Rootz

I think you can get a fantastic, long lasting result so long as you choose the right doctor and stabilize your hairloss. Lorenzo and Bisanga come to mind as producing wonderful large scale FUE results. As for skipping the crown and only doing the hairline, I don't think that is necessary if you have enough donor grafts available and you are able to get on treatment (preferably Fin) for a period beforehand and stabilize your hair. No matter what you do you need to stabilize your hair though otherwise you'll be losing a one sided battle over the next 10-20+ years.

You're going to have to choose between your hair or your job. What's more important? Kidding. You're fine. The Fin will show up in your urine/blood but it's not illegal and highly unlikely your company will even be looking for it anyways. I think Fin might be a banned substance for sports, but I'm assuming you're not a professional athlete and this is just a regular job. So worst case scenario, for some reason they actually pick up on the fact you take Finasteride... and don't care.

Without treatment I think there's a good chance the rest of his hair on top will fade or disappear, and he still has quite a bit of hair on top. He may be one of the lucky ones who experiences noticeable regrowth too. At the very least OP I think you should try Minoxidil / Nizoral, and if you're really serious about this consider giving Fin a try.

Can't say I'm surprised, smart move on his part. I wonder how many actors in hollywood are on Fin.

For someone with your type of hair loss (aggressive) I think it is imperative to stablize your hair first before getting any type of HT. I'm sure you're aware of the potential side effects of fin, but if you're serious about this you should definitely give it a go. It will greatly help preserve (and possibly regrow) some of your hair. Other treatments are icing on the cake and should also be considered. You should consult with some doctors and get some estimates on how much donor you have. You might be able to do this online with quality pictures. The reason I ask about hairline density is it's something you need to consider. I would say a density of 50/cm^2 is considered "high" and about as good as it gets. Keep that in mind, if you need to conserve grafts aiming for something lower than this might be a good idea. As for crown, you definitely want to do relatively lower density there as that area will consume copious amounts of grafts. I would be extremely cautious about getting FUT. I'm not in your situation, so I can't fully relate, but I will tell you this... if I was in your situaiton, as best I can imagine, I don't think I would never get a FUT even if there was no other option. I also doubt you can't get the results you want with FUE. Ok there, I said it. Anyways. I'll throw out a number for you but take it with a grain of salt. If you want a relatively non-aggressive hairline with moderate density that intersects your frontal hair and conservatively joins the sides of your temples, with your crown filled in with relatively low density to give a decent illusion of coverage, and nothing else you're probably looking at around 3,000 grafts. I think that could give you a pretty good looking, solid result. Again, take that with a grain of salt. Keep in mind if you get on treatments for 6 months prior to surgery, you may regrow hair and need less grafts. Either way, definitely get on treatment. I posted this in another thread but I think it may help you,

This depends on several things including, 1. How much donor do you have available? 2. What kind of hairline are you looking for? 3. What kind of density in the hairline do you want? 4. The rate of progression of your hairloss. Have you been observing it closley for a while? How much is it changing? 5. Are you on meds? Which ones? 6. How old are you? 7. Do you want FUT or FUE?

The topical RU58841 is supposed to be pretty effective at blocking androgen (and inhibiting DHT), but it's a concotion you need to mix together yourself. Aside from that there are some others that could be beneficial such as Spiro and Revivogen. There are some tests out there showing these antiandrogen topicals reduce DHT in hair by a similar percentage as Finasteride, possibly even moreso, but the studies are less concrete and because the topicals work differently than Fin it's not clear if the end result of hair loss reduction is the same or really comparable. Since my post though I've had a change of heart and plan to give Fin a try, but with a very low dosage. Taking 0.2mg of Fin per day is almost as effective as 1mg, so I'll try cutting a 1mg pull into quarters and very closely monitor what happens. I think there's a good chance I'll be fine, and if that's the case that would make things a lot easier and simpler. If I get sides at least I can say I tried.

I've sent in pictures with drawn hairlines to several docs and none have said "Sorry I don't like that style" yet. I imagine most docs are pretty flexible on how the hairline is drawn as long as it makes sense and is reasonable. I think the biggest problem you would run in too is a hairline that was too low/aggressive for them. Some docs are more conservative than others. If you have some doctors in mind you should do an online consultation with them and show them. As for dictating actual graft placement, that is an interesting question. Doctors have a preferred graft placement style and could possibly take offense if you wanted to deviate from that for something "more natural" or "better". But I know what you mean where the hairline follows too straight of a path and just looks out of place. I'd def bring that up with the doctor during your consult, just keep in mind what you think might look better could be a bad idea.

There shouldn't be any difference between branded and generic, so long as the generic is obtained from a reputable source. If you're buying from an online pharmacy, there's always the off chance they're selling you sugar pills so if you go that route be sure to read up on the place beforehand. There's a bunch of reputable online pharmacies out there though.

Using any kind of topical Minoxidil is basically a win-win situation. The only downsides I can think of are, 1. It's kind of annoying to use 2. It's not free 3. Tends to promote general growth of body hair (not just on your head) Some people do shed initially, if this happens just keep using it and eventually your hair will stabilize and come back stronger. In terms of what is does for your hair, worst case scenario you don't notice much of a difference but it helps stabilize your hair. Best case scenario, you experience noticeable regrowth. Don't expect miracles, but again you can only stand to gain from using it. If 5% is about the same price as 2%, I think you should get the 5%. Otherwise from my understanding the 2% is usually enough. You're supposed to apply it twice per day, but a lot of people still get results just doing 2% once per day. With 5%, you could probably get away with once per day easier. The biggest obstacle to using Minoxidil is just having to deal with applying it every day... a lot of people get frustrated their hair doesn't quickly and noticeacly improve and then they throw in the towel. But if you can tolerate spending 1 or 2 minutes putting it on, you should just do it.

Not experiencing side effects during 4 months is definitely a good thing and is a strong indicator you won't have future problems. However I've read accounts of people spontaneously experiencing side effects years after starting... I personally believe a lot of these type of stories are placebo. People develop sexual problems for all kinds of reasons, sometimes for no apparent reason. Then again, who knows for sure. If you suspect you are experiencing side effects though, you can always dial back the dosage. FYI for anyone unaware Proscar is a version of Finasteride that comes in 5 mg pills, instead of 1 mg.

Based on your questions it would seem you have a lot of research to do on this subject. Here is some basic info I can provide. The drug will reduce DHT levels by around 70%, making it one of the best treatments against hairloss. The only better treatment is Dutasteride, which is similiar to Finasteride but even more potent. It will reduce DHT levels by around 90% based on the dosage. Both these drugs, while very effective, severely tamper with your hormones/testosterone in order to reduce DHT. As a side effect your body's level of testerone will be put off it's natural balance. This will have several effects, including tampering with your sexual function and causing your body to produce more estrogen. Estrogen is not a good thing in men... with enough estrogen you will start to turn into a woman in that you will inherit female characteristics. The good news is typically the side effects are so mild that people either don't notice any or describe them as insignificant. The bad news is sometimes the side effects can be significant, and in rare cases irreversible. Based on numerous scientific studies apparently the chances of havig noticeable side effects is 2% or less, but many people online will argue otherwise and say it is as much as a 50%. Reading accounts of people's experience online is misleading because the people posting about the drug are typically the ones having side effects. Let's say maybe a thousand or so people routinely post online about how the drug has ruined their life, this can appear daunting but at the same time millions have used the drug presumable with no major problems. Finasteride/Dutasteride are the most effective treatments against hair loss. If you're serious about stopping your hair loss, you should give Finasteride a try. I do not recommend messing with Dutasteride as I think you're asking for trouble. If you experience side effects, immediately stop until they resolve and then either give up or lower the dosage. Some will recommend continuing the treatment if mild side effects are experienced and have reported "pushing" through the side effects in that they subside. That is up to you. Most people take 1 mg of Finasteride per day, which reduces DHT by around 70%, but a dosage of 0.2 mg per day will reduce DHT by around 60%. So I recommend cutting a 1 mg pill in four pieces and doing 0.25 mg per day initially then working your way up if no side effects are experienced. Or just stay at 0.25 mg and play it safe. It is a very personal decision, as the side effects can be severe and as I mentioned in rare cases permanent. I personally believe many of the online accounts of permanent side effects are placebo, but at the same time I suspect some are true. Merck himself recently added to the caution label that side effects can be persistent (i.e. permanent). The main side effects are, 1. Decreased libido and morning wood 2. Erectile disfunction 3. Watery semen 4. Gynecomastia (male boobs) 5. Groin/testicular pain 6. Anxiety/depression

redandwhites, It's a good idea to try to stabilize your hair loss before a HT. Any reputable doctor will encourage you to do so, and some will even refuse to do surgery otherwise. After a HT it is always wise to stay on treatments to minimize/prevent future loss. Otherwise the hairs surrounding the newly transplanted hairs will disappear (even faster) potentially putting you in an odd looking situation (sooner). Minoxidil and Finasteride will at the very least help stabilize your hair loss. In some cases people regrow hair. Either way, if you suddenly discontinue use of these treatments you likely quickly start to lose ground so it is a good idea to not stop. Think of these treatments like a dam, they help block/prevent hair loss but as soon as you remove them the hair loss floods through.

Interested in this thread as I'll be seeing Feriduni in May. I'll let you know how it goes since you're the following month. What is your hair loss level? I'm NW2, just under 30. He estimated 1800-2400 grafts. Fairly aggressive hairline with temple points. As to why I chose him, I think he consistently has the most dense and natural looking hairlines. I think this comes down to his technique and he also seems to be less conservative than the other doctors I've consulted with. Bisanga and Lorenzo were runner ups. As for the insertions I would imagine Feriduni does them, but it doesn't really matter IMO because however they do it over there at his clinic it just seems to work.

I'm afraid you are mistaken in that If you have decent donor hair density and go to a reputable doctor, it doesn't noticeably thin the donor hair. At all. Your friend had low donor density and/or went to a bad doctor. He is probably very lucky he did not get a FUT as all else being equal he'd likely be in an even worse boat. Do you have pics?

Basic steps to take, 1. Research your butt off and find out all the pros, cons, and risks involved with a hair transplant. Some people spend years doing this. 2. Research which treatments you need and determine what's best for you. It typically takes 6+ months to stabilize your hairloss once you begin treatment. The most common treatments are Finasteride, Minoxidil, and Nizoral and those are all taken together. If you're serious about stabilizing your hair, you need to take at least Finasteride (or an equivalent). 3. Take detailed pictures of your hair from many angles before you begin treatment. 4. Start treatment. 5. Determine very specifically what your goals are. This includes the design of the hairline. 6. Research doctors and get a list a few that you like the most. This can also take quite a while. Going by price is not recommended. Get consultations with said doctors (online might be good enough depending on your situation). Schedule a surgery date 6+ months out with the one you like the most. 7. After around 6 months, take new pictures and determine the state of your hair. If your hair is worse, you're not ready. Continue treatment and reasses in a month. If it looks the same or better, you're probably ready. 8. Determine whether taking the treatments from step 1 for the rest of your life is worth it, that you're willing to accept the risks involved with the hair transplant and the strong possibility for needing work done again in the future. 9. Get a hair transplant. As for the actual surgery itself, it's not painful. Most people seem to describe it as tedious and boring. Some doctors have you watch movies during the procedure.

This is an overall remarkable result. Patient must be extremely happy at the transformation, and best of all... no FUT scar.

I think it's very likely your hair will improve with those treatments. Worst case scenario, nothing happens. You just need to stick with it, if you start experiencing a shed do not discontinue. That is natural.

... sooooo, what are you tryin to say??

I have't researched SMP much, but a concerning trend I've happened to notice is that the people who advocate it or posts results... tend to avoid answering the difficult questions or just flat out disappear. Not a good sign.

I feel this is one of the biggest dilemmas with hair transplants and we're pretty much all in the same boat. I myself have surgery coming up soon and I'm still undecided on Fin. I most likely will not take it and will probably compromise with some external DHT inhibiting cream or something. I have no problem with the other treatments like Minoxidil or Nizoral. But the thing with Fin, is I don't want to significantly compromise the hormones in my body... for the rest of my life. I know I most likely will not have major side effects... even if I do, again, most likely can just stop and recover. There are horror stories out there, but the extreme ones are outliers are I think I could accept a simple black and white risk of "0.01% chance you're screwed for life, and 99.99% chance all is good". But it's not that simple. The way the drug works has very real and serious implications... whether or not the side effects are immediately noticeable, your body is still compromised. The drug is very unnatural in terms of what it does. And over the years, I suspect my body would take a serious beating from the drug in subtle but serious ways. I don't want to be the frog that dies in boiling water, sort of speak.

My 2 cents, take some time to really figure out what type of hairline (and coverage) you want, and if Rahal gives you the thumbs up on it go with that and forget about whether it's 1500 or 2000 grafts. If something goes terribly wrong (don't worry you'll be fine), you're going to basically be in the same boat whether you went with 1500 or 2000. So the question is, 6-8 months after the surgery when the results are coming in do you want to look at your hair and say, "Ya know, I really wish I had..." or do you want to get what you really wanted?

I take it you did little or no research beforehand? :confused: Your question "What's the worst that can happen" is... kinda funny in a very sarcastic way. A HT is a major decision, losing your deposit is a small price to pay. Be sure to do lots of research this next time around. There are plenty of sub-par HT doctors out there who will gladly take your money and feed you a few lies along the way. My advice is to check out the ones backed by this site.

Just make sure your expectations are realistic, do a lot of research, look at lots of pictures, try to talk to patients of the doctor and read their experiences, etc. Asymmetry is actually necessary to create a natural look. If all the hairs lined up thickly side by side in a straight line, it would look bad... because it would look unnatural. Be sure to focus on wanting something natural, not necessarily symmetrical. Some doctors will even go so far as to intentionally do an uneven and crooked hairline, the idea being it looks more natural when grown out.