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I would like to have your advice on hair transplant without finasteride do you think hair transplant are relevant with patients who don’t want to take finasteride at all ? Because i have seen people report that without finasteride even the transplanted hair are getting hit by dht and the result after ~10/15 years are not esthetics do you have case to share with us ?

Yes, you can have hair transplants without taking finasteride. The problem is two fold: (1) if you are in your 20s, the risk of shock loss (loss of miniaturized native hair) is higher than if you are over 30, less even over 35 or 40, (2) you might get to your final hair loss pattern earlier which means that your hair transplant treatments may come in a shorter time-frame. As the transplanted hair are protected against DHT, you don’t have to worry about them falling out.

As a clinical scientist, I am not clear about your results. I would suspect that if there is a change and you have been on finasteride for a long time until you switch to dutasteride 1 month ago, that the benefits you see are related mostly to the finasteride and not either the dutasteride or the spirinolactone. This is important information for the readers, listening to an expert address your results. I wish you had comparable pictures because the longer hair makes a huge difference in the appearance, and although it does look like there is hair where there was none before, the results may not be as dramatic as you may think they are.

My progress over the past year. Still thin in spots, but overall I am happy. from tressless

My hair, black and white picture, which has receded in similar pattern to the colour picture attached. It’s styled so the front is swept to the side and I think highlights my receded hair line, Norwood 2/3, or at least doesn’t make it look good.

I want to keep my hairstyle natural looking while making the hairline look as good as possible. for example I don’t want to push my hair forward just to cover the hairline. Has anyone been in a similar position have any styling tips or ways they get their haircut at the hairdresser’s to make their hair look good without changing the style too much?

That is a good positioning of a mature hairline design, something I have been creating for over 30 years with hair transplants. This is a realistic hairline. The number of grafts to create this hairline would be 1200 if your hair was coarse, 1500 if your hair was medium, and 1800 if your hair was fine.

Why I Decided To Have A Hair Transplant MY RESULTS! from tressless

I will tell you what I think. The design of the hairline is terrible, the multiple V-shaped protrusions of the hairline is absolutely abnormal. In addition, the crusting is terrible and the patient was never instructed on how to take care of his hair transplant after the surgery. Imagine, walking around looking like this?

How did the doctor decide to do such a transplant? The answer is that they did not want to make a straight hairline and maybe he did not know how to do this. This saw-tooth hairline is most certainly as bad as a straight hairline. A feathered hairline is what you see in a non-transplanted person. Just look at any woman or man’s hairline and you will see that there is no such thing as a hairline, just a place where a bare forehead transitions into hair with a “no-hairline hairline”. Below is an example of just one of over 15,000 surgeries we have done creating feathering hairlines. As you can see, this man (below) does not have a hairline at all, just a feathered transition from his forehead to a full head of hair.

(NOT NHI patient)

In telogen phase, hairs fall out, and they don’t get thinner when they regrow. Over a period of months, the body seems to turn on a switch that starts the anagen cycle again, and hair regrows. The telogen may last up to 6 months in some people, but the length of the telogen cycle varies by age, sex, and the health of the hair. Miniaturized hairs, in those who are balding or thinning, tend to have longer telogen cycle. They appear at the end of the anagen phase with a longer sleep period and often come in miniaturized.

The following summary seems to address this issue: https://onlinelibrary.wiley.com/doi/pdf/10.2164/jandrol.109.009381. The conclusion written by the drug company (Merck) is as follows:

In summary, a 1-mg dose of finasteride does not appear to adversely affect spermatogenesis. In addition, the level present in the ejaculate of patients taking 1 mg appears to be negligible. Thus, there does not appear to be any need to stop 1 mg of finasteride in those patients trying to conceive or in those whose partners are pregnant.