I've been told by a reputable clinic here that I can get a HT without Finasteride, thoughts?

[Hairtroubles]

Hey, 

So I am about to book my first hair transplant at the age of 30.  I am really really against finasteride, but obviously I know how important it is for the hair transplant and to maintain hair.  However, a reputable clinic that is often praised on this forum has said that they do not recommend or prescribe finasteride (only Minoxidil if need be), and that I can get a hair transplant now (in a few months), and that we can follow-up in in my mid thirties for my second one.  I have had good chats with the clinic, and they are super supportive, and I believe they have done great work that is often shown in this forum which gives me confidence.   It is true, that they are saying I can have it done without finasteride.  

I've received my offer letter, and I have been given a few days to send the deposit to them to secure my booking, but I cant help but find myself scrawling through the forums, looking at reddit posts, googling, 'hair transplants without finasteride', hoping to find some that work?    I would say I am a Norwood IV at the age of 30, and my brother is 5-6 (shaves his head to keep himself bald).  Sometimes I can mask my hair loss in day, when I use dry shampoos it makes my hair look better, but when its thin, you can see right through.

Anyways, I want to know, is this possible, would I be absolutely stupid to even consider getting a HT without taking fin, are there any words of encouragement that I do not need fin and I can just do this and get a second one and thats fine?

I'll include my donor area and pictures, but if my surgeon is telling me it's fine, it should be fine right?  When I put my hands through my hair, to check for active hair loss, I sometimes get 3-6 hairs falling out, is that normal?

 

 

[JDEE0]

You can go ahead, yes, but as we have all said before in your previous thread, you just have to accept that you're definitely going to lose more hair in the coming years and there's no doubt you will become a NW5 at least and very possibly may progress even further as you get older.

As long as you're prepared to get multiple hair transplants, most likely over the next decade or so, and understand that you might get to a point in your life where you essentially run out of donor and will have to compromise on coverage in certain areas, then I personally don't see why not. This is a risk for anyone in general anyway of course, but due to your type of hair loss and lack of medication, it's just much more amplified. 

The only other thing is that you have diffuse thinning and a HT in general could lead to permanent shock loss of some of your native hair, but I assume your surgeon has gone over this with you and is confident it won't be a big issue, so if they think it's ok, then trust their opinion if you've picked them for your HT.

[Britanium]

Which clinic is this ? I remember you last mentioned Dr Bicer. @JDEE0has summed it up nicely. 

[Gokuhairline]

my personal opinion is no you do NOT need to be on fin to do a HT...does it help ? maybe ? maybe not...i also think it comes down to the individual and how advanced their case is....only you and a dr. can answer that

[Hairtroubles]

12 hours ago, Gokuhairline said:

my personal opinion is no you do NOT need to be on fin to do a HT...does it help ? maybe ? maybe not...i also think it comes down to the individual and how advanced their case is....only you and a dr. can answer that

May I ask why is that your personal opinion, like how come?

[Hairtroubles]

15 hours ago, JDEE0 said:

You can go ahead, yes, but as we have all said before in your previous thread, you just have to accept that you're definitely going to lose more hair in the coming years and there's no doubt you will become a NW5 at least and very possibly may progress even further as you get older.

As long as you're prepared to get multiple hair transplants, most likely over the next decade or so, and understand that you might get to a point in your life where you essentially run out of donor and will have to compromise on coverage in certain areas, then I personally don't see why not. This is a risk for anyone in general anyway of course, but due to your type of hair loss and lack of medication, it's just much more amplified. 

The only other thing is that you have diffuse thinning and a HT in general could lead to permanent shock loss of some of your native hair, but I assume your surgeon has gone over this with you and is confident it won't be a big issue, so if they think it's ok, then trust their opinion if you've picked them for your HT.

Good to hear from you bro, and appreciate the reply.

One thing I wanted to understand was actually shock loss, how does this happen, or how can it be avoided, yes we discussed the potential to cause more hair but she was fine with it.  I just messaged the surgeon now asking about it.  Just googled it and it occurs in 5% of transplants, how come you would think it would for me?

Surely there have been some success with multiple hair transplants (which is what I would ), surely that is an option?

[JDEE0]

18 minutes ago, Hairtroubles said:

Good to hear from you bro, and appreciate the reply.

One thing I wanted to understand was actually shock loss, how does this happen, or how can it be avoided, yes we discussed the potential to cause more hair but she was fine with it.  I just messaged the surgeon now asking about it.  Just googled it and it occurs in 5% of transplants, how come you would think it would for me?

Surely there have been some success with multiple hair transplants (which is what I would ), surely that is an option?

No worries man. The shock-loss you've seen when googling it is probably just referring to general, temporary shock-loss in the donor and or recipient. Usually this is just from all the anaesthesia/epinephrine injected and general trauma to the scalp during surgery that can disrupt blood flow, but it will come back in nearly all cases. 

What I'm referring to is permeant shock-loss of already weak hairs. If someone has lets say a NW3 sort of level of loss with strong hair behind it that isn't miniaturising (look at my thread and my own hair for an example of what I mean), the healthy hair just won't really shed, or if it does, it will have no problem coming back in a few months. but in a case like yours where lots of the hair up top is on its last legs so to speak, it might not be strong enough to recover if it shocked out. You'll probably be fine and it won't be an issue, but it's just something that anecdotally happens regularly enough to be considered.

Oh yeah, there have been many cases of people who've had multiple transplants with no meds, and there will be many more, all I'm saying is that it's just more unpredictable. You might end up a NW7 that you otherwise wouldn't have reached if you took them, your donor might miniaturise quite a lot which wouldn't have otherwise happened, and s on. 

I think you'll be fine to be honest, you just need to prepare for numerous surgeries over the course of the next however many years. You might well just end up a NW5 even in 30 years, in which case 2 surgeries of say 5-6000 grafts in total in the next few years would leave you in a good spot for a very long time, who knows.

[Gokuhairline]

32 minutes ago, Hairtroubles said:

May I ask why is that your personal opinion, like how come?

i do not want to risk even .0001% of side effects due to fin...also my hairloss is stabilized. 

[Hairtroubles]

14 minutes ago, Gokuhairline said:

i do not want to risk even .0001% of side effects due to fin...also my hairloss is stabilized. 

How do you know if your hair loss is stablised, i take pics and monitor, but if i run my hands in my hair, 5-6 fall out

[Hairtroubles]

15 minutes ago, JDEE0 said:

No worries man. The shock-loss you've seen when googling it is probably just referring to general, temporary shock-loss in the donor and or recipient. Usually this is just from all the anaesthesia/epinephrine injected and general trauma to the scalp during surgery that can disrupt blood flow, but it will come back in nearly all cases. 

What I'm referring to is permeant shock-loss of already weak hairs. If someone has lets say a NW3 sort of level of loss with strong hair behind it that isn't miniaturising (look at my thread and my own hair for an example of what I mean), the healthy hair just won't really shed, or if it does, it will have no problem coming back in a few months. but in a case like yours where lots of the hair up top is on its last legs so to speak, it might not be strong enough to recover if it shocked out. You'll probably be fine and it won't be an issue, but it's just something that anecdotally happens regularly enough to be considered.

Oh yeah, there have been many cases of people who've had multiple transplants with no meds, and there will be many more, all I'm saying is that it's just more unpredictable. You might end up a NW7 that you otherwise wouldn't have reached if you took them, your donor might miniaturise quite a lot which wouldn't have otherwise happened, and s on. 

I think you'll be fine to be honest, you just need to prepare for numerous surgeries over the course of the next however many years. You might well just end up a NW5 even in 30 years, in which case 2 surgeries of say 5-6000 grafts in total in the next few years would leave you in a good spot for a very long time, who knows.

Hey mate, thanks makes sense.

Can i ask, why do you think I would be fine?

Also, gotcha, makes sense - do you think looking at my hair my hair will regrow, your right, i think some are on last legs.  Makes me a bit nervous to be honest.

[JDEE0]

20 minutes ago, Hairtroubles said:

Hey mate, thanks makes sense.

Can i ask, why do you think I would be fine?

Also, gotcha, makes sense - do you think looking at my hair my hair will regrow, your right, i think some are on last legs.  Makes me a bit nervous to be honest.

Because, people get transplants without meds, it's not an absolute must (although you already know I'm a big proponent, especially in cases like yours). Look at Melvin, he's nearly a NW7 and is objectively in a considerably worse position than you in terms of gaining coverage, but after his HT at Euguneix comes in, he will be in a very good spot. 

I can't say, it might not even shed to begin with, I think you'll be alright and either way it doesn't really matter in the grand scheme of things - all that hair on top in your NW5 pattern is going to succumb to MPB in the next 5-10 years anyway, so it's going to need to be replaced with transplanted hair. I suppose whether its your genes or surgery that pushes them over the edge is mostly irrelevant, they're still going over.

Edited January 12, 2022 by JDEE0

[Hairtroubles]

21 minutes ago, JDEE0 said:

Because, people get transplants without meds, it's not an absolute must (although you already know I'm a big proponent, especially in cases like yours). Look at Melvin, he's nearly a NW7 and is objectively in a considerably worse position than you in terms of gaining coverage, but after his HT at Euguneix comes in, he will be in a very good spot. 

I can't say, it might not even shed to begin with, I think you'll be alright and either way it doesn't really matter in the grand scheme of things - all that hair on top in your NW5 pattern is going to succumb to MPB in the next 5-10 years anyway, so it's going to need to be replaced with transplanted hair. I suppose whether its your genes or surgery that pushes them over the edge is mostly irrelevant, they're still going over.

I just spoke to Ozen on the phone for 20 minutes.  She asked me about my hair loss and if it has stablised.  I put my hands in my hair and 4 fell out, they feel weak.  She says they wouldn't transplant on hair that is not stablised...  I said I noticed my hair loss in the lass 4-5 years, like 5 years ago my hair was in a good place.  She was shocked, she said wow, so your hair loss is very fast and at a rapid rate...

I thought this was known to her.  It has been thinning, and has thinned quite a bit.  She said my hair rate is quite aggressive and naturally they suggest to wait for it to be stablise.    Now i dont know what to do. 

She has asked me to count my hair loss and hairs that fall out without touching my hair over the next few days, and she will hold the day.  How do I know if i have active hair loss, how do i count it, any advice on this, didnt expect this

[JDEE0]

 

59 minutes ago, Hairtroubles said:

I just spoke to Ozen on the phone for 20 minutes.  She asked me about my hair loss and if it has stablised.  I put my hands in my hair and 4 fell out, they feel weak.  She says they wouldn't transplant on hair that is not stablised...  I said I noticed my hair loss in the lass 4-5 years, like 5 years ago my hair was in a good place.  She was shocked, she said wow, so your hair loss is very fast and at a rapid rate...

I thought this was known to her.  It has been thinning, and has thinned quite a bit.  She said my hair rate is quite aggressive and naturally they suggest to wait for it to be stablise.    Now i dont know what to do. 

She has asked me to count my hair loss and hairs that fall out without touching my hair over the next few days, and she will hold the day.  How do I know if i have active hair loss, how do i count it, any advice on this, didnt expect this

This is a confusing response from the clinic all around to be honest.... She must be able to see from your photos that your hair loss is certainly not stabilised? I mean, you're diffusing all across the top into a NW5 - it is clear you won't be 'stable' until you reach this Norwood level. Can you ask her how she has she looked at your pics and considered your loss to be stable with this in mind? 

Also, we all lose 50-100 hairs a day, so running your hand through it and having some come out is not unusual, and more importantly, is not an indicator of MPB or active hair loss, so I'm confused as to why this is a metric being used to asses as such. Especially when she can just assess with her eyes looking at your pics. I can only imagine she is trying to see if you're loosing hundreds and hundreds every day or something, but still, it's going to be hard to get an accurate picture here and count how many hairs you're losing.

Edited January 12, 2022 by JDEE0

[Hairtroubles]

3 minutes ago, JDEE0 said:

 

This is a confusing response from the clinic all around to be honest.... She must be able to see from your photos that your hair loss is certainly not stabilised? I mean, you're diffusing all across the top into a NW5 - it is clear you won't be 'stable' until you reach this Norwood level. Can you ask her how she has she looked at your pics and considered your loss to be stable with this in mind? 

Also, we all lose 50-100 hairs a day, so running your hand through it and having some come out is not unusual, and more importantly, is not an indicator of MPB or active hair loss, so I'm confused as to why this is a metric being used to asses as such. Especially when she can just assess with her eyes looking at your pics. I can only imagine she is trying to see if you're loosing hundreds and hundreds every day or something.

I see, I dont know if I should be re-assured or not? I am confused, is hair loss over 5 years fast?  Also, yes, there is diffuse thinning, is it therefore wise to wait another year or 2 to have the transplant? My goal was to get it done this year and then another one in 5 years.  

 

Also, if you put your hands in your hair and rub backwards, how man do you lose, Im losing 5-6 each time potentially, sometimes 1-2, but it feels like i can feel my skin and there isnt much there. You are right, the hairs feel 'dead'.

 
I am not sure what to do here, like what do you recommend, move forward with the transplant, wait, go ahead, i really am so confused.. i to thought by my pics she can see this and now i dont feel as confident?

[JDEE0]

1 minute ago, Hairtroubles said:

I see, I dont know if I should be re-assured or not? I am confused, is hair loss over 5 years fast?  Also, yes, there is diffuse thinning, is it therefore wise to wait another year or 2 to have the transplant? My goal was to get it done this year and then another one in 5 years.  

 

Also, if you put your hands in your hair and rub backwards, how man do you lose, Im losing 5-6 each time potentially, sometimes 1-2, but it feels like i can feel my skin and there isnt much there. You are right, the hairs feel 'dead'.

 
I am not sure what to do here, like what do you recommend, move forward with the transplant, wait, go ahead, i really am so confused.. i to thought by my pics she can see this and now i dont feel as confident?

Yeah, it's pretty quick, but its the nature of a more diffuse type pattern a lot of the time, not always mind you, but it's not unusual with it. 

Like I said, because you're never going to take meds, you're going to end up going completely bald into a NW5 pattern eventually anyway, those hairs are destined to go, so I don't really see the issue even if they are shocked out. The thing is though, what is her plan? If you were to have have say 3500 grafts now into the frontal third, then you go for the crown in a few years, it won't matter so much. Think something like Rolandas had done. However, if her plan is to implant grafts all around the existing miniaturising hair to increase overall density along the hair that's still kind of strong then I get why she doesn't want to go ahead if you're still actively losing hair - it will look weird/you'll look the exact same in 5 more years. But then all I have to say is, if that's her plan, why would she be aiming to do so to begin with when it's clear you are still losing hair from your pics? 

I don't know man, you need to ask her what her plan is: what angle is she going at your long term HT plan with (front first, crown later, or an overall density boost for now etc?)

[JDEE0]

I see @Rahal Hair Transplantis actively posting on the forum as we speak - maybe they can chime in as a representative of a clinic I respect... what would you recommend in this situation for OP?

Edited January 12, 2022 by JDEE0

[Hairtroubles]

1 minute ago, JDEE0 said:

I see @Rahal Hair Transplantis actively posting on the forum as we speak - maybe they can chime in as a representative of a clinic I respect... what would you recommend in this situation for OP?

June 20th, 2021  picture with coloured blanket behind.

 

With black t-shirt is 2nd of August, 2021.

 

[Hairtroubles]

@Rahal Hair Transplant - any thoughts?

[aaron1234]

Of course, you can get an HT without being on fin... but the risk of permanent shock loss goes up, losing your native hair after the HT which necessitates another round within a year or two becomes more likely.