Curious25

@HugoX

The reason the topical exists is because scientists discovered the hair growth that was experienced from taking the oral.

Anyone who has been involved in the hair loss industry for even just a modest amount of time - will be able to tell you of the Dr backed recommendations for using this, and it is for good reason. I’ll tag @Dr. Felipe Pittella for you, as I know he is an advocate. I would also recommend watching Melvins Instagram lives with Dr Bisanga, Dr Mwamba, and Dr Konior. No one’s pinning you down and trying to force it down your neck, so there’s no need to be so defensive over it - you came here to ask about it, and people are just providing you with resources for you to look at, and then make up your own mind.

The scalp you can see in the pictures that you show concern over, can be seen in people who have never lost a hair in their lives, when photos are taken at these angles, in the same lighting and with the same hair length. This is a really great result, and the best patient posted result that I have ever seen from this doctor.

You look like you could benefit from a hairline softening, which would be a lot easier to execute, as @anotherbaldguy has previously alluded to, addressing the angulation issues, whilst doable, is quite a tricky and lengthy process, which would require a lot of time, money and inconvenience for what could be up to 3 years given the volume of surgeries required combined with the general average wait times that top clinics have. And when I say top clinics - you really need to be going to a top clinic for something like that. For that reason - in these situations I think the superior strategies to tackle this, tend to be one’s that think outside the box, and look to mitigate the issues via focusing on interventions that don’t actually address the (angulation) issue itself, but rather help minimise the effect of the issue. Craft-full reconstruction of your temple points will balance your hairline, and softening it with some fine haired singles, will enhance the naturalness in appearance, so these two relatively do-able surgeries (for a top clinic) could actually save you a lot of time, hassle, and cost. And as a disclaimer, I have no idea who you had your previous surgery with, to cover myself from any accusations from people who may feel I’m being unfair on the surgeon . . I’m just saying what I see from these pics in the thread.

No it would just require more grafts. The larger the balding area to be covered, the higher the number of grafts. I agree - I don’t think your hairline should be lowered, I think the main concern is the levelling of the right hand side, and to sharpen the angle of your temple closures (the right hand side is particularly rounded) and potentially bring out your temple points to balance the reinforced hairline.

It’s an NFT.

Apologies for the awful drawing, and it probably comes across more aggressive than you want or than I intended , however using this as a baseline . . . as a very rough guess , you would be looking at between 1500-2000 depending on your choice of surgeon. Someone like Dr Hasson would be potentially willing and able to dense pack this highly, which would subsequently increase your grafts required.

Apologies if offence was caused - I didn’t call people dumb per say, Rather the logic that is used is ‘dumb’ . . In the UK dumb thinking is different to someone being dumb. It’s an expression similar in tone as calling someone forgetful or clumsy.

There’s so many drama queens on here. Look I’ll give it to you straight, and you can make your own mind up based on this summary of points I’m going to put together from what I can remember reading on this thread. ‘Your hair looks good as it is is now’ I agree, and to pretty much the entire world, they wouldn’t look at you as balding, let alone understand why you’d be wanting a hair transplant. However you have clearly recessed a little in your hairline, and without seeing your face, I am pretty confident a more youthful framing would make you look better. ‘you could look worse’ Yep, you could if you go to a shlt show of a clinic. However if you go to a world class surgeon, I’m 99.9% confident in saying, you will look a lot better. ‘you risk shock loss, which could be permanent’ Shock loss is a risk, of course. A lot less of a risk under a good surgeons hands. A lot less of a risk when taking finasteride. Permanent shock loss is only attributed to hair that is already heavily miniaturised (on its way out) and I don’t see much, if any miniaturisation on your photos, aside from potentially some of the frontal hairline hairs in the area of your recession. At the end of the day, people on here are dumb in how they think. They’ll tell users your age who are NW6 and not on medication that they’re good candidates to go to Eugenix if their donor seems ok, to achieve a much sparser coverage than what you’ll be able to benefit from, (which in my mind still looks better than a bald head) . . However someone like you, who is doing all the right things (finasteride, slow progression, no signs of aggressive loss) that you’re not a good candidate based upon the fear of looking worse now, or permanently shocking out your hair. I mean come on . . you’re on here asking for advice on surgeons - and all the names people have given you are at the top of their game, so again, without being able to say with 100% accuracy this wont happen to you if you go to one of these surgeons, I am saying that, without being able to say that. Ideal criteria surgeons tend to look for is that you are on preventative medication, and you’re not in your 20’s, showing obvious signs of high classification loss. The high end baldies forget that patients with lower levels of loss can still benefit from small yet impactful restorations, probably because they’re so far gone, they look at NW2’s with hair envy, which is understandable. If you were 25 and not on meds, I would tell you to hold off. But you’re not. So I would encourage you to research a world class surgeon, find out a lot more about what surgery entails, and write out a list of pro’s v con’s and make up your mind. @Gasthoerer has had some small surgeries on his hairline, and is thrilled with his results. @TorontoMan @Adam87 and @BjornBorg are other users who have had good hairline transitions and are obviously over the moon with their amazing results as well.

Nice write up and congrats on your surgery, the work looks very clean! Do you know your avg hair shaft diameter in microns and what your native density (FU per cm2) is in areas that you have not lost . . and finally what the implanted density was?

This thread just needs to be summarised on ‘it depends on the individual, and can only be determined on a case by case basis’ (like what I said last week you bored apes) and closed. I’m all for debate, but the sooner people start realising there’s no one size fits all for most components of hair loss and hair restoration, the better for their own research and subsequent journeys.

That’s really interesting, I’ve never came across such data in the hair loss industry before - I’d be interested to hear from some of the surgeons on here as to what their thoughts are on this.

Yep - and Matt is equally biased to his approach as he did combo FUT and FUE. It’s natural to experience a bit of tribalism in these types of debates, because subconsciously people are still looking for reassurance they made the correct decision. You both make valid points and arguments, which is demonstrates my point throughout all of this - it’s case by case.

Refreshingly honest for once within this industry - thank you for your input.

Yes, I understand. It’s referred to as homogeneous depletion, a method that Lorenzo and Erdogan first identified as to why FUE is potentially superior to FUT in terms of achieving higher graft numbers. It makes sense. I still believe there is no straight answer to this, and it will always come down to a case by case assessment.

Nothing needed on your crown whatsoever - I would be inclined to say your crown has probably always been like that, you seem to have quite fine hair.

I think you make for a good candidate - you’re a good age, you’re on medication, and don’t have a huge amount of loss - however it is undeniable a good restoration would improve your aesthetic. That would be a walk in the park for any reputable surgeon with a catalogue of hairline results - I would echo sentiments to look into Belgian and Spanish surgeons , however I am confident Reddy would do a very good job on this as well.

Just to be a devil back, executing FUT has no effect on available BHT. So what’s to stop you doing FUT, then FUE, then BHT? Take BHT out of the equation, and just focus on scalp grafts, I think the question OP originally wanted is what would be the best strategy to utilise in order to achieve the maximum number of grafts *from the scalp*.

Perhaps so, but I find it interesting that the Shapiro study didn’t seem to find this to be the case. I think Dr Reddy said something similar to your theory. Anyway, I had FUE, and I will at this moment in time probably only get FUE going forwards, Yet I know FUT is still a very valid procedure for the right candidates, and it is in my opinion wrong to totally dismiss it as an option in 2022. When did bad surgeries get mentioned in this thread? As far as I was aware, the thread was discussing the best strategy to maximise a virgin scalps lifetime grafts. That video has no relevance

With respect, that video has nothing to do with this thread. Dr Hasson is addressing the improvement in FUE graft survival rates and his ability to implant at higher densities - plus the change in market demand. This thread is about how to maximise lifetime grafts from a patients donor, in which there is no mention of this whatsoever.

Hi Dr, Would you be able to further elaborate as to why, for each of these two points ? Very interested to head your take on this, Thanks

Nice results so far OP

I’ve noticed you always spell his name differently, is this for any reason? I remember this was the case for Dr Bisanga a few years ago on HLT when I believe he pulled out from sponsoring the forum, patient threads used to be like ‘Dr B*s*nga* etc.

Agreed. Your curly/wavy hair, accentuates this even further, due to the way the hairs are naturally inclined to pull away from each other. Whilst not impossible, it is extremely unlikely to see people at the age of 14 with an onset of male pattern baldness, so I think it is pretty safe to say in this situation, you are good 😉