Bhumik Shah MD

This is most likely oral Minoxidil which is used worldwide and fairly inexpensive. Some marketing genius has probably figured out a way to make money off it by giving it a catchy name.

Fego, You should follow your doctor’s advise, but there is no such thing as “competition for blood” between the new grafts and implanted older grafts. Most doctors recommend waiting 9 months or more as the recipient areas will overlap (even if only a bit), and you don’t want to damage previously transplanted hair when you are creating new sites. It also gives you time to evaluate the growth from first surgery, and troubleshoot in the rare case it was not optimal.

I can’t advise you on what clinic to go with, as I would have a conflict of interest. But I will say it would help other members answer your question if you tell them if you are interested in FUE vs. FUT technique or are you open to both?

Recovery from FUE is a breeze compared to FUT. In my opinion, it would look best if you simply buzzed everything down to the same length. By 18 days most people would look normal and as if they had their head buzzed. Some people can have some redness to the area that was transplanted. The one thing unique for you is that the FUT scars will be visible. So people may ask about that. But there is no way to hide that unless you do no-shave FUE, which I would not recommend for such a large case. By 18 days, your donor area hair will NOT be long enough to hide the FUT scar. So maybe it is better to wait till summer break for someone in your profession. Here is a photo of a patient's recipient area about 12 days after the surgery.

Yes. Future transplanted follicles can survive and grow. Try to be patient (I know easier said than done). You can't change what was done. Once you know where things stand around 6 months, then you can start planning your next step.

I would say just send the best quality pictures (high resolution), in good lighting. If they are not adequate for virtual evaluation due to your hair being too short the clinic willl give you directions:- either come in person, or let the hair grow out a bit.

You can transplant hair in that area. This is not a very common request.

I personally feel you would be a good candidate for a transplant. If you decide to not use any medical stabilization (finasteride), just try to keep things conservative. That way if you have future loss, you still have enough donor reserves to address it. Even a small session of 1200-1500 grafts would improve the recessions.

Yes. You can transect native follicles in recipient area, if care is not taken. You will have to give it time to see what happens to your native eyebrows.

Correct. Necrosed area can be transplanted again. As long as caution is used, the results should be successful.

You can most likely get away with unshaven recipient. I had to look up Thomas Shelby. He has a full head of hair. You may look better with buzzing everything off and keeping it the same length, but that is subjective. PRP may work, but the efficacy is much lower compared to finasteride. It will also be much more expensive.

All these are things you should have considered months before your transplant not 16 hours before. If you are hesitant about the surgery, the best thing would be to pull out, step back and reevaluate. You may lose money doing this, so be prepared for that.

From purely hormonal perspective the following should suffice. LH, FSH, Total Testosterone, Estradiol and DHT. I would be careful interpreting the lab values though, as hormone testing on finasteride is not validated for efficacy or side effects. But I certainly understand wanting to know those numbers "just in case."

First you need to clarify whether you are asking about unshaven donor or unshaven recipient or both? In my opinion, for your crown alone you need around 1800-2200 grafts currently. To obtain that many grafts, I would strongly encourage my patients to consider shaving their donor area. Shaving gives better visibility allowing the surgeon to use a smaller punch, and obtain better grafts. Since the hair in your crown has miniaturized significantly, you can probably get away without shaving the recipient area or trimming it minimally. As others have mentioned, medical stabilization with finasteride and or minoxidil should strongly be considered.

Agreed. Donor area looks very good.

You have a lot of post op edema at this stage. I would not go about changing the hairline at this point. Things will look different once the swelling subsides.

A change in color of the skin, and cessation of bleeding from the incision sites.

There is no cons really. It is just a device to numb the operating area. Theoretically it causes less pain compared with traditional syringe+needle injections for anesthesia. Clinics may employ it to improve patient comfort but it has no bearing on the hair transplant results. Here is an animation to help you visualize

Yes. Any good surgeon should be able to fix this for you. Look around the forum, there are a few patient journals of botched donor areas fixed via repair surgery.

Yes it is "fixable."

I think it is reasonable to consider a hair transplant given that you are on medical stabilization. Since you are on the younger side, I would recommend being conservative with your hairline design and the number of grafts that are utilized.

The subtle signs of imminent necrosis are usually evident during or right after surgery. Over the next few days it becomes more obvious. If caught early there are some medications that can be used to try and reverse it, but usually you have to let it runs its course, prevent complications like infections and then down the road transplant that necrosed area again.