On FIN for almost a year/ Need to decide on HT date/Regime (PICS attached)

[Panamera13 12]

Hi All,

I started FIN in Feb 2018 last year, no Rogaine Foam. I was taking in daily till october 2018 but because of the libido side effects, made it 4 times a week after october. I also use the laser cap every other day. I still see some miniature hair fall.

Most imp thing - I guess the hair as it as has held up, but no extra growth that I was going for. See pics - One from May 2018 when my hair was short and One from last week Jan 2019. Please comment.

1.) My HT goal is not to be young again, I'm almost 40. I just want a decent "hairline + frontal third" and in the crown I could use toppik etc. (Rahal/H&W/Scott Alexander/Koinor)

2.) Will an HT be successful even if you don't use FIN afterwards? 

3.) Should I start rogaine again. Last time when I stopped, I had crazy shedding. It made hair sticky. I got the foam version.

4.) Which is the best doc for diffused thinning which I have. Will take more skill to implant b/w existing hair.

I really want to get off of FIN and still have decent results via HT - Is it even possible.

Top Pic = May 2018; Bottom Pics = Jan 2019

Edited January 22 by Panamera13
Edit

[Panamera13 12]

All - Please share your thoughts on good surgeon for diffused thinning.

[1978matt 33]

Much of the hair that is left is of low quality so I'd forget about trying to cling on to it.  It provides no cosmetic effect and is of very low density.

All those doctors mentioned are good although some I would only recommend for FUT, which is probably what you need anyway.

 

[Panamera13 12]

Thx for the reply Matt. I keep my hair short so FUT is ruled out. I hate that scar on the back.

Any chances of decent looking hairline with FUE? Are you saying it's better to stop FIN since the hair that is left is not getting any benefit anyway?

[Kiwi Guy 28]

Matt is right in regards to a lot of the hair looking weak but have you looked into something like PRP to try to strengthen the existing hair you have left? There seems to be no definitive studies on it but you do see good results from it on some of these sites as well. You may need to seriously consider not ruling out FUT due to your level of loss. For extensive loss such as your own people usually advocate for FUT because you get the most hairs out of it during mega sessions and the graft rate sounds slightly better than FUE. I also hate the idea of a scar but would you rather have to grow your hair a little longer but have the most hair on your head as possible or have tiny scars and a little less coverage on top? All things to weigh up.

[Legend007 121]

U barely have anymore hair left ..finasteride  will not help u much .. if taking fin is not tolerable to u .. u should get off it .. u got on it way too late for it to useful .. if u were a norwood 4 around then this decision would be a lot more difficult .. but u r pass that stage .. 

[Melvin-Moderator 332]

I agree with what you’ve been told, it’s a good idea to get on Lipogaine and azelaic acid just to make sure the sides don’t drop, but once you’re at this point it’s pretty much surgery or nothing. H&W, Konoir, Gabel, Diep, Cooley, Rahal just to name a few. The finasteride IMO hasn’t done much for you unfortunately. At this point it’s just about making sure the sidesdont drop or containing the crown.

[Panamera13 12]

Thx for the reply guys. Appreciate it.

Lipogaine (after I know which one works) will on Amazon (I use T-Sal Neutrogena now). Haven't heard about Azelaic Acid, google search says it's for skin.

I'm bent on having FUE since I keep my hair short and hate that scar no matter how thin it is.

Is it worth to start Rogaine again and move off from FIN gradually or should I stop immediately.

So, basically - Rogaine + Lipogaine + Laser cap....let's say for 6-7 months and then around Aug/Sep, go for FUE. Again, goal is decent hairline for pics etc and in crown I could use toppik etc. I could do PRP but again, I don't see anyone on this forum telling it works.

Will 2500 FUE do a decent job?

Edited January 23 by Panamera13

[Panamera13 12]

Melvin - Another Question, I see there's lipogaine 3, 5, sensitive ....which one for hair loss severe as mine?

[Melvin-Moderator 332]

4 hours ago, Panamera13 said:

Melvin - Another Question, I see there's lipogaine 3, 5, sensitive ....which one for hair loss severe as mine?

Buy the Lipogaine big 3 shampoo and the Lipogaine minoxidil, i get it off their actual website not Amazon.  I buy the azelaic acid on amazon, search azelaic acid without minoxidil.

[Panamera13 12]

Thx Melvin. Ordered the Big 3 shampoo and the Blue Lipogaine minoxidil (sensitive version of the red one).

Can you also give the link to azelaic acid..too many to chose from on amazon.

The plan would be use it for the next 5-7 months but again, will an HT be successful in my case with extensive hair loss and that too with FUE. Will 2500 FUE grafts give decent hairline and frontal third coverage. (assuming we leave the crown alone)

What worries me about HT even is that even with H&W, there are only 2 patient examples with high norwood on their site. Is the success rate for high norwoods pretty bad? Also, I have a lot gray hair.

Edited January 23 by Panamera13

[Panamera13 12]

All - Who are the top docs for higher norwoods with FUE?

[hairlossPA 36]

you seem like a classic Erdogan FUE case. he can easily put 3000-5000 grafts up top for you and you’d get nice coverage. good value too

[Melvin-Moderator 332]

40 minutes ago, Panamera13 said:

All - Who are the top docs for higher norwoods with FUE?

What are your goals? I think strip first would benefit you the most, especially if you want more coverage. While there are some surgeons performing mega-session FUE. I think strip mega-sessions are still the gold standard in terms of coverage value. I H&W are the pioneers in many ways of mega-session surgeries period.

[Panamera13 12]

Thanks hairlossPA and Melvin.

@hairlossPA - Regarding Erdogan, I'm a little wary since he does many ops in a day and tech do a lot of work.

@Melvin - I'm very realistic, I know my hair loss is extensive and I can't get back the good old days. My goal is to have a non-aggressive hairline and decent frontal third coverage. I would leave the crown...and use toppik/caboki etc. I'm 40 so that should give me enough to work with. I'm in Houston but open to travel. So, who would be a good doc for my case (higher norwood) + FUE?

I'm extremely scared of the scar so really want to go for FUE and I like to keep my hair short on the sides.

My dream would be to get closer to the 4th pic (hairline + frontal third, ignore the crown). Basically short on sides, decent hairline and some coverage on top.

[purple18 3]

There's a big difference between what your sides appear to be kept at in your actual photos and the couple "dream shots" at the end.  The end shots show what looks like a 0 guard.  That might even show with FUE.  The HT example looks like about a 4 guard, as do your photos above.  Those would accommodate a FUT scar.

I was able to have my FUT scar not show at 12 days p/o with the staples freshly out at a 4 guard.  

I once was afraid of FUT because I thought I wore my sides and back shorter than I really did.  3-4 guard is pretty short, and that's with a fresh haircut.

[Lyubo93 13]

I don't want to give you empty hopes, but this guy went from this: 

To this:

So everything is possible. Go and try.

[Melvin-Moderator 332]

1 hour ago, Panamera13 said:

Thanks hairlossPA and Melvin.

@hairlossPA - Regarding Erdogan, I'm a little wary since he does many ops in a day and tech do a lot of work.

@Melvin - I'm very realistic, I know my hair loss is extensive and I can't get back the good old days. My goal is to have a non-aggressive hairline and decent frontal third coverage. I would leave the crown...and use toppik/caboki etc. I'm 40 so that should give me enough to work with. I'm in Houston but open to travel. So, who would be a good doc for my case (higher norwood) + FUE?

I'm extremely scared of the scar so really want to go for FUE and I like to keep my hair short on the sides.

My dream would be to get closer to the 4th pic (hairline + frontal third, ignore the crown). Basically short on sides, decent hairline and some coverage on top.

It’s great you have aggressive goals, but I think you may need to scale back your expectations a bit. In terms of length, I cut my hair at a #1 on the sides and it looks good. Someone who’s had a hair transplant or is educated would spot the scars, but I don’t really care.

That said, I don’t think you can cut your hair to a #0. That’s the point where the genral public would notice. If you really want FUE, plan on at least three surgeries. If you have the time and money go for it. I just want to make sure you’re fully informed. Some guys aren’t and regret not having gone strip first. I don’t regret it, because like you I’ve always worn my hair short. But theres no doubt I spent more money and time going only FUE.

[Baldrick101 16]

You are an advanced Norwood 6 or 7. I would estimate 5000-6000 grafts. 2500 will not do much at all. 

Do not worry about Erdogan's techs doing most of the work. It is better that way. They do it day in, day out non stop. And if it were me, I would rather they did the extractions and implanting. As long as he does the incisions and overall hairline design. In the end there is only one thing that actually matters - the results. Try not to get bogged down in too much of the little details. See which clinic cranks out the most consistent patient posted results and go with that. 

As for lotions and potions, each to their own, but frankly IMO the shampoos and minoxidil are a waste of time and money. They will do very little in your case as you have lost so much. Finasteride is still singularly the most important, effective, and cost effective thing to take. But considering your case, 5000 - 6000 will cover your whole area and you wouldn't need to take any of it. Just my opinion and good luck!

[Panamera13 12]

25 minutes ago, Melvin-Moderator said:

It’s great you have aggressive goals, but I think you may need to scale back your expectations a bit. In terms of length, I cut my hair at a #1 on the sides and it looks good. Someone who’s had a hair transplant or is educated would spot the scars, but I don’t really care.

That said, I don’t think you can cut your hair to a #0. That’s the point where the genral public would notice. If you really want FUE, plan on at least three surgeries. If you have the time and money go for it. I just want to make sure you’re fully informed. Some guys aren’t and regret not having gone strip first. I don’t regret it, because like you I’ve always worn my hair short. But theres no doubt I spent more money and time going only FUE.

Melvin - I'm ok with three surgeries. so, What should be the plan - do the hairline and frontal third with 2000 FUE in phase 1 and leave other areas to phase 2/3.

Now the imp question - which surgeon works for my case - Rahal/H&W/Erdogan or someone else? I just submitted online consultations with Rahal and H&W so let's see. Should I look at Koinor also? Since I have diffused thinning, which doc has more skill to put hair in existing areas.

[Panamera13 12]

2 hours ago, Lyubo93 said:

I don't want to give you empty hopes, but this guy went from this: 

To this:

So everything is possible. Go and try.

who was this guys surgeon

[purple18 3]

1 hour ago, Baldrick101 said:

Do not worry about Erdogan's techs doing most of the work. It is better that way. They do it day in, day out non stop. And if it were me, I would rather they did the extractions and implanting. As long as he does the incisions and overall hairline design. In the end there is only one thing that actually matters - the results. Try not to get bogged down in too much of the little details. See which clinic cranks out the most consistent patient posted results and go with that. 

Isn't this the case at most clinics/docs?  And as you said, don't you want it this way?  The shorter the time the grafts are out of the body, the better.  More hands, as long as they are skilled, is a good thing. 

I went to a very well known clinic but not a super well known doc knowing that a lot of the work was going to be done by a team of techs no matter where I went.  It was more about the whole clinic and their experience for me.  I wanted a team pulling for me on surgery day, not a single surgeon trying to be a hero.  Sure enough, I think there were like a dozen people working on my grafts (FUT) on my surgery day.  There was very little wasted time because of it.

The surgeon is the head coach, but there's a big team helping at the best clinics.

Edited January 25 by purple18

[Melvin-Moderator 332]

2 hours ago, Panamera13 said:

Melvin - I'm ok with three surgeries. so, What should be the plan - do the hairline and frontal third with 2000 FUE in phase 1 and leave other areas to phase 2/3.

Now the imp question - which surgeon works for my case - Rahal/H&W/Erdogan or someone else? I just submitted online consultations with Rahal and H&W so let's see. Should I look at Koinor also? Since I have diffused thinning, which doc has more skill to put hair in existing areas.

Either of those surgeons would work, Dr. Konoir charges $10 a graft for FUE so you’re looking at 50k in total cost. That’s a steep price for most, but worth it if you can afford it.

I would consult with as many doctors as possible, don’t be afraid to venture outside of the states. Dr. Bisanga, Lupunzula, Feriduni, Reddy are some impressive FUE surgeons as well in Europe.

[mrmane85 4]

Melvin what are your thoughts on Hattingen?

When dealing with a NW5+, there seems to be 2 strategies that people opt for, either a large 4000+ procedure in one go or 2 smaller procedures of 2000-2500, the first being the frontal third then the 2nd being the rest. 

In your opinions, what would be the best strategy and why?