Hair transplant - a good idea?

[Gubter]

I am a 23 year old male who has been suffering from hair loss since I was 18. I am currently almost a NW4, with thinning in a NW6 pattern. Have been on finasteride for the better part of two years, and it has significantly slowed down the rate of loss. Recently quit minoxidil after having been on it for five years - basically it never did and still wan't doing much for me. Since recently I am also using a laser helmet three times a week.

 

Needless to say hair loss has had a huge impact on my life and my self esteem. I cannot think of a single day for the past five years when it hasn't been on my mind. Worrying about it just drains so much of my energi.

 

I have tried to just throw my hands up in the air and just accept it. But I just haven't been able to come to terms with loosing my hair at this age. Now I'm at a point where I feel like if there is something I can do about it, I'll do it. Even if it means spendig $10 000, that I don't have.

 

However I have read some of the horror stories and they have me concerned I will be writing another one of them in 5-10 years. The only thing that could make me feel worse than balding would be to be balding with a great big scar across the back of my head along with being $10 000 in debt. Is a situation like this avoidable by choosing the right surgeon and setting a realistic goal?

 

 

Has anyone been in the same situation as me, and what were your thoughts on the whole thing?

[Thehairupthere]

Gubter,

It is great that you have been using finasteride for almost 2 years, you should continue using it and if possible add rogaine (minoxidil) to that regiment so you can maximize your hair growth, and stabilization. You are very young, and at your age you should be very conservative with the a procedure for hair transplantation. Since you have been using the medication for quite some time, you can have a procedure but it should be on the smaller side to work on the hairline, temples and corners.

 

Have you been seen by a hair transplantation surgeon?

 

I understand that at this age this is very important to you, but as you stated yourself, you should be weary of bad surgeons and unrealistic goals. If your goals are for a smaller procedure for the hairline, and corners then perhaps you can have a procedure like that done but I wouldn't suggest going too extreme and perhaps causing unnecessary shock loss in areas which appear to be too dense at the moment. At your age you need to be conservative, because again as you stated earlier, you may wind up a Norwood 6 and you will need all the donor supply you can get to fill in the hairline, top and bridge areas. you do not want to have a large procedure today to fill in the crown and on top, where it doesn't quite seem like you need anything from the photos I see. Since you are using the medication it should allow you to keep a majority of your native hair from the top to the crown, but likely continue to lose hair in the hairline and forelock regions. So once again you should be conservative with the first procedure and perhaps a few years later if you continue to thin, you can have another touch up. Unfortunately, this is the route that is usually best for people your age and in your situation. Be sure to see a recommended surgeon from this forum.

 

I am a consultant for Dr. Robert True and Dr. Robert Dorin. These opinions are my own. Medical Hair Restoration, Hair Transplant Surgery, Hair Loss Solution, Cost and Remedies

[Lucky7]

Gub,

Hang in there. This forum is one of the best support groups you could ever ask for. There is some very informative information on this site. Lots of young guys are on here, myself included. Stay positive, and try to get yourself an consult with one of the recommended docs on this site.

[gillenator]

Gupter,

 

If I could add a few thoughts. Try to wait it out longer. Over thirty years, I have seen many, many heads losing hair. Most young men who progress to your level in your early twenties, generally leads to class 7. Most of these men have men in their family histories who have reached class 7. Yet at the same time their fathers, grandfathers never took Propecia. Yet you are taking it and having some good experience with it in slowing down the rate of progression.

 

What I am suggesting is that you wait it out to see how you respond to finasteride Proecia over the longer term, meaning if you look pretty much the same at 30, then I agree that you could potentially keep a higher mature hairline without alot of density. Your building more definition and closing back the temporal lobe areas. Leave your crown alone for now. I would not even touch it if and when you might begin. You might even consider keeping your hair cropt short and producing the coverage but at a much lower FU per cm2. It creates the illusion of "less is more" with that type of hair style. You see alot of guys in law enforcement wear that style.

 

If however you notice that your rate of loss has increased in spite of being on Propecia, then you might not want to even get started on surgery.

 

We are throughout the day mostly viewed from the front and if you are 6' or more in height, most people won't notice the thinning in the bridge/crown area as much when viewed from the front. If your loss continues to stabilize, you want to start with very conseravtive goals seeking the advice of an established reputable surgeon.

 

Best wishes to you my friend...

[Blake Bloxham]

Gubter,

 

At this point in time, you've made an excellent decision stabilizing and possibly reversing some of the hair loss with the finasteride. Keep it up! As far as a transplant procedure is concerned, you may still be a bit young and should probably wait a few years. Frankly, because you've been on finasteride for 2 years and you've appeared to stabilize the loss, you're probably on the verge of becoming a good hair transplant candidate, but in my opinion, it's probably safer to stay on the finasteride, wait a few more years and see exactly how (if at all) the balding progresses, and continue thoroughly researching your transplant options until that time (to maximize your chances of satisfaction).

 

In the meantime, I do invite you to review our recommended hair restoration physicians. If you'd like, you could always consult with one now, discussion your options, and create a collaborative hair restoration plan together. I hope this helps!

[Gubter]

First of all I'd like to thank everyone who took the time to reply. I have been suffering from hair loss for quite a few years, so know quite a bit when it comes to treatments. However I don't know too much about hair transplants, so I am really glad I found this website as there seems to be a lot of people on this board who know what they are talking about.

 

I have actually been emailing with a surgeon that is recommended by this board. And they said they thought I was a candidate for surgery and recommended 2500 grafts for the front third - which they believed would restore me to a norwood 2V.

 

However I have heard a lot of people just like you who believe I should wait. And I am sure that would be best to play it safe. But right now it just feels like my life is kind of on hold. I recently started studying and am having trouble focusing on my studies, my social life is being affected and I am just really self concious in just about every situation I am faced with throughout the day. Its weird cause I am happy with myself, apart from the hair loss - which just ruins everything I think is good in my appearance. And at the same time I hate myself for being so shallow. My future studies and in time job, takes a lot of confidence - and where I'm at right now I am almost having doubts about being able to cope with it.

Waiting just feels really tough... I have even thought about maybe trying anti depressants, just to make things easier to handle, but at the same time I think the idea of eating anti depressants just because I am loosing hair is crazy.

[moro]

Gubter, you look great man! if it bothers you in a few years just shave and move on with your life. Believe me!

[Gubter]

Moro; Cheers mate... I actually buzz it a lot closer now, and it's not really a look I am comfortable with. I belive most people actually look better with buzzed heads as opposed to shaved heads. And it makes me think that maybe a strip scar wouldn't be so bad after all.

 

If I wouldn't want to shave my head anyway, I could just keep it buzzed short enough to still cover the scar, right? And that is just if I can't stop further loss and it will still progress and nothing else have come on the market in 5-10 years.

[Sparky]

Whoever told you that your a good candidate must be a nasty piece of work because your too young to go through with this, wait it out as long as you can, I was 22 and I have no bigger regret than having an HT. Also, the fact that you dont want a scar means fue only, i've seen a fair few NW6's restored with fue only, sometimes body hair is involved but thats no problem in the right hands these days.

[Sparky]

By the way if I had a million pounds, i'd pay that to of never had an HT at 22, serious.

[Gubter]

Sparky; Would you mind explaining exactly what it is you regret about it? Are the results unnatural or is it having the scar at the back of the head that is making you unable to shave that is bothering you? Also what surgeon did you have a HT with and how long ago was it?

 

As I know that I am thinning in a NW6 pattern. If I would plan for loosing it all (even though with finasteride and future treatments I might not have to) then I don't really understand the issue with further progression. As I have seen some transplants done on people who actually are NW6 - if they are candidates, I don't understand why I wouldn't be because of my age - just because I might be a NW6 one day. Maybe I'm missing something here?

[TC17]

gubter,

 

If your final balding pattern is a NW 6 pattern, and your donor density remains the same, then there is nothing wrong with transplanting conservatively at your age. However, because you're only 22, you potentially have that many more years to bald than someone who starts later in life. Your donor may thin, you may go beyond NW 6, and you might find yourself not a suitable candidate in 20 years.

 

I know it's not the most popular opinion, but like Sparky, I strongly believe that young people undergoing transplants should only opt for FUE.

[Gubter]

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?

[wb280]

I guess TC17 has reasons to promote FUE to u. I mean, who knows what kind of pattern u will end up with! You have to know that once shaved down, no matter how neat and lean the scar is, a scar is a scar. If shaven, the scar will be visible. However, i guess thats the only reason why he recommended FUE. Like what your doc mentioned, FUE thins out your donor and the yield might not be as good as strip. If u are looking to maximise your HT, yield matters, and FUT can safely achieve more ( not meaning FUE does not, just that its not as guaranteed )

 

I have repeated many times in other threads, some members are very biased and will only recommend FUE but whats better than advice from docs? They are the ones who have operated on umpteen patients and its their professions, not the ones writing responses to u here, me inclusive. If the docs recommend strip or FUE, there must be a reason why. My advice is to study the pros and cons of both kinds of surgeries and listen to your heart and most importantly, get more opinion from various docs. If most of them recommend either one, i am certainly sure u will not go wrong with that.

 

Best of luck!

Edited November 29, 2010 by wb280

[byron]

tbh mate, looking at your pictures you aint that bad! sure slight loss in the front area BUT i cant see anything major that would need doing

[Gubter]

Byron; Normally I would probably say thank you... but come on lets be honest with each other... My forehead is both high and wide, and I have thinning all over the head with extra thinning at the crown. This is very significant loss, especially at my age.

I need to recreate a mature hairline and add some density on top to be able to look like someone who is not balding.

 

Wb280; Yes, but with scalp pigmentation the scar can become almost invisible even when shaved down - but I guess if you're looking for it you would still find it. Probably would not bother me too much though. And hopefully it wont have to come to that with new treatments down the line. The only thing that makes me feel hesitant about a transplant is that in about one years time we will know how well A-cell hair duplication (formerly known as autocloning) works. If it's a success I might have been able to get a transplant with NO scar, although it would probably need several expensive sessions.

[Gubter]

I have had contact with a few different surgeons and right now Dr Cooley and Dr humayun are my top picks. Dr cooley because it seems that he is one of the best, and Dr Humayun because of his prices.

 

And I know that as I am young and have aggressive loss that I have to be careful with my donor, and can't really afford wasting it. But I think Dr Humayuns result look really good, he seems to have won prices for hair line designs and held lectures at the ISHRS and he is recommended by this site. So it would still seem like a safe choice.

 

Or do you more experienced users see something that I am missing on this one?

 

I have also been in contact with Dr. Madhu - but have not yet recieved a reply.

[byron]

gubter i hope you find a solution at 22 maybe you are young like the guys said here BUT these are the best days of your life where we all want to look the part, girls etc etc

 

im 26 and seriuosly considering a hairline HT

[Gubter]

Byron; Cheers mate! I am truly sick of this and really need to find a solution. Am going back and forth between a transplant and a hair piece every other hour.

 

Mainly what is making me hesitant about going for the transplant now are all the clinics that are doing research on a-cell. In about a years time there should be some definite data on how well it works. And then it might be possible to have a transplant without the risk of scarring. Although it would probably cost a hell of a lot and take several sessions (I believe Dr. Cooley charges $10 a graft today.

 

Does anyone else have any usefull information which might help me come to any kind of decision? Especially young guys who have experience from transplants and hair pieces?

Edited November 30, 2010 by Gubter
Added text

[largechris]

Well I'm 36 and just started posting, that is still young ...

 

Seems to me you've already done a lot of research and had a consult with a good surgeon (not a salesman).

 

Only 2 things I would comment on:

1) I had FUT with trichophatic closure and have no strip scar. Maybe specifically ask the doctors you are considering about trichophatic closure, and ask to see some results. Even better if you can meet a patient.

2) Acell. Is a bit controversial as to whether it will work for HTs, but it will certainly be expensive.

[Gubter]

largechris; Thank you for replying.

I would not really consider 36 being too young. I mean what is really an appropriate age for a hair transplant?

I believe my final balding pattern is quite firmly etablished, and I want to be able to enjoy my younger years without worrying about hair loss. Why would I still not be a good candidate? As my balding pattern is about NW6, I am not a candidate for a dense packed low hairline.. But what would be so wrong about a mature NW2ish hairline with medium density? It does not really seem that there is not enough donor to achieve this and at the same time being able to have enough hair for eventually doing some crown work as well.

 

Could you also please elaborate on what "no scar" means? How short can you actually shave down without it being obvious?

[Gubter]

Largechris; Oh and congratulations on your awesome HT-reults. Looks amazing!

[tarepanda]

hey gupter

 

why not defer your HT and try using concealer instead??

 

but if u have already made up your mind, choose a good surgeon and go for a consulation before making your decision.

[Gubter]

tarepanda; I have been using concealers for the past 2-3 years. They are simply not good enough anymore as there is not enough hair left. And I am not comfortable with my huge forehead.

[largechris]

largechris; Thank you for replying.

I would not really consider 36 being too young. I mean what is really an appropriate age for a hair transplant?

I believe my final balding pattern is quite firmly etablished, and I want to be able to enjoy my younger years without worrying about hair loss. Why would I still not be a good candidate? As my balding pattern is about NW6, I am not a candidate for a dense packed low hairline.. But what would be so wrong about a mature NW2ish hairline with medium density? It does not really seem that there is not enough donor to achieve this and at the same time being able to have enough hair for eventually doing some crown work as well.

 

Could you also please elaborate on what "no scar" means? How short can you actually shave down without it being obvious?

 

Thanks for the compliment. I don't regret not having an HT for example 10 years ago, because I don't think I would have got the same quality / cost of work, maybe micrografts instead of FUT.

But technology and knowledge has moved on, and I would think there is now a better case for younger patients to have the procedure.

 

Shaving - I dont know how close I can shave it, because that's not the hair style I want, pre op even in summer I've only occasionally had a number 2 if the weather is very hot.

It is possible that I could have a number 1 and the scar not be visible but I can't swear to it.

 

If I was in your position, I would go for it (with the RIGHT surgeon), but it has to be your decision.