Do All HT Docs Require Taking Finasteride?

[reverse]

For some reason, admittedly stupid in hindsight, I think I felt that opting to go for it and get a HT would not require me to commit to take finasteride long-term. Like it was a stand-alone solution.

 

Now, I can see the logic in taking it. You can reduce the size of the session and maybe avoid having to come back for another round after the hair loss progresses. But, me being a diffuse thinner, since it all just kind of goes at once I feel like I can more or less tell what the total area is of my head that I will be affected. I mean, the extent of the pattern that I will be affected by MPB. Maybe this is not true.

 

But say you have 6,000 grafts to work with of available donor. Average quality. And someone like me, who is losing the whole MPB area diffusely, and it's something around 200cm2 in total area. Could you plan out to transplant 40 fu's/cm2 to the first 100cm2 of balding area, and then 20 fu's/cm2 to the back 100cm2 of balding area? Or a blend of that?

 

Obviously, this will leave the crown area a bit thin, but not bare bald and concealer may help there and maybe even scrounge some more grafts later to fill in. But, is 40 fu's/cm2 dense enough to provide nice coverage for the frontal and not be overly see through?

 

Is this something that people will do?

 

Maybe I am expecting too much out of those 6,000 supposedly available donor grafts.

[Shampoo]

I have never heard of a doctor "requiring" finasteride.

 

Most doctors will recommend taking finasteride

because the decision not to take it carries very large risks

that one will bald more, bald quicker, and need

additional transplants sooner and/or more often.

[KO]

Pattern is not as predictable as you think. You might originally thin out in a NW 5 pattern, but then your sides could drop. Furthermore, many doctors such as Dr Rassman believe that fin protects against shockloss (I believe this is because some of your hairs can get forced into telogen, and that is when androgens are active). Furthermore, you want to keep every native hair that you can, and prevent donor thinning, which can happen.

[Cant decide]

Take a look at my pics. My average density in the front half was 47 grafts/sq cm and it is not see through at all unless you get me under some pretty harsh lighting. But that is true with any HT.

 

I think an average of 40 will give you respectable density in the front but I would not go below 50 in the hairline and this is of course is provided that your hair to graft ratio is not below say 1.9. In that case, you may want to get your average up to more line 43.

[jameslondon]

i also thought that i could do a ht without taking finasteride. from my personal research, it does seem that most doctors recommend finasteride because of the strong results in the crown area. if you have a ht and lose more hair, and you don't have much donor hair left... it makes sense. i don't think they say you must take it or anything, but they seem to be saying that if you don't take it, you may need another ht after already having your first one. ethics, i guess. i've only been on finasteride for 2 weeks so i need to wait until the 3 month date until i can see any results. i'm hoping it'll save what i have, regrow some, and slow the mpb, and hope to see a result before i go for my first ht.

[reverse]

Thanks guys for your input. And you're right Shampoo I shouldn't have worded it "required". Maybe "strongly advised" would have been a better term, or something between the two.

 

KO, I figured that pattern is not all so predictable. But, was hoping with diffuse hair loss you could get a better idea as it reveals itself all at once. So, basically I could have phase 2 of hair loss and the side/back could drop. Awesome.

 

I also understand that taking finasteride may help prevent the need of a further HT. I almost don't know if I would rather have a second one in the future, so long as my donor allows, than be stuck on a medication for the rest of my life. Sounds irrational I know, and it's easy as just taking a pill. I get that. But, I have tried taking fin previously and it just didn't go over so well.

[reverse]

Can't Decide:

Wow man, if I could achieve your results I think I would be very satisfied. Although, I would like to see a picture of the top of your head. How is the crown? I would guess that the procedure put more grafts in the front than the back, right? Also, can I ask why you took finasteride in your specific case? Because, you did not have much hair at all prior to the procedure right? So what were you looking to maintain? Or just to prevent the possibility of your pattern area enlarging?

 

47 grafts/cm2 looks like it got you some great coverage. I'm not expecting some prefect head of hair by any means. And, I expect that there will always be certain lighting conditions where there will be some see through. But, that's ok as long as it is not obnoxiously see through where that is one of the primary things people notice about me. But, do you think that in most situations your hair loss is not all that obvious anymore? Your results are what I was hoping was the case as far as the number of grafts and the results they achieve. I really don't understand how some people do like upwards of 8,000 to even 10,000 grafts and not have great coverage.

[gillenator]

reverse,

 

Nice to see you doing your research and we all wish things could be more black and white regarding this whole hairloss dilemma.

 

A couple of things. Yes, most HT doctors and also dermatologists will highly recommend Propecia for treating MPB. And you best stated it by referring to it being "highly recommended" and not mandated. Why is that you may ask? Because to date, low dose finasteride continues to be the most efficient medication for treating MPB, period. Minoxidil would no doubt rate immediately behind it. In fact, both meds are the only two hairloss meds approved by the FDA for treating genetic hairloss, and both are supported or substantiated with published clinical trials.

 

In addition yes, both meds have proven to be most efficient in the post-terior (crown) and midscalp. And you pointed out another very important point in that if the crown can be saved or the thinning greatly reduced, it leaves more of the finite donor available for the higher visual impact areas such as the frontal third.

 

But we must recognize that these meds will never stop MPB dead in its tracks. It only can potentially greatly slow down the rate of progression since MPB is progressive in nature. Simply put, it buys us time.

 

Anyone with extensive MPB can never get by with only one HT procedure because eventually more hair will be lost in the future and once the individual commits to the first procedure, more future procedures will be needed to maintain any realm of coverage.

 

If that is your photo at your avatar, then it appears that you have the Ludwig pattern of thinning which most women with MPB sustain. It is a generalized thinning pattern throughout the scalp and can potentially impact the so-called permanent donor zones. If true, then the donor hair taken from the occipital zone can be DHT receptive and that hair can be potentially lost sometime in the future. It is not then considered terminal hair (non DHT receptive), and should not be considered for transplantation "unless" the patient is fully aware of the risk and still desires to have the procedure knowing upfront that it may not last.

 

This is why many women and yes even men who have this type of extensive hairloss opt for a high end hair system "if" they must have hair and will not accept anything less than full coverage.

 

I have known and seen enough women and men who insisted on having HT procedures end up in the end to go with a hair system. They continue to lose their hair and eventually run out of donor supply. Some have told me that they regret all of the money and time vested into surgical hair restoration and in the end went with a hair system because their donor looks depleted and they still lose hair.

 

Again, these are the exception and those with extensive classes of hairloss in their futures. Most were diffused thinners with the Ludwig pattern of hairloss. Most had advanced classes of hairloss within their family histories as well. Some of these diffused thinners experienced more extensive shockloss too post-op.

 

This may not be what you wanted to hear but better to know the full extent of the risks with advanced diffused thinning patterns before you step into the OR.

[Cant decide]

I take meds to prevent me from going from a NW 5/6 to a NW 7. My crown was not touched in the first round and I am going back to get that done in August (Another 4000 grafts since I want to hit it with an average density over 40 grafts per sq cm). The front and top are in really good shape now and I could not be happier.

[KO]

What was your experience taking finasteride? Did you suffer serious side effects? If so, what nature of sides?

 

If you have sides, try trimming the dose to every other day, or a few times a week, etc etc. Some guys even get sides from 0.5 fin EOD, whereas me, I take 1.5 dut pills and 0.5 fin pills every day, and don't feel any different.

[reverse]

reverse,

 

Nice to see you doing your research and we all wish things could be more black and white regarding this whole hairloss dilemma.

 

A couple of things.....

 

Gillenator,

Thanks for taking the time to go through that in detail like you did!. Yes, I am trying to do as much research as I can. You are right that I am diffuse thinner, but I don't think it's unpatterned diffuse alopecia, I don't think. It is just the horseshoe pattern but all seems like is going at one time. Guess I really need to update my avatar. That's an older picture. You can see more current pictures from a recent thread here:

http://www.hairrestorationnetwork.com/eve/170348-another-how-many-grafts-am-i-candidate-question.html

 

So, yeah, It's not throughout the whole scalp, just the MPB areas.

 

I was just creating the example of if all was lost on the top, are there still options? Or are you screwed? Either because finasteride just didn't work for me, or could not tolerate it. I think I have seen some examples of guys that have had procedures that had very little - no hair and seemed to be able to do ok. 'Cant Decide' who also posted in this thread seemed like he started with very little.

[reverse]

I take meds to prevent me from going from a NW 5/6 to a NW 7. My crown was not touched in the first round and I am going back to get that done in August (Another 4000 grafts since I want to hit it with an average density over 40 grafts per sq cm). The front and top are in really good shape now and I could not be happier.

 

Cant Decide,

Oh, ok. But did you think that you were likely to become a NW7? Or do you think that at the time the procedure was done it had stabilized?

 

So all 5,000 grafts were transplanted to the front? Do you at this point right now have nice coverage for the front half of the top of your head, and very little for the back half? If that is the case, does it look natural, especially when you are seen from the top?

 

Sorry for question overload man

[Cant decide]

Cant Decide,

Oh, ok. But did you think that you were likely to become a NW7? Or do you think that at the time the procedure was done it had stabilized?

 

So all 5,000 grafts were transplanted to the front? Do you at this point right now have nice coverage for the front half of the top of your head, and very little for the back half? If that is the case, does it look natural, especially when you are seen from the top?

 

Sorry for question overload man

 

 

No problem. I and Dr. Rahal don't think I will become a NW 7 but my Crown could still get a bit bigger so I want to avoid any further loss. At the time I had my procedure, I had just started to take finasteride so I did not know how it would work for me. It did help to stabilize things in the almost three years since my procedure although I have had some further minimal loss. Without it, I am sure I would have lost more. Now I feel like I am getting to a point where between the finasteride and the fact that I have lost so much hair already, it will stabilize further and any loss from here on in should not have a dramatic impact on my overall look.

 

The 5000+ grafts were placed on the front and midscalp as well as the back sides so a lot of area was covered. I have great coverage everywhere in the front and top but yes the crown is thin. It is not so bad that it is completely bare and it does look totally natural. There are many guys out there that still have their native front and top but have lost a lot of their crown. Never once has the thought of naturalness entered mine or anyone else mind.

 

I should add that what helps me is my donor supply, I have about 11,000 grafts + available to me so after this next round of 4000, I will still have 2000 grafts left for the future in case I need them. Most guys are not so luckly. Although, I would take being a stable NW III with a total donor supply of 7,000 grafts any day

[reverse]

What was your experience taking finasteride? Did you suffer serious side effects? If so, what nature of sides?

 

If you have sides, try trimming the dose to every other day, or a few times a week, etc etc. Some guys even get sides from 0.5 fin EOD, whereas me, I take 1.5 dut pills and 0.5 fin pills every day, and don't feel any different.

 

KO,

Yeah pretty bad libido/ erection quality. Obvious change after a while. Yes I must admit it was a particularly stressful/eventful time in life. But, I have had stressful periods of time before and can not ever recall a change in sexual desire that abrupt, or at all for that matter.

 

Aside from that just the change in semen consistency/ volume and a discomfort periodically in the testicle area. But, I understand those are common reported sides and are a result of the physical changes to your prostate and not of great concern.

 

I also cannot say that the symptoms resolved very quickly, if ever completely, after I stopped taking it. And that is also the time I started looking for answers and began researching and learned of all this about finasteride side effects and 'connected the dots'. So I don't know what to make of that. Then there's the non-stop stress about hair loss itself which you could also say has its very own side effects psychologically and I don't know how much that has to do with the whole equation.

 

 

But I do have some other concerns regarding the other metabolites of 5AR, some subsequently becoming protective neurosteroids. I won't pretend that I am knowledgable enough to determine if this is the real concern taking finasteride and whether it explains it all, but I do wonder what good can come of artificially lowering the levels of neurosteroids that have very important functions. Is there any evidence that this is not a concern?

 

I would/will surely give finasteride another go. But I would like some assurance regarding the neurological effect of taking finasteride. If you can point me in the right direction, or shed some light about the subject I would very much appreciate it. I am not anti-fin, but am a bit cautious because of it's strange and unagreeable side effect profile.

[gillenator]

reverse,

 

You are very welcome my friend. Yes you still have options should everything go on top. But it will all come down to the type of hairline (placement) and level of restored density. Will it be ok to leave the crown thin or even not touch it at all? This is what you need to sort out.

 

And thanks for the clarification. Non-patterned diffused alopecia is what I was referring to. For some, it can affect the donor regions and sides, for others not so.

 

But I would still highly recommend that you have your entire scalp microscopically examined to see exactly what regions of your scalp have diffusion and beginning signs of miniaturization going on.

 

Best wishes to you...

[KO]

KO,

Yeah pretty bad libido/ erection quality. Obvious change after a while. Yes I must admit it was a particularly stressful/eventful time in life. But, I have had stressful periods of time before and can not ever recall a change in sexual desire that abrupt, or at all for that matter.

 

Aside from that just the change in semen consistency/ volume and a discomfort periodically in the testicle area. But, I understand those are common reported sides and are a result of the physical changes to your prostate and not of great concern.

 

I also cannot say that the symptoms resolved very quickly, if ever completely, after I stopped taking it. And that is also the time I started looking for answers and began researching and learned of all this about finasteride side effects and 'connected the dots'. So I don't know what to make of that. Then there's the non-stop stress about hair loss itself which you could also say has its very own side effects psychologically and I don't know how much that has to do with the whole equation.

 

 

But I do have some other concerns regarding the other metabolites of 5AR, some subsequently becoming protective neurosteroids. I won't pretend that I am knowledgable enough to determine if this is the real concern taking finasteride and whether it explains it all, but I do wonder what good can come of artificially lowering the levels of neurosteroids that have very important functions. Is there any evidence that this is not a concern?

 

I would/will surely give finasteride another go. But I would like some assurance regarding the neurological effect of taking finasteride. If you can point me in the right direction, or shed some light about the subject I would very much appreciate it. I am not anti-fin, but am a bit cautious because of it's strange and unagreeable side effect profile.

 

 

These are good questions, unfortunately, we don't really have conclusive answers on the neurological effects of finasteride. If you want to read papers, go to scholar.google.com . That is simply a risk we choose to take.

 

Regarding libido/ED - I think it might be worth trying low dose finasteride - say a couple times a week, you may feel lower side effects. On the other hand if you simply cannot tolerate finasteride, you will need to start the experimental treatments like RU, PGD2 etc etc. - but the problem there is that the LT term effects are even less well understood. (Ironically people complain about LT effects of fin but have no problem using RU. LOL). Let us know how it goes.

[reverse]

Guys, I won't drag this thread on for much longer. Just wanted to follow up on your responses and get just a bit more feedback..

-----------------------------------------------------------

 

 

No problem. I and Dr. Rahal don't think I will become a NW 7 but my Crown could still get a bit bigger so I want to avoid any further loss. At the time I had my procedure, I had just started to take finasteride so I did not know how it would work for me. It did help to stabilize things in the almost three years since my procedure although I have had some further minimal loss. Without it, I am sure I would have lost more. Now I feel like I am getting to a point where between the finasteride and the fact that I have lost so much hair already, it will stabilize further and any loss from here on in should not have a dramatic impact on my overall look.

 

The 5000+ grafts were placed on the front and midscalp as well as the back sides so a lot of area was covered. I have great coverage everywhere in the front and top but yes the crown is thin. It is not so bad that it is completely bare and it does look totally natural. There are many guys out there that still have their native front and top but have lost a lot of their crown. Never once has the thought of naturalness entered mine or anyone else mind.

 

I should add that what helps me is my donor supply, I have about 11,000 grafts + available to me so after this next round of 4000, I will still have 2000 grafts left for the future in case I need them. Most guys are not so luckly. Although, I would take being a stable NW III with a total donor supply of 7,000 grafts any day

 

 

Thanks again for replying!

 

What NW did they say you were at pre-op? I think I'm still a little thrown off about the NW scale. It's hard to tell what NW someone is (to me) sometimes.

 

Can someone also tell me if the crown is referred to as being part of the top? Or is the crown the back of the head only? Back of the top of the head, Or top of the back of the head?

 

By the further minimal loss I assume you mean the crown getting bigger? So, will you continue to take finasteride forever even after you address the crown in your next procedure?

 

Ok, good I'm glad to hear it looks natural. For some reason, I think I was under the impression that in this type of situation and in your case the front 1/2 of the top of the head recieved the transplants and the back 1/2 did not, when in reality it is not 1/2 you didn't have addressed, it's only like the back 1/3rd that is your crown if I'm getting it right..

 

So you are gonna have 4,000 grafts transplanted to where? Just the crown? Are you going to continue to take finasteride after the next round even?

 

Good for you that you seem to have very good donor! And I am happy for you getting such good results! What a transformation! Must be a good feeling!

 

However, I'm still dying to see a pic of your head from the top. If only to help me see where I could be after my first...

[reverse]

reverse,

 

You are very welcome my friend. Yes you still have options should everything go on top. But it will all come down to the type of hairline (placement) and level of restored density. Will it be ok to leave the crown thin or even not touch it at all? This is what you need to sort out.

 

And thanks for the clarification. Non-patterned diffused alopecia is what I was referring to. For some, it can affect the donor regions and sides, for others not so.

 

But I would still highly recommend that you have your entire scalp microscopically examined to see exactly what regions of your scalp have diffusion and beginning signs of miniaturization going on.

 

Best wishes to you...

 

Gillenator,

Thanks! That was what I was asking was the worst case scenario if all on top was lost and that was the starting point. I really don't think I'm all that far from that situation now. It might not look like it in the pictures but there's not enough on the top to do anything with at all. If I were to be stuck at this point, I would have to just shave it rather than try and rock a hairstyle I obviously couldn't pull off and get noticed for that.

 

I am not one of those guys that needs a straight across, super dense hairline. I am fine with a more mature hairline and more so am looking to address the coverage for the top. To me, it would make sense to be more conservative with the hairline now and address the top mostly, then if I can or want to in the future, I could add to the hairline and improve it. Maybe if I am conservative I can also leave open the option to address the crown later also, even if it is still thin and not as good of coverage as the top. I am not saying that I will not take finasteride, but can it be done without it if I wanted to go that route? Will my donor and checkbook allow it? That is the question.

 

When I have a consultation with one of the doctors I am finding on this site, will they go over the scalp microscopically everywhere to see what areas have any miniaturization whatsoever?

[reverse]

These are good questions, unfortunately, we don't really have conclusive answers on the neurological effects of finasteride. If you want to read papers, go to scholar.google.com . That is simply a risk we choose to take.

 

Regarding libido/ED - I think it might be worth trying low dose finasteride - say a couple times a week, you may feel lower side effects. On the other hand if you simply cannot tolerate finasteride, you will need to start the experimental treatments like RU, PGD2 etc etc. - but the problem there is that the LT term effects are even less well understood. (Ironically people complain about LT effects of fin but have no problem using RU. LOL). Let us know how it goes.

 

Yeah, I have been reading up a bit on PubMed. I'm not trying to be an internet expert here, just trying to be responsible. And I'm not trying to come across to be against the use of finasteride and I actually would love to take it for it's intended hair effects. But I am having a hard time looking past the potential effects resulting from the mechanisms by which it works.

 

Simply because it does not selectively inhibit DHT, rather it inhibits 5AR and thereby it's other metabolites as well, it seems reasonable that there could be a related change in neurosteroids.

 

Neurosteroids like allopregnanolone are important as far as modulating GABA.A receptors, brain healing, neurogenesis, myelination, etc. Important stuff. And many people with neurological disorders have been found with lower levels of allopregnanolone. Neurosteroids, the CNS and brain are such a complex subject. Again, I won't pretend that I understand any of it well. But, might it explain some of the symptoms that people report while taking, and after discontinuing finasteride? I can't say.

 

And, as you say, it is a risk that people choose to take. I understand that. But, I do just wish that I could come across some information or someone that would give some specific reason that this is nothing to be concerned about.

 

I don't know man, this is all just having me on information overload and I can't say I'm qualified to interpret it.

 

And yes, maybe a smaller dose would help alleviate the sexual sides, but if finasteride has a relatively flat dose response, then wouldn't a smaller dose have roughly the same amount of inhibition meaning same sides? Or am I wrong. Maybe I am because I am pretty sure I have read about people that have lowered their dose and not experienced the sides to the same degree.. So, maybe I will try that.

[jameslondon]

i've been on finasteride for a while now, and haven't had any side effects at all. i take just 1/4 per day with water/a drink and a vitamin tablet. i'm thinking of it as maintenance of what i already have as well as preparing for a ht.

 

my doc did say that if i had side effects, to go down to a 1/4 every other day or a 1/2 every other day, whatever works for you. he also said not to think about the side effects too much and to keep positive about it all.

 

i think a big question i had is can i have a ht without taking it... and you have to ask yourself if you have enough donor hair to cover all the top of your head (2/3 + crown) - a lot of guys don't have this much. this was a big factor in me taking the drug - if i can stabilise the hair loss with the drug, then having a ht will be a clearer step to take. i really wouldn't want a ht to then have substantial further loss on top and the crown and then have to worry about having another transplant with reduced donor hair available.

 

i also did research into some of the brain fogging that has been reported with finasteride - i asked quite a few people who take the drug and also the docs who prescribe it, how common this is, and they say it's not common at all.

 

to get the side effect of hair growth - we aren't taking the full dosage. some of the reports on side effects were very biased, and some people explain that as the drug is given in full dose for those guys with prostate problems *and* this group tend to be a bit older, that those who report such things as sexual dysfunction and fogging would be similar (statistically) to those in that age group who suffer from these things naturally. what i heard is that there isn't a strong correlation to make these studies applicable to everyone.

 

but... saying that, i do accept that a lot of guys say they have these side effects.

[Cant decide]

Guys, I won't drag this thread on for much longer. Just wanted to follow up on your responses and get just a bit more feedback..

-----------------------------------------------------------

 

 

 

 

 

Thanks again for replying!

 

What NW did they say you were at pre-op? I think I'm still a little thrown off about the NW scale. It's hard to tell what NW someone is (to me) sometimes.

 

Can someone also tell me if the crown is referred to as being part of the top? Or is the crown the back of the head only? Back of the top of the head, Or top of the back of the head?

 

By the further minimal loss I assume you mean the crown getting bigger? So, will you continue to take finasteride forever even after you address the crown in your next procedure?

 

Ok, good I'm glad to hear it looks natural. For some reason, I think I was under the impression that in this type of situation and in your case the front 1/2 of the top of the head recieved the transplants and the back 1/2 did not, when in reality it is not 1/2 you didn't have addressed, it's only like the back 1/3rd that is your crown if I'm getting it right..

 

So you are gonna have 4,000 grafts transplanted to where? Just the crown? Are you going to continue to take finasteride after the next round even?

 

Good for you that you seem to have very good donor! And I am happy for you getting such good results! What a transformation! Must be a good feeling!

 

However, I'm still dying to see a pic of your head from the top. If only to help me see where I could be after my first...

 

Right. Its only the back 1/3 that was not addressed. If the back 2/3 were not addressed, I agree that it would be unatural. It was the crown were I saw a bit more loss. I will continue to take Finasteride to prevent it from progressing further. The 4000 grafts will go mostly in the crown with a few in the temple corners.

 

I am not into the overhead shots. While my hair looks good from above, its a HT and can look a bit thin from that view as most HT do. Unless your worried about the opinion of birds, IMO, that view is not so important But seriously, I know why people want to see this view but to be honest, I dont like looking at my thin crown at this point so I would rather avoid snapping pics of it

[gillenator]

reverse,

 

You are very welcome my friend.

 

And yes, I would insist that your entire scalp is evaluated microscopically for miniaturization.

 

It is critical to know which areas of your scalp are subject to loss in the future even though there may not be much visible diffusion seen with the naked eye.

[reverse]

i've been on finasteride for a while now, and haven't had any side effects at all. i take just 1/4 per day with water/a drink and a vitamin tablet. i'm thinking of it as maintenance of what i already have as well as preparing for a ht.

 

my doc did say that if i had side effects, to go down to a 1/4 every other day or a 1/2 every other day, whatever works for you. he also said not to think about the side effects too much and to keep positive about it all.

 

i think a big question i had is can i have a ht without taking it... and you have to ask yourself if you have enough donor hair to cover all the top of your head (2/3 + crown) - a lot of guys don't have this much. this was a big factor in me taking the drug - if i can stabilise the hair loss with the drug, then having a ht will be a clearer step to take. i really wouldn't want a ht to then have substantial further loss on top and the crown and then have to worry about having another transplant with reduced donor hair available.

 

i also did research into some of the brain fogging that has been reported with finasteride - i asked quite a few people who take the drug and also the docs who prescribe it, how common this is, and they say it's not common at all.

 

to get the side effect of hair growth - we aren't taking the full dosage. some of the reports on side effects were very biased, and some people explain that as the drug is given in full dose for those guys with prostate problems *and* this group tend to be a bit older, that those who report such things as sexual dysfunction and fogging would be similar (statistically) to those in that age group who suffer from these things naturally. what i heard is that there isn't a strong correlation to make these studies applicable to everyone.

 

but... saying that, i do accept that a lot of guys say they have these side effects.

 

jameslondon,

Thanks for your help. When you say you take 1/4 per day do you mean 1/4 of 1mg Propecia, or 1/4 of 5mg Proscar?

 

Only thing that I don't get is the lower the dose is supposed to result in the nearly the same amount of inhibition, yet the sides are reduced? I guess I'll take the docs word for it though over my interpretation.

 

About the neurosteroid thing, I'm not trying to be negative but it did seem worthy of looking in to. However, I don't think there is enough information available to be well understood. It's a subject that there could be more discussion on but I don't think anyone wants to hear this thread go on-and-on about it.

 

Anyway, I think I really need to fly out to consult with one of the recommended clinics for an evaluation of my donor and scalp laxity to see what type of yield I can expect in order to figure what amount of area I will be able to cover?

[reverse]

Right. Its only the back 1/3 that was not addressed. If the back 2/3 were not addressed, I agree that it would be unatural. It was the crown were I saw a bit more loss. I will continue to take Finasteride to prevent it from progressing further. The 4000 grafts will go mostly in the crown with a few in the temple corners.

 

I am not into the overhead shots. While my hair looks good from above, its a HT and can look a bit thin from that view as most HT do. Unless your worried about the opinion of birds, IMO, that view is not so important But seriously, I know why people want to see this view but to be honest, I dont like looking at my thin crown at this point so I would rather avoid snapping pics of it

 

Cant Decide, thanks for clearing that up. And I respect your decision about the pictures. And I hear ya... it brought me no joy to put up pictures of my situation, posting pics of all angles, but I had to to get recommendations. If I could twist your arm I would but I am thankful for all the feedback from your experience either way. Just trying to do the best research I can and I am thankful to have seen your case as our starting situations appear to be fairly similar.

 

Only reason I asked was because I actually am seen from the top angle often, and not just because I am short. Surfing, the nature of my work, waterparks, etc. Luckily I have been able to wear my hat at work. There's just a lot of situations that I am seen from above.

 

But like I said I can definitely deal with the crown being thinner so long as it looks like a natural pattern of thinning. I can be fine with a mature hairline or a thinning-looking crown, it's just the straight up slick bald horseshoe I am headed for that I absolutely will not accept.

 

But, yeah, I really appreciate all your feedback nonetheless!!

 

 

 

 

 

 

And, thanks again also gillenator, appreciate all your help. I will be sure to ask for this examination and I'm glad you pointed that out as it may affect the approach to take altogether.

[gillenator]

You're welcome reverse. I still think that family history of hairloss (MPB) is the best gauge on the extent of our own individual hairloss in the years to come.

 

But ongoing examinations for miniaturization is the proof in the pudding so-to-speak to determine exactly where DHT is affecting the scalp, and henceforth where future loss is looming.

 

Best wishes to you in your resolve.