Savemyhairline

Voted no. I recall at the very beginning I had VERY mild testicular pain but it was so minor that I didn’t even realize that could’ve been the finasteride until after the fact. I think it went away very quickly, I thought I just slept funny or something at the time. I wouldn’t even really count that as a side effect it was so minor. Sex drive is just as high as it was, nipples look the same, no brain fog, I think those are the usual suspects for people.

40 minutes ago, Gatsby said:

The thing is (and sorry to digress) you don't see threads titled 'Finasteride Gave Me No Side Effects.' The reason why is because people get on with there lives. I had side effects on finasteride and stopped. However that and minoxidil are still the two only FDA drugs we have for MPB.

For sure, I apologize if I accidentally implied you were fear mongering, I absolutely wasn’t meaning to! I just mentioned Melvin as I follow his YouTube channel. 

31 minutes ago, hockeyman said:

I think you're in a good position. You mentioned the fin has helped your crown. How about the front? Has it helped? 

Yeah for sure, it’s helped all over (well fin + min, not sure which more as I started around the same time). My hairline was already mostly gone though so I obviously wasn’t returning to NW0, though the density definitely improved. Are you saying I should get grafts in the crown? Or just a good position as just focus on the frontal third?

6 minutes ago, Gatsby said:

Some people get side effects from finasteride (mostly lowered libido). With some people it can go away in time. With others it persists. All the best!

While I don’t deny sides exist, I do feel confident that they are a very small minority. The mind is a very powerful thing and if someone believes they will get sides, they probably will. I respect people like @Melvin- Moderator who actually tried it and experienced the sides without prior knowledge of them being a possibility (if I recall correctly?) but still doesn’t fear monger. Anyhow I’m certainly no finasteride shill, literally have nothing to gain (other than hair), just sharing my experience! 

1 minute ago, Gatsby said:

There's no reason why the meds would cease to work. I put that in only as a caveat. You do have a great head of hair and people see the front of your face first. The crown is the last thing they see. All the best whichever way you go.

Thank you and I totally agree, that’s why the hairline has always bothered me 100x more than anywhere else. Facial framing is far and away the most important function of hair. Out of curiosity when you said “if you can take the meds you are already miles ahead of most of us”, does that imply most people on this forum don’t take hair loss meds? I was super afraid of finasteride for many years but finally made a judgement call. Probably one of the best decisions I’ve ever made. If anything I’m more sketched out by minoxidil but I’ll stay on the topical version once a day. To clarify I’ve never had side effects with either, just the potential ones for minoxidil (mainly oral) are way worse in my mind.

1 minute ago, Gatsby said:

Personally it would be a big mistake to start off with surgery in the crown. If your meds fail completely for example you will end up with an island of hair in the back of your scalp. You have a great head of hair and in all honesty if you can take the meds you are miles ahead of most of us. If you added a few fibres then you're problem is over. Honestly your crown looks like it has improved a lot. Surgery could also result in shock loss. Stay on the meds and give finasteride up to two years before re evaluating. All the best!

Thanks! I think you’re right…. I’m already falling into “hair greed” and I haven’t even had a transplant yet lol. I think that one security cam, low quality pic got to my head. Usually I don’t even mind my crown but that pic got me paranoid. Hopefully the meds hold onto my hair for many many years to come, I do feel the frontal third can really benefit from a procedure though. I have a consult with Dr. Bisanga later this month, very excited to get evaluated in person for the first time.

1 hour ago, hockeyman said:

So, the meds seemed to have halted the crown loss?

I just dug these up from 5 years ago when I was just 21…. I am confident my crown currently doesn’t look any worse. Again, I would always just style my hair to cover it:

when I was 25 I saw further thinning but it was never as bad as my frontal third, nobody actually ever commented on my crown while they did mention my receding hairline, for what that’s worth. 

1 hour ago, hockeyman said:

So, the meds seemed to have halted the crown loss?

Yeah, it looks a lot better than it did 1 year ago. Obviously not 100% restored but the thinning was much worse mid 2021. My crown was never slick bald but it used to be thinner.

19 minutes ago, HappyMan2021 said:

Doctors have reservations about crown work bc

1) The "final form" of crown loss can take much longer to develop than the final form of hairline hairloss.

2) The crown is a black hole for hairloss and needs a sh*t ton of more grafts than you may visually thing

 

How old are you? You haven't shown your frontal hairloss. But if your MPB is generally mild and you are 35+, I see no issues with crown work. 

I’m 26. Pre-meds my hair loss was fairly aggressive considering my age, though thankfully the meds have reversed some loss and hopefully prevent further loss for many years to come. I have pics of my frontal third in other threads, it’s definitely the worst part, temples are gone, etc.

I know my crown is not “that bad” but I’m wondering if it is a possibility to get some grafts input there. I am on fin/min already for over a year, not really willing to try anything else medically yet. Admittedly I can kind of just comb my hair up/forward and it more or less hides most of the thinning:

But when I’m not doing that, the thinning is more obvious:

now I can probably live with It when it’s like this, but sometimes when everything is off (greasy hair, minoxidil residue not washed out from 8+ hours ago, not styled, bad lighting) it can look bad. I saw myself on a security cam right after lifting things/moving around a lot with it being oily, etc and it looks bad:

not sure if this was just an extra unflattering lighting illusion mixed with the lower quality cam but it seems like it looks way worse here. I know fibers are an immediate fix but ideally I wouldn’t have to use them.

pic from the top, clean hair:

im gonna be getting my frontal third addressed in a procedure most likely later this year or early next, just seeing if a potential second focusing on the crown is a possibly play.

6 minutes ago, Spacedcherry said:

Everyone’s hair looks thinner and worse when it’s oily imo. Because the hair will clump together 

True, though I think when you’re a diffuse thinner it can make an even more dramatic difference. For example say your hair is 50% of its original density before androgenic alopecia, it’ll look okay when cleaned but dramatically worse when oily. Compared to someone who has zero hair loss, sure their hair might look not as strong when oily but it won’t be as dramatic as the diffuse thinner. 

I would seriously consider saving up more money before going through with this, that’s a fairly low budget. This is permanent and you want to get it right the first time. If you have to wait an extra year or two to, it would be well worth it imho. Your hair loss at this time appears to be low enough that you can get this fixed in one surgery if you do it correctly. 

2 minutes ago, user13 said:

You did topical of both?

I do topical minoxidil and oral finasteride. I haven’t had side effects with either, though potential side effects with minoxidil imo are way scarier. Increased heart rate, facial aging being the main two. Unlikely with topical but some people have reported it. Topicals are pretty annoying as it is so ideally everything would be as simple as popping a pill but I wouldn’t ever risk my cardiovascular health over hair.

4 minutes ago, user13 said:

What are the side effects of oral min?

 

Is there a chart with all the possible side effects from Oral Fin, DUT, Min and topical fin, dut, min?

It can damage your heart. I only do and would only do the topical. Kevin Mann (haircafe) has some good videos on it. I don’t know of such a chart.

I kind of want to drop minoxidil too. I started fin and min one year ago and definitely saw good improvement, though being I started them at the same time I can’t tell which had more. Statistically I suppose min is more likely to have caused regrowth than the fin but who knows. Hasson is also one of my top choices so maybe I should just drop it and of course stay on fin. Haven’t had side effects with either but the potential side effects with min frighten me way more than fin ever could.

Is there a reason you stopped fin for 2 years? Imo your hair was looking solid before that, maybe some light fiber use for the crown area and no one would have thought you have hair loss based on what I see from those pics. 2 years is a long time for MBP to progress if you have the aggressive genes, which unfortunately appears to be the case in that 2 year period. I’d get back on the meds, assuming you didn’t have side effects (is this why you stopped) and see what you look like in 6-12 months. Maybe you can regain some ground lost in that 2 year time period.

10 minutes ago, Rahal Hair Transplant said:

@Savemyhairline,

I don’t know if you saw my initial post, but I will present it again below. If you would like to set up a 1 on 1 information session with Dr. Rahal, I’d be happy to set that up for you. Just send me a private message. I’m also here to help and answer any questions you might have.  

—-

Save my hairline,

From the photos you presented you look like a good candidate for surgery.  Having been a participating member of the forums (this one in particular) for almost 20 years, I can tell you that I’ve king been impressed with Dr. Rahal, his results and his devotion to his patients.   I only started working formally with his clinic several months ago but I’ve worked with him in other ways for almost as long as I’ve been a member here.  I’ve met and spoken to him in person several times and have met several of his patients before they’ve undergone surgery and after their results have grown in.  I’ve always been highly impressed with him.

If you are interested in a one in one session with Dr. Rahal to discuss your situation and how he can meet your hair restoration goals, please send me a PM and I’ll go ahead and get that setup for you.

Best wishes,

Rahal Hair Transplant 

I had one with Tara a few weeks back, she was very helpful, though I am likely leaning to go to a different clinic mainly due to more recent results being posted. I’ll let you know if something changes though, thanks 

1 hour ago, Melvin- Moderator said:

Of course I’m being paid. My time isn’t free. Now, I have to say, it’s quite upsetting to hear “it’s biased” this is not true at all. Any one can post any review from ANY surgeon recommended or not. Anyone can comment and share their opinions good or bad. We do not censor comments, posts, or threads. In fact, there was a recent thread where the patient was trying to use the forum to get a refund. Guess what, we forced the thread to stay up, why? Because transparency and truth is valuable. 

Respect. Honestly I’d be concerned if you weren’t being paid given the amount of time I see you put in with posts here, podcasts, your YouTube channel, etc. 

That is looking more like a NW4+ unfortunately. The good news is you haven’t tried meds yet and being a diffuse thinner, you could have a very good response like I did and get down to the NW3 realm, hopefully. You are really young though with quite aggressive loss. I wouldn’t even think about a HT until you’ve been on the meds for around a year. I’m very surprised H&W said you are a good candidate given your age and the fact you aren’t on meds….you would probably have a decent frontal third then the rest behind it would go in the next 5 or so years if you went that path without meds. And/or your native hair in your frontal third would disappear completely and the transplant  would look no better than you currently do. The reality is you need to be on something that inhibits DHT (fin/dut) and ideally minoxidil, or any HT you get will not be worth it in a couple years time. Best of luck 

In my honest opinion that hairline design on the bottom looks borderline ridiculous on anyone older than like 18. Unless you have the density to back it up (and it’s 100% impossible with a hair transplant) that hairline won’t work. I’d rather a higher, thicker hairline than a low see-through hairline any day. Being a NW3 at 22 is more or less a guarantee you will lose more hair in the future, so trust me you do not want to waste limited donor hair on a juvenile hairline. The cosmetic difference between just a NW3 and NW2 is huge.

3 hours ago, Raphael84 said:

Great discussion is what this community is all about. To provide a platform to question approaches, experiences, reasoning and to better educate ourselves.

This very forum was a great resource for me as a young individual struggling with loss and trying to feel my way through the minefield of hair restoration. This still exists today with hair restoration not being an exact science in regard to optimal design and surgical planning and therefore whilst we as patients are drawn to different doctors for different reasons. As has been detailed in this thread, much of a doctors signature is his own artistic understanding, interpretation and application.

The conversation and topic of requirement for consultation is one that has been discussed many times before, especially in regard to BHR and Dr. Bisanga as due to clinic protocols and thorough data driven approach, then consultation is requested more often than most.

I share below a thread of discussion that further explains such a consultation driven approach and if the requirement for consultation is a "deal breaker" for a patient, then that is their prerogative and personal choice that we as a clinic respect.

What I would say is that any decision to request or require an in person consultation is never a business or money motivated decision. On the contrary, such an approach adds further "steps" and therefore sometimes challenges prior to being able to schedule surgery. However in an industry that can at times be lacking in ethics, we begin each day knowing that any decision or recommendation for consultation that has been made, has been made in the best interests of the patient and this is an essential part of our protocols and I believe says a lot about the motivations of a clinic.

I could honestly share numerous examples of individuals who have presented reluctance to attend consultation due to them having attended other consultations or being told from photo assessment from other clinics that they appear to be great candidates, but upon consultation, the reality can really be quite different.

Another consideration is not always candidacy, but ensuring the objectives of a patient are inline with that of their doctor. 

Hairline design is based on many factors. This includes the standard considerations such as age, extent of loss, progressive loss, medication, stabilisation, miniaturisation, donor density, hair groupings etc.
Other important and influential considerations are the facial shape of the patient, bone structure, distance between key facial features (I attached a video below).

Photographs alone are not able to present through understanding or attainment of data in regard to many of the above points. Therefore Dr. Bisanga is not able to guarantee a particular hairline design until he has had the opportunity to meet in person with the patient. 

If a patients objectives and the doctors vision and what he/she may feel is most appropriate is not aligned or the donor will not safely provide graft demands for example, then travelling for surgery to find out that your preferred design will not be considered may be a further "deal breaker" for some patients. Only at this stage when at the clinic for surgery, it is far from ideal and would undoubtedly be a very anxious and negative experience.

 

 

Great video. As for the consultations, I definitely respect the logic. I think if Dr. Bisanga can come to the US (or whenever he has a large amount of patients) at least a couple times a year for consultations then that is a reasonable requirement. For me flying to Belgium just for a consultation would really be difficult and hard to justify, but I am more than happy to drive 3.5 hours. 

3 minutes ago, GoliGoliGoli said:

This is another good point. Don't hair systems attach with basically a glue like adhesive? I would be worried about putting anything like that on your head every day for years on end due to toxicity and general annoyance, even if they claim their is no potential for toxicity. As I brought up in another recent thread, Talcum powder was used on babies for decades until it was found to be fairly carcinogenic

Even just your own perspiration just sitting there on your scalp for months can’t be good, we shower all the time for a reason. Some perspiration of course is good for the skin but if you went out and took a run, you wouldn’t go a month without showering.

I’ve always wondered how sanitary hair systems are, for your actual scalp. Assuming you are wearing it for weeks/months at a time, aren’t oils building up on your scalp that need to be cleaned? In my mind systems are a last resort if you cannot reasonably get a full head of hair with medication and transplants, though with a large percentage of men I believe this isn’t the case. To me having to worry about it and renewing it is a lot more of a pain than fin/min and even multiple hair transplants.

17 minutes ago, HappyMan2021 said:

@Calihome1 @Savemyhairline I didn't read your guys' histories but are either of you repair patients?

If so, I understand why Bisanga may require an in person consult, but at the same time totally understand that its not realistic logistically. And yes it would be a massive bummer to need to fly anywhere for a consult, with a possibility you may not like what Bisanga has to say. 

For me personally, this is one of the reasons I turned down Bisanga and Cooley too. They are both repair wizards, but the mandatory in person consult was too much for me. Also it would have added an additional 3 months to an already agonizing waitlist for surgery (3 months to wait for the consult, before booking the actual surgery)

 

If you guys are non-repair patients, and Bisanga is still requiring an in-person consult, I truly do not understand that logic at all. 

I am not, I have never had a HT. 

5 minutes ago, Calihome1 said:

I don't see why I wouldn't be a candidate based on my age (42) and stabilized hair since starting fin 17 yrs ago. 

I think also they thought my hairline design was too aggressive, but, I responded that it was a very rough design done on Microsoft paint, so to take with a grain of salt.  But, ya, I def don't want to fly to Belgium to get turned down.

Eh I mean the choice is yours but based on what you described I think it’s safe to just fly to Belgium for the whole thing. H&W, Rahal, and several other reputable clinics were willing to work on me without an in-person consult first.