JDEE0

I'll be at week 8 next Thursday, so I'll post a proper update then, but I have noticed a fair bit of itching in the recipient the past week or 2 and from these super close up photo's, it seems like there are baby hairs sprouting, but I'm not sure if I'm just imagining things/they are old miniaturised hairs that were there before surgery. First picture is from around 2 weeks ago and the second is from a day or 2 ago - looks like there are some fine baby hairs there now that weren't there 2 weeks ago, does anyone think these are some of the grafts beginning to pop through? The pictures are in the exact same area which you can tell by the presence of some short, stalled multi-grafts in the same place in both if you look closely (there are 4 in an almost vertical line towards the right of each pic).

Here is the list:

I'll be keeping an eye out, excited to see it. Is that just for the topical fin, and was I correct in thinking that it's the dutasteride data that is a year or so out as per my post above before I saw your comment?

Hey man, I think they said the data will be released in the near future, pretty sure it's unavailable as of right now if I remember correctly from the video. Hasson did give some general figures I believe during the interview very briefly, but not much, and I would also love to see the data. To be fair, it sounded more to me like a case of they are sure it works as advertised and do have the data to prove it, but they just haven't quite finished the studies yet and so will release it shortly (I believe a year or so was said, someone correct me if I'm wrong, that may have just been for dut) when everything is finished up and in order. Still, I'm with you, I would like to see the studies and what methodologies etc were used before fully buying into the hype (even if I am at this point hopeful that all will be as claimed). Someone posted this (excerpt of a) response they got from Xyon the other day in the thread: Apart from the efficacy observed in almost 600 of his patients to date, Dr. Hasson has also performed pharmacokinetic (PK) testing in a subgroup of his patients. The results confirm that men using the 2.5% finasteride in the SiloxysSystem liposomal gel, have a lower circulating finasteride level in the blood compared with what's reported with the 1mg oral finasteride as well as a more preserved circulating DHT level measured in the blood. These data support the laboratory work Dr. Hasson had conducted to generate the optimal liposomal gel formulation and ideal finasteride concentration at 2.5%.” I would also like to see the data to find out what different testing was done to measure what exactly, and most importantly in how many patients. If it's only a few out of the 600, then I'd be very disappointed, but even if it was only say 50-80 of them, a clear and consistent measurement of Serum DHT level reduction and plasma concentration outlined between all or the vast majority of them would be good enough for me to draw conclusions from.

It's not bad progress for 4 months, still early days. You should start seeing some good growth and coverage over the next 2 months, hang in there a bit.

You're not really 'supposed' to wear anything. You just leave your head uncovered unless told otherwise for some specific reason (maybe you live somewhere very hot/sunny for example). In these cases the clinic might give you a bandanna or something similar to carefully place on your head. Saying that, it's generally fine to carefully wear a very loose fitting cap or hat a few days after surgery in my opinion once everything is scabbed over, you just need to be careful taking it off and on and make sure it's pretty much as loose as it goes.

Pics would be good as @JC71asks. But yeah, grafts can and often are placed into scar tissue in the cases of burn patients and so on. It's riskier and less predictable than completely healthy skin with overall lesser odds of great growth, but there are numerous cases out there of successful transplants into scar tissue. I'd assume since it was just chemical burning from hair removal cream that the overall state of your skin in these areas is much healthier than say someone who had 2nd or 3rd degree burns anyway and will probably be less of an issue overall, but that is just my speculation.

I agree 100% with you @Curious25. I don't understand how it's even really up for debate anymore when there are handfuls (yes, plural) worth of results posted between here and the UK forum (hairlossexperiences) in the last 12+ months that have had poor levels of growth. I mean, a decent percentage of the total, overall patient posted journeys from this clinic over the past 12-18 months have been objectively unsatisfactory... isn't this the metric we're supposed to rely on when choosing a clinic, and the metric that this site preaches and urges us to use to pick a clinic or surgeon? I feel like concerns regarding this particular clinic are being massively overlooked or shot down when raised, and have been for a long time now. The thing is, none of us have a horse in this particular race and there really is no motive or agenda to bash the Hair Dr clinic, or any other surgeon for that matter. The only agenda is one of protecting people coming here for insight into which clinic to chose and making sure they do chose someone who is likely to give them a good result, not a bad one (something that is evidenced by us all regularly logging on here to give advice to others with absolutely no gain to ourselves whatsoever). I've said it before, but people will inevitably come here and chose a clinic solely off the strength that they are recommended here. This carries huge responsibility as people are being directly led into this doctors hands and, at that point, the site is partially culpable for any unhappy outcomes as long as they continue to do so when there are clear and known issues with quality outcomes. The amount of people I've seen based in the UK who come on and clearly don't want to travel abroad and then pick Arshad after finding out he's recommended here is quite high, and as I say, the only reason they do so is because of this site.... As it happens, I know that the admin of the UK forum has removed Arshad's sponsorship from his site as a direct result of the recent results, so it's certainly not just forum members over here who are seeing issues.

Sorry to see how this is turning out for you. If I was you, I would get the ball rolling contacting some different clinics for another HT after the 12 month mark; you're going to have to wait X amount of months for a slot with a good surgeon, so it's best to get things moving ASAP, well, if you want to wait as little as possible at least. Anything insinuating that a dry scalp has caused poor growth leaves a bit of a bad taste in my mouth to be honest as it feels like excuses/trying to shift blame onto yourself or your own physiology instead of the clinic taking responsibility. It's not your fault, or because you had dry skin, and minoxidil isn't going to do anything to boost the growth of your transplanted hair that didn't make it.... I see the Hair Dr doing the same thing to a lot of their patients who have had poor growth and I don't really understand the logic. To be honest, I'll just say it at this point, the clinic is definitely having clear issues with poor growth and in my opinion it is clear they are doing something wrong that is damaging grafts and leading to results like this one. Don't understand why they're still recommended here personally, but that's just my opinion. I think the way the hair sparsely grows out is even similar looking between different patients from the clinic and at this point I feel like I can call out a poor Arshad result without knowing who did it and just by seeing a pic. I would personally not go back under any circumstances, there are much better choices, so do yourself a favour. Wishing you a bit more growth over the last few months anyway mate.

I'm no expert in systems, but no, I see a lot of people online these days rocking fades etc with hair systems.

Hi mate, You do indeed have very aggressive loss for a 22 year old, well, for any age really, but going so bald so young is a problem for the following reason. Donor hair is not DHT/androgen proof and is only resistant to their miniaturising effects - with the obviously strong genetic susceptibility to AGA that you have, it's really anyones guess as to where you will end up in even 10-20 years time. Your donor looks fairly strong at the back, but as you point out, retrograde is clearly present at the nape and potentially the sides too from what I can see. I'm sure you know all of this, but the issue is that your donor area might just completely thin out by the time you're 30, 35 or 40, and your transplant will be for nothing. All you'll have is patchy areas and probably a lot of scarring to show for it (you'll need as many grafts as humanly possible, so it will probably be visible). Beyond that, even if you did get a HT now, would you really be happy? At 22 years old and your level of baldness, even if you have a good result by your NW level, there's only so much density that can be given and only so low your hairline etc can be. The crown will probably be showing somewhat, hair will be fairly low density which will be notiecable, hairline placement might be too high for your age, and so on. This type of restoration works more for people say 40+ in my opinion, but can often actually make very young people like yourself look worse in some ways, or at least older, as a scalp with decent coverage but that is still thinning in areas/shows signs of an advanced pattern of baldness at times isn't something that screams youthful. It looks good on a guy who's older and where thinning throughout, maybe a low density crown and mature hairline etc is expected. I guess what I'm saying is it might age you more than just shaving for example. My advice would be to just shave it off if you can, or go for SMP or a hair system if you're comfortable with those, whatever it is that allows you to move on for now, and then re-assess maybe in your 30's. If your donor is holding up well at this point, it'll be somewhat clear you're not going to thin out drastically and you can hop on meds and go for a HT at that point if the desire is still burning for it.

Hello, You'll be much better off going to Spain, Portugal or Belgium than staying in France. I'm sure there's a decent clinic or two in the country, but no one on here knows of any, so it's much better to go with one of the many options that is known by people on here and can be backed up with lots of good patient posted results. To be honest, I don't really know how much less traumatic DHI is than say pre-made slits. Maybe it is a little, but it's inconsequential when all is said and done imo. Just make your decision based off which doctors work you like and not the method they use.

I don't know much about him, just that he's a fraud who spouts nonesense, but no he's not a doctor in any way (after a quick google search)... his page say's he's a 'researcher and medical editor' whatever that means, and follows up with him trying to get you to join his websites membership. As Melvin says, he's just out for a quick buck and uses lots of pseudo science to facilitate this. I'm not saying all of this to call you or your post out by the way, just so that you or anyone reading doesn't buy into these sorts of methods or the guy behind them peddling his membership fees and essentially get scammed and buy into misinformation based on trickery. I didn't watch the video because the guy is a but of a fraud, and like I said, I already know that the whole scalp tension angle has no substance, so there's really no need to watch it in the first place seeing as you have outlined that's what is talked about in it. As for how some HT's thin out when they were taken from the 'safe zone', well, there are no concrete answers to broadly answer the question for everyone who experiences this, but it's far more likely that the person was experiencing some sort of BUPA type hair-loss with miniaturisation in the donor than having anything to do with scalp tension. More people than it is realised have 30+ percent miniaturisation in the donor, including the 'safe zone' which isn't exactly a real thing overall in general anyways. If hairs are taken from pretty much anywhere in such patients, then it's inevitably going to thin out in the coming years. You can't have say 35 percent of all hairs in the donor experiencing miniaturisation to some degree and not have this be reflected in your results down the line. Go watch some of Lorenzo's vids on YouTube, he has so many cases on there of patients where he outlines that they have DUPA or BUPA. They even look completely normal lots of the time with good donors, but under a microscope have lots of miniaturising hairs throughout the whole donor and not just above and below the safe zone. It will give you a feel for what I'm talking about. Besides this, donor hair is just DHT resistant, not DHT proof. Even so, the vast majority of people's transplanted hair doesn't begin to noticeably thin after 4 or 5 years, most people are fine for much longer than this. The rest who aren't could easily be attributed to factors such as mentioned above, so to apply the argument of this guys video to hair transplants overall in general is a bit pointless to begin with. As for the donor dominance theory, or the argument that it is inaccurate should I say, this holds more weight and potential truth that the scalp tension stuff, but there is still no evidence for it. As far as we know, it's the hair follicle itself as a mini-organ that holds all of the genetic markers and relevant DNA to make it susceptible to androgens, not any specific area of the scalp. For reasons unknown, the follicles in the back and sides largely are far more resistant and this shouldn't change once moved as, like I say, it's dependent upon the individual follicles themselves. But still, for this point, who really knows for absolute, maybe in years to come it will be discovered that the recipient site does impact the grafts, but I'm doubtful as the current evidence suggests otherwise.

Yeah, sorry, already edited it before you replied but you must've quoted it before it went through

Oral minoxidil will be more effective overall, yes. It's not necessarily a catch all truth for everyone, but the problem with topical for many people is that they genetically lack the necessary sulfotranferase enzyme in the scalp that is needed to convert minoxidil into minoxidil sulfate; the drugs active form that actually aids hair growth. With oral minoxidil, the liver processes things instead and largely bypasses this issue so it doesn't really matter if someone lacks the enzyme on the scalp very much. If you happen to be someone who has said enzyme in abundance, then topical will work just fine and there's less of a need to use oral/it won't be drastically more effective to begin with. But many people see little success with topical for the above reason.

My bad, someone else posted it literally a few days ago. I haven't looked into the studies he cites in the video (or even watched it) as he doesn't link them in the comments or anything, but I already know the theories have been quashed many times before by people more knowledgable than me. Here's a video that largely counters Rob's arguments if you're interested at all: There's also many threads on hairlosstalk about the theory as well if you have any interest in reading more about it, just google hairlosstalk scalp tension and have a read of the ones that pop up.

The guy who runs that channel is a bit of a quack in terms of the hair-loss science he talks about. Not a fan at all. All the scalp tension and skull expansion theories have no reputable evidence to back them up and have been disproven... Also, did you not post this video the other day, or was that someone else?

I feel you, difference is though someone like earl has always had a high hairline with no recession in the corners. Was the same back in like 2010, and in other words, is not MPB whereas OP's is. Besides, I'm not saying he shouldn't get a HT soon even if he doesn't take fin ever, just saying that it's going to progress over the years which OP didn't really seem to fully accept/realise when he said his hairline has been the same since a teen. Sounded more like he was saying he's not suffering from MPB, I was just pointing out that he in fact is. I'm 27 myself and have just had a HT with loss a little bit worse than this, so I'm not saying don't go for it, just to be weary. My overall point is: look at someone like Ralph Fiennes, guy had a pretty sick hairline in Schindlers list when he was about 30 years old or so, but has since gone NW4+. Not the end of the world by any means and he could fix it easily with 3500 grafts and fin, but things will progress if left alone.

It's definitely male pattern baldness, and whilst you may have always had a bit of a high hairline when you were younger, I can promise you that your hair isn't the same as it was when you were 15/16; it's just progressing slowly. You need to accept this fact as it will only continue as you get older, and you'll inevitably need more HT's as time goes by, especially so if you're not using fin (which it sounds like you're not from your post). Considering using meds (if you do end up doing so) would mean that your loss will be slowed considerably and you can stave off needing another HT for as long as possible, most likely much longer than if you don't use them. Your loss isn't particularly aggressive or anything, but like I say, in the long run you will lose more hair. It probably won't be very fast (although nothing is a given), and how much will be lost is anyones guess, but I'm just pointing all of this out as lots of people (especially younger) with fairly mild MPB don't want to accept that it is indeed baldness and if you approach this from that sort of angle, well I can almost promise you that you'll be very disappointed in the future when things progress and you're tied into the HT route. You're young and you have lots of years for loss to continue, so be mindful and consider fin is my advice. As for your situation, you probably need around 2000 grafts, give or take, depending on the design. Your donor looks pretty good from what I can see, and the rest of your hair is in good condition as you have said. Lot's of surgeons are going to be weary of performing a HT on you being so young and unmedicated, they may ask you to wait a few years and try fin as a result, which is what I would reccomend too. I don't know much about clinics in LA, but I know Dr. Mohebi does decent work so maybe get in touch with them for a consultation, but really you shouldn't let location dictate where you go. Do some research and pick a doctor based off their results; it will probably mean you'll need to travel, but most of us here have done that.

2-2500 grafts would set you straight with the design drawn. You look to have the ideal donor area, very dense and your hair calibre looks pretty thick/coarse. And I would go FUE in most cases in general anyway, with your donor area, FUT certainly isn't necessary.

Looks great so far, congrats, I always like Pekiner's work when I see it.

Biggest problem I see is that he is 'only' 35 and his donor is thinning noticeably. I don't think any doctor worth his or her salt will really claim they're able to predict what will happen to the transplanted hair by the time he is 45 or 50 with this in mind, and as a result, may flat out refuse surgery for his own good. It's likely much of his newly placed hairs would also thin considerably over this time period without using meds.

Hard to really see what's going on in the donor, but it doesn't look very strong I'm afraid. You have retrograde, for sure, and I can see visible gaps throughout even in what would be considered the traditional safe zone. At this point you really need to send some clear pictures of your donor to some ethical clinics to get their take, but I have my doubts that many of them will take you on with what looks to be a fair amount of miniaturisation in the donor. Meds have the potential to put you in a much better spot, but right now, my honest opinion is that I don't know if you're a viable candidate, sorry man.

Sorry to read and see what happened with your situation - I completely understand why you're feeling the way you are and venting your frustrations. Just wanted to say though that, whilst I agree with you in regards to HOI, Asli Tarcan, and any other hair-mill or cheap, package deal multiple patient per day clinic in Turkey, it's not fair to say that going to Turkey full stop is a bad idea, and it's especially unfair to call out a clinic such as HLC and tarnish their name by saying that they have a number of botched results, because they don't. There may be a recent case or two on here where some patients have not been completely satisfied with their growth with said clinic, but this is not equivalent to a botch job in any way and it happens to every surgeon out there from time to time, no matter how good they are. A botch job refers to overharvested donor areas, mis-angled grafts or grafts implanted at the incorrect depth (which can cause pitting and cobblestoning, incorrect hair groupings placed at the hairline, excessive scarring, and so on. I don't think you'll find any such cases from HLC, nor from other reputable clinics like Pekiner, Keser or Bicer.

Hey, Forget Bosley and Cosmeticum, the rest are all at least somewhat good choices, but I don't know if any are the best fit for your case exactly. I'm sorry to say, but you're definitely not a NW2 or 3, more like a NW5 going into a 6 in reality. Yes, you still have a decent amount of hair up top on the mid-scalp, but it is heavily thinning in a diffuse pattern and will inevitably completely disappear as the coming years roll on by. It's moreso the false illusion that you're a NW3 right now, but it's clear the remaining hair is going to go, I have no doubt of that. Without finasteride or dutasteride, you're 100 percent destined to end up a NW5-6, and I'd probably say it'll happen in the next five years or so. Not what you wanted to hear, I know, but you need to face the reality of your hair-loss for your own good before you go getting a HT. If you go down this path of getting a HT, and don't take 5ar blockers (i.e. fin), then you're going to need easily 6000+ grafts for decent coverage all over once all is said and done. Do you have pictures of your donor area? Without them, it's impossible to say whether or not you're a candidate at all for a transplant. It's also a tricky case to have a HT right now as you are experiencing diffuse loss; the transplant may cause permanent shock loss to your existing hair up top, and you may end up worse off or back at square one a year post op. Really, meds would be necessary for your case imo, if they strengthened your existing hair then you would have a lot less to worry about and probably 2.5k grafts for the crown and maybe 2-2.5k grafts to create a nice yet somewhat conservative hairline would leave you looking pretty good.