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Hi all,

 

Would you kindly share how was your HT result without taking any finasteride? Was it good enough or sub optimal? Did it result in huge shock loss or no? And did it recover in time? Any additional thoughts are much appreciated.

 

I have read enough threads on the debate of why and why not take finastride, completely understand the long term stabilizer arguement etc however here I just want to hear from people who got HT done (or know someone who did) without taking any finasteride and how would they rate their result. TIA!

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I've seen a few results on here without medication that have looked good. Just search through the results posted by clinics forum and you'll usually be able to see if the patient is on finasteride or not.

 

The problem is, most people and clinics will probably post up their 12 months results and that will be the last you see of that case. The real issue with not using finasteride is not necessarily the 12 month result (although shock loss and weakened hair loss could be an issue) - it's where you might be in 2 or 3 or 10 year's time. The biggest problems are continued erosion of the crown and the sides continuing to lower.

 

I'm also reticent about using finasteride long-term and I've seen good results in patients that haven't used the drug. With long-term planning and realistic goals I think a HT without finasteride can be successful but you'll need to plan conservatively and make a serious commitment to continued procedures if it does come to that.

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If you haven't already, search HTsoon and check out his results. He's the first one I think of when it comes to success without -or discontinued use of- finasteride. Perhaps not a long-term example though?

 

He seems a helpful guy, would likely weigh in here if he sees your thread.

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The claim that taking low dose finasteride will reduce shock loss is more a myth than anything else IMHO. The reason I state this is because shock loss is a result of how an individual responds to the level of trauma induced by the numerous number of incisions made during the procedure.

 

And this is also why many docs will take a more conservative approach with those individuals who have a diffused thinning pattern because they are ultimately more susceptible to shock caused by the trauma.

 

Lastly, and speaking for my own results, I do not feel that being on finasteride had any real impact on the final cosmetic result of my procedures. It's more an issue of stabilizing the progressive pattern of MPB so that I hold onto more of my native hair and need less surgery over my lifetime.

 

So the primary purpose of taking low dose finasteride is not to enhance the cosmetic result but rather to prevent future loss...:cool:


Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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And this is also why many docs will take a more conservative approach with those individuals who have a diffused thinning pattern because they are ultimately more susceptible to shock caused by the trauma.

 

Well Dr. Bernstein has stated in writing on his website that when transplanting into diffuse thinning areas one should transplant as many grafts into that area as one would if that area was completely bald in order to offset the potential hairs lost after shock loss trauma and give the surgical outcome that best chance at improvement. This makes sense, and I would imagine other surgeons felt the same way. But I've seen NW 6 diffusers get 2000 - 3000 grafts into diffuse areas and get great results but I've also seen NW 5 diffusers get 4000 - 5000 with great results. Maybe the degree of miniaturization of hairs in the diffuse area is a factor, how thick and long they're currently growing could indicate whether another growth cycle could occur after shock less induced telogen effluvium.

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I think Gillenator makes a great point and one I haven't seen discussed that much either.

 

Although finasteride can and sometimes does stabilise miniaturising hair follicles on the top of the head, and can even help them to regrow stronger and thicker, there's still a fair chance that surgery to those areas will induce shock loss or at least that these follicles will likely be the first to "weaken" against finasteride and continue to miniaturise in a matter of months or years - not only are they compromised already but they're also clearly the areas of the head most susceptible to the effects of MPB.

 

In my opinion the major benefit of finasteride, when it comes to its role in HT planning and management, is not so much keeping what you have in the heavily miniaturised areas (though it's great if you do), it's much more about slowing down the loss in the crown area and preventing the sides from dropping further.

 

I don't know how true it is, but I've always thought it the case that each follicle has a certain amount of "resistance" to the effects of DHT. The follicles in the donor zone are the most resistant, and rarely succumb to the effects of DHT (they may over time miniaturise very slightly but remain largely healthy and functioning). The hair on the top of the head is usually the most susceptible to the effects of DHT in men, which is why of course most MPB sufferers lose their hairline, temples, crown and mid-scalp (in various different orders and patterns).

 

The border between the susceptible and non-susceptible DHT areas are fairly murky and ambiguous. This is where finasteride is most useful - those areas that have a mild or moderate susceptibility to DHT are going to benefit the most from finasteride, in the sense that they're going to see the most cosmetic impact from the drug over the longest time. This is really where finasteride does its job - if you can massively slow down or even stop the effects of DHT in these moderately susceptible areas, you may be able to keep the fringes of miniaturisation fairly high and this, combined with a good HT or two, can create really cosmetically acceptable results.

 

I've always presumed that, ultimately, the hair in the areas you're clearly balding is one day not going to be there. Finasteride may be able to save some of it for a time, perhaps even a decade or more, but I think already weakened follicles that are highly susceptible to DHT are always going to be the first go in the fullness of time. If you're 33 and diffuse thinning in say a NW5 pattern, and you get a HT around the miniaturised follicles, I can't imagine that in say 15 years time at least some of those follicles wouldn't have weakened further or died off even on finasteride, meaning less density and/or the need for another HT to compensate. But the only moderately susceptible areas may last for decades or more, perhaps even indefinitely, if DHT can be consistently lowered. That's going to enable you to make the most of your donor and maximise the chance of having a cosmetically beneficial HT plan.

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This is a tough question. Any topic involving finasteride is bound to arouse strong feelings. IMHO, if you can take fin you should after HT, but the reality is that many people simply don't and do fine. If you have sides or just do not want to, that is OK as well. Fin may help pts earlier in their hair loss more but if you are a high NW to start off with you are likely to derive less benefit from it.

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Thanks guys, very helpful. think I'll go for HT without finasteride and will post here how it goes. Cheers

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Thanks guys, very helpful. think I'll go for HT without finasteride and will post here how it goes. Cheers

 

Best of luck hkuser, we'll all be interested to see how your journey goes and wish you the best achieving your goals!

 

A good HT result without finasteride is possible, I just think it takes a somewhat more conservative approach and a commitment to dealing with future loss and planning long-term. That's true of any HT anyway though.

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Purely speaking from my own experience, but at the time of my surgery I had already taken finasteride for about 5 years. It did nothing to stop shock loss. In fact, my shock loss was pronounced and excessive. Everything seemed to regrow, but don't count on it making a difference in regards to shock loss. I think like the posters above said, it's really more a function of how traumatic the surgery was and your body's ability to handle that stress.

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My first HT was with finasteride and the results were great- no shock loss.

 

I tested HT #2 by NOT TAKING finasteride and just 1 month in I am experiencing major shock loss. I plan to get back on Finasteride ASAP.

 

However, the HT surgeon said that with my hair thickness and waviness, I may not need to take Finasteride for the rest of my life. I have ample donor hairs.

 

Anyway, I do want you to see the attached photos of me in order to make you aware of what can possibly happen just months after surgery if you do not take Finasteride... you are at highest risk for shock loss after surgery, and it is theorized that Finasteride will help to curb it.

 

 

I am now in the ugly duckling stage :rolleyes:

5b32edd90c788_200myPre-op1daypost-op1monthlater(Shockloss).thumb.jpg.ac9de82abe627d923620743921283edb.jpg


Paulygon is a former patient of Dr. Parsa Mohebi

 

My regimen includes:

HT #1 2710 grafts at Parsa Mohebi Hair Restoration in Los Angeles in 2012

Rogaine foam 2x daily, since 2012 (stopped ~10/2015)

Finasteride 1.25mg daily, since 2012 (stopped ~12/2015)

 

HT #2 3238 grafts at Parsa Mohebi Hair Restoration in Los Angeles in Jun. 2016

Started Rogaine and Propecia in July. 2016 after being off of them for about a year.

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@Paulygon,

 

it is interesting that your doctor says that you might not need fin due to your hair characteristics. Do you happen to know how thick your hairs are?

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I've been told if i have a hair transplant and don't take fin then the hair i have will be lost and the transplanted hair will remain and it will look like i have hair in patches.

Hair maybe lost even if on fin but it is unlikely.

 

Some doctors say this while others leave it to your own choice if you want to take the risk while others say don't have a ht if you don't take fin.

 

Recently i've been told to take fin for atleast a year as it improves hair all over including donor hair.

 

I'm giving it a try to see how it goes but i cannot get my head around taking it long term like 15 years!

Edited by Rashid35
info adding

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That's true about taking fin for your native hair. If you take fin and have a good response and keep a lot of your native hair, or it grows back, you need to keep taking the drug to keep hold of that hair. Even if you didn't experience shock loss, that hair is still dependent on finasteride to halt or slow down the miniaturisation process.

 

It's one of the unfortunate facts about fin - if it works for you and you regrow hair, you need to keep taking it. If you don't, you're going to lose what you've regrown.

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