2 months of difference with estradiol and spiro (4 months total w/ estradiol & spiro; 4 years of minoxidil and finasteride) (you should not take estradiol or spiro if you look manly and want to continue looking manly)

Adding medications that feminize your look, may bring back your hair (as seen here); however, this is an extreme way that should not be used for most men unless they are interested in feminizing their loss.  This patient returned to their juvenile hairline at the expense of possibly other changes, including the possibility of breast development of loss of male libido. 

Unfortunately, this man had a hair transplant surgeon who needed help understanding how the recipient area grafts would be placed in the frontal hairline and behind it.  The surgeon has 100% control of the direction and distribution of the recipient area grafts.  This man has straight hair, which brings out the improperly placed hair even more dramatically. His hair was circularly placed like the spokes of a bicycle.  Even using a thick styling agent, as in this photo, he could not get his hair to look normal.  Hair in the frontal hairline points around a center point in the mid-head in an outward direction, following the direction of bicycle spokes.

In the mature male hairline, all frontal hairs grow parallel to each other and point forward, running parallel to the ground when you look straight ahead.  A change in direction occurs at the ‘part’ where the hair transitions to pointing in the downward direction on the sides of your scalp.  Picking the right surgeon is so important. This look is not easy to live with.  Fixing it requires removing the frontal hairline, repositioning the hair in the correct direction, and then filling out the top area that is still bald. 

For those of you interested in the difference between the mature male hairline and the female hairline, see here:  https://baldingblog.com/female-hairline-transplanted-as-is-should-be-photos/

This diagnosis of Trichotelamania is made with a hand microscope, which shows how the hairs are actually broken as they come out of the scalp. Trichotillomania is an obsessive-compulsive disorder in which a person picks out their hair. As you can see from the patient’s photo, the hair loss is not in a particular known pattern, which alerts the doctor that the diagnosis is not genetic balding.  These cases can be transplanted; however, unless the underlying obsessive disorder is fixed, the patient will pull out the hair-transplanted grafts to the same fate.  I rarely perform surgery on these patients, even when they swear that the picking problem has been solved.  

I started losing my hair at the age of 18 in 2020, as soon as it was noticeable I decided to shave it off with a machine. But last year, in December, I decided to let it grow because I wanted to have it evaluated by a doctor, I let it grow for 4 months. And here is the thing, I realized that my hair was falling out a lot, I was probably losing between 100-200 hairs a day, every time I woke up I could easily see 30 hairs on the pillow, my hair was falling out just by pulling it or passing my hand through my head. I had the appointment and shaved it again, however, I noticed that my hair is no longer falling out and that there is no more hairs on my pillow, so my question is, is it possible for the hair to only fall out when it reaches a certain length? Or is this BS?

Hair has two basic phases for you to recognize.  The first phase is called Anagen, which is the growth phase and starts when a new hair emerges from the scalp.  Usually, for each hair loss, a new one emerges from the scalp. The anagen cycle lasts for different periods of time depending upon age and sex.  Women have longer anagen cycles when they are young. One of my old girlfriends, had hair grow to a length below her waist.  Woman’s anagen cycle can last between 3-7 years on average

I got scheduled for a hair transplant in 8 weeks and prescribed oral minoxidil at the same time (was already on fin). Should I wait to see how the oral min goes before the transplant?

I always like to see the my patients try all of the available medications before I would do a hair transplant on them. Sometimes I am very surprised with the results. The frontal hairlines are usually unresponsive to these medications if your hairline loss is over 5 years old and you are over 25.

The SMP, unfortunately, can be seen from the photo shown but it is a well done job. You should wear your hair slightly longer as you suggested, as it would look better and make the SMP not detectable. It is almost impossible to tell the hair growth you are reverencing because the SMP makes comparisons difficult.