Rahil B. Roopani, MD

In determining the best option, it's prudent to have various consultations with BOTH hair restoration surgeons who focus primarily on hair transplant to advance the hairline AND plastic surgeons who focus on scalp advancement procedures. In my experience, many patients who want to lower their hairline may want to reduce forehead size aggressively which may not be suitable via hair transplant. Thus, it's important to be educated on your options before you proceed.

Hello, your hair loss secondary to stopping finasteride is likely due to removing the medication and the resumption of the culprits that lead to hair loss in the first place (in androgenetic alopecia). Unfortunately, getting back on the medication will not quickly reverse the processes that lead to the hair loss in the first place. I believe you should give it more time with the current therapies you are on. We usually recommend 3-6 months of treatment to be able to assess for improvement or worsening. After that point, you can consider alternative and/or additional therapies.

Hello, with prolonged hair shedding, there needs to be a thorough evaluation with possible blood tests to determine what may be causing the hair to shed. I recommend asking your physician if they offer the work up needed to determine the cause before proceeding with your 4th treatment.

Hello, PRP can be a great addition to your hair restoration treatment regimen but unfortunately, it may not work to get you the results you are looking for in your frontal scalp region. You may consider an evaluation for a second procedure (FUE) but I would recommend waiting for a few more months in case there are some hair follicles that were transplanted and not showing up just yet.

Your question is a very good one as far as timing for hair transplant. Unfortunately, there is no clear cut guidance on this without first understanding (through examination) the extent of your current hair loss. The spectrum of a hair transplant can range from conservative to aggressive and therefore, an examination and history should be taken for the physician to determine best prognostication of your hair loss and to create (with you) a comprehensive approach that not only will hold onto your existing hairs and prevent further hair loss but correct any areas of concern through surgery (should you be a good candidate).

Hello, The appearance from the photos you have provided appears to be similar to triangular temporal alopecia. However, the appropriate next step would be to visit a dermatologist to confirm the diagnosis with appropriate dermoscopy exam. Thereafter, the decision could be made to transplant down the line as you are 22 years old and the appearance of your hair will continue to evolve.

Hello,It's difficult to usually tell the candidacy of a prospective patient to undergo hair restoration surgery (FUE or FUT) without examining in person. Furthermore, an up close examination of the hair follicles as well as the overall density helps in making the right choice with the patient as far as treatment plans. Generally speaking, however, we can have an idea of the quality of the donor area (sides and back) through pictures such as those you have posted. That being said, from these posted pictures, it appears that you may not have adequate density currently in the donor area to have optimal results with FUT or FUE. Again, it would be ideal to see a hair restoration surgeon to allow in person examination and discussion of other treatment options (such as potentially scalp micropigmentation).

PRP by nature is a costly procedure, however, if done effectively, it can potentially provide patients great benefit. Generally, the cornerstone of hair restoration has consisted of medical therapy including minoxidil and finasteride (oral and/or topical). The optimal medications, formulations, and route of delivery should be discussed between you and your physician, but using medical therapies should also be considered after hair restoration surgery in order to preserve the existing "native" hairs that were not transplanted. The combination effect of adding PRP to the above (hair loss medications + hair transplant surgery) can have the additive effect of strengthening existing native hairs. That being said, PRP like all other hair loss remedies aside from hair transplant surgery, must be continued to gain the benefit as it is not a one-time solution. This is where it can get tricky for patients as there is no wide consensus on optimal frequency of injections during the first year of PRP treatment. Make sure that your provider is experienced with and well-versed in the evidence for PRP for best outcomes for you. Hope this helps educate/guide you in your hair restoration journey!

Hello, You could be a candidate for FUT or FUE which would allow grafts to be obtained quite easily that could then be transplanted in the hairline to "soften" the current hairline and to provide more density. Additionally, upon examination in-person, a decision with your hair restoration surgeon could be made to remove some of the existing hairs in the hairline as well should it be necessary. An in-office assessment is the first step during which you are provided education to empower your decision-making for the ideal treatment moving forward.

Unfortunately, there is no wide consensus on scalp PRP injections for hair loss in regards to frequency of sessions due to lack of landmark studies researching this topic. However, some institutions have created recommendations that may offer most hair loss patients a general timeline/frequency of sessions during the first year and subsequent years where the outcome may be optimal. This should be discussed with your specialist to optimize your outcome. As with most remedies/solutions for hair loss, the therapy should be continued in order to have the ongoing benefit of the hair loss treatment otherwise the hair loss may resume. Additionally, when choosing the right physician for this, make sure they are comfortable and experienced with scalp PRP injections as the depth of injections, frequency, and overall understanding of hair loss pathology is very important.