Should I?

[TorontoMan]

Hey everyone

Wanted to get your opinions on my current situation as I am getting closer to making a decision on a hair transplant. Im 28 years old in a couple of months and started experiencing hair loss around 24/25. Have been using minox 2x a day and 1mg fin since the start of the year, but have reduced the dosage right now to .25mg as I recently starting feeling slight aches down there and its too early to attribute to meds but am testing to see if the lower dosage resolves the issue. Anyway, I've posted some pics below, (prob a few too many, bare with me), and am looking for my first surgery to restore my hair line and temple points were most of the recession has happened (some thinning in the crown, but not unbearable and will likely have to treat later in the future). Also included photos of my dad and his father, thats where I believe the genes came from because my mother's side has experience no hair loss whatsoever. 

My surgery will be in Canada, likely with Dr. Rahal and am also in conversation with H&W. Was quoted around 2,500 grafts to touch zones 1-4, but I'd like to know if you believe its the right time. The photo with the crown was taken wet under a harsh light. 

[hairlossPA]

its hard to say..

my initial thought was "you dont need a hair transplant"... what are you most concerned about? hairline? I'd say you're a NW2. Personally I'd wait until there's a bit more damage and you can clearly see an issue with it. Right now, I dont think you are at that stage but to each their own..

[RecessionProof]

Your hairline looks pretty solid, I'd wait a year or two and see how effective the fin is for you.

[Britanium]

Got to agree that you should wait a few years. Right now your good. 

[TorontoMan]

24 minutes ago, hairlossPA said:

its hard to say..

my initial thought was "you dont need a hair transplant"... what are you most concerned about? hairline? I'd say you're a NW2. Personally I'd wait until there's a bit more damage and you can clearly see an issue with it. Right now, I dont think you are at that stage but to each their own..

 

15 minutes ago, RecessionProof said:

Your hairline looks pretty solid, I'd wait a year or two and see how effective the fin is for you.

 

8 minutes ago, Johnboy71 said:

Got to agree that you should wait a few years. Right now your good. 

Thank you guys for replying. Yeah I agree, I go through phases where it doesn’t bother me and then other times I’ll have episodes where the thinning in certain situations drives me nuts. The few times it’s bad seems to outweigh the many times it’s fine, Human nature innit.. When I wash my hair, and style it and use a little bit of toppik I’m fine with it, but at the same time  these next couple of months are my best opportunity to get it done as I’ll transition to a new job in jan/feb and recovery won’t be a problem. 
& yes the main issue is the hairline. I tell myself if I go with a conservative hairline and fill it in I’ll be safeguarding myself for the future. Hopefully get a few more opinions on it but I do appreciate the feedback 

[gillenator]

A couple of things.

First, give the meds more time regarding your crown...a combination of 5% minoxidil along with the low dose finasteride will potentially help keep your crown intact and may even thicken it up.

In addition, you have such thick hair mass right now in your frontal zone that adding that many grafts could potentially shock out the native hair that is there...that is a viable risk and if it did happen, where is the gain?

Lastly, I would like to see a pic of your hair dry and not pulled back...my guess is that you look like you do not even have any hair loss.

If it were me, I would be ecstatic to have the hair you have and many guys here would probably feel the same way.

Edited June 3, 2020 by gillenator

[Melvin- Admin]

You’ve got an excellent head of hair. I’d kill to have your hair lol, I do see some thinning in the crown, might be smart to give meds longer to work, you may want to use those grafts elsewhere as you lose more hair. 

[TorontoMan]

1 hour ago, gillenator said:

A couple of things.

First, give the meds more time regarding your crown...a combination of 5% minoxidil along with the low dose finasteride will potentially help keep your crown intact and may even thicken it up.

In addition, you have such thick hair mass right now in your frontal zone that adding that many grafts could potentially shock out the native hair that is there...that is a viable risk and if it did happen, where is the gain?

Lastly, I would like to see a pic of your hair dry and not pulled back...my guess is that you look like you do not even have any hair loss.

If it were me, I would be ecstatic to have the hair you have and many guys here would probably feel the same way.

 

58 minutes ago, Melvin-Moderator said:

You’ve got an excellent head of hair. I’d kill to have your hair lol, I do see some thinning in the crown, might be smart to give meds longer to work, you may want to use those grafts elsewhere as you lose more hair. 

Thank you so much for your input. Yeah I'm definitely going to continue minoxidil I don't have problems applying it and I hope that I continue to have a healthy relationship with finasteride. & yes I am grateful for the extent of my loss up until this point and I'm happy I discovered this forum to level my head and ground me. As for shock loss, I had this concern and brought it up with Dr. Rahal and he told me there is always potential for shock loss depending on the individual, do you think in my case the chances are heightened because he would have to insert some hairs around some of my native hairs? I've seen some cases on his website and youtube videos where he restores hairlines of patients in a similar situation, and my assumption has been he works around native hairs and transplants new ones to increase the density of the hair line. I imagine along the actual front, transplanted hairs would replace my native hairs, and he would work through some native hairs behind the temple points, does that sound about right?

The photo I'm posting I took just now prior to this write up. I washed my hair this morning and when I shampoo (i usually use nizarol), my hair always looks fuller with more volume.@Melvin-Moderator I believe you once mentioned that you wash your hair more often as it gives you this effect as well? Do you have any other suggestions for the amount someone should be shampooing their hair, or other thickening techniques? Is this generally what dry shampoo is used for, because I bought a product but am pretty confused as to what purpose it really serves. 

Edited June 3, 2020 by TorontoMan

[ADuckwithNoHair]

Try reviewing H&W and Dr. Rahal's cases to find patients like you - relatively young with only minor hairline recession. I have seen some such cases on their sites and I think for you there's potential for a noticeable cosmetic improvement. IMO the two things you should think about are using your grafts wisely with consideration to future loss (maybe a physical consultation with one of the clinics would be useful) and obviously cost.

You have great hair and you're doing well to start on Fin and Minox at such an early stage of hair loss. About aches "down there" on Fin, I had those for a short time early on as well, and they went away 100%

[TorontoMan]

1 hour ago, ADuckwithNoHair said:

Try reviewing H&W and Dr. Rahal's cases to find patients like you - relatively young with only minor hairline recession. I have seen some such cases on their sites and I think for you there's potential for a noticeable cosmetic improvement. IMO the two things you should think about are using your grafts wisely with consideration to future loss (maybe a physical consultation with one of the clinics would be useful) and obviously cost.

You have great hair and you're doing well to start on Fin and Minox at such an early stage of hair loss. About aches "down there" on Fin, I had those for a short time early on as well, and they went away 100%

Thanks for the reply. I consulted with Dr. Rahal in person, because thankfully he also operates in Toronto. All other doctors including H&W, Bisanga, Diep, eugenix and a couple of others I reached out to online and for the most part they all told me roughly the same thing and the general consensus was 2-2.5k grafts would suffice and the final count would be something we would agree on day of surgery. As for Dr. Rahal, he looked at my head briefly and estimated that he wouldn’t go more than 2,500 grafts. Maybe the pictures don’t depict it well but there is some further recession past the hairline, mainly in the temples. Anyway they all directed my attention to the possibility of further loss, but I’ve been told that my donor area is above average. 

(one of rahals consultants even estimated 8,400 grafts, but I honestly don’t know how he derives that number and won’t go off it until a surgeon tests, and measures it correctly, to tell me how much is in the bank)
But you’re right, at this point I’m trying to weigh the potential for a cosmetic improvement with the conservation of my donor for the future. It’s a tricky business. May I ask how long you’ve been on meds and what dosage ? Has it worked to stabilize for you ? Any noticeable problems ? 
 

cheers 

Edited June 4, 2020 by TorontoMan

[yesplease]

3 hours ago, TorontoMan said:

Thanks for the reply. I consulted with Dr. Rahal in person, because thankfully he also operates in Toronto. All other doctors including H&W, Bisanga, Diep, eugenix and a couple of others I reached out to online and for the most part they all told me roughly the same thing and the general consensus was 2-2.5k grafts would suffice and the final count would be something we would agree on day of surgery. As for Dr. Rahal, he looked at my head briefly and estimated that he wouldn’t go more than 2,500 grafts. Maybe the pictures don’t depict it well but there is some further recession past the hairline, mainly in the temples. Anyway they all directed my attention to the possibility of further loss, but I’ve been told that my donor area is above average. 

(one of rahals consultants even estimated 8,400 grafts, but I honestly don’t know how he derives that number and won’t go off it until a surgeon tests, and measures it correctly, to tell me how much is in the bank)
But you’re right, at this point I’m trying to weigh the potential for a cosmetic improvement with the conservation of my donor for the future. It’s a tricky business. May I ask how long you’ve been on meds and what dosage ? Has it worked to stabilize for you ? Any noticeable problems ? 
 

cheers 

To provide a counter-perspective here, when I started fin I had similar symptoms, decided to lower the dose and hope that they’d fade away as my body “adjusted” ... and for me, that was the wrong call. They ultimately didn’t resolve regardless of dose/dosing schedule (they waxed and waned), additional symptoms developed, and things didn’t start to normalize for an extended period of time after stopping fin altogether. Sometimes they still recur, although with less intensity. 

[TheRealist]

Your hair is fine, do not have a hair transplant trust me leave it alone 

[TorontoMan]

Thank you for all the suggestions 

[gillenator]

Here's the thing...shock loss is unpredictable, period.

What we do know is that diffused hair is the most susceptible to shock loss...but it's the trauma to the area induced by the recipient incisions that are made...the more incisions that are made, the higher the level of corresponding trauma....in addition, the more existing native hair there is in the area, the more there is that can be potentially shocked.

The good thing is that you are having a good reputable surgeon do the procedure.

And like you said, you are having terminal hair grafts replacing the ones that can be lost.

[TorontoMan]

On 6/5/2020 at 5:06 PM, gillenator said:

Here's the thing...shock loss is unpredictable, period.

What we do know is that diffused hair is the most susceptible to shock loss...but it's the trauma to the area induced by the recipient incisions that are made...the more incisions that are made, the higher the level of corresponding trauma....in addition, the more existing native hair there is in the area, the more there is that can be potentially shocked.

The good thing is that you are having a good reputable surgeon do the procedure.

And like you said, you are having terminal hair grafts replacing the ones that can be lost.

In my case, do you believe there will be some level of predicting the loss and getting ahead of it? I ask because around the temples of course there are hairs that are just holding on but its been obvious to me for a few years that eventually they'll go. So if he transplanted right to the points where the hair is stronger, and replaces the weaker thin native hairs I believe it would create a cosmetic improvement. Is shock loss generally something someone should worry about if they haven't chosen a good surgeon, or is more a physiological thing ?

[gillenator]

It's a trauma thing...it's how the hair responds to the trauma, especially weak diffused hair and if your surgeon is replacing that weak hair with terminal hair grafts, that's a good thing... however it 's going to take several months for the regrowth to fill in the barren areas that have shocked.