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Am I a good candidate for a hair transplant?


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  • Regular Member

Hello everyone,

 

As specified in the subject, my question is: Am I a good candidate for a hair transplant based on my donor area only? What do you think it?

 

I know age and other significant factors (note that I am still in my low 20s) are very important, but I just want your opinions regarding my donor.

 

Your replies will be highly appreciated. Just took these attached images today and would like to hear your feedback.

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  • Senior Member

Your donor looks ok but now is not the time to be having surgeries. You would be better off by trying to keep hold of what you have through medications.

 

On the positive side your head shape looks pretty good to just shave it all off, keep a beard/stubble and hit the gym hard.

 

On the negative side you look likely to progress to a NW6 hair loss scale, maybe more depending on family history.

 

It would be better to save the donor you have for a top doctor to address the front half of your head at a later date, but for now I'd give finasteride a go.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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I agree with Matt. You definitely look like you're heading to at least a NW6. I would definitely start Finasteride soon to try and prevent further hair loss and stabilise your hair. Possibly add Minoxidil too.

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  • Regular Member

Thanks for the feedback Matt and HairsGone.

 

I've been doing my research regarding hair transplants and all its consequences for about 3 years now. I've been using minoxidil for 4 years as long as I can remember, as well as biotin which I started recently (if you have any other suggestions that can improve the quality of my hair, please let me know). I'm not a big fan of Finasteride and I'm not wiling to take it especially after reading that it might sometimes have permanent side effects.

 

Honestly I don't think it will make a big difference if I sit for a hair transplant now or 3 years from now and I'm not willing to wait another 10 years to do it. I want a good doctor to have a good plan for me by focusing on the frontal third and adding some density to the crown because I do not want to lose most of my hair and then go for a hair transplant.

 

Out of 15 recommended doctors on here, 8 (2 of them are coalition) said I can do a hair transplant and they'd have a good plan for me by suggesting around 3000-3500 grafts on average and specified that I will have more grafts for a second or even third transplant in the future.

 

Your opinions?

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  • Senior Member

If you have your mind made up about doing a procedure, I would only concentrate on the frontal third for now. You have a diffused thinning pattern front to back and if you were to have work done on your crown, it could potentially accelerate further loss in the crown area.

 

Your donor zone looks good but remember, your still young and almost everyone appears to have a strong donor zone in their twenties.

 

Low dose finasteride is the only medication that will stabilize your crown but it is a choice that we all make for ourselves. Eventually, the entire crown will be barren so if it were me, I would not do any surgery in that region as long as you have some hair there now.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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  • Regular Member

Hi Gillenator,

 

Thanks for the honest feedback.

 

I have been following up with the some of these surgeons for the past 2 years and back then they advised against a transplant but now they suggested that I can go for one. I am turning 24 and I am really thinking of going on with the procedure in the next few months.

 

Regarding family history, my father also started losing his hair in his 20s and I am attaching some pictures of that here (He is 53 now). Like me, he has been using minoxidil since then (he said he stopped for quite some time but as soon as he saw me use it, he started using it again). My barber (which is the same as his) says that we have the same hair and it looks like I might be heading to a similar balding pattern. Note that I will also be using minoxidil twice a day which I think might help (I've been using it only once for the past 4 years), and I don't plan on stopping using it, while adding some vitamins that may be of assistance. (If you have any suggestion for that, please let me know).

 

The plan was to transplant around 2,500 grafts on the frontal third to get a solid front, and 1,000 or 1,500 on the crown to have a natural look. Do you think I should avoid doing anything to the crown? If so, why is that? Is it because shock loss might lead to losing all these weak hairs or because I will definitely lose more hair in the future? Both maybe?

 

Apologies for the massive amount of questions and awaiting your feedback!

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Edited by Kalab23
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  • Senior Member

Stick with the meds if you don't get any side that will be your best bet

 

When i started loosing hair around 24 years of age in the crown i wanted to get a hair transplant to cover it, little did i know about hair loss.

 

I even found a clinic that time who were willing to do a transplant for me.

 

Lucky i did not get it done because now age 35 i have lost much more hair and that would have made no difference and would have messed my limited donor hair which i'm looking to use for the front hair line and add some mid scalp density. Then see later if anything can be done about the crown.

 

I learnt this by coming on this website priority is the front then going towards the back depending on donor supply and amount.

 

Family history can show how you might end up but not always the case.

 

When hair loss gets stable and the pattern is more established then have realistic goals and consider a hair transplant with a reliable doctor.

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Fast answer is no, I don't think you are a good candidate. I'd shave my head when it gets to that point, especially if you are not on finasteride. Hair systems can be amazing also.

 

The thing is, your hair loss could hit your donor area hard over the next 10 years. It may not, but it could. Then you are screwed.

 

But, it seems like your mind is made up. I'm not sure why people post a question like am I good candidate, but have made up their mind. Then, almost without exception, and sometimes only years later, come back on the board looking for a repair or regretting their decision.

 

I agree that if you go for it, do not drop your hairline at all and concentrate only on the frontal 3rd.

 

I rarely feel comfortable with you people getting transplants off of finasteride. Especially young people with such an established pattern at such an early age and not on finasteride.

 

You should understand that the hair you have now, and getting a transplant, is likely the best you would be able to hope for 10 years from now. Meaning, at best, if you get a transplant, you won't be better off 10 years from nowhat if you aren't on fin.

 

Good luck to you though.

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

View Dr. Konior's Website

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I am not a medical professional and my opinions should not be taken as medical advice.

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  • Regular Member

if you dont take finasteride ,then just shave it off. Make no sense to do any surgery at this moment if your hair loss is not stopped . IF you gonna hit NW6 ,theres not enough donor hair to cover such area. Maybe with beard / body hair. Your best option is finasteride at this moment. Thats the cruel reality

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  • Senior Member

Get on propecia (finasteride) asap asap asap- cannot stress this enough

3185 FUT with Dr. Rahal on 2/17/16

http://www.hairrestorationnetwork.com/eve/182611-fut-3185-dr-rahal-day-after-pics.html

 

1204 FUT with Dr. Rahal on 3/27/17

http://www.hairrestorationnetwork.com/eve/186586-round-2-rahal-1204-fut-frontal-third-same-area.html

 

---> total of 4389 grafts to my frontal third via FUT

---> 1mg finasteride daily since 1999:)

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Fast answer is no, I don't think you are a good candidate. I'd shave my head when it gets to that point, especially if you are not on finasteride. Hair systems can be amazing also.

 

The thing is, your hair loss could hit your donor area hard over the next 10 years. It may not, but it could. Then you are screwed.

 

But, it seems like your mind is made up. I'm not sure why people post a question like am I good candidate, but have made up their mind. Then, almost without exception, and sometimes only years later, come back on the board looking for a repair or regretting their decision.

 

I agree that if you go for it, do not drop your hairline at all and concentrate only on the frontal 3rd.

 

I rarely feel comfortable with you people getting transplants off of finasteride. Especially young people with such an established pattern at such an early age and not on finasteride.

 

You should understand that the hair you have now, and getting a transplant, is likely the best you would be able to hope for 10 years from now. Meaning, at best, if you get a transplant, you won't be better off 10 years from nowhat if you aren't on fin.

 

Good luck to you though.

 

 

Hi Spanker,

 

Thanks for the feedback. I haven't made up my mind yet and haven't booked with any doctor which is why I am here for further advice.

 

If I decide to go for a hair transplant, I will definitely not lower my hairline and will not come close to the crown. I have very realistic expectations; I know that I will need further transplants in the future and I don't think that with a hair transplant, my hairline and top would look any worse than it does now. I would only work on the hairline and the top using 3000-3500 grafts to make sure that I have at least some reserves for the future especially for the crown.

 

This way I believe that I would have an acceptable hairline and top for the next 10 years no matter how much hair I lose there, and only then I will consider transplanting the remaining grafts in the crown.

 

I honestly do not have any problem taking Finasteride or any medication as long as the sexual side effects aren't permanent, which is not the case after I have read a lot about this.

 

Looking forward to your feedback regarding the above.

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  • Regular Member
Get on propecia (finasteride) asap asap asap- cannot stress this enough

 

How long have you been using propecia and have you ever experienced any sides?

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How long have you been using propecia and have you ever experienced any sides?

Well I will share my experience

I have been using Finasteride 1mg for roughly 3.6 years now. I have not missed a single dose.

Yes I am experiencing sides but not extreme. I am happy if I have low sex drive than I loose my hair thickness. My girl is also happy, so I am not worried!

It's a personal choice, but remember Finasteride is the most effective medication. Do try it, if you experience any sides kindly quit it but if you don't experience any side effects then keep going..

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You have quite a bit of hair worth saving. For instance, the hair you have is probably 'worth' 5000 grafts in terms of the coverage it achieves.

 

We have seen on here a lot of times where someone like you gets 3000 grafts in the hairline and all it ends up doing is permanently shocking out the weak hairs, leaving the final result thin and see-through. I can remember that happening to two of the coalitions docs where they ended up having to answer negative postings from the patients in question.

 

If that scenario occurs you will undoubtedly go for another surgery straight away and before you know it 4 years have passed and your hair doesn't look any better. Then what happens?...another surgery and 18 months waiting for it to grow, $40,000 out of pocket and 6 years of disappointment.

 

Finasteride permanent sides are basically unproven but a group of individuals claim it was the drug that caused their ED. Millions of millions of men who don't take it also get ED. You're probably more likely to get it from poor diet, obesity and smoking.

 

Even if you only take 3 quarters of a pill a week it could be highly beneficial in slowing down the loss and give you a 5 or 6 year break before having to go back for more hair.

 

Who knows, you may even be lucky and get regrowth.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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  • Senior Member

You can lose a LOT of hair between your early 20s and your late 20s. It's a huge risk to do an HT in your early 20s without taking finasteride.

 

Minoxidil cannot stabilize your hair loss condition - do we even know for sure how it works ?

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I honestly do not have any problem taking Finasteride or any medication as long as the sexual side effects aren't permanent, which is not the case after I have read a lot about this.

 

Getting an erection has a lot to do with your mind and if in a corner of your mind you think that taking finasteride will cause ED, it probably will - it's a psychological thing, that's what I think. But please do your research and depend on scientific evidence instead of anecdotal :) As for me, I've been taking finasteride 1 mg everyday for a little less than a year, and so far I've had no problems.

 

All the best!

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  • Senior Member

Fin and Min can do alot for keeping the hair you have as well as regrow hair.

 

Not everyone is suitable for a hair transplant but meds can improve things alot.

 

Now i understand what Spex said,

 

'Surgery is a last resort. Give medical therapy a minimum of 12 months and then assess.'

 

I'm 4 months into meds treatment I and others have noticed a big difference in my hair thickness with regrowth in the crown.

 

If you dont get sides it well worth a try you dont know what is happening under the scalp if you respond well to meds things could only get better.

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  • Senior Member

Kalab,

 

You're very welcome my friend. Based on the photos of your father, it appears that he is between a class 6 & 7. And if you decide to never use finasteride, that's where you are undoubtedly headed. I say that because of the areas of diffused thinning already evident at your young age.

 

Yes, I say leave the crown alone for the reasons of further progression of loss as well as shock inducing further loss. You just won't have enough donor to cover everything. It does not appear that your father has donor zone thinning however that can change in the future. The good thing is that he is already 53 and his donor still looks strong. Hopefully yours will too...;)

 

Now, if you must do surgery verses buzzing your scalp, you would look best by having your frontal zone restored transitioning into the mid-scalp but leaving your crown alone. You can always get a partial system for the crown down the road. Another option would be to have a less dense single pass over the crown, not restore it, but it would look thin yet not completely bald.

 

You would need to keep the density level in the frontal zone realistic and not go too dense so you have enough for the future. If you have lots of chest and beard hair, you can always use that for the crown but again a realistic plan.

 

Have you ever tried buzzing your scalp to see what it looks like? You might like it. And you could also try getting started on finasteride in a lower dosage to see how you respond to it.

 

You have so much native hair that you could hang onto with finasteride if you get started now but again, it's a personal decision.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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  • Regular Member

Thanks for the feedback everyone.

 

Gillenator, I have excess beard and body hair. Way too much! This can help me in the future as you said.

 

I have also shaved my head tried the buzz cut several times. I don't mind doing it over and over again (I will be doing it soon); it suits me well. However, I would like to have longer hair with some decent coverage which is why I'm thinking surgery.

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I believe one problem with your approach is that you are not taking into account the future loss in the area where you will have surgery. If you are acknowledging that your will lose more hair (and it appears you will lose a lot) then you have to address the issue of the hair you have in the front, not just what you have in the back. If you have a surgery to get a strong hairline today, it won't be very strong in the future (assuming no medications) because the hair you have now will be gone as well and these hairs will represent the appearance of a thinning hairline and you will potentially be right where you are now, again. This might put you in a position of having to choose to thicken the front again or to have a thinner hairline and address the back for an end result that may not add up to give you the appearance you have now.

 

This is the problem with young patients that still have hair but are destined for advanced loss. They routinely know to plan for the future but this is usually conveyed as planning for loss in the crown or the vertex but rarely includes planning for loss in the frontal zone after the first surgery. Keeping the native hair healthy through medications enhances the final result because you are adding to the existing hair with transplanted terminal hairs and you are keeping the native hair through medical intervention so that they work together. Once you lose the native hair then the gaps they leave will have your final result looking much weaker in the end.

I represent Dr. Jerry Cooley online. All opinions are my own and do not necessarily represent those of Dr. Cooley. I am not a doctor.

 

Learn more about Jerry Cooley MD and Hair Center in Charlotte, NC

 

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  • Regular Member
I believe one problem with your approach is that you are not taking into account the future loss in the area where you will have surgery. If you are acknowledging that your will lose more hair (and it appears you will lose a lot) then you have to address the issue of the hair you have in the front, not just what you have in the back. If you have a surgery to get a strong hairline today, it won't be very strong in the future (assuming no medications) because the hair you have now will be gone as well and these hairs will represent the appearance of a thinning hairline and you will potentially be right where you are now, again. This might put you in a position of having to choose to thicken the front again or to have a thinner hairline and address the back for an end result that may not add up to give you the appearance you have now.

 

This is the problem with young patients that still have hair but are destined for advanced loss. They routinely know to plan for the future but this is usually conveyed as planning for loss in the crown or the vertex but rarely includes planning for loss in the frontal zone after the first surgery. Keeping the native hair healthy through medications enhances the final result because you are adding to the existing hair with transplanted terminal hairs and you are keeping the native hair through medical intervention so that they work together. Once you lose the native hair then the gaps they leave will have your final result looking much weaker in the end.

 

Thanks for the valuable feedback HairCenter. I do acknowledge the fact that I will lose more hair in the future even in the hairline but it's just a risk I'm willing to take. When it comes to the day where I will have to choose between thickening the hairline again or filling the crown, I will decide then. I do have realistic expectations though; if all is said and done and I end up 20 years later with the coverage I have now, I don't think I would mind (Some say it would matter more to me then, it might but I believe it won't :) ). My hair loss bothers me but not to an extreme extent; I just want to have a fuller head of hair during my 20s, probably 30s.

 

I do not mind taking any medications as long as the side effects are not severe. At a young age, sexual side effects are what concern me the most. I know that Finasteride might help A LOT in my case and most people here are recommending that, but the problem is I am afraid of long term effects. Suppose I start the medication and don't have any sides and after a couple of years the sides appear and won't go. That's my biggest concern. Even my dermatologist who is the best in the country, very reputable, and extremely experienced (he's in his high 60s) advised against it and said I've always told my friends back in the days that it might have permanent sides and now it seems that I'm right. ( He is bald and chose not to take Fin).

 

Apart from Fin, what others medications do you suggest? ( I am on Minox and Biotin now, considering Nizoral and Lipogaine Big 3 Shampoo).

 

Any feedback regarding the above would be highly appreciated.

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