taimishu

31 minutes ago, Melvin-Moderator said:

The number of grafts is irrelevant, the thickness of your hair is more important. If you have thick hair, you would look better with 30 hairs per cm2 than someone with really fine hair that gets 60 per cm2. 

I agree. My hair has thick diameter, but i'd ideally want a dense hairline so thick diameter + 50cm2 would be the best of both worlds. Do you know of any cases that specify the density in their hair and show results? It hasn't been easy to find

1 hour ago, Melvin-Moderator said:

I suggest submitting as many consultations as possible, it’s best to get a general consensus and speak with many surgeons. Take a look at our recommendation list, remember it’s just a starting point for research.

https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN-MOB

Melvin, would you say 30-40 grafts/cm2 in the hairline region is enough? I haven't seen many people post about their density in results other than ~50cm2 which have had greatly packed hairlines, which is what i'd want. 

34 minutes ago, HairNTear said:

Hey when you say Shapiro doesn’t fit your style, what do you mean by that?

 

 

Hey, i mean that I think his approach would be a bit too conservative for my liking. I haven't seen dense hairline results from him (albeit amazing results in other types of cases), but not exactly what i'm looking for. 

Hi everyone, thanks again for all your help in this forum.

I am wondering if anyone has suggestions on a HT surgeon in the US that has proven dense hairline results that's reasonably priced. My dream doc is Konior but that's out of the question. Shapiro was my next but his style doesn't fit my goals.

Anyone have any suggestions? Ive consulted Vories, Panine, Konior, Shapiro, and Rahal. Rahal would be my go-to but the border is closed. 

So if you look at my post history you will see that I have been obsessing over the usage of minoxidil and its impact. 

My question is: has anyone successfully quit minoxidil prior to a hair transplant and been happy with the results after the transplant? 

I have quite a bit of hair where I've applied minoxidil (hairline and midscalp only). I'm scared that quitting min 7 days before and 2 weeks after will shed those (+ shock loss damage as well) anyways, so why not quit now, and get grafts where they would have fallen?

So if you look at my post history you will see that I have been obsessing over the usage of minoxidil and its impact. 

My question is: has anyone successfully quit minoxidil prior to a hair transplant and been happy with the results after the transplant? 

I have quite a bit of hair where I've applied minoxidil (hairline and midscalp only). I'm scared that quitting min 7 days before and 2 weeks after will shed those (+ shock loss damage as well) anyways, so why not quit now, and get grafts where they would have fallen?

36 minutes ago, DrTBarghouthi said:

Shaving the area during the HT will show the existing hairs and these can easily be avoided. However, you existing native hair is not giving any noticeable density so you will still likely need an excellent density. While the pics are quite close but I am leaning towards you needing around 2200-2500 grafts of a 50/cm is needed. 

Thanks for your reply. Without considering my donor supply and finances, do you think I will get better results without these native hairs? I am worried if these will miniaturize even further (or die from shock loss), I will have a less dense hair transplant compared to if I received a HT if the area was slick bald. 

As the title says, I want to achieve a density of 50cm2 in the thinning areas. I have scheduled surgery in May when I will be about 7 months into finasteride use.

My question is, how will the surgeon transplant into the problem area when there is a good amount of hair (albeit miniaturized)? I plan to halve my dose of minoxidil in the next 4 weeks so some may fall, but I still have a good amount of native hair. Do you think the surgeon will be able to place grafts to achieve great density?

Also - how many grafts would you guys expect to restore the hairline and lower it about 1-1.5cm along with the side temples filled in a bit?

Thank you,

3 hours ago, DenverBuff1989 said:

@taimishu I've thought a bunch about stopping Rogaine numerous times for reasons similar to what you've described. My crown loss is significant but all in all not terrible. There aren't many bald spots in the crown, its more thinning. Since its thinning, many doctors have refused to operate on my crown for fear of damaging these thinning hair. Ironically, if my crown loss was worse and was more bald, many doctors would be more willing to work on it. I've thought about quitting putting Rogaine there so thee thinning hairs would fall off. 

I honestly don't have an answer. No doctor or anyone following any best practice would ever tell a hairloss sufferer to stop taking Rogaine, even tho in certain situations it does make sense. But be careful what you wish for. You can "hope" for a more bald area for a surgeon to work on, but then you can get a poor job and have non dense coverage, and these new grafts might look worse than your native thinning hair in the area. 

Thank you for your reply. 

I agree, the fact that new grafts will never be native density does scare me. I am really hoping i won't get a poor job though since I'll likely be considering top surgeons.. but you never know. 

I am leaning towards slowly titrating down to once nightly dosing of minoxidil. twice daily is incredibly time consuming and not really sure how much it does for me. 

24 minutes ago, Enhancer said:

I see the rationale.

-He may just eventually stop committing to the minoxidil after the surgery seeing as he's already tired of it

-Hairs grown by minoxidil holding on by a thread might just be permanently shocked out by surgery

-The gains by Minoxidil just might stop working, common as minoxidil is considered a very short term solution for a lot of people who finds it wears off in a year or two

In those cases, may as well rip the minoxidil bandaid off now and let the surgeon take care of it properly.

However this only applies if surgery was going to happen regardless. I would only do surgery if I was generally unhappy about the way I look, I wouldn't do it just because I don't want to apply minoxidil anymore.

Thanks for clarifying for me, I'm not sure why I receive two-worded comments from none other than the moderator on this forum. I think it would be better if he just didn't reply at all.

Yes, that's my thought process. I am unsure how bad the shed will be. Do you think 3 months is enough time for my shedding to stabilize before surgery? and yes, of course I am planning to have surgery in about 11 months. 

2 hours ago, Dr. Suhail Khokhar said:

I would recommend against quitting minoxidil

Is there any further explanation of why you recommend this?

If I have applied minoxidil only to the areas that I will receive grafts in (which is true), what would be the point of continuing (other than maybe having more density in those specific areas since I will have the minox-dependent native hairs.

It almost seems wiser to me to quit minoxidil, see its shedding effects, and get grafts placed in those locations. Conversely, if I were to continue minoxidil and perhaps quit AFTER the HT, them I will have holes where grafts COULD have been placed.

1 hour ago, Melvin-Moderator said:

That rationale still doesn’t hold. In that case, why not wait until you’re fully bald so all your hair is transplanted?

Melvin, I think you are taking my thought process to the extreme and using it against me. I'm not really sure how else to explain myself to you without receiving rhetorical remarks and not constructive or thoughtful feedback. Did you really want me to answer your question, or did you know that I am a NW2 who just started finasteride 1mo ago? 

7 minutes ago, ciaus said:

The question is whether the convenience of not using min is worth the additional grafts to maintain acceptable hair coverage -additional grafts you may not ultimately have in the long term war against your hairloss. Some guys ultimately loose so much hair that they run out of donor hair to transplant into the thinning areas. So in the words of dirty harry, "Do you feel lucky..

 

Some factors in this  -like how old you are, how long you've been losing, how well you've responded to the meds -did you start fin and min at the same time? or did you start fin first then later min, or the other way around, so that you have some idea how well you respond to each.

They work best together of course, fin protecting the hair from dht and min extending the growth cycles so you have more hair growing at the same time and helping to thicken them up.

 

 

 

 

Exactly. The areas that I am most concerned about are my hairline, the only place I apply minox to. So i'm torn..In an ideal world, I would rather just place grafts and let fin do its thing..I don't mind taking a pill daily.

I'm 28, and started with minoxidil first. I've only been on finasteride for about 5 weeks now so excited to see what it will do for me.

It's damn near impossible to see how well minoxidil is doing for me. I really want to stop stressing about my hair and adding minoxidil twice daily definitely does that to me. I would like density, though.

8 minutes ago, Melvin-Moderator said:

Why would you want to quit minoxidil to go balder? I don’t understand the rationale.

did you see my attempt at the rationale above? 

I understand it may be a confusing one, but I want to quit minox so that the dependent hairs may fall out and I can place grafts where they are instead. I am trying to gain knowledge and opinions on the matter to hear what may happen with my density though. I may just go down to nightly minoxidil instead.

Hi everyone,

i've decided that a HT is for me. I am a NW2 mostly at the front hairline with some mild diffuse thinning.

Currently titrating up on fin 1mg MWFS to daily.

I was originally planning to quit minoxidil 3 months before transplant, to let the minox hairs fall out so that the surgeon can place more grafts where is needed. 

Has anyone else been in this dilemma? I haven't heard of this topic too much and wanted some opinions. I despise putting on minoxidil and the way it makes my hairline wispy. However, I am uncertain how much hairfall I will have and dictate my final density from the HT.

TIA

4 hours ago, TorontoMan said:

What did your physician say about your hormones and what may have caused it? Do you carry a lot of body fat? Were your estrogen levels high? My understanding is that gyno is often not permanent, but i don't have much experience so I shouldn't speak on it for your situation. 

If you haven't done so, I believe you should go check your hormone profile, test for test, dht, estrogen and SHBG. At that point consult with a doctor

I may give 0.5mg MWF finasteride a go. Do you think I need to go and get my blood checked before, or when it has hit steady state? 

I will get a hair transplant regardless by next September..even if it buys me 5-10 years of happiness I consider it worth.

2 hours ago, TorontoMan said:

@taimishu Although stress of course is detrimental to your body for many reasons and in many ways, there isn't a lot of research with the connection to stress and direct hair loss. Your whole life's purpose I believe should be setting yourself up to live in a way that mitigates your stress, and it will surely always be there. Consider that many people endure an array of different things that cause stress in their lives. My uncle as an example, 65 who is a diabetic, smoker, had problems with alcohol, served in a war in his 30s, had separation with his family and has never had much money in his life... has a full head of hair. Your genetics are very strong, and it is the high likelihood that you have some genes that dictate some receptors in your hair will be prone to androgens such as DHT and Testosterone. Some of the things I've come to understand is that stress could literally age you, chronic stress could shorten your DNA, and part of that could be whats pro-longing your genetic variation for hair loss. Hair loss is just an unfortunate thing that happens to some 85% of men in their lives. Some of the top athletes in the world who have everything going for them, presumably with little stress, endure hair loss as well. kobe bryant, mj and lebron all went/will go bald, wayne rooney among many other soccer players and so on. Anyway the point in my rambling is that stress is a negative contributor to your health and you should do your best to relieve yourself of it all the time, however I hope you dont naively believe that your hair will just stop progressing just entirely. That is why its often advised to see how you progress before getting a hair transplant, as it will only be a temporary solution, and honestly not even a great one at that. Few people seem to get exceptional results. 

I've also read things that masturbation is linked to hair loss, and I remember resenting myself for masturbating as much as I did as a young teen.. and then I realized that I have friends now in their 30s who are still cranking them out and have a good head of hair. Generally we are an over stimulated generation and being off porn is probably the best thing. anyway I would speak to as many physicians, although few seem to be well educated on hair loss medication, hair transplant doctors and continue to research. I don't know how hold you are, but you could try reducing the dosage and frequency you take finasteride. And like mentioned above, minoxidil is a pain in the ass and is just a growth stimulant and won't stop the progression of loss over a longer period of time, but it only needs to be applied once a day and you could apply it a night before you go to sleep and wake up in the morning and take a shower. 

Thank you for your words. I agree there isn’t a strong link. 
 

What would you have me do at this point? My side effect from fin i’m afraid of is gyno. I have already had gynecomastia surgery (not steroid related) and i do not want that to go away. After so much research it doesn’t seem like it would go away even after another gyno surgery, and it is indeed a permanent side effect that does not go away after stopping fin. 

2 minutes ago, Melvin-Moderator said:

You can use minoxidil at night, than wash your hair in the morning and the problem would be solved. You need to stabilize your hair loss, otherwise getting a hair transplant is pointless. That is of course, unless you’re a Norwood 6 with no hair left.

Agreed. But what if I have virtually no hair loss outside of my minoxidil areas? That is the case with me. it is localized treatment and I'm fine everywhere else.

2 hours ago, Melvin-Moderator said:

Are you taking finasteride? Getting a hair transplant without preventing further hair loss isn’t smart. You may end up with net gain if you don’t stabilize your loss.

I tried finasteride but had side effects. 

So is it a consensus on these forums that hair transplant without finasteride is bad? I'm confused as to why someone that reacts adversely to finasteride has opted for hair transplant then. I dislike how minoxidil makes my hair wispy and crackily and am looking for a permanent solution without the use of prescription drugs. If I could use finasteride properly I wouldn't consider a hair transplant.

So I have a reason to believe my hair loss over the past 4-5 years was chronic stress related as hair loss is not really existent in my family line.

I want to schedule a transplant in September 2021, and I have been using minoxidil twice daily for 4 years now. 

I want to quit minoxidil for good before the transplant, and forever afterwards. I want to quit early enough so that when I go on my surgery date, my hair is at its' natural state and minoxidil has no effect on where they will place grafts.

If anyone has experienced this or if any surgeon can give me an estimate on how long before I should quit minoxidil, that would be extremely helpful.

I was thinking 1 month.