TorontoMan

1 hour ago, Dr. John Diep said:

Hair transplant surgery result after 2,312 hair grafts to lower hairline by Dr. Diep during follow.

Hair Grafts Breakdown

2,312 hair grafts Total

single hair roots= 341 grafts

Two hair roots= 1,276 grafts

three hair roots= 568 grafts

four hair roots= 127 grafts

Total roots= 2,312 grafts

To view this client in more detail, please click on the following Youtube link 

 

Great result,  but we can’t see a single thing you’re combing through 

You need to check your shbg levels to see how much of your total test is actually free test, and it could be possible that your problems stem from high estrogen aromatization. 
 

lower the dose of fin, try topical fin, or try something like CB which has looks promising for safety profile 

Top Result, have you been maintaining your hair with any medication? 

14 minutes ago, Ronnieman said:

 

By that I mean I don't want to be worrying every week/month if I'm thinning. I just want to be do whatever I need to 'conceal' any thinning spots.

Everyone is different though.

 

I just cbf fighting a losing battle by taking a dangerous drug that affects your hormones

That is definitely at your own discretion and you're not the first to think like this. Every person whos eventually started on finasteride were at some point in time thinking they wouldn't possibly commit to a drug. However, according to studies, the instances of side effects were very low, and this was consistent even in a long term study, such as the 10 year term done in Japan. There are also over 10 million prescriptions cut for finasteride in the states alone. 

18 hours ago, Ronnieman said:

Nearly 32 year old male here,

I'm NW 2.5 vertex 

My skin and collagen is very good though, I look 18-22 in the face 

I am planning to go on TRT in 6 months, as I want to get a very lean, muscular and athletic physique. T levels were a bit low as well at my age.

There is balding on my father's side. Both my father and grandfather balded heavily after 40. 

Call me crazy, but I don't even want to think about hair.

My leanness, muscle tone, youthful skin and zest for life is what makes me happy.

I don't want to potentially ruin that with finastride.

I'm just going to max out everything else, and conceal my hair issues (if they come up) with micropigmentarion, concealer, hair fibers and/or a hair system.

Just thought I'd share this

Pretty large contradictions. "You want to appear NW2 for life" but will not maintain NW2 without medication. You "don't want to think about your hair", but yet you say you'll conceal and do other things to give the appearance. and it of course just gets harder to conceal as you go down that path

Lmao what made you rethink finasteride? In the post previous you said it was just hair 

Oh oh.. a case where a very reputable doctor advised a young patient to consider FUE over FUT.. this should rally a few people up. 

Everything looks amazing, you'll get great density and I'm looking forward to seeing your final result

45 minutes ago, voxman said:

You know me ,one eyebrow always raised.

I don't doubt that there are outliers that are super responders to meds like that but I think the percentage is very low for those type of results.  Are results from those treatments permanent I wonder?

 

What would you mean by permanent 

6 minutes ago, JohnBob said:

According to the research I'm doing, this FUE limitation may be the true based on the tools and skill of the current doctors, not on the procedure itself. 

For example, while you have Dr. Bisanga stating in his website that the max they can extract with FUE is 4000 grafts, you also have Dr. Zarev extracting 12000 grafts via FUE and the donor still looking good. 

You may say Dr. Zarev is maybe extracting beyond the safe zone, but if you subs track 4000 from the 12000, you still get 8000 grafts, double what Dr. Bisanga believes is possible. 

 

Lol where do you get info that Bisanga could only extract 4K grafts from?

Agree with the comment above. Your donor has thinned and you have a lot of loss. You would be spending a lot of money to not get what you likely expect. But you have a great head shape and a crazy good beard, I would rock that and never have to worry about hair again 

I went to a whole foods store and bought some all organic thing. But what I’d recommend is getting Regenpure NT (nourishing treatment), that one doesn’t contain any ketoconazole or sulfates. Wait maybe 2 months then you could use their Regenpure DR that contains a mild 1% keto. You could find it on amazon 

My instructions were to use baby shampoo until the 2 week mark, after that recommended I use a gentle shampoo, try to find something without any sulfates and more natural ingredients. and the other instruction was to avoid nizarol and head and shoulders until 3 months, as they may be too hard for you grafts 

You’re good g 

PRP is definitely not able to replace finasteride. The breezula trials are promising for its safety but I’m not sure how much binding affinity it has to the receptor. I believe it’ll be a promising thing to add with finasteride 

6 minutes ago, jabbahabba said:

Hey man thank you for your response.

I'm currently 27, and my hair loss started really aggressively around 3 year ago suddenly (it was extremely dense before). Then I took finasteride for about 1.5 years, and since my hair had regrown a bit, and regained some thickness, I foolishly thought I no longer needed finasteride and stopped taking it for 2 months. Of course this led to a huge amount of hair loss, bringing me to a stage much worse than before I started finasteride and leading to the two pretty low density spots in the front. I'm back on it now again and the loss seems to have stabilized.

 

Thank you for your opinion. FYI, I got an estimation of roughly around 1200 grafts required to strengthen/restore my hairline based on pictures.

 

 

 

 

It likely wasn’t aggressive, you just hadn’t noticed it as it’s hard to detect on time. And coming off finasteride for 2 months isn’t a massive problem, you are likely to regain that ground, and you may have been experiencing a shed. 
 

yeah you could address the the hair line now, but you may have a bigger problem later if you don’t see how you progress on fin. 

1 hour ago, jabbahabba said:

Hey guys,

This is my first post here and so far I've learned a lot, awesome forum!

 

I'm currently looking into getting a hair transplant and Pekiner is currently on the top of my list.

However, due to my hair loss pattern I have some doubts about how risky it would be to increase the density near the front / temples (you can see some really low density areas there), as I've read multiple times that transplanting hairs in diffuse areas can damage the surrounding existing hairs.

What do you guys think?

 

Here you can see a pic of the front/top in harsh bathroom lighting, and one of the crown from the top in less harsh lighting.

 

Looking forward to your responses!

 

 

Diffuse thinner, think you would benefit more from meds than a transplant. Right now the risks of surgery outweigh the benefit as you may shock as much hair as you try to replace. This in my experience searching online, seems to be the type of hair loss that responds best to treatment. You could get thickening throughout and you’ve hardly receded at the hairline. Wouldn’t consider anything till you try fin, my opinion . 

It’s pretty crazy how localized your loss is. The midscalp seems untouched 

1 hour ago, Raphael84 said:

@cpfmThanks for your support and your further question.

The recommendation of hair loss preventative medication is an appropriate approach for most males who are suffering from male pattern baldness. Obviously some individuals have their own preferences in terms of what they may be willing to consider or not, and some guys understandably prefer topical medication as opposed to oral. 

In terms of medication pre or post surgery, the earlier that a patient can begin a medication regimen, the earlier any improvement (stabilisation/strengthening) due to the medication can take effect. Oral medications can generally be continued as normal throughout the surgery process ad there is no need to discontinue before surgery and wait a period of time post surgery, as there is with topical medication that would be applied directly to the scalp. 

Dr. Bisanga often speaks about levels of miniaturisation in the donor area. The term "safe donor area" can be misleading. The donor area can still be susceptible to miniaturisation, which can compromise growth, yield and longevity of transplanted hair. In more extreme cases, it may result in an individual being deemed a non acceptable candidate. This is another reason why beginning mediation pre surgery makes sense. Medication can help to stabilise the donor area for patients with higher levels of miniaturisation. Whilst mentioning the "safe donor area", it is also important to appreciate that what is deemed as safe at 25, may look very different to what would be deemed safe in the same patient at 35 or 45, with miniaturisation and further loss. This is something that younger patients really must understand.

Dutasteride is less commonly recommended. With a larger percentage of patients now that are not open to the idea of using finasteride, then dutasteride does not enter the conversation. In many cases in my experience, dutasteride is discussed after being raised by the patient. For those patients who are interested in beginning dutasreride, Dr. Bisanga will often recommend introducing it on the weekend for example. Using finasteride as normal Monday - Friday, and then considering dutasteride Saturday and Sunday.

Dutasteride is also now available as a topical gel/cream solution such as finasteride, which calms the concerns for some patients.

Currently Dr. Bisanga is a proponent of low dosage oral minoxidil. Our patients have reported very favourable response to a daily dosage of 5mg.

Thanks for the write up. Would oral minoxidil be able to supplement and replace topical application if it’s tolerable? 
 

and where is topical dut available?

No, no reason to believe it will stop.

8 hours ago, giegnosiganoe said:

0.5mg every day and no

How could you get sides with fin but not with dut? 

7 minutes ago, Ron5566 said:

Oh I get this now! So basically, it's not the amount of DHT but the fact that my hairs are very sensitive to DHT.

So if currently I am also shedding in my donor (Everywhere in the Scalp).

Does it means I am going to lose ANY hair on my head or some hairs, let's say 50% may remain in the scalp.

What age I can determine where I am heading? Looking at my dad's donor, you can see it's thinner, nape is gone but he still have lots of remaining hairs on his scalp which are enough to blend with hair piece in case he wanted to.

Basically my only concern is to have zero hairs on my head since I am shedding all over my scalp right now, it will ever be stable at some age or slow down? Or it's not possible to tell?

Yeah you may be very sensitive DHT in your scalp and likely other androgens including testosterone. Finasteride will of course help reduce the amount of DHT you have in your body meaning there will be less of it to come around and attach to your hair. For most people this reduction is enough to slow the progression of hair loss down and others still experience loss because there is still enough androgen activity in their scalp for their hair follicles to be affected. In your case I would try finasteride if you haven't already and it should help you maintain what you have, including your donor. Hair loss is progressive and there is unfortunately no real way of determining how far you will go with it.

I would also strongly suggest you go get blood work done. Ask them to test your blood for iron, folate, zinc and look into your thyroid or any potentially autoimmune issues. 

3 hours ago, Ron5566 said:

I am really happy to hear it worked for you! Since your hairloss wasn't so bad to begin with I believe it has a lot to do with that. I started to lose my hair when I was around 15.5, all my family members are norwoood 6/7. My blood is full of dam DHT 😅

 

You wrote : "guys' sex drive slowly but surely starts to lower once they hit their late 20s"

 

I don't know if it makes sense but is there a chance that in let's say 8 years (I am 27 now) the hair I am losing in my sides/back will be stable and maybe stop because my body will produce less testosterone?

Hi I think you need to take more time research and understand what finasteride/dutasteride and all these things are and what they're doing. It is not that you have more DHT in your body than any other average person, it is that you are genetically sensitive to dht at your hair follicles that you are losing your hair as opposed to another person who isn't. 

& yes theoretically if you get older and you're testosterone levels begin to drop, conversely the amount conversion into DHT will also drop. However, that is not what you want lol. You want to keep your testosterone levels high, and ideally if you didnt have MPB you wouldn't be touching your DHT levels either. The drop of 50-70% of dht from fin, depending on how you dose, is thought to be enough of a drop where you get dht reduction in the scalp, but still enough androgen activity in most men to support regular function. 

On 9/14/2020 at 1:25 PM, LonelyGraft said:

Not a doctor but here is my thinking. If the med has a higher affinity (think higher magnetic ability) to bind to the androgen receptors then it will out-compete specific androgens whether it be t or dht. Just like dht has a higher affinity than t. So if the concentration is high enough, vehicle supports good absorption for the topical to get to where it needs, and the chemical has a higher affinity, then the dht just doesn’t get as much of a chance to bind to the androgen receptor and turn on genes within the cells to trigger cell apoptosis/inflammation/etc.

Apparently it has a very low binding affinity, so it isn't very competitive at the receptor. I don't believe there is enough research yet to treat it as a good stand a lone treatment and perhaps not enough to justify its current price. On anagen it sells for $100 for 1 gram and you'd have to get a vehicle like stemoxydine, KB or even minoxidil like Melvin mentioned. The studies released this year showed that 7.5% BID (taken twice a day) was the most effective after 6 months and a year. So it could potentially cost something like $100 a month to use with its optimal effect, this would likely change when it hits the market in a few years. Maybe Melvin could speak more on how much its costing him for his current dosage. I think its probably a very good option to add for someone who is on finasteride and adds it to minoxidil.. if you had the money to support it, I think the safety profile of it makes it a good add on. 

@Hairgain22 Yes CB-03-01 is Breezula and also called clascatrone 

13 hours ago, jimcraig152 said:

Hey @TorontoMan, I'm about a month ahead of you with my 2332 FUE procedure. Redness for me didn't go away until 3 months and 1 week. I noticed in the 3rd month, after a shower, the redness would be gone. Then I would apply Rogaine foam, and the redness came right back. But now even with applying Rogaine, the redness doesn't come back. I've heard of it lasting some 5-6 months before when I researched the subject.

Something that I did apply somewhere after month 2 was this stuff. The lessening effects of redness was instant. I didn't apply it regularly at all though. When I read about it, another member said he applied it every hour and credited it with possibly saving some of his grafts. Not sure about that, but I know it definitely helped with redness.. I used it maybe once or twice a day 2-3 times a week.

I had many transplanted hairs in the forelock that didn't shed just like you did. It's atypical but a pleasant surprise.

I'm gonna check that out, thanks! Happy growing mate 

I was quoted 2,500 grafts during consultation and was ready to pay for that amount and for more in the case there was more, although I was very certain I wouldn’t need more. 
 

on surgery day the doctor decided they would aim for 2,200 instead. They got around 2,200 but when doc finished the incisions, he wanted 200 more to fill in density, so they flipped me over and extracted another 200. Totalled 2,401 exactly, and they refunded me for 99 grafts as I paid for 2,500 before we started. 
 

had it gone over I had a visa ready to pay for what they’ve extracted extra. I think that’s the policy for many doctors in North America at least