'Medication: Finasteride and Minoxidil' Dr De Reys, 1280 Grafts & 1500 Grafts FUE

[NickBaron]

Hallo everyone and first of all, a very happy new year to one and all.

 

Now secondly, here is our third update for Dr De Reys.

 

This time round, we are presenting two cases at once – cases 3 and 4.

 

Before we do that, here is our position on medication, specifically on Finasteride (Propecia) and Minoxidil (Regaine/Rogaine).

 

As a side-note, for larger operations which may need body hair transplantation or for eyebrow transplantation, Dr De Reys works with Dr Villnow in Germany who offers these techniques.

 

Dr De Reys himself is a scalp FUE specialist and does not offer FUT (strip method) or any other technique.

 

He performs all of his surgery using scalp FUE which he does using his specialised manual technique.

 

For more on his technique, please take a look here:

 

http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html'>http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html

 

And here:

 

http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html'>http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html

 

Medication and hair transplants

 

Our position on medication is that both doctors recommend Finasteride for hair transplant patients over Minoxidil.

 

We offer the guidance note below to patients who are interested in knowing more about this.

 

In our experience, it is wise to take medication (Finasteride or Minoxidil) alongside a transplant however, there are two important things to consider:

 

1. Stopping medication

 

Once enough grafts have been transplanted to cover all balding areas and all grafts have had the chance to grow out then the patient might consider stopping medication and relying on transplanted hairs alone.

 

It may take many years to get to this stage and the results vary strongly from patient to patient.

 

2. Not starting medication

 

Some patients will have side effects from medication and in those cases, we advise you not to take medication.

 

Although medication is a good complement to a transplant, it is absolutely not necessary for transplanted hair at all.

 

Medication, specifically, Finasteride, is only good to protect any remaining hairs that you might have on the top of your head, in balding areas.

 

Please read the guidance below for the details on how this works.

 

Protecting your existing hairs is good for a transplant because it helps with density however it is not essential.

 

If a patient does not wish to take medication for whatever reason then he or she should not take it.

 

Questions

 

For those who are interested taking medication to preserve their existing hairs then please read our guidance below.

 

If you have any questions on this topic then please let me know or write them in your comments.

 

As mentioned in previous posts, I am not a medical professional and so please do not take this as medical advice.

 

If necessary, I will refer your questions to the doctor however please be patient with the answer as they may be too busy to answer promptly.

 

Guidance on Finasteride

 

Both Dr De Reys and Dr Villnow recommend Minoxidil or Finasteride as a complement to the hair transplants (usually Finasteride).

 

The usual dose of Finasteride that the doctor prescribes is 1mg per day.

 

Finasteride was originally approved as a treatment for prostate problems.

 

As a prostate cure, it is usually prescribed in 4mg tablets that are also taken daily.

 

It is only as a hair loss cure that it's prescribed at 1mg per day.

 

Even at 4mg per day, Finasteride has undergone clinical trials to make sure it is safe for human consumption.

 

Both Dr De Reys and Dr Villnow recommend Finasteride over Minoxidil because the way it works is better known to science.

 

Finasteride (Propecia) inhibits the take-up of the male hormone, dihydrotestosterone (DHT), in hair follicles which prevents them from shrinking (miniaturising) and eventually falling out.

 

Minoxidil (Rogaine/Regaine) also bolsters exisiting hairs but the exact reason why is less clear to science at the moment.

 

It is a side-effect whose cause is not 100% mapped out to the doctors' satisfaction at this time.

 

So far there have been no scientific reports of major complications in humans with either drug but the doctors’ opinion is that they prefer to stick to what has been scientifically proven - i.e. Finasteride.

 

Both of these treatments preserve your existing hairs as long as you keep taking the medication.

 

They usually do not cause lost hairs to return.

 

With Finasteride, only existing hairs are affected. The transplanted hairs do not need Finasteride because they are permanent.

 

The hairs on the side and back of your head (the donor area in a transplant) are not affected by DHT in the same way that the hair on the front and top of your head is (the recipient area).

 

This is due to genetic programming that is the same in all men.

 

The combination of the transplant and using Finasteride to prevent your remaining hairs from falling out yields the best result in our experience.

 

If you are concerned about side effects then you should speak to the doctor although he notes that Finasteride/Propecia has now been in use for more than a decade.

 

Nevertheless, both doctors recommend that you stop use of Finasteride in the presence of your spouse for the entire nine months of a pregnancy and for one month before conception if you wish to be sure that you are in line with the manufacturer's guidelines.

 

According to Dr De Reys, the chemical Finasteride leaves the system within two days.

 

In case you are interested in finding out more, here is an abstract from a 2012 medical paper looking at the effects of Finasteride in a sample of over 3000 Japanese men (only sample sizes of over 2000 are considered statistically significant).

 

Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japan... - PubMed - NCBI

 

Patient Cases

 

(For Patient Cases 1 & 2, please look here:

 

http://www.hairrestorationnetwork.com/eve/177660-making-hairline-dr-de-reys-2700-grafts-fue.html

 

and here:

 

http://www.hairrestorationnetwork.com/eve/177708-extracting-grafts-dr-de-reys-1640-grafts-fue.html

 

)

 

 

Patient Case 3: Dr De Reys, 1280 Grafts FUE

 

FUE performed on a patient with strongly receding temples.

 

Treatment plan:

 

1280 grafts were implanted in one day with focus on the temples.

 

All grafts were stored using HyperThermosol.

 

The patient sent follow-up pictures at one year and is very happy with the result. If more grafts are needed for a future operation then the donor area has plenty of grafts left.

 

Pre-op:

 

 

Immediately post-op:

 

 

After twelve months:

 

 

 

 

Patient Case 4: Dr De Reys, 1500 Grafts FUE

 

Patient 4 had strong hair loss in the frontal third with a complete loss of hair line.

 

Treatment plan:

 

1500 grafts were implanted in the frontal third in one day.

 

For the hairline around 60 Grafts/cm2 and behind the hairline 35-40 Grafts/cm2.

 

All grafts were stored using HyperThermosol.

 

The patient was very pleased with the result and sent follow-up pictures after one year including one shot taken outdoors in natural light.

 

Pre-op:

 

 

Immediately post-op:

 

 

After twelve months:

 

 

Outdoors:

 

[Questionmark]

Patient 4 at least has a subpar result. It looks very sparse to say the least. Why would the clinic choose to present such a result??? (Btw we`d also need a top shot from that case to further evaluate it). I know Dr. de Reys in general takes very conservative approaches, but do you really expect to get a recommendation based on these results? Where are all the top results?

While I think Dr. de Reys is one of the best and most honest and upright surgeons concerning ethics, I didn`t see a really good result from him in the last two years, and I really did search for it... It`s just "solid" work at best imo. I do know some good results from the years 2010-2012, though, one case of aesthetically neat crown work, for instance. The work in general looks very defined, but often lacks yield imo. And I miss newer cases which would testify for current skills.

 

Here is an example of a very presentable case back from spring of 2010, when the doctor was with Moses and PHC: http://mosesmedicaltv.blogspot.de/2011/01/2950-fue-repair-by-dr-de-reys-moses.html

It looks great, but again, the newer results and foremost patient`s own postings did rather convince me not to advise to go with Dr. de Reys.

 

I also am curious why you never responded to the comments in the other threads, members asked questions there. Aren`t you the patient advisor/representative of Dr. de Reys? Then this would be your job I guess. (You also lack a signature btw.)

 

I really would appreciate an answer this time. Thank you.

Edited January 26, 2015 by Questionmark

[KO]

I respectfully disagree with you here, it was just a 1500 graft procedure, I don't think you can expect real density with that.

[Questionmark]

You`re right actually, with 1500 grafts this is probably the result you have to expect, but my point was rather in regards the approach itself, and I wondered why to present such a result as a showcase when applying for recommendation, rather than results which showcase natural and aesthetical density and hairlines. I am also a friend of conservative approaches, but as far as I know, the most dense Dr. de Reys is placing the grafts is about 40 (except the hairline, where he puts up to 50 I think). While he surely has his reasons, I`d like to also see some cases which prove that he is capable to perform large sessions, and densepacking, (just as the recommendation guidelines require it to my knowlege) in a representative number of cases. Imo this should be a matter of fact and not required to request for...

[MusoInOz]

KO is definitely right here, what would one expect from 1500 session? I thinks it's actually quite suited.

 

Mike

[PupDaddy]

I think both these cases reflect meticulous work, apparently good yield for the size of the procedure, and a good aesthetic by Dr. de Reys. If I were these patients, I would be very happy. Well done!

[LondonHT]

Well i think its good to see some results where a smaller number of grafts have been used. Of course it would be thicker if double the amount had been used.

It also would have cost more and used more of the donor supply.

Good work imo.

[hadenough2014]

For #4, I also don't understand why they leave that tuft in the front alone. It is bound to fall out in the future (even if on fin), so this guy will be back for yet another surgery. If I was him, I would have elected for 2000 grafts and done the entire frontal area as to attempt a one-and-done.