Recession1

I just went to 2 different hair transplant doctors for consultations. Both of them put on their high power glasses and told me that I don’t have any miniaturization in my donor, crown, or midscalp. I have seen more hair shedding lately and when I feel my hair it just feels thinner and more limp than a couple years ago. When I look at individual hairs they look thinner than they once were. Are those high power glasses really that effective at spotting miniaturization or do they not tell the whole story? The only other thing I can think of is that i just don’t have the hair thickness I once did since I’m 35 now. Anybody have any insight on this?

One last question… let’s say I go in and they say i am NW 6 diffuse. Do you think I’m still okay to to do frontal third transplant… or is that risky and I should wait until I have further loss and get a little older… say around 40.

You don’t think I have a some diffuse thinning when my hair is wet here?

Melvin, I’m not saying leave a hole behind the hairline. Let’s say you have 6,000 grafts available. Why not put 4000 to the front of your head and start with the hairline you want and then put the remaining 2000 grafts in the back half coupled with body hair if you can. Create solid front and then transition to thinning crown. My surgeon who you guys speak very highly of spoke to me about this. I expressed concerns of going to NW 6. He told me to be aggressive out of the gate where I want my hairline and then as I age and if I lose my crown I will have great front half transitioning into thinning back. It seems like a lot of guys have very conservative hairlines and then they just distribute grafts all over the head and never get good coverage and with that approach I think it looks better shaved than having a straggly thin transplant. Just my opinion!! Also as far as age of going to NW 6… while it seems most people reach NW 6 before 30 it definitely still is fairly common after 30. For example my dad was around NW 3-4 at 38 years old and went to NW 6 by the time he hit 45. I think many people have miniaturization in a NW 6 pattern even at 30-35 that don’t notice it and then in the next 10 years it gone. Also, without meds I would probably be NW 6 by now. I have been on finasteride since 24 and now take 2.5 oral Dutasteride and 5mg oral monxidil daily. I think that has stabilized my loss but I still have had some thinning in areas and my hair isn’t as dense as it was 2 years ago. It just looks dense because it’s long now. I personally think genetics eventually over powers meds… I think with meds you are slowing process… and just “kicking the can down the road”… that’s why I always find it very odd that people say wait to get transplant until stabilization… it’s never stable unless you are 60.

My dad is NW 6 and his dad is a NW 6 I may develop that pattern one day. You think I really have that many grafts available?

How many grafts do you think I have available?

How many grafts do you think I will need? I am thinking about filling in the corners and then reinforcing the frontal lock since there appears to be some miniaturization. I’m 35 and on oral minoxidil and 2.5mg Dutasteride.

I have always been confused on strategy for nw 6 transplant patients. Let’s say someone has 6,000 grafts to work with. It seems like most guys try to spread grafts and coverage out all over the top of the head and in my opinion are left with wispy thin results and they would look better if they just shaved their head instead. Why wouldn’t one get aggressive with the hairline and dense pack at the hairline and create great coverage of 4,000 grafts in the front half and then just use 2,000 grafts towards the crown to give a thinning crown look. In your late 30s onwards it would look much better to have a really solid hairline with great density in the front half and just a thinning crown as opposed to sparse hair everywhere. Everybody says to go conservative on hairline but in my opinion I would rather have aggressive hairline and dense front half as this is what frames your face. Anybody agree or look at this differently.

Are my thoughts correct on this? So I am planning to get fue procedure to restore frontal 3rd and recession. I am planning on taking 6 months of work off because I don’t want people to know I had it done as I can cover my hair loss. Obviously the hairline in the first 6 months exposes the most as far as having work done appearing obvious. Regarding future loss… let’s say I need work done in my mid scalp or crown if I took off a couple weeks to avoid being in public due to scabs it wouldn’t be as obvious other than having to shave my head. Is this correct in saying that your first initial procedure for hairline is the most obvious and then after than it’s less obvious?

I am going to have to disagree with you guys on this one. I agree the goal of hair transplant is to have coverage and would rather grow it out and have full coverage, but there are some men who lose their front and keep crown and some men loose crown and keep front. If you look at Melvins last procedure even with his head shaved all the way down right before transplant his transplanted frontal third frames his face and looks great head on. He looks better with transplanted stubble rather than no hair to frame his face. Just my opinion.

To you guys that have had transplants… let’s say you are a NW 3 and get frontal 3rd reinforced. Do you guys feel relieved or are you constantly worried and have anxiety about further progression of hair loss even though you are on hair meds?

I’m going to quit wearing you out here but how about transplanting all the grafts you have available to give the illusion of hair and then getting smp done in the crown around your existing transplanted hairs to give the illusion of a buzzed head density? I think smp has its place but I think getting a transplant to the frontal third looks way more natural buzzed than smp alone at the hairline.

But what if time and money was no object to you and you were simply making your decision off of cosmetic look?

Melvin, I’m actually impressed of how natural and dense your frontal third looks buzzed down… if you had a buzzed head I wouldn’t think you had a hair transplant I would just think you had some diffuse thinning. Let me ask you this… let’s say you were going to buzz your head the rest of your life… would you rather have the current hairline and situation you have now or do you think it would look better clean buzzed with no transplanted hair?

I don’t think that is an example of how it would look. That guy hasn’t had a transplant.

Mark, I completely agree with all of that. It is very tempting to not go with lower hairline especially when one of the top surgeons in the world draws it that low and recommends It based on my current hairloss situation, age, and meds. I have seen some cases from him where he has taken only 2,500-3000 grafts and restored their whole frontal third that was completely gone with great density. I guess my goal is to get through my 30s and 40s with a great hairline and good density and then can live with coverage of the mid and crown an even have a thinning but coverage look transitioning to the back. With the surgeon saying I have 8,000 grafts available I can easily accomplish that. While the lower hairline is tempting I think you are right about taking the more conservative approach.

I have heard most guys have aggressive hairloss in their 20s. The concerning thing for me is that I started medication at age 23 at the first signs of hairloss… so have I just postponed hairloss and kicked the can down the road so to speak? Would I be a NW 6 right now without medication? Hard telling…. That is the confusing thing with medication…most hair surgeons tell me that I am in great shape and can aggressive with hairline transplant based off of age and minor loss but maybe genetically my hairloss will now kick in and overpower medication and I will go to NW 6. That is the confusing part of hair loss and the risky part of surgery.

I agree that he has put this off for a long time… but is interesting his last claim said “he is going to shock the world” in 2026. Sounds interesting to make that claim… not saying it will happen. Melvin, you don’t think there will be better treatments such as GT2009 or Scube 3 or any of the other treatments in the pipeline? Looks like there is promise by 2030 there will be at least better treatments… not saying full blown cure but improvements in the field. Seems there is more excitement in the field than there has ever been.

What do you guys think the chances are I develop into a NW 6 someday? I know I have a lot of hair but it seems to be thinner than it was and my dad is NW 6. Im 35 and am on 2.5mg daily Dutasteride and 5mg oral minoxidil.

I don’t think it looks like dupa either. Donor hair is weird to me… I went to arguably the top surgeon in the world and I too was worried about my donor. Mine looks similar to yours when short. I had my hair grown out and the surgeon couldn’t get over how strong my donor was and that I had 8,000 grafts available. Yours might even look better than mine when it’s short. You may have some retrograde but many men do. I would think you would be fine but I’m not an expert.

Roughly 8 months from the time I contacted him…. But cancellations or somebody postponing surgery always comes up so chance to get in sooner.

Oral minoxidil is way more effective than topical and many prominent doctors have made that known. The percentage of oral minoxidil responders are also way higher than topical. I can speak from my experience…. I have used topical since I was 24…. I am 35 now and switched to oral 1 year ago. My hair now grows longer and thicker than ever. It also grows really fast. Another thing people don’t talk about is your donor hair. Not many people are applying topical monoxidil to their donor hair…. After 6 months on oral minoxidil my donor hair on the back and sides thickened up like crazy. There is no doubt oral minoxidil is more effective than topical. I also have many friends who started on oral minoxidil than were on topical and it is night and day difference. There are even some surgeons saying that oral minoxidil is better than finasteride… two different mechanisms but as far as hair growth oral minoxidil is better

I think when it comes to hair loss you don’t have tons of time to sit around and wait… I wish I would have gotten on Dutasteride right from the beginning. I took finasteride beginning at age 24 and it slowed loss in the front but never stopped it. I continued to slowly lose ground over the last decade. I am now 35 and have been on oral Dutasteride almost 2 years and it has stopped shedding. Everybody worries about side effects but I have had none… and I’m on a heavy dose. I take 2.5mg oral Dutasteride daily…. Thats right I pop 5 of the .5mg pills a day… it might seem excessive but studies show the 2.5mg was significantly more effective in hair count so I know I am giving myself the best chance of keeping hair before it’s too late. Just my opinion but obviously consult with your doctor.

So I started as probably a NW 2… I noticed I had just a little bit of frontal thinning but nothing major but definitely the early signs of hair loss at age 23. Jumped on finasteride and topical minoxidil. It stopped shedding and a little thickening…. That held things at bay all the way to 28 then it was just slow loss from there until 33 but only recession points. I noticed the last 2 years some minor thinning nothing noticeable to others all over the top my head jumped on oral minox and Dutasteride 2.5mg a day and in the last year to 2 definitely thickened up hair and made it grow fast. In my opinion Dutasteride is the best for keeping things at bay but I think it was the oral minoxidil that made the noticeable difference. Even in my donor it has thickened hairs.

It’s always hard to know what to do… with my current hair state at 35 years old and meds what do you think the chances of developing NW 6 are?