gillenator

RMS,

That is correct, you can purchase it over the counter even at nineteen years old. Don't ever feel that asking questions about anything regarding hairloss is dumb because it is not. We all had to start the information process at some time so let me commend you on doing your research. We are your friends here!

RMS,

Minoxidil and finasteride do not have the same potential side effects. They are very different. You can read up more about potential side effects regarding them on this Network.

You can purchase minoxidil without a prescription at your pharmacy and even large discount retailers like Walmart, Target, etc. There are generic forms of minoxidil available which are far cheaper than Rogaine. There is not a generic form of Propecia and it is quite expensive.

Some of us "quarter" Proscar (5mg) finasteride per tablet and then cut it 4 ways with a pill cutter which you can also purchase at your pharmacy. The cost is much cheaper by cutting Proscar. Finasteride in any form will require a prescription from your doctor so if you do go the Proscar route, be sure you explain your intentions to your doctor so they document your chart accordingly.

Lastly, if you are over 40 years old, you will wamt to first have a PSA test done to evaluate your prostrate "before" you start finasteride. If you do decide to cut Proscar, BE SURE to keep it locked away and out of any reach of any females especially a spouse or significant other as it can have adverse effects on the genital development of a male fetus should they come in contact with the active ingredient and conceive. Best wishes!

Hello RMS,

Glad to hear that this forum has been of help to you as it has with many of the rest of us.

Everyone responding has suggested you to start a medicinal regimen with finasteride and minoxidil which are sound recommendations. Both of these ingredients may even regrow or thicken the crown area for you especially considering your younger age. If anything, you stand a very high probability that finasteride will slow down the loss in the vertex and crown areas.

Neither minoxidil nor finasteride have demonstrated any clinical efficiency in the frontal region of the scalp which includes the hairline and temporal lobe regions. Ailene made a very good point about starting restoration in areas (like the crown) where you will have future procedure commitments to in order to maintain the aesthetic appearance. It is perfectly normal for men to have some recession or what I like to call adult movement of one's hairline with age. We expect to see that even with men who do not have genetic hairloss. It is a natural progression that comes with age. I myself wore hair systems for a decade so anytime I see a man over say 40 years or older who has mamouth density and a low hairline, the first thing I am looking for is to see if he is wearing a system. Even in the few cases when it is their natural hair, it still is not what we are accustomed to seeing so it naturally grabs our visual attention.

So it is best that you wait it out until at least your mid to later twenties before you consider any surgery. If you have extensive hairloss in your family history, men who have reached Norwood class 6 and/or 7, your decisions regarding future hairline placement as well as the other areas of coverage become very critical. The crown area demands alot of donor so if you do have the potential to see class 6 and/or 7 someday, you may not want to be as aggresive in that area. As was mentioned 5,000 to 6,000 harvestable strip grafts is the average per patient unless you utilize FUE/FIT technology. Still the demand almost always exceeds the available supply for the advanced hairloss patient.

Remember, hair restoration is a visual illusion. Most men do not notice scalp until they start to lose more than fifty percent of original density. The reverse is also true. Generally speaking, if a completely bald surface area is restored to approximately 50 percent of original density, and even a bit more, say 60 percent, you do not notice the scalp any more. Color contrast, cylinder caliper, and hair characteristics have a dynamic play in these equations as well.

When you do reach an acceptable age for your first procedure, be sure to have several in-person evaluations done or at the minimum, a vitual consultation with pics. I wish you the best and lets us know how the meds work out should you chose to start them now.

Smoothy and Hairbethere made some excellent points regarding laxity and shockloss. The shockloss is probably the biggest factor as to why there has been so much post-op shedding.

I just do not understand why ANY doctor would have done two procedures in such a short time. Restoring a different recipient area does not justify the other critical areas of risk so I believe there should have been "at least" nine months minimum between the two procedures.

I think we all want to know who the doctor was so this does not happen again!

Hang in there. Most of it should come back.

What pill or medication are you referring to?

Hi Lange,

Well it certainly does not surprise me that you had a great experience with Dr. Feller. He continually is striving to improve HT techniques especially with FUE and it's instrumentation. Keep us in the loop on how your results go! Take care.

Dr. Theodore Katz is a former long-term surgeon with Bosley Medical and he was also with MHR for a short time after he left Bosley.

Hi Dude1,

Body hair has entirely different characteristics than scalp hair. Most BH is extracted primarily from the chest and back as these regions tend to produce characteristics closer in parallel to scalp hair. Still they are not the same. Also, body hair follicules can remain in the telogen (resting) phase for much longer periods than scalp follicules and can in some cases take as long as 18 months to visualize some of the growth.

In addition, the emperical evidence for the most part originates from Dr.s Woods and Campbell utilizing chest to scalp cases. Their practice has performed more BHTs than anyone else I am aware of. Most of the remaining surgeons who have done BHTs are more reluctant to utilize leg and arm hair simply because there have not been many cases done from those donor regions. The hair in those regions tend to be of thinner caliper as well. Body hair is established in mostly single and some double hair FUs, so it's tough to get the bang for your buck (coverage)so to speak.

There are no long term studies or clinical trials published regarding the survivability of body hair to scalp that I have seen.

Generally speaking, BH is considered as a "last" resort of donor supply and utilized in repair work (scars), and fillers to blend in with scalp donor. I would NEVER consider BH in a high visual impact area, like starting one's hairline, etc. But I have myself personally seen blending of BH growth in the crown area.

Lastly, consider contacting Dr. Arvind Poswall who has some depth in this area. His FUE work is impeccable and he does have very fair pricing compared to the pricing of BHTs in the US. I believe you would receive a very honest assessment from him. He and I have corresponded on several occasions and quite frankly I have been impressed with his clinical findings and convictions inclusive of donor sealing which minimizes visible scarring. He is also "publishing" his results with pics!

Best wishes to you!

Corey,

Some folks sprout more early and some are late bloomers so to speak. You should begin to see some new growth any day and into the fourth month, so hang on! Keep us posted on your progress.

Finasteride takes at least 90 days to "effectively" begin the inhibition of Type I DHT.

And I agree, stay with it for at least one year to accurately evaluate its efficiency.

Finasteride is effective in approximately 95% of the men who ingest it inclusive of all ethnic backgrounds.

Mr. Invisible,

Do not take this wrong, but "hearing" and "seeing" are two different issues altogethor.

Yes there is much being said and discussed but I for one am waiting for the "proof" in the pudding which I have been waiting for nearly twenty-five years now.

I would not bet this to be viable for quite a while yet, and I truly hope I am dead wrong.

Do you not have your own donor supply?

That's the dilemma. There are no guarantees about any of this. We do not know what extent our hairloss might be, how we will respond to medications over the long term, etc.

That is why initially a more conservative approach is always better. Let me explain. If one's family history depicts let's say mild to medium hairloss in the men, say no one more advanced than a Norwood 4, that is an "indication" and nothing more of another male's potential hairloss within the same family. In other words if no other males within the family had more extensive hairloss why would yours be more? Does that mean it could never happen? NO. As I said it is only an indicator.

So it is more advisable for one to conclude that yes hairloss runs in my family, none of the men hit class five through seven, but since there is a chance I could be the first one, I better keep my hairline a little higher, not get too aggressive in the lesser visual impact areas, and always leaving a "reserve" for the just in case later on in life. I have seen men just start to lose hair in their early fifties. Hairloss is unpredictable.

So anyone with massive diffused thinning, extensive hairloss earlier in life, less than average denisities, Ludwig pattern of thinning, etc should do some very careful planning for their lifetime appearance.

Try to think of the areas of restoration that are most important to you. Most of us start in the front forelock including a frame to our face. Then, if things go well and you seem to continue to respond well to medications, you can always add more later. Also have the sides (lateral hump areas) examined in the future to evaluate just how far miniturization is impeding into those areas.

So if the worst should happen, more extensive hairloss than you predicted, at least you have "some" reserves left in case you do sustain more recession in the rim areas or anywhere else later in life. We can still enhance and improve our appearences even if we do not have a home run situation. It is a personal decision we all make for ourselves.

Hey guys,

I think the real issue here is "consumer safety". I never have and probably never will purchase medications manufactured overseas. Even if Merck manufactured Propecia overseas, I would not buy it because I do agree with Solid concerning greed. We see it every day. I am not singling out Merck either. I think anytime or any chance to cut corners to make an extra dime, you can bet it will happen.

And since the FDA does not regulate outside the US, too much temptation to scam people exists. Oh sure, there are indeed some legitimate drug manufacturers outside the US, but there is an outrageous proliferation of imposter medications being sold worldwide. Who has the time or resources to substantiate verification?

Well like anything else, we are all entitled to our own opinions.

Hi Whoops,

Yes I can see your reasoning for discontinuing dutasteride since finasteride is working good efficiency for you.

Most of the men I have known who decided on using dutasteride did so because finasteride "did not" seem to provide any results and continued to lose their hair. Dutasteride does inhibit both Type I and Type II DHT.

Possibly some drug manufacturer will develop a dutasteride product for treating MPB.

Glad to hear you're keeping your hair!

Has anyone noticed these pimples at four plus months post-op? I did and these can be ingrown hairs trying to break the surface of our scalp, especially those with curly hair.

I would recommend using a clean, warm, wet washcloth and then hold it on the pimple for say a minute or so. This makes it much easier to pop and also keeps the area clean. Try to not use your fingertips when popping them as alot of bacteria and germs collect under our fingernails.

Even something as basic as an alchohol pad to wipe the area afterwards works well too.

Hi Tom Hairloss,

You have some good questions. I thought to add a comment regarding what is success. Providing the yield was successful, the basis of success can be related to each patient's own individual goals.

If you are happy with the aesthetic result then I would conclude that it was successful. You probably are already aware of the fact that hair restoration produces an illusion that can in fact enhance one's appearance. So if your goal was to produce a certain "look" and it was achieved, the result is success.

You really, really want to do extensive research on the big chain organizations, especially regarding patient experiences. Best wishes to you!

Hey Smoothy,

Sounds interesting. Alot of these advertisements display a toll-free number to call to receive their free literature, dvd, etc. Did you by chance do that to get a better idea of what they are doing?

Big1,

Good points by Hugh and Corey. I also would recommend Toppik for the interim period. DO NOT use bleach now or ever on your hair and scalp. There are other cosmetic products like scalp colorations, etc., products that wash right out.

Now I would think that the majority of patients including myself are indeed concerned about post-op appearance. We really do not wish others to know for whatever reasons we have. From my own experience if you just go about your business and not react to what others are observing, they will conclude that this is not a big issue to you and not think much thereafter.

Remember, you know you just had a HT, they do not. So I often advise patients to act normal, don't go out of your way to avoid others, try to not draw attention to yourself, just be yourself as usual. For the most part others who know us well are more apt to notice a change in our behavior vs a subtle change in our appearance. I think dyeing your hair would be too pronounced of a change which will draw the eye drift to your head. Take care.

Corey,

The redness should dissipate over time and be alot less noticable. This does not appear to be an issue with you, so happy growth. You should start seeing the new growth any day now!

FUE also leaves less visible scarring so the extractions on the hairline may not be as noticable, especially in a visually high impact area like the hairline and frontal zone.

Smoothy,

I agree totally with you in that it is more probable to "buzz cut" the head after FUE vs the clean shaved look like Michael Jordan.

Any incision will form into "some" level of scarring as the tissue repairs itself in the healing process.

The question is, how visible is it post op? Patients do heal differently so a buzz cut probably is the best way to go.

Robert,

You are so correct in explaining that a HT will not be the savior to life's challenges and shortcomings. We all needed to hear those words.

And I agree that although an improved appearance may very well increase one's confidence, we all still face those challenges so it's the internal decisions we make day-to-day in life that helps us determine our own destinies.

Arfy,

I certainly did not think you went off on a tangent. You made some very good points. HTs are simply a matter of redistributing one's existing terminal hair. And obviously any of us would want it done in the most aesthetic way possible, to get as much visual bang for our buck. What we cannot change is the fact that once we lose our natural hair, the demand side undermines the supply side. It's a matter of mathematics. If we all start out with approximately 100,000 hairs and then lose say 30,000 to MPB, that only leaves approximately 20,000 for future HTs excluding the donor areas.

And that leads to a very critical point that you made. There is "no way" that a HT patient can gain back the original densities they once had. That's why the fully manifested result of "any" HT is an "illusion". EVERY individual considering hair restoration needs to know what the limitations are for them, not someone else. I also agree there are still clinics out there that tell the patient "what they want to hear" realistic or not, truthful or not.

That is the number one reason why patients do not return to their original HT clinic for a subsequent procedure. What they were told or sold does not pair up with the results. Or the patient states they want to have their youthful hairline back, a full head of hair back, etc, etc. The clinic knows then that this individual will want more and more and more. The question left unanswered is, "where does this all stop?"

Too many times the answer a unsatisfied patient hears is "oh, what you need is another procedure, you need more hair!" (yaddy, yaddy). It can be like like putting out fires on one's scalp yet more future fires ignite up (future hairloss) and then the clinic runs the firehose (more surgery) as the patient continues to lose more hair. Then the dreadful reality finally hits the patient square in the nose. They run out of donor! I have heard too many folks go down this road and end up very angry and regrettful.

Moral of the story? Do your research to understand the potential as well as the limitations of hair restoration. Then consider realistically what can be acheived for YOU and if in fact it is acceptable to YOU. I have a fair amount of Norwood 6s and 7s over the years who would comment on wanting a "full" head of hair again with a nice low hairline, etc. But is that reality? I think not.

I believe most patients want an honest assessment even if it means they dislike the honest and realistic feedback. Oh sure, maybe they won't end up enrolling based on surgical limitations undermining their unrealistic goals however, better that than having someone's life ruined.

I can't emphasize enough that there is NO ROOM for commissioned salespeople in medicine! Yet it still continues on.

The burden then falls squarely on each and every patient's shoulders. Get multiple opinions from surgeons with proven aesthetic talents and also proven ethics. Research, research, research.

Robert,

For me, every function is going much slower than it was say a week or so ago. FYI. Thanks and I know you are working on it.

Hi Northface,

I am very glad to hear there is no real hairloss in the donor areas, still you are young so yes by all means still get some in-person examinations. And yes it is possible to have your entire head examined to evaluate which areas are being affected.

Now not all derms are experienced in genetic hairloss but you will find them on the internet by doing a search for derms with clinical depth in this field. Also when you contact HT surgeons, ask them specifically how much experience they have in treating hairloss patients with the ludwig pattern. Do not limit your research with one or the other, get several opinions.

Then once you have your situation confirmed, you will have a much better understanding of how to proceed. And yes I would suggest FUE technology just in case you do have more dramatic thinning in the donor areas in the future since you are so young right now. Should that occur later in life, you would be able to buzz-cut your head. Keep us in the loop! Take care.