Need advice on starting treatment and possibly surgery

[AnxiousBeginner]

Hi, I've only recently started to seriously research hair loss treatments and even visited with some FUE specialists but I'm at a bit of a loss and would love some advice.

First of all, can anyone recommend a good FUE surgeon near Michigan, USA? I was considering Dr. Serdar Caglayan in Michigan but can't find many mentions of him on forums like this one.

I also heard that I should look for a place where the doctor does the extractions and site/hole-formations but everywhere I call they say that the techs do that. I also heard that places like these should be willing to offer you contact information for former patients but I haven't had any luck with that from any place I've called either. Am I confused on what the norms are?

Also, I'm too scared of the side-effects of Propecia and the possibility of permanent side-effects even after stopping treatment, but I was considering the topical versions and was wondering where would be the best place (and most cost-effective) to buy these. It seems like Keeps / ForHims / HappyHeads are the big players but they're also a bit pricey. I found one that seems decent - minoxidilmax.com - but they don't require any consultation or prescription which seemed like a red flag. Can anyone offer any advice on the best place to order from? And I heard that dutasteride may be even better than finasteride and was considering a mix of minoxidil and dutasteride - does this make sense?

[HappyMan2021]

-you really need to be on DHT meds before considering surgery. Don't be scared of side effects when you haven't even tried it out yet

-How old are you? What are your expectations? Most people with your level of balding need multiple procedures for a fully satisfied result

-Location and even price should not be primary factors in surgeon selection.

Hair transplants really are a "go big or go home" type deal. If you can't get it done right its not worth the risk

[THE TRUTH]

Hello 

Never heard of this doctor. I wouldn't personally risk it.

There some much better doctors in the US and also cheaper and far better options in Spain/Belgium. Stay away from turkish hairmills...

Have you checked out Zarev/Bisanga/Freitas/Pinto/Ximena Vila ?

Don't rush into surgery. Do a TON of research first. Look for independant reviews. Never trust reviews posted by the clinics themselves since they are cherry picked. Deliberately look for poor results. Check out all forums. Belicapelli, recuperartupelo, alopeziede, hairloss experiences, hairloss conquerors on FB, Reddit Hair Transplants, baldtruthtalk, international hairloss forum, sacekimisonuclari etc etc....

Give medication a try first. At least 6 months. You have lots of miniaturized hairs that might be thickened up. 

Dutasteride once daily.

Oral minoxidil once daily

And optionnal good topical anti androgen such as RU58841 or fluridil. 

Side effects of Finasteride/Dutasteride are way overhyped bro....These theories, all the stupid fear mongering, Propecia help etc...has been debunked. 

I've personally used Dutasteride at doses as high as 2.5mg daily and never got any sides. Sadly I didn't get any regrowth either because I started way too late.. 

Time is off the essence when it comes to fighting permanent irreversible hairloss. 

You are already a Norwood 4 almost Nw 5 and you will need several surgeries...

Finasteride/Dutsteride are great for stopping hairloss but they are total crap for hair regrowth. That said, they can (in 1 out 5 cases thicken the existing miniaturized hairs. 

You need to get on medication NOW to prevent you from becoming a Norwood 6. You don't want your crown baldness to drop down any further.

Talk to any renowned hair transplant surgeon and he will explain you that sides effects are generally due to a psychological effect called nocebo. 

Interesting fact that many of these fear mongerers never mention is that 5AR inhibitors actually RAISE  your serum and also your prostate/scalp tissue Testosterone levels....

Most reputable doctors strongly recommend using finasteride at least 6 months to a year before surgery. 

Without even mentionning that it is highly recommended to stay on finasteride/dutasteride after surgery because hairloss will continue on non-transplanted aread...and then you will not have enough left in the donor to cover everything...

You could be diagnosed with DUPA in the donor or have permanent shock loss due of native miniaturized hairs on top if you're not on Finasteride. 

There a tons of reasons why hair transplant without finasteride is really not recommended. 

If you are really really afraid then using a very low dose of finasteride like 0.25mg can help since it inhibits enough scalp DHT to slow down hairloss pretty significantly. 

You could try topical finasteride/dutasteride... But it's very expensive and inconvienient to use. 

All the best good luck. 

[HappyMan2021]

5 minutes ago, Hairmills and homeruns said:

Have you checked out Zarev/Bisanga/Freitas/Pinto/Ximena Vila ?

there are certainly better doctors than the one OP mentioned. But the man doesn't need to go on a 2 yr waitlist to get a good result 🤣

[RTC]

17 minutes ago, Hairmills and homeruns said:

Hello 

Never heard of this doctor. I wouldn't personally risk it.

There some much better doctors in the US and also cheaper and far better options in Spain/Belgium. Stay away from turkish hairmills...

Have you checked out Zarev/Bisanga/Freitas/Pinto/Ximena Vila ?

Don't rush into surgery. Do a TON of research first. Look for independant reviews. Never trust reviews posted by the clinics themselves since they are cherry picked. Deliberately look for poor results. Check out all forums. Belicapelli, recuperartupelo, alopeziede, hairloss experiences, hairloss conquerors on FB, Reddit Hair Transplants, baldtruthtalk, international hairloss forum, sacekimisonuclari etc etc....

Give medication a try first. At least 6 months. You have lots of miniaturized hairs that might be thickened up. 

Dutasteride once daily.

Oral minoxidil once daily

And optionnal good topical anti androgen such as RU58841 or fluridil. 

Side effects of Finasteride/Dutasteride are way overhyped bro....These theories, all the stupid fear mongering, Propecia help etc...has been debunked. 

I've personally used Dutasteride at doses as high as 2.5mg daily and never got any sides. Sadly I didn't get any regrowth either because I started way too late.. 

Time is off the essence when it comes to fighting permanent irreversible hairloss. 

You are already a Norwood 4 almost Nw 5 and you will need several surgeries...

Finasteride/Dutsteride are great for stopping hairloss but they are total crap for hair regrowth. That said, they can (in 1 out 5 cases thicken the existing miniaturized hairs. 

You need to get on medication NOW to prevent you from becoming a Norwood 6. You don't want your crown baldness to drop down any further.

Talk to any renowned hair transplant surgeon and he will explain you that sides effects are generally due to a psychological effect called nocebo. 

Interesting fact that many of these fear mongerers never mention is that 5AR inhibitors actually RAISE  your serum and also your prostate/scalp tissue Testosterone levels....

Most reputable doctors strongly recommend using finasteride at least 6 months to a year before surgery. 

Without even mentionning that it is highly recommended to stay on finasteride/dutasteride after surgery because hairloss will continue on non-transplanted aread...and then you will not have enough left in the donor to cover everything...

You could be diagnosed with DUPA in the donor or have permanent shock loss due of native miniaturized hairs on top if you're not on Finasteride. 

There a tons of reasons why hair transplant without finasteride is really not recommended. 

If you are really really afraid then using a very low dose of finasteride like 0.25mg can help since it inhibits enough scalp DHT to slow down hairloss pretty significantly. 

You could try topical finasteride/dutasteride... But it's very expensive and inconvienient to use. 

All the best good luck. 

Are you the bludflow guy (who keeps changing his username)?

To constantly push the line that decreasing a naturally-occurring hormone to barely detectable levels doesn't result in symptoms and that they're mostly in people's head is quite simply garbage..

Edited June 9, 2022 by Aslitarcan sucks

[RTC]

Anyway OP, use topical Finasteride at a low dose every other day (like @Melvin- Moderatorsuggests) if you are worried about sides. Of course, topical may not work too well for you due to the extent of hair loss, but it's worth a try. I totally understand your concerns about side effects.

[THE TRUTH]

2 hours ago, HappyMan2021 said:

there are certainly better doctors than the one OP mentioned. But the man doesn't need to go on a 2 yr waitlist to get a good result 🤣

Where did u get yours ? 

Sure. There may be some decent options that are cheaper with shorter waiting lists. Not many though as you know...

[HappyMan2021]

1 minute ago, Hairmills and homeruns said:

Where did u get yours ? 

 

Dr. Mwamba. 

Edited June 9, 2022 by HappyMan2021

[John1991]

Don't just go full bore into using dutasteride.  Start with fin every other day and see if your body tolerates it.  DO NOT jump into using 2.5 mg of dut daily when you have no clue how your body responds to DHT suppressing medications.  

Edited June 9, 2022 by John1991

[NARMAK]

I would personally tell somebody if they're scared of side affects to a huge degree and choose never to use oral Finasteride as a result, then trying the topical is a better route to reduce the potential side affects. However, do also bear in mind it will be more pricey than oral Finasteride and also you have to imo be more diligent applying topicals. 

If you are willing to try the oral version, starting at half dosage (0.5mg Finasteride) on Monday, Wednesday and Friday is the usual routine and then re-evaluate to add more days or increasing the dosage to a full 1mg dosage. 

At the end of the day, i strongly believe in doing your own research based on scientific studies and evidence over anecdotal accounts and also do some blood tests to make sure you don't have any underlying issues that need to be addressed first that using this medication can exacerbate because the drop in DHT exposed your issues rather than being the cause as some claim. Also, falling for "Nocebo" is quite common. The minds a strong thing. 

[MAIZE1694]

7 hours ago, AnxiousBeginner said:

Also, I'm too scared of the side-effects of Propecia and the possibility of permanent side-effects even after stopping treatment, but I was considering the topical versions and was wondering where would be the best place (and most cost-effective) to buy these. It seems like Keeps / ForHims / HappyHeads are the big players but they're also a bit pricey. I found one that seems decent - minoxidilmax.com - but they don't require any consultation or prescription which seemed like a red flag. Can anyone offer any advice on the best place to order from? And I heard that dutasteride may be even better than finasteride and was considering a mix of minoxidil and dutasteride - does this make sense?

You might be surprised at the small but positive changes on FIN. 

A proactive approach to mitigate physical side effects before you start FIN would be to lower body fat thus lowering aromatase expression. This would provide a better balance of e2 to test levels and can be easily done by keeping dietary intake just slightly below maintenance while increasing protein and fat intake.

You still have plenty of hair to keep on the crown and lateral humps.

I've used keeps but beware it is subscription based and auto renews every 3 months or so.

[MAIZE1694]

Also, just about every "content" creator on youtube, along with their aunt, have a keeps sponsor which includes a promo code. Never pay full price for keeps if you can help it.

[mavigo]

As a Michigander who originates from the Metro-Detroit area; I can conclusively tell you that the best surgeons in the local area are Konior & Nadimi (Chicago), Panine (Chicago), Josephitis & Shapiro (Minneapolis). Lol. 

IMO, there are no suitable HT doctors in Michigan, Ohio or Indiana.