Second opinions before consultations.

[bonkling]

Hi all,

About to consult with a few docs, and was wondering what you would do in my situation - just to get some second opinions from this valued forum.

• I'm 28, NW 2/3. Started noticing temple recession about 3 years ago, but may have started earlier. 
• Been on finasteride (Propecia) & minoxidil for about two years, seemed to have slowed the recession, and given minor new recruitment in temple regions.
• Family history: Father's side, all bald, or a NW 6/7. Older brother is a NW 5/6. Mother's side =  not much balding really.

I'm debating whether I:

a) Go unshaven at the front, and just get a couple thousand grafts to fix the temples and lower the hair line a little. I'm conscious on not going too aggressive, as I may need many more grafts down the track. 

~or~

b) Get more grafts further back as a preventative to cover the hair that I haven't lost yet. 

For reference, I am considering Dr. Lupanzula, Dr. Kesser (if graft estimate is low enough), or Dr. Sethi at Eugenix - as these doctors have quite a few patients with a similar NW pattern. I'm living in New Zealand, so I'm going to travel regardless.

Eager to hear your thoughts, and the input is greatly appreciated

Thanks! 

Note: Some of these pictures seem a bit better than how it appears in person, without the remainder of my face for contrast.

Edited March 25, 2019 by bonkling

[Upshall]

Are you on propecia? 

[bonkling]

Just now, Upshall said:

Are you on propecia? 

Hey mate, yeah I'm on propecia (finasteride) and minoxidil. Have been for a couple of years.

[Phillyman1996]

Your hairline doesnt look bad. But if you want you could get a small transplant.

[Upshall]

I would recommend against getting a transplant where you have hair man. You will most likely suffer shockloss if you do

[CosmoKramer]

In my opinion, if you were 38 and not on any hair loss medication and your hair loss was stabilized, I would say go for it....but, since you’re 28 on meds and it’s not clear how much more your hair loss would progress down the road, I’d say don’t go for it just yet, your hair looks good for your current age even with the thinning temples, maybe a try a hairstyle/cut with shorter hair on your sides/back and keep the top long see if that helps any. 🙂

Oh, and yeah, I’d be concerned with any possible permanent shock loss in areas you have hair already that are in process of miniaturization.

Edited March 25, 2019 by CosmoKramer

[Kiwi Guy]

2 hours ago, CosmoKramer said:

In my opinion, if you were 38 and not on any hair loss medication and your hair loss was stabilized, I would say go for it....but, since you’re 28 on meds and it’s not clear how much more your hair loss would progress down the road, I’d say don’t go for it just yet, your hair looks good for your current age even with the thinning temples, maybe a try a hairstyle/cut with shorter hair on your sides/back and keep the top long see if that helps any. 🙂

Oh, and yeah, I’d be concerned with any possible permanent shock loss in areas you have hair already that are in process of miniaturization.

Wow, so shock loss can be permanent? I always thought it grew back in 3 or 4 months

[Kiwi Guy]

3 hours ago, bonkling said:

Hi all,

About to consult with a few docs, and was wondering what you would do in my situation - just to get some second opinions from this valued forum.

• I'm 28, NW 2/3. Started noticing temple recession about 3 years ago, but may have started earlier. 
• Been on finasteride (Propecia) & minoxidil for about two years, seemed to have slowed the recession, and given minor new recruitment in temple regions.
• Family history: Father's side, all bald, or a NW 6/7. Older brother is a NW 5/6. Mother's side =  not much balding really.

I'm debating whether I:

a) Go unshaven at the front, and just get a couple thousand grafts to fix the temples and lower the hair line a little. I'm conscious on not going too aggressive, as I may need many more grafts down the track. 

~or~

b) Get more grafts further back as a preventative to cover the hair that I haven't lost yet. 

For reference, I am considering Dr. Lupanzula, Dr. Kesser (if graft estimate is low enough), or Dr. Sethi at Eugenix - as these doctors have quite a few patients with a similar NW pattern. I'm living in New Zealand, so I'm going to travel regardless.

Eager to hear your thoughts, and the input is greatly appreciated

Thanks! 

Note: Some of these pictures seem a bit better than how it appears in person, without the remainder of my face for contrast.

Hey man, I'm in New Zealand too and seriously considering a transplant, my temples are creeping back and I'm thinning in the middle, it's a pain with the exchange rates to get a transplant because it costs us so much more, is price much of a factor to you? If you got a transplant I'd say it would be 1500 to 2000 grafts to fill in the temple recession and possibly to bring the hairline down a half inch or so, the hair you have looks strong though which is a good sign for you.

[bonkling]

4 hours ago, CosmoKramer said:

In my opinion, if you were 38 and not on any hair loss medication and your hair loss was stabilized, I would say go for it....but, since you’re 28 on meds and it’s not clear how much more your hair loss would progress down the road, I’d say don’t go for it just yet, your hair looks good for your current age even with the thinning temples, maybe a try a hairstyle/cut with shorter hair on your sides/back and keep the top long see if that helps any. 🙂

Oh, and yeah, I’d be concerned with any possible permanent shock loss in areas you have hair already that are in process of miniaturization.

Thanks Cosmo,

That makes a lot of sense.

I suppose that's the trouble with being on the meds, we don't know how bad it really is/could be.

As Kiwi mentioned, is shock loss something that can be permanent? Or is it more the case of causing the thinning areas to accelerate rapidly after the surgery? 

Cheers

[bonkling]

1 hour ago, Kiwi Guy said:

Hey man, I'm in New Zealand too and seriously considering a transplant, my temples are creeping back and I'm thinning in the middle, it's a pain with the exchange rates to get a transplant because it costs us so much more, is price much of a factor to you? If you got a transplant I'd say it would be 1500 to 2000 grafts to fill in the temple recession and possibly to bring the hairline down a half inch or so, the hair you have looks strong though which is a good sign for you.

Hey mate,

Yeah, I feel your pain. A few thousand grafts for us can end up being over 20k, even much more.

Money isn't a huge issue, but at the same time I don't want to go nuts with it. Definitely a big decision haha. So I'm not too sure just yet. Yourself?

[Melvin- Admin]

7 hours ago, bonkling said:

Thanks Cosmo,

That makes a lot of sense.

I suppose that's the trouble with being on the meds, we don't know how bad it really is/could be.

As Kiwi mentioned, is shock loss something that can be permanent? Or is it more the case of causing the thinning areas to accelerate rapidly after the surgery? 

Cheers

Shock loss can be permanent if the hairs that are shocked are already miniaturized and on their way out.

[CosmoKramer]

12 hours ago, Kiwi Guy said:

Wow, so shock loss can be permanent? I always thought it grew back in 3 or 4 months

I have read it can be in areas that are susceptible to DHT, the areas that should come back in 3 or 4 months time are usually in the donor region.

[CosmoKramer]

10 hours ago, bonkling said:

Thanks Cosmo,

That makes a lot of sense.

I suppose that's the trouble with being on the meds, we don't know how bad it really is/could be.

As Kiwi mentioned, is shock loss something that can be permanent? Or is it more the case of causing the thinning areas to accelerate rapidly after the surgery? 

Cheers

You’re welcome! 

Exactly, it’s a catch-22 with being on medication long-term and trying to decided what’s the best route for further action at a still-young age. I, personally haven’t used minoxidil in a few years because it wasn’t helping and was just aging my facial/forehead skin/wrinkles and giving me headaches and I stopped taking my Finasteride 1.5 months post-op because I wanted to see the full natural results from my HT and how successful it would be without any life-long med assist, although my hair loss was already advanced pre-ht.

I believe it’s permanent in non-donor area regions where the native hair is already in the miniaturization process and succumbing to DHT. The Donor region is where shock-loss hair should grow back after a few months.

Good Luck!

[harry_potter1]

I would advise against a surgery right now. Your hair still looks cool and if it is stabilized, then it is a normal adult look at your 30's (which you soon to be)  

I am not a big fan of getting early HT despite many doctors advising for it. It would get a perfect hairline now but what about 10 years later? You will need another surgery and in many cases Doctors can be "generous" when they use hair that early and could make very strong hairline and leave you with less grafts for the future loss, especially with FUE which you seem to consider 

[pkipling]

The biggest cause for concern for me is what appears to be the history of advanced MPB in your family. Right now, your hair looks fantastic, and there's a chance that you won't have the same fate of hair loss that your family has had, but I would be cautious. 

If I were you, I would find out at what age your father, brother, and the other men in your family started losing their hair and see if there's a pattern. If for most of them, it was already fairly severe by their mid/late 20s, then you may be ok. If it's something that suddenly hit them in their 30s, then I would be very cautious about a procedure until you see if you end up the same way.  

[bonkling]

12 hours ago, pkipling said:

The biggest cause for concern for me is what appears to be the history of advanced MPB in your family. Right now, your hair looks fantastic, and there's a chance that you won't have the same fate of hair loss that your family has had, but I would be cautious. 

If I were you, I would find out at what age your father, brother, and the other men in your family started losing their hair and see if there's a pattern. If for most of them, it was already fairly severe by their mid/late 20s, then you may be ok. If it's something that suddenly hit them in their 30s, then I would be very cautious about a procedure until you see if you end up the same way.  

 

On 3/26/2019 at 12:10 PM, harry_potter1 said:

I would advise against a surgery right now. Your hair still looks cool and if it is stabilized, then it is a normal adult look at your 30's (which you soon to be)  

I am not a big fan of getting early HT despite many doctors advising for it. It would get a perfect hairline now but what about 10 years later? You will need another surgery and in many cases Doctors can be "generous" when they use hair that early and could make very strong hairline and leave you with less grafts for the future loss, especially with FUE which you seem to consider 

 

On 3/26/2019 at 7:30 AM, CosmoKramer said:

You’re welcome! 

Exactly, it’s a catch-22 with being on medication long-term and trying to decided what’s the best route for further action at a still-young age. I, personally haven’t used minoxidil in a few years because it wasn’t helping and was just aging my facial/forehead skin/wrinkles and giving me headaches and I stopped taking my Finasteride 1.5 months post-op because I wanted to see the full natural results from my HT and how successful it would be without any life-long med assist, although my hair loss was already advanced pre-ht.

I believe it’s permanent in non-donor area regions where the native hair is already in the miniaturization process and succumbing to DHT. The Donor region is where shock-loss hair should grow back after a few months.

Good Luck!

Thanks a lot, everyone. Really appreciate the thoughts.

These points make sense. I believe my older brother starting losing his hair properly in what would be a couple of years, but naturally he was not on fix, minox, etc. Whether this makes a real difference, I am unsure.

Concerning shock loss, and making my condition worse, would getting a transplant on areas that are already bald also incur shock-loss further back?

This is why I wanted to ask this question, as I was unsure if a clinic would take this into as careful consideration as you guys.

Thanks again!

Edited March 27, 2019 by bonkling

[pkipling]

On 3/26/2019 at 11:22 PM, bonkling said:

 

 

Thanks a lot, everyone. Really appreciate the thoughts.

These points make sense. I believe my older brother starting losing his hair properly in what would be a couple of years, but naturally he was not on fix, minox, etc. Whether this makes a real difference, I am unsure.

Concerning shock loss, and making my condition worse, would getting a transplant on areas that are already bald also incur shock-loss further back?

This is why I wanted to ask this question, as I was unsure if a clinic would take this into as careful consideration as you guys.

Thanks again!

In regards to shock loss, the concern lies in whether or not the hairs surrounding the transplanted area are already weakened and are on their way out. If they're already quite miniaturized and not expected to last much longer anyway, the stress of the HT may accelerate them falling out. If they're healthy, any shock loss you experience will typically result in them returning. 

[home1212]

I would suggest waiting until your 30's to see how your hair loss patterns develops. Yes you have temple recession, but your hair looks great and you won't be able to replicate your natural density. Stay on the meds and a healthy regiment, it looks like its working for you. Good luck