calvinmd

This one hits close to home. It's not that far off my own situation at all. 28andbalding: If you're never gonna want a buzzed-down head, no matter what? Then there really isn't a "starting too early" problem. It's only a matter of being too aggressive with the early HT work. You can get a lot or a little, but you've got nothing to lose (at least from the decent HT docs) if you won't ever consider the shave-down. You're gonna get a certain amount of hair loss that continues to worsen independently of whatever HT work you have done. In that sense, it really doesn't matter whether you get the transplants done at 28 or 48. . . . But that's IF you were going to seek out exactly the same density & hairline regardless of the age you had those HTs. The potential trouble comes when you start estimating how aggressive you can be about the transplanted hairline & density at a relatively young age. Just don't over-reach at the density & temples at 28. Your current hair loss severity & pattern is irrelevant to the overall HT plan. The eventual FINAL loss severity & pattern is what the decisions have to be built around. You're especially safe with good FUE work, if money's no object. Even a medium-short buzz down is usually still an option after the first few thousand grafts. -------------------------------------------------

I honestly don't think that younger HTs are THAT terrible in theory, but in practice they seem to be. For the sake of argument, imagine this plan: Wait to hit 21-22 years old. Get a NW#2-2.5 hairline transplanted, of maybe half-original density, and no messing with the crown at all yet. Now, unless your donor REALLY sucks and/or you're doing a true NW#7 pattern, it seems like it's pretty hard for this plan to burn you very badly. (Maybe you could eventually still regret the decision to get HTs at all, but that's not quite the same issue as just planning a decent HT.) But it's hard to recommend this to youg guys, becuase they seem to want the lo-o-ow hairline and filled temples all the time. When you're not already paying a lot of attention to hairlines, it's hard to convey how/why this extra centimeter of difference here & there will make such a big impact on the appearance & results decades later on. ------------------------------------------------

I think something is being overlooked here: Does anyone really think that Finasteride is still gonna be the only real MPB treatment decades from now? I don't, and I'm pretty pessimistic about the timeframes of medical advancements in general. With the advice to the younger guys to "skip the HTs, take the Fin," I don't think we're necessarily pointing them at a lifetime of Finasteride, so much as a few years of it. Maybe 5-10 years, but probably not 25 years. And dropping Fin may not be great for your hair, but I'll take a few years of Fin usage (assuming a gradual tapering-down upon quitting) over no Fin usage at all. I really think that a college kid starting Finasteride for loss prevention right now is gonna have other options (that actually work well) by the time they hit 35. Maybe even a little earlier. ------------------------------------------------

Craven, You're not the only one who feels like they've fouled-up their lives way beyond what the lack of hair is worth. Me too. Probably so for most of us on this board, at least to some extent if not as far as it sounds like you've gone. I'm gonna break from the rest of the pack here, and caution you not to get your expectations out of control for this surgery. You don't sound like anybody's fool or anything, but pictures can be very misleading and HTs generally look a little different in person than they do in photos. Sometimes the difference is minor, but other times the difference is night & day. 3000 grafts is a significant number of grafts and it'll make a major cosmetic difference when it's grown out. The doctor you picked has a good & honest rep. It all sounds like a valid plan. And at 36 years old with a NW#5, you're in a pretty good spot to get this work done without facing nasty hair-loss surprises in the future. You're not done balding at 36, but you're balding very predictably by now. I do wanna point out that most of the NW#5 guys aren't permanently content with 3000 grafts. 3K is a good start and it'll completely satisfy a lot of NW#3 guys, but in your case I suspect that you'll probably wanna go back for another HT surgery after this one is finished healing & grown-out thick. (Give it at least a year or so from the first HT surgery.) I don't think you'll be dissatisfied with the 3000 grafts, but I do think you'll be thrilled at every new hair sprouting and you'll want to go back for as much hair as your finances & donor areas can give you. Just something to be aware of. ------------------------------------------------

I inherited depression from both parents. I inherited acne-prone skin. I inherited a deviated septum in my nose that's taken $8,000 in surgery so far and it's not done yet. I inherited a set of teeth that took around $100,000 worth of orthodontic work & major jaw surgery before I was 16 years old just to straighten them out. Male pattern baldness? Man, just put it on the list. At least the MPB one will probably be more treatable than some of the others by the time it's relevant to them. --------------------------------------------------

Agreed. POWERANGER: It's not what you want to hear, but unfortunately hair loss ALWAYS gets worse for the rest of your life once it starts. The only question is how much worse and how quickly or slowly will it happen. The hair transplant industry is a VERY risky place. It has had some success stories, but it has also left TONS of dissatisfied men with heads in worse shape than if they'd never gotten a hair transplant at all. And the damage cannot ever be reversed with any plastic surgery methods currently known. You're just screwed for life in these cases. It's not a matter of throwing more money at it. (Ever wonder why Donald Trump wears his hair so weird? His scalp is butchered with some bad hair surgery back in the '80s, and his awful combover is done to try and hide it. Not even Trump can buy his way out of a bad hair transplant decision earlier in life.) The reason everyone on here is steering you away from going ahead with a Bosley HT is because you sound like you're headed for the same common mistake that has been happening for decades. This mistake makes the "hair mills" a lot of money at the expense of the patient. It can leave the patient anywhere from dissatisfied to downright disfigured. The earlier your hair loss shows itself, the more significant it will probably be over the course of your life. There's only a finite amount of hair that you can ever get transplanted or else the back/sides will be too thin to hide the scars. If you use up all that "donor hair" too early in life (before you know just how much of your head will eventually need transplanted hair on it). then you're screwed. You could end up with a ton of thick hair in the front of your head and a bald head behind it! And what's worst of all? Well, once you get your first hair transplant, you can't ever shave your head down buzzed/bald again. The HT scars will show if you do. So if you get an unsatisfactory job of hair transplants and decide "Screw it, I give up, I'm just gonna abandon the hair and do the Bruce Willis look" . . . you can't! The back of your head is embarrassingly scarred-up for life, even though the transplants may not have turned out well enough to be worth it! You just have to keep wearing that "horseshoe" of non-balding hair on the back/sides for the rest of your life, even though you'd probably look a lot cooler with it all buzzed off. This is why everyone is telling you to be so cautious about getting any hair transplants. It's truly a "one way street" that you can't change your mind about. Your head is scarred after the first one whether you eventually come to regret it or not. At age 21, it's too early to really predict how extensive your "balding area" will eventually become as you get older. (It's pretty hard to judge this issue before you're 26-30 years old. Even then, waiting until 35 years old is still a lot safer.) And without that knowledge, it's hard to pick out the correct hairline that is safe enough to leave plenty of donor hair for your later hair loss that hasn't happened yet. ----------------------------------------------------

There's a wide disparity of what you "need" because a lot of it is an opinion. There isn't a firm-set number that makes everyone look good or bad. HTs are virtually never a one-time thing, especially if you get your first HT before you're at least 40-50 years old. It's not about how many grafts you need right now, it's about what you will eventually need during the rest of your lifetime as your hair loss progresses for decades. So you're most likely biting off a big chunk of money & surgeries if you begin the HT process. And there's no turning back & shaving your head if you change your mind later. The costs of a 1000-1500 graft difference this time around should not be a deal-breaker for your wallet. If it is, then maybe you're not in a position to get into having HTs yet. ------------------------------------------------

I think part of the reason that we're not hearing about the donor-thinning problems is because the calendar years haven't added up yet. Even with HT surgery that was done way back in the 1970s, it's only been maybe 35 years since the surgery. A guy with an agressive balding problem who got HT work done back then in his 20's (and donor thinning was not taken into account because he was so young) would still barely be pushing 60 yet. So even though we're already several decades into the hair transplant age, this growing problem still may not have really shown its hand yet. ------------------------------------------------

As I understand it, Dr. Feller has developed the opinion that strip procedures are a better idea in most cases, even though he's one of the world's best at doing FUE work when he actually does it. There are a fair number of people in the HT community who might disagree with Dr. Feller's opinion on this issue, although Feller's skills at either type of HT method are not in question. It's up to each patient to consult with several good HT doctors and then come to their own decision. ------------------------------------------------

I saw this thread over a day ago now, and I'm still getting more sickened every time I look at the pics or think about it. This MPB problem . . . what the hell kind of situation are we all really in? People paying to basically get "scalped" alive & sewn back together in patchwork, all in an attempt to reverse the appearance of hair loss? I still don't question society's emphasis on appearance & hair, but I guess I wish more of the respected medical/research community would get exposed to cases like this. The sin of having MPB makes otherwise ordinary/healthy young men willing to pay thousands of dollars to do this stuff to themselves, whether the medical world wants to view MPB as a "serious" problem or not. As much as I don't wish more pain on the guy in the pics, maybe we'd all be better off if cases like these got more public exposure. It's disgusting that a doctor accepted money from a patient to do this to them, and he's not in prison for it. The guy in the pics actually paid money for that surgery in an attempt to IMPROVE his scalp's appearance, and then a certified doctor proceeded to do that to his head on purpose. Regardless of what happens from here, decades from now the guy in the pics will probably still be saying (only to a few of those closest to him) that this surgery ruined his life. Doing that to people, knowingly, misleading-ly, repeatedly, to take their money, should have legal/criminal consequences. We all know that having elective cosmetic surgery involves accepting a certain amount of risk, and in many cases patient expectations can exceed the limitations of medical treatment. But don't we, as a legal system & medical world, have to draw the line SOMEWHERE? This particular case is miles beyond that line no matter where you wanna draw it. I mean, what's next? If Bosley started advertising on college campuses that they can turn NW#7s into NW#2s with a simple outpatient "skull reduction" surgery, would there be no repercussions either? Where does it end? ------------------------------------------------

I can't believe there isn't some type of legal/criminal precedent for anyone doing these kinds of procedures. Or at least maybe for any doctor who's still doing them within the last decade or something. I understand it's not illegal to perform elective cosmetic surgery procedures which may be of questionable benefit if that's what the patient deisres. But these flap jobs are categorically gonna give results so far different from what is always being promised by the docs . . . it should be criminal. ------------------------------------------------

Scalp flaps? Man, oh man . . . Run, do not walk, away from any HT place offering those surgeries as hair loss treatments. If you're not already be disfigured when you go in for a "flap" precedure, then you probably will be when you leave. --------------------------------------------------

I wonder whether this study also says something (negative) about using py-zinc as well? That thinning rate for the py-zinc users sounds a little sharp. And at least in the summary above, the testers were referred to as having dandruff symptoms, but they weren't specifically referred to as MPB sufferers. --------------------------------------------------

For all intents & purposes, the best HT docs can re-create "original density." They might not technically do the number you had at 15 years old, but they can usually get 70-90% of the way there these days if you give them two or three surgeries to accomplish it. It wouldn't look "see-thru" at all, and it wouldn't feel noticeably different from how it originally was either. The lack of donor hair is the entire holdup. They can give you all the hair back in the lost areas, but virtually nobody has the donor hair to do it unless they've only lost a VERY small amount of hair to begin with. ------------------------------------------------

Before MPB really kicked in, I probably couldn't even have picked out my own hairline out of a lineup. I (and the rest of the world) was just looking at my gorgeous HAIR. I say SCREW the tiny differences between a natural 90/cm hairline and a transplanted 90/cm hairline. Just get something visually-resembling your hair's orignal density back, get something visually-resembling a normal-looking hairline, and get on with your life. I guarantee you that nothing else will matter or even be noticed as long as that "fake" hairline is growing awesome real hair out of it. No offense to anyone in particular, but some of these hairline discussions make me wonder if the entire HT community is a little body-dysmorphic. -----------------------------------------------

The answer to the question is already out there on the heads of thousands of HT patients who didn't stop getting HTs until they ran out of donor grafts. See how many 15K patients you can find. Armani's been doing FUE long enough to have produced them by now, and there's PLENTY of men out there with the cash to actually pursue Dr.A's limits. Wanna hear a train of thought that makes Armani REALLY seem full of sh*t? Okay, Dr.A insists that 10-15K is "average," right? Well, then it stands to reason that there's a few "above average" patients out there to have established that bell-curve with . . . So this means that, for all intents & purposes, Armani is claiming to have at least encountered some men out there whom he feels have WELL IN EXCESS OF 15K GRAFTS harvestable! (Hell, anything resembling a normal bell-curve would indicate at least a few 20-25K candidates out there when you're wearing Dr.A's fuzzy glasses!) Armani's donor-size estimates are fraudulent. Prosecutably so. There's no other way to view the situation. ------------------------------------------------

Either get HTs or do a shaved-down look, but you won't be able to do both. Once the HTs have started, the shaved-down look ceases to be a possibility ever again. If you get enough hair moved (with HTs) to make any kind of cosmetic difference, then the scars in the back and "cobblestoning" in the front will be too much to show later on. It's mainly the strip-scar that rules out the shaved head, but even the FUE-only cases are still usually not gonna be able to do the shiny-head look. (With FUE, they're getting away with a short buzz but not a full shave.) The whole HT process is a numbers game: Look at how much of your head is gonna be bald (eventually, not just right now). Then try to imagine how thin the rest of your hair would have to get in order to cover up all that area. ------------------------------------------------

-- There are thousands & thousands of doctors who perform HTs in North America. But the number of doctors who actually do good work is barely enough to fill a baseball dugout. -- The skills of the doctor are not correlated to the amount of advertising they do. Not at all. If the doc/clinic is on an infomercial, that usually means you should run away. Fast. -- Don't let travel be a factor. If you won't spend an extra $700 to get some plane tickets & hotel rooms, then you're not ready to do this surgery. -- Money is always gonna be a factor, but be wary about how much of a factor you let it become. Repairing/improving a bad HT later on will cost you a hell of a lot more than you probably saved on the original doc. It's much better to wait several years until you can afford decent HT work than it is to start with a cheapo job to "cover the bases" in the meantime. .

I think that the best younger HT cutoff ages for people result from a combination of factors. You need both of these things, but a little more of one can compensate for a little less of the other: -- You need a certain amount of raw calendar years of age. -- You need to be showing a clear & specific loss pattern to predict with. I really think it's safe to say, blanket-statement, that HTs when you can barely buy a beer are bad decisions. If you're not 23-24 then FORGET IT for a while. Age 25-30 is only beginning to be "safe" at all for most of us. And a NW#3 loss pattern (especially at a young age) isn't enough unless you're beyond age 30 or so. It's often an early pattern to see, but not the "final" pattern that will show itself. In your 20s, you will know a lot more once the top/back has begun to show something. ------------------------------------------------

Fr3dr1k, I point out my case to a lot of younger noobs on here who are trying to predict their future hair loss: My father has kept all his hair from high school to his 60s, my uncles all seem to be keeping their hair at similar ages, both my grandfathers died as NW#2s in their 70s/80s . . . and yet I'm visibly losing hair at 28. Without drug intervention, I would probably be a shiny-head NW#5a by age 40 or so. Genetics ARE NOT everything. It's good that you're willing to wait. Unfortunately 19 years old is just too young to tell anything yet. -------------------------------------------------

You're not the only one thinking about this stuff. Right now, I'm also at the "tipping point" . . . If I take action and get HTs soon, I'll get away without showing any major MPB to the world. But If I wait another 3-5 years, the MPB will have gotten too obvious to hide and I will be known as a HT patient. I'm just gonna risk showing the MPB and wait on the HTs for a while longer. I may not wait all the way until there's a better breakthrough available to the public before getting HTs. But I will probably go ahead & wait at least until the MPB community gets some pretty strong evidence that it will happen soon (and work right & safely). Right now they're working on a bunch of things, but I personally don't think any of them (including HM) is close enough not to fail yet. ------------------------------------------------

-- Strip method is cheaper. Literally half the price a lot of the time. Once you're talking multiple HTs for a major MPB problem, this may be the differnce between spending the price of a truck or the price of a cheap house. -- FUE leaves "thinning" in the donor area that may actually be harder to hide once a person has had several surgeries & a lot of grafts have been removed. But strip-style surgeries close the hole being created, and there isn't such an obvious thinning in the back in most cases. The strip-scar needs to be hidden of course, but modern surgeons are getting them pretty damn small/smooth these days. -- When taking into account the fact that the donor strip is actually removed & the hole is closed, FUE may ultimately leave you with with more total scar tissue present in the back of your head. Either way, most surgeons seem to think that doing a combination of both strip & FUE surgeries on a person will ultimately harvest the most possible hairs from the back & sides. -------------------------------------------------

thanatopsys_awry: Finasteride will defintely work for about 5-8 years. After that, Merck didn't do any studies and some of the actual users are reporting a dropoff in benefits. This stuff is buying you some time, but not stopping time. You're not the only one who is so drastically affected by the hair loss. But IMHO it's really necessary that you "come to grips" with the fact that your hair loss will be a part of your life for the forseeable future. It's great that you're not rushing out into a Bosley office the second day you notice some thinning. But that doesn't mean you are automatically being realistic about this just because a better doc has agreed to work on you. I'm just saying this stuff because you sound like you have such a feeling that you will be able to "get rid" of this problem soon. Good doc or bad, NW#2 or NW#7 . . . if you're dealing with cosmetically-noticeable hair loss at age 21, then you won't ever get MPB out of your life with the existing technology. I just think you don't sound very ready to buckle up & begin the process of dealing with permanent hair loss problems. HTs will hide some of the loss but they won't cure it. ------------------------------------------------

Agreed. Get generic Proscar pills, and hack them up into four pieces. It's a major-league price reduction. --------------------------------------------------

Two comments: -- I'm not saying that NW#2 at 26 is bad. I'm just saying that getting HTs for a sub-#2 appearance seems iffy at 26 years old. Getting a NW#2 hairline can look pretty natural even with some thinning showing later on. But if you're down in the NW#1 range, you look pretty weird with ANY signs of baldness showing later on in life. Getting a NW#1 at any age is really "swinging for the fence," so doing it at 26 seems risky to me. -- "As far as future surgery, I'm hoping that propecia will halt any further loss and I won't need work." Bad assumption. I'm not just being generally conservative again, I'm actually going off a lot of long-term users on this. Search the net, and you find lots of complaints that finasteride can begin losing its effectiveness after only 4-7 years. And even though this doesn't always happen, there are also a fair number of complaints that Fin's side effects are still worsening several years into usage. Fin is a good drug to have in the MPB arsenal, but I sure wouldn't bet on it to hold my MPB at any given point. It seems to be only a slowdown of MPB for several years, rather than a true stoppage. ------------------------------------------------