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I agree he got a really good result so if he went to a different surgeon maybe he would get a bad result. So if he had a bad result, would it be because of the surgeon’s crappy artistic skills? or the patients hair quality? or is it because of the technicians that plant the follicles? What’s the most common reason why people sometimes get not very good looking transplant?

Surgical failures come in many flavors: (1) the patients not establishing realistic expectations with his surgeon’s communication skills, (2) poor surgical planning (just targeting # of grafts that don’t fit into a patient’s Master Plan, (3) surgeons who do it for the $$ and never learned the art and technique through proper training, (4) over-hyped marketing to set unrealistic expectations on all hair transplant buyers, (5) unskilled surgeon, (6) lack of experience and disciplined team with a focus on quality control, (7) surgeries that last too long leaving the grafts out of the body too long, (8) Grafts that are traumatized at any point from the time they are taken out of the body until they are put back into the recipient site and this includes poor placement of the grafts, (9) poor site making by the surgeon producing hair that points in the wrong direction, (10) Poor post operative protocols resulting in loss of grafts, infection from poor techniques, (11) poor patient selection as patients may have diseases that will kill some or all of the transplanted grafts, or the patient doesn’t have the quality or quantity of hair needed to address the bald area. Bad doctors (there are a few) just care about making money so they do hair transplants because they get paid up-front. For these rotten applies, there is motive to take responsibility for these unfortunate patients.

There are unique problems with FUE including poor harvesting distribution and too much graft damage when grafts are removed. Poor distribution can produce balding in the donor area or necrosis in the donor area (see here: https://baldingblog.com/collection-victim-photos-internet-harvested-depleted-donor-areas/). There are also unique problems with strip surgeries in the hands of inexperienced surgeons including wound problems, nerve damage, bleeding, AV malformations (both FUE and Strip surgeries) and poor planning or improper placement for the location of the strip or taking out too wide a strip to produce increased scarring and even infection and necrosis.

I can write a book about this question, but I will stop here.

Some men just decide that they don’t want to fuss with medications and go for a hair transplant. As you know from my writings here on Reddit, I believe that a man should be over 25-26 before going for a hair transplant because they won’t like surprises like this link shows a man over a 40 year period and his balding: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/

For good hair transplant planning, you need to know where your hair loss pattern is going and if you are willing to take finasteride, it would be likely stable after the hair transplant, depending upon what you and your surgeon decide are reasonable goals.

https://www.webmd.com/skin-problems-and-treatments/hair-loss/what-look-surgeon?ecd=wnl_day_121423&ctr=wnl-day-121423_lead_title&mb=DIjjZuHpe4pLfebJPo6kGpOenxSl%2fWb1cYT6skpYnrs%3d

Humans do not have seasonal shedding of their hair. People keep a constant amount of hair on their head except for their normal daily loss of about 100 hairs/day. Other mammals shed.

I’m 21 years old, and I fear I may be losing hair. About a year and a half ago I noticed that my temples were a little thinner in the corners. Now my hair is getting longer, and there are thinner hairs that hang down at my temples. Also, the shallow edge of the scalp is visible. Am I definitely balding? Is there anything I could do about that, and should I even worry? I checked with that chart, and my hairline looks like an NW2, but even with it getting longer, the temples are somewhat visible. I know people way older than me with a
hairline like this, but if I’m already noticing at 21 (almost 22) that seems like a bad sign right?

Genetic Male Pattern Balding (MPB) can start in the teenage years after puberty. Norwood 2 is not really balding, but if you are noticing other patterns of hair loss, then it may be an early sign. Without an examination, anything is possible.

Will changing dose of finasteride from 1mg to 0.5mg per day reduce the risk of sexual side effects?

Yes, if you have aside effects, reducing the dose to half will reduce the side effects in many men.