mahhong

It's a solid result. I think the issue with your logic, gbhscot, is that nobody really knows how their result is going to turn out. Some men would get a better cosmetic result than this, others perhaps even less cosmetically acceptable. You won't know until you pull the trigger - as it happens I think this is an almost perfect representation of the "average" result somewhere around 4,000 grafts will get you - not absolutely stellar but a very, very appreciable and improved cosmetic difference. This guy had significant hairloss, there wasn't really any native hair to blend into and if you've got 100cm+ of pretty much bald scalp to work into (I'd say it's at least that), you're somewhat limited. This gentleman probably still has another 2 - 3,000 left in the bank by strip and/or FUE. Another procedure to beef up the hairline and perhaps thicken the mid-scalp would go a long way. And there's always concealers or other cosmetics if you want a little fuller look. As it is I don't think he needs further work - this procedure has been planned well. There's possibly scope for more but it stands by itself. I think sometimes forums can give a slightly skewed sense of what is a "successful" HT. For 4,200 I would say this represents pretty much what a lot of men with that level of loss could hope to expect.

It's a fantastic result! I think keeping a lot of the forelock must have really helped him, but he was pretty substantially bald and his hair looks fantastic these days.

Sounds good! It is worth saying that sexual dysfunction is pretty rare with finasteride and dutasteride. The internet probably makes it sound a lot more common than it is - official studies put sexual side effects at somewhere between 1-3% of people using the drugs, anecdotally it may be a bit higher than that, but still maybe only around 5-8% (and that's very unscientific, just a general judgement based on forums such as these). However a lot of men choose not to take the drug, either because they're worried about about side effects or have experienced them whilst trying the drug. Some men find they can take a lower dosage and have benefit to their hair without experiencing sides and that may be worth considering. Rogaine and Nizoral are both effective treatments too, so it's good to stick with them (though generally speaking people see the best results using them in conjunction with an anti-DHT medication). Hair transplantation is obviously a very effective solution to hair loss too, just bear in mind you may continue to lost hair even after a transplant (whether you're on medication or not), so you may need several or more transplants to meet your goals and there is always a risk you may need more transplants than your donor would allow over the fullness of time. Finasteride and dutasteride usually halt or slow hair loss down a lot over the course of decades, so they remain the best way to reduce further loss whilst having transplants to deal with any current loss. However, many men successfully restore their hair without these drugs - ultimately the choice on how best to proceed is down to you!

Hi Darkhorse, I haven't used it but noticed nobody had yet answered. I do know however lots of men use dutasteride (also known as Avodart) for hairloss - some instead of finasteride or when they feel finasteride is no longer working for them. Like finasteride, side effects are fairly uncommon but can involve erectile dysfunction, watery semen, gynecomastia and some men also report a sort of "brain fog". However these side effects are not present and can nearly always be stopped or reduced by either coming off the drug or reducing the dosage. Dutasteride is slightly more potent than finasteride in that it inhibits two types of 5ar, where finasteride only inhibits one. This is thought to make it slightly more effective than finasteride, but it may also be slightly more likely to produce side effects - the likelihood would still be statistically low, however.

What Dr. Bloxham said. I've heard varying degrees of success but I've also heard that some men get the same sides as finasteride. It works in a different way but it still essentially does the same thing and it very likely still goes systemic, so the rest of the body may be affected the same way. Add to that the hassle of having to buy it and create your own vehicle to apply it, and it just seems like a lot of hassle without a lot of clinical study to back it up. That's not to say it doesn't work, but how well it works, or what is the best dose/vehicle to use is still without proper study, not to mention any real knowledge about long-term safety (no reason to suspect it's particularly unsafe, but it's all conjecture either way). I think finasteride, minoxidil and transplants are still the three best options, with maybe some good adjuncts like Nizoral etc. Personally I don't think I'd trust purchasing and creating my own anti-androgen!

I think the main concern with RU (apart from the fact getting it and creating the formula is, to my knowledge, technically illegal) is just a lack of genuine data on how well it works and how safe it is, as well as no truly established guideline on how to produce it (i.e. the best solution, concentration etc.). Most men who try RU are, frankly, men who are probably also using minoxidil, finasteride and often "boosting" that with dutasteride, saw palmetto and various other vitamins and oils. More power to them if they want to do that, but it makes it very hard in most cases to truly know how much benefit RU offers, and it's also potentially damaging to your health too. Of the few studies/abstracts that have come out, it seems that RU is at best maybe comparable to finasteride. It possibly has a lower side effects profile due to the way it works, but if you're planning on combining the two that wouldn't matter much anyway. Personally I don't think I'd try it. I've heard nothing to suggest it's seriously unsafe or anything, but I don't much like the thought of concocting my own, not really tested anti-androgen - especially if there wasn't at least seriously good scientific evidence it had a really beneficial impact. The concept of using both is sound but it just doesn't seem practical and nobody really knows about the safety or usage aspects. It seems like an awful lot of work and energy for little more than a hope.

In my experience I would say the average man's donor yield, via FUE, is usually around the 6 - 6.5k mark. I think to only get 5k would be fairly rare, but to get more than 7.5k isn't that common either. In most of the cases posted on here on reputable doctor's websites that contain the relevant information, a yield of about 6,000 - 6,500 grafts seems the most common. I also think you bring up an interesting point about FUE being able to "spread" the hair more evenly from donor to recipient region, and in doing so balance out the overall density of their hair. I've heard a few doctors say this and it does have some merit. Going into what Dr. Bloxham said too, it might be that FUE opens up the donor area, and that going the FUE route gives the patient the option to "rebalance" their hair density across the scalp rather than simply removing a strip of hair and replacing it in the recipient site, leaving the remaining donor region at native density. I don't know if it would pan out that way, but it's interesting. I also agree that true NW7 seems pretty rare, but one thing I do think we need to keep in mind is that the Norwood scale just approximates someone's balding to a visible pattern and is not a predictor or accurate indicator of balding. Two men may both be NW5 but one could have 140cm2 of area that needs to be transplanted into and the other 185cm2, depending on a variety of factors. I do believe the donor area in most men is slightly larger than the defined SDA, but it still varies widely from man to man even if they have ostensibly the same balding pattern. And of course the problem is you can't really undo mistakes in hair transplantation, at least not to the donor region. If you overharvest you may still have some options with body hair and micropigmentation but I think most men would feel pretty glum at the thought of having to fix their donor area!

Significant improvement with a small number of grafts - great result! He looks like he'd easily have another 3 - 4,000 grafts left too, and great hair characteristics to make the most of them if he decides on a second procedure or one day needs further work.

Nice result, I'm pleased it's worked so well for you! I agree minoxidil can be a pretty potent drug by itself. It's often seen as a little "boost" to finasteride but I think in a fair number of guys it can make a big difference. That's particularly true of guys with diffuse loss, where a combination of a healthier, thicker hair shaft and more hairs in anagen phase can make a real big difference (and minoxidil can improve both!). I think you were a really good candidate for minoxidil improvement. You had a lot of miniaturisation but it's clear there's still a lot of hair up there, it was just weaker and thinner. Minoxidil looks to have thickened it up nicely and hopefully the Nizoral is helping too.

It's hard to tell with Johnny Depp. He definitely receded and thinned at the front and that was apparent as far back as 10-12 years ago or more. Certainly in films like The Rum Diary it's clear he's experiencing some frontal loss, though as usual it's hard to tell exactly what's what as there could be any amount of concealer/styling/Hollywood magic going on in movies. For a while he sported the long hair with a side parting, which I think he used to cover up some of the recession but exposed some of the thinning around the mid-part line. This photo also seems to show more extensive frontal loss: These days he's either sweeping his hair back or sort of wearing it messily, which helps to conceal some of the thinning. When his hair is brushed back I would say his hairline does look a little like a transplanted one, but it's hard to be sure. Either way he's still got a fairly good head of natural hair for a 53 year old. He definitely thinned out a bit in the front but I'm not sure if he got a transplant or just styles it more selectively now. My instinct is he probably did get one - he just seems to have more at the front than he used to, but I think he styled around it for a long time so there's no glaringly obvious before and after comparison, though a quick look at the last two photos shows a definite difference around the hairline and temples to me.

I agree. It was really misleading to go on live TV and outright lie, especially when the doctor is sat there and not being honest either. They should have just been upfront and said there was concealer and styling being used to make the most of his result - there's no crime in that, but when you're charging tens of thousands for transplants you should be honest about what can be achieved and especially honest when you're showing off a patient's hair that is using extra help to look good.

There's no hard and fast rule, unfortunately. I presume you're talking about FUE (as the donor area remains largely unchanged apart from a thin scar with FUT, even after two or three sessions, so long as it's well closed and the laxity is there). I would say that 8,000 grafts would be an extremely good yield from FUE. The norm is much closer to 5,000 - 7,000 grafts. Most men should be able to get 4.5 to 5k grafts, some men will be able to get 6.5-7.5k. I would imagine some could get 7.5k+ but that's definitely more of an exception than a rule. As to when it starts to look thin, it varies from man to man. Men with higher densities of follicular units per cm2 will generally be able to take more donor before it begins to look thin. Men with good hair characteristics (wide diameter, curly, coarse etc.) will also be able to use more before the donor area begins to look weak. Your strategy is the best one - taking around 2.5 - 3.5k grafts means you can give your donor area time to heal and, when you come to plan a second procedure, you and the doctor can have a good examination of the donor area and a good doctor can make a proper recommendation about how many grafts you have left before the donor begins to look thin. Sometimes it can be surprising - after healing a man's donor area may look surprisingly strong even after 3-4k grafts getting removed. Other times it may look weaker than expected and a more conservative second procedure may need to be planned. The odds are you should have at least another 2-3k left in the donor area before it begins to look thin, but that is just going by the odds and you need that confirmed by a doctor before really planning out the second procedure. You'd be a lucky man to have another 5k available by FUE but it's not totally impossible, just rare. You'd probably have at least another 3.5-4k available via FUT if you were willing to consider that option. Overharvesting from the donor is a real problem so the best doctors will urge caution and be realistic. You should still have a fair bit left for a second procedure, but it's worth erring on the side of caution and finding a good doctor who will be optimistic but also realistic about how your donor is looking and what could be realistically achieved from a second procedure.

Yeah Costner's is a good one, always looked very natural and wasn't overly ambitious. Jason Gardiner's hair transplant isn't the best, though I think as Mick50 says it's perhaps just that he needs another pass or something. However, I think Gardiner (and his doctor, Ziering) were extremely misleading when they went on daytime TV here in the UK. Gardiner was blatantly using a lot of concealer give his HT a dense look, but didn't declare that at all (in fact I think he outright insinuates at one point it's his natural result): It's particularly bad that his doctor is sat next to him not being truthful about it all. I remember at the time dubiously being willing to give him the benefit of the doubt but the photos I've seen of his hair since completely confirm he was using a lot of product to make his hair look like that, and in fact his overall results are OK but nothing special. I have no problem with concealer, use it myself and it can really make the most of a modest amount of hair, but you can't go on TV and pretend you have a result that you knowingly don't have! I'm pretty sure Simon Pegg has had one: I don't know how bald he got but even back in his twenties/early thirties he was receding. It looks like he's sort of kept that receded hairline, maybe just thickened up the forelock and mid-scalp. Then again, it could just be meds and concealers, it's hard to tell because of the way he styles it now, seemingly to hide the thinning perhaps. Alastair McGowan, a British impressionist, has had something done. I think he was going bald, wore hairpieces for a while and has now got a modest transplant (possibly didn't have the donor or just had too much head to cover as he had a fairly large balding area). Before: Hairpiece, possibly? How I've seen him most recently: I can't tell whether he was wearing a piece or, possibly, had a transplant and the area has continued to thin, as he did have some hair, though very diffuse, in the front half, for a while. I wonder whether he just got a transplant and now that's pretty much all that's left. Either way I'm not really a fan. I think perhaps he just had too much area to cover and not enough donor, or maybe he just hasn't got around to a second or third procedure (I can't see it though). I wonder if he's just sort of accepted how it is now. It doesn't look horrendous, it's just a bit strange. He doesn't help himself with his styling, but to each their own!

Are we 100% sure Antonio Conte is still transplant? I know he had one but his hair these days looks incredibly dense. I guess he did keep a good forelock and has good characteristics and the right sort of styling though. If it is still totally transplant he's done very well, because he lost an awful lot of hair in his mid-scalp. I'm not 100% sure McConaughey is a transplant. Could be, but possibly more of a frontal system since there's photos of him looking full, then thinning, then full again. He's not exactly a full blown international celebrity but a transplant I always thought was impressive was the UK actor/comedian Rob Brydon's. He was very thin a few years back but he looks to have had two transplants over the last few years and his hair looks great now. It's definitely a HT - he's still a bit thin in the back and you can see by the way the hair looks it's a transplant, but he must have had good characteristics because he really does look to have coverage and density. I watched him recently in The Trip to Italy and his hair holds up pretty well even in strong sunlight. It's a really interesting show if only because it shows a lot of natural, candid front and back shots of his transplant - sort of a good example of a successful but realistic result! There were two series, one called The Trip and a sequel called The Trip to Italy that was maybe a year or two later, and I'm fairly sure he's had a second procedure between the two. I think in both Brydon and Conte's cases they're helped enormously by retention of a forelock. Both lost pretty significant hair in the mid-scalp and Brydon lost the crown too somewhat, but having even just that tuft of hair at the front can really make a difference when it comes to creating the illusion of density, particularly from the front, because I guess in that front 2cm or so you have a pretty dense hairline and that just helps blend the mid-scalp in.

Having had a closer look at your photos as well I really wonder if adding SMP might be a really good option for you. You look like you have the right characteristics - uniform black hair and a good complexion to your scalp too. I've seen some great results with people using SMP and long hair to really create the illusion of greater density. You have good quality hair so I think SMP would blend really well with it. It's a tough one - I do think a little coverage in your crown would make a big difference for you. If that was combined possibly with SMP I think you could look great. I do agree with Spanker's point about your mid-scalp - unfortunately us men with higher Norwoods do have to prioritise the hairline and mid-scalp, especially if finasteride is not in the mix (although even then you have to exercise caution). You do want to focus more of your hair there to create a natural look and put the donor where it's going to make the most impact. With that having been said, you have good hair characteristics, you're willing to consider beard hair and you also have options like SMP and concealers enhance the illusion of density (I think both would work great in your case). To that extent, I think some light crown work is achievable and I do think it would make a difference to have some hair back there. It wouldn't look full but sometimes all you need is less contrast between fuller mid-scalp and bald crown to really improve the look, and even a little bit of hair back there gives you options with concealers/SMP.