JDEE0

Yeah, don't take an AI just to be able to take fin, that would be extremely dangerous in the long term as chronically low Estrogen levels are very bad for cardiovascular health (amongst other things) as Mustang says. Will also make you just feel awful in general probably. The only time you should ever really be using one is if you're blasting gear and need to offset a huge rise in levels for a period of time to bring you back within range, if you use just to offset a relatively small jump in estrogen from fin, well then you're going to tank E levels into the ground which is not good. Also, yes, Estrogen is conducive to hair growth - look at menopausal women. To be honest, I would just try fin and not overthink things too much, if you're getting sides then you can get more bloodwork done and compare to baseline to see if Estrogen is the likely culprit and make a decision to drop it from there and try alternatives such as topical dut, mesotherapy, etc.

To be completely frank, you're being extremely naive, but I don't blame you for it or think it's your fault; you just got duped as many others have been before you and as many more will be in the future. It may seem as though you were in ok hands after you meet these clinicians as I'm sure they were probably perfectly pleasant people who were nice to you, and I bet you felt somewhat comforted by the fact that this was a clinic in your home country, with American doctors/techs performing the procedure and not some back-alley clinic in Turkey where anything can happen... But the problem is that this is completely untrue, the HT industry is the Wild West rife with conmen and cheaters out to make a quick buck above all else (which includes your finite donor area and quality of life/happiness). Bosley are perhaps one of the worst offenders. If I'm being honest, and I really do hate to say it, but this looks like some of the poorest work I've come across in a minute, particularly in regards to the recipient area. The grafts are implanted very sparsely, there's no discernible implantation planning and whatever method/tool they've used to do so almost makes this look like a micro-graft procedure from the 80's when looking at the post op pics. Luckily, the donor (whilst not great either) doesn't look particularly bad, as there are no signs of over harvesting, extracting too close together etc. This is very good news as it means you should be fine going forwards in the future. Now, in regards to the 2k potentially being extracted but not actually all implanted, it's hard to tell as your native hair is covering some of the recipient zone at the front, but even so, I do agree that 2k weren't extracted (1500-ish looks more accurate to me) and I also think they actually implanted less than that unfortunately (maybe 800-1000 max). Again, it is extremely naive to think that this doesn't happen all the time with dishonest HT clinics, it's very common for them to want to extract as quick (and therefore as carelessly) as possible to increase their daily turnover and subsequent profit margins. In doing so, the transaction rate will inevitably be much less favourable than if they did things properly (i.e. slow and controlled), and as a result, yes, all the grafts extracted may not have been implanted as some were likely dead/destroyed the second they were excised from your head. Although I think it was more like 500 or so left on the table than 1500. It's just extremely poor planning at the end of the day, sorry it happened to you, I feel for you and it makes me angry that this happens, but it's not the worst situation to be in at all as you've not really been 'damaged' by the looks of things. I would get in touch with some real Dr's if I was you and plan for another round of surgery somewhere (a lot) more reputable.

Cheers for the input Melvin, I most likely will just leave them be and just sort out the hairline recession and call it a day for now.

Hi, I'm booked in with him, maybe I can help. Obviously, I can't recommend him yet as I've not had my surgery at this point, yet alone seen the results - just wanted to address your points. No, certainly isn't a hair mill, not sure where this question comes from, but either way, his clinic is about as far away from the hair mill model as you can get as he is involved in all stages (extractions and implantation) with only 1 patient per day. Most clinics (including the very best of the best) don't offer this level of Dr led involvement. Don't get me wrong, not saying it makes them/their results worse or anything, just saying it's a nice touch to have this. Mainly though, I wanted to point out that it's incorrect to say that there are very few if any reviews of the clinic, there are actually a lot of patient reviews from beginning to end - more than most Dr's I have seen actually - which was a big factor in my choosing of him for my HT personally (perhaps the biggest, in combination with the quality of the results). In fact, there are around 40 patient journeys recuperarelpelo. Lot's of them are long reviews with lots of updates, some are an initial post with only a few subsequent updates at say 4, 8 and 12 months, and some the clinic posts the updates on behalf of the patient, but regardless, they're all results posted in real time from beginning to end without anyone knowing how things would turn out, and 40 is a very good number of these types of reviews to have on display. It's hard to find this many reviews of this type (patient posted, beginning to end) from some Dr's who are widely regarded by us to be the absolute best of the best! There are also more results that aren't on the site I linked above, but are on the other Spanish forum (el pelo) floating about that you can find if you search for them, and there are also a few threads in progress at the moment with people who have recently had surgery. Hope that helps you a bit!

Thanks for taking the time to put this together! Just for accuracy's sake though, Pinto is 2.60 per graft (or was as of May this year at least) and De Freitas drops down to 2.50 EUR after the first 2000 grafts I think? Someone else can clear that one up as I'm not sure of the exact figure, but I was quoted 6.5k EUR for 2200 grafts last year.

We had a convo around this recently: Probably fine, there is some evidence to suggest it could cause hairloss, but it's not the most reliable data, doubt it will make any difference but don't risk it if you don't want to take any chances no matter how small they may be.

Most people do just maintain/slowly gain a small amount of ground from baseline over a number of years, I don't think your hair looks any worse a year later, it's just half the length of the picture on the left. You're not a 'non responder'. I don't think they actually exist, just that some people are so sensitive to androgenic activity that reducing DHT by 60-70% isn't enough to slow their loss down to a halt, but this is pretty rare and either way as most people maintain just fine and it's still working for these people who lose ground, they'd be much worse off doing nothing. Also, just removing DHT/androgens doesn't do anything to signal re-growth really, extreme examples, but we know that people who are castrated and so on don't just suddenly re-grow their hair, merely they just stop losing it from that point onwards. Other things are needed to aid growth, although just fin alone does help to rejuvenate follicles that aren't too far gone (in some people more than others). If your donor is fine I see no issue moving forwards with the HT as long as you commit to fin and don't jump off a year down the line... especially in your case, you overall have a lot of hair left right now, which is good, but it's clear that if you do nothing you're heading towards NW5 territory at some point.

Yeah, I have seen a few cases of his with them, looks pretty good but there's a bit of length on the guys' hair at the sides. To be honest, I think even if someone has a lot of skill with temple points and places at the exact right angles, directions, and so on, most of the time the hair placed there just doesn't end up being quite as fine as the native hair and so it stands out.

Sorry, my bad. MPB is male pattern baldness, so I was saying go and get checked to confirm this is a case of 'MPB' AKA genetic hair-loss (and not anything to do with your bi-polar meds etc). Fin is Finasteride, a medication that prevents further loss and has a very high chance of stopping things from getting any worse. Really, this is the only approved drug out there that tackles the root of the problem (androgen sensitivity in the hair follicle, particularly DHT) and without it you will continue down on whatever path of hair-loss that you are pre-disposed to genetically. In English, 'good old' is just an expression for something that has been around a long time/is reliable and so on. People are starting to use oral minoxidil more and more as it is more effective overall, but it has a higher potential for side effects etc, so I was saying you could just use topical minoxidil if you wanted to do it the usual way.

Been following your case also, your hair is looking great now man (I also thought you were being overly harsh on yourself for what it's worth haha). Yeah, I don't think I'd ever be too keen on having temples re-built and brought inward significantly, say by a cm or something, as I think there's no getting around it looking at least a bit odd at short lengths. If I do get something done, it will indeed be similar to Rolandas approach and I'll probably just ask for Pinto to match the left side (which is straight and I've no issues with) by throwing something like 50/60/70/80 grafts in there or so. My bad, I just grabbed some photos quickly that I had, but I can add some more, although I don't have any with significantly longer hair on the sides. To be honest, I do also have somewhat thinner hair which could potentially be retrograde in the area below the temple points (only here, not at the nape or anything). I'm not sure if it's just a naturally lower density area (as a lot of people do have here I know) or slight retrograde, my brother who isn't balding has the exact same thing when his hair gets longer, but I'll see when I'm in Porto.

Yeah, my hair is very soft as it gets to the temple points. I wouldn't worry about it too much though, at the end of the day, even if it is a bit noticeable at short lengths, youre still going to have a NW1 level head of hair, 99 percent of people will just see a full head of hair and not even register the temple points or if they do just assume it's some weird quirk of nature probably as it's usually nothing crazy noticeable, just to us who know about HT's. Worst comes to worst you grow your hair out a bit longer, can still taper/fade down short below the temple points, around the top of the sides and wear it like that instead, but you still have a full head of hair either way, so you win.

I don't know if mine are any better than yours were, always hard to compare 2 different people, but fairly similar cases overall I suppose. Maybe my frontal forelock is ever so slightly lower down on my forehead, less than a cm though probably, and I think my recession is a tad worse/deeper than yours went looking at the 2 next to each other. I would like that approach from an aesthetic point of view, my main worry though like I say would be that this amount of transplanted hair in the temple points would be noticeable against native hair when short, and I don't plan on having long hair on the sides and back any time soon! Also, my temple points were never that far in/my forehead was never that narrow at any point in my life, so it's not as if it's even 'restoring' things for me at that point.

Your situation doesn't look too bad at all, maybe just go and get confirmation that this is a result of MPB (see a trichologist or a reputable HT doc) and get on Fin if so, your hair will be saved for a very very long time, will probably improve somewhat and you'll not need a transplant for a long time, perhaps ever. Maybe you could add some Minoxidil orally at a low dose or just old fashioned topical if you really wanted some thickening/regrowth.

Yeah I remember remarking that I thought we had similar hair characteristics and level of loss when you first posted, I'm also following your procedure with Yaman, I'm sure it's gonna turn out great!

Looks good, can't see any signs of surgery, but yeah I'll be interested to see how your peaks look at this length when they grow in. I imagine they'll blend well with such a small amount grafted, can't see them standing out much. And yeah, it would be a very simple and convenient procedure so I see why you'd want to do it if you felt the need

Cheers John - yeah, he does really good work. Hopefully the one pass will sort me out for now and I can coast along for a good while without needing to return!

Yeah, my thoughts exactly. looking back at old photos it does seem that it was always a bit of a different shape. I'm going to Bruno Pinto in a few months time - estimated at 2000-2400 grafts.

Yeah, I have followed your procedure with Bisanga, just had another look and you're right - pretty much exactly what I was thinking in terms of doing to mine. I think yours are gonna look pretty good though, I don't know if there will be the need to add more, but I get the temptation! Do you usually/are you going to keep shorter hair on the sides - a 1 guard or below? I wouldn't be so bothered, but I'll be keeping my sides and back as short as can after and I don't want to regret it.

By nourishing syringe, do you mean PRP injections? (where they take your blood, separate the plasma and inject into your scalp) To be honest, unless it was a select few medications that you took for a while, I doubt they're the culprit, and it's most probably just MPB. if this is the case, the only real way to stop it is via 5ar inhibition, aka finasteride.

Thanks for the reply - just to clarify - I'm talking about the temple peaks/triangles and not the frontal-tempral areas that have obvious recession. Yeah, my hair is all good everywhere else, it's just the areas on either side of the forelock that I've ever experienced hair loss with. It's MPB, beyond a mature hairline, I'm NW3 territory for sure. And yeah I've been on fin for a number of years now. although my hairloss didn't noticeably change for a good few years before starting the meds for what its worth. and yeah I know it's generally probably best to do things uniformly on both sides, but as I say I don't really know if it's anything to do with MPB as it seems to have been this way before I lost hair, I could be wrong of course though, but it seems that way from pics.

I'm struggling to decide whether or not include temporal peaks in my upcoming surgery. To be honest they've not really receded much if at all, they seem the same as they've been since I can remember and they're 'ok' overall. I'm fine with the left side, but the right has always been a bit of a weird shape in that it sort of slants in on itself in the middle and is kind of bow shaped rather than being a straight angular line if that makes any sense. I was thinking of just asking for a very small amount of grafts to straighten it out slightly (on this side only), maybe 50-100. I will be wearing my hair as short as I reasonably can without seeing obvious scarring though and there is nearly always a visible difference at very short lengths with transplanted hair in the temple points in my opinion, so this puts me off massively. I'm leaning towards just leaving it alone, thoughts? Has anyone else been in a similar position and regretted it after for the reasons I've mentioned etc?

Really, a Dr begged you to stay away from fin? Seems strange, but either way it's a moot point as I don't think it's for you with all of the preconceived ideas and fears you have in your mind around it. No, the hairs do not become permanent, your hair is already quite miniaturised which is a direct result of gene expression and the cascade of events this induces to cause miniaturisation, the root cause of said expression being androgens. Minoxidil is a potassium channel opener, it helps to grow hair through poorly understood mechanisms, but doesn't do anything to address androgenic activity, so they will always win the fight no question if left unchecked. It doesn't really hurt to try though, it's just topical minoxidil, well, I would say that usually, but you say it's affecting your heart. Eugenix are good with higher NW levels which you already are now and will most likely continue to progress through since you're not going to use meds ever. Harley street are a somewhat sub-par, at best mediocre clinic that I would never let touch my head. Make of that what you will. Honestly, I don't really think you should get surgery right now, if ever. You seem like a very anxious person, no offence, and I don't know if you would cope if things didn't go your way, or if you ran out of donor and didn't like the way you looked and so on. That's just my opinion though, if you want to go ahead, then you need to pick clinics/doctors that are good with high NW's long term planning. Problem is that most Dr's (at least that I would personally recommend) won't touch you as you're not gonna take meds and you have aggressive loss. Some will though.

It's good she was honest with you and told you what you need to hear, and to be honest, good she didn't prescribe you fin as I don't think you should even touch it at after all you've said, personally (for saving your hair you absolutely should, but psychologically I think it's a no-go for you). However, I don't really think it was best of her to then give you minoxidil and SP as it seems she's just trying to keep the hope going that you can 'save' your hair or stabilise loss and ultimately be eligible for a transplant. She knows that minoxidil on it's own is gonna do nothing for your case personally, even if you responded amazingly and saw lot's of re-growth, it would never last long term without addressing androgens. And Saw Palmetto, well, I don't see the point of it really. Better than nothing probably, but still. It is possible to experience cardiovascular issues with minoxidil yes, although I don't think it's much of an issue with topical. Could well be your anxiety, who knows, but either way it seems silly you wouldn't try fin but would continue on with something that you're convinced is essentially giving you heart palpitations, whether they're real or not. At this point, I think you need to either accept baldness or commit to a HT knowing all the risks and potential outcomes of diving in with a high NW pattern at a young age whilst also being unmedicated. We've all told you what they are in this thread before, so you know them already. But I think you need to just make your choice and move forwards either way, carrying on like this isn't going to do you any favours mentally. Maybe contact Eugenix.

I know nothing about Diep's scars/skill performing FUT leaving the patient with the thinnest scar possible, maybe he isn't the greatest, I don't know, but either way, scarring is often tied to physiology and how your body heals. If 50 people theoretically had the exact same FUT surgery under the exact same conditions by the same Dr, some would have a pencil thin scar, some wouldn't. Some would heal with no issues, some would experience stretching, and so on. So, if you do have FUT, you need to be aware that it might end up not being a great scar whoever you go to. That said, some surgeons are definitely more skilled than others in this department. I don't think it's fair to say he's running a HT money making factory, especially when he offered FUT which is cheaper as he believes it to be a better fit for you personally. I've no idea about his techs or anything. You should start your own thread with pics etc so people can advise you, maybe FUE is a good idea. Hard to say without seeing your situation.

I'm aware a poll was run, not sure it was 50%, it might have been, but even if it was it wouldn't do much to change my mind. I don't really understand why it's become commonplace for people to argue against highly controlled scientific data with solid methodology that has been more or less replicated with the same outcomes each time (from various different studies completely independent of each other and including thousands of patients) when it comes to finasteride. At the end of the day, it's nothing to do with the fin for me, it's the point of clinical studies with real robust data vs anecdotal evidence. It makes no sense to me that in actual studies that involve thousands of people, the rate is in the low single digit figures pretty much every time, but suddenly on forums this jumps by a whopping 1000+%. The whole point of these studies is to be completely unbiased and provide data, whereas forums are quite emotionally charged and have a lot of confirmation bias etc. Either way, I don't really care to try and explain why this is the case personally, my point is that I wouldn't argue against years of study data on any drug that exists, whether it be an antibiotic, a contraceptive, a drug to treat cancer or whatever else you can think of, it has nothing to do with finasteride. Anecdotes are anecdotes, and it's fine when something has limited data, you could easily be skeptical, but when they contradict tons of scientific evidence/consensus, I don't really take any notice of it. Also, I'm not even referring to Merck studies - their patent ran out in 2005 or 2006 or something and there are plenty of independent studies that have been done in the past few decades since the original clinic trials that aren't tied to the company, so I don't understand where the incentive to fudge numbers would come from. And then on the flip side of the anecdotal coin, pretty much every Dr. I've ever heard speak on the subject and asked myself personally (all highly respected ones, think Bisanga et al) have said that their experiences of the 1000's patients they've prescribed fin to encountering sides is indeed similarly in line with the data we have on the subject. So, two options that I see really: either forum members are generally wrong/misrepresentative of the general population, or, lots of esteemed Dr's lie about their experiences and most of the clinical data conducted under scientific scrutiny has basically been intentionally manipulated. But either way, I respect everyones opinions on the subject and I do indeed think sides exist, but even let's say it is around 3 percent, that really isn't that low in the grand scheme of things - that's 30,000 out of every million who take it. It's really not that crazy that a decent amount of people come to forums and complain of sides considering this then in my opinion. Add on top of this the people with nocebo that undoubtedly is responsible for a fair chunk of online claims over recent years, and you can probably times the amount of complaints online ten-fold. And at the end of the day, I myself would like a reliable local, non systemic solution even though I'm fine on fin, but for now its the best we have and going by it's data it's very safe.