giegnosiganoe

13 months now. Still happy with the results. Having decent hair (and working out) has been life changing, social life is better than it's been in many years.

On 2/12/2022 at 2:19 PM, Dillpickle123 said:

What made you switch to dut if finasteride was working? At what age did you start consulting about a hair transplant?

Dutasteride works better with similar rates of side effects. Unfortunately I developed gynecomastia after ~1.5 years on the it (was on finasteride for 6 months before that), so I switched back to finasteride and am on raloxifene. I don't have nipple sensitivity anymore, and the gyno is not as obvious as it was at its peak, but the growth is still there and so I plan to get gyno surgery soon.

I started looking into hair transplants at the start of 2021.

20 hours ago, Inch6 said:

Wow so good result. How did you Contact Dr Pekiners, I cannot find his website?

Thank you! I'm not sure what's going on with that TBH. I have his patient coordinator's WhatsApp, if you PM me I could send it to you.

On 1/23/2022 at 2:53 AM, PutTheFolliclesInTheBag said:

Much appreciated, looks great! The difference in density is only noticeable if you know what to look for, I wouldn't worry about it! 

Also because gel is used, which clumps the hair together, resulting in less coverage.

I agree, great result.

I'm not sure of the reason, but I've noticed that De Freitas seems to implant in rows only horizontally and only near the very front of the hairline, whereas Diep does also does it vertically and over most of the transplanted area. Vertical rows result in a more unnatural appearance because people looking at you face on can clearly see between the rows.

Can you share pics of the other side? Would be interesting to compare the growth.

Can you show more pics of your donor?

Interesting to see such a different hairline design than we are used to from Dr. Ferreira. Work looks great, looking forward to how this turns out, especially the temple points (yours didn't look bad TBH).

I recall you being worried about the asymmetry in the beginning. How do you feel about it now?

4 hours ago, vanilia said:

how many did you get? i got at least 50 at first op at cinic.

The anesthesia injections really aren't a big deal. And no, you don't really receive more than someone who has their procedure done in a single day, because different areas of the scalp are operated on different days.

3 hours ago, Balding Bad said:

Hey @giegnosiganoe, just to follow up, did your insurance cover the cost for these tests? Or did you have to pay a hefty out-of-pocket price tag for it?

Just wanna get a rough idea of how much something like this would cost before I pull the trigger on it. Thanks!

Mine was covered but I've got pretty good insurance.

3 hours ago, RandoBrando517 said:

Read your thread before and still don’t think you had dupa

Not sure how that comment is relevant here, but thanks for your expert opinion..?

Bisanga, who is one of the most highly rated docs on here as of late, said my donor miniaturization was concerning and that he wouldn't recommend an operation. That's after I provided him with microscopic videos of my donor. I've posted them on this forum as well.

As I said, Diep just looked at the front of my face with his naked eye, obviously said nothing about my miniaturization, and said I had over 10k grafts available.

42 minutes ago, Melvin- Moderator said:

Didn't you also end up having a successful surgery? 

Yes but it was only 1800 grafts. Diep was saying I had over 10k available.

42 minutes ago, rambunctious said:

dr diep requires pictures of the back of your head, he knows if you have good donor or not, how is that a red flag lol

I consulted with him in person. He didn't even look at the back of my head.

1 hour ago, stephcurry30 said:

Nice. I'm thinking about hopping on it but reading the horror stories of the shed is scaring me. Have you exp a shed while jumping on oral minoxidil?

Never noticed a shed on any treatment I've taken. I don't pay attention to hairs going down the drain though

7 minutes ago, stephcurry30 said:

Do you take it daily?

Yep 1.25mg morning and night

I'm on 2.5mg and have noticed lower diastolic blood pressure and slight ankle swelling. I'm assuming it has helped my hair somewhat but it's impossible to say for sure.

9 hours ago, Balding Bad said:

Hey man -- thanks for sharing your test results. It's making me consider getting a test done myself before I dip my toes into Fin. 

May I ask what precise type of test this was so I can ask for it from my physician? Is this just a standard T test or what is it precisely?

Thanks.

There were some other tests as well but I felt that these were more relevant to display. You'll want the full testosterone panel (SHBG, free, total), and estrogen/estradiol/prolactin which if elevated can lead to sides/gyno. Can't hurt to check for DHT as well. But my understanding is that lowered DHT = raised total testosterone = more testosterone converted to estrogen, and that the resulting estrogen-related hormones is what matters the most.

1 hour ago, Ken23 said:

 

Please update us on how this works for you 

Does your endo recommend taking the raloxifene as long as you are taking finasteride or just initially ?

Definitely will. I've tried posting this on /r/tressless too but the mods keep blocking my posts, really disappointing. This is the one side people should pay close attention to, mainly because it may not be reversible. And I had no idea that it could start developing 2 years after starting treatment.

The endo doesn't have a lot of experience with using it for gyno, but they recommended trying it out for a few months, and possibly cycling it in the future, but not using it nonstop. The goal is to see if it can reduce the gyno enough to avoid surgery. If I do need to get surgery, I want to be highly sure that finasteride won't cause it to grow back.

Saw an endocrinologist today. Switching to finasteride 1mg/day and starting raloxifene 60mg/day, let's see if I notice any changes.

10 hours ago, win200 said:

Yes, I definitely feel like it's work. I don't think I'm getting any sides; I was having intermittent sexual sides from oral, so this seems like an improvement for sure.

Were you previously using 0.5mg oral dut/day? How much of the topical do you use per day?

Did you ever consider just switching to 1mg oral fin?

Ever do any labs? I'm curious how switching to topical may have affected those.

Thoughts on the Strut Health topical dut formulation? Seems easier to obtain in the US (though they don't ship to CA yet unfortunately for me), and it contains minoxidil/tretinoin.

Thanks.

1 minute ago, win200 said:

I'm using the FUEClinic 0.1% dutasteride formulation.

How is that going for you now that it has been a few months? Since you're based in the US, have you considered Strut Health's formulation?

I wonder how does the fueclinic topical dutasteride compare to something like Strut Health's topical dut formulation? I'm considering switching over from oral dut due to gyno sides.

A topical formulation of a 5-alpha reductase inhibitor, the active ingredient in Rogaine, and Tretinoin to enhance scalp penetration. (Topical: Dutasteride 0.1%, Minoxidil 0.0%-7.5%, Tretinoin 0.0125%)

In case anyone's interested, here are my maybe relevant test results:

Seems like estrogen/estradiol/SHBG are on the high end of the reference range. Meeting with the doc tomorrow to discuss, and will try to get a referral to a specialist.

Feels like the gyno is getting noticeably worse over the past couple weeks.

If you're getting a density treatment, does that mean she already knows you have hair loss, or have you been hiding it with concealers? What is your reason for wanting to tell her?

6 hours ago, Gatsby said:

I have also seen this @giegnosiganoe. I have always thought that it is to ensure their are enough grafts for work in the future or it is part of a two stage approach to address the hair loss surgically.

The number of remaining grafts in the donor should be the same for either approach though.

6 hours ago, BeHappy said:

If you use the entire donor area on the first hair transplant, you have hairs missing from all over. Now you go for a second transplant and it gets much harder for the Dr to properly space out all the grafts without taking some from directly next to (or above or below) where another graft was taken earlier which could create small spots with no hair and look moth-eaten/depleted in those spots. Using one half of the head first allows the Dr to use a full, untouched area on the second transplant and thus reducing the chance of it looking depleted. It also can be easier to extract grafts from an unscarred area rather than from an area where grafts were already taken because there can be some scarring underneath the skin from pulling the grafts out. That scarring can be a lot wider than the small dot punch mark on the surface. I'm not saying this should always be done. I'm just trying to give you the answer you seek.

But if you extract over the entire donor vs just half, then you should have 2x as much space between extractions, so it shouldn't be that difficult to space it out if you have to do a next procedure? And I never see this method done with people who actually need multiple procedures - it's always those with minimal loss (which makes sense since it's difficult to extract 3000+ grafts from only one side of the head). Take someone like Dr. Zarev, who pushes the donor to the absolute limit. Not even he has an issue extracting evenly across the donor over multiple surgeries. It surely takes more planning/effort, but he seems to be proof that it can be done without any disadvantage.

And I'm not sure I buy the scarring argument. Is it that the scarring of an extraction somehow affects the neighboring grafts? What does it do to them exactly? You'd also have 2x as much space between extractions, so it would be unlikely for the grafts you'd extract the 2nd time around to be affected assuming that were a problem.

5 hours ago, Curious25 said:

It’s pretty logical - the larger the surface area of the donor you can keep Virgin, the easier it is for surgeons in future surgery’s to execute new extraction patterns from. It also mitigates risk - carrying out as much damage limitation as possible throughout every step of the surgery is best practice. 

Like I said in the other thread , anything less than 2000 grafts in a candidate with a good donor, won’t make a visual difference at all from only one side of the donor being extracted from. 

I responded to some of this in my comment above.

How are you quantifying "damage" here? The number of extractions/surface area of scarring doesn't change whether you extract over the entire donor vs only half. I'd argue that placing the extractions closer together increases risk, as it would seem more difficult for the body to heal from wounds spaced closer together.

I get that 2000 grafts may not make a noticeable difference in most cases (I've seen docs who do this go up to 2500). But I do think a more even extraction pattern would allow a slightly shorter cut on the back/sides. And what if we think about longer term if the patient continues to lose density in the donor, even simply due to senile alopecia? At some point that difference may become visible.

Saw this mentioned in another thread and thought it deserved its own thread.

I've never heard of a good reason for extracting from only one side of the head (assuming the donor density is fairly symmetrical along the horizontal plane).

There are two things I can think of that matter in this discussion: 1) the health of the remaining grafts, and 2) spreading out extractions to limit the difference in density across the donor. For the first point, I don't see how it makes a difference - a good surgeon should be able to extract quality grafts from anywhere in the donor region without affecting the neighboring grafts. If they can safely extract from one side of the head, why wouldn't they be able to do so for the other side of the head, especially when they have more space between extractions? For the second point, extracting evenly across the entire donor area obviously wins according to basic math. So according to these criteria, extracting from only one side of the head is strictly worse.

Can anyone explain what they think is the benefit of extracting from only one side of the head? Leaving one side of the donor "virgin" is what you commonly hear as a defense. I guess it sounds compelling because people usually leave the discussion at that from what I've seen, but I really don't see how that means anything in and of itself.