So before downvoting this please read and try to get on my perspective.I am 19 and balding pretty badly, I have two older brothers (30 and 32), both of them have good hairline. my father is 60 years old and bald but he was nowhere near bald when he was in my age. From my moms side uncles aren’t bald, only matured hairline. So technically I am the most unlucky one in the entire family? or is it because Ive been masturbating ever since I was 12? well I was doing this almost daily for about 8 years. I remember 2 months ago when I stopped doing it for 8 days my hair loss stopped completely (believe me or not) then I relapsed and slowly I started to lose hair again. I strongly believe elevated level of DHT in my body and overall hormonal imbalance is caused by over masturbating. but its too late to recover now. now I am on finasteride.

Masturbating has nothing to do with hair loss, just hormones and genes.

From my understanding hair that falls out due to shock loss usually grows back (in the recipient area) unless the hair is weak and almost ready to not grow again (which is usually right next to the area of transplantation) . So my question is since you can remove hair follicles could you remove the thin wispy hairs and replace with dht resistant ones so if shock loss occurs it will grow back and not ruin the success of the transplant?

If shock loss occurs and you are under 30, the hair that is lost if miniaturized, will not usually come back. I say 30, because the older you are, the less likely that shock loss will impact your hair. If you are under 25 (I don’t usually perform surgeries on men under 25), the shock loss is worse and the lost hair with a hair transplant is almost always permanent. The use of finasteride, often thwarts this process. When I perform a hair transplant, I look at where I place the DHT resistant hairs, many times in the areas where advanced miniaturization is present, especially in the younger men.

Amazing results from this combination. I suspect it was mostly the minoxidil.

I don’t understand your argument William. its better to have hair in your twenties, so what if the graft run out. then you at least have a hairline established which makes a lot of difference. what’s the alternative? just go bald and don’t do anything., not a good alternative

The issue is complex. Men at 19-22 frequently don’t have the maturity (it is a development problem of the prefrontal lobe of the brain which does not complete its development until about 22 for men), plus there is a sense of urgency in young men (the now generation), plus there are significant financial implications of having multiple hair transplants over a very short time-frame. I always say a Good Decision Today, is a Good Decision Tomorrow. I am not insulting you here, just trust that I have years of experience in this business and I have seen too many young men make terrible mistakes that they regret too soon after they make them.

I was hoping you could answer my question. How many of your patients who are on finasteride have experienced permanent side effects (PFS)? I am not on fin, but am seriously considering it, except the possibility of permanent side effects are obviously not reassuring. Thanks for your time.

My group has probably written over 10,000 prescriptions for finasteride since it came on the market. I had no cases of PFS during that timeframe. I had one patient who called me 2 hours after his first dose while driving in heavy traffic and told me he was impotent. I told him to immediately stop taking the medication because I knew he would have problems with it. Driving in traffic and impotent? mmm. He refused to stop the finasteride and eventually claimed he had PFS. He was an anomaly because I always tell my patients who develop sexual side effects who can’t make them go away by cutting the dose in half, to stop the medications. Of course, this man refused to stop the medications even though I told him to do so and he ended up getting the renewed prescription for finasteride from someone else, not me. I firmly believe that the key to not getting PFS is to stop finasteride as soon as you get the first sign of sexual dysfunction. I am sure that this statement will cause considerable comments from others who read this post.

I had SMP done locally in the UK. My expectation was that there would be clearly resolved dots on the fue scars. DO you consider this an adequate result, otherwise I will need to have it done elsewhere. 
I’ve had to date 5 sessions with the same artist to date, last session completed last month.  After each session the smp dots seem to fade out completely;  I cannot see any clear black dots whatsoever on my scars. 
It does appear that something is wrong. The inks used did disappear as you suggested. Are they (1) using permanent ink? and (2) do they know what they are doing?  On rare occasions, even the permanent inks may disappear after the first session, but the operator should then modify what he/she is doing so that it doesn’t happen again. You are the best judge of the results and if you can’t see it, then it is not there

This patient had an FUE and lost all of the donor area hair on one side of his head most likely from shock loss. This is often caused by the over-use of epinephrine in the anesthetics.  After 5 months, much of this hair came back.  Interesting case. I suspect that the FUE grafts numbers may have been very high plus the surgeon may have increased the amount of epinephrine for the anesthesia. In combination, these two factors could produce such an unusual case of shock loss.  Lucky man, probably frightened surgeon.

complication of FUEReversed_complication of FUE

This patient has 4500 grafts 10 months earlier. It is clear that the central part of the transplant did not grow as well as other areas. This central part has the greatest problem with regard to vascular supply so I suspect that there was some compromise of the vascular supply to this area.  He will not probably get any more growth.

4500 grafts 10 month ago

This was clearly done by someone who didn’t know what they were doing.  I feel sorry for the patient who is a victim of the person who did this, probably a non-physician


Dutasteride worked here but I suspect that finasteride would have worked just as well.

I continue to post these photos to show that many men get good responses from minoxidil and finasteride

4 months on finasteride and minoxidil show a very responsive hair loss pattern in this man with generalized thinning in a Class 6 pattern of balding.

Ive noticed that the hair on the back of my head is slightly thicker than the rest, at first I thought this was balding but I recently saw a picture of me when I was 11 and it looks like the hair on the back of my head is thicker than the hair on the top, is it possible that my hair has always been different densites on different parts of the scalp, or is that not possible?

Yes and no. Each person has a particular average donor density, but often on the sides above the ear, the density is lower. When a person starts balding, hair densities will fall in varying areas of the head, so to command this process I do a HAIRCHECK test ( ) to help me put measurements to hair bulk in different parts of the head, often not seen with my eyes but the men who come to me somehow know that this is happening. This test either confirms or denies their suspicions.

Photos show a substantial change. I would expect much more benefit by the end of one year on treatment.