PLEASE HELP/need advice on what to do! - PICS

[baldboy123]

Hi everyone,

 

I've posted several times on this forum explaining my situation but have never provided pics until now. Basically, Im 20 years old and have been on propecia for 8 months now. I havent seen much improvement nor excessive hairloss since ive been on it. I have been contemplating on whether to get a ht of 1500 grafts for my hairline (that what the doc suggests i do). But I see where my hairloss is going....i will be completely bald with the usual horseshoe pattern just like my dad and grandfather. My ideal ht plan would be to get the fullest look i can get now as being bald at this age is a very hard thing to live with. Here are pics of my current situation. Any thoughts, advice, suggestions would be greatly appreciated.

 

Thanks!

 

P.S. My Hair is damp in all of these pics

 

 

[baldboy123]

Also, I figured that where I'm headed even if i were to wait to get a ht, I most likely won't have enough donor hair to cover my entire head and i am fine with that. I figured that if that were to happen i'd just shaved down and fue in my ht scar.

[thanatopsis_awry]

If you're going to get a HT....you're basically saying that you will be combating MPB with every graft you have at your disposal and to live with the results and the ultimate outcome, which may not be complete coverage. Vs. living with what you currently have and the continued loss to come. It's a decision I would likely take in your shoes, too, and in a sense it's the one that I've taken.

 

1500 seems pretty light, but you know your hairloss best; so, if you're confident that 1500 will do the best job to safely satisfy the goals of your first HT, and trust your doc, so be it.

[the B spot]

Ok, well this is a recipe for disaster. First, at 8 months your not going to see much from Propecia....generally 12-24 months shows a true effect.

 

Second, your NOT a HT candidate, period. It will interesting to know the name of your doctor who said 1500 grafts. Probably strip as well.

 

No Way. You, nor your doctor know how you will end up. At 20, with that level of baldness, your basically the poster child for a NW7 and post-HT regret.

 

 

Third, you need to buzz it down, tan your dome and live like that for a while. Your hair does NOT define you.

 

Now, if you give propecia a chance to work, give yourself some time to really understand what your signing up for, maybe 23-24 you might be ready, imo.

 

At that point, you might be a candidate for some FUE, only with the knowledge that you can have a bald crown/or work in a small crown hair piece to compliment your HT hairline.

 

I would like to know which doctor recommended doing 1500 grafts on you. You look like you need 3500-4500 grafts AT 20.

 

Your laterals are already dropping and your basically a NW6 pattern.

 

Baldboy...I feel you, feel for you in the worst way brother.....please, please, please trust me and forget a HT right and forever forget a strip HT should you go forward later in life.

 

I'll be happy to talk on the phone with you, counsel with you, offer all of my knowledge to help you through this time.

 

I understand what Thana is saying, but I'm tired of repaired and fixing guys 25-30 who got HT's when 20-22 years old. Bad scars, low hairlines, poor FUE results, white dot scarring....etc.

 

I hope you wait, hang-out, listen, learn, and formulate the right plan for you long-term.

 

Jason

[thanatopsis_awry]

I do agree w/ you Jason, actually, pretty much 100%. Honestly, I regret my first post being so "equivocating", impartial, and vague. And I apologize to Baldboy for not speaking my mind, and assuming he was getting FUE in my haste. I'm happy you stepped in with a no bs, blunt truth of the situation.

 

There is hardly ever room for error in a HT, let alone someone as young and advanced as Baldboy. And a 1500 strip recco would indeed scream a huge red flag, and is exactly the type of session and situation I think is a huge culprit in younger guys ending up in a real bind, which you see all too often.

 

Just to add on to what you have said and wisely recommended -- what would you think of Baldboy undergoing an artistic FUE plan to design him a hairline and framework for him to then buzz down? Maximize a modest number of grafts to give him ultimate flexibility for the future, while maximizing the buzzed/shaved look he can enjoy now and going forward.

[Bill - Seemiller]

baldboy,

 

What a great response from Jason. I agree with just about everything he said.

 

Frankly, 1500 grafts isn't going to do much for you. And God forbid you lose more hair (which is highly probable since your hair loss is quite aggressive for such a young age), you'll end up with a strip of hair in the hairline with no hair behind it, leaving your hair looking awkward and unnatural.

 

Your hair is thinning everywhere and at your age, this most likely indicates that without medical treatment, you're destined for at least a class 5A (more likely 6 or 7) on the Norwood Scale. Thus at your age, the best thing you can do is stay on Propecia if you wish to attempt to keep the existing natural hair you have left.

 

In the meantime, style your hair how you like. You may want to try concealers like Toppik, DermMatch or Nanogen to help promote the illusion of density. Or try sporting the shaved head look for awhile to see if it's becoming.

 

In a few years, re-evaluate your hair loss situation, develop reasonable goals, and reconsider hair transplant surgery. For now, feel free to stick around, read, research, and learn everything there is to know about the available hair restoration solutions and what can realistically be achieved.

 

Whether strip or FUE will be optimal for you will depend on the amount of baldness to cover, your goals, etc. But in my opinion, you're a long way from determining that.

 

Best wishes,

 

Bill

[aaron1234]

If anyone else says that this site is pushing young men into getting HT's, then they should look at this post. Baldboy, I must echo what the more experienced veterans said before me.

 

I can guarantee you two things:

 

1) You will continue to lose more hair, with or without Propecia.

 

2) You will regret having a HT at this age.

 

Trust me when I say that we all know much it ****in' sucks to start losing hair right after high school.... right after you stopped getting zits. But you think it's bad now? Imagine your friends down the road giving you crap for that little tuft of hair you have in the front from a HT years back with nothing else behind it. A shaved head look is better than a misguided HT look.

 

Dude, your dad and your grandpa are both bald and so you are basically keeping up the family genes. Stay on Propecia. Keep using concealer's or even buzz your head and get a soft tan. But whatever you do, don't get a HT now. Any surgeon offering a HT to a 20 year old with this kind of balding is one not worth going to EVER!

[aaron1234]

Baldboy,

 

As you were saying:

My ideal ht plan would be to get the fullest look i can get now as being bald at this age is a very hard thing to live with.

 

You won't get a full look with a HT of 1500 grafts. You might not get a full look with a HT of 3500 grafts. The only way for you to get a full look right now is to get a wig. And you don't want that...

[baldboy123]

Originally posted by thanatopsis_awry:

I do agree w/ you Jason, actually, pretty much 100%. Honestly, I regret my first post being so "equivocating", impartial, and vague. And I apologize to Baldboy for not speaking my mind, and assuming he was getting FUE in my haste. I'm happy you stepped in with a no bs, blunt truth of the situation.

 

There is hardly ever room for error in a HT, let alone someone as young and advanced as Baldboy. And a 1500 strip recco would indeed scream a huge red flag, and is exactly the type of session and situation I think is a huge culprit in younger guys ending up in a real bind, which you see all too often.

 

Just to add on to what you have said and wisely recommended -- what would you think of Baldboy undergoing an artistic FUE plan to design him a hairline and framework for him to then buzz down? Maximize a modest number of grafts to give him ultimate flexibility for the future, while maximizing the buzzed/shaved look he can enjoy now and going forward.

 

Yes, Would getting FUE done for my hairline and thinning frontal region, so i could shave down, be a prudent decision ?

[baldboy123]

Also, as you all can see my balding is pretty bad right now...why wait any longer to get a ht? Its obvious where I'm headed

[Ron J]

Originally posted by baldboy123:

Also, as you all can see my balding is pretty bad right now...why wait any longer to get a ht? Its obvious where I'm headed

because it wasn't clear you were going the FUE route. 1,500 is NOT going to be enough, most hair lines alone require 3K. having said that, I would def opt for FUE if I were in your shoes, assuming your getting significantly more than 1500 grafts, you can achieve a sick look if you get a solid hairline, and mid scalp; and even shave down to have a cool 'buzzed' look.

[Marvin]

The FUE fake hairline idea for shaving is really clever. Is that widely done?

[thanatopsis_awry]

I've never seen it practiced, but I often recco it and think it's wise for a lot of people. Poster "youngsuccess" was the first to ever mention it as far as I know (couple years back).

[MajmX]

Wonder why no one have suggested trying minox first? It will probably just maintain, but you never know if you don't try. Given your age and the degree of you loss it seems obvious you should jump big 3 (fin, minox, nizoral) wagon as soon as possible.

[bash77]

Yes, opting for rogaine foam is definitely another weapon that should be used at this stage. As for nizoral, results seem to vary (this might be the case for RF also) so definitely measure your results with regular photos etc.

 

BB, i would definitely also consider shaving down to a no 1 all over - you might look great mate Keep on the propecia/finasteride (make sure it's the real stuff for peace of mind/confidence) and best wishes friend...

[thanatopsis_awry]

Ya, shaving down is never actually going to be a bad thing, which is why every guy should prolly try it at least once. If we could all re-condition ourselves to focus not on our hairloss, but our actual "selves", we'd be better off (perhaps we still end up with the HT, and if so we'll be all the stronger to have taken that route) -- so, shave + invigorated efforts in exercise, hobbies, skills....not an easy road to take, but the risk-reward is pretty excellent.

[the B spot]

Hey Thana/BB--- an FUE only surgery is the only real option for such young patients with extensive loss.

 

However, at 20 it is just too soon, imho... at 20 we only know that BB is thinning extensively throughout the male pattern. We do not know how progressive his balding will be.

 

What I do know is that any transplant pattern would mirror the actual pattern of native hair he currently has... a bridge attaching the sides and a frontal forelock...ala Phil Collins/Bruce Willis (from Moonlighting) which would require him to maintain a rather short buzz type cut...... something BB can do right now and look great.

 

Performing a few thousand FUE grafts, in a conservative pattern on BB seems rather harmless, but the commitment both financially and mentally is not to be taken lightly.

 

Additionally, when I find younger prospective patients who have convinced themselves that losing and subsequently getting their hair back will cure or set the path of their lives, I generally discourage them initially from having a procedure.

 

Achieving higher education, a better body/health, something that ends in success seems to dampen the fervor to get hair back. That is the point where proper planning and patient willingness to accept the limitations and drawbacks of a HT can occur.

 

Obviously, this is my opinion..but in these situations I fall back on rule #1 when regarding a HT...It is NEVER a bad move to simply wait.

 

Take Care,

Jason

[Bill - Seemiller]

an FUE only surgery is the only real option for such young patients with extensive loss

 

Jason,

 

I wholeheartedly disagree. I'd really like to know your rationale for this statement.

 

Best wishes,

 

Bill

[the B spot]

Originally posted by Bill - Associate Publisher:

an FUE only surgery is the only real option for such young patients with extensive loss

 

Jason,

 

I wholeheartedly disagree. I'd really like to know your rationale for this statement.

 

Best wishes,

 

Bill

 

Bill/All

 

I would prefer that these type of patients NOT have any type of surgery. We have no idea what level of loss they are headed to, but one axiom that generally holds true is the younger you are when you start balding and more aggressive your balding is, your going to end up a fairly high norwood.

 

Using BB as an example, there is no HT doctor that could forecast how far the sides will drop or if he will recede "up" from the neck.

 

Patients in this scenario IF they choose to go forward with a strip session, remove all future options for simply walking away.

 

It has nothing to do with strip/fue argument it is an options for the future argument. It is readily apparent that a top clinic will generally produce an acceptable scar for most patients. However, there is no guarantee that a patient will heal thin.

 

Because we are dealing with younger patients, patients we already must be conservative with, it only serves to drive the point home that the "worst" result via fue is poor yield and perhaps some white dots in the donor region.

 

Using BB again (sorry!) I think most of us would be horrified and outraged should a clinic perform a 3-4K strip session, target his crown and plan for a second session. That same argument applies should a clinic perform a strip session of 1500-2000 grafts and only target the frontal half---in your early to mid 20's, your "locking-in" patients to future sessions.

 

Again, this is not a FUE/Strip related comment--it is simply a future options discussion. It is also my personal opinion. An opinion I hope going forward many people begin to share. I certainly can accept an alternative opinion...this is not right/wrong discussion...more a patient first discussion.

 

Take Care,

Jason

[Ronald]

However, at 20 it is just too soon, imho... at 20 we only know that BB is thinning extensively throughout the male pattern. We do not know how progressive his balding will be.

 

Almost guaranteed he will be a NW6 or 7....the point in this quote should not be a deterrent to transplant when it is so obvious.

 

Performing a few thousand FUE grafts, in a conservative pattern on BB seems rather harmless, but the commitment both financially and mentally is not to be taken lightly.

 

Exactly, so you just transplant him like hes going to be NW7........a few thousand grafts are better than no grafts assuming expectations are realistic and that he can afford more transplants later. If he was 30, 40, 50 thats the approach that would be taken for a transplant procedure. It drives me NUTS when 20 yr olds who are likely going to be 6/7 are denied transplants because "NOBODY KNOWS HOW EXTENSIVE THE BALDING WILL BE".

 

Id rather have some grafts @ 20 and crown balding later when I become a 6/7 than no grafts now and crown balding later after my transplant that I was not denied because I was old enough and a NW7.

In both cases, my hair will look the same when Im older and have a 6/7 natural pattern with transplanted grafts .....the only difference is that if you dont transplant me @ 20, then Im balder when Im younger when hair is generally more important because in both cases, you would transplant me as a NW7 (If you transplant @ 20, you plan for the 7, if you transplant @ 30,40,50 you transplant as a 7 because I actually am a 7 so the end result will be the same.

 

Baldboy, Im sorry to refer to you in the 3rd person in this post and Im sorry for being so blunt about my opinion on what I think your hair loss will be.

 

And yes, Im biased.....Im 25 and balding but I had a transplant done but was denied by BERNSTEIN in a consultation so I know how it feels.

 

All other coalition docs I consulted with said my age wouldnt be a problem.

[TC17]

I agree with Jason 100%.

[thanatopsis_awry]

Exactly, so you just transplant him like hes going to be NW7........a few thousand grafts are better than no grafts assuming expectations are realistic and that he can afford more transplants later. If he was 30, 40, 50 thats the approach that would be taken for a transplant procedure. It drives me NUTS when 20 yr olds who are likely going to be 6/7 are denied transplants because "NOBODY KNOWS HOW EXTENSIVE THE BALDING WILL BE".

 

Id rather have some grafts @ 20 and crown balding later when I become a 6/7 than no grafts now and crown balding later after my transplant that I was not denied because I was old enough and a NW7.

In both cases, my hair will look the same when Im older and have a 6/7 natural pattern with transplanted grafts .....the only difference is that if you dont transplant me @ 20, then Im balder when Im younger when hair is generally more important because in both cases, you would transplant me as a NW7 (If you transplant @ 20, you plan for the 7, if you transplant @ 30,40,50 you transplant as a 7 because I actually am a 7 so the end result will be the same.

 

This is almost precisely what I've always intuitively felt, and have tried to verbalize recently. Well said; agree 100%. And I agree with Jason that in having such a prognosis on someone to use FUE is the *perfect*, if not only, solution.

[Bill - Seemiller]

Jason,

 

I agree with your last post entirely. However, unless I missed something, it didn't answer my question why you would recommend FUE on a young patient with extensive hair loss (even though I understand you would prefer a young patient with extensive hair loss doesn't get a transplant at all - an opinion, I happen to agree with and feel strongly about).

 

You said above the reason for your opinion doesn't come down to the strip/FUE debate. However, stating FUE is the only viable choice for a young patient with extensive loss leads to reasons to choose one particular procedure over another, hence, the strip/FUE debate.

 

in my opinion, the best course of action for young patients with a hair loss pattern indicative of extensive baldness is to consider getting on proven non-surgical hair loss treatments as soon as possible, research all their is to know about surgical hair restoration options and others, and wait.

 

As time passes and the patient has an idea what medication can accomplish for them, they can re-explore the pros and cons of surgical and other solution and develop realistic expectations. Depending on their goals, I feel at that point strip or FUE may be a viable option depending on each case.

 

Though there are some exceptions to the rule, I think it's generally irresponsible to perform a hair transplant, especially FUE on a young patient with rapid and extensive loss. Though in theory, FUE produces less obvious scarring, the financial committment is usually greater, not to mention that once the available donor supply is depleted via FUE, they'll be forced to turn to strip anyway and acquire the linear scar they originally wanted to avoid. The only other alternative would be for the patient to shave their head in which case, they wasted a lot of money on pointless surgeries.

 

I do feel strongly about the above, but like yours, it is just another opinion and I'm not trying to say you're dead wrong. I think it might be interesting if you and I could have a phone discussion about this and bounce ideas and reasons for our opinions off each other. I expect it would be beneficial to both of us to put our two experienced heads together.

 

Best wishes,

 

Bill

[Bill - Seemiller]

Patients in this scenario IF they choose to go forward with a strip session, remove all future options for simply walking away.

 

Technically, so does FUE. Young patients who choose FUE and later walk away may avoid a linear scar, but he'll also walk away having wasted tens of thousands of dollars.

 

Thus, it's far better for young patients in BB's position to wait and carefully consider their options prior to undergoing EITHER type of procedure.

 

I'm pretty sure Jason and I agree on the above point at least.

 

Bill

[Ronald]

This is almost precisely what I've always intuitively felt, and have tried to verbalize recently. Well said; agree 100%. And I agree with Jason that in having such a prognosis on someone to use FUE is the *perfect*, if not only, solution.

 

Im glad someone agrees with me! I have always intuitively felt this way as well but since I have been a lurker for a few years, I have never had to put my feelings into words.

 

When I finally had to do so, it was REALLY hard to properly explain how I feel....after re-reading my post, the words really didnt come out that smoothly but its such a hard thing to put into words.

 

I think I edited that post 3-4 times hahahaha.

 

Regardless.....I believe some coalition surgeons share our sediments.

 

Ive seen many many NW 7 patients with good hairlines and balding crowns.....I really hope BB finds one so he can have more hair during his 20's.