Jump to content

Recommended Posts

Posted (edited)

I am 39 years old.  Began receeding and diffusing in my early 20s.  Stupidly, I thought my hair was only “thinning” with age (an adult) and I did not make the connection of MPB.  I had never heard of diffuse thinning.    

I have tried to accept hair loss over the last few years but find I cannot. I did not envision dealing with this as my father retained a good amount of hair throughout his life.  Uncles were NW 5/6s however.  I know I still have a fair amount of hair for my age, but I am extremely unhappy with it currently.  I have taken generic Propecia for at least a year and a half - I don’t really feel like I respond to it though.  Pull tests in my diffused area still pull very easily, if indeed Propecia halted my hair loss, I assume this would not be the case?  

I have no qualms with transplant surgery in theory but I fear the emerging pattern is going to be too far gone to achieve a cosmetically worth it result.  Or that a initial procedure may look good briefly, but that I will be left chasing the loss with more and more surgery.  

Again, I know others have suffered much worse loss at a younger age, and I’m very sorry for that.  Still and all, this has been a very difficult problem for me.  Here are some pics (apologies for poor quality).  Please let me know what options I may have.  I really want to find a solution to this and I feel there has to be a way.  My hair when grown out is fairly thick and has a slight to medium wave to it.  Some of these pics are under strong bathroom light with wet hair.  

The last pic shows some retrograde (which I definitely have) in my nape.  Does the presence of retrograde rule out FUE?  Rule out transplant altogether?  I want to reiterate that though you may see a good amount of hair when it’s grown out, it is sickly, diffusing, miniaturizing hair.  The camera may not pick it up fully.  My crown does not dip TOO far so I’m not sure if I’m full blown NW6 or if I can squeak by as a 5A.  

Im grateful for this community and welcome constructive help.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E583DD48-CEF1-41EF-A938-FEB30EBDB7A7.jpeg

Edited by hanginginthewire
Pic removed

Share this post


Link to post
Share on other sites

Looks good, especially the last 2 pics.  Looks like you already had a transplant.

Share this post


Link to post
Share on other sites
4 hours ago, True said:

Looks good, especially the last 2 pics.  Looks like you already had a transplant.

Nope, I haven’t had any work done. I shaved my head to see if I liked the look, not for a transplant.    

The last two are with grown out hair.  The frontal third looks fucked.  Midscalp and crown look okay for now, but, as you can see when it’s buzzed down - the pattern of diffusion is definitely hairline to crown.  So, if I improved the frontal third with, say, 2000ish grafts, aren’t I gonna be in a risky position as the loss continues and my donor is depleting and my retrograde possibly climbing up?  

Despite the Propecia, if I tug slightly on the hairs on my temples - several very weak, miniaturized/dying hairs slip right out.  On my crown and midscalp, the hairs easily pull out too, but look a little stronger / less minaturized. 

Share this post


Link to post
Share on other sites
5 hours ago, hanginginthewire said:

Nope, I haven’t had any work done. I shaved my head to see if I liked the look, not for a transplant.    

The last two are with grown out hair.  The frontal third looks fucked.  Midscalp and crown look okay for now, but, as you can see when it’s buzzed down - the pattern of diffusion is definitely hairline to crown.  So, if I improved the frontal third with, say, 2000ish grafts, aren’t I gonna be in a risky position as the loss continues and my donor is depleting and my retrograde possibly climbing up?  

Despite the Propecia, if I tug slightly on the hairs on my temples - several very weak, miniaturized/dying hairs slip right out.  On my crown and midscalp, the hairs easily pull out too, but look a little stronger / less minaturized. 

I can totally relate to what you’re feeling. I remember when I first started losing my hair in my 20s I was devastated.  Hair has always been iconic to me for whatever reason, perhaps it’s because I used to wear my hair longer and attracted many females you thought I looked like Brad Pitt.

Before that though, in freshman year of high school, I  was coerced into shaving my head, which was a tradition  for freshman on the swim team.   I was already attempting to grow my hair longer at the time so I dreaded having to shave my head. What’s worse, my girlfriend at the time broke up with me  immediately after I shaved my lustrous locks. Right there and then, I knew I look terrible without hair. 

So after I shave my head, I’ve vowed to never do it again and I started growing my hair long. Not super long, but long enough where it was down to my chin and apparently it was around the same time that movies like “legend of the fall” came out where Brad Pitt was voted best looking man of the year. And to hear women say that it looks like him especially with my hair and to have many gorgeous women want to run your fingers through it and play with it, pair became part of my identity.

So when I started losing my hair when I was in my early 20s, I was devastated. I knew I was destined to become that ugly old looking bald guy that I had learned to despise when I was a freshman in high school. Even with the smallest bald spot, I wore a hat everywhere I went. 

 By the time I was 25, I had lost a significant amount of hair and people started asking me why I was always wearing a hat. Yes, I was being cold cold even though people could not see my head. But yet it still made me feel better wearing the hat.  

 By the time I was 27, I decided something had to be done. I was insecure about my looks, despite the fact that I was in some of the best shape of my life. I just felt like I couldn’t be normal. I would avoid going to events that meant the hat had to come off.    My hat, instead of my hair had become a big part of my broken identity. 

So in doing some research I found this very website. Now, it didn’t look anything like this at the time, it was 14 years ago. But there was a discussion forum and it was still pretty active even back then. I found a local doctor and learned that with the amount of hair loss I had, I would need multiple hair transplant procedure is to achieve my goals.

So I knew what I was in for, I knew it was a journey and not a one time fix. I also knew that Though I already have significant hair loss, the remaining hair on top of my head but also disappear. Thus, during my journey, I would experience a net gain but I would also lose the rest of my natural hair while I continued restoring as much hair on top of my head as possible.

 I didn’t start developing any sense of self-confidence until after my third hair transplant was mostly grown in. By that time,  I had over 7000 grafts and all the rest of my natural hair had fallen out.  What my hair looked pretty good and I was actually able to go around without a hat.

After my fourth hair transplant, I had over 9600 grafts  and I felt very confident about my hair. The frontal third of my scalp was  covered by fairly thick hair, the mid Scott region was also pretty thick and the back, was still a little thin but to be honest, by the time my journey was complete, I really wasn’t overly concerned about the mild thinning I had compared to the fact that I would have been completely bald. 

 I wore my hair very short for many years and it looks great. Frankly, I think my hair looks best when I wear it short. I combed it forward and spiked the bangs And nobody even knows I’ve experienced any hair loss. That is, until they see the back and then the only comment I usually get is “well it’s a little thin back there but nobody would ever really notice that “ or “ well it’s a little thin back there but that’s perfectly normal for guys your age“.  

 So why did I take the time to share all this with you? Well, because it’s very possible that you may embark on your own journey that leads to hair restoration  and a renewed sense of self-confidence. However, right now you are still in the early stages just like I was when I was 21. You still have a significant amount of hair, at least as far as I can see in the pictures. When I was 21, I had a significant amount of hair but even a slight bit of thinning in the crown cost me to panic and feel like I had to wear hat hide it. 

Believe me, you will adjust. I know that doesn’t sound overly comforting, but there are solutions here that can make you feel much more confident and accept some realities over time.  

 So what is your long-term strategy?   If you are not already using hair loss  medication such as Propecia and Rogaine I encourage you to consider it. Make sure you understand the potential side effects if you are going to use them however, if you do it may help you save much of your existing hair and then you can get air transplant surgery to thicken the thinning areas. But yes, you may be on a journey that requires multiple procedures over time just like I had to do. But for me, it was worth it in the end.

Best wishes,

Bill


I am the managing publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum. I am also a 4 time hair transplant patient. View my patient hair loss website to view my entire hair restoration journey with photos.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Share this post


Link to post
Share on other sites

Here’s how I see it.  You’re 39 years old, you’re on the meds to slow your progression, and you appear to have a decent donor supply.  Go get a consult.  Get an honest opinion from someone who is conservative and realistic as to what you can expect now and into the future.  Get it from someone who isn’t giving you a hard sell.   

Full disclosure: I’m 55.  Had a full head of hair at 42.  Now NW5.  I guess that’s what 3 kids can do to you.  I wish I knew about and used  meds over this period, because it would be significantly less expensive and seemless today if I had.  

Share this post


Link to post
Share on other sites

I don't know - for the type of hair you have (straight and looks like fine hair) it looks just fine to me.  Some recession - but it doesn't look bad at all.

I suppose if you threw 5-7K grafts in there it would look alot more full, but frankly as is - seems normal.

Maybe I'm missing something.  You are 39 so, you've kept most of your hair which is way better off than 90% of balding men.

Good luck on whatever you decide.

Share this post


Link to post
Share on other sites

I’m so confused, lol.  Anytime I post pics people tend to say “it’s not that bad” whereas I don’t see how much worse it could get.  Yes there’s hair there, but it’s a diffused rat’s nest.  

Ive had a couple consults, but I don’t know who to trust.  Everything you read online is so contradictory, and results seem to be very hit or miss.  It just makes me feel very lost and down on myself.  

Share this post


Link to post
Share on other sites
Posted (edited)

Well, we are seeing things OBJECTIVELY - so would a hair-loss restoration surgeon.  As well as Bill (managing publisher). 

You've had consults and don't know what/who to trust?  That means you are not in a position to have hair surgery yet (imho).  Maybe I'm completely wrong.

I know it can be very difficult - I've had alot of grafts (8.7K) and will be doing more again this winter - I have a certain 'base' of hair.  But when you consider how many original hairs are in the frontal zone to the back of the mid-vertex, it's easy to lose perspective on how much real estate we are trying to cover w/the 'illusion' of hair at less than 50% of total density.

Especially if one has straight and/or fine hair.  Losing one's hair is not easy.  It's why we come to this forum and look for objectivity; it is easy to lose that when it's personal.  I'm not satisfied w/my hair but others see coverage and don't really think of me as balding.

Finally, it is sometimes difficult if we don't accept the aging process that EVERYTHING in/on our body is moving steadily (although slowly) towards entropy. 

Give yourself a break and get all the facts and then make an objective decision on how and if you want to move forward.

Good luck.

Edited by jjsrader

Share this post


Link to post
Share on other sites
16 minutes ago, jjsrader said:

Well, we are seeing things OBJECTIVELY - so would a hair-loss restoration surgeon.  As well as Bill (managing publisher). 

You've had consults and don't know what/who to trust?  That means you are not in a position to have hair surgery yet (imho).  Maybe I'm completely wrong.

I know it can be very difficult - I've had alot of grafts (8.7K) and will be doing more again this winter - I have a certain 'base' of hair.  But when you consider how many original hairs are in the frontal zone to the back of the mid-vertex, it's easy to lose perspective on how much real estate we are trying to cover w/the 'illusion' of hair at less than 50% of total density.

Especially if one has straight and/or fine hair.  Losing one's hair is not easy.  It's why we come to this forum and look for objectivity; it is easy to lose that when it's personal.  I'm not satisfied w/my hair but others see coverage and don't really think of me as balding.

Finally, it is sometimes difficult if we don't accept the aging process that EVERYTHING in/on our body is moving steadily (although slowly) towards entropy. 

Give yourself a break and get all the facts and then make an objective decision on how and if you want to move forward.

Good luck.

My hair is actually slightly wavy.  I think it has an okay thickness. 

With regard to trust I just mean that one can’t know if the doctor is giving the go ahead on surgery because they think they can truly help you or because they see an opportunity to make money.  

 

What types of procedures have you had jjsrader? 

Share this post


Link to post
Share on other sites

Dude I feel u.. I’m pretty much in the same situation as u .. almost 40 .. didn’t realize I have mpb till recently with .diffuse thinning .. it’s more difficult to do hair transplants on diffusers , until u have a bald area . Because we be sacrificing native hair to be replaced with donor hair .. What does ur hairline look like ? Is it receding yet ?  If it’s receding enough U can transplant into the hairline .. with a dense hairline , it makes a big difference on ur overall hair .. ur top can remain thin like it is now ,; but with a nice hairline u can comb it up to make it appear thicker .. only good thing about diffusing hair is that u don’t look bald ,. Good luck .. 

Share this post


Link to post
Share on other sites

Dude.

Your hair looks great.

If you risk a transplant, I think you're out of your mind.

Get temporary SMP to create illusion.

Share this post


Link to post
Share on other sites
Posted (edited)
54 minutes ago, hanginginthewire said:

My hair is actually slightly wavy.  I think it has an okay thickness. 

With regard to trust I just mean that one can’t know if the doctor is giving the go ahead on surgery because they think they can truly help you or because they see an opportunity to make money.  

 

What types of procedures have you had jjsrader? 

 

 

Quote

These are my (jjsrader) procedures I posted from another thread, see below.  I have very very straight 'baby-fine' hair and began losing my hair at age 21 (very different from you).  Here is a recent post of mine (my experience).

I have a big head; here's the gory details.  Due to avodart, progressively stronger rogaine from 5% up to 30% 2X's per day, hair laser from overmachogrande.com and Nizoral 2% shampoo - I was able to do really well from age 38 w/my surgery w/Dr. Feller for about 6-8 years.  Then, my genetics and family history and many years of taking fin, then dut, rogaine 2% then up to 30% 2X's per day and using Nizoral shampoo 2% for many years - my hairloss accelerated again after about 8 years from my strip surgery w/Dr. Feller.

I don't have a bald spot nor any areas where hair is not growing - but I would like to maximize my results.  At 18 months out from my last surgery I'll do another one and then a year or so after that I'll have my final surgeries, which will be FUE

At that point, w/permanent micropigment from Mark Weston somewhere in between these surgeries I'll be done.  I always knew that I would do anything in my power to not be bald and from the outset I was prepared for many surgeries if necessary.   Unfortunately, aggressive baldness w/a family history of almost everyone balding is not very good.  This type of balding is a progressive illness and requires follow-up surgeries if you are committed to not being bald (and alot of medicine and treatments as well). 

Again - I don't even recommend surgery to anyone w/early balding or poor hair quality (thin/fine hair) or family history that is stacked against them; it's a truly personal decision.  If I could go back and do it again knowing what I know now - I would have gone bald w/a bit of grace and dignity.

Age 24 - two strips a month apart from Dr. Matt Leavitt (100 & 120 grafts respectively).  This was the OLD days of strip removal.  Small scars but they were micrografts of 2-8 hairs.

Age 27 - One strip from Dr. Pomerantz  400 grafts.  Again micrografts.

Age 28 - Another strip from Dr. Pomerantz - 700 grafts.  Again micrografts

Age 38 - A strip from Dr. Feller - 2250 grafts.  Follicular units dissected under microscopes.

Age 50 - A strip from Dr. Soni - 4500 grafts.  Follicular units dissected under microscopes.

Age 50 - (same day from Dr. Soni) - 500 FUE

Edited July 17 by jjsrader

 

Edited by jjsrader

Share this post


Link to post
Share on other sites

I think if you do several more consults you'll get a 'baseline' for what is reasonable vs what some surgeons say that want to do possibly (in your opinion) an excessive amount of grafts.

Cosmetic hair-loss surgery is NOT for everyone - it takes so long for results and even then you are not guaranteed good results.  Most people do well but there are probably way over 50% of patients that regret their decision longer term. 

This is a fact and keep in mind on a hair forum we are seeing the VAST amount of posters either shortly after their surgeries or within a year or two - never to be heard from again.

Hairloss in nearly 100% of patients is progressive and often it can accelerate greatly after age 40 or 45 years old.  One never knows.  These are all valid reasons NOT to have surgery.

There are also many many reasons to have surgery and it can be very satisfying in the short-medium AND long term as well.

In the end it is completely personal and win/lose/draw your hair should not be the most important thing in your life as you age.  Seriously.  It can be something you do the best you can with but like all things in life as we age perspective should be the great equalizer.

 

peace...

Share this post


Link to post
Share on other sites
Posted (edited)

It is very personal, yes.  The thing is one can’t make that personal decision when there are so many unknowns.  

Its truly baffling to me that someone could say my hair “looks great.”  

The main thing I want to know is can a NW5/6 get decent coverage with let’s say 3 FUEs?  Consistently?  I often wonder who exactly transplants are for.  There are 7 Norwood’s, #1 doesn’t need one, #2 is a mature hairline, and anything beyond #4 seems to be dicey.  So I guess it is for Norwood 3 only?  I thought this forum was pretty pro-transplant?  

Edited by hanginginthewire

Share this post


Link to post
Share on other sites
Posted (edited)

Yea, this forum is pro-transplants for sure.

Anything beyond NW5 is mostly about 'reasonable expectations' after all there is only so much hair you can replace that is lost - however, those w/very favorable hair characteristics who are NW5 or NW6 'skew' the results in my opinion.

For example, on hair forums the vast amount of photograph evidence is from doctors or patients that get very good cosmetic results (even w/advanced baldness) vs the amount of pics we see that are not so good.  That's a fact.

For example, take a look at Dr. Bernstein and a few other doctor's websites (Shapiro/H&W) that feature ALOT of NW5/NW6 results and take a good hard look and think to yourself w/your own hair characteristics and long-term hairloss pattern if those are results that would seem good to you if you did 3 FUE surgeries?

I don't recommend hair transplants to anyone - but that doesn't mean my opinion is any more valid than the many people who have had hair-restoration surgery and been completely satisfied with it.

My entire family male history on both sides are all NW5's/6's and 7's - someone like me who began losing his hair at age 21 should probably not ever start going down the hair transplant road.  I waited until I was 23 years old to begin.  Even w/the arsenal of meds & stuff I am on (in my profile) I have only managed to slow down my long-term hairloss slightly (and I have been on alot of stuff for 20+ years). 

8.6K+ hair transplants w/fine straight hair doesn't look NEARLY as full as someone like Bill (managing publisher) who has wavy thick hair.  That's just a fact.  My expectations have diminished as I have gotten older,  yet I will be having another surgery in Feb '19 because I want enough hair in my frontal hairband and 1/3rd of my head to have enough hair to create the illusion of a near-normal head of hair.  After that final FUT I'll finish off w/FUE - but this is my personal journey and the FUE will be for my midscalp to the back of my mid-vertex.  I'll have to let my crown slowly lose but have a 'base' of grafts to keep the natural crown whirl.  Even w/13K of grafts w/my type of hair (fine/straight on very white skin) the contrast created doesn't create the illusion of a full head of hair throughout my entire head of hair.   Of course w/a bit of dermmatch and/or hair volumizing fibers and such it looks pretty near normal - but that can be a pain in the ass everyday as well (which I don't do on a regular basis).

Even w/temporary SMP or even permanent ink via Mark Weston that is NOT exactly like natural regular density hair - there is no magic bullet.

 

PRP and laser helmets are still not well documented.   So, it never really ends, in a manner of speaking.

It is all about personal perspective and realistic expectations under all lighting conditions etc...

All I know is that if you are commited to the long haul and are not taking any systemic meds/topicals/hair laser/prp or whatever to slow down hairloss - is that hairloss is progressive (the severity depending on your genetics and family history) and anything can happen when you are much older.

 

Edited by jjsrader

Share this post


Link to post
Share on other sites

Let's imagine that you were able to transplant 10,000 grafts.  You would STILL benefit from temporary SMP which basically carries zero risk.

Why not get the temporary SMP done first, and take it from there?

  • Thanks 1

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×