Hello hair restoration community! I've been looking at this site for a few days and some of you all's posts have really encouraged me, to the point where I think my next best step might be to get a hair transplant. I have a ton of questions about the process though, and I also wondered if you could take a look at my photos and my hair loss and help me with what to expect a bit. Actually my most burning question is am I even well-positioned, i.e. is my thinning too bad given my potential donor area? If so, what compromises could I make?
As a bit of background, I am a fresh 24 year old, which I know is a bit young, but unfortunately I've been battling this for a little while now. I noticed some recession June/July of '21 so I started taking finasteride that October or November. My hairline was definitely receded then and my top had thinned, but it was workable, and I was ok with where it was at as I didn't notice any thinning of the crown or back-top (although I do now looking back at the pictures). The finasteride was holding me steady, though I didn't see any regrowth. However, spring 22 I was not able to get back for a follow up appointment so I started taking it more intermittently. I got a prescription again this May, and took it regularly until July when I moved abroad and haven't been able to get finasteride until a few days ago. I've been on topical Minoxidil for a little over two weeks now, but my balding has accelerated very rapidly to the point where I really could use some corrective action beyond just these tools in the not too distant future.
Ideally, I would love to aim for February or March to get a transplant, as that would give me 6 or so months on the Minoxidil and Finasteride for my balding to stabilize a bit, and to allow for some potential regrowth. However, I wonder if realistically I should wait until next summer.
I know 24 is quite young, but unfortunately having the hair that I do it deceived even me into thinking there was more than there was. It is just miniaturizing and thinning so fast now, and it is of noticeably poorer quality than it was even just a month or two ago. I didn't realize quite how bad it had gotten, but it is driving me to the edge just watching it all evacuate. Thankfully, I never experienced side effects from finasteride, so taking it for essentially the rest of my life doesn't bother me, though I would not mind swapping out topical min for oral min.
So here are my questions for you all:
1. First of all, the basics that everyone asks: how many grafts do you think I would need, and would it even work in my case? I acknowledge that I won't be able to get to my original thickness, but I would love to have a hairline, repopulate the obviously thinned areas, and just in general feel some dimension/fluffiness on top again. Looking back on my older pictures, I have always had a decently high hairline, and my hair has never even been that thick to begin with so I don't need anything super crazy. My concern is that my back and sides are too thin. It has always been a bit cowlick-y, especially on my right side, so I don't know that it's quite as thin as the pictures may show (these are not great images, so if you need better lighting conditions feel free to let me know and I would be happy to provide them.
2. Are there any particularly gifted curly hair practitioners in the US or Anglosphere? I would love if I could do this without completely shaving my head, but I acknowledge that might be a tougher ask. My family is based in the Southeastern US, and I live in Japan right now, but I'm not super confident that even the most gifted surgeons in this part of the world would be completely familiar with how to best deal with my hair type. I would love if you have recommendations for someone in the Southeast US but this isn't a must. I won't completely rule out somewhere like Turkey since I know some of you all have great results, but would prefer if I could do it without travelling too far/too unfamiliar a place as I would be better positioned for any follow-up that might be necessary. I'm not ruling anywhere out, as I have heard you all praise doctors like Bisanga and Mwamba in Belgium, but I would love to know if anyone has some first hand experience elsewhere.
If it helps, I am willing to pay a little more to stay stateside/NA.
3. If I need multiple sessions, what are the logistics of this? My hope is that I could do it just in one, since I would need to take off of work and travel so far, but I fear that I might need more than one and I wondered if you all had any experience with this - what was the timeline between sessions? For anyone who went to somewhere really far away, did you have to go back after a few months? And as far as follow-up appointments go, how does that work? Do places usually offer online sessions?
4. Also, I'm not totally sure about the consultation process... Once again, being in Japan I worry that many doctors here or in South Korea would not be familiar enough with my hair type to quote me properly. Is it a good idea to get a consultation/quote and then go to another doctor? Basically, as with everyone, I'm trying to minimize trips abroad, but I don't really want to fly somewhere and feel like I can't walk away if I don't like their treatment plan. Alternatively, I will be visiting the states in December, and places like Anderson Center for Hair Restoration in Atlanta are within driving distance - could I go for a consultation then, and then come back a few months later for the actual procedure? I apologize that these are kind of silly questions, and I'm sure they often depend on the individual office, but if anyone has experience I would love to hear it. Researching all of this has been a bit overwhelming.
5. Realistically, is there any chance that most doctors would even let someone this young do a transplant? I've seen some cases here and on Reddit that would suggest so, and I am already committed to finasteride and minoxidil and am willing to put in the work to stabilize my hair loss for the best long-term results. I am afraid that I would be given the advice just to wait and see what the finasteride/minoxidil does, even though I haven't witnessed any regrowth when I was on finasteride consistently in the past. I just think I worry that it is hard given my hair type to determine the extent of the hair loss, and I am afraid I would be turned away.
I'm sorry this is such a long post, but if you've gotten this far, thank you so much for reading and for your help. I'm a bit timid about this whole process, but even knowing that this is potentially an option brings me a comfort that I can't even describe, to the point where I really think that this could my best option in the near future. It's so nice to have an encouraging community here, and I appreciate any insight you all can offer!
Thanks!
Here are the pictures. Like I said, my hair is quite fluffy so it can be hard to tell, and I think that's why it took me so long to detect any balding.
1. Hairline on the right. This has taken a drastic hit
2. Hairline on the left. This has been even more noticeable and rapid within the past two months
3-4. Back and back/top. I know you can see this same "crack" in the back in older photos, but I don't sleep on my back anymore like I used to and still the thinning miniaturization is getting bad
5. Top. It feels terrible but I didn't realize how terrible it looked. I would especially love some more density at the front, but I would love to be able to part it and feel some fluff again instead of committing all resources to go to the front
6. The whole top. It's hard to see, but the front is considerably miniaturizing and I'm left with a tuft that has been shedding like crazy these past few days. Hopefully that's the minoxidil doing it's job but I worry still.
My potential donor sites (Not great photographs, and my hair has clumped together like this quite a bit for a while now)
7. The right
8. The left
9-10. The back (Really hard to photograph so let me know if you need a better idea - I'm a bit unwashed at the moment so my curls are clumping together)
For reference, this is what I used to look like, and what I would like to get close to
11. 2019. Note that I used to part it on the cowlicky side, so my hairline looks really high, but regardless I generally have showed a decent amount of forehead as I've grown it out.
12. 2020. It's looking especially luxuriant lol but note that the hairline is still quite high, its just that the curls there are a lot fuller. All this is to say, my hairline goals are not that unrealistic I don't think.
13. 2021: This is me on finasteride, with a little bit of thinning in the crown. I had had this bald spot for a while, and I usually sleep on my back, so I wasn't particularly concerned at the time. I would be perfectly fine with having some version of this, i.e. I don't need the back that densely packed.