mahhong

I agree! Not only does the work itself look great, but this is one of the most impressive transformations of the patient's whole facial appearance that I've seen in a while.

Impressive stuff and the patient must be rightfully very pleased!

I'd just like to clarify I don't work for the doctor, have never visited the doctor, have never had a transplant by the doctor (or indeed, haven't had a transplant at all yet). Assuming I have some intimate connection to the people involved just because I'm defending the work isn't really a sensible concluson.

I would agree with the general consensus that it would be nice to see uniform pictures (same lighting conditions, same angles etc.), as this is always the best way to work, but it's not that simple. All it takes is a bit of extra sun on any given day, a new paint job on the walls, to change the look of a photo. Whilst I agree it does detract from the overall ability to judge the work, it is somewhat annoying when people assume the slightest discrepancy in before/after photos to be the doctor attempting to cover something up or deceive people.

Obviously everybody is entitled to their opinions and I'm not here to try and stoke up an argument (nor do I believe anybody else is), I just felt words like "mortified" were a bit unfair on what is clearly, in any lighting or from any angle, a pretty significant transformation for the better. I think it's also a bit unfair to bring so much judgement and assumption about the patient and the photos; suggestions like the angles/lighting are trying to deceive or that the patient was probably coming back for repairs just because he showed up at all for a follow up.

I can't see it myself. I can understand that masturbation might have some small effect on the rate or severity of the hairloss, but if you're gonna lose your hair genetically, I don't think abstaining from masturbation will be enough to stop it happening, and if you're not going to lose your hair genetically, then there's nothing to worry about.

There might be some threads of evidence linking the two, but you're not going to get far keeping your hair if you think abstinence from masturbation is the key! It's like all the other medical and physiological solutions that are on the fringes of the mainstream; whether the evidence is there or not, it was never really the real problem to begin with.

For me mate it looks natural because it looks like he's losing his hair in the front hairline even though he's not due to the fact he's had a ht. The reason i say this is in pic 3 which is a straight on shot there are huge gaps that remind me of when my hair was falling out and my hairline was going back i also have the exact same style corse wavy hair and then when you look at picture 4 from the side you see how big the gaps really are which is not good, taking all this into account i would not like to pay thousands of pounds on a ht and still have a hairline that looks like it's thinning but i guess it's a matter of standard some people have been bald so long that they're not bothered just as long as they have hair.

Hmm, I have to disagree with that. I mean I can see what you're saying technically but I don't think "massive gaps" is quite the description I'd use. This guy has hair that would make getting a natural hairline relatively difficult, by the looks of it. But the doctor has managed that and the uneven nature of the hairline is part of the natural look of it. Besides, an awful lot of natural hairlines on non-balding men have that kind of feathered look at the front of the hairline anyway.

I don't think any average Joe is going to look at his hairline and think for one second it's thinning. It might not be absolutely chock full of transplanted hairs, but that wouldn't look any more refined anyway, and in addition we all know we only have a limited number of grafts anyway; hairs saved upfront are hairs that could be used later if further thinning occurs.

I really don't see the problem. Yes, the hairline does look a little uneven at a push, but I wouldn't call the hairline full of "gaps" and I certainly wouldn't say this guy looks like he's still balding.

mahhong the pictures are numbered i presume picture 3 of 9 far right and picture 4 of 9 far right are the result pictures if they are i wouldn't be happy at all have a look and tell me what you think. As i say i may be mistaken to which is the final result but let me know.

I think we're looking at the same pictures and they are the final results (2 years, 8 months after procedure). To me the results look largely excellent. The density is absolutely brilliant and the hairline looks very natural, which I believe is quite difficult to do with this type of coarser, wavy hair. I don't think anybody would guess this guy had had a transplant.

All I can really see (picking pretty silly holes) is that in picture 4 of 9 the temple area looks a little uneven, but that's really clutching at straws. What is it about the procedure and the photos you don't like? I can't really find anything that looks unimpressive and I don't think you'll see many better transplants, in terms of density and naturalness.

Just looked back through and if the the far right picture of picture 3 is the final frontal result after 2 transplants with over 10000 hairs i'd be absolutely mortified and be wanting my money back i really hope that's not. On the good side you did very well with the birds eye view but i doubt many people will be looking at the top of his head.

I'm not quite sure what you mean? I think the density is excellent and the results are very natural. The hairline also looks pretty darn good as well. I don't really understand what would mortify you about results like these?

mahong, He was there specifically touting the results of his hair transplant, not to promote his show or anything else. He had his HT doctor, not a make-over stylist on the show with him. The concealer was used to enhance the look of his hair, specifically the density of the HT, not face or body or any other features. The fact that he is a celebrity and that's it's an entertainment show does not justify false advertising.

 

"Secondly, he's been pretty open and honest about the whole thing..."

 

Well, not really. If he was being open and honest he would show what the results really look like, sans concealer....

 

"It's probably a bit misleading but if that doctor can get interested men and women through the door or onto his website, it's at THAT point he's duty bound to be upfront about what they can expect and to show honest, concealer-free results and to answer their 'can I look like Jason Gardiner?'"

 

So it's okay to lie to get people in the door.. that's essentially what you're saying? Wow, that's really bad, and unethical business practice in my book.

All I'm saying is that whilst we can all discuss and debate the specifics of Jason Gardiner's HT, none of us know the truth or have the facts in front of us for definite. I think it's pretty clear he was wearing some kind of concealer yes, but none of us have any idea for sure what exactly is going on. For all we know the makeup girl put that concealer on seconds before going on air? For all we know he's wearing a hairpiece along with HT?

I'm not trying to defend the whole thing as it does seem misleading to me, as I keep saying. But I stand by my opinion that whilst I of course agree the Dr. is duty bound to be honest and open, there are circumstances and facts here we simply don't know about. I'm not trying to claim that makes it alright or OK, simply saying this is a daytime entertainment show and unfortunately it's always riddled with inconsistencies and liberal with the truth or the facts.

The Dr should post the honest results of Gardiner's HT on his website, along with fair and true photos of the end result. If he fails to do that, or Gardiner continues to use concealer and they try and pass it off as HT alone, then I'm 100% with you this Dr. is lying and being unethical. But daytime entertainment TV is a fickle and difficult place and there may have been things going on behind the scenes or without the knowledge of the Dr or Jason Gardiner that would make it unfair to judge this Dr (or Jason Gardiner) purely on a daytime interview alone. In his own domain though, on his website, the Dr has an absolute duty to show the honest, end results of his work; and it's there I think everybody has a right to be truly judgemental about the work and the results.

I see what a lot of you guys are saying but ultimately I think you are placing way too much emphasis on the "balding" part of life. I honestly think that for most women it's a case of how the man deals with balding that plays the biggest impact.

I think the general rule that the most attractive people attract the most attractive people is true; but you're setting yourselves an impossible task if you go down that road. There will always be someone better looking that you. Always. There will be men with better bodies, better hair, more handsome faces, who are bigger and more masculine, who have a more commanding presence, who have a stronger voice or a nicer smile. The idea that if you have hair it puts you in a different league is a dangerous game to play because it's a downward spiral. There will always be someone that has what you have but much better. If you could have a full head of hair again, that's not going to solve the problem.

And, at the risk of sounding too cliche, beauty does come in many shapes and sizes. What you might consider to be "beautiful" I may not consider the same at all. It's never the case that bald=unattractive. But feeling unattractive is always likely to hinder you.

As another poster said, I think the video deceives because a woman having pretty bad MPB is not the same as a man having MPB. You would not normally expect a woman to have such pronounced balding and fewer women do. Balding is very prevalent in men, however. It is more common to see it; the sense of shock when the woman reveals her hair is not the same sense of shock you'd get from seeing a man with no hair. I'm not saying the point raised isn't interesting or without merit, but the direct comparison it's trying to draw is misleading, yet there are many men who'd watch that video and be insecure enough to believe it's strictly true.

I think a big part of the thing with being bald is accepting it, one way or the other. If you choose to use drugs and HTs to get a head of hair back, fine. If you choose to shave it down and be bald, fine. If you choose to abandon your hair and try to pretend what little scraggle left doesn't exist, it becomes blatantly obvious to most people and if it's the first thing you notice on yourself, it will be the first thing they notice.

I'm not naieve enough to believe balding has zero impact on how a man looks or comes across, but similarly I think it's dangerous to promote the idea that being bald is some kind of death sentence in the attraction stakes.

Funny video, but I don't really buy it to be honest!

The biggest issue with bald/balding men is not really the fact they're bald, it's the fact that it's quite clear they've given up on their appearance. When men start thinning or go bald a lot of them tend to assume they're ugly and unattractive (an assumption this video rather cruelly perpetuates) and don't bother to groom themselves or make the most of their appearance. The net result is the guy looks like he either can't accept he's balding or has simply assumed it's not worth taking care of his appearance.

I think the simple truth is every man would like to keep his hair, even if it was only to have the option of having it. But you cannot tell me that men like Jason Statham, Vin Diesel or Bruce Willis would look "themselves" with a big mop of hair on their head. The bald look is part of what makes them physically attractive to women because they've embraced it.

Now, granted, not all men look their best or feel their best bald, but I think what women generally find the most unattractive quality about baldness is either a man's denial over it, or a man's refusal to continue striving to look his best because of it.

There are millions of bald men in this world who have wives, girlfriends and lovers; many of which the average man would class as generically 'beautiful'. If baldness was that deeply, universally unattractive, we'd have absolute legions of bald men who were single and completely unable to find anybody. It doesn't happen. There are of course lots of unhappily single bald men, but there are lots of unhappily single men with great heads of hair.

A lot of being attractive is down to how you feel about yourself and how you come across. It's a cliche but absolutely true. Look at Jason Statham. He's a man that, if he put on a stone of fat, grew what left of his hair out into a straggly mess and wore ill-fitting, bad clothes could very easily look horrendous. Instead he's just got on with it. And he's an out and out sex symbol. Now I know in his case being rich and famous helps, but I see dozens of guys down the gym with what's left of their hair shaved down to their scalp, and they have no trouble with women.

Nobody likes losing hair but those that choose to additionally become a complete victim to hairloss will really come across as undesirable and weak-willed. It happens to a huge amount of men, but many of them get on with their lives because they have a bit of confidence to do so. If all you can think of when you're speaking to a girl is your hairloss, then that's all you'll present outwardly.

This video is funny but I think it's a bit of a bullying tactic to be honest. The insinuation is that if you're bald or going bald, that's it, game over. That's never the case, but as long as the myth is around, we'll have people lining up for transplants that will never give them what they really want.

You're missing the point. Had he gone on this show just to talk about his results and hts in general is one thing. But he took his doctor on the show which essentially turns it into an infomercial. He is now marketing a specific practice's results. What would you say if all ht clinics had results on their web sites with guys with concealer and did not say they had it in their hair?

I do get your point and I actually agree with it, but where we differ is in the definition of what he's done.

When HT doctors post results on their websites they are (if they're good, honest doctors) posting a range of results that demonstrate the quality of their work and what you might be able to expect from your own situation. It should be less about "promotion", in the strictest sense of the word, and more about "demonstration". Using concealers would be a false representation of the quality of the results the doctor is capable of with the resources available to him/her.

I don't doubt Gardiner appearing on the show with his doctor is a form of advertising and promotion but it differs because it's about Jason Gardiner first and promoting the hair restoration doctor in question second. Is it misleading? Yeah, probably (although I have read the doctor claim that Gardiner actually wasn't wearing concealer at the time, not that I believe it). But is it falsifying results? No, because this was not a technical demonstration of the hair transplant procedure and subsequent results. This was about Jason Gardiner's new look and the man primarily responsible for it (which is true, whatever extra he had done to it).

Look at it this way, let's say a man or woman had gone on to This Morning to show off their new look after extensive plastic surgery. They look 20 years younger, very attractive and generally it's a vast improvement. The doctor appears on the show with them to explain what they did to make the improvements. The person in question is, of course, very likely dolled up in studio make up applied by the best in the business, with any inconsistencies or blemishes neatly covered and the work made to look as flattering as possible.

The point is, This Morning is about entertainment and celebrity gossip. It's the TV equivalent of Heat magazine or gossip columns. I don't think it's particularly right but I don't think it's essentially wrong either. Jason Gardiner has gone on the show to flash his new look hair and he's giving the doctor some free promotion and publicity. It's probably a bit misleading but if that doctor can get interested men and women through the door or onto his website, it's at THAT point he's duty bound to be upfront about what they can expect and to show honest, concealer-free results and to answer their "can I look like Jason Gardiner?" questions with absolute professionalism and honesty. Everything else up until that point is just showbusiness, unfortunately.

All doctors are guilty to some degree or other of bias. Whether it's as harmless as putting their best results on the front pages of their websites or making a big fuss over the biggest and most successful procedures. Please don't get me wrong - I'm not suggesting doctors lie and/or deceive. I know there plenty of good doctors who talk very openly and honestly about everything that happens and I'm not suggesting these people are being misleading. But it's up to the patient to do their research and it's up to the doctor to be honest to each individual patient about each individual question and aspiration. But in the first instance it's important simply to be raising awareness of the leaps and bounds HTs have made as it still has the stigma of "plugs" and "doll-features" in the eyes of most people.

Ultimately I'm not suggesting it was entirely fair what he did, but I don't think it was morally wrong either. Firstly, nobody can really prove he was wearing concealer. I think it's pretty obvious he is, but that's speculation unless he comes clean about it. Secondly, he's been pretty open and honest about the whole thing, I think even if he is using concealer he's not doing it deceivingly. Gardiner may just feel him using concealer is no different to a woman using makeup to make the most of their features. I know a lot of people that would think very differently about that (myself included), but how he chooses to present himself is really his own decision and his own business.

Whilst I agree generally with the sentiments of the majority of people on this thread, I don't necessarily blame Jason Gardiner. I haven't seen the interview but my impression is that what he's really interested in showing off is his new "look". I agree it may be a bit misleading what he's doing but it's still more frank than simply turning up with a full head of hair one day.

At the end of the day, essentially he has no obligation to promote or explain HTs. It looks pretty clear to me that he's wearing concealer and possibly making the best use of lighting/style but that's not really a crime and theoretically it's only possible to do that thanks to the Ht in the first place.

I don't want to suggest I'm condoning what he's doing but, at the same time, the guy is just excited about showing off his new look. I guess some men are of the opinion that it doesn't matter how you get that full head of hair look as long as you get it. He is misleading people perhaps, but anybody serious about getting a HT is going to have to do their research, speak to a doctor and look at a range of results before making their decision.

I think Jason Gardiner has been more honest than he's had to really. Yes, he has misled to some extent, and that's not good. But the decision on how to present himself is his and his alone, and it's up to the man who's interested to do his own research and make his own informed decisions in my opinion.

Sorry to hear about your problems usedandabused. You do raise some good points, although in my honest opinion most of them are just part and parcel of researching HTs. That does not make your points any less valid, but what I'm trying to say is that people should do lots of research and make their choices with an experienced and recommended doctor (doing a couple of months research will quickly show there are probably really only a dozen or so doctors that keep getting mentioned over and over as excellent in their field).

I don't think anybody should go into an HT without a 'master plan' - and creating that plan is common practice amongst good doctors. The long and short of a master plan is to take all scenarios into consideration and make sure that every procedure can look natural by itself and that a long term plan is established for future balding.

I'd urge everybody to research HTs incredibly thoroughly before making any firm plans. I think a lot of what usedandabused says is right but, and I don't mean this disparagingly, a lot of it is also common sense if you do the research. Baldness is a progressive issue and no drug or therapy can truly reverse or completely halt it - not even propecia and minoxidil. One of the first things anybody considering an HT should understand is that this is a lifetime commitment with not entirely certain outcomes. You must be prepared to need future transplants (or be comfortable with the limitations of one transplant) and you must understand that a transplant is a cosmetic procedure - an artificial reinstatement of your previous hair. A good doctor will understand this and use as much art as science to achieve a natural look that nobody will question under even close general scrutiny.

Shock loss is always possible. Progressive balding is always possible (and should be assumed likely). MPB is something that you'll have to be prepared to actively battle all your life and if that's not something you wish to do, it is best to shave your head and simply not start the fight. I would always say to people that if they get one procedure done they must be prepared to get further procedures done in 2 years, 5 years, 10 years, 20 years - whatever. The lucky ones don't need to go down this path, but most people do and even the "lucky" ones are never secure that their hair will stay the way it is now.

usedandabused makes some relevant and logical points, but it's clear the whole ordeal has hurt him and his vitriol towards HTs is clear. My advice would be more restrained; HTs, performed by recommended and experienced doctors, can produce stunning results from NW2 right up to NW6. But hairloss is not an easy thing to predict and is very fluid - never assume you've got it beat. Prepare for the long haul, look at worst case scenarios, and always make sure every procedure or therapy fits into the "worst case scenario" jigsaw that is hairloss. You never know if that NW3 is going to suddenly thin to an NW5, or if shock loss is going to reduce the cosmetic effect of a procedure. MPB is a difficult enemy - never assume it's beaten!

HTs are, overall, safe and effective in the right hands though. usedandabused has had a bad result under what sounds like a bad doctor and it's good of him to raise his concerns and hopefully save the hair of a few others on here. Just do the research, put in the time and effort, and discuss in great detail your goals and the plans with your doctor. A HT is like a war - it needs incredible planning and detailed foresight. Cover every angle, look at every possibility, allow for every side effect. If your doctor ever talks in absolutes be wary! There is always a risk, always a trade off, always a theoretical complication. Knowing these and accepting them means you're in control. Both you and your doctor should always proceed with cautious optimism and pragmatism. You know there will be a scar, you should be clear the sort of density and look you can expect, you should allow for complications and accept risks. If you can't then usedandabused is right - don't start going down the path. The worse case is it can be costly, worrisome and never produce the results you want. But with the right planning and commitment 98% of men and women would probably count it amongst the most beneficial things they've ever done for themselves.

I don't think there are many (if any) photos of patients with modern transplant techniques and their results 10+ years after the procedure, primarily because the most modern surgical techniques are relatively new (as you suggested) and thorough long-term evaluation is difficult unless undertaken by the patient; and it's only really in the last 5-7 years that the internet and digital camera technology has made taking and uploading photographs very commonplace.

I've seen a few people at 4-6 years follow up and they have looked fine. The transplants themselves shouldn't really change over time as if they're done successfully they should be permanent. The main change might come from continued hairloss, which hairloss drugs help battle. If a patient feels their hairloss has continued (which is possible with or without the drugs) most will opt for a second procedure (or more) to deal with that. As a result the transplants should continue to look fine for the lifetime of the patient.

I think a good doctor will always try and make each transplant look natural on its own, so if the worst case scenario was that a patient lost everything except the donor and transplanted hair it would still look 'natural' (though obviously not as dense or with as much coverage). In short, good doctors these days don't just patch in thinning hair with a transplant and their plan with the patients will always aim to leave the patient with a natural looking transplant even if they elect to have no future work done. This is all part of the master plan for the patient; no doctor will leave a patient "half finished" - every procedure should be able to stand up on its own unless its planned and executed in combination with future procedures or goals.

I've yet to see a transplant "turn bad" and don't think it's really a concern. The only changes I can see happening to transplanted hair are greying (in line with donor area it came from) and maybe slight thinng into old age. This thinning, however, will blend naturally with the rest of the natural thinning (and is not like MPB). If a man does experience that thinning its usually well into old age and the transplant should continue to function and look natural on the person at that age. Apart from that, a transplant should act permanently like the donor region it came from and I haven't seen anything to suggest that wouldn't be the case!

I'm not a doctor or a professional but my instinct, as some people have already suggested, would be that you have more than 4000 grafts left, all things being normal. Your balding pattern doesn't seem to be extremely severe and at first glance there looks to be nothing to suggest you'd have a below-average number of grafts.

Was the doctor's estimate of 4000 simply done by looking at your head? Most doctors do get a hunch for the number of grafts available but from the sounds of it the "4000" was pretty much an educated guess rather than being based on tests or detailed examination?

Also, perhaps the doctor just meant that he felt 4000 grafts would give you good coverage and leave some in reserve if you needed them later? Most doctors would want to use as few grafts as possible and leave at least a small reserve for any unforeseen consequences or additional balding that is as yet unseen (not suggesting that will happen, but it's always a possibility). Maybe the doctor just meant he felt 4000 would achieve a good look without depleting all your donor hair?

Either way the recommendation of some on this board to try and do it in one procedure also seems a good one. The fewer procedures the better; it's quicker, somewhat safer and probably financially better for you as well in the long term. I don't think 4000 grafts in one session would be considered particularly major in this day and age so it seems perfectly doable, at least from what I know.

Shock loss could be an issue but you did make the good point that your transplanted hair upfront will probably be more resilient this time. Because you have diffuse MPB (as I do) it's probably almost worth assuming (worst case) that all the native hair in your 'balding' areas will one day be gone and make your plans from that perspective. That may mean holding back a little on the density to get coverage and seeing how that goes. Your donor area looks pretty healthy though and the balding area doesn't seem massively extensive at first glance; I've seen a lot of guys with similar patterns get great coverage and impressive density (just look at some of the moderators on this board if you want proof of that!).

It may be worth getting a second or even third opinion if you can afford. It's good practice not to suggest that you shouldn't "trust" the first opinion, just that HT is as much art as science and it's good to get opinions and suggestions corroborated or countered.

Ultimately I would say you look like you could have good results from one or more HTs, but that's only my opinion based on a few photos. Nevertheless I'd continue discussing things with your doctor and on this board as it seems you could have everything going for you once a few confusions are cleared up.

I don't really subscribe to the whole conspiracy theory idea. I don't doubt there's a bit of foul play from time to time and of course companies have their own interests, but it's in the interests of the hairloss industry to advance the cause. We live in a world where conspiracies theories about the man vs. the corporations or the state are popular and easy to perpetuate, but I don't believe that's the main reason, or even one of the major contributing factors.

I don't imagine a 'cure' any time soon, but I do imagine advancements in the next 5-10 years in surgery and medication. The point is there isn't going to a magic pill or procedure that can give you your hair back easily, cheaply and quickly any time soon. But there are going to be increasing combinations of techniques that can provide people with genuinely excellent coverage I would imagine.

The patents are up on propecia/proscar soon (if not already) and the same with minoxidil. That means they're pretty much there for anybody to take advantage of anyway. I don't believe there's much for the drug companies to try and suppress and, if anything, they need new and improved product coming their way. But medicine is nearly always evolution and rarely revolution and I think people are hoping for that front page find that will solve everything. Life doesn't work that way, but if you look at how things have developed over just the last 10-15 years the surgical techniques and drugs available have quite literally skyrocketed, and now there are men with severe hairloss getting good heads of hair back. In 15 years time I doubt we'll have a 'cure', but I think we'll be looking back at this time the same way we look back at the early-90's.

Thanks for your reply, Dr. Simmons.

To give you some info about myself, I'm nearly 28 and first started noticing my hairloss around 25 years old. I don't have any photos just yet but will try and get some up soon.

Looking at the history of hairloss in my family I would be conservative and say I imagine myself to end up something like a Norwood 5 or 6. My father is something akin to a Norwood V and his father is probably something like a Norwood 4. On my Mother's side my Grandfather was a Norwood 6 (quite heavy loss, but not quite a 7). There is (to my knowledge) no history of Norwood 7 in our family, on either side, going back 3 or 4 generations.

My hairloss has been most pronounced at the temples/crown but has also been quite diffuse, so that there is a definite 'pattern' that can be seen when taking a top-down picture. I have to be pessimistic and simply assume everywhere that's thinning is eventually going to go completely! I would say that the margin of my 'side' hair is fairly high - like my father I think it's only going to be a relatively narrow portion of my hair that's going to go in comparison to some people (but of course, you never know, I'm only going by what I can see at the moment!).

I will try and get some photos but I think, as you say, it'd be best to plan conservatively!

Treatments take a long time to get to market and a long time to filter through the medical community into common use, unfortunately.

I think there is plenty of exciting research and trialling happening worldwide at the moment, and a lot of encouraging data to support it, but things have to be tested for efficacy and safety. Techniques for usage have to be developed, refined and explained. Those ideas then need to be documented, presented and brought to the medical community and shown to other doctors who, themselves, need to learn and become comfortable with them.

That takes time, usually years. If I discovered THE bona fide cure for hairloss in my garage today I probably couldn't get it to market within 5 years, and it's be a hard enough task to do it within 7-10.

Of course, the internet is a hive of information unlike never before. So, when a tiny company in Taiwan posts a tidbit of news about a promising treatment they're looking into, it becomes front page news in the hairloss community for a few days. It makes it feel like it's weeks away when, in fact, if it even has any positive use it's likely to be a long time coming.

The good news is there are several really promising treatments and advances which are being tested and have made it past initial concept to more detailed trials. But it's like a delayed reaction; that amazing drug (or technique) you're hearing of today is (if it ever turns out to work at all) really 5-10 years away from market because of the various tests, trials and difficulties that lie in the way.

My advice would be to stay away from people offering experiments; especially when it comes to stem cells. There's a reason clinical trials take a long time and a huge part of that reason is to test for safety and any longer term effects. If anybody is willing to jump the gun and give you something before it's been proven safe or effective, then that's bad ethics.

It's frustrating watching the hair fall out and hearing about a new drug or procedure every other day, but that's life. Things are moving though; there are several promising techniques being researched right now and one (ACell) is already FDA approved for use. How successful such techniques are in the hairloss industry only time can tell, but I think within the next 5 years there should be a few more options on the table. No magic bullets, but an ever expanding arsenal of techniques to combat hairloss and do it more effectively. But my advice is to wait until the bigger and better options are proven safe and reliable. The last thing you want to do is mess with untested medicine. The results can be disastrous indeed.

Hi all,

I've been away a few months, busy with various things, but in that time started taking propecia. I was on it for about 4 months and believe it was having some effect at that stage, though it wasn't dramatic (nor would I expect it to be).

The problem was, however, I did experience sexual side effects. I wouldn't describe them as severe but they were too problematic to continue the medication. I tried with generic proscar a second time for about 6 weeks but similar problems occurred. These have again since resolved, but I would say it's unfortunately the case that propecia doesn't seem to sit well with me!

My question really is; what are the options? I think I probably have quite a large balding pattern (Va or VI) but it's in the relatively early stages (though diffuse, hence being able to see the pattern). I know minoxidil can have some benefit but I get the overall impression it's not really going to fight off the hairloss for long, so I'm preparing for the idea of losing most of this hair that's already going.

I haven't thought about surgery too much yet, though always assumed in the next few years I would need it. Obviously the issue now is, without propecia, how effective can surgery be? And how best to plan for the (almost definitely) multiple surgeries without drugs? Can you essentially play 'catch up' with your hairloss by having top up procedures to deal with it? Or is it almost better just to let it go and see what you're dealing with before making commitments?

I, like everybody else, am obviously hoping over the next few years the surgical and medical options will expand with everything that is being trialled and tested, but I also know nobody could or should hedge their bets on new procedures coming about.

So, I'm just wondering, without drugs, is surgery still able to produce good results? I see many V and VI Norwood patients having incredible success with multiple procedures, even when their heads are totally bald. I know there is always the risk of future hairloss without drugs, but I'm assuming surgery can still in some form be an option? Does anybody have any direct experience of surgery without drugs to support it?

I know I'd be looking at multiple procedures at very least, which is something I could be comfortable with as long as I could get a good illusion of density again. What I would be reluctant to do, though, is end up with a wispy, see-through appearance that I'd paid a lot of money for!

I know only a HT doctor can really make firm plans for me personally, but since I'm not quite at the stage to take a plunge, I'm just looking for some personal thoughts and opinions at the moment!

Thanks!

Sparky has it spot on. Propeciahelp is for the most part 'reputable' strictly in the sense that patient and doctor reports are true and honest, but it represents a small minority of millions of propecia users. The problem with the site lies not in what is said, but in the bias representation of propecia it gives.

It's a bit of a silly comparison, but think of it this way. Somebody could create a "Pro-propecia" website strictly for men that have seen dramatic increase in the hair all over their head from the drug. You'd probably have a rare few thousand men sign up to that site, posting pictures of their hair and waxing lyrical about how much they love propecia and how it's given them a new head of hair and new lease of life. And then you could take propecia and find like, for the mass majority, you in fact have only mild or moderate regrowth in the crown/vertex area, or perhaps only manage to hold on to your hair rather than grow any. The the pro-propecia site would look dubious to you; all these men bragging about how amazing propecia is! You'd think: "I took it and it was pretty good but not nearly as dramatic, are they really telling the truth?".

The point I'm trying to make is that propeciahelp is not a "bad" website, or in any way false, but as a standalone site it is misleading. It makes you feel propecia is some drug that is secretly ruining the lives of many young men and the whole use of finasteride is some corporate scam where everybody stands to lose out. But the point is, propeciahelp represents a tiny (though unfortunate) number of finasteride users. In the same way very few people are likely to experience total, dramatic hair growth just by taking propecia, similarly very few people are likely to experience severe or long-term repercussions and side effects.

So, yes propeciahelp is a "real" site, but it's a tiny majority of men discussing their views of the drug. The choice will still ultimately have to be yours regarding the risk of using finasteride, but context is everything with the internet.

I think most respected doctors will repair problems that are down to their negligence or mistakes made on their end, but the chances of getting a 'patient contract' are slim, if only for the simple fact that it would be unfair on each individual patient if it was up to them to develop tailored made terms.

Ultimately when you have an initial consultation you should be able to ask any of these questions openly and most good doctors will say upfront if they make a mistake or cause a problem, directly or indirectly, they will fix it. Of course problems that are due to nothing more than bad luck or unforeseen circumstances (for example, poor yield due to patient characteristics, which is rare) a doctor will be pretty quick to point out they cannot be held responsible. It's about good faith though, really; doctor's with great reputations have no reason or desire to see them damaged, so they will happily repair mistakes or negligent problems. There are some examples of doctors performing these kinds of services for patients that I've read on this very forum.

So, ultimately, although I could be wrong, I just don't think a doctor will sign anything unless it's been written and approved by them or their lawyers. This is because they are providing a service, it should be a good and fair service, and it should be identical for all patients. Tailoring terms of service would theoretically run the risk of making some patients lose out to other more savvy patients. It's not the best example, but if you're a lawyer and you tailor a contract for your own HT, that's probably going to be a better contract than what your average Joe would tailor.

I see where you're coming from, and I think in theory you could go to a doctor with your terms of service, but they would pretty much definitely refuse it out of principle. They'd have to have it checked out by their lawyers (costly) and it would make your service different to that of other customers, which would be unfair. Ultimately a good doctor should be happy to say on gentleman's terms what they would do if mistakes were made or problems arose and it should even be in their own contract - I just don't think it would be possible for them to sign something someone else has created. They run their own shops and they need to make sure every customer has the right to a good and equal service. To be honest I would be more dubious of a doctor that was willing to "do deals" - especially if he said he'd give you a 'safer' or 'better' service than other clients! That would be essentially unethical and, with a good doctor, unnecessary I think.

Happy that there are new avenues always being explored but, I agree, this is absolutely no miracle cure unfortunately. It looks like it might have some benefit to hair and I guess we'll know more over the next few years. I couldn't find much information on the product but it is a prostaglandin (a certain family of medicines derived from fatty acids in animals) and, although I couldn't be clear, it seemed to work by being a sort of anti-inflammatory.

For $120 this stuff would seem, for hairloss, essentially worthless. It would appear to have no specific effect on the causes of MPB and instead works, like minoxidil, by treating the problem in a 'roundabout' fashion. That's not to say it doesn't have some benefit; but for $120 you could probably pick up 12-18 months worth of FDA proven hairloss drugs like minoxodil and/or finasteride, which would almost undoubtedly work a lot more effectively.

Still, interesting stuff! And, as an anti-inflammatory, maybe it could eventually become an adjunct to minoxidil and finasteride one day? But for $120 per 3-week cycle it's just economically unfeasible, especially given it's more than likely going to at best improve your hair a bit, and not in any way slow down or stop the genetic MPB you're experiencing! It'd have to be more like $120 for 24 months supply, and then it might be economically justifiable for hair!

I must admit it's odd to find so many people claiming minoxidil has given them sexual side effects. Although it cannot be verified or unverified, it's strange to say the least!

With finasteride it's clear to understand how, in principle, it could cause sexual side effects. It works by lowering DHT, an important hormone in males. For most men this lower DHT value causes few problems but for some they seem to have much more severe reactions to the drug. Some claim it has altered them permanently, or at least over a long period of time. Those statements have not been verified, but it is at least possible to see the logic behind how finasteride could cause these symptoms and problems.

Minoxidil, on the other hand, does not effect your endocrine system in any way to my knowledge. I'm sure it has to be excreted like pretty much any substance that enters your body, but it does not cause or try to cause any changes in any hormone. It's a potassium channel opener, and in short is a vasodilator, meaning it opens the blood vessels in the body. This aids hairloss by essentially making your hair follicles as well supplied as possible and thus being able to produce healthier hairs for longer.

Now, I am not a doctor or medically trained in any way, but with minoxidil the potential route to ED is much less clear, and the route to reduced libido even more so. I could sort of understand how minoxidil, which affects blood flow and hyperpolarizes cells, could in some way at least be theoretically linked to ED (given that penis erection is directly caused by blood flow), but reduced libido and minoxidil usage seem near enough completely unrelated (unless people claiming reduced libido actually are getting that confused with ED?).

I don't think there's any particular way to stop the ED apart from ceasing minoxidil, but the cases of minoxidil reportedly causing ED are extremely rare and the mechanism not understood (if there even is one). I would almost certainly imagine cessation of minoxidil would completely stop it from affecting your body in any way, so if you're really worried that's the best thing to do for now.

Also, I know people never like hearing this, but go see a doctor and explain it to them. ED can be caused by lots of other things and whilst nobody can doubt your personal belief that it's minoxidil-related, only a doctor has a chance of being able to verify or even affirm any association between the two events.

From what I can tell the yield is somewhere between 50-75% in the recipient area when ACell is used. That's still quite a big difference in success so that's one of the areas that needs research and hopefully improvement.

From the donor area I believe 100% of the plucked hairs grow back. I don't know if that was specifically mentioned but that's what I'm led to believe. It's essentially just the same as plucking a hair from your head right now. The follicle will regenerate a new hair, so my understanding is that from a donor perspective there's no problems.

As for the reason more people aren't trying this, well I think that is changing and a lot of doctors are now looking more seriously into this. There have been lots of 'regeneration' medicines and powders in the past that doctors have tried on hair with little or no success. To that extent this is not a new idea, but it's the first stuff that has seemed to have a good success rate both in wound healing and also hair duplication (autocloning). There are now several doctors studying this stuff, including Dr. Rassman, who is working with a statistically significant group of patients, meaning that his results will give a good idea of efficacy. In the meantime it seems Cooley is really getting to grips with how to use the stuff effectively.

As for how long the hair lasts; that is the single biggest question. Nobody knows if this will be a permanent hair follicle or one just as susceptible to pattern baldness. However there is one interesting thing to mention. Dr. Hitzig has been implanting beard hair into scalps for a long time (nearly 10 years I believe). It might amaze you to know that he has actually had success in getting those hairs to grow using NO extra products or medicines. His success rates were very low, however (less than 5% I think). You can find some of his research on the net.

But, what was interesting is that the hair that did grow in the small number of cases seemed to be permanent hair that cycled normally. In other words it took on the donor characteristics. This is why I believe Cooley and Hitzig are so excited (but remaining cautious). There is already evidence to suggest these hairs WILL be permanent from previous work, but that will need to be properly verified before it can be labelled as fact. In principle, though, this procedure has already been done successfully before; it just wasn't successful enough to be a useful treatment. Now that ACell seems to have made a massive impact on the success rate it would seem the possibility of infinite donor hair and minimally invasive HTs is very close - especially because the product in question is already FDA approved and does not need to go through safety trials again.

Well, I should clarify on two points.

Firstly the hair duplication (formerly known as autocloning) procedure is in theory scarless. It takes plucked hairs with endothelial tissue around them and implants them into the bald scalp, meaning that there is no strip or punch procedure.That is of course the best case scenario (if hair duplication is possible and has a high success rate), but the actual hair duplication procedure involves no cutting of donor tissue.

In terms of its application for FUE/strip I admit the term 'scarless' is a bit misleading. Dr. Cooley's presentation suggests that wounds treated with ACell heal and feel like 'virgin scalp' again (his words). There is a depigmented scar still present, but that scar is not rough and fibrous but instead smooth and much more like 'normal' skin. In Cooley's brief he actually mentions that this could end up being ACell's biggest contribution; namely that it has huge uses in the realm of scalp laxity and the ability to potentially increase the number of strip surgeries.

This was my understanding anyway. Hair Duplication (Autocloning), whilst the least tested and confirmed of ACell's uses, seems to be to be scarless (unless you count the invasive act of implanting the graft a scar, which I don't think it would class as). The actual plucking of hairs is essentially a slightly refined version of simply taking a hair between your fingers and plucking it - of course standardised to make sure the hair contains the necessary tissue.

As for efficacy I have heard Dr. Cooley suggest success rates of between around 50-75% and Dr. Rassman seems to confirm that. Dr. Cooley suggested he was getting improved results as he continued his research, especially in healthy scalp, but that of course the conservative lower figures were the current working percentage until the technique can be refined.

Although I wouldn't totally condemn that website I'd say it represents about the most fundamental dislike and disdain for finasteride you can find on the web. I would take a lot of it with a pinch of salt; whilst I don't doubt the stories of some of the people on the website they often post up theories, therapies and ideas that are, frankly, bizarre. Some of them are on dozens of different drugs and supplements in an attempt to re-balance their endocrine systems, often on the advice of other equally unqualified suggestions. In other words, I wouldn't dismiss it completely, but the extreme views posited by a lot of those users represent a tiny, tiny fraction of the finasteride-taking world.

The simple fact is that finasteride is mostly safe and mostly sife-effect free for what would appear to be a big majority of its users. It's generally accepted that finasteride (whether propecia, proscar or generic) is taken by millions of men; let's say for argument's sake it is 4 million. If it's true that, on average, a reported 2% of men will experience some sort of side effects, that would be 80,000 men with some sort of finasteride related symptom (ED, loss of libido etc.). If we say of those 80,000 around 5% experience "moderate" to "extreme" side effects, that would be just 4,000 men with what they would consider severe and/or long term problems.

Obviously those numbers are largely plucked out of the air, but my point is most people who take finasteride seem to do just fine. The remainder of people that do experience problems generally have mild or temporary symptoms. There are some, however, that do seem to experience quite significant side effects that do not resolve. The number of those men is tiny in comparison to the overall user base - but just because it's tiny it doesn't make those particular sufferers feel any better!

Basically, this is a hairloss site, where as propeciahelp is a site very specifically for men who feel they're experiencing intolerable and long term side effects from the drug even after quitting it. As you can imagine, the users of propeciahelp are very angry about the drug and will look for any evidence from any trial of any size that suggests the drug may be dangerous or more severe than the FDA acknowledges.

The simple fact is the jury is still largely out on finasteride. It appears safe and usable, even in the long term, for most men. But the Merck study, even though it was large, couldn't possibly account for how the drug would effect everybody. Indeed, it would now seem some men have perhaps genetic or medical issues with their own endocrine system that finasteride wreaks havoc with and causes all kinds of problems. This is not medical fact at the moment (in another words it's not an independently observed medical phenomenon), but there are enough people claiming serious side effects to make a convincing case that a tiny, tiny number of men experience major problems with the drug.

In short, if you take finasteride you're much more likely to stay fit, healthy and side effect free, or to have mild symptoms that disappear or cause you no problems. This website represents what I would call a pretty 'average' range of finasteride related opinions: most people tolerate it well, some have minor side effects, very few have reported more major side effects or longer term issues. Propeciahelp is purely, purely for those who feel they've been hit hard by the drug. Therefore I see it as essentially as a real but bias community (and I mean that as no disrespect to them). On the surface it looks like a lot of men having serious finasteride problems. In context, however, I think its user base is only 1-2000 big, a tiny fraction of the overall finasteride taking world.

You unfortunately have to make your own mind up on finasteride. I'm still on the fence with it myself. I am not taking it and even though my logical brain tells me it's been trialled, approved safe, and there's very little chance I'd experience problems with the drug, there is a part of me that sees some issues I still don't feel are resolved. Genuine long term data for thousands of men hasn't been collected. In addition, it can't be forgotten that it still essentially works by artifically altering the balance of your endocrine system. Most men don't seem to notice any problems, but it's quite a fundamental bodily change for what is essentially a cosmetic issue. I would be happy taking medication which works in less invasive ways (minoxidil, for example), but finasteride requires in my opinion a more profound decision on whether you're happy to have about 60-80% less DHT in your system for the rest of your life. I know I'm wasting time by not getting on the drug, but personally I haven't quite built up the courage or comfort in knowledge this is the best trade off. Many people on this site have taken the drug with nothing but amazing hair growth or stability, and have been that way for a decade or more.

It's sort of like anything in life though. If something affects you positively with little or no negative repercussions you'll gladly tell anybody it's great stuff. If it negatively effects you in a serious or long term capacity, however, you'll be angry and frustrated that such a drug could even be on the market. The vast majority of people fall into the former camp; that doesn't make it any easier to be in the latter camp though.

Keep researching on finasteride and make your own, informed opinion is my advice. Propeciahelp might be worth a read but it's the strong views of a tiny community - not some sort of underground 'truth' applicable to everybody on the drug. Keep objective and keep your opinions unbiased and you'll hopefully make the right decision on finasteride for yourself!