hairywannabe

Hair will mature so the visual effect should get better, although at this stage probably not many more grafts will pop out. You can try to draw (with a marker) a 1 cm2 square on the transplanted area and count how many grafts are in that square - then you will get an idea what density you have achieved and whether the surgery was successful.

I wouldn't go crazy about your hair direction, some people have more vertical direction of growth, imo it's about adding more density and there is no need to correct all your grafts.

I haven't seen a signle case in which hair goes literally from left to right (or from right to left). The natural direction before and after a hair transplant looks like that imo: You can see that on the hairline grafts are more flat than in the middle of the head. So this whole discussion about angles is not about left to right or right to left but how vertically or how flat grafts are placed. A flat placement provides better skin coverege but it could be harder to style when hair are too short. That's why some people with a really low hairline have to wear a haircut like this: Because their natural direction prevent them from having a hair parting totally on the side like this (it would be very hard to style): So they just let their hair to be aligned with their natural direction:

The natural direction of growth isn't aligned with those arrows in my opinion. I suppose those arrows show how you want to style your hair but the natural direction goes to sides (not to the center):

Well if @Bronamath123 and @knivesout09 are reporting poor yields from procedures performed by Mwamba then it starts to be worrying. Not so long ago we had more dissatisfied patients: https://www.hairrestorationnetwork.com/topic/63234-dr-patrick-mwamba-fue-clinic-1300-grafts-5th-6th-of-july-2021 https://www.hairrestorationnetwork.com/topic/65602-dr-mwambas-fue-2200-grafts-work-7-months-review/ https://www.hairrestorationnetwork.com/topic/64494-dr-mwamba-june-2022-asli-tarcan-botch-job-repair

If you are using hair fibers in those pictures then it explains why this area might look worse than the rest. In general hair will mature and get longer so skin coverage will be greater and hence visual effect will get better for sure. Although after 7 months most grafts will pop out, so if at that stage there are significantly less grafts visible in comparison to the number that was implanted then there is a high chance that something went wrong. Can you see thin hair popping out?

This area may be visually lacking the most because usually temples have a bigger area without native hair at all so it's harder to fill them - in comparison in the middle of a head usually people receed slower and a supbar growth rate is not so recognizable there because native hair (behind transplanted hair) prevent that sparse look. I've seen this in many Mwamba's cases from the past, for example the left temple here: or this case:

Kudos for showing the picture taken slightly from the bottom which exposes the regrowth density, every result should be presented like that. Too many people don't realize how easy it is to camouflage a poor result with proper pictures. Great work!

I was thinking about a 0.1% topical dutasteride and using 2 ml weekly (so 2 mg for 2 ml) or a 0.05% topical dutasteride with a mesotherapy every 2 weeks.

Has anyone tried making homemade topical dutasteride? Buying a topical dutasteride can be expensive and delivery might take a long time. In addition, after 3 months the product is not usable so it seems reasonable to produce it every 2 weeks or every month in a smaller amount. I've found this vehicle recommendation: https://www.reddit.com/r/tressless/comments/ssy23v/i_wanted_to_share_with_everyone_this_cheap/ and I'm thinking about using it: https://getsomebeauty.com/product/balea-men-power-effect-caffeine-boost-tonic-150-ml/ to dissolve dutasteride oily capsules inside of it. Not sure if should dissolve whole capsules or try to cut them and dissolve only what's inside of them. The downside I can think of is that this vehicle contains alcohol, so it won't do well with dutasteride mesotherapy (alcohol can irritate the skin quite easily). Another vehicle I've heard of is: https://www.reddit.com/r/tressless/comments/nijtt9/topical_dutasteride_oral_minoxidil_dermastamp/ https://www.amazon.de/-/en/Pantostin-Scalp-Hair-Therapeutic-Solution/dp/B00DIWYBS4/ref=sr_1_3?keywords=PANTOSTIN&qid=1680099447&sr=8-3 Not sure if it could be better.

Was the nape BHT procedure performed by Dr Mwamba?

This is a great result, hairline seems really natural and dense (especially for only 2200 grafts, area was not that small in the end), the donor area is managed perfectly (spaces between extractions), congratulations!

There is a huge misconception between the percentage of hair that popped out and the percentage of final visual effect (maturation and proper length of hair). Probably after 7 months most grafts will pop out, so if at that stage there are significantly less grafts visible in comparison to the number that was implanted then there is a high chance that something went wrong. However, it doesn't mean that it is the final result; hair will mature and get longer so skin coverage will be greater and hence visual effect will get better.

@mustang What are pros and cons of topical dutasteride (let's assume once a week) vs dutasteride mesotherapy?

Have you thought about adding Tongkat Ali and/or Boron supplementation to decrease SHBG and estrogen and increase TT/FT? I'm currently testing Tongkat, will do blood work at the end of the month. In theory it could reduce unwanted effects created by fina/duta.

Don't limit yourself to procedures only in Poland or Turkey. HT is a big deal, if you choose wrong you will regret it a lot, your donor area isn't unlimited. If your first procedure in a budget clinic isn't successful then you will be forced to have a second procedure (this time in recommended clinic) and you will pay more than you would if you went to a recommended clinic at first (Freitas, Bisanga, Pinto, Feriduni). You can find world class surgeon for 3-3,5 euro / graft. You can check out my result: https://www.hairrestorationnetwork.com/topic/64160-2979-grafts-fue-przybylski-clinic-dense-packing and see what's the risk.

Anyone have some thoughts about that?

Well, from a logical perspective this is true - if DHT and testosterone makes you balding (even though testosterone is way less impactful) then to prevent this as much as it's possible you should address both things, can't see anything wrong in this statement. Other thing is how impactful is any of those in a specific case (a particular body). Our attitudes and med stacks change when time goes, nothing wrong with that. Anyway, I've sent this link to give a brief view on what hormones can change after taking finasteride and I think it's good to have this knowledge to begin with. In my country dermatologists prescribe DHT blockers without recommending doing blood work tests and I think it's really dangerous thing.

Probably you can have so high sensitivity of hair follicles that even when you have low DHT you will still be balding fast. On the other hand, probably you can have let's say an average sensitivity of hair follicles and then changing your DHT levels from high to normal can be crucial for balding. I think it's always a case study, a matter of specific person's organism.

As I said in previous post, it's good to test DHT, testosteron, free testosteron, estradiol, shbg, prolactin, progresterone. You can read a little about changes can occur after taking finasteride here: https://moreplatesmoredates.com/post-finasteride-syndrome/ (especially "Unaddressed Estrogen Imbalance" part). If you have high estrogen, shbg, prolactin and low testosterone, free testosterone then you can expect more side effects.

Theoretically it should allow you to block more than taking just finasteride but less than taking dutasteride every day. It's best to do blood work test before taking finasteride, then do it again after taking only finasteride for a while and then add dutasteride and do blood work again. In my case, my DHT levels were like that (standard level is 250-990): 1. Before taking any meds: over 2657, scale of a blood work test ended so potentially it was enormously high 2. 0,33 mg finasteride daily: 2578,6 3. 1 mg finasteride daily: 2380,2 (theoretically it should block around 70%) 4. 0,33 mg finasteride 6x a week + 0,5 mg dutasteride 1x a week: 790,2 Funny thing is that if we assume finasteride blocks around 70% of DHT and dutasteride around 90% then my natural level of DHT was around 8000 (when standard is 250-990). Theoretically you could take just dutasteride 1x a week but I take low dose of finasteride daily hoping that it makes my hormones more stable (because dutasteride is taken rarely). Btw. it's best to control not only DHT but testosteron, free testosteron, estradiol, shbg, prolactin, progresteron too.

Well, the thing is when your transplant is successful everything will be ok (and there is a chance for it) but the question is how would you feel if transplant wasn't successful and when many people warned you about this clinic. In my case, I have chosen other clinic even though I saw negative opinions about it. My transplant wasn't successful and now I feel just stupid because I wanted to see only positive reviews. My clinic offered me free touch up but I don't trust them anymore - they got bad reviews and did bad job with first procedure. When we are talking about a clinic with mixed reputation, would you accept a touch up from them if your first procedure didn't work out? If not, you would have to not only sacrifice another year for second procedure but pay again for it (in another, more reputable clinic). I suggest not to think wishfully, there is too much to lose.

Perfect donor management, congratulations!

Thanks @Botch me baby. It wasn't Saifi, it was doctor Przybylski (as it is stated in the title). Well, the problem of poor survival is for sure here, I can clearly notice large spaces without hair and it wasn't the case after procedure. I think that blood vessels could have been damaged during the procedure and combined with large scabbing, it could have disrupted the blood supply, it seems like the job wasn't so "clean" as it could be (comparing to other clinics): However poor survival and bad donor management is one thing, another thing is how many grafts were used. What do you think about that? And is it common to divide double grafts into single grafts?

Thanks to @rob7331 who said that it looks more like 2000-2500 grafts I've started to wonder if it might be the case. I talked with the doctor who performed the procedure and he said that 2979 (and that's what I paid for) grafts were extracted, but to create a natural looking hairline on first day of the procedure, around 100-150 double grafts were divided into single grafts. So as far I understood there should be around 3100 implanted grafts after the procedure. I tried to calculate those grafts as meticulous as I could but it is not easy since before the procedure my native hair were in the recipient area: I counted 2593 grafts which seems to be significantly less than around 3100. However, besides of native hair in the recipient area, it is even harder to assess because some transplanted grafts could just fell with scabs. Here is the link to PDF file with better quality pictures: https://drive.google.com/file/d/1YLwzVt2FEqD2hz9zQXC1MUiqyeT9PNAK/view?usp=sharing What do you think about that?