Senior Member Blake Bloxham Posted June 27, 2015 Senior Member Share Posted June 27, 2015 John, It will likely depend on the amount of scar tissue in your scar. If the scar tissue is too thick and avascular (without blood supply), even the strongest, healthiest grafts won't grow. Dr Karadeniz does a lot of strip work, so he could probably evaluate the scar and give you an idea as to the best way to proceed. Doganay obvious does a lot of scar work as well, so both probably good ones to talk to! "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted June 27, 2015 Senior Member Share Posted June 27, 2015 Thanks for your advice Blake. Its appreciated. Its tough to choose between them. Im hoping for about 2000 beard grafts - Doganay says this is possible. Link to comment Share on other sites More sharing options...
Senior Member FUE2014 Posted June 28, 2015 Senior Member Share Posted June 28, 2015 Wow, would love to see what your Donor looks like after 13000 grafts ! Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted June 28, 2015 Senior Member Share Posted June 28, 2015 Im 4 months out from my last procedure. So i will take a pic of donor area soon. Link to comment Share on other sites More sharing options...
Senior Member delancey Posted June 28, 2015 Senior Member Share Posted June 28, 2015 Johnboy, What was your donor density like before all the surgeries? I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own. Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted June 28, 2015 Senior Member Share Posted June 28, 2015 Really thick thankfully ! :-) looked ridiculous having so much round the sides and back with nothing going on in the front lol. Link to comment Share on other sites More sharing options...
Senior Member delancey Posted June 28, 2015 Senior Member Share Posted June 28, 2015 Lucky guy. haha I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own. Link to comment Share on other sites More sharing options...
Dr. Alan Feller Posted July 3, 2015 Author Share Posted July 3, 2015 great thread this, Dr Feller, just to go slightly off topic for a moment, do many of your patients report sexual side effects from taking Finasteride? The answer is ABSOLUTELY YES. Many patients who've come for an HT consult have already tried finasteride and reported sexual side effects. Link to comment Share on other sites More sharing options...
Senior Member CaliHairGuy Posted July 3, 2015 Senior Member Share Posted July 3, 2015 The answer is ABSOLUTELY YES. Many patients who've come for an HT consult have already tried finasteride and reported sexual side effects. I can tell you that being on Fin has affected my libido. However, I will take it for a full year (5 months on it so far, 2 months post HT) and see where I am. I do plan on reducing dosage to 2 or 3 times a week and seeing if that helps once I have gone a year on it. At this point, the side affects are more of an annoyance. I'm single right now and I am busy enough with work that it's not really an issue. Link to comment Share on other sites More sharing options...
Senior Member mav23100gunther Posted July 3, 2015 Senior Member Share Posted July 3, 2015 The answer is ABSOLUTELY YES. Many patients who've come for an HT consult have already tried finasteride and reported sexual side effects. Put it this way - us single guys have two options: a) go to a bar with a full head of hair in tack and approach a hot woman and worry about the sexual side effects later OR b) go to a bar with a bald head and try approach that same hot woman. When she rejects you, you can reply to her - but look at least I have an erection I choose option A 1 Link to comment Share on other sites More sharing options...
Senior Member mav23100gunther Posted July 3, 2015 Senior Member Share Posted July 3, 2015 The answer is ABSOLUTELY YES. Many patients who've come for an HT consult have already tried finasteride and reported sexual side effects. Dr Feller - can you take viagra if on Fin? Link to comment Share on other sites More sharing options...
Senior Member Shadow of the EMpire State Posted July 4, 2015 Senior Member Share Posted July 4, 2015 Ah, Feller. Sigh. At least he doesn't think he's the living incarnation of Jesus Christ. Not yet anyway. Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 4, 2015 Senior Member Share Posted July 4, 2015 Mav, No obvious reason why you could not take viagra on fin. However, you would need to see a doctor familiar with your medical history and current health before determining if viagra is appropriate for you in general. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 4, 2015 Senior Member Share Posted July 4, 2015 Yonex, Just to quickly discuss the finasteride issue a bit further: I think the "sexual side effects" tide is changing. Hair loss doctors have prescribed this drug for almost 20 years now, and it seems like the consensus is that the percent experiencing sexual side effects is greater than the initial studies quoted (around 2%) and there is concern for long lasting effects. Endocrinology -- hormone medicine -- is one of my favorite topics -- specifically how it relates to alopecia. Altering hormone levels -- especially androgen hormone levels -- has serious consequences. This has been known generally for years, but it seems like more doctors are specifically looking into how this occurs with finasteride and the consequences it may have -- which is why you now have conditions like "post finasteride syndrome" (PFS). "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Noodles123 Posted July 5, 2015 Senior Member Share Posted July 5, 2015 This comment really caught my attention. So Blake, is it your opinion that finasteride is much riskier than previously thought? Can you outline the "serious consequences" of altering androgen levels for us non-science folks? Yonex, Just to quickly discuss the finasteride issue a bit further: I think the "sexual side effects" tide is changing. Hair loss doctors have prescribed this drug for almost 20 years now, and it seems like the consensus is that the percent experiencing sexual side effects is greater than the initial studies quoted (around 2%) and there is concern for long lasting effects. Endocrinology -- hormone medicine -- is one of my favorite topics -- specifically how it relates to alopecia. Altering hormone levels -- especially androgen hormone levels -- has serious consequences. This has been known generally for years, but it seems like more doctors are specifically looking into how this occurs with finasteride and the consequences it may have -- which is why you now have conditions like "post finasteride syndrome" (PFS). Link to comment Share on other sites More sharing options...
Senior Member Yonex Posted July 5, 2015 Senior Member Share Posted July 5, 2015 very worrying but im not surprised given my own experience with this drug, it's good to here what actually happens on the ground rather than rely on the manufacturers study Link to comment Share on other sites More sharing options...
Senior Member KO Posted July 5, 2015 Senior Member Share Posted July 5, 2015 Uhmm...that said, it is not uncommon to hear doctors having a very different opinion on the prevalence of side effects for a drug, compared to what studies say, it is not limited to fin. I personally feel the debate is moot, fin may have side effects, but it is really the only thing we have that works against hair loss. 3382 FUE Lupanzula http://www.hairrestorationnetwork.com/eve/185463-3382-grafts-lupanzula.html Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 5, 2015 Senior Member Share Posted July 5, 2015 KO, Unfortunately, you're right. Blocking the DHT from ever binding to androgen receptors in the follicle is the only way to truly avoid the AGA process. Like I said above, however, I think the newest consensus is that this may have more side effects than initially suspected. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted July 6, 2015 Senior Member Share Posted July 6, 2015 Yonex, Just to quickly discuss the finasteride issue a bit further: I think the "sexual side effects" tide is changing. Hair loss doctors have prescribed this drug for almost 20 years now, and it seems like the consensus is that the percent experiencing sexual side effects is greater than the initial studies quoted (around 2%) and there is concern for long lasting effects. Endocrinology -- hormone medicine -- is one of my favorite topics -- specifically how it relates to alopecia. Altering hormone levels -- especially androgen hormone levels -- has serious consequences. This has been known generally for years, but it seems like more doctors are specifically looking into how this occurs with finasteride and the consequences it may have -- which is why you now have conditions like "post finasteride syndrome" (PFS). I think it would be a really bad think for the ht community it propecia goes by the way side or doctors were to stop off label perception of finasteride. Hopefully, something better comes along, but I believe if they came up with a sugar pill that cured baldness for 90 percent of men, there would be a good chunk of people claimed ed, fatness, and brain fog because aging. I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 6, 2015 Senior Member Share Posted July 6, 2015 Spanker, You're right about "herd" symptoms and placebo side effects. However, there is no doubt that altering hormone profiles is serious business. I think many doctors are starting to feel less comfortable prescribing medications that do this in general. It's the same reason why a lot of primary care providers send patients to OB/GYNs, endocrinologists, et cetera, for things like estrogen therapy, testosterone injections, hormone pellets, et cetera. There are a few new drugs in the pipeline. The two with the best chance of making it to market are bimatoprost and setipriprant (may have spelled that one wrong) both now owned by Allergan. They are also both based of the prostaglandin theory of androgenic alopecia. One blocks an enzyme that makes a "bad" prostaglandin, and the other is a "good" prostaglandin. However, they are both in phase II (ish) testing and definitely act on a more "down stream" aspect of the AGA process. Who knows though! We will see. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member mav23100gunther Posted July 6, 2015 Senior Member Share Posted July 6, 2015 Blake, what are your thoughts on the topical form of Fin being prescribed by the good doctors of Hasson & Wong? If oral Fin turns out to be more severe than anticipated, would that be a viable alternative? Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 6, 2015 Senior Member Share Posted July 6, 2015 Mav, It all depends on how systemic it goes. If topical fin stays in the scalp, you shouldn't -- theoretically -- experience any of the systemic side effects of the hormone level changes. If it goes into the blood stream from the scalp, it will likely be about the same. It stands to reason that a topical solution applied directly to the scalp would have less distribution throughout the body than the same medication taken orally. I really believe that the only way to halt or prevent the androgenic alopecia process is to stop DHT from binding to the androgen receptors. This is what kicks off the entire process and causes a very complicated chain reaction that is EXTREMELY difficult to reverse. There are a few other topical anti-androgens people have tried. RU58841 and CB-03-01 are the two most popular. Experiment-ees reported side effects with the RU58841 and insufficient results with CB-03-01 -- though some think the vehicle (the formula of chemicals used to allow the medication to penetrate the scalp) is the issue. Other medications being tested are a BNP/Wnt pathway agonist -- a drug that promotes a very important pathway in the cycling of healthy follicles -- and the two prostaglandin drugs I mentioned earlier. This doesn't account for the other "future treatments" being investigated -- injectable growth agents, hair multiplication, and my personal area of interest, donor doubling. In an ideal world, the best "hair loss drug" would either be something that would completely eliminate DHT from getting into the scalp or a medication that could bind to the androgen receptors in the dermal papilla cells to prevent the DHT from binding. However, the first theoretical drug would wreak havoc on your hormone profile and the second would block all the androgen receptors in your body -- as the androgen receptors in the follicles are the same as the ones all over the rest of your body -- and be the theoretical equivalent of stripping the body of all androgen hormone! AGA is actually a super complex ailment and we still have many things to figure out! Frankly, I think finasteride and minoxidil will remain the predominant agents for quite some time. I also don't want to completely disparage finasteride or make it seem like I'm refuting scientific evidence. If someone is on finasteride and doing well on it without side effects, more power to them! However, I do urge those experiencing side effects to speak with the doctor who prescribed the medication. I also recommend any patient considering the medication to see a doctor EXPERIENCED with the drug to go over the pros, cons, and whether or not they think it would be a good med for you. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member lileli Posted July 6, 2015 Senior Member Share Posted July 6, 2015 I will add in my thoughts. I am a 26 year old male who is of hispanic ethnicity with medium curly hair. I have been losing my hair since the age of 16 and had a norwood 2 to 3. My hairless has been stable for a couple of years and I am now committed to being on propecia and biotin. In researching hair transplant surgeries I did consider getting a FUT in order to maximize my donor area grafts. However, being someone who likes to wear my hair short plus wanting the option of one day buzzing it, the linear scar was just unacceptable. I had seen that many doctors claim to now get the linear scar virtually undetectable but it did seem to depend on the person and vary a lot. In the end, I went for a FUE procedure to fill in the frontal portion of my head and I am dedicated to maintaining the rest of the hair I have. I understand I am somewhat limited in future procedures but I still have plenty of donor hair to spare. FUT has its place but it highly depends on the person and what they are willing to accept. Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted July 7, 2015 Senior Member Share Posted July 7, 2015 Lieli, Makes sense! Like you said, both have their place and one procedure was better suited for your needs. Best of luck and thanks for sharing! "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted August 1, 2015 Administrators Share Posted August 1, 2015 FUT is more popular than FUE for two reasons, price and amount of grafts you can safely harvest at once, however in my opinion FUE is the preferred surgery for young men for the simple fact that in the event the transplant fails you can still shave your head. FUT in the years to come will start to phase out, once FUE techniques improve, once more and more physicians learn FUE and perfect the technique there will be more competition, which will drive the prices down, simple supply and demand. I do believe that in about 20 years you will hardly see FUT being done, I do believe that transection will be on par with FUT in the future as instrumentation improves. I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
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