What to do next?

[crashbash]

Hello to all! I am now 29 years old.

Soon a year from my transplantation at Hattingen hair. I want to say that this is an amazing clinic with amazing people. Thank them very much. I had 5400 FUT. Mainly in the middle and front of the head, and a little crown. I am very pleased with the result, as I was already NW5.

You can see how I was here(the head from that moment became worse by 20-25%):

Help answer the questions:

1) I want to finish the crown + plant it in the scar. This will take 1800-2300 grafts. I will do it in HLC. They said that about 500 grafts can be taken from the beard to save the donor. Is this a rational use of grafts? It seems to me that after the second HT there will still be about 2000-2500 grafts in reserve.

2) My front line is conservative. Should I lower it a little or leave a reserve donor for compaction, if I continue to lose hair further?

3) Now I use topical DUT from FUE clinics. Should I add FIN in micro doses? I still don’t understand if DUT works on me or not. I stopped taking fin 1mg due to decreased libid

My English is not my native language, I can write somewhere that is not clear   I want to say thank you to this forum. Without your advice, I would be a less happy person.

[Fue3361]

I think your hairline looks great.  I'd keep it conservative.

[MachoVato]

It is not easy to determine in pictures, but it looks like your donor is pretty good. I would always advise to use grafts from the beard if possible. Grafts from the beard are thicker so they are not good for the hair line, but the putting them in the scar line should not be a problem.

Personally, I think you could add some grafts to your temples. If your donor has enough grafts, why not add some to your hair line? HLC will spend a lot of time drawing lines on your head. Make your decision when you are at the clinic with the doctors. Ask for options, they will help with the decision.

There is no reason to add finasteride if you are taking dutasteride. They do the same thing.  The only thing you could add would be minoxidil. If you can find oral minoxidil, that might be better. Again, I would discuss this with the doctors. 

Good luck!

[gillenator]

I agree to keep your hairline conservative because you are still young and MPB as we know is progressive over our lifetime…and it is highly ill-advised to take both DUT and finasteride together…also, how long have you been using DUT?…because you want to give it enough time to see if it is working effectively.

Because you are young…it would be wise to maintain some reserve scalp donor for your frontal third…so I concur that using some beard donor for your crown would be a consideration…while keeping in mind that your crown has a diffused thinning pattern…so, the added use of minoxidil whether the oral form or try using 5% foam (topical) may help thicken up your crown.

[crashbash]

Thanks for answers! 

I still thought. Is it possible to make a small FUT? And the third, if necessary, is already FUE?

3 hours ago, MachoVato said:

 

Personally, I think you could add some grafts to your temples. If your donor has enough grafts, why not add some to your hair line? HLC will spend a lot of time drawing lines on your head. Make your decision when you are at the clinic with the doctors. Ask for options, they will help with the decision.

I draw badly. add to the temples like this? In real life, will this visually thicken the front line?

 

[MachoVato]

My guess it would look something like this. Maybe lower the front of hair line 1/2 CM and add more to the corners. What do you think?

[ConnorCrosby]

13 hours ago, gillenator said:

I agree to keep your hairline conservative because you are still young and MPB as we know is progressive over our lifetime…and it is highly ill-advised to take both DUT and finasteride together…also, how long have you been using DUT?…because you want to give it enough time to see if it is working effectively.

Because you are young…it would be wise to maintain some reserve scalp donor for your frontal third…so I concur that using some beard donor for your crown would be a consideration…while keeping in mind that your crown has a diffused thinning pattern…so, the added use of minoxidil whether the oral form or try using 5% foam (topical) may help thicken up your crown.

If you don't mind me asking - why is it highly ill-advised to take both dut and fin? I've been on 1mg fin six times per week and 1 avodart per week for quite some time myself.

[crashbash]

18 hours ago, MachoVato said:

Думаю, это будет выглядеть примерно так. Возможно, опустите переднюю часть линии волос на 1/2 см и добавьте больше к углам. Что вы думаете?

 

I would like that. but I'll stay conservative Now, I'm thinking of making a crown and watching for 2-3 years. If hair loss does not progress, then I will do the front with Kesser or Freitas.

Edited December 20, 2021 by crashbash

[MachoVato]

17 hours ago, ConnorCrosby said:

If you don't mind me asking - why is it highly ill-advised to take both dut and fin? I've been on 1mg fin six times per week and 1 avodart per week for quite some time myself.

It would be redundant. As I understand it, dutasteride blocks the same 5AR that finasteride does, plus a second type of 5AR. Something like that.  

[gillenator]

20 hours ago, ConnorCrosby said:

If you don't mind me asking - why is it highly ill-advised to take both dut and fin? I've been on 1mg fin six times per week and 1 avodart per week for quite some time myself.

‎It's because of the adverse effect that using a combination of both drugs can potentially have on the prostrate... just ask any ‎urologist.

Did you first consult with a licensed physician about taking both drugs concurrently?

[Gatsby]

I think you should leave it. For example if you start going for the crown now at 29 you could be chasing it for the next 25 years. You have shaped your face really well. Do you have pre surgery pics before the work you had at Hattingen Hair?

[Fabulous]

3 hours ago, gillenator said:

‎It's because of the adverse effect that using a combination of both drugs can potentially have on the prostrate... just ask any ‎urologist.

Did you first consult with a licensed physician about taking both drugs concurrently?

Im scheduled with a recommended doctor from here, top in Europe, and in the medication plan received from him i have 1mg of Finasteride 5 times/week, and 0.5 mg Dutasteride 2times/week. I was already on 1mg Fin daily (for a bit over 6 months), I'm still debating if I should start with Dut as well.

[crashbash]

5 hours ago, Gatsby said:

Думаю, тебе стоит оставить это. Например, если вы начнете стремиться к короне сейчас в 29 лет, вы можете гоняться за ней в течение следующих 25 лет. Вы действительно хорошо сформировали свое лицо. У вас есть предоперационные фото до работы в Hattingen Hair?

Do you think not to make a crown? I use 1800 grafts from the back + 500-600 from the beard. About 2000-3500 grafts will remain in reserve.

Unfortunately I have no pictures before. Photos are in my topic above (2019) 

 

[ConnorCrosby]

On 12/21/2021 at 3:30 AM, MachoVato said:

It would be redundant. As I understand it, dutasteride blocks the same 5AR that finasteride does, plus a second type of 5AR. Something like that.  

 

On 12/21/2021 at 6:01 AM, gillenator said:

‎It's because of the adverse effect that using a combination of both drugs can potentially have on the prostrate... just ask any ‎urologist.

Did you first consult with a licensed physician about taking both drugs concurrently?

I had no idea and has not been informed about this. I understand that it's not your profession, but based on the knowledge that you do have - do you know what potential risks the combination has on the prostate? Obviously wouldn't wanna mess with my health more than necessary.

[JDEE0]

22 minutes ago, ConnorCrosby said:

 

I had no idea and has not been informed about this. I understand that it's not your profession, but based on the knowledge that you do have - do you know what potential risks the combination has on the prostate? Obviously wouldn't wanna mess with my health more than necessary.

I would be interested to know also...

As far as I know, neither finasteride nor dutastride (or both drugs combined as in this case) actually have any negative health consequences on the prostate. More than this, I know of no reason why combining the two would have any risk specifically to the prostate (or really any more risk than just taking dutasteride alone as I will cover below).

There have been long standing worries and claims that 5-ar inhibitors in general increase the risk of high grade prostate cancer specifically, but very good data in recent years has come out to pretty much completely refute this and show without question that there really is no increased risk for prostate cancer of any kind afaik... not sure if this is the overall angle Gillenator is referring to when he says that taking the two together is risky or not, but either way, I don't think it matters.

I don't really see why taking fin in addition to dut would make things any more risky than just taking dutasteride alone as it blocks all 3 isoforms of 5ar anyway. Adding fin on top of this likely just does very little as the dutasteride has already blocked the type 2 5ar enzyme that the fin is mainly designed to. When it attempts to inhibit that enzyme, the finasteride will likely just struggle to have much of an effect as it's already been done by the dutasteride.

I think it's just more pointless than it is dangerous, but I'd be interested to hear more, like I say, as I suppose I could be wrong. 

[gillenator]

Sorry I missed your recent posts…the larger concern or risk as I understand it is the impact these drugs have on the prostrate…both finasteride and dutasteride are drugs initially developed for treating the swelling of the prostrate in patients diagnosed with prostrate cancer…taking either drug or especially both together can potentially produce false PSA readings…prostrate cancer progresses very slowly over 10 to 20 years and can be mis-diagnosed or missed altogether until it becomes acutely symptomatic and/or progresses to advanced terminal stages.

[gillenator]

One other thing…if you are taking these drugs for hair loss, it’s important to let your primary doctor know so they account for this when administering PSA tests…prostrate cancer sometimes is referred to as the “silent killer” so guys, make sure your doctor does PSA tests routinely.