BackFromTheBrink

Minoxidyl can thicken hair but it won't stop you losing more. It may slow down the effects of DHT by supplying the follicles with more blood supply but ultimately those hairs will miniturise until you take medication to reduce the amount of DHT on your scalp. If you're really opposed to trying finesteride orally, you could consider topical application which is less likely to cause side effects, but it's less effective.

Given his age and current situation, I'd probably be more conservative; If I were to ask my father to pay for the surgery, I'd want a reasonable chance of it being effective for the long term. To do that,I believe medication fin or dut will be absolutely necessary. Put simple, in his position, I'd have to either resign myself to shaving my head in the next 10 years or commit to using medication (and taking the risk of side effects). Anecdotally, I'd say that finesteride recovers hair more often on younger patients. I'd use it for at least 12 months before considering surgery.

Sounds like a plan. My advice would be to make sure the planning on the day is done collaboratively and that you're entirely happy with the approach before going ahead. They'll only really know the hair diameter, hair/follicle ratio and general health of your donor when you're examined in person. At that point, you can plan with more certainty and make sure that your preferences are understood and catered for. Eugenix are by all accounts an ethical and skilled team. However, I have seen people comment that planning has seemed less patient involved than is perhaps desirable, so it'll be up to you to take some control over that on the day.

I paid for 3000 grafts. They charge £3/graft.

Thank you. I still find it surprising that Dr Arshad got the density given the number of grafts used. Remember though, it was a result for surgery and finesteride. I suspect I was fortunate enough to have a really good yield, a high hair to graft ratio, intelligent planning and a good response to the medication. The crown is a black hole for grafts. I've seen 3k and upward used for just the crown and it still leave scalp showing. I suspect a thorough analysis of your donor area would influence the plan significantly. One of the reasons for recommending finesteride is that it would slow down loss, but also improve donor and recipient (so you should have more donor capacity, reduced demand for grafts and reduced shock loss). Have you thought about what you're looking for? For example, if you had to have a weaker area, where would it be? I took the approach that framing my face was more important. After that, I'd rather my midscalp was dense. If I had to, I'd settle for an age appropriate look where my crown was starting to thin (think Frank Lampard). I'm now hopefully I can tackle the crown too. I'm at the point where it bothers me enough to consider another procedure but those around me (including my hairdresser) think I should be thankful for the hair I now have and leave it alone! Front (in bright sunlight) Vs crown

I can see the apparent contradiction. I would summarise the advice as: 1) Get on finesteride to slow down further hair loss 2) The quote you've had is from a recommended doctor and would improve your appearance. 3) it's unlikely to be a complete restoration and even after success use of medication and an initial transplant, you are likely to need a second surgery at a similar cost for full coverage.

You can see the details here. Its thickened up further since then and I'm much happier with my hair after the procedure. I'll probably get a much smaller second procedure for the crown now that we know how much impact finesteride had on recovering hairs. I

@GoliGoliGoli I'm not sure you understood my point, which was that th reduction in hair density everybody sees in old age is unlikely to be the main cause of a reduction in density in 35 year old (on average) patients over a 4 year period. I also do not believe the study adequately measures how long transplanted hairs survive for, which was its aim.

Thats the thing though - you'll both need two procedures, unless you go for a gigasession, and that's not a great idea unless you have a fantastic donor. If you have a bad result for a single 3000 graft procedure it will leave you with option, unlike a much larger surgery. As I said, I feel my 3100 grafts made a massive difference, so it's not as if you'll need to wait for 2 years before seeing results.

That sounds sensible. They seem to get good yields, and make excellent use of beard and body hair. Given you're likely to need 5-6k grafts for total coverage, I suspect that may be necessary in your case. That said, with careful management of your donor area there's every chance you'll be able to get a good result from them.

True. Though with an average age of 35 in the study you'd think there wouldn't be a major drop in density over 4 years

I I'm not sure that tells us too much. It doesn't seem to monitor the survival of transplanted grafts, but instead whether the patients hair thinned over 4 years. Only 35 percent continued on finesteride. So for me, there are too many variables for it to be a useful exercise. Ideally you'd want to find a way to identify which hairs were lost (transplanted or native). The only reasonable way of doing that is choosing patients who have a proven stable situation prior to surgery (probably through finesteride over a period of time). The sample set here is pretty small, and it didn't record how many patients that were taking finesteride showed a reduction in hair density. Even if it had, it won't prove that it were effective, so the amount of lost transplanted hairs.

I'd say your loss is similar to mine (Norwood 5). Fortunately I didnt have retrograde so managing my donor wasn't as tricky. I had 3100 grafts to cover the frontal third (and a few reaching back to the vertex) and did not lower the hairline. I planned to wait to see how the donor recovered and whether finesteride helped with regrowth before a potential second surgery. I think a similar approach would work well for you.

That's nuts. It was May'25 just 1 month ago.

Really? Why's that? People use credit for all kinds of things nowadays. Most new cars are financed, large electrical items, kitchens/bathrooms etc. If a hair transplant increases mental health and possibly helps with work (due to confidence or just generally looking better), then you could almost argue it's an investment. For full disclosure - I didn't get a loan or exhaust savings. However, I don't think it's fair to judge people who do. Who are we to say how others run their finances?

I think the logic is that you don't want excessive bleeding during the procedure as it makes grafts difficult to position / more likely to pop out. For that reason, most surgeons suggest stopping minox prior to surgery.

Generally I think after 2 months you'll keep what you're left with. Theres the lucky fabled 5% who don't shed though I've never seen any cases where that's the case. It's entirely possible you've done your shedding, but the only way to know is through being patient 😊

Most of them, I'd say 80-90 percent. It doesn't affect the outcome in any way.

I've always thought I had relatively fine hair. However, I got great coverage with minimal grafts which isn't what I'd expected. Under a harsh light it's pretty easy to see individual (grey) hairs. What do you think - average diameter, thin, thick?

From the web site it reads as if there is a more intense initial treatment followed by a maintenance dose, so perhaps it won't be that expensive in the long run.

@FITA Did you speak to him in the end, and which surgeon did you ultimately choose?

A once and done procedure from Zarev would be my choice despite the waiting list size. It'd be expensive but would be transformational, imho.

Would you be ok to consider future surgery to stay ahead of your hair loss in the future? How about using topical Medication rather than oral? Your hair loss is similar to mine though and our donor areas look similar so it is possible to get a reasonable illusion of density. However, I would be concerned about the longevity of a transplant given your level of loss.

I agree. I can understand why the his apparent philosophy doesn't appeal to some. From what I can see, he's invested time and money to increase the success of his procedures. He could share that for the benefit of everyone, or he could use it to build a larger practice and ultimately gain financially by doing that. I'm a capitalist, so his approach doesn't bother me in the slightest. I hope he's rewarded for his work and shares it all once he's made his millions.

If you search for the Drs name on YouTube there are some videos which cover how he performs the hair analysis and planning. There appears to be some unique attributes of his approach, which he seems to consider IP and therefore does not disclose. What is curious is that the commonly held view that follicles compete for blood flow and so the maximum number in a single procedure seem to being challenged here. That said, most of his surgeries seem to be for high Norwood levels so perhaps the ultimate density isn't massively high. Either way, it's impressive. One of (of not the) best surgeon operating at the moment, imho.