H.K

Hi , I'm leaning to choose Eugenix for my HT , was wondering which is best package to choose in all packages below leading surgeon will do planning & design , 100% slits , crucial hairline implantation Premium package cost 210 Rs/graft , Dr Arika will do crucial extraction Super Premium "Dr. Arika" cost 350 rs/graft Dr Arika will do All extraction . Super Premium "Dr sethi" cost 350 rs/graft , dr sethi is Not involved in the extraction phase . Thanks,

well i don't mean in anyway that any product will cause miniaturization , that's mainly genetic . many of my friends who uses gel even if they don't have MPB , have lower density over time "possible due traction like you said" my only suspect is that blocking hair pores at scalp surface via any product may affect follicle health .. i have to mention a theory though although i'm not sure its true , DHT is cause by gene expression mainly yes , but some think that increased inflammation because of any reason in scalp can increase hormone signaling . https://www.sciencedirect.com/science/article/pii/S0306987717310411 anyway , i believe that no one faced such issue with hair fibers , maybe it's just a coincidence as my hair loss is slowly progressing anyway .. Thanks all for your thought ..

well your hair look great at the moment , you just have to maintain it .. i use hair mousse when necessary as it's the lightest product or sea salt spray , and when my hair is really dry after a shower or so i use very small amount of weightless oil like OGX kuku oil , others . i had to use fibers though on occasion as i have pretty obviuos bald spots but i guess i will stop using it if my 1st HT gives an acceptable density .

yes product won't increase DHT ofcourse .. Gel and hair products can make hair heavier so it can fall out easier , but i didn't expect hair fibers to cause any issues as it's really light , and with current hair fibers i use i don't feel any itching or somethin. like the previous one .. i know hair strand itself is dead cells and it get its nutrient from blood vessels in scalp , but i believe hair follicles can be affected if some product like hair fibers prevent hair pores from breathing .. I don't like keeping hair fibers for too long , but also don't want to wash my hair so often .. in all cases i uses fibers on occasions only .

i know it shouldn't cause hair loss , and that's seem to be the case with everybody .. but each time i use it i end up having bald spots . so do you wash it in the same day of the application ?

HI , did anyone face increased hair loss while using hair fibers ?

Many Thanks for the great article . I suggest to have that article pinned and have any addition or modification revised by moderators , and add more of the recommended doctors to the list .. that will make a great reference for all users on the forum .

that's disappointing to hear 😂 , but you are correct i have to assume MPB may progress further although i believe that region 4,5 look solid , i'm more afraid about region 1 to 3 + 5v .. i'm 36 now as mentioned earlier . hopefully breezula will be out soon with good efficacy , better safety profile . I really can't blame anyone who use or avoid using finasteride because both sides have valid points . but i like to focus more on this thread on the best options i have available for the surgery while eliminating finasteride from medication plan while accounting for the diffused thinning/low density in frontal area that i'm blessed with 🤪

thanks alot for the advise regarding adenosine , yes it's not regulated by FDA , although there's some published research about it , although it's a small group , but i assume they won't do it if it have high risk factor , i will consult a dr before administering it of course . https://pubmed.ncbi.nlm.nih.gov/24183218/ being one of the 2%-4% mentioned in the researches is scary for me specially when some of that percentage don't recover , or recover in very long period , also i saw multiple cases for people who tried finasteride without having bias against it and stop after a while ..

@Melvin- Moderator thanks melvin , any comments on the other points in my last post ?

@Melvin- Moderator That's a pretty sad news 😐 .. keser is one of my top choices as he have the ability to give great result , nice hl with fewer graft no. which is ideal for a conservative 1st procedure . In youtube link below , dr sethi show importance of using magnification in diffuse thinning https://youtu.be/w385SyvaJlQ I'm not sure if dr keser use microscopes or not , are you sure about this info. ? ... also it's not clear from link below if he use microscopes or not . https://hairsite.com/ankara-turkey/dr-keser-fue-hair-transplant/ regarding dr bicer , my only concern that if doing procedure on one day , that may cause more trauma and using more Anesthesia for longer period can lower blood flow and increase risk of shock loss , i was considering proceeding with manual extraction instead of micromotor with her even if that cost me double the cost of the procedure , the thing is she don't recommend one method over the other . what is your thoughts about rest of short list , how do you compare them to bicer/keser for my particular case ..

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@Melvin- Moderator no didn't check sethi , i will do a consultation and share feedback .. but not sure if it's even allowed to travel to India with covid situation there . I agree i want to avoid working between natives as possible , but not sure how surgeon can correct my situation without doing so . So what re your thought about choosing between the surgeons i mentioned . i just need to add that i sent a pic with hair line i want only to dr keser when he asked to .. so i believe most of other surgeon gave high graft count as they assume i need to lower hair line by 2 cm or so "as per my estimation for pics they sent for the proposed hair line" .. i had video call with dr bicer , graft count provided based on lowering hairline by around 1.5 cm ...

@Melvin- Moderatorno , i'm not .. i'm not intending to risk the side effects .. i'm using stemoxydine which seem to stabilize shed , but on product web page it's advised to use it for 3 months .. when i stop using it , shed begin slowly to increase , will try using adenosine and share my feedback . on the other hand , i was thinking to lower hairline a little bit "0.5-1 cm" "just to avoid working much between native hairs" , but that can impose risk of consuming more follicles , also as you can see from pics , hair line recession as well as density in front area is not symmetrical .. not sure how surgeon can handle this 😏 , will he need to graft follicles asymmetrically as well ..

@Melvin- Moderator Hi Melvin , i'm 36 , hair thinning started in mid-twenties "with no noticeable shed/no bald spots , no recession , just thinner hair" possibly hair loss started and progressed slowly at that stage . hair shed and recession started at 31/32 , now shedding is noticeably less , but didn't stop completely , possibly may proceed within following years ,, hopefully breezula will be out soon with good efficacy/safety profile 😆 that's why i want to have a moderately conservative HT as hair is impossible to style now , not sure yet what my donor capacity can provide . Lastly , i prefer a surgeon who can work within native hair "as/if required" without causing un-reversible shock loss .

I Made another thread earlier and i got great help from members to nominate some of the good surgeons for FUE HT .. i made consultation with these doctors and reviewed their work , but i find it really hard to make the final choice 😭 , my goal of the procedure is basically to restore original hairline not lower than that , and increase density in front/mid areas .. i attached an old pic just to show my original hairline , as per my calc. , hairline need 0.5 to 1 cm to be restored , area with low density in front/mid area is 6-7 cm . I have some diffused thinning/shedding in front area , don't intend to use finasteride . Below is my thoughts and consultation results , appreciate if you can share and elaborate your thoughts , as i understand that all of these surgeons are top surgeons - Erdogan : Advised 3500 grafts .. he do very good and dense hairlines but in my opinion he work with large number of grafts which can be explained by density of hairlines he creates i intend to choose package where dr himself do surgery .. on downside , i saw some complains lately on this forum regarding some inconsistent results from asmed lately , also i'm afraid that not using finasteride to be used as an excuse in case that HT didn't go well . - Kesser : Advised 2000-2400 , then after reviewing pics in sunlight and drawing hairline i want on a pic , estimation was modified to 1500-2000 "with higher probability towards 1500 range " , operation to be done in 3-4 days , manual extraction , i believe taking enough time to implant grafts carefully between native hair , using less Anesthesia and implanting few grafts per day can lower possibility for permeant shock loss .. also dr kesser do very good hairline , he do much with few grafts which is good for a conservative 1st hair transplant as i don't know how hair loss will progress . - Bicer : Advised 2600-2800 grafts "can be changed upon live consultation and hairline design" , she's a very genuine person with great care and dedications towards patients and do very good work .. if working with micromotor operation will be done in one day , if manual , price will be double , and operation to be done on two days , not sure which option i will proceed with due to Controversy of manual vs micromotor .. - HLC : advised 2000-2400 grafts .. communication is a bit of issue , but this can be tolerated , hairline design and density are good , operation is done on 2 days with manual extraction . - Pekiner : recommended 3000 grafts "2600 grafts + 400 for crown" .. i believe he use large number of grafts , but create dense hairline with nice design in return . Thanks in advance ..

well , i believe based on my situation , grafts must be placed in between native hair . you refer to the pictures , you can see my original hairline/look "when i was 18" and the current situation .. hair line recession is not symmetrical and there's low density and bald spots on 1st half of the frontal area .. My surgery plan is to restore hair line "without lowering it" and increase density on frontal area , as advised by multiple assessments i made and avoid working on crown for now . As mentioned , my concern is about permeant shock loss ,i'm not concerned about temporary shock loss , some people advised that weak follicles will be lost down the road anyway if i'm not using finasteride, but procedure will fasten the process , that make me worried about having non-homogenous look after surgery if native hair was lost as my hair loss pattern is not symmetrical . I can't take minoxidil regularly because of my low blood pressure , i'm not using or intend to use finasteride to be honest , so i'm really stuck in the middle 😭 . i've tried stemoxydine although it causes some side effects , but i think that hair start to slowly shed after i stop using it , and i can't find a source that mention how long i should stop using it after the advised 3 months cycle .. Until now my action plan is to work with a surgeon who does the surgery on multiple days , in order to take his time to place grafts carefully instead of having one mega session , also i heard that having anesthesia in small area at a time can shorten the period where blood supply to the native follicles is affected .. i expect that will lower the trauma . I'm using micro-needling , and infrared lamp regularly and having moderate results . lastly , i started to consider to get CB0301 "Breezula" from an online source because i can't find other safe/effective solution 😔 , possible by the time i can get it i may have about 1 month before the initial surgery date I'm considering (surgery Not scheduled yet) and probably i will continue using it when it's safe to resume topical products after the procedure . Really Sorry for the long post ☺️ , i tried to elaborate the whole scenario as i can , awaiting your inputs .

I have a small additional question , from pics attached , Is my hair loss considered a diffused hair loss .?

@gillenator i actually have low blood pressure , not high .. stemoxydine was causing me dizziness that's why i distributed the dose through the day .. minoxidil as i understand lower blood pressure . I found that link https://www.belgraviacentre.com/blog/can-i-use-minoxidil-if-i-have-low-blood-pressure/ it mention that low blood pressure users can use minoxidil with cut-off point of 90/60 ... so i know it's going to cause dizziness in my case as i'm usually 100/70

Thanks all for your answers . so does Nanoxidil or minoxidil help with that ? the only issue is that my blood pressure is normally around 100/70 , that's why i'm hesitant to use it .

Hi , I have low blood pressure normally .. it's basically around 100/70 , rarely it become lower .. Is it safe to use Minoxidil .. ? also when you stop using it , do you lose the benefits you gained with it only , or lose more hair compared to your status when you start using it ?

Hi All , I just want to know the proper way to use stemoxydine . - As i know it should be used for 3 months then off , but how long shall i stop to use it before starting back again ? - I had some side effects like teeth pain , pain around ear canal .. so i had to lower and distribute the dosage "I take 1.5 pipette twice daily" , anyone had similar side effects ? - i didn't notice extreme shed after stop using it , but i feel that hair loss rate started to bounce back to the rate it was at before using stemoxydine .. can other people share their experience as well ?

Thanks for your input , what i meant with multiple sessions is that some surgeon do the surgery on 2 or 3 consecutive days .. i was under the impression that miniaturized hairs have more change of permeant damage , either way it's clear to me now that either way those follicles is going to be lost in near future "unless finasteride is used" , I believe that Minoxidil is useless in this case as well . I guess also , it's useless to wait further as it's hard to predict when hair loss will stabilize , so probably i will proceed with a conservative/Medium operation 2000-2600 grafts and follow it with a smaller procedure later if necessary .. is it feasible to give a rough estimate of my donor capacity "grafts that be extracted not just the overall capacity"

I mean isn't shock loss more possible when hair is transplanted in area where there's still existing weak/miniaturized follicles ? Anyway of minimizing risk of permanent shock loss "not including using finasteride" , does having multiple smaller sessions which some surgeons do increase or decrease shock loss possibility ?

The Estimations for consultations i did is at the beginning of the thread .. i believe that long/curly hair kinda mask the full real situation , that's why they go to a higher grafts estimations , 2 surgeons including Dr keser "advised not to work on crown for now" . currently i can't use any product even a light one like sea salt spray as it will show the bald spots and i can't style my hair hair because low density makes it more curly . so i really stuck between having the HT now and risk permanent shock loss of weak follicles , or live with current situation "maybe until breezula is out" or until hair loss is stabilized .