Is this a good HT strategy?

[Boondock]

So I'm not thinking of a HT in the near future (certainly not in the next year or so). But I want to work out and research everything as far in advance as possible. I thought I'd post my ideas on here to see if they make any sort of sense.

 

Current facts:

- 23 years old

- NW 2.5 hair loss

- Experienced sides on finasteride despite two attempts

- Now on topical regimen with hopes of at least significantly slowing loss

 

The above should make everything count against me, but the one good thing on my side is genetics. Nobody in my family is bald. On my mother's side, people retain full heads of hair into their 80s. On my father's side (where I no doubt got my hair genes), people lose fairly early and stop at NW4 or NW5. Even my 80-year-old grandfather on that side would not be called "bald", and my father and uncle (despite being NW3 and NW5 respectively), never went the whole hog into horseshoe-land.

 

Anyway, my plan at the moment is to get a relatively modest FUE transplant in perhaps two years (c. 2000 grafts). This would bring my hairline forward, and make a real difference, without being too aggressive.

 

I would hope to retain this for some time with my topical regimen (which seems to be working), but as a fall-back I would be willing to undergo additional procedure(s) in the future to retain modest coverage, perhaps in tandem with concealers. If I do not end up beyond NW5 or so, this should be doable.

 

In the worst-case scenario that my regimen completely fails and I become the one person in this family to hit NW7, I would either a) remove the grafts, micropigment the scars, go bald and deal with it, or b) go the hair system route. I'm OK with both of these as a backup.

 

Does this make any sense? I know people advise against young HTs, but bear in mind I'd likely be around 26 before I did this, and I'm also fully aware of the risks and willing to take steps to deal with them. If it goes well, I get fairly good hair into my 40s and beyond, and get to stop worrying about this mess so much. What do people think?

Edited May 25, 2010 by Boondock

[MikeTheDane]

Yes, I would say that it does make sense. Do you have a full crown and scalp? If these are thinning, FUE may not be a very good idea as you are likely going to end up with additional procedures if you're not on meds. And as you know, it's unthinkable to be able to restore a full head of hair with fue alone.

 

This is what I would do if I were you;

 

1) Try to get on propecia again, but this time lower the dosis to maybe half or less. There is still significant benefit from this in terms of keeping the hair.

 

2) Wait a year or two, and if no additional loss has occured, procede to 3

 

3) If your crown and scalp are full, then you can get FUE, but if not then go for the strip because you're likely going to need the grafts.

 

I know that micro pigmentation is really the hype now. While for adding density or creating hairlines I'm a bit cautious about it due to how the ink might age differently than you, I suppose that for strip scars it's a win/win situation, since a bit of discoloration in the back of your head is probably going to attract less attention that a shiny white scar. Just a thought. It's pretty unlikely that you turn NW7 due to your family history, but even NW6's can have trouble getting enough density.

[Boondock]

Thanks for the response, Mike. To answer on your points:

 

1) Sadly I've tried low-dose finasteride and had the same outcome side-effect wise. My second trial was essentially an extended attempt to get it to work for me. I lowered the dose down to 0.25mg over several weeks, but in the end I couldn't stomach the sides. Even topical fin had similar effects.

 

2) Given that finasteride isn't an option, my alternative approach is to blitz my head with anti-androgen topicals. I'm having some success with these, and am yet to invest in the most promising option in this area. If I can maintain on this regimen for two years, then I suppose I'll have a similar outcome to that with finasteride. In any case, I'm aiming to wait at least two years, probably longer, before I take the plunge. Partly this is because I don't yet know if this regimen will have lasting effect, and I don't yet know what my 'pattern' will be.

 

3) So far no crown loss, but I suspect there's some thinning there. A minituarization study might show more. My plan here, I suppose, would be to FUE the front for perhaps 2,000 grafts, and then - should loss occur further back - take the nuclear option of an additional 4,000+ grafts via strip many years later. I believe this is more or less possible with a NW5 pattern. If I went further, however, I suppose I would opt to fill in the front and allow some crown baldness. This to me would look better than the full bald look, and would be reasonably age-appropriate by the time this happened.

 

So far as strip scars are concerned, I guess if micropigmentation were not an option I could try and stick some FUE grafts in it. My approach to the scar is really this:

- If I can get by on just FUE, I won't have it anyway

- If I do have to have it, I may be able to micropigment, FUE it, or dermabrase it down

- If all of the above fails, I can just keep my hair a little longer

 

So either way the scar wouldn't be holding me back in the long haul, but it is something I'd like to avoid if possible.

 

Thanks again for your response. Like I say, I'm not about to fly into the doctor's office anytime soon, but when I do seriously think about it (perhaps mid-late 20s) I want to know what my options are.

[MikeTheDane]

Can I ask you which sides you're having?

[Boondock]

Can I ask you which sides you're having?

 

I experienced sexual sides, but I also experienced what some people might call 'brain fog', but to me was just a feeling of being medicated and 'not quite myself'.

 

They happened both times I trialled fin, and I attempted to 'ride them out' and to lower the dose. I have accepted that I am not an ideal candidate for the drug, as personally I could not tolerate these effects.

[Churchies49]

How long did you experience sexual sides?

I had that for first 3 -4 weeks then got better with time.

Most of mine was the power of the brain...

I read up about sides and i thought i had most of them.

main sides was less sensitive when having sex and climate feeling where getting less and less.

[Boondock]

How long did you experience sexual sides?

I had that for first 3 -4 weeks then got better with time.

Most of mine was the power of the brain...

I read up about sides and i thought i had most of them.

main sides was less sensitive when having sex and climate feeling where getting less and less.

 

I experienced the sides all the time. It didn't get better or worse, really, for the duration of the time I was on them (3 months).

 

Funnily enough, it wasn't the sexual sides alone that did it for me. If you get the 'brain fog' effect, like I did, you really feel compelled to stop the stuff. I didn't know why I felt so weird but I knew I didn't want to go on feeling like that.

 

I believe I gave it sufficient time, and I also believe my topical regimen may give me similar levels of effectiveness without side effects (albeit at greater cost).