GoliGoliGoli

If the study below of 249 patients is accurate, very low dosages of finasteride cause the same amount of scalp DHT reduction as the more "normal" recommended dose of 1 mg or 2.5 mg. 

Unless dutasteride works different, his recommended dose of 0.5 mg of dutasteride is going to have the same levels of DHT reduction as 5mg. Even 0.05 mg of Fin lowered scalp DHT by large amounts in the study below. Yes he recommends only taking it 2-3 times per week, but as he mentions Dut has a longer half life than Fin so it doesn't stand to reason that these recommendations would signifigantly lessen the potential for side effects.

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia - PubMed (nih.gov)

44 minutes ago, Aogl said:

He bumped it to 9 as of right now looking at his website.
Would a good respons to finasterid changes this, maybe that and the option of taking beard hairs could give me hope for the future.
 

Personally, even if you were a super-responder to finasteride I still don't think you're a good candidate 

I heard Zarev was like 5 euro per graft but I could be totally wrong. 

The thing is in your case, Fin might help, but I still think your donor is too sparse to consider a HT even if you're very conservative. 

I don't mean to be a buzkill, but I think a HT would be a big mistake for you. You seem to have signifigant thinning in your "Safe donor" area, so even if you moved the hairs from there to the front I'm not sure they would survive long term. 

In my opinion you are not a good candidate unless you have VERY conservative expectations. If I had to guess Zarev would reject you as a patient =/ 

30 minutes ago, duchaine said:

From what I see, the apex of the angle should be closer to the Cantus of the eye.
Turkish surgeons tend to draw this kind of hairline.

Which angle? 

Not trying to argue btw, just curious what you mean. Also you can't see his eyes so kind of confused

On 12/15/2023 at 9:34 AM, duchaine said:

I think the frontal hairline is too wide.
Do you have any pic with the hairline design?

What do you mean by "too wide"? Do you mean too thick? 

I have also been considering shaving my head recently. Not so much for aesthetic reasons or because I'm sick of styling it, but because I'd like to see the extent of my miniaturization to help me decide when is the best time to do a 2nd HT for my hairline. I'm pretty sure I'm moving in the direction of NW5 but it's always been a very slow loss for me and its' easiest to see what's going on with a fully shaved head it seems. 

But can also relate to the liberating feeling of shaving. I'm pretty happy with how I can stlye my hairline right now, but windy is the enemy if I don't have hair spray in. 

On the 2nd HT, did you focus mainly on the crown but also reinforce the hairline? Apologies if you already said 

The hairline isn't excessively low, it frames the face well. The only risk of going that low is that it eats up a lot of grafts. In some of the post op pics it does look like OP is progressing to NW5, but he also looks to be in his 30's/40's so it will probably be a very slow process. 

Looks great

1 hour ago, Melvin- Admin said:

Minoxidil max has a formula. But why not switch to oral?

I'm not convinced it provides superior growth to topical, and also not convinced of the long term safety of using it. Will be happy if I'm wrong on both counts.

Hey all, does anyone know any good brands of Min Foam without alcohol? I've been using the Keeps brand stuff but I believe it has alcohol. 

Also, what is everyone's opinion on min with alcohol, does it work better than minoxidil without alcohol? Seems to be some mixed messaging on the subject online

Your donor looks fine, not great but not bad either. Hair caliber looks fairly thin in size. Hair to skin contrast is about medium. 

The thing is at 23 it's really hard to say what your donor quality is. Most guys with early balding develop retrograde alopecia but that usually develops later on. 

There's very little difference in DHT reduction if you increase/decrease the dose. Fin has what's called a flat dose response. Increasing/decreasing the dose will typically have no effect on sides or results. 

Dutasteride is the next step if you feel Fin isn't working. 

22 hours ago, Steeeve said:

I think your strategy is sound, you’re not going to be a dude with an island on your head when you experience further loss.

Ya it's actually one of the benefits of not having super thick density in the crown. As I continue to lose around my recipient area, it will just look like normal diffuse thinning for a good long while. If I had really super thick density in the recipient I think the bullseye would manifest itself a lot sooner. 

Appreciate your input. 

Hi all, I'm a few weeks passed the 12 month mark so figured I would share a final update. As always I try to present my case both in favorable and unfavorable conditions to give people a realistic idea of what to expect. It's extremely difficult to gauge what is a realistic expectation for a crown, so any feedback you have please feel free to share. No need to sugarcoat, I'm curious what everyone's honest opinion is.

Picture 1 above shows the crown with no combover in very harsh light. Pic 2 shows the crown with no combover in less harsh light (Same room, just turned around 180 degrees so I'm back lit not front lit). Pic 3 shows the crown with combover in harsh light. Pic 4 shows the crown with combover in less harsh light. 

In real life conditions the visual appearance is most similar to the 2nd and 4th picture, so overall I'm pretty happy with the result. As mentioned it's really tough to gauge what is a realistic expectation for crown surgery because most of the results posted by clinics aren't entirely trustworthy, and most results posted by patients show things in really favorable (Unrealistic frankly) conditions. I definitely know what people say when they call the crown the black hole. Maybe I could've used an extra few hundred grafts, but at the same time that's a dangerous game to play because you don't want to spend too many grafts on the crown. That said, if I could go back in time I would have advocated for a few hundred more grafts probably. 

I'm very happy with my decision to not get any hairline work done for now. I'm very happy with my current hair style (fringe style) and think it covers it up well without really looking like I'm blatantly hiding anything. If I had gotten hairline work I would've probably used very few grafts and gotten only a minimal aesthetic improvement, and then been left in a position where I have to chase further loss to look normal. With the crown, as I continue to lose hair I will eventually be left with a bullseye, but that is waaaay down the line because of how slow my hair loss progression has been historically. As further hair thins around the recipient, I will just look like I have a larger diffuse thinning crown, but I think by the time a true bullseye develops I'll be ready to address the hairline anyways so the timing should sync up. Because I'm only using Minox I reeeeally didn't want to be left in a position where I have to chase loss to look natural, and I think my strategy will accomplish that.

Please share any thoughts you have on my final result. Like I said it's really tough to gauge what a good crown surgery is for the reasons mentioned above, so honest opinions are appreciated. But from my perspective, I'm happy with the result and feel comfortable going out without a hat or hair fibers, but I'd like to hear everyones thoughts as well. 

I know this is the same advice I gave before, but if I were you I would get good at giving yourself the cut you have in the pics from October 27th. This looks pretty darn good. It sounds like you're reaching the limits of both your financial and donor resources, and the truth is you're going to continue to experience further loss. You don't want to be chasing this Save the grafts you have left for years later when you really might need them, and spend some money to get the mirror set up right that allows you to give yourself and awesome fade that completely removes the horeshoe pattern. 

Cutting your own hair sounds really challenging and daunting, but I don't think it's nearly as hard as it seems. Especially once you're practiced and have the right set up. 

I asked my Dr about this (Nader) and he said to continue applying Minox to the recipient area (After waiting a bit post surgery). 

I'm still not really sure if Minox is "site specific" or whether putting it on one area helps the other areas adjacent. Probably a little of both, but I try to saturate my Norwod 5 area with it anyways. 

He has very advanced retrograde alopecia which I don't think you usually see in someone who had a hairline like his. Not that his hairline is perfect, but NW2/NW3 don't usually have retrograde loss that far up the ear. 

I didn't read much of the above, but it's a very simple point that is being made.

The point is: It's well known that Fin causes certain side effects in a certain amount of people. We all know what those side effects are. If someone doesn't have any of those sides and starts taking Fin, gets the sides, gets off Fin, and then continues experiencing the sides, you can just use basic reasoning to assume that Fin was the causative agent.

But sure, you can keep thinking it's lack of sleep or diet or something.... You sound like a religious person almost. 

8 minutes ago, TheGreatPretender said:

Any abnormal hormonal changes that would be permanent due to Finasteride would support their claims but then again you just slipped into one of the reasons why I don't believe on it since it is well known that the majority of people have their 5-AR enzyme return to baseline levels after discontinuating. 

I think you have a fundamental lack of appreciation for the complexity of biological symptoms. There is a lot we don't know about how  biological systems interact with each other to produce a desired result, so looking at one variable (5AR in this case) and saying "SEE! LOOK! It returned to normal, therefore PFS is FAKE!" is not really scientifically literate. 

6 minutes ago, TheGreatPretender said:

Enough trials with a large amount of subjects that alegedly suffer from the condition with proper blood test results. The same subjects would also have to be tested against any other possible conditions which they could have.  

But that is me, perhaps a PHD level doctor would provide you a better answer or maybe our iliterate specialist that is allegedly more knowledfull then the overwealming majority of doctors that studied upon the subject.

I don't think blood tests would show anything, so what exactly would these trials be testing the subjects for? 

7 minutes ago, TheGreatPretender said:

And yet decades after the aproval of Finasteride for Hair Loss no definitive evidence has been found for Post Finasteride Syndrome. 

You can use as many alegories as you'd like, fact still stands.

What exactly would definitive evidence look like to you? Like what exactly would it take for you to believe that a certain number of people who take Fin end up dealing with persistent side effects?