general-etwan

Looking great! You’re still off finasteride and have no reason to take it, is that right? I am trying to decide what to do about my own situation. Half of me thinks finasteride (at 3 days/wk) hasn’t done anything noticeably positive for me (I’m NW7 pattern, already determined, and fin definitely hasn’t regrown anything for me. On the other hand, it’s possible that the final cm or so of my original hair may continue to bald without finasteride at all, resulting in another future problem. Not really sure what to do at this point. I also use pyrilutamide topical daily, which is supposed to eventually be able to replace finasteride, but the downside is now I don’t know which one is doing anything positive, or if neither is doing anything good for me. And pyrilutamide is extremely expensive to keep using daily.

The work looks so clean and the healing happened so quickly after the procedure that it’s difficult to tell where the crown work stopped and ended. It looks like a gradual decrease of grafts to about mid crown, am I right? 7700 total grafts, should get a very dense result across the top.

Yeah I mean the boundary at which the balding will stop at during someone’s life. In Zarev’s words, he makes an evaluation of where balding will stop in a person, and based on that, he can draw the safe donor region as being right up to that predicted line.

Insanely good looks. One thing I just can't help but notice though is how aggressive Zarev seems to be with his classification of the safe donor area. I watched an interview in which he explains he makes a personal evaluation on what a patient's safe donor area is and where the severemost boundary of balding will end in that person's life. In your case, it looks like he considers all the way up to your temples and up high on the side humps to be "safe" from miniaturization. Looks like fantastic work right now; just curious how some of Zarev's most amazing outcomes are going to look a few decades from now.

Good work. You're about the same age as me and also have advanced loss that is lowering into the lower crown area, unfortunately. I know you mentioned the hope of being one and done, and of course, it's all personal preference on what your goals are and where you will accept satisfaction. I think it's clear however that this area will continue to thin and was of course not addressed during the first HT. It would need another procedure to be tackled, if you ever want to address it.

Additionally, and this may or may not end up being a major concern, I notice that it seems like my temple areas have continued to recede, despite me being on finasteride and using minoxidil every day. After the fade cut, you can see a gap between where the transplanted hair on the temples ends and the "thick" native hair begins. Or, maybe it was always in the works and it just wasn't as noticeable before. It may be that I just won't be able to end up wearing my temple areas this short in the long run. I don't know. I think the unfortunate reality is I may be destined to perpetually move towards a boundary shown here in red: Finasteride and minoxidil may not be strong enough to prevent that. I don't know what would be, or if there is any hope for that area at all.

First, thanks for the recent comments everyone. Definitely thankful for the growth all the way through thus far. I want to say though that man, what a difference just a few days after a fade cut makes, and not in a good way. First, let me share some more pics of the situation before I got the fade cut. The diffuse look on the sides was no surprise, as I have always suffered from this since my teens and know it's not just going to go away. I think finasteride and minoxidil has somewhat maintained the situation from getting even worse there, but this is that length where the diffuse retrograde loss is obvious...shorter helps hide it and longer will help hide it too. Now, last Friday I got the fade cut which you all saw me post. Looked great, I agree, and the "horseshoe" pattern was minimized by my barber's technique, or so it appeared. But just 3 days later, the donor area is outpacing the recipient area again as usual and the dreaded pattern is back: Do you think that my barber took the cut too high into the crown area? Now I think he did. But I think it was out of ignorance because he does not know that these areas are currently behaving different from each other; he may just assume it all grows at the same rate/length and that his fade would maintain the same contrast over the days. It kind of seems like he made a fade "boundary" here | When it should be more here: I absolutely dread this horseshoe pattern making its return so quickly. The acceptable contrast didn't even last 3 full days. I know it's still early after my 2nd HT (only 4.5 months) but I still think that just looking at the difference between the areas, the density in the lower crown is still substantially lower than the density of the rear donor area. I know that's usually a reality of hair transplants. I just detest this look from the back and need to have a plan to extinguish this phenomena for good going forward. I expect that a few more months down the line, the hair in the lower crown will be able to be kept a little longer than the rear donor and hopefully will look more balanced; something more in the direction of this: But the thing is, this guy's hair will all grow at the same pace; he does not require constant fades to maintain proper balance. His lower crown hair and rear donor area hair will grow together, and the lower crown hair will remain longer and more dense looking than his upper neck area from this point forward. With me, I don't know if that will ever happen. I see what you mean about the donor area, and SMP could definitely be used to fill in those tiny lighter spaces where the grafts were taken. However, my more crucial concern right now is the area above. I feel that if I am to go for a consultation on SMP, I'm going to want it done in this area, to try to make everything appear more uniform:

8,300 total, 1,300 of which were beard and 7,000 scalp. Yes, they used side lock hair in the 2nd procedure. I had pretty thick sidelock hair still so yes, it is acceptable to use as standard "scalp" hair but is used in the midscalp and crown area; never the hairline area which needs to be softer.

No product, no filters, harsh light.

Sorry Melvin, read your comment too late. I went to my barber and he really insisted that we go short. He is really good at his artistry and even though I was nervous I said fine let's do it. He is not a fan of the bangs alongside the current crown situation and insisted we get rid of them for now. I like how it came out. I can grow it back out when the 2nd HT region catches up fully with the surrounding area. Experimented with adding some fibers in the back half of the top and crown and think it helps for now: ^ This right here is getting impressive, I think. First full day I went out and about without sporting a hat at all and felt like the fear that I've always had of the "ring pattern" being super obvious finally went away. Rubbing some fibers into the crown area really helped. Not perfect yet, but such a recovery so far.

Yeah, definitely will consider this over the coming months.

Hello all, Have some recent pics to share. Been super busy with life. I would never have allowed myself to be this busy if I hadn't chosen to embark on this journey and fix the most fundamental problem I was gifted. Simply having hair, as a young man should, was by far the most important thing I needed to take care of to simply pivot to a feel-good daily life. 4 months post-HT #2; 13 months post-HT #1 Combed backwards for evaluation as requested (I don't wear it like this daily): Obviously, considering my original starting point and the massive area to cover, it's not super high density. But the great thing is that really no one even cares or notices. It's enough that it appears as a pretty normal head of hair to the vast majority of people. Here are some more pics of forward-laying (hair is often just messy; I still wear hats so I don't spend too much time on the style; most days I just spray in a tea tree oil conditioner and ruffle it up and go): Here you can see the progress on the rear lower crown; growth starting to come in stronger the last few weeks. I have just been buzzing the back and sides myself at home once a week, so don't be too hard on the look; I haven't been getting it consistently professionally faded yet. Once the growth kicks into consistency, then I'll have it faded by my barber every week: Hairline region: And finally, you can see where there is some see-through when looking directly down from the top. This is no surprise; as said earlier, I am very realistic about density. I was thinking about buzzing all the hair shorter to uniform length, but I'm a bit afraid of the density still being too low to match the sides and back, and it looking too diffuse: I purchased fibers last month and used them once or twice and yes, they do a good job at visually filling the transparent-risk regions. However, I don't see them as something I want to use on a regular basis as I am very active and have to change my clothes multiple times a day as I engage in varying responsibilities. The fibers come off as dust on your hands and clothing, and ultimately are incompatible with water and the elements. I am thinking about if there's anything else I'll want to do in the future for appearance of added density. An option as mentioned months back is SMP on the recipient area to create that illusion. If I were to do that, I'd have to buzz my hair all the way down to a short buzz-cut and then have it done. And I would just have it done on the entire top to help even the appearance out with the back and sides as much as possible. If I decide to do this, I'd want to do it this winter. But still undecided as I haven't seen enough cases of it yet to evaluate its success on others.

This is correct; that post of mine you quoted was well over a year ago and since I've definitely learned that the scarring is the major difficult thing that prevents this simple math in most cases. Most people's donor can't be massacred beyond a certain point without looking just bad from all the tiny scarring adding up.

Only occasionally the past few months. Nothing much. That’s been my routine but I think using conditioner a little as well should help.

Up until yesterday, no! But now I am and will

Yeah, this has ketaconozole and is framed as a non-drying shampoo but honestly not sure how true that is. And not sure if ketoconozole even does anything positive worthwhile for me at this point, so going to use other shampoo & conditioner and see how that goes.

To the OP: In theory, you'd think that would make sense to do and produce a good look. But in reality, the math just doesn't end up working out that way. As Melvin posted his photos, you can see exactly what happens. It's just a reality that hair transplant recipient density will never match that of original donor area hair. And so if the entire head is buzzed to the same length, the recipient area is going to look thin/balding/lower density than the donor area. And then we want to say, well then keep taking more grafts from the donor area until the entire scalp is homogenous. Well, when the donor area gets to a certain point of extraction, the little dot scars become too bad looking. Hair transplant technology keeps getting better but it's still surgery and it's not completely scarless. So to keep the scars from looking too bad, enough hair has to be kept back there, and that's too high of a density for the recipient area to ever match. So realistically, the best look should be some sort of fade/taper where the top is longer than the sides and back. That's how illusion of desired outcome is maximized.

But the real question is how did it come to be that MPB occurs in the pattern it does. Why are the hairs on the sides and back of the scalp not affected by DHT nearly to the degree as those on top in that ring pattern.

I have been using this https://intelligent.shop/products/intelligent-shampoo for about a year now

Kind of unsure why my hair has been looking so dry and unhealthy the past few weeks. Not sure if the barber just didn’t do a good job cleaning up the top this time or what. But my hair is always so dry looking. What products do guys use to keep more of a moist look all day? I’m really struggling with the styling of it at this length and not sure why it’s not looking better than a few months ago. Directly under gym light

I would not do any chemical alteration on hair until at least 4 months after a HT.

Will give it a go tomorrow! As everyone should have expected, my density isn’t super high, so I’ll have to decide if I’ll eventually want to add SMP to increase illusion of density. Or just try other things like fibers. I’m not going to obsess too much over it though because even just coming this far has been fulfilling.

I was anxious about cleaning up the top but barber insisted it would look even better just taking a little bit off:

11 months after 1st HT; 2 months after 2nd HT. I've started mentioning to some new people that I've met recently that I've had a HT, and everyone is in disbelief/would have never guessed/knows nothing about them. A pretty refreshing feeling to finally get to that point where I blend in as having normal looking hair for my age. The temples and 2nd-HT area have begun to grow in.

11 months after 1st HT; 2 months after 2nd HT: No fibers, no powders. Only sea salt spray some days.