Tom R.

If one were to encounter some of the side effects of Avodart use such as decreased libido and ED, what course of action could be taken to combat those problems? I'm not sure there is an easy remedy but all thoughts and experiences are welcomed.

If one were to encounter some of the side effects of Avodart use such as decreased libido and ED, what course of action could be taken to combat those problems? I'm not sure there is an easy remedy but all thoughts and experiences are welcomed.

fit2btide, If you spend a little more time researching what you truly seek from this site, you will find it. I'm not going to try to convince you to do anything about your hair loss situation. You must decide that all by yourself. But the longer you remain on this site and research what you seek, you will find that it's one of the best resources available. I fully understand how difficult the decision to go ahead with a hair transplant can be. As a matter of fact, I can't believe that any one of us who have had the experience would have gone into it without thinking about the outcome. However, all of us are different and sometimes we have to learn from out mistakes. And if you read posts here and elsewhere, you'll find horror stories as well as stories of success. That being said, I applaud you for being so concerned about such a potentially life altering decision...and a HT could alter your life in either direction. The good thing is that you are on track to making the best and most well informed decision by consulting members of this forum. Just don't stop here. Many posters will recommend you visit the clinics you are considering and make time to meet with patients if possible. There is nothing better than actually seeing a doctors results in person. I have had HT's with the Shapiro Medical Group in Oct 0f '02 and most recently Oct of '06. Would I tell you to go to Shapiro in Minneapolis? Absolutely not! The choice is yours. Shapiro was MY choice but I thank Publisher Pat for providing a place where hair loss suffers can share experiences together and assist others through this condition. I don't know where you live but I'd be willing to meet with you as would most other posters in an effort to give you what it seems you need most. An opportunity to see for yourself and compare the results of several doctors. If posters on this site were to give you that opportunity, would that allow you to accept some of the things we have to say? Please keep an open mind. Posters such as Bill, the B Spot and NN are here to help. In some cases, they've been here for years in an effort to share their experiences, both positive and negative, in a concerted effort to provide potential HT candidates such as yourself with everything they have to offer. Don't let terminology or phone calls deter you from an opportunity to make a significant change in your life either. All the resources you need are right here to get you started. Keep asking questions and researching your concerns. When you're done do it again. And when you finish that last time, do it again once more for good measure. Good luck with your decision no matter where it may lead.

I don't want to be attacked here by anyone for sharing information. I thought I'd put that out there before I type anything else. I have used low level laser therapy in the past with some success. I did not regrow hair but it did enhance the quality of hair I have. For those of you who don't know anything about me, I've had HT's done by the Shapiro Medical Group as recently as October '06. Just prior to the recent surgery, I contacted Matt Zupan or was it Jenny to inquire about the use of lasers prior to the surgery. To my amazement, they acknowledged it has "some" benefit. So much so that they have a unit, purchased by Dr Shapiro, for patient use after a HT peformed at the SMG. That's all I have to say about my experience with the LLHT.

Hey LYNX, My suggestion would be to start Propecia immediately. Wait a year and see where you're at with your hair loss. You've got some good pics so I would keep them for reference and continue to take pics periodically to evaluate your progress. I'd also advise against the notion of a transplant right now. It's way too early especially if you haven't used medication to date. Reconsider your options after the medication has had a chance to work and keep visiting this forum. You'll receive excellent adviced from very experienced individuals willing help you every step of the way. Most of us have been or are going through it just like you. Good luck!

Moris, From the pic you provided, I can't detect a problem. If you had MHR add grafts to the front hair line, it looks good from what I can see. Perhaps, there is a different appearance to your scalp when the hair is grown out. I honestly can't see much of a problem unless you show us a pic to that effect. As far as the strip scar goes, you have an option of letting the hair in the donor area grow long enough to completely cover the scar. If you were not informed about the fact that you'd be left with a linear scar on the back of your head, I'm sorry for that. I could offer my two cents on that issue but you are upset enough and I don't want to add to that. Members of this forum are here to provide execellent advice on all aspects of hair transplants and it comes directly from personal experiences both positive and negative. We can help you through this if you let us. All is truly not lost. Remain positive, carefully weigh all of you options and seek every bit of advice this forum has to offer. Remeber, hair loss is currently a progressive disorder with no cure but we're all working on it together.

I think Bill is correct in stating that the regrowth has everything to do with the genetic growth stage that particular follicle was in before it was extracted and implanted in another area of your scalp. At any given point of each day, about 90% of normal scalp hair is in fact growing and about 10% is resting. So it makes perfect sense that not all newly implanted follicles will grow at the same time simply because they were implanted at the same time.

Hey B, Thanks for the offer but I am well aware that Dr's Ron & Paul, Matt Zupan and all the rest of the staff at SMG are there for ALL of their patients. As a matter of fact, I've contacted Matt several times via cellphone during off work hours. I know they are a class operation otherwise I would not have subjected myself to a surgery at the hands of someone I have any reservations about. I could have had my last surgery done by Dr Ron but I was confident that SMG would not let me down. Hence my surgery with Dr Paul. I am saying that you can't put the perverbial cart before the horse. Despite the fact that Ron has trained Paul and stands behind his work by putting not only his reputation but that of SMG on the line, one should be a little cautious in every case when their appearance is on the line. As for the tricho closure issue, Pat-our inspiration, had this to say about his last surgery with Ron Shapiro. "He also used three internal sutures to reduce tension on the skin level sutures which were STAPLES. He also did a TRICHOPHYTIC CLOSURE to minimize any cosmetically visible scarring." Pat has had four surgeries to my much smaller three. Now I know each case is different but with Paul's minimal experience, I would find it difficult for him to simply choose sutures and a regular donor scar closure when Ron himself uses the tricho closure in almost all of his current procedures. I do trust Ron, Paul, Matt and SMG but we all have to agree that it's OK to remain a little cautious with something of this magnitude on the line. I am very pleased to have found this site when I did and everyone who has responded to an inquiry of mine has also been wonderful. We all have Pat to thank and I do many times over. I wish everyone well and look forward to sharing my opinions, perspectives and personal experiences to anyone willing to listen. Thanks to all of you and Happy Holidays!

Pat and NN, While I am a fan of the SMG, having had a procedure performed by Dr Rose in '02, I'm slightly hesitant to give Dr Paul Shapiro the thumbs up just yet. I had my third procedure performed by Dr Paul Shapiro on October 30, 2006. The surgery provided @1500 grafts to my crown...a thickening up procedure if you will. While the procedure itself was wonderful, from the first shot to the last graft, I've had some minor concerns afterwards. Aside from some shock loss at the donor site, the tissue was red and painful for sometime afterwards. In addition, I know Dr. Ron uses the tricho closure with staples but Paul chose sutures and I'm not certain the tricho closure was used. I'm waiting to hear from Matt Zupan to see if that kind of information is noted in my file. I've posted my concerns about these issues on this forum and it seems that many people are NOT familiar with Dr Paul's work just yet. I'm going to wait six months before I give him my vote of confidence. Simply because one brother is a top notch HT surgeon doesn't mean the other is too. If sibling skills were that evenly distributed to all of us, I'd be a Major League Baseball Player.

Hey waggy, It's six weeks for me too only this is my third HT. Everyone'e healing is a little different. My donor area is still a bit sore but only to the touch. My recipient area is about the same. I wouldn't worry about it unless it interferes with sleep etc. Every day will be a little less painful and before you know it, you'll be looking at the new head of hair and not care so much about a little discomfort. Happy growing.

Panther5000, I looked over your pics and I'm certain you could do a megasession of 3500 or so and get exactly what you're looking for. I'm not a doctor but I can't see why a good HT doc couldn't get 3000-3500, especially if they go high on the sides. If a doc could get 3500, you could get a decent hairline and some coverage where you'd like it; then no more comb forward. Good luck and go for it! Oh, and don't forget the meds. You'll want to keep what you have.

LT, I've read and I can't recall where, that while it is not a problem conceiving a child while taking Propecia, there are potential problems during the preganany. If I recall correctly, the problem comes in when potentially exposing the fetus to any level of Finasteride during the development of the sex organs. I'm not sure when that occurs but I believe it happens about 10-12 weeks after conception. Something you might want to look into. Although you did say your wife is 4 months along. That's past the 10-12 week mark but I was only guessing at that time frame.

Bill, I actually don't have two aliases. When I joined in Sept of '01 I used the screen name Not so bad. I guess when I revisited the site over a year later, while seeking more information, I singed on under Tom R. Either I didn't remember my old screen name or I may have changed my email address. Hence the new screen name, Tom R. (my real name), since October '02. Believe me, I have no objective here other than obtaining opinions and experiences from those, like you, who have walked in my shoes. Now for the other chat...When I say Propecia has gone sour over the last two years, I'm referring to its' effectiveness at halting my hairloss. I was great for about five years but in the last two I have lost much more hair and that is why I had my most recent surgery with Paul Shapiro on October 30, 2006 (1500 to crown). My prior surgeries were in '00 with Dr. Wettleland of Elliott & True (600) and SMG (Dr Paul Rose) in October '02 (2021). It has been since the surgery in '02 that my hairloss has increased and necessitated the third surgery. I contacted Matt Zupan of SMG and through Dr Ron Shapiro, he recommended the 5mg of Finasteride versus moving onto Avodart. I did some of my own research and found that 5mg/day of Finasteride reduced scalp dht by about 41%. In contrast. .5mg/day of Dutasteride (Avodart) reduced scalp dht by about 56%. That's a 33% increase over 5mg of finasteride. I'm not sure I need that much of a drop in scalp dht to resume the benefits of 5alpha-reductase inhibitors so that's really the dilemma. If I could incrementally increase the drop in dht some way until I reached a positive level I would do that but I can't simply guess at it. I've looked at the dosing chart that Robert has posted, and I think I'm going to make the switch to Avodart but begin by taking it every other day. This will reduce my scalp dht much slower and I should reach about 50% supression by about month two. By reaching 50% supression, that will be a 25% increase over the maximum achieved by 5mg of Finasteride. Oh well, enough of that. I'll periodically post my experience with this new drug for any intersted parties. Take care Bill and Happy Growing.

Thanks guys. For some reason when I siged on last, my old screen name came up. Anyway, I called Matt Zupan of SMG and he told me not to worry. He asked me to take a photo and send it to him so Paul and Ron can take a look. I think it's really a bit of inflamation. My donor area is still a bit more painful on that side more so than the remaining donor area. It's not painful to the point where I can't sleep or anything like that. I never took any pain meds either but that's just me. I have never looked at my donor area after prior HTs but this one just felt a bit funny in that I could feel the shock loss this time. This is my third small surgery (600, 2000 and 1500). I have decided to use some ointment on the donor area. I've decided on Neosporin just in case. Oh, I don't think Dr Paul used the Tri-closure. If I remember correctly we discussed it before the surgery and he said he didn't think it was necessary. I'll check with Matt to verify that as well. In addition, I'm going to have one more surgery in October to add some density to the front half. I don't think I need it but I'm afflicted with HAIR GRRED> And lastly, would the two of you give me some feedback on my post under screen name "Not so bad" in the hair loss drug section. Thanks again.

I had a procedure done by Dr Rose in October '02 when he was with the Shapiro Medical Group. Excellent skills and quality work. If it makes you feel more at ease, I would recommend him to anyone considering a HT.

Michael, I'm almost 42 and my sideburns are almost to the end of my ears. I get occasional comments both positive and negative. The bottom line for me is what "I" think when I see the reflection in the mirror.

I recently had my third HT. All have been fairly small sessions (600, 2100 and 1500) because I've maintained decent coverage thanks to Propecia. I've used Propecia since January '99 and about a year and a half ago it began to lose its' effectiveness. Now is it time for me to swtich to Avodart? I tried it once before, about two years ago and had a two month long shed. Any ideas and personal experiences would be greatly appreciated.

I recently had my third HT. All have been fairly small sessions (600, 2100 and 1500) because I've maintained decent coverage thanks to Propecia. I've used Propecia since January '99 and about a year and a half ago it began to lose its' effectiveness. Now is it time for me to swtich to Avodart? I tried it once before, about two years ago and had a two month long shed. Any ideas and personal experiences would be greatly appreciated.

Likewise on the Avatar. I've had a total of about 4200 grafts (600, 2020 and 1600). I imagine I could easily get another 2000 out of my donor area. My procedures have been small simply because I still have quite a bit of original hair remaining thanks in part to Propecia but the benefits are losing steam.

After my third procedure on Monday, October 30, 2006 I'm already considering a fourth. Without posting pics to assist those of you willing to respond, I have a question. My hairline is fairly well established as is the rest of my scalp. However, I would like to add some density to the hairline and mid-scalp areas. When does it become more risk (i.e. shock loss) than reward?

After my third procedure on Monday, October 30, 2006 I'm already considering a fourth. Without posting pics to assist those of you willing to respond, I have a question. My hairline is fairly well established as is the rest of my scalp. However, I would like to add some density to the hairline and mid-scalp areas. When does it become more risk (i.e. shock loss) than reward?

Hi Bill, Thanks for the response. I have not really opted for the smaller sessions myself. I still have quite a bit of original hair left on my head. I'm one of those fortunate enough to have fought off hair loss with the assistance of Propecia. All of my smaller procedures have been based on what the doctors could do without really being concerned about severe shock loss while placing grafts between all my exisiting hairs. As a matter of fact, my last HT, Monday, October 30, 2006, Dr Shapiro wanted to go with just 1000 to thicken up the area I was most concerned with. We pushed and I went with 1500 and he added a few to my left temple, which for some reason is not symetrical to my right. Now it is! If I do anything in ther future, I'm goint to opt for adding some density to the hairline but even Dr Shapiro said he doesn't think I need it. Perhaps I'm getting overly aggressive since HT's have come so far in recent years.

Hi Everyone, I just had my third HT. The first was peformed by Dr Wettleland in 2000 while he was with Thomas True. That was about 600 grafts and before I learned a great deal more after that experience. Since then I've had two surgeries with Shapiro. I had just over 2000 grafts done by Dr Rose in October of '02 and another 1600 this week by Dr Paul Shapiro. I'm content enough with what I've had done thus far. Especially when these newbies grow in this spring. Dr P. Shapiro left my hairline alone and thought Dr Rose did a great job. I'm just about to turn 42, have been on Propecia since '99 and next year would consider thickenig up the hairline a bit. Has anyone here had a fourth procedure?

Hi Everyone, I just had my third HT. The first was peformed by Dr Wettleland in 2000 while he was with Thomas True. That was about 600 grafts and before I learned a great deal more after that experience. Since then I've had two surgeries with Shapiro. I had just over 2000 grafts done by Dr Rose in October of '02 and another 1600 this week by Dr Paul Shapiro. I'm content enough with what I've had done thus far. Especially when these newbies grow in this spring. Dr P. Shapiro left my hairline alone and thought Dr Rose did a great job. I'm just about to turn 42, have been on Propecia since '99 and next year would consider thickenig up the hairline a bit. Has anyone here had a fourth procedure?

Will any doctors on this board prescribe Avodart(Dutasteride) for their patients when it becomes available in December? I'm not going to assume anything but please answer ethically...business aside. Thank you.