Future Hair Doc

@Dr. Vladimir Paninedoes FUE mega sessions and his consults are free. He's an elite coalition surgeon, has been putting out amazing work for 25+ years, is board certified in dermatology, and did his surgery training at Stanford. I think he does virtual consults too. If you consult with him, tell him I said hi. Are you in Chicago? Man, I miss Chicago.

The most prominent side effect from oral minoxidil is hypertrichosis. Very rare side effects include edema and even more rare, pericardial effusion. The doses for these rare side effects are much higher than the standard 1mg to 5mg dose that I've seen being used for treating MPB. I haven't seen these rare side effects in my patients. I won't prescribe oral minoxidil for underlying cardiac conditions such as CHF. In addition, I get a baseline EKG as well to watch out for any arrhythmias.

Is your hair loss stabilized? Are you on finasteride/minoxidil? I would focus on the frontal 1/3 and this will frame your face well and serve as a barometer for the rest of your scalp.

Yeah, India is facing a huge covid surge. The ER there probably won't even see him unfortunately

Your friend needs to see a doctor NOW. It definitely looks like hypertrophic scarring and the beginnings of necrosis.

Awesome results. Very refined work and his hair looks completely natural. Thank you for sharing.

Sorry to hear about this. I've messaged you privately as well. Feel free to reach out anytime.

You should ask the clinic these questions. I'll try my best to answer, but I'm not sure what some of these meds are since they're in Turkish. I do know standard procedure is to give an antibiotic for prophylaxis (such as cephalexin, cefazolin, etc.). Some people have very low pain tolerance so they require oral opiates and some people are fine with a high dose acetaminophen and/or aspirin. Some people request light sedation/or may have anxiety so a benzodiazepine can be used. Prednol is a steroid to prevent edema. Coraspin, per my internet search, is aspirin. It can be used for pain or as an antiplatelet agent. Usually you don't give these before or after surgery since it increases bleeding risk. Trental is a PDE inhibitor (so it vasodilates and it also has some anti-inflammatory properties). I'm not sure why they're using some of these meds (I don't see the utility of a PPI, for example). I would ask them. You can continue taking finasteride. It'll help with preventing shock loss as well.

Omeprol is omeprazole. It's a proton pump inhibitor, which basically means it lowers the acidity in your stomach (it's used for stomach ulcers, etc.)

Not that I know of. I would like to know if there is a consensus on this as well.

The gentleman needs to learn/educate himself more on hair loss, as well as medical and surgical solutions for this. Getting involved with this community will help him tremendously.

Awesome results. Very densely packed and looks completely natural. Thanks for sharing

The only clinical studies I've seen on dexpanthenol in regards to hair growth are of poor quality (I've linked them here). Unfortunately, for now, the mainstays are still minoxidil and finasteride. I've asked some folks with biochemistry/hair loss science backgrounds and they're equivocal about it as well: https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.13729 https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.13729 Both studies used subjective measures (Dermatologic Life Quality Index (DLQI) and a modified hair growth questionnaire) to gauge success, which isn't useful. They should have used objective measures such as measuring improvements or lack thereof in terms of hair density. It could be promising, but they need better methodology to gauge actual effectiveness.

In the end, it's up to patients. Having undergone 2 FUTs myself, I understand wanting not to shave. I opted to shave. As everyone else has said, it'll be a much more seamless procedure with trimming/shaving. You want to minimize the margin of error as much as possible.

Great choices. I'd add @Dr. Vladimir Panine as well. He's been putting out phenomenal work for 25+ years and is board certified in dermatology and did his surgery training at Stanford. I believe his consults are free too and he's doing virtual consults. Sorry to hear about your poor experience. Feel free to contact me anytime and welcome to the community.

That depends on the characteristics of your donor area to begin with.

Interesting. I've never heard or seen this based on my convos with surgeons. I've heard from some surgeons that they prefer sutures since they think it can approximate wound edges better than staples and hence the scars won't be visible nearly as much from FUT. But I've also seen work done with staples where the FUT scar can't even be discerned. I wonder how common of an issue this is. Dr. Bernstein definitely knows his stuff well and I trust him. Thanks for sharing and I'll ask around from some surgeons what they think of this and get back to you. I'm in training so I'm always looking for evidence based medicine (as all surgeons should be). Thanks for sharing. Always great to learn about the intricacies of hair transplant surgery. I would ask @DrTBarghouthias well.

I haven't heard about this. Can you please provide a link to the website?

Can you do finasteride 1mg daily without side effects? If you've reached the apex for finasteride and are still losing hair, I would suggest that and see how your body responds.

Yes

You should be able to get a few more FUTs before getting FUEs. You'll maximize the number of grafts this way. And you're usually safe at 2 years to get another hair transplant surgery.

I'm sorry to hear about your dilemma. Feel free to private message. This is a very informative and supportive community. People are happy to help.

I would wait 1 year to truly gauge your progress on finasteride before getting a hair transplant. I'm assuming you're already on minoxidil.

You likely need to be on oral finasteride and topical finasteride. The chances of side effects from oral finasteride are a little less than 5%, based on published research. If you're getting side effects from oral finasteride, titrate down and/or consider topical finasteride.

Yes, you need to get this checked out with your doctor. It could be an infection, usually fungal. Do you have tenderness, erythema, pus, etc. around your scalp?