30 y/o, Early NW IV, *No Fin* - Candidacy?

[aletheia225]

I started using Rogaine a couple of months ago and am either shedding or going through a spike in my genetic 'curve' - the temples and forelock are noticeably thinner than they were when I started (though perhaps another person would not have noticed). As can be seen from the photos I've attached, my crown loss is not bad at all (and a reputable HT doc told me several months ago that I have very little miniaturization in the crown) and I have solid density through my mid-scalp region (pic #'s 5, 6 and 7), though it is beginning to thin. The attached pics don't cover the full mid-scalp region but are representative of the density throughout that area. From what I gather, my donor isn't fantastic but is nonetheless 'normal', 'sufficient', what have you - not defective or anything.

 

I am committed to Rogaine for the long term and will consider adding Nizoral. Am I a candidate for a conservative frontal procedure? I understand the risks given no fin and the possibility of needing to shave down the road. Are reputable docs willing to transplant in this kind of situation? I believe I have encountered cases where they are...

[Speegs]

Candidate, yes. But it will be in vain if you don't get proactive with the crown, and finasteride is the best way modern medicine can help.

[aletheia225]

Yeah, I hear you on Fin. But I've been on it and my body cannot tolerate it. 'Post Finasteride Syndrome' is, while very rare, absolutely real and a hell I wish on no one (I did recover though). I understand the vast majority of people don't experience sides or significant sides, and that it works out very well for them. Whatever the reason, I am not one of those people.

 

As to crown - it's more or less looked like it does now since I was 23. Also, as mentioned, there's not much miniaturization. Even without toppik, my crown loss is not much in the way of detectable unless under very harsh light. And even then, not all that aesthetically consequential.

[Speegs]

If you're willing to be partially bald but have your hair line restored then you can consider a hair transplant, if you don't want advanced baldness to take your hair away behind the transplant then I'd hold off doing one.

 

You don't want to look like Joe Biden in my opinion.

 

See how unnatural his hair looks having a restored hairline but having lost everything behind it?

 

An HT must be approached with long term thinking, will it look good at 50 or only in your 30s?

 

[JeffC45]

Wondering if the advice would change if he was 40 and a NW 3?

[aletheia225]

Probably, but make your own thread if you want that question answered. Thanks.

[Speegs]

Without finasteride full crownal baldness is almost inevitable from genetics and the aging process.

 

So it really comes down to your expectations, are you willing to live with a restored hairline that frames the face from the front, but with near complete baldness elsewhere on the top of the scalp as time progresses?

 

If the answer is yes, then proceed with due diligence in your hunt for the best surgeon for your needs.

 

Just realize hair loss is progressive if left to its own devices, you're still a young man, my age. And we need to make sure we realize hair loss is a life long struggle.

[aletheia225]

Yeah, those are concerns obviously. I just doubt with Rogaine use, my crown and mid-scalp will be an issue for the next 10 if not 15 years. My crown has looked more or less the same for the past 7 years (with only 5 months of fin use and no other treatments) and has little miniaturization. And my mid-scalp is not 100% but nonetheless very thick. For all intents and purposes, it's a completely 'full' area of hair. If and when things go south, I am fine with shaving and/or getting the grafts removed. Easier said than done I know, but I don't see myself having an issue with that if I'm in my mid 40's.

[Spanker]

Yeah, those are concerns obviously. I just doubt with Rogaine use, my crown and mid-scalp will be an issue for the next 10 if not 15 years. My crown has looked more or less the same for the past 7 years (with only 5 months of fin use and no other treatments) and has little miniaturization. And my mid-scalp is not 100% but nonetheless very thick. For all intents and purposes, it's a completely 'full' area of hair. If and when things go south, I am fine with shaving and/or getting the grafts removed. Easier said than done I know, but I don't see myself having an issue with that if I'm in my mid 40's.

 

Planing surgery with the idea of shaving or getting grafts removed is just a bad idea....you'll be looking at your scarred scalp saying...man, why did I do that? Removing the grafts is a big no-no and again, surgery should never ever be done with that in mind.

 

The center part of your crown appears to be about 65 to 70 percent miniaturized...so I don't understand why you are are saying it has little miniaturization. The thin spot doesn't appear to be that big yet, so that is good.

 

I am kind of teetering on whether you are a good candidate at this point because without fin you have a pretty good hairline at this point and a lot of hair to lose. I suggest you have an in person consult with a trusted doc and see what he or she says.

[Bill - Seemiller]

alethia

 

Welcome to our hair restoration forum. You are likely a candidate as others have said though only a qualified hair restoration physician can tell you for sure. A lot of people undergo hair transplant surgery without being on finasteride. Just understand that surgical hair transplantation does nothing to stop the progression of male pattern baldness. Given that you are 37 still with a decent head of hair, I suspect you won't go completely bald. But hair loss is progressive and those who don't take non-surgical treatments are at greater risk of losing additional hair.

 

Best wishes,

 

Bill

[Spanker]

alethia

 

Welcome to our hair restoration forum. You are likely a candidate as others have said though only a qualified hair restoration physician can tell you for sure. A lot of people undergo hair transplant surgery without being on finasteride. Just understand that surgical hair transplantation does nothing to stop the progression of male pattern baldness. Given that you are 37 still with a decent head of hair, I suspect you won't go completely bald. But hair loss is progressive and those who don't take non-surgical treatments are at greater risk of losing additional hair.

 

Best wishes,

 

Bill

His profile and thread says he is 30...and I think that is young enough that off meds that there is still a fairly high risk of extensive loss, but of course not garunteed.