Am I too far gone? Or do you think a HT might be viable for me? Only just started learning about finasteride / minoxidil and plan to start taking them. 31M

At 31, there are things you can try like microneedlng plus finasteride and minoxidil.  Give it 6-9 months and if it doesn’t reverse, then let’s talk practical terms. You have a Class 7 pattern of balding. This is the most advanced pattern. You need to find a doctor who will try medications with you but also establish baselines for your donor supply if, in the future, you want a hair transplant and, therefore, find out if you are a real candidate. 98% of Turkey clinics will do a hair transplant for the money, even greater than 50% of American doctors, but are you a real candidate? That requires evaluating your lifetime donor supply, your donor hair mass calculated on individual hair thicknesses. If your donor area is healthy, I would be happy to help you if you can’t find a local hair expert by emailing me at williamrassman33@gmail.com.

Currently. I’m taking around 0.3mg a day of topical finasteride daily, but wanting to switch back to oral (0.5mgs every other day) as I experienced way better results on the oral finasteride. Should I slowly taper the transition or go cold turkey?

You can stop the topical finasteride and go on the oral immediately with no issues. In fact, oral is always better because it reaches areas that you often miss with the topical.

Yes, as shown in your photo; however, you could do SMP and wipe out the evidence of the hair transplant. You can also cover it with longer hair.

How is this looking so far ? You guys think this was a good transplant? It was done yesterday at QHT clinic in India. Does it looking like 2200 grafts? From my experience i was so nervous but it was totally painless now i am just hoping for good result. Please share your views and help anyhow you can . Any tips you have to get better results are welcome.

It looks good. The spacing and the placement seemed first-class. Unfortunately, you never know what happens behind the scenes until you reach 6 months. I particularly like that the recipient site is free of crusting, which reflects well on the people who did this work and your washing technique. What doctor did you use?

I’m a 31 year old male here. I have been obsessing with getting a transplant for the last 6 months and have read just about everything here on Reddit about it, from the pre/post care, no. of grafts, what to look for in a surgeon, the ugly duckling phase, etc. From my consultation with a few clinics, I am a NW4/5 with a healthy donor area, and approx 4000 grafts will be required for the transplant.

I recently performed a hair transplant on a well-known litigator He went to a trial hearing just 3 days after his FUE hair transplant. We shaved the back of his head and trimmed it to look stylish. The donor site had healed entirely.  He called me immediately after the hearing because he knew that he had worried about going to court. He told me the judge commented: “Nice HAIR-DO you got there!”  He was relieved and then continued on with the hearing.  Many people were in that court hearing, and he managed his appearance well.

If one opts for a transplant, is it still necessary to take Finasteride or any other medication?

Since hair loss is progressive, I generally recommend that a person having a hair transplant stay on this drug for life, provided that they don’t have negative side effects. In addition, the drug has value in reducing the risk of prostate cancer (the # one cancer in men) and also reduces the risk of heart disease by lowering cholesterol and possibly directly impacting atherosclerosis. To get the benefits of finasteride to avoid the shock loss, you should be on it at least 2 weeks prior to the transplant. 

If I apply 0.1% 1 ml solution of topical liposomal finasteride daily. That would mean a dose of about 1mg.
If I apply 0.1% of 2ml solution daily. That would mean a dose of about 2mg. Is this what you mean or would I have to change it to 0.05% to keep with the 1mg dose? I believe you have mentioned that about 5% or 18% of the medicine goes systemic. Which one of these would be the better estimate? 

If you have the time I do have a few more questions:

If my hair loss still regresses, is there a point in increasing the dose? If so, by how much and what would be the limit? Also in your experience how effective is 0.1% for people around my age and does it actually reduce the chances of side effects? 

Finally, although I know they are rare, I wanted to get some clarification on the side effects:

I have mild gynecomastia left over from puberty. Does that make me more likely to get finasteride-induced gynecomastia?

Can long-term use of finasteride cause side effects like infertility? If so, in your experience do these always go away once the mediation is stopped?

1. I only prescribe the Liposomal form of topical liposomal finasteride, not regular topical finasteride, and step-wise, increasing the dose from 0.01% over a year to the 0.1% ideal dose. I don’t know if I agree with your math. From a practical point of view, what I do works.
2. The ideal dose, in my experience, is 0.1%
3.  I have seen rare reports of side effects that can be offset by lowering the dose to 0.01%
4. Juvenile gynecomastia usually doesn’t increase the risk when taking finasteride as an adult or late teen.
5. Finasteride is not known to cause infertility, but there are reorts of reduced sperm count for men on finasteride.
6. Fertility side effects usually go away in a couple of months after stopping the oral finasteride.