I am a Plastic Surgeon in Mumbai with a special interest in Hair restoration. As a protocol I do not transplant a patient of Pattern Hair Loss without a mandatory 8 week treatment with Minoxidil 2% and Finasteride 1mg. The idea is to reduce post op shock loss. I am very keen to know your opinion on pre treatment and whether you use it in your practice.

Thank you

I recommend finasteride 1mg to almost all my male patients before a hair transplant procedure. While I agree it may prevent some degree of shock loss, I do not consider it an absolutely mandatory issue, particularly in the men over 45. Shock loss is more of an issue to a younger patient population with significant miniaturization. Moreover, I try to include my patients in the decision making process, as some patients firmly object to taking any medication. As long as all my patients are well informed of all the risks and benefits associated with a hair transplant procedure (including shock loss) I do not make finasteride a mandatory issue. I do not recommend topical minoxidil routinely in my practice, as I have not seen any clinical benefit with respect to shock loss and surgery. Paradoxically, I often see patients who complain of increased hair loss after starting topical minoxidil.