I just read this super friendly discussion about whether or not you need to take finasteride after a hair transplant and I’m kinda curious about who’s in the right.

Finasteride will prevent the loss of native hair that has miniaturized after a hair transplant. Without it, you run the risk of loss of your miniaturized hair.

Alopecia Areata is a disabling disease for those afflicted.  A new treatment is now going through clinical trails. Read about it here:  https://www.nejm.org/doi/full/10.1056/NEJMoa2110343

From digging around various hair forums it’s clear there is a generally negative feeling towards PRP as a treatment for MPB. From my limited knowledge on the area though it’s seems like this stems from unrealistic expectations around it regrowing lots of hair. Pretty much every study I can find on it reports statistically significant positive effects in terms of growth and density. Neither may be enough to make a different aesthetically but if at the very least it maintains then it seems like a pretty solid (though expensive) treatment option.

The studies all use fairly limited numbers of participants (< 50) and only really cover up to 2 year time frames but results are pretty consistent.

Am I missing something or is this a legit option for people who want to maintain but don’t handle the DHT blockers well?

PRP is thought by experts, like me, to have little value for genetic hair loss other than the microneedling that goes along with it.

Can these be excised and replanted? I’ve got some singles at the front of my hairline but the hairs are maldirected and the hairline is too low. Can I repair this? Will I have scars at the front of my hairline? My hairs seem to turn radially along with my hairline instead of pointing forward. This isn’t normal, right? It seems like things should just be more forward pointing instead of radially pointing.

Can any well trained, experienced hair tech remove them with a manual punch and redesign my hairline? I know this is a hard problem to fix, I’m looking for advice

A skilled surgeon can use the FUE technique to remove recipient site grafts when they are positioned improperly.  Radially placement of grafts is far too common.  When I train doctors, I have to drive the point that hair is not like a bicycle wheel with the center being the top of the head.  Hair between the parts are parallel to each other and point forward almost horizontal in the very front of the hairline.

This is the poor man’s treatment routine for hair loss

These dots are so large, they can be seen even behind the hairline, but when placed at the leading edge of the hairline, they are awful and strikingly obvious.

Anybody considering a hair transplant must have a Personalized Master Plan because balding is progressive. You must know your donor supply, your hair mass index and these two factors will tell you a great deal about your ability to keep up with the balding and not run out of hairs to move around. A good doctor who cares more about you then your money is critical to this entire process.