, and possibly cancer, over the age of 50. Here's what he said: "I will prescribe finasteride up to age 50 or so, after advising the patients accordingly, naturally. Over 40 is a "relative contraindication", mostly because the oldest person in the trial was 41. This seems appropriate most of the time because of the general reversibility of any sexual problems. "Over 50, I start to worry. One reason is the significantly increased incidence of sexual dysfunction. The other is that, while finasteride early may retard the development of prostate cancer, it may promote the progression of the last precancerous stage to frank prostate cancer. As a practical matter, this is probably not an issue under age 50, if it is an issue at all." - Peter H. Proctor, PhD,MD Any thoughts, particularly from docs, about this? Thanks.

Excellent result! Very natural. No doubt the patient's thicker caliber hairs contribute greatly to making 35-40 grafts/cm2 look like higher numbers.

Thank you for your reply, Dr. Wesley.