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In reference to Someguy's request for info - FYI for Hairdude
In hopefully addressing the original question ..... And to just add a friendly comment for Hairdude. I understand your concern about HT verses Finasteride, however as in the 'real-world' of Medicine & Surgery, we do generally try the less invasive techniques first [i.e. for a fracture we place a cast on the broken limb ... before considering just going to the operating room to insert a rod into the cortex of the bone //// In cardiology we prefer medications to control BP or decrease lipids, before angioplasty and placement of a stent ~ or ~ taking the patient into the O.R. to do a open-heart bypass graft].
I understand that this is just dealing with 'hair' ... But I still like to advise my patients on ALL options available and if they are a candidate for medication [i.e. Finasteride], then I will offer it.
However, as you pointed out ... definitely some patients are best just going directly to HRS [Hair Restoration surgery] ... However, I do still like to educate the on all options and create a viable plan for them.
I discuss these facts with my patients and new consults everyday.
Two comments that I think are important [and may shock the HT community] .. First, Finasteride is pretty effective at lowering DHT, thereby it does take 18 -24 months to really see the full benefit of the medication. Most men will take it for years [which is not a bad thing, considering it is also very effective for maintaining prostate health and lowering your risk for BPH and Prostate Cancer]. Then when and if you do decide to stop taking Finasteride .... Your hair does NOT just fall out! Instead, the DHT will have to build up again [over 18-24 months] before you will then 'start' at that point to have progressive thinning and the hair loss that you may of had many years earlier ... but it will take time and 'start' from the point in which you stop taking the medication.
Secondly, [and I am sure this will get alot of comments], FUE is NOT a new or wonderful or fabulous procedure! I only advise it when my patients have had extensive HRS [usually the old plug method of the 60's & 70's] and therefore have alot of scar tissue and limited donor supply! Then FUE has a good place for HRS. On that note, I feel that ALOT of Doctors & clinics tout the FUE as a 'Scarless Procedure' ... ONLY for 'Marketing' and 'Revenue' for their office!!
FUE is NOT a Scarless procedure .... instead you just have hundreds of small punch holes which WILL leave hundreds of little round scars!!!
Even in the best of hands [i.e. The Surgeon] ... FUE is a BLIND procedure that leads to transected grafts and alot of WASTE of good donor and follicles!
So do not be mis-lead on this point!
FUE does have a place ... and I use it only in very select patients.
FTU [Follicular Transplant Units] are in 'my' opinion ... still the Gold Standard!
I would also add [and I am sure that this will stimulate discuss] ... That the 'New' rage of "Ultra-Refined FTU's" .... Is just a 'finer' type of FTU ... and therefore is again just another marketing tool to stimulate office/clinic revenue!
I can say all of the above, because I have been doing HRS procedures for MANY years and I have pretty much seen it all .... Plus, I am successful enough that I do NOT rely on all the 'B.S.' marketing Hype that unfortunately plagues the field of HRS.
When it [HRS] is done correctly, it can and is a fabulous and life changing procedure .... any of the above [i.e. Ultra-refined FTU, FUE or even FTU's] in the wrong hands can leave the patient wishing they had never done anything at all!!
I see many unfortunate patients everyday ... who now have limited donor, many scars or round FUe punch holes .... still in need of repair work.
I could go on, but enough siad.
Sorry for the long 'rant'
In closing, i would just ask the members of this forum to choose wisely and always look at the Doctors work .... and above all, get educated on all the options.
I hope this puts this matter to rest.
Best Regards, Mark D. Baxa, MD
In hopefully addressing the original question ..... And to just add a friendly comment for Hairdude. I understand your concern about HT verses Finasteride, however as in the 'real-world' of Medicine & Surgery, we do generally try the less invasive techniques first [i.e. for a fracture we place a cast on the broken limb ... before considering just going to the operating room to insert a rod into the cortex of the bone //// In cardiology we prefer medications to control BP or decrease lipids, before angioplasty and placement of a stent ~ or ~ taking the patient into the O.R. to do a open-heart bypass graft].
I understand that this is just dealing with 'hair' ... But I still like to advise my patients on ALL options available and if they are a candidate for medication [i.e. Finasteride], then I will offer it.
However, as you pointed out ... definitely some patients are best just going directly to HRS [Hair Restoration surgery] ... However, I do still like to educate the on all options and create a viable plan for them.
I discuss these facts with my patients and new consults everyday.
Two comments that I think are important [and may shock the HT community] .. First, Finasteride is pretty effective at lowering DHT, thereby it does take 18 -24 months to really see the full benefit of the medication. Most men will take it for years [which is not a bad thing, considering it is also very effective for maintaining prostate health and lowering your risk for BPH and Prostate Cancer]. Then when and if you do decide to stop taking Finasteride .... Your hair does NOT just fall out! Instead, the DHT will have to build up again [over 18-24 months] before you will then 'start' at that point to have progressive thinning and the hair loss that you may of had many years earlier ... but it will take time and 'start' from the point in which you stop taking the medication.
Secondly, [and I am sure this will get alot of comments], FUE is NOT a new or wonderful or fabulous procedure! I only advise it when my patients have had extensive HRS [usually the old plug method of the 60's & 70's] and therefore have alot of scar tissue and limited donor supply! Then FUE has a good place for HRS. On that note, I feel that ALOT of Doctors & clinics tout the FUE as a 'Scarless Procedure' ... ONLY for 'Marketing' and 'Revenue' for their office!!
FUE is NOT a Scarless procedure .... instead you just have hundreds of small punch holes which WILL leave hundreds of little round scars!!!
Even in the best of hands [i.e. The Surgeon] ... FUE is a BLIND procedure that leads to transected grafts and alot of WASTE of good donor and follicles!
So do not be mis-lead on this point!
FUE does have a place ... and I use it only in very select patients.
FTU [Follicular Transplant Units] are in 'my' opinion ... still the Gold Standard!
I would also add [and I am sure that this will stimulate discuss] ... That the 'New' rage of "Ultra-Refined FTU's" .... Is just a 'finer' type of FTU ... and therefore is again just another marketing tool to stimulate office/clinic revenue!
I can say all of the above, because I have been doing HRS procedures for MANY years and I have pretty much seen it all .... Plus, I am successful enough that I do NOT rely on all the 'B.S.' marketing Hype that unfortunately plagues the field of HRS.
When it [HRS] is done correctly, it can and is a fabulous and life changing procedure .... any of the above [i.e. Ultra-refined FTU, FUE or even FTU's] in the wrong hands can leave the patient wishing they had never done anything at all!!
I see many unfortunate patients everyday ... who now have limited donor, many scars or round FUe punch holes .... still in need of repair work.
I could go on, but enough siad.
Sorry for the long 'rant'
In closing, i would just ask the members of this forum to choose wisely and always look at the Doctors work .... and above all, get educated on all the options.
I hope this puts this matter to rest.
Best Regards, Mark D. Baxa, MD
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