My first FUE but one doctor thinks I should not get it done!

[giannaj]

Hi all, First post on this forum! After weeks of researching FUE I decided to take the plunge and have the procedure performed abroad. I researched the doctors on this and other forums extensively. I ended up contacting four doctors for an online consultation which included me sending them photographs of my scalp and explaining my finasteride sides.

My story is as follows I am now 40 years old. I stated losing my hair at around 30 years of age. For the past 6 years I have been using minoxidil. The first two years of using minoxidil I was blown away with results and so was my doctor but the monoxidil effect have dwindled. Four years ago I was also put on finasteride by a hair and skin specialist in Melbourne. Unfortunately I suffered from side effects like erectile dysfunction. My scalp also responded very well to finasteride just like it did to minoxidil. I discontinued finasteride due to its sides.

Back to my point and question. All four doctors replied to my questions relatively fast and I explained my side effects to all the doctors. They all suggested 4000-4500 grafts which I have no problem with at all except for one doctor.

One doctor’s reply particularly caught my attention. Please see reply below.

Dr ********* thinks that to do a hair transplantation will not help you, because you will keep losing your hair, and without finasteride we can’t help you. you will lose the upper area and only the transplanted area will be left. and you will not be satisfied. That’s why Dr ******* does not want to do your Surgery. He doesn't want you to be unhappy with the result.

Im just after some opinions and I realize that most of you guys are not doctors or physicians but it would be good to get some first-hand experience from members who has gone through the same process and have been in the same situations as me with . I have included a few pictures of my scalp. What do you all think?

[Luca]

Hi mate,

Even I read somewhere that hair transplantation is only a valid option for small balding areas. Although FUE allows physicians to extract grafts from a larger area of the donor region, it also allows for extraction from areas outside the “universal safe zone.” These hairs may not be not be immune to the effects of genetic hair loss and may be lost over time.
Nobody has enough transplantable hair to restore a full head of hair on a bald scalp. It is also important to note that the hairline only stops receding around the age of 50-60. Anybody who has a transplant before that age is likely to find their hairline receding further behind the transplanted area. Hair transplant surgery can be a worthwhile solution for thinning hair or small bald areas.

Not to discourage you, but I feel you should understand pros and cons of this surgery before making a choice.

[J_B_Davis]

Whoever that doctor is should be commended. Taking a look at your current balding pattern, unless you are able to control further loss, you’ll most likely need a couple of more hair transplants in the future. It’s also possible that you could have shockloss that might not grow back without being on Proepcia so at the end of the day you could be out a lot of money and be unhappy with the results. If you do decide to have a transplant you need to use your donor hair wisely, so you probably should not go near the crown and save all of those grafts for the front and mid scalp if needed.

[AnnaM11]

I think it also depends on surgeons skill to evaluate the angle, direction and depth of the graft he is about to extract. Some surgeons do this better than others. No one can predict how low the crown loss will be so I feel it is warranted to mention that as a potential disadvantage. May be you need more sessions like if someone needs 5,000 grafts, then it would be done in 2 sessions with a 12 month wait in between.

[giannaj]

I have decided to give Propecia another try for at least 6 months. What's the normal dosage 1mg per day?

[Notcoolanymore]

Dr ********* thinks that to do a hair transplantation will not help you, because you will keep losing your hair, and without finasteride we can’t help you. you will lose the upper area and only the transplanted area will be left. and you will not be satisfied.

I agree with this 100%

[asianguy]

Wow, I wish I had went to that doctor before I had my first surgery! He is telling the truth! I'm not on meds and can see the thinning that has happened through 2 surgeries.. If I had known meds were required for life I wouldn't have gotten a surgery at all.

[gillenator]

giannaj,

Probably what supports that doctor's opinion is that he sees you headed to an advanced Norwood class such as class 7 as it shows in your photos. And as was mentioned, none of us in the upper classes of MPB have enough scalp donor to provide complete visual coverage. But here's the thing:

It depends on whether or not you are willing to compromise some of the coverage. For example, if you are willing to leave the crown alone for now, you probably have enough donor to provide decent restoration for the frontal third zone. And it also depends on the density of that proposed coverage. If are willing to go less dense as measured in FU per cm2, then you will be able to utilize your grafts to a broader area of coverage. It also depends on where the commencement of a new hairline would be situated.

My only other concern for you is that it appears that you may have some DUPA going on in your donor areas. DUPA is Diffused Unpattern Alopecia. I blew up some of the pics to make some distinction between the grey hair and the diffused hair patterns.

That's the difficult thing with photos, it's hard to tell for sure without using the proper instrumentation to calculate hair shaft diameter and the differences (+/-) in the hair shafts. But if you do have some DUPA, then that hair is DHT receptive and would be lost sometime in the future if used for grafts. It is possible to use instrumentation like a scope to see where there is miniaturization going on.

[giannaj]

Thanks for all the replies everyone. I have stated taking fenestride (Propecia) and take 1mg tablet every other day. One 1mg tablet a day gave me side effects last time I used Fenestride. The doctor thinks every other day may be fine with me. I will be taking photos of my head every month to see if it has made any difference. I'm not expecting miracles and not expecting to see much in 6 months either but If I have not thinned further then I’ll be happy.

Gillenator thanks for having a detailed look and I agree with most of what you said. The pictures are probably a little hard to make out just how thick my lower hair is. It's extremely thick and very dense in all donor areas. On the sides you mentioned it may look like I may have DUPA, I don't have DUPA at all its a bad haircut by me. I clipped my own hair this time around and it didn't turn out the way I wanted it to turn out. I will let my hair grow out now and I will update every few weeks with pics. Please also note my hair in those pictures was clipped with a .5 clipper guard and is extremely short.

I also should of mentioned I seemed to have lost a lot more hair over past 6 months than usual. Two things changed In my routine 6 months ago and accelerated the hair loss dramatically.

I have been using Rogain monoxidile for around 6 years now but 6 months ago I changed the brand from Rogain to Kirkland. I bought a year’s supply of Kirkland at one time online from a US company on eBay. I also changed my shampoo from head and shoulders to REVITA Shampoo. These two changes in 6 month shed more hair than I had lost in the last 6 years combined. I remember sitting at my desk at work and seeing hair on my keyboard. This was not right and I couldn’t figure why all of a sudden I was shedding so much. The Kirkland did absolutely nothing in six months what so ever, infact it made my hair thinner and grow a lot slower. My partner mentioned since I started using Kirkland even the surrounding hair next to my hair that's falling out stopped growing at the rate that it use to grow to as well. The Kirkland also did not feel like the rogain did after I applied it and it had dried. I think I may have been duped!

I really thought I had my hair loss under control or at least slowed down but as mentioned above obviously not. Over the past 3 weeks I changed back to Rogain, started using my old shampoo again plus Nizoral twice a week and my hair seems to be growing faster than it did on the Kirkland. It’s not really thickening up but it growing at a much faster rate which I like. I also have no hair on my keyboard anymore too!

I am determined to fix my hair, I look a lot older than I actually am and I don’t like it. So fenestride, Rogain and Nizoral will be my routine for the next six months then I’ll contact the doctor that gave me the truthful advice above and see if he will do a 5000 graft FUE transplant.

[gillenator]

Well thank goodness it was just the haircut and not DUPA...

Wish you the best in your journey!