In his case, we planned 4500 grafts through MHT (FUT +FUE) out of which, 1500 grafts were planned by FUE and remaining by FUT.

In FUT, sometimes we get more than the expected number of grafts like in this case we extracted 3350 grafts instead of the expected 3000. 

FUE alone would not have given us the required no of grafts needed to cover both the front and the crown region.

Most of such cases that you see on internet which claim to have transplanted 5000-6000 grafts by FUE alone (which is not possible) are in actuality boosted by finasteride 1 mg per day. 

There is a basic fact that FUE gives us the option to cherry pick multi grafts(More than one hair per graft), while FUT doesn’t have this option. So 2000 FUE grafts can even have close to 5000+ hair, while same number of 2000 FUT grafts might give a patient just 3000 hair. That means the result of FUT & FUE should not be compared in terms of number of grafts. And this also means that by adding FUT we are in a way saving the multi grafts for future use.

Thus this case is the testimony to our advocated theory that not every patient needs finasteride, which is blindly prescribed to every single hair transplant case as a blanket therapy. As we know the medicine can have side effects &therefore should not be bombarded on every patient just to hide the inferior surgical work & fake number of promised grafts. Sometimes this medicine is proving beneficial for the clinic more than you. People find these results impressive when in reality this is just the work done by the medicine. So here the hair transplant surgeon happily takes credit for the work which finasteride is doing. This can also mislead other patients opting for transplant by setting unrealistic expectations which can only be fulfilled by finasteride and not transplant alone.

In our case, the result is without Finasteride as the patient was put on Hair-art kit (nutritional supplement) &topical Minoxidil 5% three times a week. Even after 6 years into hair transplant, he is maintaining his hair pretty well. No doubt adding finasteride would have boosted the results much more significantly by improving the thickness of miniaturised hair & would have given a more aesthetic look to the hairline, but it would not have done any good to the patient in the long term.

As finasteride works on all the three aspects of hair transplant:

• Area coverage: Improves hair even in those areas where no hair are implanted as miniaturised hair get thicker.
• Density: Improves miniaturised hair in transplanted zone as well adding a great deal to the density.
• Hairline Aesthetics: Gives more aesthetic look to hairline as it grows a lot of softer hair in the hairline.

People who are happily giving testimonials to such clinics, are unaware that these results are temporary& over & premature use of the resources like donor and finasteride can adversely hit their long term prospects.

Finasteride can have issues of dependence & tolerance as well. Once patient starts taking it, he becomes dependent and with time tolerant as well to this drug. Besides there can be issues of potential side effects like erectile dysfunction, loss of libido or gynaecomastia.

So it is not mandatory to start finasteride from day one to all the patients, instead its use should be customised. But the clinics are definitely benefitted by finasteride use.

As soon as the patient stops the medicine, there will be severe hairloss. Poor patients don’t know all this & are easily influenced by finasteride boosted results, taking them as real hair transplant results. 

It is not justified to put the patient on risks of medicines for your photo opportunity. If needed at all, finasteride can be easily added later on at low dosage.