JayLDD

Yes strip surgeons tend to lie and suggest that taking out a strip first and then utilising FUE will yield the most, however this makes no logical or mathematical sense. The way to best utilise the donor is through a combination. FUT removes surface area, while FUE diffuses it like you say. It doesn't matter whether you first remove a strip or first use FUE, the amount of hairs you can get out of the area remain the same. However obviously a strip will yield less down the track if FUE is done first. In saying that, FUT has a number of advantages over FUE in the quality of the cosmetic results in the recipient, and most master surgeons can produce FUT with minimal scarring in most cases. The biggest reason most avoid FUT is fear of having a strip cut from their scalp, not because of the scarring.

Ice pack for a day or two, the shampoo and mouse for 10 days and I kept using the shampoo until it ran out at about day 17. After that you can go back to your regular shampoo.

Try finasteride at 0.25 mg and see how you go, if you stabilise and you're comfortable go for it. No reason to go through your 20s as a baldite just to stop the people who waited till their 30s being jealous. Wouldn't touch the crown though.

Steady improvement but must say the experience is incredibly stressful at the moment, even more so that ugly duckling stage. Comfortable where I'm at currently, just hoping the improvements keep coming especially from months 4-6 which is obviously nerve racking. I'll take some new photos in a week at the 4 month mark.

Best frontal results of all time after the second transplant already. Will be a mammoth to titanic result here.

That dark area looks bad. Do you have any closer photos of it?

In shape yes, but in terms of diffusing you are going on a norwood 5. Finasteride will help you a hell of a lot more than 2000-2500 grafts which will do virtually nothing and create problems down the road. Also no reason to be worried about shock loss considering you aren't on finasteride so you will lose all of those hairs in a few years anyway. It makes little sense to be worrying about "reserves" considering you would end up using them anyway if you're not on fin and your balding pattern is already very obvious. 5000 today across the whole scalp is no different than 2500 now and 2500 in a few years, which is what you will end up with if you opt for a small transplant but you will achieve a lesser result in the short term, its harder to plan and will incur more travel expenses, time out of work and hassle. A transplanted patch in the middle of your head with nothing in front or behind is not a good look which is what you would have with 2500 grafts after a few years more of balding. I'd try a microdose of fin first, but if you're not up for that then a large megassession is ideal.

You are nowhere near a norwood 2-3 and your hairline is borderline non existent. Diffusing also in a norwood 5 pattern. Without knowing how quickly you are thinning, it should still be said that getting a 2000-2500 graft transplant if you weren't on finasteride would be disastrous. Most hairline procedures alone utilise more than that and you have major thinning across a norwood 5 area. Do you want to fill in a hairline, wait a few years until you are completely bald behind it so it looks ridiculous and then get another transplant, or fill in the entire area now? Even a 0.25mg microdose of fin would do you more good than a transplant in the long run, but if you get one without medication keep your expectations reasonable. Do you want to fill in the entire balding area so even if you lose more hair you will have decent coverage across the scalp, or do you want a hairline that is going to look ridiculous in a year or two as you lose coverage elsewhere across the entire norwood 5 area?

I think unshaven FUE can be useful for small hairline procedures, but for yours a large megassession at the 5000 graft level would have been a better option.

"I'm not sure where you read that I was comparing myself to anyone else" - "Has anyone had this similar experience at 5.5 month mark...let me know, thanks!" Not trying to be a dick, I'm at 3.5 month mark and going through the same stress but the positive is that you could potentially have another 50% left in the tank and at least a few months before any conclusions can be made.

Again its impossible to tell you anything accurately because you seem to want to compare yourself to others but don't post decent photos for some reason. If the result is outright bad at 7 months there is a very low chance it will drastically improve. If it is adequate at 7 months, 20% improvement and changes to hair texture from 7-12 which is typical can turn it into a fantastic result. At 5.5 months you still have plenty of time for newer sprouts to emerge, thicken and get to a length where they make a cosmetic difference.

5.5 months is still relatively early. The bulk for most occurs between 3 - 7 months so you likely have a while yet for improvement. Usually by 7 months you have a good idea of what you're going to end up with.

Better pics?

Photos or can't judge.

Considering your age you are more susceptible to donor thinning at particularly at the edges of the safe zone, so FUT is ideal. Rahal is the best option in that case.

I wouldn't specifically worry about punch size, but that is an issue with the ARTAS, and 1mm is far too large. I would primarily focus on the results of the doctor rather than their tools, but it becomes blatantly obvious with research that ARTAS results are of a lower standard and it also tends to be more expensive also. The best FUE doctors all tend to use a manual punch. Don't take my word for that either, research the work of manual punch FUE doctors like Lorenzo, Erdogan, Feriduni, Bisanga, Lupanzula, Konior and Keser and you'll quickly realise that ARTAS results do not come close. Punch size and lack of manual control will also cause issues with long term donor management which may not be an issue after one procedure but will down the track.

Avoid ARTAS and go manual punch. Manual punch is mostly utilized in Europe, so its typically cheaper with the added benefit of doing less damage to the donor, extracting across the full range of the donor and having a lower transection rate. It is not that the ARTAS is "bad" per se, but rather that it is typically more expensive and a lower quality procedure, so there is almost zero reason to go for it. Bernstein, Arocha and a number of others are getting good results, however it's telling that Hasson + Wong and Rahal, being some of the top names in FUT for over a decade trialled and subsequently rejected the ARTAS for manual or motorized handheld punch. None of the cream of the crop names for FUE are using the ARTAS, and I doubt a single person who has researched even to a mid-level extent would disagree.

After decades people are still buying castor oil and non-medicated hairloss shampoos to treat their hairloss. Lets be real, people don't always make logical decisions.

This is not to discredit Dr. Reddy, but I think very few on these forums would consider him to have the reputation or output that rivals Bisanga. The cost of a procedure with Reddy for 2500 FUE grafts is quite frankly completely outrageous too. Just an opinion, but I don't think there is justification for prices at that level apart from the fact that there are those willing to pay it.

If you're using minoxidil in the areas that they will be transplanting into, then discontinue it. It should be fine if you're say using it in the crown and only getting transplants into the frontal area. But still discontinue it the month or so prior as it can make bleeding during surgery worse.

Agree that this forum largely supports patients and they are far better off with it than without it, but lets be real; this is a bad result and even in terms of forum recommended doctors some are without a doubt better and more consistent than others. Certainly the results on this forum reflect that apart from the absolute cream of the crop FUE doctors FUE is more likely to have a low yield or fail altogether like this result.

So many ASMED SA children

What did you do with the extracted grafts? I don't think this was a great idea, you can clearly see the marking on the recipient area and you still had a decent amount of hair in those areas.

Does it necessarily make a fundamental difference whether FUT is used first or last to maximise donor capacity? Obviously a strip from someone with a donor already harvested by a substantial number of FUE grafts will yield less, but isn't this still a possibility?

3 months. Unflattering as possible styling without a wash and in sunlight. Only just begun to see a few sprouts in the past few days, hopefully it picks up from here.