Hair-here

I’ve been on fin for almost two years. For almost all that time I’ve had some of the typical mild sexual side effects- lower libido, weaker erections, etc. Everything still works, but it’s still kind of annoying. I’m a NW 6/7 and had a transplant so the doc recommended taking it to protect the transplant and whatever further loss could occur- so I’m not protecting a full head of hair with fin by any means. I took 1mg of fin for a year then decreased to 1mg every other day for a few months and then have been doing 1mg/twice a week and .25mg every other day for a few months now. The decreased dosage doesn’t seem to have helped the sides go away. I think I’m at about the lowest dosage that could be effective and so I’m close to quitting. Has anyone else gone this route of lowered dosages without getting rid of side effects? What did you do?

Ok interesting feedback. So maybe the yield wasn’t great but not quite as bad as thought? Maybe the bigger issue is density and it should have been concentrated in a smaller area, more focused on the front 1/4th instead of 1/3rd? In retrospect, I don’t think I had a good sense of what the end density would be like and for sure wasn’t expecting this. I think I trusted the doctor that surgery would bring me from slick bald to “naturally balding with hairline”. And I was OK with that, I knew 3000 grafts was never going to get me anything near a full head of hair. The balding dad with hairline look seemed better than bald horseshoe dad. I just wanted the results to look somewhat natural whatever they were. Buzzed it looks patchy. Any longer and it doesn’t really accomplish any real coverage and I look like the guy who has some odd scraps of hair left and should just shave his head already. Ive been buzzing the implanted area at 0 guard to keep it slightly longer and skin shaving the sides and it looks kind of OK for a couple days. And yes I do have a big head, so definitely some real estate to cover. Has anyone done anything like scalp biopsy or testing for this purpose? What exactly would they be looking for or testing for?

Based on my post-op photo, do you think if it had all grown it would have been decent? It seems like you rarely see photos of buzzed down transplants a couple years later since most guys wear it long to give more coverage, so it’s hard to know what actually survives from the original implanted density. Had I known about the high NW expert docs before my surgery, I probably would have gone with one of them because they could have gotten many more grafts which was what I really needed. But a few years ago when I was researching, I guess I just hadn’t read enough consistently good things about any of them to include them in my search. But researching now, they seem to be the commonly agreed 3 docs for a situation like mine.

To answer your question, I had no inkling that this was anything but a standard surgery- no unusual bleeding, no mention of anything from anyone that this was anything but standard. It was my first surgery, but everything about it seemed pretty normal. If it all grew in like in my after-surgery photo, I think I would have been happy enough since that’s basically the look I was expecting- a buzzed down frontal third with moderate density. We spoke at length about my expectations so this was not the doctor mis-estimating. 3000 grafts was the most any of the docs I consulted with were quoting me (due to my donor I assume) so I went in knowing 3000 grafts on an advanced NW wouldn’t go very far, but since I was buzzing it down anyway, my goals were realistic in just creating a hairline and gaining some frontal 1/3rd coverage to help connect the horseshoe.

My scalp seems pretty normal. I get a bump here and there from time to time but nothing frequent or bad. And I can keep an eye on it since I still buzz it weekly at 0 guard. i will look into a scalp biopsy and second opinions.

Yes I realize 3K grafts was never going to do the full job at all. However when I first got consults, that was the maximum grafts any of them quoted me. I got consults from 5 of the top docs recommended on this site (though not any of the 3 top advanced NW guys). So 3k was the most I was quoted and with lowered and realistic expectations I went with it. I actually think I would have been reasonably satisfied if the grafts grew. Again I was just looking for some hairline definition since I was going to keep buzzing it down. I probably still would have gone back for a second procedure at some point but most of those docs didn’t have high hopes for my donor as a NW 6/7. It was only now that I have gotten quotes from advanced NW docs that I am being told they can harvest up to 10k grafts from a weak donor and beard. And so that has given me new hope that I can get some real coverage.

I did get a bunch of decent sized whitehead type pimples in the first few months, nothing full on infected looking, but for sure some of these were in/near areas that look weak.

Sure, here it is- I had a few random hairs still hanging on but basically solidly bald.

I would be open to a doctor visit but what exactly are they looking or testing for? I’ve been to a dermatologist and he didn’t notice anything atypical about my hair or scalp that would explain poor growth. But also a dermatologist might not have a lot of experience with hair transplants.

Yes I didn’t plan to take up my old doctor on his repair offer. I was really just looking to cut my losses and go back to buzzing it, but then I saw some results from the big 3 high NW doctors and changed my mind. I don’t know them as repair docs but they sure seem to be good at advanced NWs like me. I’m willing to travel as far as needed. My only concern was whether there’s any way to know if there’s any indicator how second surgeries turn out after a poor yield on the first surgery. I don’t see cases like those posted much, especially for advanced NWs like me. In my mind though, even worst case another poor yield would still be a step better than where I am now and best case, the doc works his usual magic with a tough case.

I’m not saying there was no growth- for sure I have more hair than before. Probably my biggest issue is the patchiness. Had it been thin but consistent I would have just looked thinning and balding maybe more normally. But the patchiness is what makes it look much worse.

I obviously chose not to name the doctor. I honestly just don’t think this was their fault at all and I wouldn’t want to give them any negative press. They were very responsive throughout the process and even afterwards with suggestions and advice. And everything looked good when surgery was done. I think this is just the reality of any surgery, results aren’t guaranteed and everyone’s body reacts differently. To be fair, the doctor did offer a free follow up procedure which seemed very generous but I was just unsure that the amount of grafts suggested would be significant enough. i was planning to just go back to buzzing my head and forget about any more surgery but seeing some of the high NW docs like Pitella, Zarev, and Eugenix I’m now reconsidering. Even though I keep my hair short and have buzzed/shaved it usually, I have an objectively bad head shape for shaving and really think it would look better with some hair. My intention with posting was to hopefully hear from some people who had poor yield transplants who went back for another surgery and what their results were. I’m just trying to figure out if it’s worth giving surgery another shot.

It’s been about 20 months since my hair transplant. 3000 grafts with one of the top frequently recommended docs. Well over $10k spent. And it just didn’t yield well. It’s patchy and just not what I expected at all. I don’t get it. I know there’s no guarantees in surgery but it just really sucks to go through all that for such a disappointing result. My surgery seemed to go smooth. I didn’t bump my head. I stayed 4 days after just for careful head washes by the staff. I made it past the initial 14 days and thought my grafts were in for good and the wait began. i probably am the kind of case where I should have skipped surgery- a NW 6/7 in my 40s who wasn’t on any meds or any hair regimen at all really. But I was very realistic though with my expectations and went in knowing 3000 grafts would give me back a hairline and some density in my front third only and leave a bald crown. I just wanted to keep buzzing my hair and the new hair would erase the dreaded horseshoe even if I was still left with a donut. I thought any new hair would be better- balding is still better than bald, right? Us advanced NWs have a different view of hair. I just wanted to see a hairline again even if a mature pushed back one. I gave Finasteride another shot after my surgery, even though my previous attempt 15 years earlier (when I still had a nice head of hair) gave me some mild but unpleasant side effects. I just don’t know what went wrong. My doctor had no explanation either but fully agreed it did not turn out well. My mind has gone to a number of things but none seem likely: Did the large whitehead pimples in the months after surgery hurt my growth? My donor isn’t looking so great either. I like to keep it buzzed down and had always planned to do that even after surgery. Probably SMP would have been suggested for my situation but I really wanted some real hair. I was totally ok to keep looking like your average balding (but not bald) mature Dad, I just don’t get why it failed. It’s frustrating. I’ve recently consulted with the top advanced NW docs and plan to give it another shot though. To those who have had poor yields, any idea why? My pics show 18 months after surgery and a week after surgery. No pic but before surgery, I was pretty slick bald on top.

The more I read, some people suggest the extra oiliness could be coming from shampooing too often. Cleaning the natural oils off can cause the scalp to dry out and make more oil creating an overly oily condition. I currently shampoo daily even though Im a NW 6/7 so I’m basically just shampooing my bare scalp.

Yes I always shampoo daily, though I have a very short buzzed hair style and basically a NW 6/7 pattern of loss. i have been using the nizoral usually once per week and then a basic shampoo the rest of the time.