zenmunk

Impressive! Please keep us posted.

Very nice result, hairthere. Thanks for keeping us posted.

Thanks for your replies, guys. I've been experimenting with 0.5mg everyday for the last two months. So far I think I haven't lost any hair. I check the mirror every day, and I take pics every month for comparison. Hopefully I can get to 6 months without noticing any hair loss. If I do, then I'll continue with that dosage indefinitely. jsnw, How long did you remain at every other day before you decreased it to 3x/week?

Anyone notice an increase in hair loss after decreasing finasteride dosage?

Congrats! Can't wait to see your results.

Dr. Wesley's work is among the most natural I've seen. Well done.

Like night and day! Congrats! Next 6 months is icing on that cake.

Hmm... that's a tough call. Finasteride is a funny thing. Very often a user will experience minor side effects that resolve on their own while still taking the meds. However, if you feel more comfortable stopping until you feel better before you try MWF, then go for it. From what I've read, general consensus is stopping for up to two weeks won't do much to make you lose hair that finasteride was preserving. So, start the new regimen as soon as you can within a two week time-frame.

No other way to do it except personal experimentation. Start taking it MWF for a week. See if that helps. If not, then try MTh. If not, then once per week. You can also try taking less per dose like 0.5mg or whatever. Everyone reacts differently to the meds. You've got to find out what works for you. If nothing works, then discontinue altogether.

Looks good! Thanks for posting.

Congrats on your good progress so far, driver. I'd love to see your donor again. Please post an updated pic of it when you can. Thanks.

MAGNUMpi, Can't speak for beaverbuzz, but no need to apologize, imo. If beaverbuzz came on the forum as a virgin scalp seeking advice, then your question about risking surgery would have been a valid one for his consideration. It's just a moot point now, since he already took the plunge. z

Bottom line is it's a done deal. Can't go back. So, we should all just offer support and advice and not say things like, "he really didn't need a HT." That kind of talk is better reserved for virgin scalps seeking advice. Beside, need is a very subjective thing. He has to stare at his own head everyday of his life. It also appears that he and Dr. Shapiro attempted a relatively conservative approach. IMO that was appropriate for his case. If the yield had been better, I'm sure he wouldn't be contemplating HT #2. I think SMG have proven they're top-notch. Every clinic, no matter how great they are, has less than perfect results. FUE yield is also more unpredictable. What's most important is they stand by their work and do their best for their patients, and it appears that's what they are doing. Good luck, beaverbuzz.

Excellent! Thanks, Jotronic.

chrisdav, That would be an interesting comparison. At 6000+ grafts, I think strip would beat out FUE in most cases (if not all). My personal opinion is FUE is best for relatively small procedures. 2000 or less is a safe bet. Hard to say where the cut-off is, though. More may be OK. It depends on many factors. Regardless, I'm becoming increasingly convinced that 2000+ FUE procedures should be divided into two procedures a minimum of 8 months apart for best results. z

I've often wondered the same thing, Mickey85. It's an important consideration for those contemplating FUE. I'd venture to say that 5000+ FUE would have a big impact on one's donor. Density would take a big hit and scarring would be noticeable. How noticeable? That will vary by surgeon skill, punch size, extraction pattern, remaining density & healing characteristics. Unfortunately, we don't have a lot of post-FUE donor pics/vids shaved down to see the full impact among many patients. As such, I think Dr. Lorenzo's multiple YouTube videos entitled, "Can you shave your head after a HT by FUE technique?" are invaluable. You've probably seen them, but for those who haven't, they shave down numerous FUE patients who have had large procedures (as in thousands of grafts) in preparation for further FUE work. That is something you rarely see. From what I could tell, every one of those patients resulted in white-dot scarring, but the scarring was hard to detect, even up close. From a distance, I'd say it would be impossible to notice. Also, we are rather experienced at looking for these things, because of our shared interest in HT. For the average person, it would probably be undetectable (unless the patient made the mistake of standing too long in the sun without adequate sunblock). I think it's reasonable for most patients to expect to be able to buzz to a #1 after FUE (with a top FUE surgeon) with little-to-no observable scarring. As to graft numbers... Hard to say. Obviously the higher one goes, the more risk involved. Bottom line, HT is a gamble with recipient yield and donor aftermath. No way around it. I'm very curious about Dr. Wesley's "scarless surgery." I plan to consult him in the near future. I believe he charges $100 per consultation, but I think it's worth it to get that information as well as his overall input on my situation. For that money, I would expect a very thorough evaluation.

Good luck, GBU! Happy growing, but you might wanna re-think the beer; it may be your best friend during the "doldrums." lol

Sean, Sure, definitely PM some links to Bisanga threads on other forums. Thanks! I wouldn't call your extraction pattern compressed. Was it spread out as far as it could have been? Perhaps not. It may have been extended down and forward more. Then again, there may be a very good reasons(s) why Dr. Rahal didn't do that which I'm not privy to. I agree with you, it was "somewhere in between." Great Feriduni links! Thanks! z

Haha, no problem. I couldn't find the audio, but here's the transcript: MUSIC VO: His left side is his good side. And so is his right. He once shook his own hand, just to see what all the fuss was about. When he dances with wolves, it’s usually the tango. His hair gets thicker with age. There are people still laughing at a joke he told in 1997. His anecdotes have subplots. He has never stepped in gum. SFX: MUSIC REACHES CRESCENDO VO:He is the most interesting man in the world. SFX: THE MIM’S MUSIC BEGINS TO PLAY MIM: I don’t always drink beer, but when I do, I prefer Dos Equis. VO: Enjoy Dos Equis Responsibly. Imported by Cervezas Mexicanas. White Plains, New York. MIM: Stay thirsty my friends

Spanker, I just heard what I presume is the latest DOS EQUIS BEER radio spot about the Most Interesting Man in the World, and one of the lines is: "His hair gets thicker with age." I thought of you and lol'd! So true, so true... z

MAGNUMpi, There isn't one place where you can compare all the hairline work of the different surgeons. You've got to find as many results for each doc as you can separately, and then compare them yourself. The way I've reviewed photos is mostly on this site. I use the search function, so if I want to see Feller's FUE cases, I just search for "Feller FUE." In Feller's case, there are a lot of photos of his FUE and FUT work here. He also has a site called fellermedical. I also do a general web search, because there are other hair loss forums on the internet which showcase patient results from these same doctors (and others not recommended here). Regarding Lorenzo and Bisanga, neither one is recommended here. As such, there are very few cases represented on this forum. You can use the search function to check anyway. However, if you do a general internet search, you'll find their work represented on other forums, on their own websites and on YouTube. Bisanga's site is called BHR Clinic. Lorenzo's site is injertocapilar.com, and his videos are on the YouTube channel of the same name. The good news, according to Mickey85, is Lorenzo plans to showcase his work on this forum soon, so keep a look out. z

Thanks a lot, Mickey85! Dr. Lorenzo's approach to hairline design seems quite thorough. Please feel free to PM me the link to the Spanish forum. I look forward to Dr. Lorenzo's posts on this forum, too!

Thank you for your thoughtful reply, Mickey85. I'm a Norwood III with a little thinning in my forelock, so I definitely need my hairline rebuilt. If you go to post #1 on this thread, you'll find a little drawing which indicates what must be done. I've already consulted Feller in-person, and plan to again since he's very close to me. During the initial consultation, I explained that I will only allow FUE. He said that would be OK and quoted me 1300 grafts total which, in retrospect, was way too conservative. Even Spex, his rep, recommended 2000+ grafts (not knowing the Feller quote). Rahal quoted 2000 - 2200 grafts. I think when I see Feller again, I will ask if he would be on board with my two procedure strategy; if he would use a manual punch (no larger than 0.8mm) for both procedures; and, if he would spread out the extraction pattern much more. If he's not willing to at least spread those extractions out and use the smallest possible punch, then I'd definitely cross him off the list. If he balks at the manual punch, then I may cross him off, too, but maybe not. Not too many of the elite FUE docs use manual punches these days, at least not in North America. We'll see. In fact, I may run the idea by Spex first to get his opinion. I appreciate your honest assessment of Lorenzo's work. I agree that your concerns are valid - hand drawn customized hairline design is essential, and a lack of patient posted results is a problem. I look forward to hearing Lorenzo's response to the laser template question when you ask him. Please feel free to post it here or make a separate thread about it. The second problem seems harder to resolve since Lorenzo is not recommended on this forum. What about other forums? Do you know if Lorenzo patients post elsewhere? I'm also intrigued by Wesley's "scarless surgery." I plan to consult him to learn more about it. Regarding regular FUE, Wesley does use punches as small as 0.75mm. I don't know what his feelings are regarding manual punches. I think his hairlines are very natural. Not especially dense, but natural (and if I had to choose I'd pick natural every time). On the whole, he seems like a very careful doc which is a plus. I guess if I wanted to approach a 60fu/cm2 hairline with Wesley, we'd have to do two passes which would kind of suck. That would make it a total of 3 procedures - one for the forelock and two for the hairline. Any thoughts on Wesley? z

Mickey85, My strategy is to do two FUE procedures (8 months apart) to equal approximately 2000 grafts. First would address thinness in forelock (I'd estimate 400 - 600 grafts). If that's a success, then second would be to build out my hairline laterally (I'd estimate 1400 - 1600 grafts). With that strategy, Feller may be a good doc to consider, because they are both relatively small procedures. However, that doesn't negate my concerns about his extraction patterns. And, I have seen that thread before which influenced me to strongly consider Rahal instead. But then, we have Sean's yield issue which concerns me. Having said that, both Feller and Rahal have outstanding FUE results (especially Feller since he's been doing it longer). I guess FUE is just more risky, period. Even in the best hands. Does Lorenzo accept international patients? Doesn't he use the choi implanter which seems to concern many people? What are his extraction patterns like? What size punches does he use? How would you describe his hairlines? Clearly, you're a fan, but if you had to point out concerns you have with Lorenzo's work or methods, what would they be? Thanks, z

Thanks again for your thoughtful input, Sean. When you say you have "mixed feelings," what are you referring to exactly? Density? Naturalness of design? Could you elaborate a little more on that? I'm a fan of Rahal's hairlines (like most of us on the forum). I think he's a very talented surgeon, but the issues I have are: 1) he uses a motorized tool, 2) I don't think he goes down to 0.75mm punches (like Bisanga), 3) He hasn't been practicing FUE for all that long, 4) I haven't seen many examples of his FUE extraction patterns; does he spread them out well? I'm more concerned with numbers 1, 3 & 4; less with #2, because he uses 0.8mm punches when appropriate, and that's pretty close. Even if I split my procedure up into two relatively small procedures for safety reasons, I wonder how much not using a manual punch will contribute to the final outcome. If you had it to do over, would you have opted for a manual punch? SMG is also an FUE consideration, but the same concerns I have for Rahal, I have for them. Feller is a strong consideration. He's been practicing FUE for a long time. He dense-packs where needed. His hairlines are very nice. As a bonus, he's close to where I live. The downsides are he's quite expensive; he doesn't use a manual punch (although I wonder if he'd do so if requested...); I don't think he goes down to 0.75mm punches (like Bisanga); and (most of all), I'm not a big fan of his extraction patterns. I feel they are not spread out enough (like Bisanga) and sometimes result in a geometric pattern which is discernible as slightly thinner than the surrounding hair. An example is found in this thread: http://www.hairrestorationnetwork.com/eve/142984-fue-patient-1-year-post-op-also-**update**-2-year-post-ops-dr-feller-patient.html The yield and hairline design are extraordinary in the above case, but the extraction pattern is a little troubling. If you compare immediate post-op donor (which is in post #1 entitled "Just after FUE") with donor two years post-op (which is in post #17, fourth pic from the bottom), then you can see the rectangular outline of the extraction pattern. If Feller had spread those extractions further down and further forward above the ears the way Bisanga does (which is more difficult to do), then I suspect there would be no discernible pattern. ***Update: In fairness, I asked Spex about this case, and he thinks the extraction pattern was at the request of the patient, and because the patient had extraordinary donor density, Dr. Feller felt like it was safe. I also concede that the lighting in the pic I reference was very unflattering, and at different angles the donor looks much better. Spex went on to say that Dr. Feller will work with the patient to spread out the extraction pattern (he did so with Spex himself). So, before committing to him, I will make sure that Dr. Feller is cool with approaching my extraction pattern similar to how Dr. Bisanga tends to - as spread out and non-geometric as possible. But I digress. I'm having an awfully hard time narrowing down my choices for FUE. All the surgeons have their strengths and weaknesses. I wish I could take the best from all of them and put them into one doc! lol Bisanga seems to cover all the bases, but I'd love to know more about why you think his hairlines are not quite up to par. Also, any thoughts on Feriduni? Thanks, z