Advice needed

[jimwpg]

I've been reading through this site doing my research over the last month. I am really impressed with the level of knowledge here. I am now considering hair restoration surgery and I am hoping to get some advice or comments.

 

I'm now 27. My hairloss started when I was 22 or 23, I started proscar and rogaine when I was 24. I wish I started earlier, but I was in denial for close to a year... I've now been on proscar and rogaine for over 4 years and I think it has been working very well. Pictures from 2007 and 2011 are attached.

 

It's not easy to tell that I'm experiencing hairloss unless it's a windy day or I get my hair wet. But I find myself facing away from my girlfriend in the shower or avoiding swimming or whatever. I'd like to get this fixed, and based on my research here, it looks like the risks are minimal if in the hands of the right surgeon. I think I'm at the point where the rogaine and proscar are close to maintaining my existing hairline, so if I do a few grafts to take me back to 2005 maybe I can maintain that for quite a few years?

 

I'm located in Winnipeg, Canada. I've read very good things about Dr. Ron Shapiro. Seeing him would be an 8 hour drive. I could also easily fly to Vancouver, but I have not encountered a Dr. on here from Vancouver who is as highly recommended as Dr. Ron Shapiro.

 

I would greatly appreciate any advice or comment! Thank you!

[Thehairupthere]

You seem like a good candidate, continue using those medications. Both of those doctors are good choices. I'd say you should expect somewhere around 1200-1500 grafts into the hairline and corners.

[mattj]

Do I see a little bit of improvement between the 2007 and 2011 pictures? What do you think? Things definitely haven't become worse.

 

You haven't heard of Hasson & Wong? (!) They're in Vancouver.

 

I would agree with Thehairupthere. You do seem like a pretty good candidate.

 

Do you feel that you've lost any density further into your hair, beyond the more obvious recession? Your hair seems very fine and overall not very dense, but this could be your original density.

[aaron1234]

Going to Dr. Paul Shapiro (Ron's brother, same clinic, SMG) was a 7 hour drive for me from Chicago. Not too bad at all and definitely worth the trip even just for a consult. They are extremely thorough in the consultations.

 

But if you are in Canada you have some great docs up by you as well. Rahal, H@W, Cam Simmons. So I'd consult with them as well.

 

You definitely seem like a good candidate especially since it appears your loss as stabilized. Staying on fin was a very very good call for you.

[corvettester]

Jim,

 

Your story is very similar to mine in many ways. You and I have very similar hair characteristics and almost the same amount of hair loss. I never took meds though. The fact that you've been on meds for so long and that you appear to be responding well to them probably makes you a good candidate for an HT in the near future.

 

I do wonder what role the meds played in your hairline and temples though because so many doctors state that Propecia doesn't really address that area... Either way, if you're not experiencing any adverse side effects, then I'd stay on it and not bother risking more loss if I were you.

 

If there is one thing that I come across time and time again on the forums, it is men bemoaning the fact that they stopped taking Propecia after it initially worked well for them. Some times it's out of apathy or frustration, or it's just too high maintenance for them. Soon after stopping, their hair loss will pick up with full force and then they're left with patches and bald spots that only HTs can address... and they always end up regretting it. So long story short, be mindful of this and search the forums to see for yourself.

 

I did my first consult when I was 28 and had my first HT last year at age 29. I completed my second just two weeks ago. You can see my experience in the links below in my signature.

 

You're probably old enough to go for it if you feel like it is the right thing to do for yourself. SMG is a great clinic, both Paul and Ron Shapiro consistently produce great result. Vancouver has Hasson & Wong which are on par with SMG, in my opinion. I don't see how you could go wrong with either of them.

 

Also, due to your minimal hair loss, FUE may be a more viable option for you... so that is something to look into as well. H&W do not perform FUE, however, if I understand correctly, SMG does do it. Other great FUE docs are True & Dorin and Bisanga.

 

Regardless of your decision, it's clear from your post that you still have a lot of researching to do before you decide upon which clinic to go with. Feel free to ask as many questions and take as much time as needed. You really can't do too much research. You'll be glad that you took your time and didn't just jump into such an important and impactful life-decision.

 

 

Corvettester

[orlhair1]

Yes, you are consulting with great doctors. All of the doctors referenced in these posts are really good, so do your consults and decide on who you are the most comfortable with in the end. I would be more than happy to answer any questions you might have about my experience with SMG.

[jimwpg]

Thank you to everyone for your advice. I'll be contacting Hassan & Wong, and SMG, for consultations this week. I'll need to do some research on what sort of questions to ask, Corvettester's information on FUE is definitely something I'll ask about, healing quickly and minimal scarring risk is important. But why could FUE be better for minimal hair loss?

 

Mattj, I've wondered if my hairline improved a little after starting on the rogaine (or?) finisteride. One frustrating thing is I don't know if it's one of them that's doing the job, or both. And I have always had very fine hair, I don't think it has gotten worse. I am concerned that with such fine hair I am not a good candidate for HT since they take hair from the back of the scalp?

 

Thank you

[NEWHAIRPLEASE]

I certainly wouldn't rule out Dr Rahal either!! The doctors you mentioned are top notch, Dr Rahal is definitely worth checking out!

[corvettester]

Corvettester's information on FUE is definitely something I'll ask about, healing quickly and minimal scarring risk is important. But why could FUE be better for minimal hair loss?

 

Jim,

 

FUE is not better for minimal loss, per se. It's just good for small, potentially one-time jobs like yours because it's minimally invasive and won't leave you with the strip scar. You don't need that many grafts in the first place... The rest of your hair looks solid so I think that you have a good chance of not losing anymore provided that you stay on the meds.

 

I don't care what any doctor says about FUT being minimally invasive, it is not. It's a big deal in my opinion.

 

I just spoke with a friend of mine today who had an FUE procedure done yesterday. He had 275 grafts and said that he didn't even have to take aspirin afterwards. It took two hours and he just went right back to work after the procedure. There was no swelling, no oozing, no bleeding and no pain. He didn't take any pain killers after the procedure or the next day.

 

This is not the case with FUT.

 

FUT is designed for the big jobs. You'll get different opinions from everyone, but I think that there is broad consensus that FUT is generally not recommended for anything under 800 grafts. It's just too much trauma and too much of a scar to be really worth it, unless you're doing multiple procedures or scar revision.

 

 

I am concerned that with such fine hair I am not a good candidate for HT since they take hair from the back of the scalp?

 

I had the exact same concern. My hair in the back of my head is much coarser and darker than in the front, which is quite fine and lighter in color.

 

I discussed this with a couple docs. They told me not to worry about it. It's darker because it gets less sunlight than that on the top and in the frontal third. It's coarser because it's denser back there and kept shorter, so it feels differently. Regardless, it won't be cosmetically noticeable after the HT.

 

I'm only 10 months post-op so I can't really say with full authority that this is the case. I will say that it's looking to be just that though. My hair still has a lot of maturing to do so I'll have to wait it out, but I think the docs were right.

 

 

Corvettester

[Levrais]

...I just spoke with a friend of mine today who had an FUE procedure done yesterday. He had 275 grafts and said that he didn't even have to take aspirin afterwards. Corvettester

 

I agree with Corv about fue being less invasive. No pain killers are necessary after the procedure. In my case they gave me some tylenol just in case but it wasn't necessary.

[jfables]

Damn, I took painkillers for all my FUE and I needed them. It wasn't so bad but it's like a having a massive headache for a couple of days. 275 grafts is really nothing, of course, but when you get 3,000 FUE in one day you've had your head poked 6000 times (extractions & recipient holes).

This is just another reason why I'm reluctant to do strip. I'm not into all this pain that strip patients are always describing.

[jfables]

btw jimwpg, If you want to just close the recession I think you need about 1,500 grafts: 750 on each side. If you want to lower your hairline, which I don't recommend for you, you will need at least 2,000.

For 1500 grafts it's not worthwhile to go through a strip surgery and get a scar. At the same time your hairloss is minor and I don't see you losing much hair in the coming years, especially since you're on the meds, so you likely will not be dealt with the fate of shaving your head because your hairloss will be so bad. Hence you very well may not care about the scar because you're donor hair will cover it. FUE is also more expensive.