Curious25

A vast improvement from where you were before last year. Good honest documentation with the lighting and comb throughs - I think your hair wet is particularly impressive. For HT #5 , should you go down that road, which I think you probably will do at some point - if 1000 scalp grafts are obtainable, I would personally look at adding around 400 of these into the hairline, to reinforce the frontal line with some buffering behind. 600 multi’s from the scalp and a few hundred more BHT into the crown, would leave this more than up to standard. Hopefully the Xyon products will work out for you, and you can largely leave your hair loss worries behind in the past. Good job all around,

Your inconsistent use of minoxidil is likely negatively impacting your ability to improve - if it’s not used consistently, then your hair cycles will be all over the place, and probably going in and out of shedding phases continuously. You have a lot of miniaturised hair, so from your personal hair loss standpoint, to give yourself the best chance of improving from where you are just now, you would be much better poised with consistent use of proven medication.

You’d be a good candidate in my eyes if you commit to a) continue with medication, b) learning more about hair loss and hair restoration. Your hair line design with the black line is EXTREMELY aggressive, and would possibly require up to 3500 grafts to achieve the density that would be required in order to make it look somewhat natural. The hairline design drew with the green line is closer to what would be a much more suitable, yet still enhancing intervention.

I’m shocked your friends have made comment to be honest - I wouldn’t be surprised if you went for a trichoscopic examination and they found no miniaturisation in your crown at all, it could very well be just the way your hair naturally parts. Your scalp looks inflamed, which might be worth checking out - potentially something as easy as Nizoral 2% twice weekly could sort that out, but a hair specialist would be in a much better position to advise you with that. Do you have any signs of hair loss at the front, or any hereditary hair loss in males in your family? If not, you may not even need to start on medication at this stage. Try book in for a trichoscopic exam with a reputable hair surgeon, it will answer all your questions and put your mind at rest.

Hi L0ke, Do you have any recent examples of temple point restoration by Dr Feriduni you are able to share? Agree with OP - your clinics website details temple restoration extremely well.

From scanning the Spanish forums , I have seen a higher volume of pinto cases - however Ferraira holds his own for the majority of the time also. Worth consulting with them both and going with your gut feel.

If you are based in Europe, I would recommend consulting with; Portugal Dr Ferraria Dr Pinto Spain Dr Couto Dr De Freitas Belgium Dr Feriduni Dr Mwamba Dr Bisanga Switzerland Hattingen Hair Clinic However - the general rule to follow is that there is no one best Dr for all, rather it be a particular Dr for a particular case, so without knowing what your situation is, the above is all very speculative. Post a few pics of KSL hairlines that you have seen, and that you have liked, and see what the feedback is like from the community on here. There are some very well versed and educated users on here, who have been around for years , some decades - I would trust the general consensus from experienced posters on here rather than a one off patient of a clinic on a Facebook group.

Find me a post of mine that has ever recommended someone here to start medication without consulting with a Dr beforehand. I never recommended someone to start on medication. I recommend people to learn about hair loss, learn about the available medications and then consult with a Dr. Always. Ironically - if you go far back enough, you’ll see the majority of my posts have actually been discouraging people to carelessly hop on medication without understanding the potential consequences, and I have disputed with many people on here countless numbers of times for advising them to do so, without any concern. Commercials for Dr’s? I have no filter - if I see a good result I praise it, if I see a bad result I discredit it, regardless of who the Dr is. I have been warned many times over by the forums moderation for my blunt approach style of posting, but it helps people navigate between the politics of the good and the bad. You’re wrong on everything, once again. Mike, 42 and PRP has supposedly kept you at a NW2. Your time is wasted on a hair loss forum, seriously.

You made uninformed presumptions attacking the clinic for failing to educate the patient on his hair loss from what I can remember. Congrats on your hairloss pattern, and you are right - everyone has a different nature of hair loss, however the overwhelming majority of men who start to recede at the age of 22 continue to recede well beyond that of a NW2 by the time they reach their 40’s, so most ‘intelligent’ people who understand hair loss would indeed recommended people to consider medication at this age, should their hair loss be of concern. You’re just a bored a man who seeks confrontation on here. One minute you’re slating clinics for performing surgery on patients who aren’t on medication and the next you are making off the cuff remarks about taking medication being of more detriment than it is of benefit. And for what it’s worth - I would bet my next pay cheque that your beloved PRP injections have done sweet FA for halting your hair loss progression, and if it truly has stopped or majorly slowed down, that is purely genetic. 42 and a stable NW2 - Go and find a hobby and stop handing out bad advice on here.

Yes I’m a Tik Tok influencer for my favourite hair surgeons. Funny what a difference the best part of 2 years can make - I wouldn’t recommended Dr A at all now if anyone was to ask, but at the time he was a relatively new name and I had seen a few decent enough results online, i didn’t outright recommend him though. And I maintain my comments with regards to KSL, their work continues to be awful, and they continue to rely on giving Z listers and YouTubers the same terrible hairline for their marketing strategy. Got to dash, I’ve got a new dance to work on for my channel.

Ahh, the return of the networks favourite troll. He’s probably not staving off those dreaded androgens with your trusty PRP injections Michael, hence the mediocre result right? Best get back to slagging off Bisanga and his oral minoxidil prescriptions, there’s a good boy.

Well he’s an egotistical idiot if so. Given the era this transplant was likely performed, it is nothing short of exceptional in my mind.

This 100%. Even just the idea that you’re taking a medication with heavily backed research proving its benefit in addressing hair loss, is enough to greatly reduce anxiety, because it’s giving you control over an otherwise uncontrollable situation.

That would be speculation under a different umbrella of thought - I was under the impression you were (they were) referring to 50% of a hair follicles diameter. The stem cells of a hair follicle are a different subject - and I believe it would probably hold more merit in terms of measuring the potential of regrowth based upon their state of play. Until there are actual studies and research conducted on the relationship between androgen suppression and how it correlates with stem cell counts/remaining follicle diameters etc, in achieving hair regrowth - it’s all just guesswork. Would be interesting though. If you find any studies along those lines, you should put them up and make a thread. I’m curious to know whether there’s a rough estimation on how many years post a hair follicle no longer being produced because of miniaturisation, can starting 5AR blockers help to restore that. Again it’s going to be an individual answer person to person, but I assume there would be a fairly accurate median number that could be used to go off.

There’s no one size fits all answer, and the reason for that, is because every single follicle has its own individual sensitivity profile to exposure from androgens. The general rule of thumb, however, is the lesser the extent of the miniaturisation, the higher the likelihood of reversal, which for some follicles could mean they will eventually get back to their original glory, for other follicles it might mean they continue to miniaturise at a dramatically reduced rate. For a Dr to make speculative claims that 50% of the original hair shaft diameter is the make it or break it line is just stupid. There are hundreds of before and after case study’s available online from patients experiencing regrowth in areas that are previously bald before androgen suppression - as there are equally some cases (albeit low) of patients with hair, who continue to miniature despite some form of androgen suppression. Take home message - The earlier you start, the higher the likelihood of your chances of success.

You said 3 months in your initial post.

Likely to be a finasteride induced shed, which commonly occurs upon onset of the medication. Minoxidil since aged 13. Why?

Was it dutasteride mesotherapy, or just vitamin mesotherapy? Personally, I believe 1mg daily finasteride is a strong enough preventative regime for the vast majority of men with AA, and would recommend 6-12 months of consistent compliance with this before looking to add 5mg daily oral minoxidil or dutasteride. If you are specifically looking to gain regrowth, then adding 5mg daily oral or 5% topical minoxidil would then become an option to look into. Some patients don’t want to take any chances, and go for the more ‘nuclear’ options from the get go, and in that case the strongest research backed options would be 0.5mg daily dutasteride and either 5% topical minoxidil or 5mg oral minoxidil.

I would advise against a hair transplant.

More terrible advice - you should be banned from commenting on here because you’re wildly misinformed on most of the input you provide, and constantly very negative. Transplanting into OP‘S crown is a much more complex approach than restoring the slick bald temple points; A) because there is still a lot of miniaturised hair in the crown - posing a difficulty in design, graft allocation, ascertaining graft count,future planning, and shock loss. B) He is planning on consistently restarting topical minoxidil - which with continued use of 6+ months has huge potential in thickening the miniaturised hairs and filling in the lighter areas. I’m surprised at Dr Bicer‘s plan to go with 800 grafts here, given I have always perceived her to be more of a conservative surgeon. I would have thought a much more universal strategy would be to focus 2000 grafts on the hairline (600 either side isn’t likely to be enough IMO) and leave the crown for the time being, due to the difficulty it poses - and the fact that it’s important to give medication a good chance to hopefully nullify the need for transplantation. Surprised you’ve not recommended PRP Mike 🙄

If topical minoxidil is an issue for you, daily 5mg oral minoxidil may very well regrow that crown area. The oral version will hopefully ensure more consistency - I get the impression due to your wording of using minoxidil on and off, it possibly hasn’t been given the opportunity to work its wonders on you, given that regular and continued use is the key to success for all hair loss medication. But going off your crown pic anyway, I have seen A LOT of regrowth cases with OM use in patients from an almost identical starting point. Hairline will need to be transplanted for sure.

I think you’re making a good decision going ahead with a HT, given the concerns you have expressed. What is the plan for the 2000 grafts, Restore the hairline, and leave the crown alone?

Oxford online pharmacy. You will need to submit a written prescription from a UK doctor, which I would recommend trying to obtain via a hair surgeon as it is unlikely a GP will give you one from personal experience.

If your hair looks like that at 33 after being on DHT prohormones and running TRT - I’d hedge a bet that if you do have a donor capacity of 10,000 available grafts, you’ll likely be able to manage your hair loss with continual transplants as and when required. Just be emotionally and financially prepared for it.

It’s actually the complete opposite, temple recession is usually always asymmetrical, with the right hand side more commonly found to recess at a quicker rate. OP - pre op and post op pics are required for anyone to really understand what’s going on here. But what can be said, is that communication and mutual understanding between surgeon and patient are fundamental - if your wants weren’t feasible or appropriate for whatever reason, this should have been clearly communicated to you as to why, and then back to the drawing board together to come up with a plan B compromise that suits both. Bedside manner is a bit more of a tricky area to address, however if I felt a surgeon wasn’t as focused or attentive as I would expect, I think we can all agree it would be an underwhelming feeling. Hard to address though, because perception is subjective. At the end of the day goal of surgery is to achieve good growth within a natural design. I would rather achieve that with the rudest surgeon on the planet, than walk away after having the friendliest experience ever, only to look in the mirror 12 months later with zero hairs on my head. I’m not suggesting he was rude, I’m just trying to cast things into perspective. Cosmetic surgery patients can often times be a hard calibre of patient for Dr’s to work with, and I don’t doubt for one minute there are quite a few erratic HT patients out there in the world that would quite literally want the Dr to hold their hand the whole way through surgery, so I can sit on the fence and empathise with both parties in this sense. It sounds as though the main gripe you have is that you feel you weren’t heard or listened to - so in this case hopefully you can reach out and request feedback from the clinic as to why what happened, happened - and then perhaps they can also take on this feedback to make sure communication between patient and surgeon is fully established moving forward. Wishing you a great result !