Have followed the forum for years and wanted to share my experience in particular with subcutaneous fat loss and plastic surgery.
Took fin about 10 years ago for two years. Had sexual sides while on it, but never after and I never had the PFS “crash,” so I know I am extremely lucky compared to many on this forum. I stopped (at age 22) because i began struggling with physical stress-like symptoms that I would later spend years trying to control (poor sleep, constant feeling of stress, need to clench my fists, no relief from exercise, poor focus, trying to improve cortisol levels/HPA axis imbalance).
I really noticed during the second year or taking it that my face looked different, and while no one ever seemed willing to confirm what I was saying, I felt the my cheeks had fallen or I looked older. Looking back at pictures, changed definitely occurred while I was on the drug - my smile was not the same, I looked tired around my eyes. For the following 8 years after stopping, it never came back. I think I slowly continued down this path of volume loss, perhaps at the normal rate starting from where I left off after propecia, or perhaps at an accelerated rate. Last year (age 30) I felt I looked so old and tired, I started investigating options.
I ended up meeting with a leading plastic surgeon in the field of fat grafting, who has written many respected articles on aging and fat grafting. He (and the other doctors I met with) all remarked that I had lot of tissue volume loss in my mid face, but somehow not around my lower face as much. It was a unique pattern of facial volume loss that he could only theorize occurred perhaps because I had an umbilical cord wrapped around my face as an embryo. But showing him pictures of myself when I was 20 (before fin) he was really surprised and said he had not heard of a rapid aging or degenerative condition like this.
I decided to go ahead and do the fat transfer (despite the high price, it was a priority for me). During the surgery, the doctor discovered that the tissue and bone loss was even worse than he thought. There was virtually no tissue at all present. He had to graft 70 ML of fat — the amount he said he would typically use for someone in their 60s or 70s undergoing this procedure.
The recovery took months. The doctor was completely shocked by the level of swelling that occurred, saying he had not seen fat grafting heal like that in 40 years in the field. Finally, the swelling went down. Now, I sort of have the facial volume similar to what I did before taking fin 10 years ago. My skin has also improved a little in terms of thickness. Who knows if it will last! Its definitely a major improvement.
The Dr.’s main take away from my long recovery was that I had no vascular system in my cheeks - that it had effectively dried up - and that the fat grafting took a long time to heal because it basically had to regenerate the entire system of vascularity. Perhaps damage to the vascular system is the mechanism behind this side effect of Propecia? I’m not a medical expert and hesitate to theorize too much.
I share all this not to suggest everyone should go spend thousands of dollars on plastic surgery. Moreso just to share that a leading plastic surgery confirmed that my facial fat loss was real and unprecedented for someone my age and in the pattern it occurred in his significant experience.
Happy to discuss further or chat of PM.