Interesting case- 10 year followup- on &off finasteride

[Dr. Jerry Cooley]

This patient came to us in 2003 at the age of 26 and had type IV hair loss. Although not very apparent in the pre-op scanned photo, he had signs of miniaturization all the way to the crown. He was started on finasteride and we did 2.800 grafts to the front of the scalp. He sent us photos in 2004 and was very pleased. We did not hear from him again until 2010 when he came to see us for another transplant. He had stopped taking the finasteride several years prior and had begun losing hair slowly at first, but then more rapidly. He reported no side effects or problems with the finasteride, just that he had neglected to keep it going, not being sure how much he needed it. We performed another transplant: 3,278 FU's ( 1-889, 2-1624, 3-705, 4-60) covering his entire scalp, including crown. Photos are 15 months later.

 

This case illustrates some important points, the first being the value of finasteride, and the importance of staying on it! The other point is that we try to plan our transplants in such a way that it will be relatively natural even if the patient stops finasteride. The transplant from 10 years ago held up relatively well and when he came in last year, virtually the only hair in the frontal scalp was in fact the transplants from 2003. It also shows the value of keeping hair in the donor bank for future use, especially for guys in their 20's, where future needs cannot always be accurately predicted.

 

The first row of pictures shows the progression from 2003 to 2004, off finasteride in 2010, and post transplant 2011. The next pictures are of the pre-ops for the 2010 case and the next series are the 2011 pictures at 15 months.

[NEWHAIRPLEASE]

Great documentation Dr Cooley...thanks for sharing this!! I personally can attest to the importance of staying on finasteride!! Wish I would have!!

[oceanchild]

Great post Dr. Cooley. The transplant looks so natural after such a long time. What a big difference meds can make!!

[chrisdav]

That is a great post Dr Cooley.

Thank you and nice result.

[orlhair1]

Great post. I think sometimes younger patients are too focused on using a ton of grafts and not keeping enough donor in the bank for the next several decades of potential additional loss.