Mountinvan

Hi all---just saw that Brett posted his 6-month results on YouTube. No question about it--2400 grafts into an NW2 (is that correct?) hairline and it shows lots of hair. My question is the refinement of it when you see the curly implanted hairs when he pulls back his hair. It just looks odd up close or is that my imagination? Anyway, I can see definite improvement. Do you agree? No question about it

Well said..and would expect nothing less. While we haven’t cured baldness there are certainly many good options that were not available a few years ago. Melvin has enjoyed a tremendous year as moderator, husband, patient and father—and seems to navigate all those hairy situations with great finesse and agility. My hat is off to the Community for all its support and guidance. I am so thankful to all of you and wish you much merriment in the coming year.

I never wore a piece but always was cognizant of my hair since about 25--the wind was a big issue---swimming, too. Never had to worry about sex because I wasn't willing to risk it. Amazing how self-conscious I became; it affected so many parts of my life. In retrospect, maybe it would have been better to just have shaved down? If you are a good candidate and go to the right clinic, it is a life changer. I cannot believe we live in a time and age when baldness is for the most part optional. Great to have this Forum to steer in the right direction.

Why don’t you use the 1 percent Nixoral?

I want to say that I will have to take a different viewpoint. Your hair looks great, but you obviously have some problems with its current state and are worried about further progression--worried enough that you post on this Forum. The notion that this is hair greed is ridiculous--all of us suffer from it to some degree. My take is that you should keep your appointment with Dr. K. tell him what you want--what concerns you. He is a hair magician that can solve hair greed. Yes surgery has risks--as Gatsby points out--but Konior is the GOAT. I would trust him to not screw up. We can all be envious of your great hair--but in the end it is you that needs to be happy! Konior is the right Dr. to steer you. Medication is a good first option, but surgery with Konior is worth it IMHO if he thinks he can achieve your goals. You only go around once as they say.

The results are wonderful for you and show the Community what can be accomplished cosmetically for a higher Norwood who does his due diligence and picks a clinic that is capable and willing to address his goals. Baldness, thus, becomes a choice not a life long condition without option. There is no doubt in my mind that certain clinics are better for higher Norwoods, certain ones for afro, certain ones for high density artitisc juvi hairlines, etc. There is no one size fits all---even with geography and budget out of the equation. Thank you so much for all the sharing you do.

The best hair transplant doctors seem to obtain a better illusion of density with the same number of grafts. Couto and Konior are the two that immediately pop to mind. I have heard that it is difficult to densely pack because of blood supply to the grafts and the increase possibility of shock loss to surrounding hairs. Isn't original hair density around 80-100 follicles per square centimeter so it is an illusion that is being created? The art and skill of angling must be a factor for the elite surgeons but I also think they have adopted a technique that produces a transplant with the least risk of trauma and infection. You might also want to add in one more factor and that is the patient's healing recipient capability. You sometimes see excellent results from hair mills because you might have a particularly adept technician/physician combined with excellent patient characteristics or conversely not so spectacular results from an elite surgeon. Consistent superb results come from the best surgeons because they combine skill, technique and attention to detail.

Kind of looks like my hair when I comb it. Great density, youthful hairline. Are NW0s wasted on the young?

Have you considered strengthening the crown a bit?

Melvin this is very informative. Don't we all have second doubts? The lesson, of course, is don't be in a rush---make an informed decision and save if budget is an issue/ Surgeries, once done, are pretty permanent. While there are work arounds, it is better to try to get it right the first time. Travel, if necessary. This is one big decision that dramatically impacts quality of life. I am glad that I didn't pull the "plug" on those pluggy transplants in the 80's. We are so lucky to world class physicians vetted by this Forum who do cosmetically beautiful, life-changing work. Thank you Melvin----and PS we want to see the 11 month growth on you!

The cameo picture looks a whole more dense--maybe it is darker lighting, picture angle or at a different time frame than the gray picture. I would not be a happy fellow if this were the final result in the gray shirt. The hairline looks thin and unnatural. Looks like a hair transplant--a throwback to that dreaded pluggy look. I would be thinking about getting another pass but be worried that there would be shock loss. If the thinning occurred post-transplant after having sufficient density, then it would present a whole different set of considerations. The bottom line is that there needs to be a better cosmetic outcome than what we are seeing for someone so young because the possibility of further thinning is a real possibility.

Very nice improvement. Like the dense hairline. As they say---refined. I would probably be game for 500 more in Crown, and maybe some additional on right hairline. Is he getting another pass? I would think a 1,000 would more than do it. What is the plan?

Without a doubt Konior is King. His work is truly amazing. He could even restore Seinfeld's mullet.

Should we all be eating black chokeberries? A study shows that mitochondrial dysfunction of the dermal papilla cell --> cellular senescence via p16 --> inhibition of normal paracrine signaling pathways is the culprit. From another post: "Cellular senescence is really key to why treating the androgen side of the equation typically leads only to maintenance after the first 6 months of treatment and not significant regrowth (especially of the original, juvenile hairline). Senescent cells aren't easily repaired and/or cleaned up by the immune system (especially with age) and regenerated. They're also known to infect neighboring cells via SASP. Simply limiting serum/tissue androgen levels or even using an AR antagonist might really not be enough to bring senescent DPC cells back into the cell cycle." Link to study: https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-022-00800-7 Other studies on DPC senescence: https://pubmed.ncbi.nlm.nih.gov/17989730/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828374/ I ordered some berries---they are a great antioxidant.

Just saw a 4 month update on youtube: Interested in comments about what he thinks a line of transplanted hair at 8.05. Is this normal or a technique issue?

Glad you posted and asked for advice. First, Turkey is an option but given al the good clinics in Western Europe you should broaden your choices. Melvin is spot on in his selections. The crown can be tricky. It can take a good amount of grafts. Go to some of the good London clinics and get an estimate. It wouldn't surprise that you need at least 3,000 to do front and crown. Hope your donor is good. Take some pics of the back below the crown. I bet the right surgeon will work magic on you. Good luck.

Question: Do you want to test something before its safety can be verified?

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I thought taking Fin and Dut as a combo was a non-no---but dug a little deeper from hairlosscure2020: Finasteride and Low-Dose Dutasteride Combination Treatment March 4, 2019 admin 125 Comments Almost anyone who takes 5α-reductase inhibitors to reduce dihydrotestosterone levels (and treat hair loss) chooses either: Finasteride (1 mg/day; brand name Propecia). Or, Dutasteride (0.5mg/day; brand name Avodart). I have discussed the dosage and efficacy of both Finasteride and Dutasteride in lengthy detail in the past. Most people take either 1mg Finasteride per day or 0.5mg Dutasteride per day to treat their hair loss. While Dutasteride inhibits all three isoforms of 5α-reductase (types I, II, and III), Finasteride only inhibits the type II and III isoforms of the enzyme. Dutasteride inhibits a significantly greater percentage of dihydrotestosterone (DHT) in comparison to Finasteride. Taking Both Finasteride and Dutasteride to Treat Hair Loss A few years ago, one of this blog’s frequent commentators mentioned taking Finasteride for six days a week and the much stronger Dutasteride for one day a week. This would theoretically limit the side effects from taking the much more potent Dutasteride for all seven days of the week. I blew off this idea as pointless, since Dutasteride by itself has such a long 5-week half-life (Finasteride has a 6-hr or so half-life). So one might as well just take Dutasteride once or twice a week and completely ignore taking Finasteride to keep things simple. In fact I myself have been taking 0.5mg Dutasteride every two days rather than daily for a couple of years now. However, a short time after the above commentator made the suggestion, another blog reader made the following comment: Dan DECEMBER 8, 2016 AT 2:58 PM Hi, I have just been advised by a hair transplant surgeon, that if you combine 1mg finasteride daily with 0.5mg dutasteride once a week, you can expect regrowth. He learnt this from a recent conference he attended. A hair specialist presented a paper which showed good results from combining finasteride regularly with just one capsule of dutasteride per week on top. I’m yet to try this, but am willing to give it a go and just stop the dutasteride if there is no change or bad side effects. And then yet again, someone else made the below comment last year: Tom FEBRUARY 8, 2018 AT 6:20 AM I had been on Propecia alone for 15 years. Noticed hair started to thin again in 2016. Added Avodart in Jan 2017 and I can honestly say my hair is better and thicker than all the years on just Propecia. I take Propecia every day and one 0.5 Avodart once a week. Never had any sides at all. I did have a shed when I added the Avodart, but stick with it and within about 4 months I could feel and see new hairs. My hairline is better than I can remember. It has taken one full year of this dosage to fully appreciate just how effective it has been. I will continue until things change and then reassess, but hopefully that won’t be for a very long time. Combination Therapy: Finasteride and Low-Dose Dutasteride While doing research for this post, I came across a 2013 study from Australia that found combination treatment on one male patient quite effective. Finasteride by itself was not working for him, but adding 0.5 mg Dutasteride once per week drastically improved the hair growth results. Before and after photos can be seen in the study.

Just wait until you start changing diapers, the grey hairs will start to sprout! But, there's a solution....

Would be helpful if you posted some pics then the Forum might better steer you. Different docs excel at different type of cases. For example, only certain ones do a good job with body hair--others ecel at hairlines and still others at smaller or larger cases. Not a one size fits all in most situations. As to waiting lists, I would pick the Doc I prefer and get on stand-by. I have heard of people getting in on short notice if there is an opening.

Konior is at the top of his game. Great techs. Great artistry. Great skill. If it is a smallish procedure--2500 or less--he excels. If you want the best possible chance for a stellar outcome, i wouldn't think twice about Konior--and I speak from personal experience. I know H&W have enjoyed an excellent reputation over the years as a first class clinic. They do seem to be less hands-on of late---especially with FUE. Post some pictures, and tell us what the two clinics have suggested.

A very nice frontal piece I think. Gatsby is spot on, as usual.

Gatsby----it could have been from Mom's side, too. Scientists really don't know. They talk about the concentration of one sex hormone (dihydrotestosterone) increases in the tissue on their heads. That hormone leads hairs to become thinner and even stop growing out of the follicles altogether, which might be the key mechanism at work with genetic hair loss. But scientists still aren't quite sure how it works. Environmental factors may play a part---smoking and drinking. Genetics on both sides have been mentioned as well. A study on more than 600 German men in 2008, found that a location on Chromosome 20 had a "strong effect" on early onset male pattern baldness. That's a clue that both a mother's and a father's DNA are involved in baldness genes. It's a crap shoot---literally.

I recommend the Le Meridian part of Marriott-clean and new. Not far at all. Used points; part of It is adjacent to a Mall. Walking distance to many restaurants. There is a wonderful steak restaurant caddy corner. I think Comfort Suites is dated. Nice to have some food options in Hotel.