Is the doctor a liar?

[Arthur Passos]

Hello everyone.

 

I'm 22, fom Brazil, and I'm balding really fast. I've noticed I was balding when I was 17. There is no family history, except for my mother and grandmother's thin hair.

 

Here's the thing: I went to the doctor when I was 18 looking for some kind of treatment. He recommended minoxidil and some vitamins. He also said I couldn't get a hair transplant because my donor area was very poor. I believed him, because, IMHO, my donor area is poor. I stopped minoxidil a few months later because I wasn't seeing any improvements and I thought I could shave my head some day.

 

Four years later, I can't shave it. I decided to go for a hair transplant, but I've been researching and I see a lot of doctors and non doctors claiming it's usually a bad idea to get a hair transplant in their early 20s. They even say it's unethical to do a hair transplant without thinking on the long term.

 

Anyways, I've talked to a local doctor who does hair transplants. He said my donor area is very good and there is no problem at all on performing hair transplant on young patients. When I questioned him about another doc saying the opposite. He said: every doctor is going to tell a different thing. I don't know who to believe. I'm starting to think he's saying my donor area is very good only because he wants the money. He asked me 4.738,80 Euros for the procedure.

 

I've attached some pictures of my wet hair to show you how thin my hair is. It's wet because I let it grow a lot so I can hide it. If it wasn't wet, it'd be harder for you guys to see it.

 

I need help. Is he lying to me or is my donor area good enough to do hair transplantation in such an young age. What do you guys think? Any suggestions?

 

This is my first post here. I've read the guidelines and it looks fine to me, but please, correct me if I'm doing it wrong.

 

 

[duchaine]

"I stopped minoxidil because I didn't see results"
BiG MISTAKE! Minoxidil requires several months (and sometimes more than 2ml daily) to show his results.

Considering you are balding in the crown/middle scalp and you say that your donor is weak, I would try fina.

I would give a try, in your specific casse, to PRP and dermorolling.

[Arthur Passos]

6 minutes ago, duchaine said:

"I stopped minoxidil because I didn't see results"
BiG MISTAKE! Minoxidil requires several months (and sometimes more than 2ml daily) to show his results.

Considering you are balding in the crown/middle scalp and you say that your donor is weak, I would try fina.

I would give a try, in your specific casse, to PRP and dermorolling.

Yeah, I know I should have continued with minoxidil. I'll try it again.

I've tried fina 1mg, but the side effects (low libido) were very hard on me, so I stopped it.

[LaserCap]

17 minutes ago, Arthur Passos said:

Let's address one thing at a time,

 

I'm 22, fom Brazil, and I'm balding really fast. I've noticed I was balding when I was 17. There is no family history, except for my mother and grandmother's thin hair.

You're young.  You are balding fast....hmmm.  So, do you see a lot of hair on the sink, the floor, the pillow? There are two types of loss, the type you see and the type you don't.  If you do see hair everywhere, we refer to this as shedding.  This is normal.  Most believe 100 hairs a day is normal.  Hair loss is different - you don't see it.

Hair loss is miniaturization of the native hair.  And, yes, you have lots of that going on.  Look at each strand.  Some shafts are very thick while others are thinning and withering away.  Eventually the hair seems to stop growing and eventually disappears.  Once gone, it never returns.

When you say mom and grandma are thin, does that mean the caliber of the hair is very thin or that you can see their scalp easily? - like in your case?  This is not only thinning, it is hair loss.  And, you do seem to be following a Ludwig pattern.

Here's the thing: I went to the doctor when I was 18 looking for some kind of treatment. He recommended minoxidil and some vitamins. He also said I couldn't get a hair transplant because my donor area was very poor. I believed him, because, IMHO, my donor area is poor. I stopped minoxidil a few months later because I wasn't seeing any improvements and I thought I could shave my head some day.

Most doctors will turn patients away at that age.  They will typically recommend some type of medical therapy.  The reasoning behind is the fact they have no idea at that point what exactly the pattern is going to be like. Imagine an 18 year old with crown loss. The doctor does a procedure.  10 years later the patient loses all the hair except for the island worth of hair.  Obviously this would leave the patient hanging with an unnatural looking pattern.

Now let's address medical therapy....I find most patients rely on visual results.  So, when they see no improvement they are under the belief the medication is doing nothing.  Wrong.  The medication is intended for you to keep what you have.  There is no medication out there that will regrow hair.  In a small percentage of patients, however, the medication can enhance the hair.  It seems, by what you've written, you did experience some of this benefit.  I would encourage you to get back on meds.  (Propecia, Rogaine, Laser and PRP). The mechanism of action of each of these is totally different and, thus, there can be synergism when used simultaneously.

 

Four years later, I can't shave it. I decided to go for a hair transplant, but I've been researching and I see a lot of doctors and non doctors claiming it's usually a bad idea to get a hair transplant in their early 20s. They even say it's unethical to do a hair transplant without thinking on the long term.

 

Anyways, I've talked to a local doctor who does hair transplants. He said my donor area is very good and there is no problem at all on performing hair transplant on young patients. When I questioned him about another doc saying the opposite. He said: every doctor is going to tell a different thing. I don't know who to believe. I'm starting to think he's saying my donor area is very good only because he wants the money. He asked me 4.738,80 Euros for the procedure.

How did you find this doctor?  Have you seen photos of his work? You've obviously have had a consultation with him.  What area(s) are you considering working?  How many grafts did you discuss? Are you back on meds or not yet?

I've attached some pictures of my wet hair to show you how thin my hair is. It's wet because I let it grow a lot so I can hide it. If it wasn't wet, it'd be harder for you guys to see it.

 

I need help. Is he lying to me or is my donor area good enough to do hair transplantation in such an young age. What do you guys think? Any suggestions?

You are dealing with a few issues.  First, an advanced Ludwig pattern.  You also have dark hair and light scalp - the contrast makes it look worse.  You do have some waviness to your hair which will give you more lateral coverage.  Your hair is long, however, and the weight pulls away from the area leaving the entire top open.  Consider a shorter hair cut. You'll find all strands working together and provide more coverage. Additionally, if yo part on the side, you'll even get some shingling.

Transplant wise, work on front and middle. Do as many grafts as you can afford. Leave the crown alone for now until you are happy with the density in the front and top.  Get on meds if you haven't already and give it a year.  

 

17 minutes ago, Arthur Passos said:

 

This is my first post here. I've read the guidelines and it looks fine to me, but please, correct me if I'm doing it wrong.

 

 

 

[Arthur Passos]

First of all, thank you so much for your consistent reply. I really appreciate it.

 

12 minutes ago, LaserCap said:

You're young.  You are balding fast....hmmm.  So, do you see a lot of hair on the sink, the floor, the pillow? There are two types of loss, the type you see and the type you don't.  If you do see hair everywhere, we refer to this as shedding.  This is normal.  Most believe 100 hairs a day is normal.  Hair loss is different - you don't see it.

I doo see a lot of hair on the bathroom floor and some on the pillow.

When you say mom and grandma are thin, does that mean the caliber of the hair is very thin or that you can see their scalp easily? - like in your case?  This is not only thinning, it is hair loss.  And, you do seem to be following a Ludwig pattern.

I've attached a picture of my mom's. She's 47 now. TBH, I didn't notice she had thin hair until she told me. And two pictures of my grandma, she's over 60. I can't get a picture of her top, she doesn't live with me.

Most doctors will turn patients away at that age.  They will typically recommend some type of medical therapy.  The reasoning behind is the fact they have no idea at that point what exactly the pattern is going to be like. Imagine an 18 year old with crown loss. The doctor does a procedure.  10 years later the patient loses all the hair except for the island worth of hair.  Obviously this would leave the patient hanging with an unnatural looking pattern.

You say I have an advanced Ludwig pattern. I'm 22 now, is it "more predictable" now? Predictable enough for a hair transplant surgery?

How did you find this doctor?  Have you seen photos of his work? You've obviously have had a consultation with him.  What area(s) are you considering working?  How many grafts did you discuss? Are you back on meds or not yet?

There are not many doctors who perform hair transplant sirgury where I live. A friend of mine said he was quite famous around here. I've seen some photos of his work. Looks good, but that's on his instagram. So there might be hidden bad cases.

It wasn't a consultation. More like an in person evaluation. He did not give me much attention and hurried up to finish the evaluation. In a nutshell, he said he'd work on the top, that my donor area is really good and that he can get me an improvement of 80 - 90% on density. He said he could put something around 15.000 hair shafts (not grafts). And if needed, he'd take some from my beard. He also mentioned the terms biological age and chronological age, claiming that my biological age is "older" and therefore I can perform it. He acted more as a salesman than a doctor. He kept talking about how good his clinic is and how modern his equipments are.

Currently, I'm back on minoxidil. But soon, I'll check on PRP.

Do as many grafts as you can afford.

Wouldn't that compromise my donor area and ruin future hair transplants? Also, I've read that since I'm young, my donor area is not very well defined. Therefore, the doctor may miss it and extract from non donor area.

Leave the crown alone for now until you are happy with the density in the front and top.  Get on meds if you haven't already and give it a year.  

Okay. So your advice is to get back on meds and wait for a year. A year later, perform hair transplant given priority to the front and the middle? That means it's possible (read possible as good), in my case, to perform hair transplant in such age?

Again, thank you very much for your attention. Please let me know if I'm asking "too much".

 

 

[Arthur Passos]

Hi, an update.

I've managed to get a better picture of my grandmother's head.

[sl]

Yes you do have more of a Ludwig pattern as does your Grandmother. 

Young and therefore medication is probably the best advice. The donor doesn't look the strongest but that said wet and long hair also sticking together can give a false impression so have it assessed dry and have real empirical data on density and not just subjective opinion, but real actual data from accurate readings.

Don't rush into surgery but look into medication is the honest opinion because at your age things could develop a lot if not on medication so best not to commit to surgery yet and see firstly how you tolerate meds and secondly how effective they are before you pull the trigger on surgery. 

[Melvin- Admin]

Your donor is impossible to judge based on wet hair. You need to show us your hair when it is dry. Also, at 22 I would strongly suggest against a hair transplant. Instead, you should focus on trying to maintain the hair you have. While your are very thin, you still have a lot of hair left. You can save a lot of that hair.

[Arthur Passos]

Hello everyone, just an update.

 

I've been to another doctor, we examined my hair scalp with a trichoscope. There are quite a few hairs close to "full miniaturization" on my bald area and, according to the doctor, those can be saved with the proper treatment (Propecia, rogaine and some vitamins).

Also, he evaluated my donor area as 5.5/10 (very different from what the other doctor (who acted as salesman) told me).

Therefore, I got back on meds and will wait a year before considering a hair transplant again.

I'm so thankful for this forum because it provided me so much information that I was able to "judge" what doctors were telling me. If it wasn't for this forum, I could've gotten a premature hair transplant.

Research, research and research.

 

Kind regards,

Arthur Passos.

[Melvin- Admin]

Glad we could help 👍🏼