Hair Transplant without Finasteride

[JD34]

Ok guys. I’m getting ready to put my deposit down on a HT. I am 38yo and am considered a N5-N6. It’s down to H&W or Eugenix. I’ve consulted Konoir as well…but would prefer to do a higher number of grafts on the first go. I prefer to go the FUE route over FUT and have realistic expectations for coverage in front and mid scalp. I know I’ll need a 2nd procedure for crown but it won’t be priority.

I know the obvious response will be I need to be on Fin but I’ve tried 5 times to get on the oral Fin and every time I do, the first week is fine but then I develop side effects that force me to stop. Even micro-dosing doesn’t seem to wrk. I am opening to trying the topical fin but not overly optimistic on it.

Any forum members that proceeded with getting a HT that aren’t on Fin and have good results? I suppose my logic is I am already close to N6 so there’s not much of my native hair there to begin with…so if it goes, it goes and I could leave the crown and reinforce down the road… I just wouldn’t want to donor hair to fail.

just looking for someone to tell me I am not crazy and I’m not wasting my money😆

 

 

 

 

[BaldDude]

How long did you stay on fin before quitting? Most guys report side effects going away or becoming manageable after six months.

[StillAlive]

There are many of us who underwent or are undergoing an HT without using finasteride or minoxidil and I believe that your age and high NW makes you an ideal candidate for this, especially given the fact that you have realistic expectations.

Finasteride is recommended to younger patients in order to stabilize their hairloss and retain as much native hair as possible. If a 26 year old for example who is a NW3 gets a transplant with aggressive loss, if they don't go on fin, in all likelihood they will continue balding behind their fancy hairline and will end up looking quite funny and unnatural.

If most of your native hair is gone and you are fine with a good hairline and working with concealers for the mid and crown, I say that you can definitely manage without fin. 

[mafpe]

i think as long as you're prepared to lose the transplanted hairs after some time has passed, it's fine to do it. on the bright side, it might never go away. although looking at many of the member or people who shows up and said they lost hair proves otherwise. then again, it might be minority, we don't know.

[hairman22]

1 hour ago, mafpe said:

i think as long as you're prepared to lose the transplanted hairs after some time has passed, it's fine to do it. on the bright side, it might never go away. although looking at many of the member or people who shows up and said they lost hair proves otherwise. then again, it might be minority, we don't know.

no one goes bald in the donor. So you wont lose all tarnsplanted hair although yo may lose quite a bit later in life

that said who knows what the industry will be like in 10-20 years. Can easily see improvements in BHT & less regrowth in donor possibly

 

OP I would look at Zarev. Worth waiting for him as he will get the most out of donor

[mafpe]

4 minutes ago, hairman22 said:

no one goes bald in the donor. So you wont lose all tarnsplanted hair although yo may lose quite a bit later in life

that said who knows what the industry will be like in 10-20 years. Can easily see improvements in BHT & less regrowth in donor possibly

 

OP I would look at Zarev. Worth waiting for him as he will get the most out of donor

if they are in the donor area yes. unless they have DUPA all over. i meant for these donors that was transplanted into the recipient area.

agree on how we have no idea if there are any breakthrough in hair loss industry. hopefully, there will be solution for us.
we have been trying to cure hair loss for decades, with many "possible cure", that for me i'll just take what's there presently, as long as it's worth the risk. for example HT back then was... horrific with total pluggy hairline, but that's all we had. it wasn't really done often because most people don't want the look and risk involved.

on a random note, if i can see the future, rather than seeing when hair loss can be cured, i'd look for a lottery winning number instead 😂

[Rahal Hair Transplant]

Jd34,

to be honest, I am a firm believer that not all men require to be on finasteride as a prerequisite to undergoing hair transplantation.  It’s me, educating prospective patients and informed consent are the two most important aspects of preparing for her transplant surgery. As long as patients understand that androgenetic alopecia is a progressive condition that will continue and progress as far as the jeans dictate unless there is some intermediary Process which in this case would be finasteride. Finasteride and other medication like minoxidil are pretty good at slowing down or even stopping the progression of this genetic condition.

The question I have for you is, are you still experiencing hair loss or has it pretty much slow down and or stopped at this point? Are you a full-blown Norwood 5 or Norwood 6 at this point or do you still have a lot of hair on top of your head and are simply heading that direction?

These questions are important because frankly, if you really don’t have much hair left on top of your scalp and hair loss has pretty much slowed down or stopped at this point, using finasteride would be essentially pretty pointless anyway so there’d be no point in even suggesting it’s a criteria.  On the other hand, if you still have a lot of hair on top of your scalp, then you will most likely lose it and the transplanted hair will become a replacement for your natural hair.

At the end of the day, I think you need to understand the pros and cons and the advantages and risks of proceeding with hair transplant surgery without finasteride. If you understand and accept the risks,  understand that the result may not be as dense and full depending of course on the answers to my questions above and you’ve worked with a reputable surgeon to come up with a long-term strategic plan that you understand, except and take full responsibility for, then I think that you would be a good candidate for the procedure.

that said, if you are making an emotional decision because you’re just really upset about your hair loss and you’re not thinking about all of the possible consequences and considering them as well, then I don’t believe he would be a good candidate. Patience should fully understand and he excepts not just the advantages but all the risks associated with their decisions as it pertains to surgical hair restoration. 

if you are willing to post some photos of the top of your scalp and donor area, we could probably provide you with a more detailed opinion. But at the end of the day, what we say won’t replace a reputable surgeons advice based on professional evaluation/consultation.

I hope this helps.

Rahal Hair Transplant 

[ciaus]

 

The better audience for this question would be your male family members suffering from hair loss, but even then you won't have a good basis for a decision because hair loss is caused by the unique expression of many genes, some known, some still unknown.

Unfortunately there's no may to forecast someone's final hair loss severity. Even guys that do take finasteride, like me, still run the risk of potentially running out of hair down the road. Its just a lower risk because we have lower levels of DHT. Since you're relatively young at 38, you still need to be careful even as a NW6. There is still room for things to get worse, from progressing to a NW7 pattern, or even your donor area hairs starting to substantially thin. Make sure you get a good in-person analysis of your donor area by the doctor before actually doing the surgery. You don't want to be moving hair around your head that is going to eventually fall out anyway.

 

[Mood Swings]

11 hours ago, BaldBobby said:

How long did you stay on fin before quitting? Most guys report side effects going away or becoming manageable after six months.

Hey @BaldBobby

Do you mind elaborating more?

I started using fin about a month ago and stopped three days ago after noticing sidies lol

 

so do you suggest keeping on using it for at least 6 months and then the body will kind of adapt and overcome the side effects?

P.S, I’m kinda skeptical on the 3.8% of guys don’t see any side effects.. as clearly most of the people I know or read their threads say they do from the second week!

[BaldDude]

12 minutes ago, Mood Swings said:

Hey @BaldBobby

Do you mind elaborating more?

I started using fin about a month ago and stopped three days ago after noticing sidies lol

 

so do you suggest keeping on using it for at least 6 months and then the body will kind of adapt and overcome the side effects?

P.S, I’m kinda skeptical on the 3.8% of guys don’t see any side effects.. as clearly most of the people I know or read their threads say they do from the second week!

Yes I did that too when I was younger (a NW 1 or 2)...now I'm a NW 5 and I wish I stayed on it....I would give it at least 6 months to see if side effects decrease because the clinical studies show most men do, but yes I do believe more men have side effects than what the clinical studies reported.

[asterix0]

Chances are, you will only lose some hair due to senile alopecia like everyone else does as they age, but it may happen your androgen sensitivity is so high that even your transplanted hair (after some number of years) begins to fall out.

It is not very likely, but still a possibility. 

I would look into topical finasteride if you are sure you cannot tolerate oral. 

[LookMaxx]

0.3-0.5mg finasteride every other day or every 3 days 

Can’t go wrong with that 

 

[MazAB]

You should never quit trying different modalities of treatments especially when it comes to finasteride. Definitely try the topical before throwing in the towel altogether on it. Even at 38 nothing is stable, your body is still producing enough DHT to continue the progression of hairloss if it doesn't get treated at the source.

Follow my Journey with Eugenix and Dr Arika Bansal!

[Melvin- Admin]

Can you share some pictures? 

[JD34]

Photos of my balding attached. Let me know what you all think.

Buzzed it down shorter than it’s ever been with zero and 1 Gaurd. My hair is naturally thin. I’ve only had one in person consultation with Dr Ken Buchwach in Kansas City. He said my donor was average but I wouldn’t go to him for many reasons, so I don’t much stock in his evaluation.

Har never heard of Dr Zarev. But now looking after @hairman22 mentioned him…Wow…how is he not more mainstream. Seems to good to be true.

[airporteffect]

@JD34Why wouldn’t you go to Buchwach?

[Mike10]

Irrelevant of the medication issue, the first thing you have to understand is expectations. In my opinion, HTs from NW5 generally onwards lack density.  There is simply not enough hair in the safe donor to cover higher NWs. That is why  HTs surgeons go outside the safe donor area.  

Now moving to the medication issue, you have to understand that HTs are all about supply and demand. As somebody rightly mentioned, the risk is if you will progress to a NW7 you will be fXXed. You will be left with a weird look or if you shave down you might reveal scars. Now you might stay at a NW6. It is a gamble. You decide. 

The best candidates for HTs without medication are older patients with limited hair loss. Let's take a patient over 40, who is a NW2 with otherwise good density , pretty stable and on a working alternative treatment like PRP or laser. He is likely to keep a good head of hair for quite some time. Due to his rich donor , he can always have 1-2 additional HTs when things progress. There is less of an end risk in such case. 

 

 

Edited January 4, 2023 by Mike10

[mister_25]

1 hour ago, Mike10 said:

Irrelevant of the medication issue, the first thing you have to understand is expectations. In my opinion, HTs from NW5 generally onwards lack density.  There is simply not enough hair in the safe donor to cover higher NWs. That is why  HTs surgeons go outside the safe donor area.  

Now moving to the medication issue, you have to understand that HTs are all about supply and demand. As somebody rightly mentioned, the risk is if you will progress to a NW7 you will be fXXed. You will be left with a weird look or if you shave down you might reveal scars. Now you might stay at a NW6. It is a gamble. You decide. 

The best candidates for HTs without medication are older patients with limited hair loss. Let's take a patient over 40, who is a NW2 with otherwise good density , pretty stable and on a working alternative treatment like PRP or laser. He is likely to keep a good head of hair for quite some time. Due to his rich donor , he can always have 1-2 additional HTs when things progress. There is less of an end risk in such case. 

 

 

I’ve seen a lot of good NW5 comebacks with strong density, I don’t think that’s the case anymore that NW5 level patients will lack density. Sure it won’t be native density but they can still get a head of hair that is very good in the most extreme conditions such as wet with harsh lighting or even very harsh lighting, but it will require alot of grafts with good surgical skill and planning. The reason why most NW5s don’t chase that higher level is that they want to have some left in the bank if their crown ever expands or dips. I would say when you have to accept diminishing density is at Norwood 6 or if you are showing signs that you will progress into Norwood 6 later in life.

Although I do agree with you, the two best patients for HTs without medication are patients that are NW2/3 at 50-60 with family history suggesting little to no additional loss, or patients with no balding at 40-50 that want a slightly lower hairline.

[Curious25]

4 hours ago, Mike10 said:

HTs from NW5 generally onwards lack density.  There is simply not enough hair in the safe donor to cover higher NWs.

This is just stupid.
 

You can have a NW5 with fine straight calibre hair and a donor density of 70 grafts cm2 vs. a NW5 with thick wavy calibre hair and a donor density of >90cm2, producing two completely different surgical restorations both in design and aesthetic. And that’s not even factoring in head shape and surface areas of the individuals recipients. 

Advancements in technique, and a higher success rate of the utilisation of BHT has led to NW6’s now undergoing temple point work with their donors still looking healthy, and further availability of scalp grafts.
 

There is never a one size fits all answer for hair restoration, and the quicker people let that cement in, the faster they will be able to realise their own individual potential. 
 

Is medication essential for a hair transplant? Guess what - it depends on the individual. It depends on the individuals goals and what they deem as satisfactory in appearance. And it depends on the individuals propensity to experience further loss.  
 

Perfect candidates for hair restoration are educated patients, who understand the ratio between their goals and limitations (what is realistically achievable), have researched the science and industry for hours, are happy with their choice of surgeon, surgical strategy, and future preventative strategy, should they choose to follow one. 

[Mike10]

8 hours ago, Curious25 said:

This is just stupid.
 

You can have a NW5 with fine straight calibre hair and a donor density of 70 grafts cm2 vs. a NW5 with thick wavy calibre hair and a donor density of >90cm2, producing two completely different surgical restorations both in design and aesthetic. And that’s not even factoring in head shape and surface areas of the individuals recipients. 

Advancements in technique, and a higher success rate of the utilisation of BHT has led to NW6’s now undergoing temple point work with their donors still looking healthy, and further availability of scalp grafts.
 

There is never a one size fits all answer for hair restoration, and the quicker people let that cement in, the faster they will be able to realise their own individual potential. 
 

Is medication essential for a hair transplant? Guess what - it depends on the individual. It depends on the individuals goals and what they deem as satisfactory in appearance. And it depends on the individuals propensity to experience further loss.  
 

Perfect candidates for hair restoration are educated patients, who understand the ratio between their goals and limitations (what is realistically achievable), have researched the science and industry for hours, are happy with their choice of surgeon, surgical strategy, and future preventative strategy, should they choose to follow one. 

While not every NW5 case is the same, you need to understand that HTs expecially for higher NWs can look a lot different on photos than in reality. Clinics tend to take the most favourable photos in terms of combing, light  and angle. There is generally imply not enough hair in the back to cover such large surfaces for high NW cases with good density. That is just simple mathematics. Our difference in opinion may also be explained by expectations. I may simply have a higher expectation for HT surgery than you

 

Edited January 4, 2023 by Mike10

[Mike10]

11 hours ago, mister_25 said:

I’ve seen a lot of good NW5 comebacks with strong density, I don’t think that’s the case anymore that NW5 level patients will lack density. Sure it won’t be native density but they can still get a head of hair that is very good in the most extreme conditions such as wet with harsh lighting or even very harsh lighting, but it will require alot of grafts with good surgical skill and planning. The reason why most NW5s don’t chase that higher level is that they want to have some left in the bank if their crown ever expands or dips. I would say when you have to accept diminishing density is at Norwood 6 or if you are showing signs that you will progress into Norwood 6 later in life.

Although I do agree with you, the two best patients for HTs without medication are patients that are NW2/3 at 50-60 with family history suggesting little to no additional loss, or patients with no balding at 40-50 that want a slightly lower hairline.

I think we had this discussion before. I am a bit more lenient as the 40-50 year old age period is generally not aggressive for these kind of  cases. But it si never wrong to take a more cautious approach in HT, as suggested by you. 

[JD34]

13 hours ago, airporteffect said:

@JD34Why wouldn’t you go to Buchwach?

Why he is not on the recommended list and his Google reviews look fake 

[airporteffect]

@JD34Where is the reasoning for him not being on the recommended list here? I found a few people on Reddit who worked with him and had good results. Also, many of the Google review profiles seem more than legit. I'm still confused but wanting to make sure that I am making the right choice.

[Curious25]

1 hour ago, Mike10 said:

While not every NW5 case is the same, you need to understand that HTs expecially for higher NWs can look a lot different on photos than in reality. Clinics tend to take the most favourable photos in terms of combing, light  and angle. There is generally imply not enough hair in the back to cover such large surfaces for high NW cases with good density. That is just simple mathematics. Our difference in opinion may also be explained by expectations. I may simply have a higher expectation for HT surgery than you

 

Coming from the guy who claims to have stabilised his hair loss from PRP, ok Mike thanks for the maths lesson that I have been blissfully unaware of all this time 🙄 

Off the top of my head - look up @Aftermath and @Rolandas 

2x NW5 patients with fine hair - Did the maths not add up for them either? 
 

You need to forget this general rule of thumb rhetoric you continually drive down peoples throats, and encourage people to research and learn about hair restoration specifically towards their individual set of circumstances.

Going around brandishing statements such as anyone that is NW5 or above to be destined for displeasing hair transplant results is both incorrect and unhelpful. 

[Pbaird98]

2 hours ago, airporteffect said:

@JD34Where is the reasoning for him not being on the recommended list here? I found a few people on Reddit who worked with him and had good results. Also, many of the Google review profiles seem more than legit. I'm still confused but wanting to make sure that I am making the right choice.

Unless you can see actual patient posted journeys with pictures then you should be careful. Any Google review can be faked, and they mostly are. Take a look at any clinic and you will find the same, 5* saying the same stuff, mostly from 1 post reviewers.