We had planned for 4700 MHT (FUT +FUE) for this patient where in 1500 grafts were planned by FUE & 3200 by FUT.

Sometimes in FUT, we get more than the planned number. We got 3200 grafts through FUT in this case, all of which were implanted.

You can see that both the front and the crown areas were covered in a single session. This was possible only because of the combination technique.

Only FUE surgery wouldn’t  have given us these many grafts. Most of such cases which  you see on the internet as 5000-6000 FUE only are  boosted by finasteride 1 mg per day as these many FUE grafts can’t be extracted through this technique from the scalp’s safe donor zone.

We hope you understand the fact that FUE gives us the option to cherry pick follicular units with more hair. This means more hair per graft as compared to FUT, which doesn’t give us this option.

So 2000 FUE grafts may have close to 5000+ hair, while the same number of 2000 FUT grafts might give a patient just 3000 hair.

That explains why the result of FUT & FUE should not be compared in terms of the number of grafts. And this also means the patient who has undergone FUT has more multi-grafts left in his or her donor bank for future use.

This result is without Finasteride. The patient was put on Hair-art kit (nutritional supplement) & Minoxidil 5% three times a week.

No doubt, adding finasteride would have further improved the result by improving the thickness of miniaturized hair in the recipient zone and would have given a more aesthetic look to the hairline as it grows a lot of softer hair in the hairline.

But we respect the patient’s discretion about taking the medicine or not and medicines can always be added later if there is significant progression of AGA.

All the effects of finasteride are credited to the hair transplant surgeon & hair transplant surgeons happily take the credit for the work which finasteride is doing. This not only misleads the patient  but also other people who are interested in transplant. They can overestimate the results of that particular clinic and expect the same from them.

Finasteride works on five aspects of hair transplant:

1. Area coverage: Improves hair even in those areas where no hair is implanted as miniaturized hair gets thicker.
2. Density: Improves miniaturized hair in transplanted zone as well adding a great deal to the density.
3. Hairline Aesthetics: Improving the thickness of miniaturized hair in the hairline zone gives it a more aesthetic look as it grows a lot of softer hair.
4. Thickness of donor hair: It improves significantly with finasteride.This is more obvious in thin donor zones in the lower and upper parts of donor area. It creates a false impression in the mind of the patient who thinks that the donor area is still looking good even after extraction when actually it is almost gone or very much thinned out.
5. Thickness of transplanted hair: It is important to note that even the transplanted hair becomes thicker when finasteride is given at high dosage. The effect of medicine on the thickness of transplanted hair is directly proportional to the dose of medicine. This again may create a false image of a wonderful hair transplant result, which actually might be very ordinary.

People who are happily giving testimonials to the clinics, don’t even know that these results are not going to stay long  & premature use of the resources like the donor and finasteride can hit their long term prospects badly.

Finasteride can have issues of dependence & tolerance as well. Patients who once start taking it, can’t stop it & if stopped, it leads to severe rebound hair loss. Even if somebody keeps taking the medicine, finasteride may stop working on his hair after one point of time because of tolerance. There can be issues of potential side effects like erectile dysfunction, loss of libido or gynaecomastia.

So, it is important to not start finasteride from day one in all the patients as this may not be in the interest of the patients. But yes, clinics are definitely benefited because of prescribing finasteride.

As soon as the patient stops the medicine, there will be severe hair loss & it is not justified to put the patient on risks of medicines for your photo opportunity. If needed at all, finasteride can be added later on at low dosage.