DavidAnderson

There is still a chance that it will improve however I do agree that like others have mentioned that it is probably going to end up close to that. Unless you are considering another surgery I would not revise that scar alone as the risks outweigh the potential benefits. I would FUE into that scar but you should wait a bit longer to see if there is any improvement.

From looking at many guys hairlines over the years it tends to be that the right side of the hairline is worse than the left in general so it could is very possible that the right side might be slower to see results than the left.

I have seen significant improvements in patients after 6 months. Some of your hairs may have only just sprouted and be as other have already said very fine, colourless and short and not adding any cosmetic benefit to the eye currently.

You may have experienced some shock loss and that is just coming back through now. It is disheartening when you see all these great results at 6 months but for every great result at 6 months there is a slow grower for sure.

Do keep the faith hair grows painfully slow.

Hi all,

I will be in London catching up with a few patients on Thursday August 18th and if anyone was interested in meeting up to discuss their hair loss or a possible hair transplant and wanted some advice I have some spare time to meet. If you don't know my history I have had 5 hair transplants and been on Propecia for 10 years now and been battling hair loss for 22 years now.

You can PM me on here with your details or email me on david.anderson@themaitlandclinic.com

David

Hasson & Wong have a representative in Toronto he would be able to arrange a meeting with some patients if you don't get any response on here. You can email them directly about this.

I think something you have to remember is that finasteride/dutasteride rarely truly "halt" hairloss. For most men they slow down the rate of hairloss, sometimes significantly, so that for example the amount of hair you would lose over one year naturally may take 3 or 5 or even 10+ years with finasteride. This makes planning procedures and producing consistent, cosmetically acceptable results easier. The more aggressive your balding, the less likely finasteride is to slow the hairloss over time, but for some men that perhaps only have moderate balding, the drug can significantly slow hairloss, so that you might have in your 50s or 60s the hair you were going to have in your 30s or 40s.

 

The bottom line is, though, that for most men hairloss will still continue. It's unlikely that finasteride is losing its effectiveness, it's just that you're not blocking all the DHT and those hair follicles are still "under attack" somewhat because of that (we need DHT, so the drug only blocks about 70% of it). If you were to stop taking fin/dut, you'd likely notice a pretty significant loss of hair, so the drug is still probably working, it's just not a perfect solution.

 

The honest truth about surgical hair restoration is that, once you're on the boat, you're on the boat. Essentially all men, no matter how stable their hairloss seems, must commit to the idea that they may need more than one surgical procedure to meet their goals over time and that, ultimately, even on treatment, their hairloss may progress to the point that they cannot cover every cm2 of their balding with the available donor.

 

That's why most doctors will focus on building a decent density hairline and move back naturally into the midscalp, with much less focus on restoring the crown with any density. That way, if the day comes that you do age and continue to bald, you'll likely have a pretty good hairline and midscalp with a natural fade back towards a bald or thin crown - this will look natural and will likely happen fairly slowly over time. Of course, multiple surgeries down the road could continue to correct further loss - the idea with finasteride is that it will either limit the amount of surgeries you need or significantly extend the amount of time needed between surgeries, so that you may need 2 or 3 over 20 or 30 years instead of 5 or 6.

 

That's also why good doctors will be hesitant to chuck 5,000 grafts into 70cm2 of balding, particularly in younger men. Further loss is always possible, probably even likely in the fullness of time, so a good doctor will focus on rebuilding your hair with maybe 3,000 - 5,000 grafts and try to leave a couple of thousand in reserve for the "rainy day" fund, which is usually needed if the sides of your hair drop or the crown opens up significantly over time and you want to touch those up.

 

Your position sounds like a tricky one; on the one hand it's a positive situation because it sounds like fin/dut is working and you still have a pretty significant amount of hair, which is great. The downside with that is surgical restoration becomes more tricky - you're probably wanting to use a few thousand grafts wisely to build and thicken up a mature hairline and thicken up the mid-scalp a little. The reality is, though, if you do this, you almost certainly need to commit at least to the possibility of more surgery down the line to address further loss - and you also need to plan conservatively and assume the areas that are thinning will one day be gone. Then, with a good doctor you can estimate how much donor you're likely to have in total, how much balding is theoretically possible, and come up with a plan that meets your goals without compromising the basic supply/demand issue common in restoration.

What an excellent post by Mahhong.

Correct planning for the future is so important, restoring a conservative hairline that looks natural in the future if the crown does continue to open up is the key. Not using up the vast majority of your donor in just the front to solve your issues now.

You should only consider upping the dosage of fin or switching to DUT if Propecia at 1mg is not working for you and in any event the chances of the higher dosage or DUT working are very debatable.

Sounds like you just got off it and feel you have some catching up to do. I would get back on it and wait it out no need to switch.

Most docs believe that propecia is not dose related and that 1mg is more than enough for hair.

Best advice is to stick with something and do it consistently it is a lifetime commitment or at least until something better comes along in the hopefully not too distant future.

Thanks Doug. It was a pleasure working with you and I look forward to a continued working relationship and friendship.

Hi madmaxwell,

Thanks for your interest in Dr Edward Ball and The Maitland Clinic. Hairsgone is a previous patient of Dr Ball and there is a poster on here called ntheory that recently had surgery here is his account http://www.hairrestorationnetwork.com/eve/183872-2200-grafts-fue-dr-edward-ball-%40-maitland-clinic.html

I started working with Dr Ball two months ago after leaving what is regarded as one of the best clinics in the world so hopefully that will give you some comfort on the skill of the surgeon. Drop me a pm or contact me through the clinic if you would like any help.

Congratulations on your recent procedure with Dr Hasson and for the detailed write up. Work looks very impressive as always and thanks for my mention it was a pleasure to deal with you. That was a serious number of grafts you got and should give you an excellent outcome.

Good growth to you and keep us all posted.

Thanks Aftermath appreciate your words.

Incredible results Aftermath. Really happy to see that you finally got what you wanted. Beautiful work and amazing density.

Yes it can help with the illusion of density but I would wait it out for the full year before you make any decisions on what do. Crowns always take longer and you might reach your goals without the need for the SMP.

The crown always takes longer to grow in as the blood supply there is less than in the front. As for shock loss it depends on how weak the hairs were in the crown as to whether they survived.

Looks really nice improvement for 6 months Chris, very happy for you!

Leonilly,

Happy to help.

A NW6 ideally is going to have some miniaturized hair already in the area that can be saved. This will make a big difference on what the final result will look like if you can keep this hair.

Your sides where the permanent hair is currently appear to be quite high this is a very good thing as of course it means there is less area needed to be covered.

The down side to this is of course that they sides have a real risk of dropping leaving the transplanted hair disconnected.

Good donor density above 75-80 in the donor per cm2 and at least a medium to medium-coarse hair caliber. Lower contrast between hair and scalp so not black hair and pale skin. A wave or slight curl is better than straight hair.

If considering FUT then above average scalp laxity which is the movement of skin at the sides and back of your scalp. The more movement means the surgeon can take a wider piece of tissue containing more grafts.

A small head! yes less donor supply but less grafts needed as a result, less grafts the lower the cost.

And finally realistic expectations.

I see definite improvements the hairline has a much more defined shape than before. Dr Wong is one of the best so I am sure things will thicken you are just a late bloomer.

Stay positive and please keep us all posted.

You deserve a great outcome and I sincerely wish the best for you. 3 days in the chair wow that can't have been easy. How you feeling now?

I agree with Bill, if you are going into the same area you should wait at least 9 months ideally a year to see the full benefit of the first surgery before having a second.

Excellent results, really happy for you. Are you taking Propecia?

Congratulations on your recent surgery with Dr Karadeniz the work looks very good and you are healing well. That was quite a big session you had there and should really make a nice difference.

Good growth to you!

Thanks for the update Dutchie, you are in the peak growth period now so I am glad to hear that the anxiety has gone. Enjoy the next few months and look forward to following your progress.

As others have suggested there is not definitive solid answer to give. It comes down to a number of factors and it is imperative that you understand the limitations of surgery should you decide to go ahead especially when not taking medication.

As you have tried the medication and had sides I can understand your reluctance to try it again. Is Dr Lindsay wrong for offering you surgery without it no I don't think he is provided that you fully understand the commitment you are getting yourself into.

From the photos it is clear you are going to be a 6 in the near future where that ends is uncertain. To have any idea you need to look at the males on both your Mothers and Fathers side to have any clue but even this is not totally reliable.

You need to understand the limitations of your donor and plan accordingly, to me that is giving you a 40-50 year old hairline. Most guys in their 20's are not happy with this which is why many clinics won't operate on patients so young without meds.

Of course you can create something lower now and make you happy short term but what about the future? What if your sides drop and the hairline becomes disconnected, what if the sides recede and the front is top heavy.

One thing is certain that more surgery will be required but it depends how much donor you have to chase this loss and whether you have enough for more than a light dusting of hair in the crown. There are many factors to take into consideration. I would suggest you visit some Doctors in person for assessments and get some more opinions. All the best.

I would check with your Doctor it is unlikely that a glass of wine would hurt but as tempting as it is you should resist for a few days ideally.

The first couple of days are the most important if you do not have ATP then a saline would be the next best thing. Every clinic has different advice on what they want their patients to do post op so always check with yours first.

Good growth to you.