Long term plan? Late 20's - can't tolerate Fin

[vboteju]

Just turned 28. Pictures below are with wet hair. People don't think I am balding when hair is dry/styled. 

Genetics - Dad is a nw1 who has just started to experience thinning around 55. hair line is fully intact for him. Normal people wouldn't notice any thinning. Don't know about paternal grandfather. Maternal grandfather is a nw7 at around 80. Was about a nw4 around 40ish. I think I am following an accelerated pattern of my dad, because my maternal grandfather had recession rather than diffuse thinning. 

Currently on Minoxidil and Nizoral. Lost quite a bit of hair over these last few months - not sure if its the Min causing shedding or simply accelerated male pattern baldness. Can't tolerate Finasteride - tried .25 mg and still got sides. 

Had a 2k graft in the frontal hair line portion done by a recommended doc via FUT. Per him, I have 9k grafts total (so 7k more left in the bank) if I go the full FUT/FUE route. My hair caliber is medium fine. Had about 2 hairs/graft from the procedure.

Realistically, my goals are to get to around 40-45 with hair. If I can maintain after that, great. His prediction was that I would end up at nw4 at around 40 without meds. I see a clear nw5/nw6 pattern emerging.  

My thoughts-
Max out FUT/FUE
Figure I can get 1k viable total from BHT
Throw in SMP for increasing the look of density
Did a round of PRP with him - if I respond well, I will continue to do this. 
 

Edited January 27, 2019 by vboteju

[vboteju]

Any thoughts?

[pkipling]

You're already setting yourself up to win by really looking at the longterm goal here and making sure that you plan accordingly. One thing you have working in your favor is the curliness of your hair, which will aid in adding the illusion of density. 

My main question would be this: Are you satisfied with your surgeon, and is this someone you trust and want to move forward with throughout this entire journey? If so, I would lean heavily on him to support you in coming up with each next step, as it's called for. If this isn't the surgeon you want for your entire journey, I would suggest getting other consultations and opinions and seeing if there's someone out there you feel comfortable enough with to take this task on with you. 

I would also caution you against planning everything as if you won't care what happens after 40/45... While that may seem like the case right now, you'd be surprised at how much this all continues to matter - with guys getting HTs even into their 60s. So while I commend you for thinking relatively longterm already, I urge you to take it a step further and really set yourself up to win even into your older years. 

[vboteju]

The transplant was done by a highly rec’d doc from this site. I’ve been happy so far, obviously waiting for the final results to pass judgement. 

Ideally I would have hair after 45- I’m just not sure whether that is a feasible option for me given my genetics, hair loss, inability to use meds. And if that’s the case, I’d rather be aggressive in treating loss early and being bald later on. I think hair is important, but it is more important for me to have hair earlier rather than later. 

Does it look like I will be a nw5/6 and do you think my donor will be able to match up?

[Legend007]

u Have to maintain that crown thru meds .. no way around that .. u already did the hairline , so a second procedure to ur frontal 1/3 will do u good .. ur donor and sides seems good .. there’s been much balder people with less donor hair than u that’s able to achieve a good dense result .. also, ur curly hair and transplants will camouflage ur thinning crown later in life .. and since u already got a fut .. n ur scalp laxity is good . A second fut would be a good route to take . After that u can FUE it out .. 

Don’t stress too much of the future . Just have a game plan for it . 

[gillenator]

Have you tried a topical form of finasteride?...you may not get sides with that, just not sure if it will prove efficient for you over the long haul.

Your crown diffusion is a large area and why some form of finasteride would potentially be a great benefit to you.

Ask your doctor if using it every other day or every third day might help with the sides since it has a long shelf life.

[vboteju]

1 hour ago, gillenator said:

Have you tried a topical form of finasteride?...you may not get sides with that, just not sure if it will prove efficient for you over the long haul.

Your crown diffusion is a large area and why some form of finasteride would potentially be a great benefit to you.

Ask your doctor if using it every other day or every third day might help with the sides since it has a long shelf life.

I have not tried topical. I would prefer not to, given that I will eventually have kids/wife and there is a strong possibility they would be exposed to it. 

I used Fin 2x a week and had sides. 

[hairman22]

Just earn as much money as u can to get as good surgeon as possible to utilize grafts.

 

Your donor area looks very good.

 

Use toppik next few years until hair gets worse

[gillenator]

That would definitely help in the short term.