Future hair loss pattern vs transplant now

[Neperican]

I am 32 years old and have had hair loss for 8 years. How do i know when my hair loss has stopped so that i can go ahead with transplant. Will the surgeon let me know the plan of action based on his review of my hair? I think i am getting into norwood 5 but have thick donor hair space. Is it ideal to go totally bald and then undergo transplant? Because what's the point of undergoing transplant if my natural hair continues to fall. Is it then i undergo 2nd or 3rd transplant? This is pretty confusing to predict future hair loss.

[thebossman]

nobody really knows but the best guess is to look at your dad or your moms dad and see how their hairloss is progressing or has progressed. yeah good surgeons will take a conservative approach and plan for the future. most people take propecia after getting a HT to stop your natural hairloss from progressing, its an on going battle

[hsrp10]

yep that is true, you just never really know and even being on Fin etc. the drug could stop working after a few years

 

being in my mid 40's and having had multiple sessions, I can say that hairloss is really unpredictable.

throw in things like seasonal sheds, reactions to medicines and just getting old, you just never know.

 

it is wise to go conservative in terms of trying to save grafts for the future, but don't compromise too much on the hairline your really want. if you want to have a procedure, consult with a recommended hairloss doctor on here. how aggressive has you loss been recently? are you on any meds now?

[Eman]

I was very similar to you in terms of loss and where I was headed in terms of hairloss.

 

It got to the point where I simply didn't want to spend my thirties as the bald guy. I wanted to have my hair and not have to constantly be the guy who looks easily ten years older then friends and girlfriend.

 

I did my research, picked a highly recommended doc and came up with a strategy in terms of how we would attack my hairloss. I wanted a one and done transplant--even though I know at some point down the road another one might be necessary. I just didn't want to have to do it twice in my thirties.

 

Five years later and still going strong and could not be happier. At some point, I just decided that for me...it's time.

 

It's great that you are asking these questions. Keep asking, keep researching and good luck with whatever decision you make!

[gillenator]

What we must come to terms with is the scientific fact that we cannot completely stop the progression of genetic hair loss. The rate of progression can vary over our lifetimes but MPB never stops completely.

 

We can only buy ourselves time with the current hair loss meds and low dose finasteride continues to prove the most efficient for the crown and mid-scalp. And yes some have longer terms of success than others and there is really no way of predicting how we will respond or for how long. But generally speaking, low dose finasteride is not efficient in the frontal third of our scalps and it is that area where we must plan surgical restoration prudently.

 

And this is why I also agree with what thebossman stated. Take a long look at the men with MPB within our individual family history. That's where we are potentially headed in our lifetimes.

 

The more advanced the classes of hair loss are, the more prudent planning one has to be considering the loss over a lifetime.

 

Take a quick peak at the Norwood chart and you will inevitably find your pattern of loss and the various stages of progression.

[Dr. Michael Beehner]

From the appearance of the one photo provided by the initial poster, it looks clear to me that a person with this pattern through the midscalp of hair loss is 99% of the time going to end up as a Norwood VI pattern later in life, which is the classic U-shaped (horseshoe shaped) zone of shiny baldness. Each man arrives there at a different speed over a different number of years. And, yes, while finasteride does help slow down this hair loss schedule, eventually the intended genetic outcome will occur. I usually tell my patients that it will give you an extra 10 years of hair before that day comes.

Being in your 30's rather than your 20's is much more valuable in predicting where things are going to end up. With a patient in front of you in their early or mid-20's, the surgeon might as well have blindfolds on in predicting the future. The family history is helpful but can be very unreliable as a predictor. When a male patient is in his 30's, the one thing that I can predict more accurately than at a younger age is what the "safe" donor area is likely to end up being. That can allow me to be a little more aggressive, although I still stay out of the rear vertex/crown until after age 35.

Mike Beehner, M.D.

[FUE2014]

Great advice Dr Beehner

[Paulygon]

You never know if hair loss has really stopped completely. That being said, miniaturization studies performed by your hair restoration surgeon can be valuable in determining how your hair loss is progressing.

 

My physician, Dr Mohebi tries to perform these study to keep track of his patient's hair loss. I am uploading my miniaturization study so you get an idea of what its looks like and how be valuable the info is.

[hsrp10]

Pauly, I love this approach! really do, a good way to monitor hairloss and even hair growth

[gillenator]

You never know if hair loss has really stopped completely. That being said, miniaturization studies performed by your hair restoration surgeon can be valuable in determining how your hair loss is progressing.

 

My physician, Dr Mohebi tries to perform these study to keep track of his patient's hair loss. I am uploading my miniaturization study so you get an idea of what its looks like and how be valuable the info is.

 

I agree that close examination of the scalp for miniaturization is the best way to determine which areas are in fact being impacted by DHT and to note how MPB is progressing.

 

Diffusion is more readily seen by the naked eye, but miniaturization many times cannot.

[Patriot34]

I agree with the Doctor's assessment that you are likely going to be a NW7. Where I perhaps disagree with him is that a likely NW7 patient should never be operated on. The transplanted hair is permanent and the scar is permanent and if you end up with the classic horseshoe hairline with transplanted hair sprinkled in on top in a some design then it will look very odd. You'd be better off with a horseshoe or complete shave. However that option would no longer be available because of the goofy scarring from the donor area. I wouldn't look at it as a simply getting hair for the next ten years and enjoying it because the misery you would have after that time frame would not be worth it.

 

HTs should always be approached from a cradle to grave mentality and your last years on this world should be taken into consideration, not just the next 5-10. Obviously, many doctors would be happy to operate on a likely NW7 because of the repeat business, but IMO, an ethical doctor would steer you away. However, if you have reason to believe based on genetics and medication that you are not destined for that level of hair loss then you might be okay. You have a good texture of hair for a HT, but that pattern of loss is not a good sign.

 

Do not put your faith in a doctor for a diagnoses, though listening to their opinions is very beneficial. You have the best research available, as mentioned above, to give a fair estimate of your future.