2nd HT Surgery _ 3900 Grafts

[Britanium]

15 minutes ago, npk21 said:

But i am tired of it over these years.. I have tried all kinds of medicines, they all have helped me to keep it under control but no permanent solution I have found till date.. Evry month it comes back... Starts from my nose and ears .. And then the scalp.. Dry shafts and red burning skin.. 

Yeh I haven’t really found anything that will totally help, only allieve to a certain degree. 🫤

[jjsrader]

6 hours ago, 5BetaReductase said:

What’s your family history like? Have you looked at nutritional issues through blood tests like vitamin d, ferritin, etc? You’re obviously not a newbie as you’re well versed in a lot of this but I’m surprised to hear fin/dut stopped working for you after it initially helped.

All members reached NW6 or NW7 (some as early as mid 20's - some as late as mid 40's).  As I wrote - strong baldness genetics determine our fate.  Sometimes fast or slow w/or without meds.  Lots of men keep alot of mid-vertex & crown hair (very slow hairloss) til late 30's - mid 40's & then it just goes.  It's called middle-age & the hair just goes relatively quickly.  Medications only slow hairloss - never stop it.  Father time remains undefeated.

I was happy not to have surgery on my mid-vertex & crown until I was 51 years old - the meds bought me 10-15 years of time.

My younger brother always had great hair & by mid 20's it was going & by age 35 he was NW6 - so it's all relative.  No meds for him.

Edited May 4, 2022 by jjsrader

[THE TRUTH]

This a classic case a long term hair transplant failure because of DUPA and retrograde in the donor area. 

Did you doctor advise  you  to use Finasteride/Dutasteride back in the day after your 1st surgery ? 

If not, then it is a big mistake from him. 

If I were you, I wouldn't wait anymore.  You have very agressive Androgenic Alopecia  with the presence of DUPA in the donor area and a family history indivative of future severe baldness. 

Dutasteride 0.5mg daily (avodart) is your best bet. 

Add some oral minoxidil 2.5mg/5mg daily and topical anti androgens if you want extra protection. 

Make sure you discuss all these options with your doctor. 

[npk21]

34 minutes ago, What is your agenda here said:

This a classic case a long term hair transplant failure because of DUPA and retrograde in the donor area. 

Did you doctor advise  you  to use Finasteride/Dutasteride back in the day after your 1st surgery ? 

If not, then it is a big mistake from him. 

If I were you, I wouldn't wait anymore.  You have very agressive Androgenic Alopecia  with the presence of DUPA in the donor area and a family history indivative of future severe baldness. 

Dutasteride 0.5mg daily (avodart) is your best bet. 

Add some oral minoxidil 2.5mg/5mg daily and topical anti androgens if you want extra protection. 

Make sure you discuss all these options with your doctor. 

Sadly.. My doctor never told me about it.. In fact none of the doctors I consulted in past ever told me about it..

After my second surgery I have started taking Dutasteridr tablet daily, and also apply minoxydil in donor and transplant area.. What else should i do?

[THE TRUTH]

4 minutes ago, npk21 said:

Sadly.. My doctor never told me about it.. In fact none of the doctors I consulted in past ever told me about it..

After my second surgery I have started taking Dutasteridr tablet daily, and also apply minoxydil in donor and transplant area.. What else should i do?

Standard dose of Dutasteride is 0.5mg daily. That's already very solid for scalp DHT supression.

If you want to play it extra safe then 2.5mg will supress it over 90%. 

I am not a big fan of topical minoxidil in general. I prefer the oral version. But you need to discuss that with a good doctor in india who specializes in Hairloss and Hair Transplants. Try to reach out to Eugenix or Dr. Bhatti. 

I think topical version of minoxidil is crap...Even when mixed with tretinoin and dermarolling to increase  sulfotransferase enzyme bla bla bla etc...

Also I am not a big fan of applying topical minoxidil after a hair transplant. I know many people do it but from what I've seen I don't think it will make any difference to the final outcome of the transplant. 

Minoxidil sulfate works by hyperpolarizing the K+ potassium channel in the dermal papilla cells and somehow prolongs the life of the cells that DHT is trying to destroy via various mechanisms. If you are a responder, it may artificially trick your hairs into an anagen phase. 

But again for most people it doesn't do anything either because you either lack the sulfotransferase and it just doesn't absorb well enough when you have long hair and thus just cause unecessary shedding when you try apply it which can speed up hair miniaturization if you are not on a 5AR inhibitor in the first place. 

That' why I prefer the oral. But the oral has a higher side effect profile. 

You can continue to use topical if you want. It's totally up to you. 👍

For the moment, I'd just stay on Dutasteride 0.5mg and increase the dosage to 2.5mg if you feel your hairloss is still progessing (although very unlikely on 0.5mg). 

After 6 months once most of your transplant growth is completed, I'd add oral minoxidil and a topical anti androgen like Fluridil or RU58841. 

There is not much else you can do drugs wise.

There are some other extreme hardcore drugs used by transgender people that can give  significant regrowth such as oral estradiol, spironolactone but these are definitely not viable options at all...

Ultimately if you are not happy with the final outcome, you could go for a third procedure (but be very careful since your donor already looks depleted because of the extraction pattern + DUPA) and maybe use some beard grafts and combine with SMP. 

For the moment please don't do anything.

Very important to stick with Dutasteride  and you can continue minox if you want. You should wait till the 6 months mark and see what your hair looks like. 

[npk21]

46th day.. 

 

[THE TRUTH]

59 minutes ago, npk21 said:

46th day.. 

 

Looks normal for the 1.5 month mark. You are basically right in the ugly duckling phase. Your implanted hairs are currently going through the telogen phase. 

The decider is generally between month 3 and month 6 so for the moment nothing to worry about 👍

Edited May 6, 2022 by What is your agenda here

[asterix0]

On 5/5/2022 at 8:35 AM, What is your agenda here said:

This a classic case a long term hair transplant failure because of DUPA and retrograde in the donor area. 

Did you doctor advise  you  to use Finasteride/Dutasteride back in the day after your 1st surgery ? 

If not, then it is a big mistake from him. 

If I were you, I wouldn't wait anymore.  You have very agressive Androgenic Alopecia  with the presence of DUPA in the donor area and a family history indivative of future severe baldness. 

Dutasteride 0.5mg daily (avodart) is your best bet. 

Add some oral minoxidil 2.5mg/5mg daily and topical anti androgens if you want extra protection. 

Make sure you discuss all these options with your doctor. 

No...it is a classic case of eventually transplanted hair miniaturizing and falling out, which happens infrequently, but often enough that it is worth mentioning if a patient is considering a procedure without using an anti androgen.

 

[npk21]

22 hours ago, What is your agenda here said:

Looks normal for the 1.5 month mark. You are basically right in the ugly duckling phase. Your implanted hairs are currently going through the telogen phase. 

The decider is generally between month 3 and month 6 so for the moment nothing to worry about 👍

Please note that the hairs which are grown are my old transplanted hairs, my concern is that newly transplanted hairs are not visible yet , they are still inside the skin..I was expecting some small open pores with baby hairs after 45 days.. I mean it was visible after my first surgery..this time it is taking some more time I guess ..

Secondly.. my doctor is recommending a prp on 80th day for early growth.. should that help?

[THE TRUTH]

1 hour ago, npk21 said:

Please note that the hairs which are grown are my old transplanted hairs, my concern is that newly transplanted hairs are not visible yet , they are still inside the skin..I was expecting some small open pores with baby hairs after 45 days.. I mean it was visible after my first surgery..this time it is taking some more time I guess ..

Secondly.. my doctor is recommending a prp on 80th day for early growth.. should that help?

From my experience, you should start seeing new growth at around 3 months. It is unlikely that it is going to happen before. 

PRP has shown very little efficacy when it comes to thickening miniaturiared hairs but I do belive it can help a speed up a little the growth of the transplanted hairs. 

If the PRP your doctor is recommending is not too expensive then yeah why not give a try 👍

[npk21]

4 hours ago, What is your agenda here said:

From my experience, you should start seeing new growth at around 3 months. It is unlikely that it is going to happen before. 

PRP has shown very little efficacy when it comes to thickening miniaturiared hairs but I do belive it can help a speed up a little the growth of the transplanted hairs. 

If the PRP your doctor is recommending is not too expensive then yeah why not give a try 👍

Yes.. 4 free prp are included in the package.. I hope it will help to get into anagen phase early. 

[npk21]

Day 51... No changes yet...

[npk21]

 Few visible pores in front...

[npk21]

2 months Donor Area improved...

[npk21]

2 months.. No new baby hairs visible yet..

[Britanium]

Donor area definitely improving. Still early days for any growth to start happening. Maybe in about a months time 🙏

[npk21]

6 minutes ago, J-C said:

Donor area definitely improving. Still early days for any growth to start happening. Maybe in about a months time 🙏

I was expecting some baby hairs atleast 4 or 5 hairs to sprout by now.. But nothing so far.. Not even in front... 

[npk21]

Day 68

[OliverAtom]

On 5/1/2022 at 10:07 PM, npk21 said:

By 2022, I lost all my hairs again .. And the bald issue spread till Crown...

 

 

ohhhh so in 5 years you lost almost all implanted grafts from 2013! 😳. How many did you get on your first op?

Are you gonna go for Meds after this 2nd op? 

Thanks for sharing your experience!

[npk21]

10 minutes ago, OliverAtom said:

ohhhh so in 5 years you lost almost all implanted grafts from 2013! 😳. How many did you get on your first op?

Are you gonna go for Meds after this 2nd op? 

Thanks for sharing your experience!

Yes...I lost them all.. It were around 2900 grafts... Now I am on multi vitamins and minox after second surgery

[mafpe]

i think you retained around 30% of your HT, since the frontmost tuft is still there. there are several empty areas though. i hope with meds this time you'll be keeping all your hair!

[npk21]

1 hour ago, mafpe said:

i think you retained around 30% of your HT, since the frontmost tuft is still there. there are several empty areas though. i hope with meds this time you'll be keeping all your hair!

I wish.. But it's almost 67 days now.. My all grafts shedded completely by 18th day.. And not a new single hair has sprouted so far.. I am worried now..

[BaldDude]

20 minutes ago, npk21 said:

I wish.. But it's almost 67 days now.. My all grafts shedded completely by 18th day.. And not a new single hair has sprouted so far.. I am worried now..

too early to worry, need a couple more months at least.

[mafpe]

noworry, that's pretty normal. it's not always going to be the same as the transplant before. technically, 2months in is the ugly duck phase, you still have at least half a year to see real result. 

[npk21]

Day 73 

Vry small open pores with thin hairs are visible at mid scalp now...