Paulygon

Have any updates?

Yes, the shock loss has been counteracted by means of time. I think the meds help to prevent some shock loss, but naturally the hair that has fallen due to shock comes back in anyway. It just depends on whether you're ok with a temporary blip; if not, go for the meds.

amazing results! you must be stoked- -- congrats mate!

that's actually pretty interesting.. i'm looking forward to any hypotheses.

Ever wonder how much the meds help to prevent or counteract shock loss after HT surgery?

Check out my results in the attached picture.

Facts:

• I used to be a user of Finasteride and Minoxidil
  
• but had quit it about 7 months prior to surgery. So Day 0 results is my baseline state (without benefits of hair loss meds).
  
• I was suffering pretty bad shock loss 1 month after 2nd HT surgery. This is when I restarted the Finasteride and Minoxidil.
  
• So far at 3.75 months, I seem to have decent quality hair, and the meds appear to have helped to counteract the shock loss. My hair still appears to be less than baseline, but it still seems better than I would have expected considering the shock loss at Day 30. I also think that my hair grew back a bit faster than normal-- though I can't be sure.
  

Any thoughts?

Hi Pauly,

I think you did the right thing especially regarding #5, in the future if you have to ever go off Fin again then most of your hair will be basically permanent. Though you had to go through a lot to get to that stage, but I think in the long run it will be worth it.

Yes, I went through a lot... basically 2 strip procedures, which I now realize was alot more effort for me than had I done FUE (except it was less $$$).

In the future I still may go for 1-2 FUEs because I've seen people who have done 4 procedures (who would have been bald otherwise) and their front hairline looks so darn good. After this 2nd procedure grows out, I think my front will be better (Mohebi did crown but had extra hairs and filled in-between some of the previous implants at the middle to front hairline).

What is your current Fin dosage btw? You may have read that I cycle a few months on then off due to sleep-related side effects and am now on .625mg 2x week on Tuesday and Friday. If this works out I will try to stay on long term.

Current dosage is 1.25 mg 1x/day. I considered 5mg/day but at the advice of many people on these forums, decided against it. You guys were right because, as in my pics in my previous post, you see that 3 months of 1.25 mg really counteracted alot of the shock loss I was dealing with at the 1month post-op stage. So for me, it looks like 1.25 is a very effective dosage. I never considered going lower while on the regimen, however I do think it could be a good idea. I am amazed that your .625 mg 2x / week is effective.. but you are an expert on these forums so I'm sure people will follow your lead if it works for you long-term... I know I would consider going lower.

Since a lot of my hair is transplanted in the front I don't see any major differences unless I go more than 6 months off of Fin, most recently did seven months off which gave an honest assessment for my temple point procedure with Dr Bisanaga but mid scalp area became a bit thin which is why I started this thread.

Do you plan on getting another procedure in the future?

How many have you had thus far?

Hey Pauly !

Good to hear from you man.

 

I think I read your ugly duckling phase post before when I was traveling.

Good to see that things are getting better for you.

 

Were you off Fin due to sides? Ive been on and off but when I can tolerate it hair gets a major boost of course. Will check out your latest thread.

Good to hear from you too hsrp!

At the time, I had started a new relationship. I got off of meds because of some combination of the following reasons:

1. the side effect of watery you-know-what. I thought it would be embarrassing. Now I just spin it off as being manly (lol).

2. I wanted to give my body a break from the medicine.

3. stupidly, I thought there may be a chance that my body has adapted to having hair and stopping medication might not drastically change my hair quality.

4. my gf was so infatuated with me at the "new relationship phase" that I felt it doesn't matter how I look.. little did I know how after the "new relationship" phase, every little flaw is nitpicked. a few months after stopping the meds, I started getting comments from her and her family about how I am losing hair and it is probably because I wear a hat too often.

5. part of me knew that I do need to get a 2nd HT in the future and I wanted an honest assessment of what areas of my scalp need implants. Since implants are resistant to DHT they are permanent and this would reserve the option of getting off meds again in the future but still having a scalp with proper distribution of hairs (a good look / not too many hairs in one area and not enough in other areas).

Bad points of getting off meds:

1. You can lose hairs that will never grow back!

2. You can lose ALOT of hairs VERY QUICKLY and people WILL notice the balding but your mind still thinks that you have a decent amount hair. Eventually the mind catches up to reality and you either get back on it or just accept your more bald look.

I had a choice for my 2nd HT and decided to shave. I didn't want to have any nagging thoughts about 'what if' if things did not turn out as expected. They did turn out fine (Thank You Dr. Mohebi) and I am very happy and can't even remember the ugly duckling phase being that horrible - and I had to get in front of people less that 30 days after.

Me too. Dr. Mohebi said it could make a 10% difference in final results. So I shaved.

I also had shock loss (my fault for not getting on meds sooner). So I had a very bad ugly duckling phase, which lasted 3.5 months (I am at 4 months now) and things are almost back to pre-operation at this point. See attached pic, which I made today.

A happy update regarding my shock loss.

I immediately started back up on Fin + Minox after realizing shock loss was occurring (Day 30 post-op). After about 3 months, I've gotten back into decent shape (see Day 111 post-op).

Just curious? How come you stopped fin 8 months ago?

No side effects but I just didn't want to take the pill for the rest of my life. I dropped rogaine also.

Really, my sex appeal was way up, I was pretty darn good meeting new girls, but then I got a girlfriend and got too comfortable. Stopped the Rogaine and then Propecia a couple months later.

Now I see how big a factor they were in my great hair just a year ago. Hopefully going back on those meds can revive the hairs that were dependent on Rogaine or Propecia. But I am sure some follicles have died in the nearly 8 months of not taking the two drugs. But I'll go back on and take as much as I can get.

Below is a chart from a study conducted that shows the DHT serum levels in the skin and scalp at different dosages. As you can see there is very little difference between 1mg and 5mg. Additionally, one could even argue that taking 0.2mg is still effective in treating MPB.

 

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia. - PubMed - NCBI

Love that you found This chart. Ya, there is such a marginal difference between hair growth at 5mg vs 1mg. Thank you for this information.

Pretty much agree with all of the above…However I wouldn't rule out dut if you are really wanting to see a difference…

But then again…you risk more sides…I completely quit taking finasteride…now I just take one .5 dutasteride every 3rd day..I can tell a pretty big difference.

Hmm. Maybe I will try Dut. If there is a big difference.

Thanks for the idea!

OP was on Day 5 and they seemed wet/mucusy.. by Day 10 these things became hardened and were very annoying bumps on my scalp. Dr. Mohebi's after-care instructions said that I could wash my hair a little more aggressively starting Day 10. I did, and alot of these bulbs came out along with their attached hairs follicles on that day. This has me a little worried, but as Dr. Blake mentioned, the roots heal very fast (usually by day 4 you're good)... so realistically, the massive fallout on day 10 shouldn't be anything for me to worry about, right?? I can see myself worring for the next 9-12 months that I messed up my procedure by being a little more aggressive on Day 10's shampooing.

I'm on my third FUE procedure now, currently at 6 days post-op. Just wondered if anyone else had experience with 'white blobs' around grafts after washing in these early days.

I'm on HT #2 and was experiencing this. I was concerned had to reach out to my HT Doc. See the attached image of my scalp under similar conditions as OP and Dr Parsa Mohebi's diagnosis. He quickly eased my mind that these bulbs are nothing to worry about.

My first HT was with finasteride and the results were great- no shock loss.

I tested HT #2 by NOT TAKING finasteride and just 1 month in I am experiencing major shock loss. I plan to get back on Finasteride ASAP.

However, the HT surgeon said that with my hair thickness and waviness, I may not need to take Finasteride for the rest of my life. I have ample donor hairs.

Anyway, I do want you to see the attached photos of me in order to make you aware of what can possibly happen just months after surgery if you do not take Finasteride... you are at highest risk for shock loss after surgery, and it is theorized that Finasteride will help to curb it.

I am now in the ugly duckling stage :rolleyes:

FYI, current state of affairs.. pretty bad shock loss. I should have started finasteride immediately after surgery. Now I'm 1 month in. See pic.

Here is the photo of my current shock loss.

I feel for you, pal.

My transplant was last month and I am the ugly duckling for now.

Attached pics show my current situation (and the shock loss is shocking :eek:)

Note: I believe the shock loss was because I didn't take propecia immediately after surgery, not heeding the advice of my HT-doc.

I stopped taking Finasteride 1.25mg about 8 months ago and have had catch-up hairloss. After a recent HT #2, I am also experiencing shock loss.

Just filled my prescription for Finasteride. Instead of cutting each pill into 4 pieces to get 1.25mg, I plan on taking a whole tablet, which is 5mg/day.

Any opinions on how much of a difference there is between 1.25mg/day vs. 5mg/day?

I have talked to a pharmacist and have been told there is no danger, so please keep your answers directed to:

(1) Should I expect better results with the higher (5mg) dosage, and

(2) if I should expect better results, would the benefits be dramatic or marginal?

I feel like I've bugged my HT-doc alot in the last month, and I just want to hear community opinion/experiences right now.

Note: I am not concerned with side effects for the time being.

Damn, look how bad things got at 41 days post-op. Geesh. This was after the transplanted hair had shed, and during the worst phase of my native frontal forelock shock-loss. Yikes. Glad that's over. Second one is today, wet hair.

wow. huge difference.

i am pretty sure i am experiencing shock loss as well. im currently at day 30 post-op (2nd transplant). how long did shock-loss last for you?

Please post the link or photos if you don't mind.

Like Jeff said, the main issue with concealers is getting overly reliant on them. If you continue to lose more hair you're likely to keep using more and more concealer until eventually you're just pouring fibres onto bald scalp and that can look pretty horrid -

This!!

My HT doc prefers I get adequate coverage to the point I don't need concealers.. but with concealers I am more confident that pictures will turn out great. I'm afraid the flash will brighten up my scalp in photos, but the dark concealers (toppik) will ensure that my scalp doesn't show in photos.

I have been in the situation (prior to first HT) where I was putting in concealer to create a hairline that had long gone away.. I think everyone noticed it but I was in denial. I remember an interviewer basically just stared at my hairline the whole time (the hairline which was created almost completely out of Toppik :eek:)!

Nice helpful review but really it is incomplete without pics.

Kindly upload some

And thanks for the detailed feedback

Snapchat vid of me during surgery (very informative)

Photo Album of Second HT results so far:

Hair Restoration Social Network - Hair Loss and Transplant Photos

I think the Snapchat / Youtube video above is is very informative, so definitely check that out!

Just uploaded a few days worth of headshots to my HTN photo album -- and wanted to let the community know I'm still active....

Hair Restoration Social Network - Hair Loss and Transplant Photos

I will upload more as the months go by..

In case you missed it, here is the snapchat video of the hair transplant surgery being performed on me at Dr. Mohebi's office!!

2nd Hair Transplant (June 28, 2016)

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Beautiful work & awesome analysis.

I think I had "early growth" (about 3 or 4 month point) after my 1st procedure, which was about 4 years ago. I had just started Rogaine about 10 days after surgery. I suppose that's analogous to Dr. Blake Boxham's hypothesis that early growth is due to increased blood supply in the recipient region.

Nice helpful review but really it is incomplete without pics.

Kindly upload some

And thanks for the detailed feedback

I will post pics as soon after my 10-day followup, I promise!