End of the day I have realised that I have to do something about this now. I can't keep walking around and not feeling confident because of my hair, having it on my mind all day long, waking up with anxiety, and even having it affect my social life.
Believe me I have tried to just get over it, but I have not been able to. This all started about six years ago, and I am sure that I would feel exactly the same in another six years if I don't do anything about it. So instead of walking around and feeling sorry for myself I have decided to do something about it.
As it is, it seems the two viable options are a hair transplant or a hair piece. I have been in contact with the clinic of a surgeon recommended by this site, and they basically said that if hair loss is affecting my life then it is reasonable to proceed with a transplant. They did recommend strip, as it would give the best results and FUE causes diffuse thinning in the donor area which is not something good when it comes to possible future transplants. And also with the use of a-cell I have heard that the strip scarring is usually minimal.
They did recommend about 2500 grafts which should restore me to a NW2-vertex, which is something I would be happy with. I believe if I stay on my regimen then it is reasonable to believe that I would not suffer from excessive thinning over the next few years.
I realise that this would probably not give me perfect density back, but I am hoping that it will be enough to make it look okay on it's own and possibly really good with some dermmatch/toppik in it.
The clinic has also said that the results would not look unnatural even if some further thinning would occur, it would just look thinner but that at least I wont be completely bald.
Worst case scenario that I can see is if the transplant would be too thin in a few years time, I could always go for scalp pigmentation, which I have seen in real life and it is really a very effective treatment to cover scars - making them almost invisible. And because I don't want this to be a discussion about scalp pigmentation I will just say this: There are good scalp pigmentation clinics out there that do look very natural, especially if there is still some hair left on the head (like if one has had a transplant) and that are also 100 % reversible. As I said I have also seen them and I think they are definately very realistic as long as it is not used to create a new hairline where there is no hair.
And this would be my last resort - which I hopefully would not have to go to if finasteride kept it's effectivness and then in a few years we'll have new treatments like histogen, A-cell hair duplication (formerly known as autocloning), hair multiplication etc.
The other option is to wear a hair piece, but naturally I would be much happier if I was able to keep my own hair. And also it feels like I would give up on the hair I still have left, and I would not be able to use my laser helmet or minoxidil on it. Which might keep stalling the hair loss untill better treatments come out.
So I'm still asking from input from all you guys with a lot of experience. I believe that I have realistic expectations. I realise that this is not a one-stop cure, but I will have to stay on medication and might need an additional transplant in a few years time. I also realise that it is important to pick the right surgeon. I am not comfortable with having thin hair, and feel like I do have to do something about it. Would it still be stupid to get a transplant at my age and with my degree of hair loss?