BurnieBurns

Right, Xyon are still working on expanding to international for now. How bad were your sides on oral finasteride? Did you try reducing the dosage? If they were fairly minor there's a chance you might do fine on a standard formulation

If you're based in Canada or US go for the formulation from Xyon Health, otherwise you'd want a liposomal version. All the liquid based ones result in high systemic exposure

It's the same drug so yes, he same side effects can occur. Secondly, no two topical formulas are the same. there are different concentrations (e.g. 0.1%, 0.25%) and different vehicles, e.g. trichosol, hydroalcoholic, and liposomal. All can affect the absorption and then of course it will vary from patient to patient. Some are more sensitive than others.

Low libido, ED, mild depression. I tried 0.025% trichosol and got the same sides. From extensive research, the Parati formula is the only other vehicle besides Xyon scientifically proven to reduce systemic exposure to a very small amount. A majority of topicals out there cause a lot of systemic absorption. Most of people using them are doing so out of fear of side effects rather than having had them so likely would have been fine with oral anyway

Low libido, ED, mild depression. Any side effect from oral you can also get from topical

I have had correspondence with Xyon and they'll contact me when they announce their plans. Crossing my fingers for Farmacia Parati's tried and true liposomal meanwhile

I've been battling with side effects from finasteride both oral and topical finasteride/dutasteride for the better part of 5 years. Even microdoses of the liquid formulations result in side effects which has been beyond frustrating. Having recently had a hair transplant megasession with Dr Jerry Wong, I'm hellbent on trying out anything anything I can to target DHT. Unfortunately, I cannot recieve the XYON formula because I am based all the way in New Zealand and we have no indication of when they can offer their services internationally. I have, however, recently spoken to Shapiro Medical and may be able to order the Farmacia Parati Liposomal version through them. Does anyone have experience this formula that previously had sides? If so, which medication/ concentration, etc Would be grateful for any responses.

https://www.xyonhealth.com/topical-dutasteride/

Talk about a cliffhanger!

It's a pretty commonplace tool for not just hair transplant surgeons but dermatologists

Have you thought about trying the XYON topical Dutasteride? Apparently the absorption is even lower

I believe you're talking a bout a dermoscope. I would be surprised if any of the recommended Doctors here don't have one of those in their clinic.

It will be very interesting to see if they have any studies around the systemic absorption of topical dutasteride. So far it's only been by anecdotes and speculations because of the molecular weight but it would be great to see proof.

Very cool, do you have any before photos?

You'll need a lot more than 3k grafts for any significant improvement. Your donor is also quite limited so you'd want to go to a doctor with a track record of excellent donor management. You mentioned you stopped medication because hair loss no longer mattered to you? If it does again then it would be unwise not to go back on treatments to see if you regain anything lost over the past few years.

Most do FUE because that's where the market is. On the forefront of their mind is avoiding a scar rather than maximising donor - keep in mind many people won't even need to as they won't progress into advanced stages be that genetically or due to a treatment regime.

You can greatly improve you chance of having a great scar but going to a great surgeon but like I said there's no guarantee. Dr Wong would probably be in the top 3 FUT doctors in terms of skill, but some will always be better than others. Individually some people scar more than others. JT can a few FUT surgeries with him. One had a good amount of stretch-back then he performed a scar revision and luck for him that one stayed fine. There's also doctors that use things like A-cell claiming it results in a better scar. There's no proper data to support this but that's been their experience for what it's worth. Another interesting point is apparently you're more likely to get a better FUT scar when you're older. If the collagen content in the skin in lower with age, it can't produce as much scar tissue. Weird huh?

I'd say an FUT scar could still be visible on a 2 unless you get a perfect outcome and it stays 1mm. There is unfortunately no way to guarantee this even in the best of possible hands

Not to undermine the other names recommended here, as a H&W patient in November (Although I was with Dr Wong as not Dr Hasson) I had a very different experience from that case mentioned and believe it would be a mistake for a another potential patient to be discouraged by it.

I don't know much about Dr Nakatsui but haven't seen anything negative. He seems to be knowledgeable and skilled plus his posted results look great (though the pictures could be better). It could be worth asking the clinic if they can any former patients you could be put in touch with. I recently did an FUT megasession with Dr Wong and I cannot praise it enough (albeit the result will be several months away). The 'rows' that people talk about here (which are more like 'paths' than rows) are done purposely for ensuring survivability, protecting native hair, and minimising trauma. There is a reason H&W achieve high density megasessions with full growth, while most other surgeons can't. Unless you plan of wearing your hair shorter than an cm, this should be that last of your concern. Are you on medication? If you really truly to push the brim on maximising grafts then Wong is one of the only 3 doctors I'd trust to get the absolute most from my scalp via FUT. I consulted with another experienced (airquotes) doc who said I couldn't get more than 5000 grafts via FUT in in my lifetime. Dr Wong got about 5700 and said a lot could still be taken in future! Moneywise, if 10k vs 20k was here nor there I'd go with Wong, but I wouldn't rule Dr Nakatsui out if would lift a heavvy burdon off me.

You're welcome @beak, it all revolves around your expectations/goals. Either way you're looking a few thousand at least. I'm also thinking that 15k is a bit low considering you have fairly advanced baldness. Eugenix (which Dr Sethi founded) does have cheaper packages but you wouldn't be operated on by him. Personally, I'd save up more or take out a loan as you'd want to go to an elite surgeon. You've also got two options of going about it. Doing multiple smaller sugeries or one big megasession. Different doctors often fall in to one of those schools of thought

Totally agree, When a HT Doc turns a patient away, sometimes it's because 'they' can't help them, not 'nobody' can help them. The mentioned names are great and I'll throw Dr Felipe Pitella to that mix. If your hair loss is stable and doesn't get worse from the pictures shown, I'm confident there are surgeons who could give you a fantastic improvement if not appearance of fullness FYI Drs Muresanu and Wong would be likely to recommend FUT first to maximise available grafts. Drs Sethi and Pitella do FUE only and would likely want to use a good amount of beard grants. Fortunately your face looks well supplied!

Wow too low as well. Chances are he'll be unsatisfied with the density in his midscalp and might not have the donor required..

Mate before you even think about a transplant you need to focus on stopping your loss. Topical Minoxidil alone hardly regrows hair on anyone. With this extent at your age you might become a Norwood 7 which would be severely limit your hair transplant options. Even if your hair loss never got worse you'd be needing a few thousand grafts at least depending on your expectations. You need to try finasteride or dutasteride. Combined with minoxidil (even oral) this may provide some recovery. Alternatively, I'd seriously consider looking into hair systems as well.

Hi there, all these questions your need to ask your surgeon, not strangers online. Some doctors have different instructions and they may be due to specific ways they practice or medications they give you so it's crucial to get your information from them. I can say shock loss refers to native hairs, there is always a risk but how high that is depends on a number of things. The shedding phase refers to the transplanted hair and this will virtually always occur.