Friedman

How many people on this board have had a "shock loss" after a procedure? Do you know anyone personally? I've seen people whose results weren't as good as they were hoping, but even they had clear gains. Can you link to a shock loss example? After my last procedure, I had a "shock gain". In any case, doctors have incentive to tell you to do a surgery now, so when one says to wait, we at least know they aren't just trying to drum up business. LaserCap, i'm guessing, by your name, you've had success with the lasers? There are RCTs supporting the laser treatment as well? Which exact combo do you use yourself?

psychopomp1 -- Are you doing microneedling? That is proven to work in RCTs. So is minoxidil, PRP, and topical finasteride. Why not try the things are are proven to work in clinical trials? If I were you, I'd go straight to a hair transplant, and then follow it up with the four headed monster of microneedling/PRP/minoxidil/finasteride. This will be a slam dunk for you without question.

They are banking on you forgetting about it in 6 months. Also, they may or may not actually give you your money back. (Do you have your receipt, proof of purchase, the original box? Did you remember to send it in and fill out the refund forms correctly? Maybe you can get a refund after 6 months but not 7?)

I did a consult with a doctor who recommended 8 months of a topical finasteride/minoxidil mix before doing a second surgery. I'm a bit skeptical this will work, but I'm also not really looking forward to doing another surgery at the moment. Part of the reason I'm skeptical is because I did 14 months of micro-needling plus minoxidil pre-op, and the benefits were tangible but modest compared to the huge positive impact of a transplant. Adding in finasteride seems unlikely to be a game changer. On the other hand, there is a chance I might need fewer grafts... I looked online, and it does look like there are RCTs backing topical finasteride. Seems less chance of side effects? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/ https://clinicaltrials.gov/ct2/show/results/NCT03004469 Thus it seems like this topical finasteride/minoxidil combo plus micro-needling will be the way to go? Plus PRP if you can hack it?

Update: Here is an overview of 5 RCTs with topical finasteride: https://www.ncbi.nlm.nih.gov/pubmed/29601622 Here are some of the results: https://clinicaltrials.gov/ct2/show/results/NCT03004469

So, I put in my details and uploaded some photos to some surgeon, and they suggested not doing surgery, but actually doing a combination of topical finasteride and minoxidil for 8 months first, and suggest that they've had patients do really well with this combo, plus PRP. I am a bit skeptical. I did 14 months of minoxidil + microneedling before surgery, and while I did see some mild benefits, the key word there is mild. The Hair Transplant was a real game changer. Does anyone have real success with adding in topical finasteride to a minoxidil + microneedling regime?

Anyone got results with topical finasteride?

OP, can you post a picture of your hair as you wear it when you go out in public? Without a single real post-op picture, we can't really say the transplant was a success or not. Or, you could post pre-op pics where you pull it back to make it look like you have even less than you did? Update: I see you did post a normal post-op pic eventually. I agree it does look like there is a thin spot. How does the other side look?

This timeline didn't fit me very well. At 3 months, i barely had any coverage. Suddenly, by 4 months, I was looking good. Halfway home. By 7 months my growth basically finished (90% there). At one year, I haven't noticed that much difference from month 7, or even month 6. Partly, this is because I like to keep my hair short. If you like it long, of course it will take 9-12 months for those new hairs to simply grow. I wouldn't expect additional thickness though.

Did you ever go back to do a second one? And, why not also do microneedling to protect what you have?

Has anyone used this clinic recently? I want a quality clinic in Northern Europe. No Georgia, no Asia, and f*ck no to Turkey (i was just there). I had a HT at Talizi Clinic in Georgia. The technicians did the transplant, the doctor didn't really do anything except draw the lines. He was a bit of an idiot, so I didn't mind. It's always the technicians that do the work, not the "doctor". Prohair clinic doesn't provide much info about it's "doctor" here: https://www.prohairclinic.com/en/highly-experienced-fue-clinic-institute-team-europe

double post

Shamelessly bumping my own thread here... Any recommendations for doctors in Northern Europe? More advice on #s of grafts? Should I fill in my temple area?

So, update here, Dr. Akaki, the guy I was originally recommended to at first, now just works in Russia, and has left Talizi. I found out because I emailed the clinic asking about what they would recommend for a follow-up. As a result, I'm now in the market for a new doctor. I think I'm going to go to Western Europe this time. No Georgia, no Turkey, no Ukraine. Austria or Switzerland would work. I care less about price. Any suggestions?

Anyway, here are some pics almost a year out. Soon after a hair cut, which may bias the results against the transplant, as my hair could be longer. Any thoughts? I'm thinking of going back for one more. Feeling lazy though.

So, I'm starting to feel like my new hair up front is thinning in a big way... Part of this may be the natural cycle of the hair. Part of it could be that I was less diligent about microneedling and Rogaine for about 3 months this year (now back on it full time...). Part could be that I got my hair cut shorter and traveled, and saw myself in a mirror in bright lights;( Is one year too soon to start seeing regression after a transplant? My one year is coming up in a year. I'm still leaning toward doing a second transplant...

Here is the official 6 months out pics. And here is a pic pre-ops, that was also before any Rogaine. And here is after a year of rogaine + microneedling: Quite a substantial difference. I also did 5 months of PRP after the surgery. No idea how much that helped. The surgery probably did the most. On the whole I'm pleasantly surprised, even if I should have done 3,500 rather than 2,700.

Here are some more pics. Definitely not perfect. There are still some thin spots. But much better than pre-op. And, these pics are with uncombed hair and not-great lighting. My overall judgment is that my hair looks much better than pre-op, and good relative to what I feared in the immediate post-op stage.

So, my hair has continued to get better. I'm not sure I had a clear image of how I wanted my hair to look before the operation. However, at 5 months, I see substantial improvement. If one year of Rogaine plus microneedling improved my hair thickness by a noticeable 5-7%, then my hair transplant improved it by about 50-70%. I still would like more thickness up front, but now I think I'd have been good with 3,000-3,500 grafts. I just wet my hair, or I'd send hair pics. Also, for blonde guys transferring hair from darker areas, I feel like my hair did lighten up a bit in the sun. Lastly, I was worried about the direction of the grafts. They look fine. This wasn't an issue for me. If you do Talizi, at least request the main surgeon (I forget the guy's name now...) and not the idiot who was there when I went.

^Hey Tommy. At a minimum, I would consult with 2-3 doctors in person, and get advice about hairline, and recommended number of grafts. Important to do that to get your questions answered (angles, color, exact hairline, etc.), and to get a consensus on grafts. My recommendation at this point is probably to not use Talizi -- for all the reasons I wrote above. If you do, negotiate hard. In terms of actual results, it's positive so far, but I still think I needed more grafts.

OK, Now I'm close to 3 1/2 months out. I'd have to say I've continued to see steady improvement. There now is more hair on my head than there was pre-surgery. It's starting to look better. I think I'll probably need a touch-up still (i probably needed 4,000 grafts, not 2,700), but it's actually better than I feared in the weeks after my surgery. Also, I bet I can lighten the new hairs when I go from northern Europe down south for winter, after I spend some time in the pool and sun.

That's super fast growth. My advice for the pictures is to wear your hair as you normally would. If this is how you normally wear it, then maybe consider seeing a stylist.

So, I'm no expert, but given that you weren't that bald before, 4500 grafts seems like overkill. I suppose that will guarantee a good result...

My question is about the ACell. Is there RCT evidence for it?

Are there any randomized controlled trials (RCTs) showing a positive impact of ACell on hair growth? I'm already doing PRP, so I'd like to add ACell, but only if there is supportive RCT evidence...