zenmunk

Might consider trying some toppik or dermmatch to see if it improves your appearance, too. Good luck.

hairthere, Very sorry to hear about your father. You have my sincere condolences. I lost my mom around 2 years ago. It was the most devastating experience of my life. I still struggle with it everyday. I hope you can find peace sooner than later. To anyone in utter despair over their hair, Expose yourself to real tragedy and heartache - terminally ill children, the impoverished, the homeless, etc; volunteer some time trying to help them, and you will undoubtedly have a new perspective on things. Also, obsessive compulsive thoughts can be a serious problem. Do not feel embarrassed about seeking professional counseling. z

I'd say you'd probably be in the safe zone if you cut out weekends, because DHT rises rather slowly over a 7 day period. Also, assuming you take 1mg/day, that's reducing finasteride intake from 7mg to 5mg per week - not a big reduction at all.

I'm no doctor or pharmacist, so take my advice with a grain of salt. Always consult a physician expert in these matters before taking action. Here are some finasteride observations: - How does finasteride work? Testosterone floating in the bloodstream of the typical adult male routinely combines with an enzyme called 5-alpha reductase. The result of this interaction forms the more potent sexual hormone known as DHT (Dihydrotestosterone). When a man begins to lose his hair, certain genetically programmed follicles begin to develop DHT receptor sites. The DHT attaches itself to these receptor sites and begins to treat the follicle as a foreign object in the body. This chemical change not only affects hair. It can cause itching, inflammation, and oiliness. During this time, the follicle, under the attack of DHT, begins to miniaturize with every growth cycle, until after several years, it simply is too small and short to be seen. When finasteride is taken, it works to inhibit the formation of DHT in the system. Within a few months, the overall DHT levels will have remained low enough on a constant basis that the adverse effects DHT is having on the follicles will stop, resulting in a cessation of hair loss. - When one first starts taking finasteride I suggest following Merck's directions - 1mg or 1.25mg (in the case of splitting proscar tabs) every day for a minimum of a year before evaluating the effectiveness of the results. If you experience mild-to-moderate sides, try to wait it out for a few months, without reducing dosage/frequency, to see if they resolve on their own; they often do. If they don't resolve, then consider reducing dosage/frequency. If you're having severe sides, you should discontinue using the meds. - Finasteride starts to inhibit DHT right away, but it may take several months before you notice less hair loss. In fact, it’s likely that you will experience a shedding phase for the first few months (usually around 3-4) after which time the miniaturized hairs will (hopefully) be replaced by stronger regrowth. - Finasteride seems most effective at the vertex and mid-scalp, but that doesn't mean one won't preserve one's hairline or even regrow some hair at the hairline. However, from what I can tell, impressive hairline regrowth is uncommon. - Everyone responds differently to finasteride based on their unique physiology (similar to hair transplants). It may work wonderfully for a long time or it may not work at all or something in-between. - It's very important to take the meds regularly. Having a set schedule helps to avoid missing a dose. - If you discontinue finasteride you will eventually lose the hair the meds were preserving for you (usually within six months). - After one has been on finasteride successfully for a while (I'd say a minimum of 1 year), then it may be OK to start experimenting with dosage/frequency in order to save money, reduce minor sides or simply because one feels better taking less meds. The key word is experimentation, but remember that experimenting (deviating from Merck's recommendations) may involve some degree of risk. In other words, you may lose more hair. z

My pleasure, guys. I hope others find it helpful and convenient as well.

I posted the following in another thread, but I thought it might be helpful as its own topic. This info is floating around in bits & pieces all over this forum, but collecting it all in one place may be useful. In human clinical trials, the pharmacokinetic half-life of finasteride was found to be 6 - 8 hours. However, the pharmacodynamic lifetime of finasteride action, measured in terms of the drug's ability to reduce the systemic concentration of DHT, after a single oral dose of between 0.04 and 5mg, was greater than or equal to 7 days. See the first chart below (taken from the book entitled, Integration of Pharmaceutical Discovery and Development: Case Histories): You can see how a single dose of the drug reduces the systemic concentration of DHT over a 7 day period. That leads one to believe that taking finasteride daily is probably not necessary to maintain one's hair count. However, it also leads one to believe that taking one dose every 5 - 7 days is probably unwise as well, because while the DHT remains reduced over the 7 day period it does slowly rise over that time. Then the question is how often should one take finasteride? Based on the above chart, I'd say it would probably be pretty safe to take it every other day or even three times a week (MWF). You may even get away with twice a week (MTh). The next question is how much (as in mg) should one take? Take a look at the charts below (the first three charts are from a Propecia study story (circa 1998) by Sherman Frankel, a University of Pennsylvania professor of physics): You can see from the Serum DHT graph above that from doses of 0.2mg all the way through 5mg, the amount of inhibited DHT was about the same. You can see from the Scalp Skin DHT graph above that from doses of 0.05mg all the way through 5mg, the amount of inhibited DHT was about the same. You can see by the above graph that the dose dependence appears also in the accompanying rise in T, one-onehundredth the 5 mg dose being identical in its effect on the scalp skin testosterone. The above graph (origin unknown) indicates how the following dosages of finasteride inhibit DHT: - 0.2mg = 61.7% - 0.5mg = ~65% - 1mg = 68.7% - 5mg = 69.2% All pretty close in terms of percentages. ____________________________________________________________________________ I'm no scientist, but the first plasma DHT graph seems somewhat at odds with the rest of the graphs: - 0.2mg reduces DHT to ~ 55 ng/dl - 0.5mg reduces DHT to ~ 42 ng/dl - 1.5mg reduces DHT to ~ 32 ng/dl - 5.0mg reduces DHT to ~ 25 ng/dl The first graph deals in blood serum levels. The rest in percentages of inhibited DHT. Unfortunately, I'm not sure how to compare the two. Perhaps plasma DHT levels of 55 ng/dl are not much different than levels of 25 ng/dl when it comes to preventing MPB? I welcome others more expert in these matters to chime in. Regardless, I conclude: It's probably pretty safe to take finasteride every other day or even three times a week (MWF). You may even get away with twice a week (MTh). Dosage is a matter of personal experimentation. Merck recommends 1mg daily for optimal results. Maybe they are right, but when you consider the above information; the personal testimonials of many forum members who have successfully reduced dosages; and, the fact that Merck is a pharmaceutical company interested primarily in profits, then I think a healthy bit of skepticism is warranted. If you want to save money and/or reduce side effects, I'd suggest tapering down slowly, and paying very close attention to any changes, until you reach a regimen which preserves your hair and eliminates sides. Keep a hair loss journal complete with weekly photos if it helps. Perhaps something like this (if you're splitting 1mg Propecia tablets): - 1mg every other day for one month. If still experiencing sides, but not losing hair, then - - 1mg MWF for one month. If still experiencing sides, but not losing hair, then - - 1mg TTh for one month. If still experiencing sides, but not losing hair, then - - 0.5mg MWF for one month. If still experiencing sides, but not losing hair, then - - 0.5mg TTh for one month. If still experiencing sides, but not losing hair, then - - 0.25mg MWF for one month. If still experiencing sides, but not losing hair, then - - 0.25mg TTh for one month. If still experiencing sides, stop the meds. If one month at each dosage doesn't work for you, adjust to a time period which does. Obviously, if you start losing hair anytime during the tapering-off period, then you've gone too low and you have an important decision to make - do I up the meds again to preservation levels and deal with sides or just stop completely? Only you can answer that. _________________________________________________________________ Regarding finasteride and conceiving children. I am aware of no evidence that men taking finasteride while trying to conceive will cause birth defects. Here is some information to consider according to Dr. Richard Lee: - "In rabbit fetuses exposed to finasteride in utero from days 6-18 of gestation at doses equivalent to 5000 times the recommended human dosage, no evidence of malformations was observed. This result would be expected, since there was no exposure during the critical period of genital system development in rabbits." - "When pregnant rhesus monkeys were given intravenous finasteride at a level equivalent to at least 750 times the highest estimated exposure of pregnant women to finasteride from semen of men taking 1mg/day, there were no genital abnormalities observed." - "In the human embryo, the sensitive period of external genitalia development is during the 7th - 9th weeks of gestation. Although the chromosomal and genetic sex of an embryo is determined at fertilization by the kind of sperm, either Y-bearing or X-bearing, that fertilizes the ovum, male and female morphological characteristics do not begin to develop until the seventh week...Since the sensitive period of development of the external genitalia in the human embryo is the 7th to 9th weeks of gestation, there can be no danger to the child if the father is taking finasteride at the time of conception. Originally, Merck decided to err on the side of caution and warned against the possible problem of finasteride transfer in semen. This warning has since been removed from the package insert. Considering the medical/legal implications of a theoretically possible link of finasteride treatment to birth defects, it is reasonable to assume that Merck & Co. must be very confident in knowing that impregnating a woman while taking finasteride absolutely does not cause birth defects." - "Nor is there any evidence of birth defects when the father taking finasteride has intercourse with the pregnant mother during the critical periods of sexual development. The in utero effects of finasteride exposure during the period of embryonic and fetal development (gestation days 20-100) were evaluated in the rhesus monkey, a species fairly predictive of human development. Intravenous administration of finasteride to pregnant monkeys at doses as high as 800ng/day (at least 60 to 120 times the highest estimated exposure of pregnant women to finasteride from semen of men taking 5mg/day) caused no abnormalities in male fetuses." - "Still, Merck retains this admonition: "Women should not handle crushed or broken Propecia tablets when they are pregnant or may be potentially pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus. Propecia tablets are coated and will prevent contact with the active ingredient during normal handling, provided that the tablets have not been broken or crushed." - "Considering that intravenous administration of finasteride to pregnant experimental animals during the critical periods of sexual development didn't cause birth defects, there is no reason to believe that transdermal absorption of finasteride from handling broken tablets could cause birth defects in the male child. But, since Propecia has not been approved by the FDA for use by women, Merck has nothing to lose by retaining this warning. In fact, it has good p.r. value." - "So, can finasteride cause birth defects? Yes, there is a theoretical possibility that it can, but the probability is close to nil, when finasteride is taken in the recommended dosages. Since Propecia was approved by the FDA on 22 December 1997 and Proscar on 28 August 1996, millions of doses of finasteride have been taken and there has not been a single case report of a birth defect. Now that's reassuring information." - "We do caution men who desire to father children to discontinue finasteride use two week prior to planned conception. Actually, there have been no reports of birth defects due to taking finasteride. But because birth defects can occur in women who have a DHT deficiency, the warning is mandated by the FDA for the 5mg. tablets." Despite the above information, some guys (and their significant others) are still concerned about it. Something to keep in mind is the half-life for dissociation of the inhibitory complex between finasteride and its enzyme target is in excess of 30 days. Half-life is defined as "the time required for something to fall to half its initial value." So, it works out something like this: Day 1 - 100% Day 30 - 50% Day 60 - 25% Day 90 - 12.5% Day 120 - 6.25% Day 150 - 3.125% Day 180 - 1.5625% And, so on... So, at 6 months you still have around 1.56% remaining to be dissociated. That's also something to keep in mind regarding how long side effects can last for the average man (nevermind those who are genetically predisposed to severe side effects). So, obviously, I don't know if or how finasteride could affect conception via semen. But if it can (which is what some are worried about), then discontinuing finasteride 2 weeks prior to planned conception, as Dr. Lee (and the FDA) prescribes, may not make much of a difference - it doesn't appear to be enough time. Unless the two week rule has something to do with the pharmacokinetic half-life or the pharmacodynamic lifetime of finasteride action, both being much shorter? If you have evidence that stopping for two weeks makes a difference, please present it. Based on the evidence thus far, it seems to me if you're going to stop for conception purposes, stop for the long-term, or don't bother at all. And, if you're going to stop for conception purposes, once your lady is pregnant, wear a condom for the duration of the pregnancy. Lastly, there's little doubt that after the first month of discontinuation you will be losing hair that finasteride was preserving for you, so weigh the decision carefully. z

sandy, In human clinical trials, the pharmacokinetic half-life of finasteride was found to be 6 - 8 hours. However, the pharmcodynamic lifetime of finasteride action, measured in terms of the drug's ability to reduce the systemic concentration of DHT, after a single oral dose of between 0.04 and 5mg, was greater than or equal to 7 days. See the chart below: You can see the how a single dose of the drug reduces the systemic concentration of DHT over a 7 day period. That leads one to believe that taking finasteride daily is probably not necessary to maintain one's hair. However, it also leads one to believe that taking one dose every 5 - 7 days is probably unwise as well, because while the DHT remains reduced over the 7 day period it does slowly rise over that time. Then the question is how often should one take finasteride? Based on the above chart, I'd say it would probably be pretty safe to take it every other day or even three times a week (MWF) as TakingThePlunge has indicated. You may even get away with twice a week (MTh). The next question is how much (as in mg) should one take? Take a look at the charts below: You can see from the Serum DHT graph above that from doses of 0.2mg all the way through 5mg, the amount of inhibited DHT was about the same. You can see from the Scalp Skin DHT graph above that from doses of 0.05mg all the way through 5mg, the amount of inhibited DHT was about the same. You can see by the above graph that the dose dependence appears also in the accompanying rise in T, one-onehundredth the 5 mg dose being identical in its effect on the scalp skin testosterone. The above graph indicates how the following dosages of finasteride inhibit DHT: - 0.2mg = 61.7% - 0.5mg = ~65% - 1mg = 68.7% - 5mg = 69.2% I'm no scientist, but the first plasma DHT graph seems to contradict the rest of the graphs somewhat: - 0.2mg reduces DHT to ~ 55 ng/dl - 0.5mg reduces DHT to ~ 42 ng/dl - 1.5mg reduces DHT to ~ 32 ng/dl - 5.0mg reduces DHT to ~ 25 ng/dl The first graph deals in blood serum levels. The rest in percentages of inhibited DHT. Unfortunately, I'm not sure how to compare the two. Perhaps plasma DHT levels of 55 ng/dl are not much different than levels of 25 ng/dl when it comes to preventing MPB? I welcome someone(s) more expert in these matters to chime in. Regardless, I conclude: It's probably pretty safe to take finasteride every other day or even three times a week (MWF) as TakingThePlunge has indicated. You may even get away with twice a week (MTh). Dosage is a matter of personal experimentation. Merck recommends 1mg daily for optimal results. Maybe they are right, but when you consider the above information; the personal testimonials of many forum members who have successfully reduced dosages; and, the fact that Merck is a pharmaceutical company interested primarily in profits, then I think a healthy bit of skepticism is warranted. If you want to save money and/or reduce side effects, I'd suggest tapering down slowly, and paying very close attention to any changes, until you reach a regimen which preserves your hair and eliminates sides. Keep a hair loss journal complete with weekly photos if it helps. Perhaps something like this (if you're splitting 1mg Propecia tablets): - 1mg every other day for one month. If still experiencing sides, but not losing hair, then - - 1mg MWF for one month. If still experiencing sides, but not losing hair, then - - 1mg TTh for one month. If still experiencing sides, but not losing hair, then - - 0.5mg MWF for one month. If still experiencing sides, but not losing hair, then - - 0.5mg TTh for one month. If still experiencing sides, but not losing hair, then - - 0.25mg MWF for one month. If still experiencing sides, but not losing hair, then - - 0.25mg TTh for one month. If still experiencing sides, stop the meds. If one month at each dosage doesn't work for you, adjust to a time period which does. Obviously, if you start losing hair anytime during the tapering-off period, then you've gone too low and you have an important decision to make - do I up the meds again to preservation levels and deal with sides or just stop completely? Only you can answer that. z

MAGNUMpi, Something else to keep in mind regarding sun exposure. If you are considering FUE, and plan on keeping a very short hairstyle, then donor scars will not tan like unscarred skin. You'd have to take great care to keep your donor covered with copious amounts of high SPF sunblock or else you'll be left with a noticeable contrast between the scars and your normal skin. The darker the skin, the more obvious the scarring. This thread shows a dark-skinned gentleman who got FUE: http://www.hairrestorationnetwork.com/eve/166527-these-typical-fue-scars.html You can use his case as an example of how dark skin (natural or from the sun) and FUE scars don't go well together. z

Deleted, because I noticed my questions answered in another thread. Glad your hair is hanging in there, TakingThePlunge!

Great info! Thanks, Dr. Beehner.

You can see here that 0.5mg is around 65% whereas 1mg is 68.7%. That's more than 80% as effective despite what that doctor said (actually closer to 95% as effective).

Koenig, There was a study (can't link to it per the forum rules) that said: - Scalp skin DHT: from doses of 0.05mg all the way through 5mg, the amount of inhibited DHT was about the same. - Serum DHT: from doses of 0.2mg all the way through 5mg, the amount of inhibited DHT was about the same. Also, I read on the forum that a doctor (his name escapes me) claims that 0.5mg of finasteride is 80% as effective as 1mg. So, I'd say if you lowered it to 0.5mg/day there's a good chance you'd still be able to maintain your hair (no guarantees though). You may even get away with 0.25mg/day. z

Definitely agree that most people who dish it can't take it, but that girl has mental problems. No other way to describe someone with such social dysfunction. My condolences to any man she's ever had a relationship with. How could it possibly be appropriate to ask someone that question? And, she walks away shaking her head? Talk about adding insult to injury.

Nailed it. Everyone is insecure about something(s). Unfortunately, empathy is in short supply. It's about group status. Many people put others down to lift themselves up. The problem is that it doesn't work. The effect is superficial, short-lasting, and often replaced by guilt and regret. They have less self-esteem than before, and if it's done in public they end up looking like douche bags. Their anger eclipses their consciences over and over again. It's a sad and pathetic downward spiral - the lower they sink, the more they try to tear others down. Solution: avoid those toxic people at all costs. Life's too damned short to waste it on them. Regarding why there may be more of a stigma attached to MPB, perhaps it also has something to do with status in greater society. Men have typically held the power positions. So, one can look at it two ways: 1. It's a great opportunity for anyone consciously or unconsciously looking to lower a man's status (the "they have it coming" mentality). That doesn't only apply to women. A man can feel threatened by another man's status. 2. There's social conditioning at work. Because men have traditionally held the power positions, any exposed vulnerability or deviation from the norm is perceived as weakness. Men have to be tough guys 24/7. As long as they're engaged in war, sports, fart jokes, and the like - then it's all good. God forbid they pamper themselves or focus on their appearance. Then they're considered "gay" (an insult to homosexuals everywhere) or "metrosexual" or some other label meant to disparage. That's why that woman told swayzedo, "I can understand being upset if a woman goes bald, but a man? Grow a pair and just accept it!" That's also why most men keep their hair transplants to themselves, as RCWest points out. It's unfortunate that men have been trained/forced to keep their feelings inside. It's not as severe as it was in the past, but that social conditioning still exists.

Sean, Thanks for the photo update! I think the photo which best illustrates what concerns you is post #286, 3rd photo from the top. It's not bad by any means, but I do agree your concerns are justified. If it doesn't improve by month 12, given the amount of grafts you had implanted, then I'm sorry to say you'll definitely have a legitimate gripe, and hopefully Dr. Rahal will make good on it. Obviously, I'm no expert. Just my opinion. Of course, you'd have to try to determine if you've lost any native hair during the past 10 months despite finasteride use. That said, your hair in its present condition is nothing to be embarrassed about. It still looks better than the majority of the guys on this site (myself included). z

Sean, wb280 is on the money. You do look great, and you've made good progress. Perhaps not what you were expecting so far, but far from a failure. Try to take some pleasure in that despite the less-than-sensitive critiques of others. That said, I completely understand where you're coming from regarding all of the sacrifices and investment you've made to achieve your goal and worrying that it may not happen with one procedure. Those are natural and justified feelings. One of the hardest things to do in life is to let go of the worry and stress regarding things we simply cannot control. It's a challenge everyday, but we really don't have a choice but to meet that challenge head-on. This is one of those things. You picked one of the best docs in the world, and you followed post-procedure instructions to the tee. What else can you do? My advice is to keep working hard on accepting what you cannot currently change, and give it the full 12 months. If you're not satisfied at that time, then talk to Dr. Rahal about your options. He seems like a stand-up guy, and I'm sure you'll be able to find a workable solution. As always, best of luck. z P.S. Regarding finasteride use, I'd suggest to anyone who has been on it for while and experiencing sides to lower the dose first before stopping. Experiment to find the lowest dose which preserves your hair. Try 0.5 mg per day for a few months. That reduces fin intake from 7mg per week to 3.5mg per week. See how that goes regarding hair preservation and reducing sides. If your hair is holding, but sides are still plaguing you, then try 0.5 mg M, W, F, Sun; that'll take it down to 2mg per week. Some people try 1mg M, W, F. There are lots of regimens to explore. It's worth it to experiment before completely discontinuing the meds. You may just be able to find a dosage that works for you. The other advantage to that approach is if you ultimately end up stopping, then you've followed a sort of tappering-off regimen which some have recommended as a good way to stop. If you stop completely, odds are you will lose your hair. Of course, some people who are not genetically predisposed to advanced MPB take fin. as as a preventive. So, in their cases, the fin. wasn't really doing a whole lot to help them preserve their hair. They didn't really need it much or at all, but they didn't know that, and that's the point. Can you be sure you're one of them? I know I can't. Unfortunately, we can't go by how others experience the drug. Even though David the moderator hasn't reported anything after stopping, doesn't mean you won't. Also, it's not easy to measure hair loss unless you experience a massive shed. Often, it's an insidious process. So, you may think you're doing OK after you stop, but you are actually losing hair, and eventually you will notice it. Just my $0.02. To each his own.

Here are some things to consider regarding the permanent tattooing of scar tissue: 1. It is time consuming. Depending on the individual's skin or scar texture, a single line may require two or more passes with the needle before it takes. 2. It can be and often is more painful than the average tattoo. Scar tissue is very sensitive since the nerve endings are closer to the "new skin" (unless the nerve ends were destroyed when the damage occurred). 3. Once set within the scar, black ink will stay. Colored ink can be set within the tissue; however, it may bleed or fade from the skin, and this possibility should be anticipated, but not expected. There is always a slight possibility that the black ink may blot or run beneath the tissue, but if a very fine line is used this problem can be virtually eliminated. 4. It may be a good idea to have a small test area done first to determine if your skin will accept the pigment before committing to a larger session. 5. Last but certainly not least, it is very important that the scar tissue be at least one year old before tattooing is attempted (the older the scar, the better). Destroyed tissue takes a long time to heal, so the older the scar, the better it will take the pigment. It may be that all 5 points apply to temporary tattooing as well to some degree. However, the advantage of temporary SMP is that it's temporary. If things do not go well, you are not stuck with it for life. Beauty Medical's site says the optical effect could begin to decline from the sixth to eighth month post treatment. After two years, not a trace will remain. Therefore, one will have to get regular touch-ups to maintain the optimum illusion consistently. My guess is once per year on average, but that will vary from patient-to-patient. If one has the desire and resources, then it's much safer to experiment with temporary SMP. Spex and others are bringing attention to Beauty Medical's services. As a result, many more people, at varying stages of hair loss, will undoubtedly try it out. We will get more reports about their experiences in time. It has to start somewhere. SMP (permanent or temporary) for strip and FUE scars is not like the typical tattoo design applied to a different kind of scar. SMP are small "dots" which resemble zero guard hair, not elaborate designs with multiple colors. Also, the scars which are left after strip and FUE are controlled. They're usually better, smaller, tighter scars when done by a good doctor. Consequently, perhaps there is a better chance of success with SMP on strip/FUE scar tissue. That's just a guess, though.

Very impressive!

moonfresh, You'd do well to read (or re-read) all of the advice given in this thread from the beginning. z

Formertrackstar, One thing to keep in mind... SMP, the way Beauty Medical appears to practice it, is an art. I'm sure it's taken Milena a number of years of daily practice dedicated solely to her technique to become as proficient as she is. Even if Dr. Shapiro discovers a natural talent for SMP and brings the technology back to the states, he will probably be unable to reproduce Milena's level of proficiency for quite some time. Part of the reason is micropigmentation is probably all Milena does day-in, day-out, whereas Dr. Shapiro would be juggling SMP with his surgeries. The other option would be for Dr. Shapiro to hire a full-time and very skilled SMP practitioner trained and recommended by Milena. If all goes well with Spex (and I assume it will), then you may consider a nice trip to Italy. z

The odds are much better of being able to wear your hair short with FUE. FUE is NOT scar-less, but if small punches and an intelligent extraction pattern are used, and if you naturally scar well, you could get away with #1 on the clippers. Some people report that they can shave their heads bald without any noticeable scarring after FUE, but I'd venture to say that's pretty rare. The size of FUE procedure(s) and donor density are big factors regarding scarring and the potential for the "moth eaten" look. Have realistic expectations - some noticeable white-dot scarring is likely, but you'll be able to wear your hair shorter than if you elected to have strip done. Other advantages with FUE is less donor pain (usually) and quicker donor healing. The trade-off with FUE is that yield is reportedly a little less than with strip. However, in the hands of the most skilled FUE docs, I'd say it's pretty close. I think some people have reported being able to wear their hair as short as a #2 on the clippers after strip, but I think that's uncommon. From what I can tell, a #3 is more realistic providing the scar is relatively thin. I'm just going by what I've read on the forums. Perhaps some strip patients can chime in. Lastly, SMP (temporary or permanent) may be an option for FUE white-dot scarring which would allow you to wear your hair very short with little-to-no observable scarring. Take a look at these threads: http://www.hairrestorationnetwork.com/eve/166711-has-anyone-had-there-scar-tattooed-do-you-have-before-after-pics.html http://www.hairrestorationnetwork.com/eve/166743-spex-goes-smp-into-scar-19th-july-2012-a.html

I believe that all of the docs recommended here are held to a high standard. However, not all docs are created equal, and not all docs are proven FUE experts. To some degree it's subjective. Everyone has their tastes. It's up to us as patients and future patients to do as much research as possible before we commit. That includes comparing and contrasting the results from all of the recommended docs. Look at as many results as you can (videos and photos); consult with as many docs in-person as possible; review the results of as many FUE patients as you can in-person who, before their surgeries, approached your level of hair loss and share similar hair characteristics; and, ask as many questions of experienced and learned members of this forum as you can. Some people have been lurking or actively posting on this forum for a number of years before finally having a procedure done. Do not rush it. What you put in, you get out. If you spend enough time here, the best FUE docs for you will become clear.

Point is - choose among the best proven FUE docs in the world, and don't let money or distance be a factor (unless you're trying to decide among the best). If you don't have enough for the best, then save up until you do. HT is forever. It can have a devastating effect on your self-esteem if things go wrong. Give yourself the best odds of success by consulting with the best FUE surgeons. Good luck.

Excellent reply, Dr. Wesley. The general consensus on the forum seems to be that weak existing hairs "that are on their way out" may not return after indirect shock loss even if a patient is on finasteride. Meds supposedly help prevent shock loss, but no guarantees. What is your opinion on this? Thanks.

Great, Sean! We'll coordinate in late August and make sure it's a clear day when we meet. Late morning/early afternoon will work nicely. Really looking forward to it, and thanks again! Like I said before, you've made some really good progress, and I'd be happy if my final FUE results are as good as yours are right now. I know it can be frustrating, but try to stay positive. At least you have a stand-up surgeon worse case scenario. I'm sure he'd do right by you. However, give it the full 12 before making that final judgement.