June 2021 vs. today (11.2.2022), 1.5 years on 1mg fin every day, Niz 3x per week, and 1 month on 2.5mg oral min every day.
Nice improvement. Stay on your routine and it will only get better. It may take another full year to see more value of what you are doing and it is even more likely that it will get better if you add weekly microneedling to your routine. If this is not enough and you are over 25, then a hair transplant will give you a normal hairline, something to consider.
Your donor area appears over-harvested especially because I see that the doctor went out of the permanent zone, into your neck hair which is not permanent and above the permanent zone on the right side. The area itself, looks like the density has been significantly depleted. Time will tell as you allow the donor hair to grow out.
This patient had 4,500 FUE grafts and you can see in the photo the difference between the donor area, which is a bit too high, and the normal hair density on the neck side of the photo. The surgery depleted the donor hair significantly. This is caused by either (1) very fine hair or (2) a low original donor density (something that the doctor can measure in advance).
2020-09-21 03:20:182020-09-15 09:04:124500 FUE grafts, has see-through donor area
You have a Class 3 Vertex pattern of hair loss which means that you are losing frontal hair and crown hair. At your age, I would suspect that if you lose more hair, it will not be very dramatic. You could try the drug finasteride (requires a doctor write a prescription for it) or you can transplant it. Transplants will work well for someone of your age and probably you will be stable so after a hair transplant you will just look like you never lost any hair
I gave him two choices of hairlines and he selected the lower one and that is what he got.
This is truly an amazing response to finasteride. This rarely occurs in men over 28 but is more common in men under 25.
Hi Dr. Rassman,
I find your blog to be incredibly informative and helpful to those with concerns after their hair transplants. I decided to undergo a transplant exactly 5 months ago as preventative maintenance. 1,700 grafts to fill-in the thinning top portion of my head. I still have hair on my head, but under direct light you could visibly see through to my scalp. I followed my doctor’s instructions and had no major issues after the surgery.
At 5 months, the incision scar is still pink and I have occasional pimples on the top of my head (with what seems to be a noticeable increase in grease on my head). Also, after the surgery I had shock fallout. But it seems that ever since my surgery for the last five months my shedding has been consistently increased. Not just from the top of my head, but all over (sides and back). I have yet to see any growth from the grafts. But I have noticed white streaks in my hair. I have pitch black hair, and there are now random strips of white developing throughout my hair (I had never had white hair before the surgery). Is it possible that the shock of surgery would cause some of my hairs to begin to turn white?
And I’m also concerned at this point that my grafts will not grow in and that I will continue to get thinner and thinner since my fallout has increased. Thank you for your input and advice.
In my practice, we never recommend a hair transplant surgery for “preventive maintenance”, mainly because most patients would not likely see much of a result as they continue to bald and run the risk of being worse off. There is also a good possibility that the surgically induced hair loss might make it look worse, something we call “shock loss”.
If you are really losing hair on the sides, maybe something else is going on like diffuse unpatterned alopecia (DUPA). Shock loss doesn’t usually cause hair to fall out from the back and sides of the head. White hair does appear with stress on some people, but I really do not understand the cause. It sounds like you need a good doctor to talk with and be examined by. Perhaps the surgeon that did your transplant would be a place to start.
In general it takes about 6 to 8 months before you can see results and I tell my patients that most people can see 80% of the impact from a hair transplant in 8 months. You should notice growth beginning about now and see improvement in the next 3 months. If you are young and had the transplant without taking the drug finasteride, and assuming that your preventive hair transplants were not really needed, then you will most likely not have as much hair as you did before the transplant (based upon what you are saying here). Hopefully though, over the next 3 months you’ll see some gains.
I recently turned 46, and I’ve been damn lucky with my hair. Around 5 years ago, I wanted to change my hairstyle to go more forward, rather than back. I was 41. I noticed that when styled more toward my forehead, my hair looked a little stringy. I initially thought it was just a bad haircut. Upon closer inspection, the individual hairs/follicles appeared to have gotten thinner at the front of my hairline. Probably further back as well, but I have enough coverage that it’s harder to notice. There has also been some recession of my hairline (maybe a quarter of an inch), although not much, and happening extremely slowly. It’s difficult to tell a significant difference in photos from 5 years ago to today. The top of my head/crown is still full; no bald spot at all, just the cowlick I’ve had since I was a kid. At 46, does this just sound like normal aging, or is there something to be concerned about?
The things to try would include (1) oral minoxidil, (2) oral finasteride, and (3) microneedling. If these don’t work, then at 46, a hair transplant is the best option, and it will work, provided that you get a competent doctor. Your hair loss is likely to have been present for more than 5 years. The combination of all three drugs should be tried first unless you decide on a hair transplant, which is no fuss and with a good doctor, and best of all, there is no uncertainty.
I have been on finasteride but still encountering recession in my hairline in terms of miniaturization. But i noticed that my hair fall has actually decreased, so is the fin working or…? Was wondering am i really having Androgenetic alopecia
Yes, it is working but possibly not well on your hairline.
