ThePerseverantWarrior

Recipient area would look okay, but donor area could stand out 19 days after HT, depending on its condition and the extent of extraction

Could you share your scalp pictures please? Also, what's the exact medication regime you've been on, and for how long?

On 12/20/2023 at 1:43 PM, Kamran10 said:

Hi dude . I saw that you mentioned the name of QHT clinic in India and it seems you have done procedure there . What is your overall experience ? Do you recommend them for NW 6 ? I have seen they produced some impressive result on high Norwood . Have you met dr Ankur ? 
 

Thanks, 

Overall experience there was decent. In their price range, they are certainly one of the best clinics in India. I don't like their temple work. Rest of the things are fine

I'm not sure about NW 6. I'd recommend you get in touch with them, ask for the contacts of some of their high Norwood patients and talk directly to them (they do share; you can even browse through their YouTube results & ask for some specific contacts from there). 

Dr. Ankur had designed my hairline. I didn't interact with him beyond that though

You look NW 2 at the most, from those pictures. And it's really good that you're on proper medication this early. 

Your target should be complete hairloss stabilization, and then maybe a minor hairline work if need be (doesn't look like that at the moment). 

17 hours ago, Rossybop said:

I came off dutasteride because of horrendous sides.

I have now recovered from the sides but won't touch dut again.

Fin lost a lot of efficacy on me after 18 months or so.

Should I go back on finasteride and minoxidil? If so when? Should I give my body a rest seen as I've only recovered from dut sides having stopped 2-3 weeks ago?

Am I now more at risk to getting sides from fin?

When will new treatments hit Europe and what will they be?

1) What dosage of dutasteride were you on? 

2) How long were you on dutasteride before you got those sides? 

5 hours ago, mister_25 said:

 

I don't really have a choice, hair loss has damaged my social life and destroyed my confidence. My options are either struggle and try to restore my hair or live a miserable twenties by giving up.

 

I am past the 11 month point, I will be withholding information about my communications with H&W until the 12 month point. 

 

I have been communicating with other surgeons. General consensus is that I have 2000 grafts left and I have to choose between fulfilling my front or crown.

And to answer the question, Dr Hasson said that my hair was Coarse and Wavy, so any misconceptions about my hair being fine contributing to the less than stellar result should have their answer.

You have "2000" grafts left? Generally, at your age, people do have 7000-8000 grafts available that they can harvest without damaging donor area's visibility. 

Have you got a trichoschopy done through your donor area?

Could you share some pics? Will help people understand it better

6 hours ago, mister_25 said:

Midscalp seems to be a bit stronger thanks to Oral Minoxidil, I’m having a better time concealing the weak points before pre-op. I’ll attach a photo, which you can compare to your own leisure

I like your idea of a in person consultation to some degree, it’s getting more reinforced as a good measure the more I think about it. What I’m thinking on doing is I’ll see what the other online consults say, I am interested in seeing which clinics accept me or reject me first and I may select one for a online consult, and then a in person consult. If I had a preferable doctor to give me a in person consult I think Couto would probably be a great call.

I am asking these questions because it is appropriate to do so, I expect somewhat accurate responses because at the end of the day I am asking hair transplant related questions on a forum on the topic of hair transplants and hair restoration rather than reddit, my GP, real self, google or whatever other unreliable source. This forum literally has surgeons and representatives active on here and is made for patients by patients. 
 

I will wait for a reply from H&W after the weekend.

Are you on 2.5 mg oral minoxidil daily?

On 10/11/2023 at 6:26 AM, mister_25 said:

Its more than just dating. I've been treated differently depending on what social circles I am in by people I once thought of as my friends.

Also even if my balding had no effect on my dating life such as covering up with fibers. The insecurity and lack of confidence associated with my hair loss surely will.

It is a big personal issue for me on multiple fronts. I'm not expecting for my hair to come back and all the damage to be  undone to my mental health and relationships, but I just want to feel a sense of normalcy and not have "balding early 20s" as my defining physical trait.

I am taking your advice, I took it the first time around. I've started to see a psychiatrist and I've returned to my diet and my hobbies as past times. But thats all they are now, past times. They no longer serve as a sense of fulfilment to me.

I am treating it as a work in progress, it's just what I was told to expect and what I expected myself is such a mismatch to reality. It's gotten me anxious for any future surgery because if I yield poorly the first time around, what's to say it won't happen again?

I was told two surgeries were needed, but I can't realistically see my goals being met if my growth the first time around is the standard that's set for me. It's looking like 3 to 6 possible surgeries at this rate and I'll be 26-30 by the time its all over.

I don't want my 20s to be remembered as me hating myself for a insecurity that I fought with everyday with all my effort and it still wasn't enough.

I completely echo your sentiments. The lack of confidence, insecurity and the related emotional/mental tolls that early balding takes on men is the key issue. And this damage is much harder to undo. 

Being in a fairly similar boat as you, all I can tell you is that you should probably take another shot at a HT procedure. What do you have to lose, since your present condition isn't gonna improve on its own anyway? If things work out, you will at least spend the 2nd half of your 20s in a much better frame of mind. 

The best way to tackle this situation is to think as less about it as possible, and that will only happen when you know your hair doesn't look abnormal/unnatural. So probably you should give it another shot. You don't look too far from your goals. One good procedure should take you there

After 18 months of unsatisfactory results on finasteride, I switched to a fin 5x a week + dutasteride 2x a week combo a couple of months ago. And I am only 25 years old! 

If you haven't experienced side effects from finasteride and have age on your side (i.e., you're 30+), you should certainly consider switching or adding dutasteride to your finasteride regimen. Needless to say, since dutasteride requires a prescription, you'll need to keep your doctor in loop. 

Have you been experiencing increased hair fall off late?

Most likely it's your native non-transplanted hairs that fell out. If transplanted hairs fell (probably due to hair cycle change on stopping oral minoxidil), they shouldn't need medication to return

16 minutes ago, Big Rome said:

can’t you up it to dutasteride daily and drop the fin? 

I can, but I want to tread cautiously. One doc advised me to start with 0.5 mg dutasteride just once a week (cuz I am 25) while another doc recommended twice a week. Besides, I have read/heard that several poor responders to finasteride benefited from this 5+2 combo, so I wanna give that a try. If this doesn't work, I will try and up the dut dosage gradually

19 hours ago, BeHappy said:

 

I was on it for 11 years, but my hair kept falling out anyway. I stopped using it a long time ago.

 

I guess high retrograde alopecia is a sign of extensive susceptibility to MPB, which might be one reason why you didn't respond to finasteride. 

My case is slightly opposite. When baldness hit me, my sides were also affected (I didn't realise that first). Now whenever I keep my side hairs short, the retrograde alopecia stands out. That's probably an indication of very extensive MPB, which is why even I didn't respond well to finasteride over 18 months, and I'm afraid even addition of dutasteride (which I've already done) might not be enough for me!

3 hours ago, Gatsby said:

It can take up to one year for the full benefits of oral minoxidil to appear. Perhaps if you are not experiencing any side effects speak with your dermatologist to up the does to 5mg? All the best!

Thanks! 

Yeah my plan is to try this 2.5 mg regime for one year, and I'll reassess thereafter. If I don't get any bad sides, I may double the dosage. Let's see 🤞

Camera doesn't play as big a role as lighting does. Direct sunlight is the harshest. If a picture under the sun doesn't look thin, it won't look thin in real life either. If a picture under harsh bathroom line doesn't look thin, it won't look thin in real life. 

If the lighting conditions in which pictures are clicked are different from real life conditions when the scalp is being viewed, there will be a difference in most cases

That depends on your current stage. If you are a NW2 with stabilized hair loss and a good donor area, you can get a great result via a transplant that focuses just on the hairline. Although you won't get the original density, it will be as good as original for all practical purposes (50-55 grafts per sq cm). 

However, if you grade is NW 3-4 or worse and if your hair loss isn't stable, and/or your donor isn't good enough, the surgeon will have far fewer resources to fix your hairline. In which case, it won't obviously look so good. The surgeon may have to give you a maturish/higher hairline and the density would obviously be lesser (it does have an impact on the appearance)

11 minutes ago, A_4_Archan said:

Slowly building up is a good idea...

Yup. Current plan is to try this 5+2 combo for at least 6 months and then reassess in January. 

6 hours ago, Recession1 said:

I think when it comes to hair loss you don’t have tons of time to sit around and wait… I wish I would have gotten on Dutasteride right from the beginning. I took finasteride beginning at age 24 and it slowed loss in the front but never stopped it. I continued to slowly lose ground over the last decade. I am now 35 and have been on oral Dutasteride almost 2 years and it has stopped shedding. Everybody worries about side effects but I have had none… and I’m on a heavy dose. I take 2.5mg oral Dutasteride daily…. Thats right I pop 5 of the .5mg pills a day… it might seem excessive but studies show the 2.5mg was significantly more effective in hair count so I know I am giving myself the best chance of keeping hair before it’s too late. Just my opinion but obviously consult with your doctor. 

Demn! What grade were you when you started dutasteride, and how long did it take to stabilize you hair loss? 

As much as I am inclined towards it, I don't wanna even wanna try 0.5 mg dutasteride daily (currently I'm on dut 2x a week and finasteride 5x a week), since I'm only 25! 

If anything, I may slowly build up to a higher dut dosage over the next 12 months if my hairfall doesn't stabilize on the current dosage

14 hours ago, Big Rome said:

Hi All,

Anybody in here taking Oral Dut?
I’ve made a start last week, taking 2 a week, Monday & Tuesday after watching the podcast with Melvin & Sergio Vanó. Wondered if 2 0.5 tabs a week will be beneficial or should I up it to 3? 

I was on finasteride for 18 months without significant results. Added 0.5 mg dutasteride a week for 6 weeks, and have been on 0.5 dut twice a week (Sunday & Wednesday) and 1 mg finasteride five times a week for 1 month now. 

Fortunately no side effects so far, but my hair fall hasn't stopped yet 🥲

1 hour ago, BeHappy said:

It's going to be hard to get an accurate picture of how common retrograde alopecia is because it's going to be different depending on how old everyone is. For example when I had my first hair transplant I didn't have any retrograde alopecia. Years later I now have it to the extreme where I am pretty much completely bald to almost the top of my ears.

 

Were you on finasteride in the meantime?

6 minutes ago, jim1973 said:

I started oral Dut (1.25mg) in Aug 2022, moved up to 2.5mg in Dec and onto 5mg in April of this year.  I get my blood tests done every 6 months and I was low on Ferritin in 2021 so I began taking a Ferritin supplement to bring that into normal range since then.  Everything else has been normal.  I feel like I'm a non-responder to oral Dutasteride for some reason.  My libido is much higher on Dut than it was in Fin many years ago.  I'm now in a position where I may need to try a topical anti-androgen such as Breezula or Pyralutamide.  The only downside is that these products are not yet FDA approved so I'd need to obtain from a grey market if I proceed, which is not ideal.  

5 mg dutasteride daily or oral minoxidil? And for exactly how long have you been on dutasteride? And what's your baldness grade?

14 hours ago, jim1973 said:

I'm on oral Dutasteride (.5mg/day) and oral Minoxidil (5mg/day).  Hair is still falling more rapidly than the previous year.

How long have you been on oral dutasteride? And have you got your vital vitamin levels checked? 

19 hours ago, jim1973 said:

Unfortunately only my body hair is becoming thicker.  My scalp hairs are all miniaturizing still.  Every day, I lose more hair and even the hair on my head have become noticeably thinner over the last year.  

Six months on 2.5 mg daily oral minoxidil and I have broadly similar results. Biggest visual boost has come in my arm hairs (not even beard). 

My hair shedding hasn't properly stabilised either. But idk why, my scalp hasn't started to look thin yet (fortunately). Hope it stays that way

I have been on 2.5 mg oral minoxidil daily for 6 months now. No scary side effects fortunately so far, but no major noticeably significant improvement either. The only visually obvious change is that hairs on my hands (arms as well as fingers) have grown longer and perhaps a bit thicker. 

Anyway, since I find it infinitely more convenient than topical minoxidil, I plan on using it for life regardless of improvements, provided of course that I don't get bad side effects 🤞