Am I fit for a HT?

[ICUman]

Hi I am a new member here

 

Hoping to get some advice. Can anyone tell me what type of Norwood I am?

I have been taking finasteride 1mg/day now for 13 months. I tried Rogaine in the past but no longer use it.

 

Am I a candidate for a hair transplant? Based off the photos, is FUE or FUT a better option for me? I feel like I have a decent donor area to pull from… I am age 24.

 

What should my next steps be if I want to reduce my hair loss? My prescribing surgeon has told me that Finasteride has halted my loss based off my 6 and 12 month follow up with him…but I've yet to see any regrowth, I don't know how long it takes, or if I will even see any, which leads me to consider a HT. There are some really inspirational stories on this forum and I hope to eventually be one myself.

[lorenzo]

This is a hard question to answer based on your photos. When I look at photo 4 of your donor it appears that even though your donor area is large that the upper part of it doesn't appear to be in a safe area. Based on your age and your aggressive hairloss I would talk go see a recommended doctor and get their opinion face to face.

Good luck

[Spanker]

I agree. That is why you aren't getting a lot of feedback probably as well. It's just in that so, so area that it would be hard to make a good call based on photos and your age, and your donor. Go see a very reputable doc face to face.

[Dutchie]

I'm nowhere near an expert, but I'm gonna be brutally honest and say based on this pic alone you are headed for a severe Norwood 7. But thats only if the red arrow area is early stage hairloss.

 

If for some reason you shave that area, or keep it extra short because thats how you style your hair, then kindly disregard my opinion.

 

You also appear to have some retrograde hairloss happening, which doesnt bode well for the future (rear neck area, below your ears)

 

Edited April 8, 2016 by Dutchie

[gillenator]

ICUman,

 

Thanks for sharing your case and photos and welcome to this community...

 

I would say that you are in a Norwood 4 class, soon headed for class 5 and so on.

 

A couple of things. First of all, and no respect to your doctor, your hair loss has not stopped from finasteride. Stabilized? Sure. But the meds never completely halt the progression of MPB, only slow it down and sometimes pretty well for a season. Yet you are still very young at age 24.

 

But invariably, the visible signs of diffusion are quite pronounced from your photos and I agree that there appears to be some retro-grade alopecia going on. Your donor zone appears diffused throughout the entire zone so it would not hurt to get more opinions "in person" where a microscopic exam can be done to confirm how stable your donor may or may not be. Because if your donor is confirmed to be DHT receptive, or a significant part of it, then that hair is not suitable for transplantation, meaning, you could lose it in the future.

 

Keep in mind that this is based on multiple photos, and only an in-person exam will be the most beneficial for you.

[Dutchie]

Based on just your pics, this is absolutely worst NW7 case scenario. Of course that doesnt mean you're necessarily headed that way, but its a distinct possibility (area within red zone only suitable for transplant):

 

 

And if so, you have very little donor hair and I dont think most reputable doctors would touch just for a scalp HT alone.

 

BHT + scalp HT might still be a possibility though

[Ernie]

Those outlines are not correct.

 

 

Based on just your pics, this is absolutely worst NW7 case scenario. Of course that doesnt mean you're necessarily headed that way, but its a distinct possibility (area within red zone only suitable for transplant):

 

 

And if so, you have very little donor hair and I dont think most reputable doctors would touch just for a scalp HT alone.

 

BHT + scalp HT might still be a possibility though

[Dutchie]

Those outlines are not correct

How so?? :confused:

 

Can you take the same pic and draw the lines you think are accurate, please??

[Melvin- Admin]

With respect to the photo in question I believe it's #4, I believe there's a lighting issue here, I believe that there is a light reflecting off of the back occipital region which is making it appear diffuse, the area in question is prime real estate in terms of donor safety for most even Norwood 7. Additionally, the lateral humps don't appear miniaturized as well which they would if headed to Norwood 7. I will venture to say however that OP is headed for Norwood 6 probably by age 30. Personally I would wait a few years to see how you progress, if you can maintain this hair by 30 you'll be in good shape and a prime candidate. What you don't want is to play catch up with surgery, you want your result to make a significant improvement and stay that way for the coming years.

[gillenator]

Dutchie,

 

I can definitely see why you drew in the area that you did. It does seem to be the most stable "at the present time".

 

My concern for him is his young age (24) and the fact that his entire donor zone may destabilize further as he gets older.

 

If I was in his situation at 24, I would buzz the entire scalp, wait and see how things progress.

[Dutchie]

With respect to the photo in question I believe it's #4, I believe there's a lighting issue here, I believe that there is a light reflecting off of the back occipital region which is making it appear diffuse

If thats the case then please disregard my post altogether

[Rashid36]

At 24 years of age my hair was falling then after upto about 28-29 it had fell out then after it seemed to stop in the past 2 years it has thinned now 35 years old this year i can see much more scalp. So if i was like you and had a ht then where would i have been by 30 needing another one and then by 35 another and very limited donor...

 

I would wait and see how it goes 24 years old is way to young in my opinion.

It would be better to see where you could use your limited donor hair later on when it seems to have stabilized.

 

Doesn'tmean you can't take other action apart from ht such monoxidil etc

 

Just what i think and everyone is different best to have in person consultation and ask top docs.

[Spanker]

With respect to the photo in question I believe it's #4, I believe there's a lighting issue here, I believe that there is a light reflecting off of the back occipital region which is making it appear diffuse, the area in question is prime real estate in terms of donor safety for most even Norwood 7. Additionally, the lateral humps don't appear miniaturized as well which they would if headed to Norwood 7. I will venture to say however that OP is headed for Norwood 6 probably by age 30. Personally I would wait a few years to see how you progress, if you can maintain this hair by 30 you'll be in good shape and a prime candidate. What you don't want is to play catch up with surgery, you want your result to make a significant improvement and stay that way for the coming years.

 

I agree that what Dutchie drew has a lot to do with lighting, shaped of head, etc. It's not a miniaturized pattern.

[lorenzo]

It could be a lighting issue or minimization of pattern but it not easy to say based on the photos. When you are 24 and have aggressive hairloss in both the front and the crown its best to get an opinion face to face from a good doctor.

[Rashid36]

Yes but at the aggressive stage would any top doc do a ht ?

[lorenzo]

I think it depends on many factors

 

1) age of patient'

2) how he is responding to meds

3) his safe donor area

4) area to transplant

5) his expectations

[ICUman]

Thanks all for responding.

 

I keep my sides and back of hair at a #1 so it's pretty short and the lights in that room were bright. I think that is what causes it to appear that way.

 

As for shaving my scalp, that's not an option. My scalp has a few misshapen lines that look quite odd with short buzzed hair and I think it would be even worse than how my hair is right now. I got screwed in the hair and scalp genetics category.

 

Those photos were taken at a hair transplant doctors office. He quoted me 1000-1200 grafts to be moved to the front, and leave the crown untouched for now. I decided against it. I will wait another year or so and go with a doctor with a better reputation.

 

If you were all me…would you risk getting a HT? What should I do to keep my hair from progressing from bad to worse? I feel a little hopeless here.

[ICUman]

When you are 24 and have aggressive hairloss in both the front and the crown its best to get an opinion face to face from a good doctor.

 

Yeah but the difficult part about this is finding one that tells the truth and is trustworthy…and not just trying to fish money out of your pocket.

[ICUman]

It's not a miniaturized pattern.

 

Would you mind explaining what this means?

[ICUman]

With respect to the photo in question I believe it's #4, I believe there's a lighting issue here, I believe that there is a light reflecting off of the back occipital region which is making it appear diffuse, the area in question is prime real estate in terms of donor safety for most even Norwood 7. Additionally, the lateral humps don't appear miniaturized as well which they would if headed to Norwood 7. I will venture to say however that OP is headed for Norwood 6 probably by age 30. Personally I would wait a few years to see how you progress, if you can maintain this hair by 30 you'll be in good shape and a prime candidate. What you don't want is to play catch up with surgery, you want your result to make a significant improvement and stay that way for the coming years.

 

I am still new to understanding some of the jargon and terms associated here. Are you saying it appears that I do have a good donor area? I hope that's the case.

 

More impatient than I probably ought to be, but 6 years is a long time to wait around and see how things progress, no? I feel like I'm in a state of urgency, as though I need to act quickly before this gets worse. Take some preventative measures, whatever they may be. Am I mistaken?

 

I realize mistakes come from rushing into things, though.

[ICUman]

My concern for him is his young age (24) and the fact that his entire donor zone may destabilize further as he gets older.

 

 

If this happens to be the case, what options and action(s) do you recommend I take right now, to give myself the best outcome?

 

My regimen currently is 1mg/day Fin.

[Dutchie]

Thanks all for responding.

 

I keep my sides and back of hair at a #1 so it's pretty short and the lights in that room were bright. I think that is what causes it to appear that way

If thats the case, and if that area doesnt thin, I'd say you're most likely an excellent candidate for HT surgery

[ICUman]

If thats the case, and if that area doesnt thin, I'd say you're most likely an excellent candidate for HT surgery

 

Thanks, do you have any idea of estimated grafts I may need? I know that's a question for the surgeon also.

 

How do most guys pay for pricey transplants?

[Dutchie]

We rob banks.

 

 

 

 

But seriously, I have about $60K saved up for a rainy day fund.

And going Norwood 6 is raining cats and dogs, so it looks like I'm gonna need about 40K of that to restore my hair.

 

To me its worth it. Cant put a price on happiness

[gillenator]

If this happens to be the case, what options and action(s) do you recommend I take right now, to give myself the best outcome?

 

My regimen currently is 1mg/day Fin.

 

Based on photos, it's very difficult to know for sure if your donor is diffused, or if it is indeed an issue of lighting. Only a microscopic exam will confirm if your donor shows miniaturization and diffusion from DHT. I took the liberty of opening your photos into much larger frames and IMHO, it looks like diffusion, not lighting. But again this is based on photos.

 

Now if you have this exam, and it confirms your donor is DHT receptive, there is not much if anything at all that you can do to reverse it because to date, the clinical studies on Propecia do not show nor confirm improvement or a reverse effect on the donor zone.

 

If it were me, I would wait it out and continue to have the donor zone examined for several more years to see if it continues to diffuse or if it's just a issue of varied density but not diffused loss.