Advice needed

[UKLad81]

Hi All, hope everyone is well. I’m after some advice. I’ve had a couple of transplants already (1st 4100 grafts and 2nd 3500). Results i felt were pretty good as compared to where i initially started. I’m now keen on filling the midscalp up with a little bit more density and fill the crown up as these areas are irritating me and also to get rid of the hair fibres that i have been using for many many years.  

I’ve tried finasteride for a few years and started to get sides with them. I reduced the dosage to MWF and still they persisted and therefore have stopped and dont wish to go through all that again. I have however, been on oral Minox for the last 8 months (5mg daily) and seen a slight improvement but not a huge amount. 

I’m not keen on a shaved transplant either because of the job i do. Looking for any recommendations you may have. I really want this to be the final one (i hope!). 

Cheers

[duckling]

First request is posting a pic of your donor area. With 7600 grafts taken already , your donor has to be checked before any opinion can be given for next HT.

I see so many hair but they are thin so they are not adding to density. Reason is probably you not taking fin. I would suggest to consult a doctor and take topical finasteride. That has shown to work for many on this forum who got sides from oral fin. Probably add ketocanazole shampoo too to the mix.

If you are unable to take the above meds then you might have to go down route of another HT. Shock loss is risky in your case so i suggested to add these meds first.

 

[Rahal Hair Transplant]

@UKLad81,

It’s obvious that your hair has improved substantially since before your for first transplant. I’d be curious to see what your hair looks like dry as it appears that your after photos are showing your hair wet or styled with gel using the wet look. Wet hair always looks a bit thinner

Now, you’ve already undergone 2 larger procedures using a large number of follicular units. I’m not sure who the doctor was but did they say approximately how many grafts you have left available for transplanting?  For instance, I know Dr. Rahal has a formula determine how many follicular units each patient has available in the donor area for transplanting during the course of the patient’s lifetime.   This obviously varies from patient to patient as it depends on his individual physiology and characteristics.

But if you have hair left available for transplanting, you can always consider going back for a third procedure and filling in the midsection as much as possible, assuming it makes sense to do so.  This ultimately depends on other issues such as your age, developing or acquired hair loss pattern, family history of hair loss, hair shaft diameter, hair texture, color, hair to scalp color ratio, etc.)

I hope this helps.

Rahal Hair Transplant

Edited May 12, 2023 by Rahal Hair Transplant

[Bucky O Hair]

Your AFTER photos are pretty good, but the hairs are wet and under a harsh bathroom light.

Have you tried a more dry look using hair paste instead?

You may not need to bother with a third HT if you wear your hair in a more flattering way.  

[UKLad81]

On 5/11/2023 at 6:48 PM, duckling said:

First request is posting a pic of your donor area. With 7600 grafts taken already , your donor has to be checked before any opinion can be given for next HT.

I see so many hair but they are thin so they are not adding to density. Reason is probably you not taking fin. I would suggest to consult a doctor and take topical finasteride. That has shown to work for many on this forum who got sides from oral fin. Probably add ketocanazole shampoo too to the mix.

If you are unable to take the above meds then you might have to go down route of another HT. Shock loss is risky in your case so i suggested to add these meds first.

 

Apologies i thought i had uploaded a picture of my donor. Please see attached. Hope this helps. I’m considering the topical finasteride but cant see many reviews of it in this forum. 

If it helps the surgeon who performed the two HTs estimates another 2500ish left in the bank. 

[duckling]

On 5/31/2023 at 10:29 PM, UKLad81 said:

Apologies i thought i had uploaded a picture of my donor. Please see attached. Hope this helps. I’m considering the topical finasteride but cant see many reviews of it in this forum. 

If it helps the surgeon who performed the two HTs estimates another 2500ish left in the bank. 

thanks for pic and if possible do upload front and mid-scalp pic when hair is not wet. with wet hair its will look more sparse.

if mid-scalp is actually sparse when hair is dry then i will say use 2000 grafts to make mid-scalp more dense .. you can have a slick back hairstyle to cover the crown that way. and use just 500 on upper part of crown. meds will take care of lower part of crown for you. you have to give topical fin a chance as you dont want crown to dip down more, its already going down a bit more than desirable.  it doesnt make sense to use grafts in area which can be fixed with meds/hidden with hairstyle and is at back of head.  

you can check reddit for results on topical finasteride. for me personally i used topical for 5 years ( but i used alternate days and sometimes quit it for weeks or months due to topical being inconvenient and also during peak covid i was out of stock and it was a non essential med for them to deliver. ) even when i used it daily , topical fin slowed down progress but no huge gains. rather lost my crown but may have been due to stopping it 2-3 months. 

oral i think is more effective but have seen cases on reddit with huge gains on topical too. you may be one of them.

 

[Smile Hair Clinic]

About topical Finasteride, you it is better if you start using it and observe how your body reacts. Each person unique and give different reactions to different medications. There is a possibility that topical finasteride can work for you. Also you have a good donor area for another hair transplantation. Having a transplantation and using medication after HT can work for you really well.

[UKLad81]

On 6/1/2023 at 9:26 PM, duckling said:

thanks for pic and if possible do upload front and mid-scalp pic when hair is not wet. with wet hair its will look more sparse.

if mid-scalp is actually sparse when hair is dry then i will say use 2000 grafts to make mid-scalp more dense .. you can have a slick back hairstyle to cover the crown that way. and use just 500 on upper part of crown. meds will take care of lower part of crown for you. you have to give topical fin a chance as you dont want crown to dip down more, its already going down a bit more than desirable.  it doesnt make sense to use grafts in area which can be fixed with meds/hidden with hairstyle and is at back of head.  

you can check reddit for results on topical finasteride. for me personally i used topical for 5 years ( but i used alternate days and sometimes quit it for weeks or months due to topical being inconvenient and also during peak covid i was out of stock and it was a non essential med for them to deliver. ) even when i used it daily , topical fin slowed down progress but no huge gains. rather lost my crown but may have been due to stopping it 2-3 months. 

oral i think is more effective but have seen cases on reddit with huge gains on topical too. you may be one of them.

 

Cheers @duckling appreciate your reply. I’m going to order the HIMS version of topical finasteride which also has the Minox in it and give it a go. Hoping that i get some growth back with the use of topical. 

I have also attached a picture of the top (not the greatest quality) but gives you an idea of what the hair looks like just blowed dried. With toppik in it doesn’t look bad at all it’s just irritating that i seem to have lost some hair behind the hairline and the crown area. 

 

[duckling]

25 minutes ago, UKLad81 said:

Cheers @duckling appreciate your reply. I’m going to order the HIMS version of topical finasteride which also has the Minox in it and give it a go. Hoping that i get some growth back with the use of topical. 

I have also attached a picture of the top (not the greatest quality) but gives you an idea of what the hair looks like just blowed dried. With toppik in it doesn’t look bad at all it’s just irritating that i seem to have lost some hair behind the hairline and the crown area. 

 

wow your condition doesnt look bad at all with dry hair. If you use toppik after this then i dont think anybody notices anything. Use the meds , fingers crossed there is no sides and you get your hair to thicken a lot more and maybe get some regrowth too in crown area. if it does either of these 2 then its a success.

post 6 months you should know if meds are working or not (results take 1 year sure but you can get an idea at half way mark if its doing anything). Then you can consider your options about HT.

HT will be always there as backup.