[Pictures included] Is FUE suitable for me without Finasteride?

[Hex13]

*English Is not my first language*
Hello Guys,

I would like to seek your advice regarding considering FUE.

I have a very dense donor area, as per the picture I had a ponytail a month ago ( which as I read is considered a good thing).

I begin to lose the area in the front when I reached 30 ( I’m now 31) * I don’t know if this important or not but it was one of the toughest year for me ever. Lost my job in the beginning of the pandemic, couldn’t  find another one because of the pandemic as well, having problems with my GF then we broke up, and a lot of other stuff that made me very stressed and depressed* > I mention that because I’ve read that psychological factors are important

I don’t take any medication or never did. 
So my questions:

1-Am I a good candidate for FUE( without taking Finasteride )? just only thinking that I would take Finasteride, makes me can’t get an erection! 
2-Can I compensate NOT using Finasteride after first surgery with another one in the future( if any )? 

So I just need to make the surgery and live my life without thinking about my hair again. Is that doable?

 

 

 

 

Edited December 12, 2021 by Hex13

[FUT4000]

If you fue the front balding area without Finasteride then you will have a patch of hair in front and start to recede behind it. Finasteride is to maintain what you currently have

[Hex13]

30 minutes ago, rambunctious said:

If you fue the front balding area without Finasteride then you will have a patch of hair in front and start to recede behind it. Finasteride is to maintain what you currently have

But I think i have a good donor area that if your scenario happened, I could do another surgery to compensate that. Is this a valid plan?

[MachoVato]

5 minutes ago, Hex13 said:

But I think i have a good donor area that if your scenario happened, I could do another surgery to compensate that. Is this a valid plan?

 

Some doctors require you to be on Finasteride, so some doctors may not operate on you. Without being on finasteride, you will probably lose more hair and will need a second transplant in 5-10 years. If possible, find a top doctor who is willing to implant into your existing hair. 

But yes, a second transplant is a valid plan. 

[Mike10]

While I do think Fin is overrated on this Forum, in terms of what it can do in the long term and the risks it entails, I would probably not recommend surgery without Fin in your particular case. The specifics of your case should be throughly discussed  with your surgeon prior to the suregry. The analysis whether Fin is needed should be done on a case by case basis in my opinion.

[Curious25]

You look to have a dream donor, so assuming there are no NW7's in your family, and NW6 would be the highest level you will reach in later life, with careful and strategic planning, in GOOD doctors hands - I think you'd qualify as one of the luckier hair loss sufferers, who could probably get away with not taking any DHT inhibiting medication. 

That said, you need to have realistic expectations, learn what your limitations will be, and make sure that your future surgeon/s are aware of you not taking preventative medication. 

Whilst not really being too visible from your photos, your beard density looks 'average -> above average', so you should be able to squeeze a further 1500-2000 from there also. 

 

[FUT4000]

1 hour ago, Hex13 said:

But I think i have a good donor area that if your scenario happened, I could do another surgery to compensate that. Is this a valid plan?

You're right but why go through multiple surgeries, there are always more risks associated with surgeries than finasteride

[Curious25]

28 minutes ago, rambunctious said:

You're right but why go through multiple surgeries, there are always more risks associated with surgeries than finasteride

It's subjective to how risk averse you are to the different risks that each pose. 

Personally, I don't think theres any catastrophic risks involved in hair restoration surgery with a renowned clinic or surgeon. However living with PFS would be catastrophic for me. 

I'm not insinuating either way whether this is a possible risk of finasteride or not, it's just my risk profiling of the two scenarios you posed. 

[ciaus]

6 hours ago, Hex13 said:

just only thinking that I would take Finasteride, makes me can’t get an erection! 

Yea this is the thinking that ruins what could otherwise be a valuable tool in managing hair loss long term. 

To your hair, alot of guys think their hair loss started when they first noticed it. That's actually not true. You can lose 30% to 50% of your hair before it starts to become visibly noticeable. So judging by your age and pics, you probably started actually thinning back in your early to mid 20s.

And seeing how obvious the loss looks in these pics now, compared to just a year ago when you first started noticing, it sounds like its accelerating. Your frontal temple point sides are gone, the frontal hairline is hanging on to the last hairs, and from the overhead pic the thinning along the top is starting to become noticeable. 

Your donor does look good at this length, but if you're wanting to gamble on hair transplants without the meds, I'd get it buzzed down and go have a HT doctor do a thorough microscopic check to better outline where your safe and vulnerable hairs are for future planning.

 

 

 

 

 

[Hex13]

3 hours ago, MachoVato said:

 

Some doctors require you to be on Finasteride, so some doctors may not operate on you. Without being on finasteride, you will probably lose more hair and will need a second transplant in 5-10 years. If possible, find a top doctor who is willing to implant into your existing hair. 

But yes, a second transplant is a valid plan. 

Thanks for your answer. Appreciate it

your reply made me very happy that I can have this option. But why when I ask this question, people seem a lil bit skeptical? * Making another surgery after 5-10 years is a fantastic solution for the problem in my opinion* 

[Hex13]

3 hours ago, Mike10 said:

While I do think Fin is overrated on this Forum, in terms of what it can do in the long term and the risks it entails, I would probably not recommend surgery without Fin in your particular case. The specifics of your case should be throughly discussed  with your surgeon prior to the suregry. The analysis whether Fin is needed should be done on a case by case basis in my opinion.

Thanks for your answer. Appreciate it.

the problem: I’ve read horror reviews about this drug and I don’t risk my hormones for my hair. Not good risk reward ratio.

[Hex13]

3 hours ago, Curious25 said:

You look to have a dream donor, so assuming there are no NW7's in your family, and NW6 would be the highest level you will reach in later life, with careful and strategic planning, in GOOD doctors hands - I think you'd qualify as one of the luckier hair loss sufferers, who could probably get away with not taking any DHT inhibiting medication. 

That said, you need to have realistic expectations, learn what your limitations will be, and make sure that your future surgeon/s are aware of you not taking preventative medication. 

Whilst not really being too visible from your photos, your beard density looks 'average -> above average', so you should be able to squeeze a further 1500-2000 from there also. 

 

Appreciate your detailed answer. Thanks a lot.

In my family no one has NW6 or NW7 at all.. Maximum NW3.

I have a realistic expectations, whatever the doctor tells me, I will complied. I just need to know if my donor area could help me in the future or I don’t have a clear view.

[Hex13]

2 hours ago, rambunctious said:

You're right but why go through multiple surgeries, there are always more risks associated with surgeries than finasteride

Based on what I’ve read, HT is not a risky surgery( compared to DHT blocker), I would be inclined to second surgery ( maybe I’m myopic and can’t see the full picture).

[MachoVato]

4 minutes ago, Hex13 said:

Thanks for your answer. Appreciate it

your reply made me very happy that I can have this option. But why when I ask this question, people seem a lil bit skeptical? * Making another surgery after 5-10 years is a fantastic solution for the problem in my opinion* 

People are skeptical because a transplant should be the last thing to do. Most people agree that finasteride and minoxidil should be used for at least 1 year before surgery. 

Your plan is valid. However, it isn't the *best* plan without medicine.

The good news is that your donor is excellent so you might be able to have 3 transplants. My only recommendation is to go to a top doctor that can help you with this plan. 

[Hex13]

32 minutes ago, ciaus said:

Yea this is the thinking that ruins what could otherwise be a valuable tool in managing hair loss long term. 

To your hair, alot of guys think their hair loss started when they first noticed it. That's actually not true. You can lose 30% to 50% of your hair before it starts to become visibly noticeable. So judging by your age and pics, you probably started actually thinning back in your early to mid 20s.

And seeing how obvious the loss looks in these pics now, compared to just a year ago when you first started noticing, it sounds like its accelerating. Your frontal temple point sides are gone, the frontal hairline is hanging on to the last hairs, and from the overhead pic the thinning along the top is starting to become noticeable. 

Your donor does look good at this length, but if you're wanting to gamble on hair transplants without the meds, I'd get it buzzed down and go have a HT doctor do a thorough microscopic check to better outline where your safe and vulnerable hairs are for future planning.

 

 

 

 

 

Appreciate your answer man. Thanks a lot for the detailed answer.

first time to hear about microscopic check! Is this something that the doctor could know my future pattern ?
Regarding age. No I don’t have any problems in my 20s at all. All begins in the lates 29 and the beginning of my 30s.

 

 

[Hex13]

5 minutes ago, MachoVato said:

People are skeptical because a transplant should be the last thing to do. Most people agree that finasteride and minoxidil should be used for at least 1 year before surgery. 

Your plan is valid. However, it isn't the *best* plan without medicine.

The good news is that your donor is excellent so you might be able to have 3 transplants. My only recommendation is to go to a top doctor that can help you with this plan. 

3 transplants! That’s very relieving! I don’t mind that option at all ( If i could do that) as people said either FIN or I’ll lose all my hair in my head ( I can’t imagine * denialism * that this is the only option under the doctors’ belt).

I’m still searching about world class doctors. I hope they could align with my plan.

[FUT4000]

2 hours ago, Curious25 said:

It's subjective to how risk averse you are to the different risks that each pose. 

Personally, I don't think theres any catastrophic risks involved in hair restoration surgery with a renowned clinic or surgeon. However living with PFS would be catastrophic for me. 

I'm not insinuating either way whether this is a possible risk of finasteride or not, it's just my risk profiling of the two scenarios you posed. 

I've been on Fin for 10 years before getting a HT no issues sexually, even had a kid on it. I have friends on it too and its working. Surgery is always last resort, ask any doctor that. 

[HappyMan2021]

@Hex13 It looks like your donor hair is quite curly, is this accurate? Does the native hair in the potential recipient area match this same curly shape and texture?

It might look a bit unnatural having a curly hairline if all of your other hair has a straight and soft texture. If you don't mind using product everyday to tame your hair, this isn't an issue. 

[Berba11]

1 hour ago, Hex13 said:

Thanks for your answer. Appreciate it.

the problem: I’ve read horror reviews about this drug and I don’t risk my hormones for my hair. Not good risk reward ratio.

Why don't you try it and see for yourself? If it gives you bad sides, stop taking it.

You can try taking it at a smaller dose but using a pill cutter to split the tablets, or try a topical solution. Having more than one transplant is certainly doable, but it seems a bit daft to go down that route without first having tried other options first.

[HappyMan2021]

2 hours ago, Hex13 said:

the problem: I’ve read horror reviews about this drug and I don’t risk my hormones for my hair. Not good risk reward ratio.

Only like 1% of men suffer true side effects from Fin. Also consider that many men start taking Fin in their late 20s and early 30s. Naturally, during late 20s and early 30s, sex drive naturally starts going down for men and its not uncommon for ED issues to arise. Many men falsely attribute this to Fin. 

It's like being in your 60s, starting a new blood pressure medication, then blaming that medication for a new wrinkle or gray hair. Totally unrelated events. 

It would be a real tragedy if you allow all your hair to fall off based on hearsay and rumors. 

Edited December 12, 2021 by SadMan2021

[Curious25]

9 hours ago, rambunctious said:

I've been on Fin for 10 years before getting a HT no issues sexually, even had a kid on it. I have friends on it too and its working. Surgery is always last resort, ask any doctor that. 

Good for you.

But that means absolutely nothing as to how someone else will react, because your body is the same to no other man’s, and your anecdotal experience certainly doesn’t qualify as being a valid reason to over ride another users personal decision on their own risk:reward ratio.  

People shouldn’t be made to feel like hypochondriacs for being uncertain about committing to a life long medication that alters their hormone profile - and they certainly shouldn’t be vilified for deciding in the end to prioritise their hormone profile ahead of their hair loss. Just because we are on a hair loss forum, doesn’t mean it is the be all and end all for every user. 

I do agree, people shouldn’t jump into surgery blindly, and if they feel comfortable, the optimum strategy would always be to start a medical regime beforehand, and see how this goes.

However, this doesn’t suit everybody - and that is where rationally looking at patients on an individual case by case basis, is fundamental to determine whether pursuing a transplant journey without using medication is feasible or not, because, some are more likely to get away with this, than others - considering factors such as age, age of onset, miniaturisation across scalp, donor capacity, family history, goals of surgery, beard source, hair calibre, hair coverage value, hair groupings etc. 

In this instance, going off the pics that OP has provided, I would lean towards suggesting he is in a more favourable position to pursue a non medicated journey, than others.
 

Comprendes?  

[Mike10]

19 hours ago, Hex13 said:

Thanks for your answer. Appreciate it.

the problem: I’ve read horror reviews about this drug and I don’t risk my hormones for my hair. Not good risk reward ratio.

Personally I would not even consider Fin. The horror stories are for real. But I will say this, in the vast majority of cases the side effects are not persistent. However, the idea to think that it is a given that you can take Fin for life without sides is plain wrong. It is not rare that sides will occur at one time or another, they can appear even after many years. Also hair loss will continue to progress even while on Fin. I really like what Dr Feller wrote abot Fin, I could not agree more: https://fellermedical.com/proven-hair-loss-drugs/

Edited December 13, 2021 by Mike10

[Melvin- Admin]

 

[Hex13]

19 hours ago, SadMan2021 said:

@Hex13 It looks like your donor hair is quite curly, is this accurate? Does the native hair in the potential recipient area match this same curly shape and texture?

It might look a bit unnatural having a curly hairline if all of your other hair has a straight and soft texture. If you don't mind using product everyday to tame your hair, this isn't an issue. 

No no my donor is complete straight, I don’t have curly hair. But to be honest, I will not care about the hairline( When I do the surgery). But I got your point, thanks man for the comment

[Hex13]

19 hours ago, Berba11 said:

Why don't you try it and see for yourself? If it gives you bad sides, stop taking it.

You can try taking it at a smaller dose but using a pill cutter to split the tablets, or try a topical solution. Having more than one transplant is certainly doable, but it seems a bit daft to go down that route without first having tried other options first.

I’m the type of person who overthinks a lot of stuff in his life. From my perspective: doing one, two or even three surgeries is better than committing for the drug for the rest of my life. It is just an 8 hour surgery( didn’t read someone classified it as a dangerous surgery), but I’ve read tons and tons of reviews about FIN.