zenmunk

Aside from the opportunity to review Dr. Lorenzo's FUE work (which appears quite good), I think the multiple videos entitled, "Can you shave your head after a HT by FUE technique?" are invaluable. 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. 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). Scarring will vary based on patient physiology, but it's encouraging to see numerous patients represented. Also, Dr. Lorenzo apparently strives to use 0.75mm punches as much as possible which do not seem to negatively affect yield in his case. That will result in a rather small scar. I'd venture to say that doctors who routinely use punches which are 0.9mm or larger may not enjoy the same degree of scar undetectability. Like Dr. Bisanga, Dr. Lorenzo also appears to use intelligent FUE extraction patterns which are nicely spread out. This also reduces the appearance of scarring; noticeable hairless regions; and, larger, more diffuse patterns. Jotronic has brought the services of a temporary SMP practitioner to the attention of the community. Her name is Milena Lardi. She's part of a Milan-based company called Beauty Medical, srl (you can find the company with a google search). Her work looks very natural from what I can tell by the site. The procedure lasts up to 18 months before a touch-up is needed. I have no idea about price. If I encountered major problems with FUE scarring (which doesn't seem to be the case with Dr. Lorenzo's patients) and wanted to keep a buzz-cut, I'd probably go that route, because it's only temporary. If the SMP artist messes up or you get tired of it, it's not forever. The downside is the frequency and expense of touch-ups, but that's the price you gotta pay.

Thanks for the photographic and video updates, Sean! You hair looks good! I compared your current updates with your 6 month updates. I can see a slight increase in density, but what I notice the most is your hair appears softer, more natural, now. That will only improve in the coming months. What are your thoughts on your progress? What are you most happy about? Are there any areas that you are less satisfied with? Thanks, z

Best of luck, Spanker! Are you going for FUT or FUE?

trapps99, Wow, hearing how much of a positive difference discontinuation made for you, especially since you didn't experience major sides, is really food for thought. It's encouraging to know all of your sides eventually cleared up, too. I tried Rogaine long ago for a short time. I really didn't like the process and how it felt, but if I decide to get off the propecia, then I'll probably give it another try. Although I have a feeling it won't work nearly as well as the propecia has. Decisions, decisions... All I can say is hair loss really sucks! z

I've been on propecia so long that I can't remember what I felt like before starting it (14 years in August). If I have sides, they are so minor that they don't register after such a long time. If they exist, they've become my "new normal." However, I often wonder what I'd feel like if I stop. I wonder if my overall sense of well-being would improve. That, plus staying on meds for non-medical reasons never sit too well with me, and the recent attention to finasteride side effects leaves me feeling unnerved. Also, I'd save a lot of money if I quit. On the flip-side, I wonder if stopping may have bad long-term effects on my body (I know it will on my hair), because my body may have become dependent on the meds to whatever degree. Propecia has been quite successful for me and the detectable sides (if any) are very minor, so it's a very hard decision. When I think about losing all of the hair I've preserved it really disturbs me, but it also disturbs me to think of what the meds may be doing to my body on levels that are not easily detectable. I was wondering if other long-term finasteride users struggle with the same things. If so, what are your thoughts on the matter? And, for those long-term users who have quit finasteride, I was hoping you could address the following questions: 1. How long were you on the meds before you quit? 2. How long has it been since you quit? 3. What were the side effects you experienced while on the meds? Or, what prompted you to quit? 4. Did any of your sides increase, or new ones develop, after discontinuation? 5. Have all of your sides resolved since stopping? If so, how long did it take? 6. Have you lost any hair since stopping meds? If so, how soon after? And, how much? Thanks, z

Thank you for your reply, trapps99. Glad to hear all of your sides eventually resolved. I've been on propecia so long that I can't remember what I felt like before starting it (13+ years). If I have sides, they are so minor that they don't register after such a long time. If they exist, they've become my "new normal." However, I often wonder what I'd feel like if I stop. I wonder if my overall quality of life or sense of well-being would improve. That, plus staying on meds for non-medical reasons never sit too well with me, and the recent attention to finasteride side effects leaves one feeling unnerved. Lastly, I'd save a lot of money if I quit. Propecia has been quite successful for me and the detectable sides (if any) are very minor, so it's a very hard decision. When I think about losing all of the hair I've preserved it really disturbs me, but it also disturbs me to think of what the meds may be doing to my body on levels that are not easily detectable.

trapps99, - how long were you on propecia before you quit? - was decreased libido the only side effect you experienced? - did any of your sides increase after discontinuation? - have all of your sides resolved now after one year? - have you lost any hair since stopping propecia? Thanks, z

I don't think it's a "crazy" regimen. However, I'd probably reduce it to only one multi-vitamin per day, and drop the folic acid and B6 and take a B-complex instead. "I'm thinking about adding another folic acid and biotin at night. I may also add Dut once-- twice a week, I'm aware it may be pointless since it inhibits both DHT's but think it can help." I wouldn't bother with the extra folic acid or biotin. IMO one good B-complex supplement and one good Biotin supplement should suffice (if you want to consume more than the B-complex provides). And, definitely stay away from DUT. You're already taking 1.25 mg of finasteride. It's overkill, and you run the risk of increased sides.

crackershoes, If you get FUE, then you should go in expecting to have white-dot scarring. You may be one of the lucky ones whose scars don't show even shaved bald, but I think they are the exception to the rule. In other words, be pleasantly surprised if you have no visible scarring after your donor heals, but do not count on it. I'd suggest that you ask your doctor to use punches between 0.75mm and 0.9mm whenever possible to help reduce the appearance of scarring. Try to avoid using punches which are 1mm or larger. Of course, sometimes the doctor must use a larger punch in order to give you the best result possible. It really depends on your specific hair characteristics. Dr. Carlos Wesley (a recommended surgeon on this forum) has been conducting some interesting trials with what he calls "scarless surgery." He claims it "may lead to both increased graft survival as well as elimination of any donor area scarring (i.e. less than FUE)." Regarding availablilty, Dr. Wesley says, "we are hoping to carry out a follow-up investigation near the end of this summer with the hope of having the instrument available for more widespread use in late 2013." On his site it says, "the surgical technique patented by Dr. Wesley will be made available to patients worldwide," so any doctors interested in this technology will be able to use it on their patients. I have no idea if this is legit, but if you're very concerned about FUE scarring, it may be prudent to postpone your HT until you know what this technology is. Please see this thread for more info.: http://www.hairrestorationnetwork.com/eve/162173-invitation-participate-hrs-enhancement-investigation.html z

Very nice! Quite natural, and impressive density with only 1281 grafts.

Awesome! Best of luck, Gandolf! We look forward to following your progress.

"...having great native hair like he does helps." Exactly. Dr. Rahal quoted me 2000-2200 grafts to restore my hairline, but even with 100% yield I'd never have that kind of density. My hair is too fine, and although my density is good, it's not that good. Nothing a doctor can do about that. Also, this patient's hair at the temple point regions was in great shape which helps make the overall result outstanding. Great to see what can be done with ideal candidates. Regardless, this result is a testament to how skilled Rahal and his team are.

H-o-l-y S-h-i-z-e-r ! ! ! Thank you for gracing us with your presence, Wolverine. Very good of you since we all know how time consuming saving mutant-kind can be. Unreal...

markhenry, I, too, am a long-term finasteride user (started a year before you). If you do indeed stay off of propecia, I'd really appreciate periodic updates regarding: 1) your physical and psycho-emotional states - Any side-effects after stopping? If so, how long before they went away? - questions like that. 2) how much hair loss you experience (if any), and when? I've also become somewhat paranoid about continuing finasteride use despite having a battery of tests done to determine if I'm OK. So far, so good (I guess ), but who really knows for sure? I sometimes wonder how stopping the meds would affect my overall sense of well-being (maybe improve it?). I've been on it for so long I can't remember how I felt before starting. I also wonder if I'd experience side effects after stopping, because my body has become dependent on the meds to whatever degree. Anyway, I hope to hear how you're feeling post-finasteride in the months ahead. Thanks a lot, and good luck. z

Great progress, Sean! Thanks for posting the pics. Looking forward to the video.

Great result so far! Congratulations!

aj, Congratulations on your procedure with Dr. Bisanga, and best of luck with it. I've always been impressed with Dr. Bisanga's FUE extraction patterns. He really spreads them out well. I notice in your case that he only extracted from the rear and right side of your head, leaving the entire left side untouched. Can you explain why he chose to extract in this manner? Thanks, z

Sean, Thanks for the information on SawPalmetto/BetaSitosterol. Food for thought. z

It's good to hear that after 5 months of discontinuation you have experienced no lingering side effects from the meds. I've been taking propecia daily for 13+ years with little side effects. I noticed slightly less semen viscosity way back when, but that's about it. Interestingly, I recently had a semen analysis done (and a battery of other tests) and the results came back completely normal. All of this talk lately of side effects, especially severe ones, which do not resolve after discontinuation of finasteride, and Merck's new labeling, etc. has me somewhat concerned. While my experience on the meds have been good, I worry about how discontinuation might affect my body. I'm not planning on stopping now, but I may someday. I guess there is no way to know until I do it, but the thought is not pleasant. Are you aware of cases where people have had no problems while on finasteride, but developed problems after stopping? Thanks.

TakingThePlunge, I've read on one of these threads that you've decided to discontinue finasteride indefinitely. Is that true? If so, how long were you on it? And, how do you feel since stopping? Thanks, z

No facial hair loss here after 13+ years of daily Propecia use. Definitely consult your Dermatologist.

Propecia and Finpecia are both finasteride. However, my family doctor (who prescribes Propecia for me) told me that the delivery method of a drug can affect how well it works. Propecia (Merck) has a specific shell which holds the finasteride. He said if I were to divide Proscar into fourths or use a generic form of Propecia (like Finpecia) to save money, I may find that they are not as effective as Merck's Propecia has been for me. I stress the word "may" here. Everyone responds to meds and their respective delivery methods differently. Personally, I didn't want to take the chance even though my wallet was begging me to do so. Bottom line, "if it ain't broke, don't fix it." Now, if you've never taken finasteride before, then I don't see any problem starting with a generic to see how that works for you. No one can answer this question for you. You have to decide if your hair loss bothers you enough to take the risk. You'll be comforted to know that the majority of men taking finasteride do not experience severe or permanent problems. Some of the more commonly reported side effects are decreased or "watery" ejaculate, decreased libido and erection problems. Minor side effects usually resolve themselves while continuing the meds. All sides usually resolve completely for men who discontinue the drug. There does appear to be a smaller group of users who are developing side effects that do not resolve after discontinuation. Unfortunately, you cannot know whether you'll fall into that category until after you've started the finasteride. So, again, it's a risk. I've taken propecia daily for 13+ years. You may be interested to read about the results of a series of medical tests I had done recently to see if propecia has been affecting me on levels not easily observed: http://www.hairrestorationnetwork.com/eve/163746-those-considering-starting-finasteride-therapy.html Your results may vary. I have little-to-no experience with minoxidil. Regarding propecia, it is a life-long commitment or at least for as long as the drug keeps working for you. Finasteride is most effective at the crown and mid-scalp; less so at the hairline/temple areas. In my experience, it has been more about preservation as opposed to a reversal. Good luck, Z

You may find that finasteride reverses the weakening/thinning-out of your temple hairs somewhat, but it's usually most effective at the crown and mid-scalp. In my experience, it has been more about preservation at the temples as opposed to a reversal. So, I'd say your temple hairs will probably not return to the way they were prior to losing hair, but the finasteride may help you retain what you currently have for a good long while.

Sorry, you're not a candidate, aaron1234. I fall somewhere in between. I'm not an ideal candidate, but I would benefit from it. My doc said that my results would not be permanent. I'd regress over time (15 years), but the worst vision I'd regress to post-procedure would still be better than the worst vision I will experience if I never have the procedure done. He can't make a recommendation either way in my case (which is frustrating). He said he'd do it tomorrow if I'd like, but gave me the option of revisiting the idea in 3 - 4 years and wearing contacts in the meantime (which is what I've chosen to do). For anyone considering vision correction surgery, take what Jotronic and Sean said seriously. They're right on the money. Personally, I'd choose PRK over Lasik any day. PRK preserves the integrity of the eye. Yes, it's more painful at first, and it takes longer to get back into the swing of things so to speak, but it's much healthier for your eye, and that's what's most important. And, it's a must if you are very physically active. Also, put as much research into that as you do hair transplants (if not more). There are some real horror stories out there re. vision correction surgery. Make sure you know what you're getting into and find the best doc possible.

My family doctor (who prescribes Propecia for me) told me that the delivery method of a drug can affect how well it works. Propecia (Merck) has a specific shell which holds the finasteride. He said if I were to divide Proscar into fourths or use a generic form of Propecia (like Finpecia) to save money, I may find that they are not as effective as Merck's Propecia has been for me. I stress the word "may" here. Everyone responds to meds and their respective delivery methods differently. My doc's advice is worth considering, however. Personally, I didn't want to take the chance even though my wallet was begging me to do so. Bottom line, "if it ain't broke, don't fix it." Now, if you've never taken finasteride before, then I don't see any problem starting with a generic to see how that works for you.