Help deciding: 27 yo, hairline work needed, few clinics in mind (namely: Nader, De Freitas, Pekiner, Eugenix)

[neverendingsearch]

20 hours ago, PizzaWolf said:

@neverendingsearch You said: "Given that my hair loss has progressed considerably despite finasteride, I wonder whether my vertex is the next to go."

I think you're putting the cart before the horse in looking at all these hair transplant surgeons. You aren't a surgical candidate until your hair loss is stable. Anyone who tells you different does not have your best interests at heart.

Well finasteride doesn't typically stop hair loss forever, and I started shedding at 16-17 since we have pretty strong balding genes in my family, so my progression/journey may not be typical. Comparing my photos from 2 years ago to now, there are minor differences in density but not significant (mind you, I was on minoxidil but no longer am), so I feel like now or soon is a good time to do this.

I've also consulted with Bernstein Medical in NY and they do think I am a candidate. How long does hair loss have to be stable before being considered a candidate for surgery in your view?

[MattJosh]

Is the row implantation of De Freitas a big negative?

His results are excellent of the most part and come to think of it it seems that Couto also kind of implants in rows

What are the main problems with this?

[neverendingsearch]

42 minutes ago, MattJosh said:

Is the row implantation of De Freitas a big negative?

His results are excellent of the most part and come to think of it it seems that Couto also kind of implants in rows

What are the main problems with this?

I think there are quite a few instances where the row pattern is apparent, especially it seems with thinner hair (which we all inevitably grow to have). For example the case shows it on the left side of the hairline. I attached a pic with the area highlighted. Agree that he is a great doctor though and maybe people don't notice this.

 

[PizzaWolf]

@neverendingsearch I'm not trying to be your daddy. If you're determined to get a hair transplant--go for it. You seem to be well-researched and have arrived at some good surgeons. BUT if you're continuing to lose ground on finasteride, that's a very bad sign. From what you've described there has never been a point where your hair loss is actually stable.

As far as Bernstein, who cares. You'll always be able to find a HT surgeon that thinks you're a candidate.

[neverendingsearch]

17 minutes ago, PizzaWolf said:

@neverendingsearch I'm not trying to be your daddy. If you're determined to get a hair transplant--go for it. You seem to be well-researched and have arrived at some good surgeons. BUT if you're continuing to lose ground on finasteride, that's a very bad sign. From what you've described there has never been a point where your hair loss is actually stable.

As far as Bernstein, who cares. You'll always be able to find a HT surgeon that thinks you're a candidate.

Hi, I don't really appreciate being spoken to like that. You offered your advice based on a few posts of mine, and I responded giving more data and asking a question since you seem to know a thing or two yourself. I mean thanks for answering, and maybe you have a point, but "I'm not trying to be your daddy"? Dude, gross. Anyhoo... noted, and no need to engage any further if you don't feel like responding – no one is forcing you to, I promise 

[PizzaWolf]

If you are determined to get a hair transplant, no one can stop you.

But the hard truth is that you are a lousy candidate for one. You have been losing hair since you were a teen, and have not been able to stabilize your hair loss even while using the most potent, established treatment available.

There will always be people willing to blow smoke up your ass and tell you what you want to hear, especially when there's money on the table. There's also many people in the transplant industry who love desperate, delusionally optimistic men. 

If my last, very tame, post offended you, I think you are going to be a prime target for the previously mentioned issues.

Good luck. 

[neverendingsearch]

8 hours ago, PizzaWolf said:

If you are determined to get a hair transplant, no one can stop you.

But the hard truth is that you are a lousy candidate for one. You have been losing hair since you were a teen, and have not been able to stabilize your hair loss even while using the most potent, established treatment available.

There will always be people willing to blow smoke up your ass and tell you what you want to hear, especially when there's money on the table. There's also many people in the transplant industry who love desperate, delusionally optimistic men. 

If my last, very tame, post offended you, I think you are going to be a prime target for the previously mentioned issues.

Good luck. 

Again, genuinely appreciate the input despite having to pick it out of a sprinkling of subtle underhanded insults. Not sure how you conclude that if I don't like being addressed disrespectfully then I'm naturally susceptible to hair clinic marketing, but I also don't actually care to learn!

[Melvin- Admin]

@neverendingsearch

I can understand why you would be offended by the statement “Im not trying to be your daddy”  that’s a patronizing statement. That said, besides the patronizing part, there’s some substance to the post. 
 

Always question who has something to gain by telling you that you’re a candidate, and who has nothing to gain by telling you’re not a candidate. In the end, users have nothing to gain by telling you the truth.

 

[PizzaWolf]

@neverendingsearch 

No, not susceptible to clinic marketing. I think you come across as susceptible to your own wishful thinking and what you would like to be true. 

You want a hair transplant to fix your hair loss and genetics--it simply can't do that. With the history you've described, even a great surgeon could leave you as a complete mess.

I don't like to recommend medications, but maybe consider moving to dutasteride or RU58841 if you're okay experimenting on yourself.

@Melvin- Moderator

It was patronizing. I should definately be more thoughtful of how I respond to fellow hairloss sufferers. We're all in the same boat. 

Apologies to @neverendingsearch

[neverendingsearch]

3 minutes ago, PizzaWolf said:

@neverendingsearch 

No, not susceptible to clinic marketing. I think you come across as susceptible to your own wishful thinking and what you would like to be true. 

You want a hair transplant to fix your hair loss and genetics--it simply can't do that. With the history you've described, even a great surgeon could leave you as a complete mess.

I don't like to recommend medications, but maybe consider moving to dutasteride or RU58841 if you're okay experimenting on yourself.

@Melvin- Moderator

It was patronizing. I should definately be more thoughtful of how I respond to fellow hairloss sufferers. We're all in the same boat. 

Apologies to @neverendingsearch

Thanks @PizzaWolf, I appreciate it.

Fun fact, Bernstein actually prescribed me 1.66mg of finasteride to "make up for the tolerance I've built", which I'm not sure is actually a thing. May go out and try to get a dutasteride Rx instead, and probably restart minoxidil. With that said, I'm scheduling for well into next year so I'll have time to plan interventions and figure out if my hair loss is accelerating any further.

[Melvin- Admin]

Just now, neverendingsearch said:

Thanks @PizzaWolf, I appreciate it.

Fun fact, Bernstein actually prescribed me 1.66mg of finasteride to "make up for the tolerance I've built", which I'm not sure is actually a thing. May go out and try to get a dutasteride Rx instead, and probably restart minoxidil. With that said, I'm scheduling for well into next year so I'll have time to plan interventions and figure out if my hair loss is accelerating any further.

If you’ve built a tolerance, it’s better to switch to dutasteride. I interviewed Dr. Vaño one of the leading hair loss doctor’s in Europe. He said dutasteride even 0.5mg every other day is better than 1mg of finasteride daily. It’s cheaper too, have a listen.

 

[PizzaWolf]

1 minute ago, neverendingsearch said:

Thanks @PizzaWolf, I appreciate it.

Fun fact, Bernstein actually prescribed me 1.66mg of finasteride to "make up for the tolerance I've built", which I'm not sure is actually a thing. May go out and try to get a dutasteride Rx instead, and probably restart minoxidil. With that said, I'm scheduling for well into next year so I'll have time to plan interventions and figure out if my hair loss is accelerating any further.

I'm not sure if I believe in a tolerance to 5-AR inhibitors, but who knows, I'm definately no doctor.

I've done many blood tests on myself, including a pre-5AR DHT test. My natural DHT was something like 79 ng/dL, which was at the very top of the range, and my hair was getting obliterated fast. After taking .5mg a day of Fin for 1 year, my DHT tested at high 50 something ng/dL, and though my hair loss slowed, it was still progressing. I upped the Fin to a full 1mg per day, tested my DHT, and it was 42 ng/dL. At this level, my hair loss has stopped and some even regrew. It took quite a while, though.

I think the question is really: how sensetive is your hair to DHT, and how low are you willing to tank this hormone? Some say it's a trash hormone, others say a lack of it has ruined their lives.

Either way, good luck in whatever you decide.