Steady45

Amazing result. Can't wait to look like this. 3 months in after getting 1500 grafts from Rahal

Would love an update too

Hey @Melvin- Admin,

Just wondering if I could get your thoughts on the above. There’s quite a few more than 2 multis right in the hairline, and many more in the row directly behind.  

I noticed this poor chap’s hairline on my Reddit feed this morning and couldn’t help but think that the middle peak of my hairline is going to end up looking the same - pluggy and unnatural.

Do you think my concerns justified? The earlier I come to terms with the potential need for a revision the better I think. 

Otherwise, I’m very happy with the work done along the hairline either side of the peak, I just wish they could’ve replicated that for literally the most important part of the hairline.

27 minutes ago, FUEnator said:

 

Wait...what?

Care to elaborate?

15 minutes ago, Coffee_bean said:

Honestly looks quite good, especially for tech implantation. Assuming this doc knew what they were doing here. Density looks quite good as well

I agree brother, most things about this procedure are top tier. I’m generally very happy.

But I also know that implanting multis right at the front is a no-no so I’m just trying to gauge how concerned I should be

I should also be clear that I still have a great amount of confidence in this doctor and believe that I will mostly still get a solid result, but also think I’m well within my rights to zero-in on what could potentially be a fundamental error in a crucial place in the hairline. 

I acknowledge this is not the personal fault of the doctor as there were two techs doing the implantation, but still, surely the doctor would have taught this stuff as like implantation 101 for techs.

1 hour ago, Melvin- Admin said:

I only see two multis in the front. Maybe I’m missing something. The two I left unmarked appear to be doubles. 

 

The hair behind the front is typically multis for density. As long as the front row is singles, it should look okay. 

Hey Melvin, 

Cheers for responding.

Based on my research it was my understanding that there should not be any multis placed in the transition zone, which should span between 0.5-1cm (in cases such as mine where there is limited loss it should apparently be closer to 0.5cm). 

This understanding is what I  based my post on, as there are many dozens of multis within 0.5cm (or within 2-3 rows) of the hairline. However, you would know better than me how multis should be properly placed, so if you say it is okay as long as they aren’t in the first row then I’ll take that into account.

However, even if that is the case, I can still see quite a few multis right at the hairline in the middle peak. Please see below. 
 

4 minutes ago, asterix0 said:

What's done is done now. I don't see any egregiously thick grafts so probably it will be ok. However, the density doesn't appear to match your native density behind the transplant. This is of course normal for transplants, they cannot replicate native density. Anyway, It is really hard for anyone to say how this will turn out, you will just have to be patient and judge the results in 6 months or so.

Of course! Given my naturally fine hair calibre (43 microns) as well, I was resigned to probably needing a second pass for this. However if the middle is going to turn out pluggy and unnatural due to incorrect placement of multi-grafts then I may need to consider someone else for the second pass, or at least seek to rectify it with the same surgeon by pulling them out and implanting them somewhere else (if that’s even possible?). 

Hi everyone, 

I’m seeking opinions on my transplant I received 8 days ago. I received 1400 grafts along my hairline from a highly reputable surgeon, their name is very well known to this forum. 

My hairline was lowered by perhaps 0.5-1cm, but most of the transplantation was performed in an area of existing miniaturised hair.

As the hairs begin to grow out I have noticed quite a few multi-haired grafts in the peak/middle of my hairline. Things are much more natural looking towards the temples, but in the middle (which will be the most obvious/clearly visible part of the new hairline) there appears to be quite a few multis either right on the hairline or within the 0.5-1cm transition zone. 

I do not wish to name the doctor just yet as I would like to see what the consensus on here is first. I will also be shortly reaching out to the surgeon’s assistant to get their thoughts.

Please let me know your thoughts. My fear is that this middle area is going to look highly pluggy and unnatural. 

(Also don’t mind the large macro-irregularities. They were designed to restore my hairline’s natural shape).

Middle peak

 

Closer look 

Left and right sides. Much more natural looking than the middle with (mostly) soft singles used in the transition zone.

13 hours ago, wprevil said:

Appreciate the recommendation of Rahal. But I had a friend who went to see Rahal for an in-person consultation. Unfortunately, Rahal told him that he cannot work on diffuse hair. So at this point I'm booked to see a doctor far more skilled than Rahal and is well known to work with diffuse hair.

But thanks anyway.

'Far more skilled than Rahal'.... Haha, jeez. Rahal is cautious yes, but is also very, very skilled. Don't mistake caution for lack of skill

12 hours ago, Melvin- Moderator said:

Fluridil has been around, not very effective. I think pyrilutamide is a better option.

That was my stance until pyrilutamide gave me really nasty cardiac sides (albeit grey market pyrilutamide from hairlisciously). As I stated above, obtaining stronger fluridil in the 6%-8% range sounds far more attractive to me as there is at least a clear explanation as to how fluridil does not go systemic, unlike pyrilutamide, RU, etc. etc. It may not perform great as monotherapy, but if it's function is to mop up the remaining androgens on the scalp that oral fin/dut do not target, whilst giving confidence that it will not go systemic, then it seems pretty useful to me

On 9/21/2023 at 1:13 AM, ssimpson7511 said:

Is there any scientific research that states Fin loses its effectiveness?  I hear people saying they are losing ground on fin after a certain amount of time but I have never seen any data that shows this is the case.

I'm not saying that finasteride necessarily loses its effectiveness, what I am saying is that finasteride is simply not 100% effective at targeting all DHT that reaches the scalp. As the graph below makes clear, finasteride only targets roughly 30% of scalp DHT.

For some people, their scalp sensitivity to DHT is such that the 30% reduction in scalp DHT caused by finasteride will be enough to do the job, and they will either regain slightly or maintain so long as they stay on finasteride. For others such as myself, finasteride will still work, and in my case has certainly slowed the rate of loss, but my scalp sensitivity to DHT is such that the 70% of scalp DHT not targeted by finasteride is still causing me to lose ground. Hence looking to other treatments to supplement finasteride.

Rahal the heavy hitter strikes again! Some outstanding results from him coming through on the forum recently

On 4/17/2023 at 8:53 PM, Follicle1984 said:

I've tried fluridil, been through many boxes. I would agree I think it's not overly strong and likely to ne ineffective for many as a monotherapy at 2ml/day. I'm currently using it again with alfatradiol until something better comes along through official channels as I can't tolerate fin sadly.

 

 

How has Fluridil been going for you these last few months? I'm lucky in that I can tolerate fin but am noticing that I am still (slowly) losing ground after 3 years on it. I'm planning on starting fluridil soon as well as topical dutasteride to mop up the remaining androgens on the scalp that oral fin does not target

On 8/28/2023 at 12:45 AM, TorontoMan said:

Yeah would be a good combination, essentially what I do with RU. Another option could be to add topical fin/Dut to try to get the conversion effect in the scalp directly. my friends were using it mono and there weren’t many noticeable differences, but at a higher dose with a 5ar it will likely work better. 
 

Yeah cool, I can see why then. fluridil monotherapy does not seem very promising.

I was considering doing the same as you with RU until i tried pyrilutamide and got bad cardiac sides after 1 months use. After that, the only anti-androgen i'll consider is fluridil.

Yes I think I will add topical dut as well. I had been considering it for a while but after seeing this study the other day that seems to confirm all the hype i've finally made up my mind: https://pubmed.ncbi.nlm.nih.gov/35648446/.

Hopefully, a protocol of oral fin & dut, topical dut, and topical fluridil (at least 4%, considering 6-8%) will be enough to stop the androgens that oral fin & dut alone don't seem to be targeting.

On 8/28/2023 at 12:45 AM, TorontoMan said:

where do you live ?

I'm in Australia brother. Not cheap to get fluridil out here but probably worth it given my situation.

On 7/3/2023 at 5:32 AM, TorontoMan said:

Not many positive anecdotes for efficacy in my experience. Two of my friends were on it for a period of time without side effects however, but it might be too mild of an anti androgen to maintain hair. 

What about stacking it with either fin/dut to target the remaining androgens that still make it to the scalp? Noting that 1mg finasteride only reduces scalp DHT by 30%-ish and .5mg dutasteride by 50%-ish.

I ask as I am a NWII still losing ground (albiet slowly) after 3 years on 1mg fin daily and 10 months on .5mg dut every 3 days (as well as minox, tretinoin and microneedling). I was thinking it may be useful to source a higher dose of fluridil (between 4-8%) and use this to knock out the remaining androgens not affected by my oral fin/dut.

Were your friends using fluridil as monotherapy?

Unreal result!!

Will there be a video coming soon with a close up of the hairline being combed back? Your videos are always helpful

On 7/12/2023 at 8:40 AM, TheDarkHour said:

Thanks. Does this mean I can resume smoking fairly soon after the transplant?

Smoking causes vasoconstriction which reduces blood flow to healing wounds. Not smoking is literally post-operative care 101 after any type of surgery.

With a hair transplant, you are literally taking little parts of your scalp out and reinserting them somewhere new in the hope that they will heal into the new tissue and establish a new blood supply. Why on earth would you want to jeopardize that by cutting off blood and oxygen to the healing grafts.

In case you care to read more:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797353/

2. https://www.researchgate.net/profile/Harriet-Hopf/publication/21225835_Cigarette_smoking_decreases_tissue_oxygen/links/59dbcaf20f7e9b1460fc2814/Cigarette-smoking-decreases-tissue-oxygen.pdf

How are you progressing brother?

How'd things end up brother?

Keep us updated! Great to see Rahal addressed this. Hopefully this will be your last

@jim1973

Sorry to hear brother. Still on the dutasteride and oral minoxidil? Have you considered microneedling as well?

How you traveling brother? Would love an update

Hey man, how you going? any update?

I should've linked the paper itself as well for anyone interested: https://www.sciencedirect.com/science/article/pii/S0306987717310411?ref=cra_js_challenge&fr=RR-1