Motoro

All the folks I knew from 20 years back who espoused that philosophy as a hair loss treatment--at least those who advocated for it in opposition to 5-α-reductase inhibitors (as opposed to those who suggested healthy lifestyle changes to compliment proven hair loss treatments)--are now NW6+ or well on their way. Every singe one of them. That's a cold fact. An educated, active and ongoing awareness of what you put in your body and where it originated--not to mention the environmental and social impact of actually getting it on your dinner table--is critical to overall health, conscientious citizenship and individual well being. Just don't confuse or conflate any of that with stopping hair loss. Of course you don't need a stranger like me on some Internet forum to tell you these things. Time always gets the job done. The thing is, once your hair is gone, it's gone. There simply isn't enough time in this war, especially in the early stages when the stakes are highest, to make the wrong decisions.

If changing your diet has an effect on your hair loss, you're suffering from malnutrition, an almost unheard of malady in population groups who frequent Internet hair loss forums. Aside from Loniten, which isn't safe or predicable, there are three substances that pass through the mouth and arrest falling hair: finasteride, dutasteride and any sort of terminal poison.

Last night’s post put me in a reflective mood and I have a few additional thoughts about thinning, transplants and length. I didn’t talk about hair length in Dr. Lindsey’s video and I don’t want anyone thinking hair loss and long hair go together. They do not. My hair hasn’t been this long since 2001 and it isn’t going to stay this way. I grew it out to cover my FUE donor and recipient areas (all my surgical work is in and around my hairline). I did this with each of my four procedures and recommend it to those who want to keep their business private. As far as I know, nobody knows about my work aside from a handful of close friends and family. Advertising hair loss and your treatments focuses attention behind the curtain, where it doesn't belong. It’s much easier to find Waldo when you know where to look. On that note, I currently blow dry my hair and basically have long bangs. I generally wear a hat as much as possible during this “ugly duckling” recovery phase, but I can and do go hatless when necessary. A little planning is all it takes. That said, I normally keep my hair short and neat. To repeat that old line, hair restoration involves a lot of visual trickery. Short hair and low scalp contrast conceal thinning and loss. Indeed, dying my transplanted hair to reduce scalp contrast is something I’d consider if I wasn’t already going gray. Guys obsessed with looking “young” and dying their hair dark often end up with a shoe polish look that draws attention where it shouldn’t. Older white guys with thinning hair and dark dye jobs universally look terrible. That’s not a look you see in nature, which is generally the best measure of any treatment. SMP, which I’ve never had, can contribute to the contrast illusion from the scalp angle. Combined with very short hair, FUE and a nicely shaped head, SMP results can impress. But all density illusions break down with length, and if I had a nicely shaped head I’d just shave it off and call it a day. There are more important things in life than hair, but it didn’t feel that way to my 17 year old self, who committed to this endless fight. My shaved head looks like a still-lumpy proto-planet that's full of impact craters, however, and I don't regret my choices. To conclude on a positive note, I haven’t been excited about my hair since the mid-1990s, when I first noticed fallen strands in the pages of my high school textbooks. But I’m genuinely excited about going gray and getting older. Hair loss in your 30s and 40s is commonplace. Only now do people ask how I kept my hair when all my people went bald. There's still a 17-year-old kid in the back of my head who chuckles each time this happens. I’m entering new and uncharted territory as I close in on 40: no man in my extended family—to paraphrase an Irish saying—has ever combed gray hair.

I'm the dude in the video. I intended to chime in earlier, but my (healthy) aversion to hair loss forums kept me away. More on that in a moment. First of all, a big thanks to Dr. Lindsey and his staff, especially Wendy. This was my forth transplant with Dr. Lindsey, which says all you need to know. Donor hair is a limited resource and hair loss is a never-ending battle. Pick your surgeons carefully. I’m almost 39 and started losing my hair at 17. Every male in my bloodline, going back three generations, went NW6 by 30. I started minoxidil at 18, finasteride at 20 and dutasteride at 22 (replacing finasteride). I’ve been taking 0.5 mg of brandname Avodart each morning for the past 17 years. In the early 2000s—when the forums were less foolish and hysterical—people talked about “the big 3.” Minox/Fin/Niz. I took that to heart and never wavered, which is why I still have most of my hair in spite of genetics. In 20 years nothing has changed when it comes to drugs that work. The guys from the early forums who still have hair don’t have it because they ordered unapproved and untested drugs from China on the advice of online bro scientists. DHT-prone follicles are an even more precious resource than donor hair. Don’t mess around. Get on one of the two FDA-approved 5-alpha-reductase inhibitors and stay on it. Forever. While I’ve had four hair transplant procedures, they have all been relatively small FUE sessions—think 500-1000 grafts. I have thin hair and the illusion of density requires tight packing and multiple sessions. Realistically, that’s true of most people and is what you should count on. One and done isn’t reality for most guys and hair loss never stops. Let me say that again: hair loss never ends. The idea of “stabilizing” loss with meds before getting a transplant shouldn’t be confused with stopping loss—meds slow loss in good responders, at best, over a lifetime. And once you’re taken a surgical stand against hair loss, know that there will be more transplants in your future at your current vanity levels. Don’t think hair loss isn’t going to bother you once you’re reached some unspecified age. If hair loss bothers you now to the point where you can’t accept it, hair loss will always bother you. Finally, be careful about spending too much time on these forums. Countless folks lost hair they’ll never recover as a result of the finasteride hysteria that started around 2005. It’s easy to freak out online, quit the things that work and convince yourself your dick is about to break off and tumble down your pant leg. Don’t believe the hype. Take your meds religiously and if you decide to get a transplant, plan it out with the next several decades in mind. Thanks again Dr. Lindsey. I’ll stop by in 6 months or so to catch up.

I've had a dream multiple times where I wake up in the morning, walk to the bathroom, look at myself in the mirror and see a NW6 staring back at me. In this dream I'm not only a NW6, but I have a really, really bad haircut. It's longish in the back and on the sides and looks badly dyed. I look like an "accountant" from Central Casting... I have this dream once or twice a year. I also have the broken/missing teeth dreams. Terrible stuff.

Nice job Dr. Lindsey. With this guy's minimal hair/scalp contrast and limited scaring, this is going to be a great example of what a few transplants can do for an individual's overall look. The refusal to try medication is baffling to me, especially since this guy comes from a class 6 background, but he may just pull it off in the end. I'm looking forward to seeing a final update in a few years, after that second round.

For most men, there's no medical treatment that can regrow cosmetically acceptable hair in areas that are completely bald. There are exceptions to this, but they are just that: exceptions. Having said that, I'll also say this: I've been on dut for 13 years and during that time I have lost very little additional hair around my hairline. Keeping what you have for multiple decades counts for a lot. You can always fill in what's missing with a transplant or two.

Hey man, you are going to be just fine. You weren't botched, as far as I can tell. You obviously need more density, but the hair you had transplanted is growing. It's thin, but that's not the end of the world. It's also early, at only 6 months. Another pass by a recommended surgeon and you'll look great. Remember, most people need more than one transplant during the course of their lives. Some people need that second procedure quite soon after the first. You're one of those guys. That's no big deal--you'll turn out fine in the end. It's just going to take some time, money and patience.

What I'd suggest--which is what I have done after each of my three small FUE sessions--is to grow my hair out and just style it forward when I need to meet with people and can't wear a hat. The long hair is also able to cover up the shaved donor area in back. Again, this is for small sessions. It's not a perfect solution, but it gets the job done. As far as I know, nobody has detected that I've had anything done while in the ugly duckling phase. After three weeks, get a real haircut to even things out. And after six weeks, you'll be golden.

If you are concerned about your hair being dirty and greasy, take the extra time to take a shower. That's not very hard to do; it should only take a minute or two. If you are concerned about your hair loss (if you have any), start taking finasteride. That not very hard to do either. You'll be better off having done both things. Worrying about your follicles being clogged with "gunk" is a waste of your time and energy. "Gunk" may make you smell and look nasty, but it's not a big factor when it comes to hair loss.

How much hair are you having transplanted, where is it being transplanted, what transplant method is being used and how long will your hair be at the time of the procedure? Finally, who is your audience? Who are you trying to fool? Your family or co-workers/acquaintances? Cover up strategies should be based on the answers to the above questions.

What does this individual hope to achieve with his transplant(s)? Does he have realistic expectations, considering his starting point?

Nothing is permanent when it comes to hair. Even some hair transplanted from the safe zone may fail if you live long enough and are predisposed. Finasteride can slow the progression of loss to the point where you may only need one or two additional HT procedures over the course of your life, assuming you catch the loss early and are a good responder to the medication, as most men are (despite what you may read on the forums). You should shed the idea that there's something you can do to fix your hair loss problem permanently. You already have extensive loss and your best first step--regardless of how much hair you get transplanted and which method is used--is to save as much of your native hair as possible. That should always be the starting point once you've decided you want to walk down this path. There isn't a magic bullet and the best results, over the course of a lifetime, are going to be achieved by attacking the problem on multiple, proven fronts.

First things first. Post a picture so we have a frame of reference.

Don't count on it! We haven't had a major MPB breakthrough on the medical front in 20 years. Hanging out on the forums, it's easy to get yourself pumped up about things that might be just around the corner, but history suggests these future products: 1) Won't work at all. 2) Won't work well enough or better than anything we already have available. 3) Aren't going to be profitable enough for drug companies to bring to market for MPB. The online backlash against fin doesn't help here. At some point we'll see gene therapy address MPB, but probably not for decades. It's not something I'm counting on being available to me. Hair cloning falls into the same "don't hold your breath" category. Based on what I've seen over the last 20 years, I don't believe there will be a major MPB breakthrough brought to market between now and the time decades from now when gene therapy becomes an option. History suggests there may be a MPB product or two that hits the market between now and then, but history also suggests it won't be a breakthrough product that works much better than anything we already have. I'm not trying to be a downer. Quite the opposite, in fact. I believe most men who are starting to bald in 2015 can achieve a great outcome with fin and modern transplants. The trick is to catch the problem early and to remain consistent with the medical treatment. I'd also suggest staying off the forums once you've learned everything there is to learn about hair loss in 2015. Once you've done this, stop by in another 10 to 15 years. You'll likely find there have been advancements on the surgical front but not on the medical front. The forum conversations will all be the same. The old users may be gone, but there will be a new crop (who were young children when you were last on the forums) arguing with religious intensity about one thing or another. But the situation on the ground will be the same. This has been my experience.