Faxanadu

2 minutes ago, gillenator said:

You also want to first discuss the use of DUT with a doctor experienced in treating hair loss…you will need a script so discuss recommended use and amounts with Dr. Bisanga?

Hey. Thank you - good advice. I will email his assistant to see whether it’s something he would suggest. As of now, he’s suggested oral minoxidil 5mg 1 a day, and fina 1 a day. But worth asking! 

3 hours ago, Kraki77 said:

Let's take a look at the positives here:

- You have great amount of hair for someone who is 40 years old. I believe that it's getting hard to style and that weather conditions make it look awful sometimes but there's always a good old hair spray that can save the day.

- Even though you haven't posted before it's clearly obvious that you have studied this field to some degree. You have chosen one of the best out there and you didn't rush into it before taking any kind of medications. That doesn't happen by chance.

 - If you still insist on hair transplant or if it becomes more viable option after consumption of oral minoxidil there are other doctors in the field who are specialized in harder cases, dr. Jose Lorenzo is definitely one of them. But, don't get me wrong, dr. Bisanga deserves all the credit that he receives, he's undoubtedly on the top of the food chain.

- As Melvin mentioned there is always that possibility that some other therapy proves to be jackpot in terms of hair maintenance or regrowth (dutasteride can always be considered, if it affects your body to the point that it's messing up with your everyday life you can always decide to let it go).

- If the hair loss bothers you so much that you are spending too much time in front of the mirror or you don't feel satisfaction for any other reason whatsoever you can try to shave it. Shaved head would certainly make you feel liberated, at least at the start. SMP can always add that extra touch to the look and make you feel more happy with yourself.

I strongly advise anyone to stay positive and patient, no matter how hard their current situation is. Just imagine sometimes how much harder it is for some people in comparison to you. There are people without limbs, people suffering from all kinds of incurable diseases, they have it much worse but they still persevere.

Hey. Thank you so much for your inspiring words. Many of the supportive comments I have received on this thread have really made me feel better. Being told to be heading to a NW6 truly shocked me - it’s reassuring to read that this doesn’t necessarily have to happen. With conservative treatment, I hope  NW6 could be delayed by a significant amount of years, or perhaps halted altogether.

I hear you re: putting oneself on other people’s shoes to get some perspective. I am lucky enough (!) to have two incurable, life-threatening health conditions (well managed by meds). Hair loss should really be at the bottom of my priorities but can’t help it - seeing that giant forehead has always given me paranoia since my teens, and now more than ever! 

Take care, and thanks again for encouraging words. 

6 hours ago, Melvin- Moderator said:

Your hair looks great, I would consider dutasteride with mesotherapy. 

 

Hey - thanks so much for your reply and for the time and effort you put in your videos. I have indeed been considering switching to dutasteride. I have been taking fina 1mg for over a year but clearly without much benefit! Wanted to try duta but wasn’t sure about The right dosage. I will have a good look at your video, and hopefully by the end I will know how much to take, and how many days each week! Take care.

On 10/3/2021 at 12:18 PM, Gatsby said:

@Faxanadufor a first post that is an excellent question! 👍 It’s also a question that so many 18-24 year old guys who believe that getting a hair transplant will solve all their problems never ask. 

Thank you - you’re too kind! Didn’t want to end up with a random line of fluffy hair in the front and a totally bald head of hair behind it!! Not a great look

On 10/3/2021 at 1:39 PM, BLE123 said:

That's surprising, your hair doesn't look bad from those pics.

Is it the thickness of the hair that's the issue or just not enough of it? Do you have a pic of the donor?

Hey, dr said it’s a combination of both: diffuse thinning hair everywhere including the donor area, and my natural hair consistency which if fine by its own nature. A couple of pics from the back, not the clearest I know!

28 minutes ago, gillenator said:

It sounded like the doctors did a microscopic exam of your scalp including the donor...they stated 20% affected?

Hello, yes he used a microscope and also chopped three strands of hair from different parts. Diagnosis as follows:

Donor Density: Measured in 2 areas as 50/60 Follicular units per cm2, most of the follicles are 1 and 2 hair follicles
Miniaturisation: 20% miniaturised hair in the donor area 

Recommendations:  not to do a hair transplant
due to the higher miniaturisation and the smaller follicles in your donor area. 
You don't have a DUPA, but you have quite some grafts that are also thinning in your donor area.
To help with the miniaturisation the doctor recommends to look into medication to stabilise your hair loss and reinforce your thinning hairs.

1 minute ago, Faxanadu said:

Hey there, sure. Might take some more in proper daylight that’s all I could muster by myself tonight …

Consider I didn’t wash my hair today as I was in a rush, and it was dirty with last night’s rogaine foam and hair wax , both of which make them stick to each other. 

26 minutes ago, Kraki77 said:

Can you maybe post pictures from the back of your head? It would be interesting to see how that part of donor looks like in your case.

Hey there, sure. Might take some more in proper daylight that’s all I could muster by myself tonight …

25 minutes ago, gillenator said:

am curious to know what the older males in your family history look like, both maternal and paternal...are any of them b

Thanks for sharing your experience. So in my family:

mum, thin hair but all of it (the sort of thin that when you wash it looks very full, in between shampoos it almost shows the skin)

Dad- passed away. I remember him pre chemo and had all hair (very thin too but all of it). After chemo, baldness and all kicked in before he passed away. 
 

brother - full head and zero receding temples!

nonna (dad’s mum): went quite bald on top in her…late sixties? Proper alopecia. 
 

mums brothers: one NW6, the other one kept his hair until his seventies, that I can recall. 
 

that’s sort of it. Worth mentioning that I’ve had a HUGE forehead since I was a toddler and in my teenage years.

37 minutes ago, Curious25 said:

Your hair looks good to me for a 40 year old

That’s kind of you to say, thank you! 

In normal indoor circumstances, it can still be styled and look fine. 

Outdoors, even with a gentle breeze, I turn into an Elizabethan painting. 

57 minutes ago, ciaus said:

I'd check out these guys on youtube

This is super helpful. Thank you so much. And agree re crazy stuff - I already take meds for epilepsy so need to be careful as to what other “stuff” I put in my body. 

But have read of various other treatments, such as topical spirolactone, dutasteride instead of fina, and another one whose name I can’t remember (it’s all numbers!). Was wondering if anyone had a perfect recipe they could share - though am also fully aware that every head is different!

Just a bit depressed I suppose. Fair enough to be told I don’t have enough donor hair for a transplant.. but to hear I’m destined to NW6?! makes me even angrier as both my dad and brother have full heads of hair. 

Thank you for reading my ramblings

Hi everyone. As mentioned, I went to see Dr Bisanga and he seemed really competent and kind. His assistant was amazing.

Unfortunately he delivered some sad news which I was totally not expecting: I’m heading to NW6.

He recommended 5mg oral and fina 1mg. Is there anything you could suggest for me to keep my hair as long as possible? 

I’m 40 and I (think) have hair all over, apart from receding temples and diffused thinning. I can see through the scalp under direct light shining over my head. My friends though don’t tell me I looks bald or that my hair looks different from my 20s. 

I also asked my neurologist to switch my epilepsy medication as I have read what I am currently on (lamotrigine) has hair loss as a side effect. Many forum users report this too.

Hope you can advise on best treatment mix on top of the above. PRP? Dermaroll? Biotin? Other drugs? I am open to anything!

Below are the doctor’s notes.  

Norwood classification: Diffuse hair loss from front to back, going to a NW6
Hair Characteristics: Salt & Pepper, Slightly wavy, Fine Hair
Donor Density: Measured in 2 areas as 50/60 Follicular units per cm2, most of the follicles are 1 and 2 hair follicles
Miniaturisation: 20% miniaturised hair in the donor area 
Dermoscopy:Normal, no signs of scalp issues 
 

2 hours ago, JDEE0 said:

The answer is that this is why you use meds such as finasteride. In doing so, you can be confident that your loss is being slowed drastically and that you very likely won't suddenly have lost all your hair in 15 years time. 

The other answer is genetics, you might only be destined to reach a NW4 or so, in this case even without using meds, you'd need another HT at some point yes, but then you'd be alright. Obviously no one can predict the future though and it's not wise to bet on luck of the draw. Hopefully, you have both of these things in that you use meds consistently and your genetics aren't particularly strong in terms of pushing you higher up the NW scale.

Then there is the potential for future treatments that may come out in the next 10-20-30+ years, we very well might (at the very least) have drugs that can completely halt the progression of MPB somewhat soon, and then whatever else is over the horizon. Who knows, but I personally think we will get to a point where the decision to have a HT will be mostly limited by financial reasons rather than hesitations over continued loss etc. in the not too distant future. 

I was also confused as to why Bisanga was saying he couldn't perform surgery on you because your hair is too 'fine throughout' when reading your initial post as this isn't a factor of candidacy generally speaking. But from your second set of pictures, it appears you unfortunately have DUPA, meaning that your hair is miniaturising throughout and not that it is just fine in calibre. Surgery is unfortunately not an option unless you can rectify this through the use of meds, and even if you do manage to, you really will have to rely on them forever in order to not revert to your previous state of thinning throughout. 

Here is a good video from Lorenzo on the subject, maybe it will help you: 

 

Hey there, thanks for your time and input. Dr Bisanga essentially said that I didn’t have enough hair at the back and sides to move to the front and achieve a “full” result. He didn’t rule it out altogether, but said I was on the “edge” of the spectrum in terms of who’s a good candidate and who is not.

Not sure if it changes anything but the earlier photos were taken with the sun starkly shining over my scalp. I have just taken a couple of pictures in different light conditions. Also worth mentioning that Dr Bisanga cut off three strands of hair to the side hence those more visible “hole”. 

I also attach a photo from 10 years ago, just out of the sea. My hair has always been so fine that, when wet, it would show the scalp throughout. Once dried up it would look much fuller and “normal”. My mother has the same thin hair. 
 

i have been using fina 1mg and minoxidil foam plus nizoral for over a year with breaks when on holiday. Haven’t seen much change. Hoping the oral mino Bisanga’s colleague will prescribe to me will bring better results. Is there anything else you recommend I could take? Saw Palmetto for example or overkill?

Thanks, and have a great evening. 

3 hours ago, BLE123 said:

That's surprising, your hair doesn't look bad from those pics.

Is it the thickness of the hair that's the issue or just not enough of it? Do you have a pic of the donor?

Thanks. It’s surprising but I sort of knew deep down…the issue seem to be both according to Bisanga. My hair is naturally fine and just not a lot through I guess! He confirmed what I had feared… But I appreciated his honest feedback. He said I would have needed at least 2000 grafts to achieve the density I needed to slightly lower my hair and temple line. And even then he couldn’t guarantee it, plus he said I would be left with visible holes in my donor area. 
 

He was accompanied by a British doctor, who told me my only real option was to switch from Minoxidil foam to the oral tablets, which he said he’d prescribe. Oh well. Let’s hope for stem cell harvesting to become a reality at some point in the future. 

Here are a couple of pics I have just take of my donor area.
 

Hello, and thanks for your reply. Just had my appt with Dr Bisanga. He was very honest indeed. No hair transplant for me as I don’t have enough donor hair - too fine throughout which would have resulted in a see through transplant to the front, and visible gaps on the sides and behind. Oh well. Big shame but appreciated his honesty. 

Hi everyone. This is my first post, but have been reading the forum regularly for a while now. I am on my way to meet Dr Bisanga and really excited.

I will ask him this question but also keen to hear from you and your perspectives. I would a hair transplant to reduce my extremely large forehead and temples area. What would happen in 15 20 years, once the rest of the hair behind the transplant area thins or falls out? Some might answer “ you can have another transplant”. But my hair is fine throughout, and I’m concerned I may not have enough to cover any future hair loss in other areas, therefore leaving me with an unsightly patch your hair to the front, and an empty area right behind it. Should this be the case, could transplanted hair be removed at a later stage?

Thanks in advance to anyone who wants to provide your feedback.