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Just curious, what happened to Chad at Rahal? He was the main rep, right?

Curious, would you all say his scar is good? And OP hope you get the result you are looking for. I think you did the right thing coming here for advice. But am curious what others think about the scar...

Dr Feller posted a video in another thread here saying that if you have a loose scap (low collagen content_ that you may be more prone to scar stretching. Has anyone here had an HT, with a loose scalp that can comment how their scar healed? I know everyone is an individual case but how much more likely is your scar to stretch if you have high scalp laxity?

Nevermind, sorry I didn't notice the thread that was a bit more down the first page that answered that question. Appears that most agree to wait at least 6 months

So, what is the consensus as to how long until it is ok to be out in the direct sun after HT? Do you need to wait a year until you have a day at the beach?

Bump for Dr. Feller?

Hey KO, thanks for thinking of me and mentioning that! I have certainly considered RU and almost pulled the trigger on it. But then, with the reliability of getting it and hearing of some users reporting heart issues, I just didn't think there was enough info out there to make a decision. But I sure like the idea of a topical anti androgen that works locally, rather than be absorbed systemically.. Just makes so much more sense. But, I also wonder why in the world RU was abandoned in testing, I believe in phase two? Far as CB, I don't know too much about it and the mechanism by which it works but aren't people having a hard time finding a good vehicle for it? Or what is the issue with it? From my limited-knowledge point of view I just wish there was a safe, effective anti-androgen that works as an antagonist (or whatever) and basically competes with DHT at the receptor locally and not throughout the body. But I am not going to pretend I am knowledgeable enough to even really have a firm grasp on what I am saying and am just speaking generally..

Thanks everyone for your take on this! This place is awesome! It's just that, for me, I have never had anything like this done before and I certainly have not spent this type of money on any one thing before. I just really feel like I would feel so much better if the doctor could assess me in person before committing to a particular approach. I'd really like to know the total amount of donor I will have available and hair to graft ratio, all that, the best that they can tell beforehand. It's not that I don't trust an experienced and talented surgeons recommendations from pictures but I would just be a nervous wreck going into it without meeting with him first and letting him evaluate me completely, give me some time to ask some questions directly and see what else the in person meeting might bring about. Yeah, it might cost me $800 or so to go do this from where I am but I think I might rather do that, even if it meant that that money, from the HT fund was spent and I needed to wait another month or two to save it back up, I just think it might be worthwhile. How many people go travel all around and meet with more than one surgeon before making a decision? Also, would it bother you if you spoke with a clinic and after the online consultation, you then offered to fly to meet for an in person consult, and then were told that it is not necessary, would that concern you?

Are we saying that in general a person who is NW5/6, without much (quality) native hair to speak of left, is a lost cause then? Even if donor was pretty good? In the scenario that they could not/ would not take finasteride for the rest of their life? See, this is why I need to have an in person consult. I would really like to know (an approximation) of my total donor supply and hair to graft ratio beforehand.

Just wondering how many of you recommend going in for a personal consultation before the final decision? The obvious answer to me if yes. I feel like it would make me more comfortable to be seen by the actual surgeon performing this life changing, costly procedure. Even though they offer online consults, I really would feel better and less nervous if I had had a chance to meet with the doctor personally, ask more questions, have him examine me hands-on and for him to get a better idea about both my balding, and donor situation. Sure, from where I am, it might set me back ~$800 to do so, just for an evaluation, but would it be worthwhile to do so?

Please continue to post updates. I'm interested to see when it starts coming in for you..

This is great. The video responses are a really good idea. You can say so much more... and I don't have to read ... and it probably takes less time than to type once you get the swing of it, if from a cell phone. Most importantly, we like it. So, the 1,000 grafts in '91 basically did not do much. Obviously the 2,200 grafts 10 years later went well. But I was wondering how many grafts the third procedure? Would you say it filled in the front 2/3 well? It's hard to tell in the video the size of the area that wasn't touched. Have you any idea of the density cm2 in the hairline and behind? I was wondering why you did not have a larger session than 2,200 grafts. Or was donor properties an issue? I know I am asking a lot of questions, I don't know what's come over me. Andrea come through here a bit the day before. Hope you fared out well. oh, is that a reference to Anchorman there at the end?

Thank you for personally replying Dr Feller. I don't mean to pry, but then again how often is it that the opportunity presents itself to ask a hair transplant surgeon about his own procedures, especially a reputable one such as yourself. I can't help myself but to ask... What type of procedures were they? The new-standard methods of hair restoration have obviously changed over that time period. But what were the procedures that you had? What were the sizes of the sessions as far as amount of grafts and how distributed? What density did it leave you with in these areas? In your reply, you mentioned that you have absolutely no native hair on the top. I fear that is where I am headed as well. By that, what NW were you naturally destined to be if you did nothing? NW6/7? When you leaned in on one of the videos it appears that the crown area was not addressed all too much. Had you exhausted the available donor or just moved on... It took me a little bit of courage to ask that stuff. From the perspective of someone on information overload and trying to do his due diligence of research before making such an important life changing decision, the feedback of every hair transplant patient is valuable, much more so coming from a reputable doctor.

Awesome that Dr Feller posted a video response! Although I am certainly not qualified to judge my donor characteristics myself with any certainty, I do believe that my scalp laxity is pretty loose. I can move my scalp all around while keeping my fingers on the same part of the skin. So here I am being happy about that, thinking it will help with the amount of grafts I can obtain in a procedure and maybe also be a plus in other areas. Now i'm a little bummed that having "good" scalp laxity might mean that the scar may not heal as well. But, I am sure it is still more advantageous to have higher scalp laxity than not obviously. Anyway, Dr Feller mentioned in another video, on his way to work (cool idea), about the time when he was in the 7-11 and noticed himself in the camera monitor with hair loss. Strictly out of curiosity, does anyone know if he underwent a procedure at any point?

Maines, Get your own thread, stop hijacking mine! Just kidding man, jk. I'm still working on figuring all this out myself, but the members here on this forum have been such a great help. Anyway, what I believe they will tell you is that you are right about the transplanted hairs not falling out even if you do not take fin. They are taken from the donor area and those hair follicles from the donor area are not subject to DHT. However, as your hair loss progresses, you will still continue to lose hair around the transplanted hairs if you do not do anything to address the underlying causes of baldness. You said your hair loss is 'very slow' so in that case I would think it would be very hard to guesstimate how far your hair loss will progress. I'd rather have slow hair loss than quick diffuse loss, but at least with my situation I know where I'm headed roughly because it happens at one time, although as KO pointed out earlier in this thread, the pattern may not be as predictable as I think. But, in your case it must be even harder to predict if it is very slow and receding. You should definitely put some pictures up and let the more informed guys here give you some recommendations. Please, don't be one of those guys that make me sick and has basically zero hair loss but thinks needs a hair transplant. Gillenator, yeah my uncle (mother's brother) has the most hairloss of anyone in my family. In fact, it seems like him and my mother are the only ones who really experienced obvious hair loss on either side of my family. When i'm around him lately I've been finding myself trying to get a real close look at his pattern and trying to be all sly about it, lol. He buzz's it so it's hard to tell but he has lost most all of the top and his back is lower than mine so I am becoming worried about that. But, I like the idea of a examining the scalp for signs of miniaturization, maybe that will help me determine if the back and sides are more likely to drop down.

Cant Decide, thanks for clearing that up. And I respect your decision about the pictures. And I hear ya... it brought me no joy to put up pictures of my situation, posting pics of all angles, but I had to to get recommendations. If I could twist your arm I would but I am thankful for all the feedback from your experience either way. Just trying to do the best research I can and I am thankful to have seen your case as our starting situations appear to be fairly similar. Only reason I asked was because I actually am seen from the top angle often, and not just because I am short. Surfing, the nature of my work, waterparks, etc. Luckily I have been able to wear my hat at work. There's just a lot of situations that I am seen from above. But like I said I can definitely deal with the crown being thinner so long as it looks like a natural pattern of thinning. I can be fine with a mature hairline or a thinning-looking crown, it's just the straight up slick bald horseshoe I am headed for that I absolutely will not accept. But, yeah, I really appreciate all your feedback nonetheless!! And, thanks again also gillenator, appreciate all your help. I will be sure to ask for this examination and I'm glad you pointed that out as it may affect the approach to take altogether.

jameslondon, Thanks for your help. When you say you take 1/4 per day do you mean 1/4 of 1mg Propecia, or 1/4 of 5mg Proscar? Only thing that I don't get is the lower the dose is supposed to result in the nearly the same amount of inhibition, yet the sides are reduced? I guess I'll take the docs word for it though over my interpretation. About the neurosteroid thing, I'm not trying to be negative but it did seem worthy of looking in to. However, I don't think there is enough information available to be well understood. It's a subject that there could be more discussion on but I don't think anyone wants to hear this thread go on-and-on about it. Anyway, I think I really need to fly out to consult with one of the recommended clinics for an evaluation of my donor and scalp laxity to see what type of yield I can expect in order to figure what amount of area I will be able to cover?

Yeah, I have been reading up a bit on PubMed. I'm not trying to be an internet expert here, just trying to be responsible. And I'm not trying to come across to be against the use of finasteride and I actually would love to take it for it's intended hair effects. But I am having a hard time looking past the potential effects resulting from the mechanisms by which it works. Simply because it does not selectively inhibit DHT, rather it inhibits 5AR and thereby it's other metabolites as well, it seems reasonable that there could be a related change in neurosteroids. Neurosteroids like allopregnanolone are important as far as modulating GABA.A receptors, brain healing, neurogenesis, myelination, etc. Important stuff. And many people with neurological disorders have been found with lower levels of allopregnanolone. Neurosteroids, the CNS and brain are such a complex subject. Again, I won't pretend that I understand any of it well. But, might it explain some of the symptoms that people report while taking, and after discontinuing finasteride? I can't say. And, as you say, it is a risk that people choose to take. I understand that. But, I do just wish that I could come across some information or someone that would give some specific reason that this is nothing to be concerned about. I don't know man, this is all just having me on information overload and I can't say I'm qualified to interpret it. And yes, maybe a smaller dose would help alleviate the sexual sides, but if finasteride has a relatively flat dose response, then wouldn't a smaller dose have roughly the same amount of inhibition meaning same sides? Or am I wrong. Maybe I am because I am pretty sure I have read about people that have lowered their dose and not experienced the sides to the same degree.. So, maybe I will try that.

Gillenator, Thanks! That was what I was asking was the worst case scenario if all on top was lost and that was the starting point. I really don't think I'm all that far from that situation now. It might not look like it in the pictures but there's not enough on the top to do anything with at all. If I were to be stuck at this point, I would have to just shave it rather than try and rock a hairstyle I obviously couldn't pull off and get noticed for that. I am not one of those guys that needs a straight across, super dense hairline. I am fine with a more mature hairline and more so am looking to address the coverage for the top. To me, it would make sense to be more conservative with the hairline now and address the top mostly, then if I can or want to in the future, I could add to the hairline and improve it. Maybe if I am conservative I can also leave open the option to address the crown later also, even if it is still thin and not as good of coverage as the top. I am not saying that I will not take finasteride, but can it be done without it if I wanted to go that route? Will my donor and checkbook allow it? That is the question. When I have a consultation with one of the doctors I am finding on this site, will they go over the scalp microscopically everywhere to see what areas have any miniaturization whatsoever?

Guys, I won't drag this thread on for much longer. Just wanted to follow up on your responses and get just a bit more feedback.. ----------------------------------------------------------- Thanks again for replying! What NW did they say you were at pre-op? I think I'm still a little thrown off about the NW scale. It's hard to tell what NW someone is (to me) sometimes. Can someone also tell me if the crown is referred to as being part of the top? Or is the crown the back of the head only? Back of the top of the head, Or top of the back of the head? By the further minimal loss I assume you mean the crown getting bigger? So, will you continue to take finasteride forever even after you address the crown in your next procedure? Ok, good I'm glad to hear it looks natural. For some reason, I think I was under the impression that in this type of situation and in your case the front 1/2 of the top of the head recieved the transplants and the back 1/2 did not, when in reality it is not 1/2 you didn't have addressed, it's only like the back 1/3rd that is your crown if I'm getting it right.. So you are gonna have 4,000 grafts transplanted to where? Just the crown? Are you going to continue to take finasteride after the next round even? Good for you that you seem to have very good donor! And I am happy for you getting such good results! What a transformation! Must be a good feeling! However, I'm still dying to see a pic of your head from the top. If only to help me see where I could be after my first...

KO, Yeah pretty bad libido/ erection quality. Obvious change after a while. Yes I must admit it was a particularly stressful/eventful time in life. But, I have had stressful periods of time before and can not ever recall a change in sexual desire that abrupt, or at all for that matter. Aside from that just the change in semen consistency/ volume and a discomfort periodically in the testicle area. But, I understand those are common reported sides and are a result of the physical changes to your prostate and not of great concern. I also cannot say that the symptoms resolved very quickly, if ever completely, after I stopped taking it. And that is also the time I started looking for answers and began researching and learned of all this about finasteride side effects and 'connected the dots'. So I don't know what to make of that. Then there's the non-stop stress about hair loss itself which you could also say has its very own side effects psychologically and I don't know how much that has to do with the whole equation. But I do have some other concerns regarding the other metabolites of 5AR, some subsequently becoming protective neurosteroids. I won't pretend that I am knowledgable enough to determine if this is the real concern taking finasteride and whether it explains it all, but I do wonder what good can come of artificially lowering the levels of neurosteroids that have very important functions. Is there any evidence that this is not a concern? I would/will surely give finasteride another go. But I would like some assurance regarding the neurological effect of taking finasteride. If you can point me in the right direction, or shed some light about the subject I would very much appreciate it. I am not anti-fin, but am a bit cautious because of it's strange and unagreeable side effect profile.

Cant Decide, Oh, ok. But did you think that you were likely to become a NW7? Or do you think that at the time the procedure was done it had stabilized? So all 5,000 grafts were transplanted to the front? Do you at this point right now have nice coverage for the front half of the top of your head, and very little for the back half? If that is the case, does it look natural, especially when you are seen from the top? Sorry for question overload man

Gillenator, Thanks for taking the time to go through that in detail like you did!. Yes, I am trying to do as much research as I can. You are right that I am diffuse thinner, but I don't think it's unpatterned diffuse alopecia, I don't think. It is just the horseshoe pattern but all seems like is going at one time. Guess I really need to update my avatar. That's an older picture. You can see more current pictures from a recent thread here: http://www.hairrestorationnetwork.com/eve/170348-another-how-many-grafts-am-i-candidate-question.html So, yeah, It's not throughout the whole scalp, just the MPB areas. I was just creating the example of if all was lost on the top, are there still options? Or are you screwed? Either because finasteride just didn't work for me, or could not tolerate it. I think I have seen some examples of guys that have had procedures that had very little - no hair and seemed to be able to do ok. 'Cant Decide' who also posted in this thread seemed like he started with very little.

Can't Decide: Wow man, if I could achieve your results I think I would be very satisfied. Although, I would like to see a picture of the top of your head. How is the crown? I would guess that the procedure put more grafts in the front than the back, right? Also, can I ask why you took finasteride in your specific case? Because, you did not have much hair at all prior to the procedure right? So what were you looking to maintain? Or just to prevent the possibility of your pattern area enlarging? 47 grafts/cm2 looks like it got you some great coverage. I'm not expecting some prefect head of hair by any means. And, I expect that there will always be certain lighting conditions where there will be some see through. But, that's ok as long as it is not obnoxiously see through where that is one of the primary things people notice about me. But, do you think that in most situations your hair loss is not all that obvious anymore? Your results are what I was hoping was the case as far as the number of grafts and the results they achieve. I really don't understand how some people do like upwards of 8,000 to even 10,000 grafts and not have great coverage.

Thanks guys for your input. And you're right Shampoo I shouldn't have worded it "required". Maybe "strongly advised" would have been a better term, or something between the two. KO, I figured that pattern is not all so predictable. But, was hoping with diffuse hair loss you could get a better idea as it reveals itself all at once. So, basically I could have phase 2 of hair loss and the side/back could drop. Awesome. I also understand that taking finasteride may help prevent the need of a further HT. I almost don't know if I would rather have a second one in the future, so long as my donor allows, than be stuck on a medication for the rest of my life. Sounds irrational I know, and it's easy as just taking a pill. I get that. But, I have tried taking fin previously and it just didn't go over so well.