England

Generally, no. Propecia is mainly effective further back in the crown area. However - being on some kind of preventative medication is almost a pre-requisite for having a hair transplant because if not, you will always be playing catchup as your hair loss progresses. If you have a hair transplant to fill out the temples, and then your hair loss continues, you may have a gap behind your new hairline which also needs a hair transplant. It's a long term 'battle'. Propecia helps to slow down your recession making it easier to win that 'battle'. Just to address the figures you quoted on Propecia, they are not correct. The FDA noted side effects of decreased libido and consequent difficulty getting erections, but there are some important facts to point out: 1 - Decreased libido and impotence aren't the same thing. Sperm count was not found to be reduced, you just don't feel like having sex as much. 2 - The above only applied to 2% in the studies the FDA carried out - however, 1.3% of men receiving a dummy pill reported the same problems. The point being that many men will have these problems whether they take the pill or not - the pill is often a convenient excuse. 3 - The FDA found that all of the problems in their studies were completely reversed by coming off the pill, in other words no permanent effects. In my experience, I've been on Propecia 7 years. Going on Propecia initially did knock my hormonal balance, but actually caused an increased libido at first. It balances out and for me at least you end up back to normal.

Hi JamieJay, Your hair looks great, honestly I can barely tell that you need an operation at all. It doesn't look to me like you require too many grafts, is it just to close out the temples? To give you an idea on density, natural hair is probably in the 90-100 range (grafts per sq cm). To achieve the 'illusion' of natural density, a 'dense packing' strategy of say 50-60 grafts per sq cm is about as far as you can go. No transplant will ever give you native density but that's as close as you can get and will probably give you the result you want. 30 grafts per sq cm generally will not give you the thick result you are probably after. It's worth noting that while you may need 50+ grafts per sq cm in the hairline, this is because hairline grafts only contain 1 hair (for naturalness) whereas grafts further back can have 2 or 3 hairs and so lower densities of perhaps 30 can achieve the right result. If you're just looking to close off the temples, which is all I can see you need, I would estimate 1,000-1,500 grafts for a dense result. Of course I'm not a doctor at all and if you're serious you should consult with numerous surgeons, eg Dr Rahal, Dr Charles, Dr Feriduni, Dr Bisanga and get their opinions. Good luck with it all!

Robbie, sounds very standard to me. Almost any clinic you contact will ask you for pictures so they can at least provisionally assess your case and advise you. If you're not a good candidate, it's better for them to tell you now rather than when you travel however many hours to go for an in person consultation. That could be a waste of both yours and their time if you turn out to not be a good candidate. In my case I sent over a series of pictures initially and then I arranged an in-person consultation later on. The original online consultation was actually very close to what was said and agreed in person, but there's no reason why you can't do both.

PM sent Hariri.

Hi Robbie, I recently had an FUE with Dr Feriduni and can't speak highly enough about him and his team. I consulted with numerous surgeons and he was my preferred choice. Best of luck.

Hi Buzz, It's to scale, in that 1 pixel is 0.1mm, but it's not 'Actual Size' because the size you see depends on how large your screen is - for example on a phone it will appear smaller than on say a TV being used as a monitor. If you zoom in or out on your browser so that the box is 1 cm sq on your screen then you will get a true indication. You can do this by pressing control and - . You can then use control and 0 to reset your screen zoom. The reason why this is OK is because if you see the box bigger, the incisions also appear larger (in the same ratio) - so whichever size you are using you can see how much gap there is inbetween. The surgeon will typically have many times of magnification - you can also simulate this by zooming in. Thanks Bonker :-)

Just whipped up a quick and to-scale example of 49 incisions per sq cm. This assumes a flat edged 0.9mm blade (which I believe is quite common, blade sizes can be as small as 0.6 or 0.7mm especially for single hair grafts). 1 pixel = 0.1 mm As you can see there is loads of space inbetween the incisions.

Agree with 1 very much - important to consult with your actual surgeon. Not sure on 2 - before going into my recent 2nd operation I thought I needed about 1,000 to thicken up the hairline. Once I consulted with multiple surgeons and they all said I needed 2,400 grafts (pretty much bang on) that was all the confirmation I needed that that was the correct amount. I realised during the process that my recession had carried on more than I realised. Surgeons are far more experienced and knowledgeable so to second guess their recommendation is a risky game. Any ethical surgeon will not overstate the amount of grafts you need, but if concerned just have a consultation with multiple surgeons and compare what they say. Since all top surgeons are booked up well in advance they gain nothing by telling you you need more grafts than you do. If you have fewer grafts, they can fit in another surgery around you on the same day, or a larger one than they otherwise could have. They are also judged on their results and with the proliferation of online forums it's very important that they get the approach right. Not sure on 3 either - I've seen cases of dense packing from the very best surgeons of up to 60 grafts per cm2, with great results. 35 grafts per sq cm doesn't give you 70 hairs in the hairline, because for a hairline to achieve a natural result the hairline should consist of single hair grafts. This is why a typical dense packing approach is say 60 single hair grafts per sq cm in the hairline, perhaps 40 doubles going back per sq cm and maybe 30 triples per sq cm at the back. This gives you 60, 80 and 90 hairs per sq cm respectively and gives a very natural result. Average native hair ranges between 60 to 110 grafts so even 60 grafts per sq cm is still lower than native, despite being labelled 'dense packing'. I've seen many great results from it. I myself had over 2,500 grafts spread over an area of just over 50 sq cm so my average was around 50 grafts per cm2. Dr Feriduni even showed me, using a blade and a piece of paper, how easy it is to cut ~50 incisions into a sq cm (7 x 7). There was plenty of room to spare and the paper held up fine. On 4, I guess there are different levels of sedation. I agree there's no need to be knocked out before the op but a little sedative helps ease the pain of the injections whilst keeping you fully aware of what's going on. On 5 - if the surgeon was solely responsible for the implantation you would end up with a number of undesirable side-effects. Firstly, fatigue as others have mentioned, which could mean sloppy work. Secondly, the grafts would be out of the scalp for longer which would risk losing more of them, so yield could be lower. Thirdly, the technicians in many cases are every bit as skilled as the doctor at the top clinics when it comes to placing the grafts into the pre-made incisions. Because it's all they do, it becomes their speciality. There is little danger of the techs making a mess of this stage because if the incisions have been made correctly there is only one way the grafts can be placed inside them. Another consequence of the doctor managing the whole process would be increased cost because obviously a doctors time costs more than a technicians, and similar amounts of man hours would be required. Again, I think there are many top top clinics which often speak about the whole team of doctor and technicians being important, not just the doctor. On 6 - each doctor gives you their own post-op instructions with their own sprays, etc. The vast majority give you vitamin sprays or other healing-agents which should be used post-op, and their results speak for themselves. I don't think it must necessarily be saline solution, they all seem to have found their own working formulae. Thanks for sharing your experience and opinions though! :-)

Hi Sheath, The meet is on 5th May. Here's more information: http://www.hairrestorationnetwork.com/eve/165093-spring-hair-meet-up-london-may-5th-2012-a.html In both my original consultation in January and in my pre-op consultation in March Dr Feriduni was very honest and forthcoming about what density to expect - he's a very ethical surgeon and he will not mislead you in any way. Good luck!

Hi Sheath, I would always say it's a battle between your goals and a reasonable long term plan. At 24, this kind of early recession, even if slow as you mentioned, does suggest to me that you could potentially recede further, certainly over a period of 10 years or more. While taking Propecia is an excellent step and should help to slow this, it doesn't necessarily stop balding completely for most people. The position you are in pretty much matches what most people who opt for HT's have - the risk of the need for future operations. Given this situation, most surgeons would advise a conservative hairline (which I believe Dr Feriduni has done correctly on you), and aiming for a visibly good density in that area - this is to leave room for manoeuvre to handle any future loss. You have a limited supply of donor which can be extracted and the 'battle plan' is usually to ensure that you have enough left over to cope with future hair loss I say visibly good, because your donor may be perhaps 70 to 100 follicular units per sq cm, but 'dense packing' in hair transplants tends to mean 50 or so at the front, lessening as you go back. While this density will always be lower than your natural density, it can be sufficient, if done correctly, to give the illusion of a full head of natural hair. You do need to have realistic expectations though, the hair you have transplanted will never be as thick as your hair going back, so if that is what you desire you may end up disappointed. What I would say is don't take this decision lightly. If you are opting for the FUT route (as I did at age 20) you are committing yourself to potential future surgeries when the hair loss progresses (which it inevitably will, even if it appears stable now). Not only do you lose the option to go with a short cut or to shave your head completely, it also becomes essential to have future surgeries if the hair loss continues because otherwise the hair would look 'top heavy' and unnatural. This is why some people such as Ben, who anticipate the possibility of a lot of future hair loss, opt for the FUE route. FUT does on average produce a slightly better yield than FUE (assuming you're in the hands of a top FUE doctor), but this can vary by patient and is by no means set in stone. Typical numbers doctors have provided me are 1.8 to 2.2 hairs per graft for FUE and 2.1 for strip. If your main concern is maximum density and you don't mind the strip scar, and can commit to future surgeries, FUT is a good way to go. In my opinion it is rare to see cases where 1 surgery can achieve the visible appearance of native hair starting from a point of nothing (ie no hairs in the area), but it can happen if packed with a high enough density. If you don't achieve the desired appearance first time you can always go back and have it thickened up. I had a strip surgery 7 years ago and while it was never as thick as my natural hair, it was thick enough that it looked natural and not balding up until recently. Last month I went for a further surgery to add density and to also address the areas behind which had continued to recede. So long as you're comfortable with this long term 'battle' - I'm sure you can gain a lot of confidence from the right procedure. If you're happy or could be happy with a shaved look then I would give this a lot of thought.

As I understand it, the majority of surgeons can perform BHT. However, the vast majority advise against it or would only recommend it in extreme situations or as a last resort. I would say the consensus amongst the more experienced guys is that BHT does not look as natural as a normal hair transplant so it's something to be mindful of. Things like scar revisions are perhaps the exception but even then normal hair would produce a better result. I don't think there is a trend towards BHT due to many factors such as its different texture and consequently lesser results.

You sound like a good guy, Atticus. I'd be very tempted to befriend the guy and direct him towards some good surgeons to get repaired, but I know it's something you could never bring up - it would have to be him. The problem is the rest of the guys in the office are probably not as considerate as you!

It depends on many factors, such as your donor density, hair type & colour etc. 4,000 is a lot to be extracted by FUE in a single sitting, it may or may not be possible for you. The best thing you can do is head over to Belgium and consult with Dr Feriduni and Dr Bisanga, who are regarded as some of the finest FUE surgeons internationally. They will be able to measure your donor density and give you better advice than all of us can. I saw a recent case by SMG (Shapiro) where they combined FUE with SMP (Scalp Micro Pigmentation) - you should definitely check that case out and give it some consideration if you want the Statham look.

Just to give you an idea, here is a post I am copying from Bill: 3 months - 10% 4 months - 25% 5 months - 40% 6 months - 60% 7 months - 70% 8 months - 75% 9 months - 80% 10 months - 90% 11 months - 95% 12 months - 98% 18 months - 100%

In short, yes. By 5 months you're just starting to see the first 'shoots' of hair coming through, typically they are a bit wiry or curly at first. It takes time for them to become stronger and to take on the characteristics of your native hair in that area. Then you have to consider that some areas may grow more slowly so you may not have seen much of that growth yet, it continues to develop. Obviously it varies by patient, some see great results by 6 months, others take 12-18 months, but as a rough guide I believe the figure floating around on here is that you can see perhaps 40% of your final result after 5 months, taking into account all of the factors above. Be patient, I would certainly wait at least another 4-5 months at which point you'll have a better idea.

Propecia was a banned substance but it isn't anymore: (promotional link removed)

I agree with Spex - you may not be able to shave your hair very very short with FUE, depending on the quality of your surgeon, and how well you react as a patient. If it goes right for you, however, there are cases where people can get away with very short hair afterwards Having had both a large FUE and a large FUT I am in a great position to let you know that you will certainly be able to have your hair shorter with FUE than you could with FUT - even immediately after my FUE it was the FUT scar which was the more obvious problem - and I've got quite a thin scar. While most surgeons tend to agree that FUE yield is slightly lower, the developing consensus amongst those doctors who are the best with FUE (in my opinion) is that it doesn't have to be significantly lower if done right. If you do get FUE, you should be prepared for the possibility of not being able to have your hair cut very very short, but 'quite' short should be no problem for the majority of cases, particularly if you go to one of the best, who in my opinion right now are Rahal, Shapiro, and Feriduni. So long as you have realistic expectations and recognise that possibility you should be fine.

It's been raining before and he looked better. Like myself and Spex said - I think he's using less concealer.

This sounds awesome. I don't know if you planned this anyway but it would be great if you saved the streaming so that people can view after the event. Good luck!

After my FUT I found that I could still feel 'tightness' at the back from the scar even a year or so afterwards, and on occasion even after that. The pain should go away within a couple of months though.

I watched the game yesterday afternoon (what a cracker!) and I too noticed for the first time that his hair at the front looked gappy and his style was more of a comb-over than I've seen before. Having watched many other games in which he's been sweating and/or it's been raining his hair has not looked as thin as it did last night. Perhaps his balding has continued, or perhaps he was trying to play without concealer for the first time, showing the true state of his hair.

I think you've received some excellent replies already, and clearly it's way too soon to judge the end result so you have no need to panic there. I just wanted to chime in and address the above comment, because it's important. When your grafts are healing it is possible to lose hairs as early as 3-4 days after the procedure. This is especially true when it comes to single hair grafts which I assume most of yours are given their position in your hairline. Not only can they simply fall out at this early stage, many also fall out when the scabs do, as they become attached during the healing process. I witnessed this first hand with my recent surgery, I noticed that when some scabs fell off, the hair went with them. I asked my doctor about this and he said it's perfectly normal, some fall with scabs, some fall 2-4 weeks later, some may never shed. This means that after 17 days you may already have lost many of the hairs and what you're seeing may not necessarily be an accurate representation of what you should expect. Of course I can't guarantee that this is the case, and there's a possibility that the density you received may simply be too low - but I would wait for at least 6 months to get a better idea of the density and about 12-18 months to see the final, thickened end result. Good luck!

Outrageously good result. Donor looks perfect too. Congratulations on your FUE.

Supposedly drinking a lot of water helps, the fluids have to flow down your face and when it reaches your lower body and neck it will be released through your lymph nodes. Dr Feriduni provided me with an ice pack to help it along but I didn't use it. I think you may find that in 2 days some swelling is still visible but it should look a bit better than it does now, however it may look worse before it looks better over the next couple of days as it goes to your eyes. In my personal view there's not a great deal you can do to stop it, it's just one of those things you have to ride out.

18 months is a long time for hairs not to have softened and become more similar to your native hair in that area. Perhaps your donor hair is particularly frizzy and you may always notice a difference between your transplanted and native hairs.