TheGreatPretender

So previously I have made a few posts with the conslutations I had with the different doctors so far from my shortlist and now I feel like I have a better understanding of the bigger picture. Thing is I am currently still undecided about which clinic to chose because even though I was happy with one of them I am still not sure if this is what I would really want to go for or at least feel like it would be the most confortable path. So my situation is the following: Current Baldness level - Norwood V (Diffuse) Medications: Finasteride 1MG daily + Minoxidil 5% twice a day (Regaine) + Nizoral 3 times a week Objectives: Restoration of the density in order to be able to perform long hairstyles. So here is the feedback I got from different consultations. Dr.Bicer - Was told that I would need 3200 for the frontal part but that I could be looking at more than 3800 if I was looking to restore the crown in total, howeaver she was willing to go to 3800 max. The doctor was also happy with the density within the donor. Dr.Lorenzo - Was told that my baldness was quite advanced and that I would require over 6000 grafts total in order to achieve the desired results, this would require two sessions, I presume this would be somewhere between 3000 + 3000 in two years. They would require me to go to the clinic though to evaluate the donor. Dr.Ximena Villa - Recommended me to start Oral Minoxidil (5MG) and continue Finasteride for an aditional year before going to a surgery. Howeaver she estimated that over 3000 frontal grafts would be initially required for the frontal part, also advised a visit to the clinic for donor evaluation. Dr.DeFreitas - Probably on my top tier list currently, recommended 3000 grafts which would be distributed in the frontal, entrances and middle of the scalp within one session split in two days. I also asked if the 3000 would be enough to restore the required density to which the answer seemed positive, howeaver they noted that if the crown required transplantation this would require a second session which would be quoted later. But from my understanding it seems like De Freitas was confident that he would be able to restore enough of the ilusion of density within my scalp with these 3000 hairs without the need of a second intervention, also from the hairlines I have seen of him he seems quite capable of doing it so. What is keeping me from pulling the trigger you ask? Same thing is it was before, there is still the temptation on my part to go for De Freitas because I like his hairlines and his artistry he seems to be one of the best if not really the best surgeon in the world for many but at the same time I feel like I didn't consult with my other two top tier surgeons which are more location friendly in terms of their location which are obviously Bruno Pinto + Ferreira. Also I know that the quotation from De Freitas lasts only 3 months, which would have the deadline placed sometime at the following month and this is one of the things that is making me procrastinate because I know the clock is ticking on this. I also recognize that taking forced decisions with these kind of procedures is not really a good thing, which is why I am still taking my time to decide. Working from home has been making things a bit easier as well because I rarely go out but as soon as I know I have to step out of the doorstep I know I need to have either my hat or the fibers on which gives me the dreaded reminder of how far I am gone with my head of hair. So my question is, even though one of the doctors team have been really great with the coms and feedback is it worth pulling the trigger now or is it always the best to wait until the other two are open for consultations in order to make a so to say "more informed decision"? I know loads of people that went through hair transplant have gone through the same process as I and It has been only a few months since I started my reesearch. I also don't pass my whole days looking at the doctors results meticulously as I already seen the ones that interested me for the most part but I also know I need to decide sooner or later because a surgery is just waiting down the road and the only question at this stage for me is with whoom.

You are right there isn't just one that concludes that it works for every single hair folicle affected by DHT. I'l rest my case.

Again, you are going under the simple assumption that OP wont recede further without medication. That "light aggressive" form of MPB that you describe could very well get more aggressive by day without OP even noticing that by itself is a risk that he has to be willing to run in case he gives up on his medication. PRP is a good therapy but the evidence for countering hair loss is not as significant as for Finasteride and Minoxidil. I would say best case scenario its a superior therapy to Microneedling. And that last statement is also false, Finasteride works in every single place where there is hair, just like Minoxidil and it works to prevent further loss of hair better than regrowing but its effects are universal within the hairline.

Yes I did and my argument stands. The process is simple, once you see that you have MPB you start medication and if you find side effects you stop it, its as simple as it is. Having MPB at an early age and plan to take it later only increases the risk of being it too late once you start having real trouble to the point you cant even style your hair appropriately while going outside. You would rather start early than late, especially considering that the majority of people does respond well to the medication and barely has any issues while taking it. The only reason I find advisable to delay starting is if you still havent matured or havent finished puberty, other than that there arent any good reasons to the point I can recommend people not try it. Another thing, Finasteride is good for every single part of your hair, not only the crown or Middle and it has been proven time after time that is the best medication available to stop Hair Loss at its tracks. Your case is an optimistic one because you started receding by 23 at the temples, a lot of people lose everything by then in that area from all sides like me. Why run the risk if you are likely to benefit from a medication that is intended to give you the peace of mind that you need for years to come in protecting your hair?

If one has MPB and is losing hair than Finasteride is an absolute must unless for any reason this is not the case. Anyway I am 27, I became prety much a NW5 diffused at 20 so dont count starting later as a guarantee to not lose any further. Also, after puberty it is more than safe to start treatment, ideal even especially if you start losing at such an age. The truth about Hair Loss is that it is unpredictable, it can strike at any age young or old especially with a family history of parents,uncles,cousins that hold such a problem. Starting Finasteride is the best thing OP did and the decision to hold on the transplant for now is even better. I am sure he will be more than happy to keep his hair for years to come down the road.

You may not bald at all. My stance on your case is mostly due to the work that goes in getting the right call when doing a surgery. Remember that there are no guarantees when doing a HT and if for example it fails that means you have a % of hairs that you would permanently lose as part of that even if the doctor agrees a touch up. There is also shock loss which may happen in your donor and/or recipient in which the native follicles get through trauma for a specific amount of time before coming back. If you chose a poor/unethical clinic you may even face serious health issues as this isn't like going to a dentist to get your teeth done. I am not obviously trying to fearmonger or force a decision upon you, at the end of the day it's your call. If you are looking to do some research for some good clinics look for some recommended names here for Europe and avoid the UK if possible, I know it's hard because I live in there as well but there are far Better options for yourself overseas. Bruno Ferreira/Bruno Pinto for Portugal, Lorenzo, De Freitas, Ximena Villa for Spain just as examples. Turkey has Dr Bicer. These are just some examples, there are more if you search in this forum.

I feel like it's to early of a stage for you though even in that aspect. For one you mentioned that you have been on Fin for 10 months, I would say it can take until two years to get optimal results. Even if not likely you may even regrow at that time making a potencial surgery pointless. But even adding some small grafts does come with a risk not even to mention the cost I'm which the trade-off from pros and cons I think it's not worth taking the surgical route atm.

No way. I wish I had as much as you have at your age. A hair transplant will not make your hair look like it did before or even as good by rule of thumb, a hair transplant is in essence the ilusion of density rather than the density itself. UK clinics are the last place where you want to be for HTs too but at your age you are fine. Also you are already on Finasteride which can even give you improvements until 24 months alongside oral Minoxidil (if you can tolerate). Honestly in my understanding if you are on medication at this stage I am prety certain you will be set for life with no need of surgery in one lifetime and if you feel like you lack hair in certain spots you can always grow it longer to conceal it without much effort.

Thats insane for just two months! Keep going.

Wow! Absolutely stunning, tremendous delivery by Mwamba, you literaly came back from the dead. This is one of those cases that really gives me the pleasure to see.

Very unlikely. You can stop if you feel them or even decrease dosage (3x a week .025mg) but usually it's very tolerable for more than 90% of who uses it. Bear in mind that for MPB (1mg) the dosage is far less than used for Prostate issues (5mg). Keep yourself active in the meantime and do some exercise which could help you counter them anyway.

This, I am 27 and you dont want to know how bad my degree of baldness is. Needless to say I would "kill" to be at the estage that you are. If fighting MPB is what your're after then Finasteride should be started ASAP, you might even regrow in the process, and if you feel like you need more you call also commit to Minoxidil but a hair transplant at your stage is something I wouldn't recomend. You could even grow the hair longer to get that covered and that would be it.

I think its a lot to do with your gut then anything else since there are so many variables that come when doing a transplant. Usually you would try and make sure that the results you see are from people that were in your scale of baldness which could relate to it. I am currently a diffused NW5 so I really need someone who is able to get it done in 1 session and if required just do a small touch up for the second proccedure on the crown but De Freitas basically recommended 3000 grafts for me on that level. I loved Tamara when exchanging emails, she was very patient even when I was being a bit anoying throwing questions out of the blue due to my ongoing anxieties and insecurities. And they got back to me quite quickly too. Anyway, let us know what choice you make whichever it is and good luck.

Yeah, you might be right. Maybe in the end it is a matter of personal preference, I feel like by the time you narrow it down to the best surgeons you hit a so called "grey area" where you got to make a choice and commit to it.

I am originally from Lisbon, but am currently residing in the UK. I do own a house in Lisbon though so it would be a 2/3H jump to my home. There would be an option to travel back to Lisbon post surgery I guess and recover there. Yep, he is on the list but also busy. Though I have seen more movement from Ferreira as he seems to be a bit better though. The thing that seems consensual among most people around is that even though both Ferreira and Pinto are great at their craft they still fall short in comparison with De Freitas though but I am not sure if this is just because of personal preference or if his technical skills are better for most patients.

I got contacted by lorenzo asking some better quality pictures back which were sent too a week back but no answer came from his assistant. Oh well, at least it reduces down my options currently. I like De Freitas work a lot but I think Ferreira would be a bit more of my comfort zone because the surgery would be done in my own country, although he is a tad more expensive now.

That option is down too sadly, I am not sure how long it will take as Alexandra (his assistant) told me that it "might take a few months". The option where you pay for a face to face consultation in Porto for 75€ only starts in September. Hopefully the online ones wont take that long but only time will tell.

I would expect it roughly a year to be honest. All great clinics are saddly facing high volumes of trafic so its a bit of a miracle if you are able to find something in less then a year so one year is not too bad. Plus you got the time to spare all that money in so its not too bad.

Never said that. I only did a consultantion with bicer that's all. But I would like to have with pinto and Ferreira since these are on my top shortlist too. Problem is they are too busy atm.

Similar dilema here between Pinto,Ferreira and Freitas. I consulted with both Bicer and De Freitas a few months back. I feel like a lot of it depends on your gut/intuition. But I am slightly leaning in for De Freitas but there is something that is keeping me from pulling the trigger.

Absolutely stunning! Kind of jealus, not gonna lie.

Honestly there shouldnt be much difference, its just one percent less. I think they should share similar effects overall, just bear in mind that Nizoral is the third of the "Big 3" treatments out there so for hair loss so Finasteride and/or Minoxidil should be tried first.

I always like to make use of 2% for effectiveness, plus also my dandruff can be a bit agressive so its double the strenght.

I think once should be good enough tough I always been following the twice a day as a standard just to eliminate any doubts on my mind.

It will lose effectiveness in case you dont use Finasteride, if you combine these two you have a lifetime to lock those hairs for good. People may start Finasteride and wait for a year to see the results. If they are not happy then add Minoxidil to it.