UnbaldEagle

Wow, you started regrowing? 😮 Oh, man, that's so great to hear, I always had a hope in topical antiandrogens. Would be great if you could document your progress with some pics eventually.

If there was no blood you should be fine.

I didn't say Rooney was doomed, note how I used present tense in describing his hair situation. He is "doomed" now because he lost all his native hair and after 3 HTs has very limited amount of donor hair he's got a thinning crown and general thinning all over, maybe even DUPA, very poor hair quality imo, but either way was not a very good candidate for HTs because of these combined factors, PLUS the aggressive MPB. So yeah, if he went to some good clinics in the first place, he might be in a somewhat better situation, for sure, but you built an argument of something I never said. Also, as John corrected me, he went to HS Hair Clinic for the first procedure, but we don't know where he had his subsequent ones. As well as how many grafts were used and most importantly, what was the regrowth rate. This either means he went to really poor clinics every single time, or he was not a very good candidate for HT, I think guys with very aggressive MPB - without being on any treatment - rarely are, the donor tends to miniaturize so I believe Rooney's transplanted hair has thinned out as well. Here's Rooney at 19 and then at 22. See how in just a few years he lost almost all his hair, how far his sides have receded and tell me he was "just" a NW5 and not destined to go way beyond that. How on earth could he replenish all that with transplanted hair, that's why I suggested his only hope was a scalp + body hair transplant, or staying on meds and keeping his native hair. But tell me again I'm plain dumb for thinking that, I noticed that's how you communicate with people around here.

Danny, you're really grabbing the bull by the horns here, can't see why you won't improve significantly on such a treatment. If you can thicken up that midscalp region (and I genuinely believe you will), you'll be over the moon with your hair. Please keep this thread updated, I'd like to follow your progress. As for microneedling, start with once a week imo, see how quickly your scalp heals and then you could move on to 2x a week. Good luck, man.

Giulio, really sorry you have such an aggressive MPB. I agree with @BeHappy, you're technically already a NW7 because there's very little vellus hair left on the top, BUT the worst thing is that your sides have receded all the way to your ears. I'm not trying to be so negative, but you can't and shouldn't want to be a NW2, don't let any clinic fool you it could be achieved with scalp donor, because it's not just about restoring your hairline and midscalp region, but also your sides. I'm really not trying to discourage you, but you don't seem to be a candidate at all, some might say you could do an FUT or two for better yield but then if the worst happens and you'll still have to shave it all off what would you about the scars? I think the only thing you could try at this point is what @PizzaWolf suggested, forget about HT and try treatment first, but you probably need to throw in anything but the kitchen sink, I'd go for dutasteride + a topical fin with high dose minoxidil from minoxmax and microneedling. PRP too. Give it a year, if you improve it might be worth consulting with some top clinics on what your options are, with a bit of body hair thrown in you might get a very good result as opposed to what you have now.

I understand and feel you, buddy. Damn, losing so much hair in only 2 years while trying out so many treatments must be very, very disheartening. Wish I could help more. Like I said earlier, go for topical dutasteride, safer, less side effects, more efficacy!

Sure, here's my own thread: 1800 grafts FUE with Dr. Kyriakos Maras - HDC Truth is, I'd be a NW6-7 by now given the family history and how aggressive my MPB is, the hair that you see before my recent transplant is due to 11 years of treatment of nearly chemically castrating myself. Besides the "big 3", I've been on high dose spironolactone and various other HRT stuff, as well as trying pretty much everything else from growth stimulants to experimental drugs, etc. My own experience and what I've seen from countless reports on hair loss forums, the only way to regain hair treatment-wise IF you don't take action in the first 1-2 years of experiencing MPB is to pretty much nuke all DHT and testosterone from your system, which would then lead inevitably to some effeminizing side effects if you don't mind these. Good thing is I had a PRP for the non-transplant areas so if I have any improvement in those areas it will be due to PRP and nothing else. Will let you know either way. From what I gathered based on patient reports on various forums, it works better than minoxidil at turning vellus hair to terminal. You seem to have lots of miniaturized hair left so might just be a very good solution. I didn't know it's so expensive in the US. 😕 What I'd suggest in your case is topical dutasteride. Due to the size of the molecule it won't penetrate past the subcutaneous layer therefore it's not going systemic, just acting locally and without any side effects. As topical finasteride's efficacy (especially with dermarolling) seems to be matching the oral administration, I can only speculate topical dutasteride to be more effective than oral finasteride. Or Breezula as soon as it gets approved by the FDA, hopefully next year. If you do any topical antiandrogen, I highly suggest combining it with microneedling though.

Lol, you made my day.

I agree, and this could be a very good idea, one smaller (test) operation could show if it's worth pursuing further intervention.

The way I see it, it's not a losing battle. Either you start early with treatment and preserve your native hair, or you have enough donor to sustain a realistic NW3 long term. In Rooney's case, that should come from body hair, but he just doesn't seem to care anymore, I think he applies some topik for now and once he's retired and no longer appearing on telly so much he'll just shave it off and will be having a completely normal life as he's loaded and famous and has a family. I'd be more interested what are the options of John Doe with the same aggressive MPB but without the fame, money, etc.

That's not that bad, I feared it might be something like 1-2%. I think the reason why H&W and Dr. Paul Rose rejected you is due to the potential low outcome of the transplant due to excessive bleeding, not because the procedure itself wouldn't be doable. I would suggest contacting pretty much all reputable surgeons from the list Melvin provided and let them know of your condition. Then you'll get a better idea of what could be achieved.

Also, I don't wanna play the devil's advocate, but it seems like most of your hair is gone and it would be difficult to resurrect long dormant follicles unless you go down a near castrating anti-androgen route, and you won't do fin no more, so.. how about a hair transplant? 3000-4000 grafts and you could be a NW3 vertex or so, not the best density, but an absolute improvement from where you are now.

So you tried all those treatments and absolutely no improvement? Not even maintenance? How long you've been on finasteride? I had a PRP and waiting for its result, from what I've seen anecdotally it works, however the gains are not permanent, you have to repeat the sessions every year or so. It's pretty much like minox hair. I've been looking into exosomes and couldn't find any scientific evidence, but I think it's in the PRP category. Currently the only surgeon I know who advocates it is McGrath. He's a questionable surgeon here, but I think his work is decent and he's got great experience. I like his Ultra Density approach, where he'd transplant the outdated micro and mini grafts into areas that need density (not the hairline too as opposed to the days when it was all we had).

What's the severity of your factor IX deficiency, could you perhaps give a percentage if you were diagnosed?

I would classify this patient as a NW6 as that's a combover in the befores + some insignificant amount of fine, vellus hair, so this result with only 2500 grafts is just AMAZING, I'm lost for words, really. By all means for most people this would look like he has a "full head of hair" at his age. Absolutely amazing transformation and I don't think he had a great donor either, yet it still seems unchanged. 😮

I wonder if he even had a good result to begin with. It could have been topik augmenting things, as he always looked different in interviews. Just look at this photo only 6 months ago. On the pitch however, especially on a rainy day, he could not conceal how thin his hair was.

Your temple points are great, man, they seem to extend almost to the same level as your eyes. Nothing to worry about.

OP what amazes me most (apart from your phenomenal result - 100% natural, dense) is that after 8300 grafts you can still grow your hair long and it actually looks great in the back! I too had long hair and after 2 HTs (2nd one just a week ago) I was worried I might not be able to have a ponytail again. This gives me hope.

Not a tragedy for Rooney, he's rich and famous and most importantly has a family of 4 kids, plus he was always kinda ugly to begin with. 😁 For others who are not Rooney but went through the same, well, whole different story.

Beautiful work Dr. Barghouthi. 👏

Wish I could say the same. Almost no body hair, except for my minox beard.. Literally, 80% of that is from minox.

Yeah, well, that's what I said.. But he might just have enough body hair, guy is a true wolfman.

Oh... Okay, makes sense, thanks for clarifying, John. I thought the same. HS Hair Clinic is clearly not the best, Spex may advocate them along with all the other IAHRS members, but I have never even seen a single patient posted result here.

Anyway, if Rooney would be lurking these forums (lol), I'd advise him to go to Eugenix for 4-5K beard grafts, I mean he always had short hair so it wouldn't be an issue. His hair problems would be pretty much solved (well, until the sides start dropping too - but he might just have enough BHT for that too).

Rooney had his HTs done at the Harley Street Hair Clinic, where Spex also had one of his and is a patient advisor for the clinic now. I wouldn't call them a poor clinic, however they are not quite there as the only 2 elites in the UK imo - Dr. Ball and Dr. Reddy and they are unreasonably expensive - Rooney forked out £30,000 (!!!) there. I agree with the rest though.. He was chasing a NW6 and while he once took finasteride, he surely stopped after having kids (4 if I recall correctly) and that must have made things only worse. To be honest, he's pretty much doomed hair wise, unless he'd consider BHT in the future as he seems to be having a lot of that. On the other hand, to show you how most people have no idea what happens when you have a HT without being on meds or with aggressive MPB - I remember an article by The Sun years ago, something like "Rooney's hair is thinning again" and most comments were like "how is he still balding if he spent all that money on hair transplants".