1845 FUE, Dr. Bisanga in Athens

[bald-and-bearded]

Hi @Dumbo,

I think it has thinned out because there was still some native hair where you had the transplant which have now miniaturised.

I agree with your retrospection that someone who doesn't take Finasteride should (especially) not get a frontal hairline hair transplant done.

I really doubt Minoxidi will do anything for you except for maybe buy some more time.

A bunch of people on Reddit have posted good results with topical Finasteride. Now the research on this is really questionable, but it might be worth a shot. At least I mentally feel like if the side effects are nocebo, I would get them lesser if on a topical product rather than a pill. YMMV. So far I've found that it's made by one place in Europe and two places in India. The Indian one is more popular and called morr-f and you can search on reddit for posts about it.

Good luck

[Melvin- Admin]

I would definitely get on meds, it does look like it may have been some native hair that thinned.

[Maa]

2 hours ago, bald-and-bearded said:

Hi @Dumbo,

I think it has thinned out because there was still some native hair where you had the transplant which have now miniaturised.

I agree with your retrospection that someone who doesn't take Finasteride should (especially) not get a frontal hairline hair transplant done.

I really doubt Minoxidi will do anything for you except for maybe buy some more time.

A bunch of people on Reddit have posted good results with topical Finasteride. Now the research on this is really questionable, but it might be worth a shot. At least I mentally feel like if the side effects are nocebo, I would get them lesser if on a topical product rather than a pill. YMMV. So far I've found that it's made by one place in Europe and two places in India. The Indian one is more popular and called morr-f and you can search on reddit for posts about it.

Good luck

Why should you not have the front done if you are not on meth.?

 

[bald-and-bearded]

34 minutes ago, Maa said:

Why should you not have the front done if you are not on meth.?

 

Because it's the worst thing to have hair on the front and to eventually lose hair behind. The hair transplant catch up game is bound to be stressful and possibly one you would eventually lose if you have NW6+ genes.

[Maa]

3 minutes ago, bald-and-bearded said:

Because it's the worst thing to have hair on the front and to eventually lose hair behind. The hair transplant catch up game is bound to be stressful and possibly one you would eventually lose if you have NW6+ genes.

Okay but if you have enough donor to have the front and middel done, you just have to tell youself that if you dont use meth you might need to have 1 or 2 transplant done in the future to keep the result good.

And Then if you are unlucky to have a higher norwood Then a good doctor Will also have this in mind when here makes the front

[Curious25]

1 minute ago, Maa said:

Okay but if you have enough donor to have the front and middel done, you just have to tell youself that if you dont use meth you might need to have 1 or 2 transplant done in the future to keep the result good

Hopefully having a good donor isn’t the only reason you don’t wish to use meth ! 

Edited April 15, 2021 by Curious25

[Britanium]

2 minutes ago, Curious25 said:

Hopefully having a good donor isn’t the only reason you don’t wish to use meth ! 

😂 kids don’t do meth mmmkay 🙏

[Britanium]

@Maaim thinking you do mean “meds” and not “meth” 👌

[Maa]

43 minutes ago, JohnAC71 said:

@Maaim thinking you do mean “meds” and not “meth” 👌

Hahaha yes😂

[Maa]

49 minutes ago, Curious25 said:

Hopefully having a good donor isn’t the only reason you don’t wish to use meth ! 

No not at all!

But the reason why I have decided to start the hairtransplant journey despite I do not use Meds😀 - is beacause my donor should be able to cover the balding for worst case scenario, and my genes for the family is not high norwood.

And thats why I do Think it is good enough to make the front without meds as long as the doctor agree with it.

[Dumbo]

15 hours ago, bald-and-bearded said:

Hi @Dumbo,

I think it has thinned out because there was still some native hair where you had the transplant which have now miniaturised.

I agree with your retrospection that someone who doesn't take Finasteride should (especially) not get a frontal hairline hair transplant done.

I really doubt Minoxidi will do anything for you except for maybe buy some more time.

A bunch of people on Reddit have posted good results with topical Finasteride. Now the research on this is really questionable, but it might be worth a shot. At least I mentally feel like if the side effects are nocebo, I would get them lesser if on a topical product rather than a pill. YMMV. So far I've found that it's made by one place in Europe and two places in India. The Indian one is more popular and called morr-f and you can search on reddit for posts about it.

Good luck

Thanks!

I actually just rather go bald than taking finasteride (oral or topical) and if I'd known I'll have to take it eventually to keep the transplanted hair, I wouldn't have gone through the procedure. 

The area that is thinning now didn't have much native hair from the start, so it's mostly transplanted hair that is thinning now. I guess I should have done my homework beforehand. Oh well, at least it's just hair

[Dumbo]

12 hours ago, Melvin-Moderator said:

I would definitely get on meds, it does look like it may have been some native hair that thinned.

Hey Melvin!

When you say meds, which do you mean? I've seen your video where you said you don't take Finasteride anymore, and I remember it actually inspired me back then. Your hairline looks amazing. Do you use minoxidil? Do you have a video explaining your hair regimen and treatment now after your hair transplants?

[Maa]

23 minutes ago, Dumbo said:

Thanks!

I actually just rather go bald than taking finasteride (oral or topical) and if I'd known I'll have to take it eventually to keep the transplanted hair, I wouldn't have gone through the procedure. 

The area that is thinning now didn't have much native hair from the start, so it's mostly transplanted hair that is thinning now. I guess I should have done my homework beforehand. Oh well, at least it's just hair

I have the same opinion as you.👍🏻

But do anyone knows if you need to take meds to keep the transplanted hair? 
I did not know that - I though that most of the hair would be there for life

[Curious25]

11 hours ago, Maa said:

No not at all!

But the reason why I have decided to start the hairtransplant journey despite I do not use Meds😀 - is beacause my donor should be able to cover the balding for worst case scenario, and my genes for the family is not high norwood.

And thats why I do Think it is good enough to make the front without meds as long as the doctor agree with it.

I agree with you - I was joking because you had said Meth instead of meds. 

[Raphael84]

8 hours ago, Maa said:

But do anyone knows if you need to take meds to keep the transplanted hair? 

The "lifespan" of the follicle from the donor area would be expected to be the same regardless of it remaining in the donor area or being placed within the recipient area. This is to say that if a particular individual were to have advanced miniaturisation/thinning/loss within their donor at some point in time, any follicles extracted from their donor and placed within their recipient area would also follow this genetic predisposition, which would reflect in their result at the time of decline.

Some patients may show zero signs of miniaturisation in their donor at the time of surgery, whilst other patients may present higher levels of miniaturisation. As Dr. Bisanga explains in the following video, any patient who may be showing more than 20% of miniaturisation within their donor area would not be viable candidates for surgery due to the fact that their unstable donor area may have an effect on possible yield, and/or longevity of their procedure. 
 

Depending on all patient characteristics including age and extent of loss, patients presenting less than 20% miniaturisation, 15% for example, would be acceptable candidates for surgery. However Dr. Bisanga would at this stage explain the importance of beginning a regimen of hair loss preventative medication due to the risk of progressive loss and decline of hair quality. As with any loss, there are certain factors that help "predict" how loss may evolve, but there is no definitive accurate timeline on how quickly this may accelerate, and environmental and lifestyle factors can also have an influence and so medication would be highly recommended.

The choice to take medication or not is a personal decision. I completely respect those individuals who choose not to, or are not able to commit to a medical regimen. It is fair to say that due to the mechanisms of hair loss preventative medication, ie. finasteride and minoxidil, most individuals will benefit from using such medication in terms of their hair. However, some patients and cases require medication much more than others due to such factors as age, extent of loss, progressive pattern, family history, and any higher levels of miniaturisation in their donor area.

Here is a recent thread with video from Dr. Bisanga answering the question - "Will my hair transplant last", and the ensuing discussion.

Specific to Dumbo´s case, until the last few days we had not been in contact and as I was not his advisor, I personally had no knowledge of his case or its specifics other than reading this thread. 
In Dumbo´s case, miniaturisation in the donor area fell within the acceptable range, although it was higher than average and therefore as Dumbo has said, medication was recommended.

As the onset of thinning appears to have occurred reasonably quickly based on what Dumbo has said, and based on the photos provided, it would appear as though there is decline in both native and transplanted hair and therefore the concern may not be due to miniaturisation in the donor, as it is not only transplanted hair that has thinned.
Seasonal shedding could be responsible and by diligently applying minoxidil and increasing vascularity, this may achieve improvement/return of these follicles. 
As we know, due to the increase in vascularity that minoxidil presents, individuals may experience initial hair shedding. While this might sound like cause for alarm, it's actually a normal process as the minoxidil starts to alter the way that the scalp produces hair. As the healthy new hairs grow, the hair follicles can be pushed from the telogen (resting) phase into the anagen (growing) phase, which results in a temporary increase in shedding.

It will be a case of applying and committing to minoxidil and remaining patient to see how you may respond. At the very least, the minoxidil if applied throughout can help with other miniaturised follicles and knowing the elevated levels of miniaturisation in your donor area, can only be a positive step in terms of your hair.

Edited April 16, 2021 by Raphael84

[Britanium]

@Raphael84 Dr Bisanga is spoiling us with all of these excellent videos 👏

[Dumbo]

3 hours ago, Raphael84 said:

Specific to Dumbo´s case, until the last few days we had not been in contact and as I was not his advisor, I personally had no knowledge of his case or its specifics other than reading this thread. 
In Dumbo´s case, miniaturisation in the donor area fell within the acceptable range, although it was higher than average and therefore as Dumbo has said, medication was recommended.

As the onset of thinning appears to have occurred reasonably quickly based on what Dumbo has said, and based on the photos provided, it would appear as though there is decline in both native and transplanted hair and therefore the concern may not be due to miniaturisation in the donor, as it is not only transplanted hair that has thinned.
Seasonal shedding could be responsible and by diligently applying minoxidil and increasing vascularity, this may achieve improvement/return of these follicles. 
As we know, due to the increase in vascularity that minoxidil presents, individuals may experience initial hair shedding. While this might sound like cause for alarm, it's actually a normal process as the minoxidil starts to alter the way that the scalp produces hair. As the healthy new hairs grow, the hair follicles can be pushed from the telogen (resting) phase into the anagen (growing) phase, which results in a temporary increase in shedding.

It will be a case of applying and committing to minoxidil and remaining patient to see how you may respond. At the very least, the minoxidil if applied throughout can help with other miniaturised follicles and knowing the elevated levels of miniaturisation in your donor area, can only be a positive step in terms of your hair.

Thank you! As always, you are well informed and you provide comfort in your knowledge. I will start the regimen today and hope for the best. I will update in due time.

[BaldingBogger]

Wouldn't panic just yet as it could be shedding for the transplant hair anyway. I had a huge shed at 18 months post op in transplanted area which freaked me out but it slowly grew back in.

I've read it can be common for transplants to dip and shed around this time before 'resynchronization occurs and hair grows back at maximum calibre and thickness

Edited April 16, 2021 by BaldingBogger

[Dumbo]

On 4/17/2021 at 1:48 AM, BaldingBogger said:

Wouldn't panic just yet as it could be shedding for the transplant hair anyway. I had a huge shed at 18 months post op in transplanted area which freaked me out but it slowly grew back in.

I've read it can be common for transplants to dip and shed around this time before 'resynchronization occurs and hair grows back at maximum calibre and thickness

Interesting! Never heard that before. I hope it's the same case with me. Thanks for sharing