Am I too young to have a hair transplant?

[UndecidedHTP]

Hi all, 

After reading this forum for several months (which has been incredibly helpful and enlightening), I wanted to make my first post to ask for advice from anyone who could help please - any advice from members would be extremely appreciated (and apologies in advance for the lengthy post!).

My situation

I am a 23-year-old male from the UK. My hairline began receding when I was a teenager (only around the hairline really) but has accelerated quite quickly in the past 3 years. 

Although I did not take any preventive action until the end of 2019, I have been taking Finasteride 1mg tablets & Minoxidil 12.5% + Azelaic Acid 5% cream for the past 9 months (since beginning of October 2019) and have seen great results so far. My hair loss has stabilised considerably, and I have also had great regrowth. Although I never expected to be suitable for a hair transplant due to the amount of hair loss I suffered at such a young age and the quick rate of my hair loss, due to the recent stabilisation of my hair and my receptiveness to the dual treatment, I have begun to consider whether a hair transplant would now be feasible. Although I do not expect Finasteride / Minoxidil to ‘beat’ my genes forever, I aim to continue taking this treatment to slow future hair loss and coupled with a potential hair transplant(s), I am now starting to believe there may be hope yet! 

I have attached comparison pictures I have from the original state of my hair prior to taking Finasteride / Minoxidil vs. 6 months of treatment to contextualise my situation. You can also see the state of hairline in the month 6 photos which would be the main focus of any potential transplant. 

Main concerns

My aim for a hair transplant is for frontal hairline and temples restoration, maximising coverage and density. Although I am not necessarily desperate to get a hair transplant right now and can wait until I’m older or at a later stage if people think it would be wiser to do so, the reasons I am contemplating a hair transplant now is because:  

1.     I am beginning a new job in 8/9 months which I expect to be very full on. I don’t really expect to be able to take that much time off during the first 2 years of this job unfortunately (i.e. until at least mid 2023). By contrast, I am currently completely free at the moment before this job starts and having a transplant now rather than taking time off once I’ve started my job would be extremely convenient. 

2.     Due to Covid 19, I have spoken to a few surgeons from my current shortlist of potential surgeons who have availability in the next 8/9 months due to cancellations from overseas patients. Although some still have huge waiting lists, I was contemplating whether it made sense to go with a surgeon in the timescale that suits me i.e. now. 

3.     My hair loss has stabilised greatly due to my treatment which makes me think that despite being only 23, if I have realistic expectations and a long-term plan for my hair loss, it may be possible to have one now when my hair loss is stable rather than wait until later.

 

However, before committing, I have the following concerns:  

1.     I am only 23 years old. I’ve seen that most patients are at least 25 or older. What are the main drawbacks from having a hair transplant at such a young age?

2.     I have only been on Finasteride / Minoxidil for 9 months. Although my hair loss has stabilised, I am aware that the efficacy of the treatment may drop off in the future. Should I wait a while (e.g. 2 years) to see if my hair loss is remains stable (given it was quite rapid before treatment) or is 9 months evidence sufficient?

3.     Given my age and hair loss, I understand that 1 transplant is unlikely to be sufficient to ‘win’ the battle against hair loss for the rest of my life. With this in mind, I am very keen to retain as many donor hairs as much as possible for future transplants. Although I was quite set on FUE (due to the expertise of European surgeons in FUE & minimal scarring), would it actually be better given my young age and considerable hair loss to have FUT first to retain as many donor hairs as possible? I have two thoughts here: 1) Choose a European surgeon for FUE who has excellent donor management and will allow multiple FUE surgeries; or 2) Choose an excellent FUT surgeon e.g. Dr Konior for my 1^st transplant to ensure maximum donor capacity for any future transplants. I expect I will need an estimated 2400 – 2600 grafts right now, but more in the future. 

 

I would be so grateful for any advice in relation to any of the points above. I really hope I will make the right decision. I’m not adverse to delaying my surgery if necessary (especially as some excellent surgeons won’t be available until quite a while anyways e.g. I was told that Dr Couto is not available even for a consultation until November 2021, and the transplant may be another 10 months after that!), but seeing as some great surgeons are available, any thoughts on the above would be great.  

Huge thanks in advance and any input is welcome (especially if it is to correct me on any of my above assertions).

Edited July 1, 2020 by UndecidedHTP

[1978matt]

Who in the family is bald and how advanced are they?  Did they lose a lot early on and end up NW7?

You can see in the before photos the DHT affected area is really quite big, and as you state, Fin effectiveness may decline over the years.

I would try to wait at least two years but no harm in those 2 years actually visiting some doctors for a long term plan.

You could look at adding in Dutasteride.

[aaron1234]

Dang, killer results on the meds!  Nice! 👊

I agree with Matt.  No need to rush, stay on the meds and research in the meantime.  That's great that Dr. Konior is on your radar - he's definitely worth the wait.  You may even want to reach out to him for feedback on your pics.  Your future self will thank you if you start thinking longterm today.

[ADuckwithNoHair]

First of all: OMG. The improvement you achieved on Fin and Min alone is unreal. You're a great responder!

Regarding your questions:

1. The main drawback of undergoing a procedure at a young age is that the progression of your hairloss as you age at this point is very uncertain. You might have suffered the worst of it, or you might be destined for Norwood 7. The permanent hairs that you place now might look very out of place as your hair loss advances. In worst cast scenarios, you see young men who fill in their temples in their 20's left with two tufts or "horns" of hair as their balding continues behind the transplanted hairs. Yikes!
2. 9 months is good. As a rule of thumb I see a lot of clinics ask for patients to be on meds for 1 year prior to a transplant. It's obvious from the photos you've posted that you're responding excellently to Fin and Min though.
3. I think the traditional philosophy of graft maximization is to FUT first, then punch out what else you can with FUE. Dr. Bloxham has some good background reading on this: https://fellermedical.com/young-hair-transplant/ . There have been some stunning results lately with pure FUE though that have shaken my belief in the yield possible with pure FUE. Check Dr. Zarev, who does 11,000+ graft FUE gigasessions and donors still look pretty good. Don't know if he's seriously that good or if he is cherry picking patients with God-like donor regions.

[UndecidedHTP]

Hi @1978matt - Thank you very much for your reply!

1 hour ago, 1978matt said:

Who in the family is bald and how advanced are they?  Did they lose a lot early on and end up NW7?

Perhaps unusually, there isn't actually that much history of hair loss in my family. I'm the only one in my immediate family who is currently suffering hair loss. My 2 Brothers and Father haven't really receded or been effected by any hair loss (all a lot thicker). Both my Grandfathers also had good sets of hair throughout their life (with only a bit of diffused thinning for 1 in later years). A majority of my Uncles / Cousins also appear unaffected. However, there were a few I identified as possibly being similar - my Great-Grandfather (couldn't see exactly but likely Norwood 6/7 around 50) (Fathers side) and Uncle (Mother's side) (appears Norwood 6 at 60). My Father also mentioned his Cousin was also bald (Norwood 7 at quite a young age). I will try to look at some more photographs to determine the different levels of hair loss they had at different ages. 

1 hour ago, 1978matt said:

You can see in the before photos the DHT affected area is really quite big, and as you state, Fin effectiveness may decline over the years.

I would try to wait at least two years but no harm in those 2 years actually visiting some doctors for a long term plan.

You could look at adding in Dutasteride.

Thanks - I appreciate the advice. Although I am obviously eager to try and get my hair looking as good as possible as early as possible, it might be in my best interest long term to wait and really assess the rate of my hair loss.

I'll definitely look into Dutasteride. To be honest, I haven't really thought / heard about Dutasteride but I've just had a quick look - Can it be taken in conjunction with Finasteride or is it an alternative? 

Thanks once again.

[UndecidedHTP]

29 minutes ago, aaron1234 said:

Dang, killer results on the meds!  Nice! 👊

I agree with Matt.  No need to rush, stay on the meds and research in the meantime.  That's great that Dr. Konior is on your radar - he's definitely worth the wait.  You may even want to reach out to him for feedback on your pics.  Your future self will thank you if you start thinking longterm today.

Hi @aaron1234, 

Thank you very much for your response - That seems like great and sensible advice.

Yes, I've been incredibly impressed by Dr. Konior. My only concern is that I live in the UK and perhaps it would make more sense to go to an excellent European surgeon (I have 6 European doctors I'm currently looking at). However having said that, if I feel Dr. Konior will best suit me in the long run, I am most definitely open to making the trip. 

Edited July 1, 2020 by UndecidedHTP

[UndecidedHTP]

Hi @ADuckwithNoHair, 

Thank you for taking the time to respond. It is extremely helpful.

Yeah I've been absolutely delighted with the treatment so far - Truthfully I never expected anything to come of it! 

22 minutes ago, ADuckwithNoHair said:

The main drawback of undergoing a procedure at a young age is that the progression of your hairloss as you age at this point is very uncertain. You might have suffered the worst of it, or you might be destined for Norwood 7. The permanent hairs that you place now might look very out of place as your hair loss advances. In worst cast scenarios, you see young men who fill in their temples in their 20's left with two tufts or "horns" of hair as their balding continues behind the transplanted hairs. Yikes!

9 months is good. As a rule of thumb I see a lot of clinics ask for patients to be on meds for 1 year prior to a transplant. It's obvious from the photos you've posted that you're responding excellently to Fin and Min though.

I think this is one of my main concerns. As I am only 23 and the rate of my loss before treatment was quite rapid, I worry that I'm going to end up in constant race to keep catch up with my inevitable hair loss if I have a transplant now. Perhaps it may be wise as others have suggested to delay my hair transplant for at least another year or 2 just to ensure that my treatment plan has indeed stabilised my hair loss. 

22 minutes ago, ADuckwithNoHair said:

I think the traditional philosophy of graft maximization is to FUT first, then punch out what else you can with FUE. Dr. Bloxham has some good background reading on this: https://fellermedical.com/young-hair-transplant/ . There have been some stunning results lately with pure FUE though that have shaken my belief in the yield possible with pure FUE. Check Dr. Zarev, who does 11,000+ graft FUE gigasessions and donors still look pretty good. Don't know if he's seriously that good or if he is cherry picking patients with God-like donor regions.

Thank you very much for providing this information. I have seen a lot of fantastic results with this combination and it is definitely something I will think about. I typically wear my hair quite long so I am not too bothered by the scar that FUT leaves. However, a scar would bother me if I am not able to consistently restore my hair through hair transplants over the course of my life (as mentioned above) as I would then much rather shave my head (if my treatment also loses effectiveness). 

I guess I have to weigh up the likelihood of potential transplants being successful for me over the course of my life (I'll have to consult with the doctors for this of course), or whether I should just stick with my treatment for now and ultimately shave my hair off if I run out of luck.

Thanks once again!

[Gabreille Nelson Mukhia]

5 hours ago, UndecidedHTP said:

Hi all, 

After reading this forum for several months (which has been incredibly helpful and enlightening), I wanted to make my first post to ask for advice from anyone who could help please - any advice from members would be extremely appreciated (and apologies in advance for the lengthy post!).

My situation

I am a 23-year-old male from the UK. My hairline began receding when I was a teenager (only around the hairline really) but has accelerated quite quickly in the past 3 years. 

Although I did not take any preventive action until the end of 2019, I have been taking Finasteride 1mg tablets & Minoxidil 12.5% + Azelaic Acid 5% cream for the past 9 months (since beginning of October 2019) and have seen great results so far. My hair loss has stabilised considerably, and I have also had great regrowth. Although I never expected to be suitable for a hair transplant due to the amount of hair loss I suffered at such a young age and the quick rate of my hair loss, due to the recent stabilisation of my hair and my receptiveness to the dual treatment, I have begun to consider whether a hair transplant would now be feasible. Although I do not expect Finasteride / Minoxidil to ‘beat’ my genes forever, I aim to continue taking this treatment to slow future hair loss and coupled with a potential hair transplant(s), I am now starting to believe there may be hope yet! 

I have attached comparison pictures I have from the original state of my hair prior to taking Finasteride / Minoxidil vs. 6 months of treatment to contextualise my situation. You can also see the state of hairline in the month 6 photos which would be the main focus of any potential transplant. 

Main concerns

My aim for a hair transplant is for frontal hairline and temples restoration, maximising coverage and density. Although I am not necessarily desperate to get a hair transplant right now and can wait until I’m older or at a later stage if people think it would be wiser to do so, the reasons I am contemplating a hair transplant now is because:  

1.     I am beginning a new job in 8/9 months which I expect to be very full on. I don’t really expect to be able to take that much time off during the first 2 years of this job unfortunately (i.e. until at least mid 2023). By contrast, I am currently completely free at the moment before this job starts and having a transplant now rather than taking time off once I’ve started my job would be extremely convenient. 

2.     Due to Covid 19, I have spoken to a few surgeons from my current shortlist of potential surgeons who have availability in the next 8/9 months due to cancellations from overseas patients. Although some still have huge waiting lists, I was contemplating whether it made sense to go with a surgeon in the timescale that suits me i.e. now. 

3.     My hair loss has stabilised greatly due to my treatment which makes me think that despite being only 23, if I have realistic expectations and a long-term plan for my hair loss, it may be possible to have one now when my hair loss is stable rather than wait until later.

 

However, before committing, I have the following concerns:  

1.     I am only 23 years old. I’ve seen that most patients are at least 25 or older. What are the main drawbacks from having a hair transplant at such a young age?

2.     I have only been on Finasteride / Minoxidil for 9 months. Although my hair loss has stabilised, I am aware that the efficacy of the treatment may drop off in the future. Should I wait a while (e.g. 2 years) to see if my hair loss is remains stable (given it was quite rapid before treatment) or is 9 months evidence sufficient?

3.     Given my age and hair loss, I understand that 1 transplant is unlikely to be sufficient to ‘win’ the battle against hair loss for the rest of my life. With this in mind, I am very keen to retain as many donor hairs as much as possible for future transplants. Although I was quite set on FUE (due to the expertise of European surgeons in FUE & minimal scarring), would it actually be better given my young age and considerable hair loss to have FUT first to retain as many donor hairs as possible? I have two thoughts here: 1) Choose a European surgeon for FUE who has excellent donor management and will allow multiple FUE surgeries; or 2) Choose an excellent FUT surgeon e.g. Dr Konior for my 1^st transplant to ensure maximum donor capacity for any future transplants. I expect I will need an estimated 2400 – 2600 grafts right now, but more in the future. 

 

I would be so grateful for any advice in relation to any of the points above. I really hope I will make the right decision. I’m not adverse to delaying my surgery if necessary (especially as some excellent surgeons won’t be available until quite a while anyways e.g. I was told that Dr Couto is not available even for a consultation until November 2021, and the transplant maybe another 10 months after that!), but seeing as some great surgeons are available, any thoughts on the above would be great.  

Huge thanks in advance and any input is welcome (especially if it is to correct me on any of my above assertions).

Finasteride seems to have worked wonders in your case. You seem to have an amazing recovery in the mid-scalp and the crown. 

For the frontal zone, you can opt for a transplantation procedure (the number of grafts would be dependent on the hairline that you choose.

The age of 23 is considered okay for a transplantation procedure. However, if the current look does not bother you much then you can opt for transplantation whenever you feel is the correct age for you. Since you are taking Finasteride, you are not going to have any further progression of baldness. 

 

[1978matt]

13 hours ago, UndecidedHTP said:

Hi @1978matt - Thank you very much for your reply!

Perhaps unusually, there isn't actually that much history of hair loss in my family. I'm the only one in my immediate family who is currently suffering hair loss. My 2 Brothers and Father haven't really receded or been effected by any hair loss (all a lot thicker). Both my Grandfathers also had good sets of hair throughout their life (with only a bit of diffused thinning for 1 in later years). A majority of my Uncles / Cousins also appear unaffected. However, there were a few I identified as possibly being similar - my Great-Grandfather (couldn't see exactly but likely Norwood 6/7 around 50) (Fathers side) and Uncle (Mother's side) (appears Norwood 6 at 60). My Father also mentioned his Cousin was also bald (Norwood 7 at quite a young age). I will try to look at some more photographs to determine the different levels of hair loss they had at different ages. 

Thanks - I appreciate the advice. Although I am obviously eager to try and get my hair looking as good as possible as early as possible, it might be in my best interest long term to wait and really assess the rate of my hair loss.

I'll definitely look into Dutasteride. To be honest, I haven't really thought / heard about Dutasteride but I've just had a quick look - Can it be taken in conjunction with Finasteride or is it an alternative? 

Thanks once again.

I'm not sure of the protocols but I think you take it in addition to finasteride.  0.5mg DUT once or twice a week or something.  There are two GPs here you can ask about it:

Aston Kutcher took it for a few years but I think gave up when he was trying for a kid.  There's an interview on youtube where he discusses it.

It looks like you're on the Belgravia Centre medications list by the looks of it.  A bit pricey and there may be cheaper ways to obtain Fin and Min.  Azelaic Acid is good for dermaitis as I've used it on my nose area with great results.  Not sure if it is really useful for hairloss unless you have/had scalp dermitis issues.

 

[LaserCap]

It is evident you are a great responder to medication.  Only a small percentage of people actually get to enhance the hair.  Please continue and take as prescribed. Propecia/Fiasteride is 1mg per day.  There is a reason for that.Taking it once or twice a week means there are 3-4 days in which the med is not in your system.  I should tell you, there is plenty of documented info regarding Rogaine.  Seems to work for about 7 years and then loses some of its efficacy.  Regardless, if you see more shedding than normal, just continue using it as you always did.

You are young and seem to have a good head or your shoulders. Caution is always best, particularly when the meds have done their job.  The reason why there is a preference to wait until the age of 25+ is for the doctor to determine the pattern.  Identifying it is huge.  It can help make decisions as to how to proceed.  If a preliminary 6 pattern becomes evident, the doctor would not discuss working the crown, for example. His job would be to discuss medical therapy and to work the front, designing a conservative hairline, (conducive to a pattern appropriate result for a 6). Let me give you another example.

A 19 year old arrives and is enjoying a very juvenile hairline.  He is panicking as his hairline is starting to recede.  The doctor agrees with him and puts grafts in the middle of the hairline.  10 years later the patient has a row of hair in the middle of the forehead but the native hair has receded 2 inches.  (I've seen it, it happens).  (It is worth mentioning.  Typically the patient is always right.  In hair restoration, however, this is not the case.  You truly have to rely on the doctor to be ethical and really look out for your best interest). 

Most believe there is synergy when medical therapies are combined.  Propecia, Rogaine, Laser and PRP are the modalities we typically discuss when dealing with this condition.  Add laser, for example.  Give it a year and post another set of photos.  We can have this same discussion then.

[Al - Moderator]

Since you are young and the medication is working well so far, then I would keep doing what you are doing and hold off on a hair transplant.

 

[Melvin- Admin]

WOW that is just 6 months. You should definitely give it another 6 months, it may look even better. Proof that if you catch it early you can save it. 

[Curious25]

First of all, I would like to mention that your rationalising is as excellent as your response has been to the meds. As has been earlier mentioned, you appear to have a very composed and analytical thought process behind this decision, so from that alone I feel you will be victorious in your battle against hair loss. 

Once you have experienced hair loss, it is always natural to want more hair, and you have clearly been Inspired to continue with the pursuit of ‘perfection’ from witnessing first hand the impressive results you have gained over the last 9 months. You are now at a point where you’ve probably reached (or reaching) the upper limit of results to be expected from the meds, as it is unlikely your recession will grow back from your current routine, so I do understand both the logic and desire to undergoe a HT.

‘Hey we’ve came this far, so why not finish it off and go stick the icing on the cake?’ 

Not only this, but combined with the logistical benefits whilst having the 8-9 month period of down time to have the intervention now, as opposed to 2 and a bit years due to work commitments - it really is as though all ducks are lining up, and you have an even further motive to pull the trigger and go for it! 

But let’s break it down. 
 

There is no denying the fact that your hair loss has unfortunately been aggressive for your age, and the medications are merely just masking this. So what I mean by this, is that you need to make your decisions based on your before photos, not your current situation.

I’d be inclined to suggest that right now, you’re in a pretty liveable situation, not just because of the fact of how vast an improvement you’ve experienced - but because aside from the temple recession, you now have a decent head of hair, which the majority of the population wouldn’t look twice at. 

The types of questions I would be asking myself , would be along the lines of, what would October 2019 you have said to yourself, if you were sporting back then, the hair you have today? I imagine you’d have been jumping for joy. That alone , is a victory - without the financial expense of surgery, or usage of grafts.

I would advise to continue with the current routine, and see how you get on over the next two years. Efficacy can sometimes reduce after prolonged usage, and DHT sensitivity can also increase. The older you are, the more accurately one can establish final patterns and likelihood of future loss, which ultimately means you can implement a better informed strategy in relation to usage and placement of grafts. Your goals, equally, are likely to change as you age. 

So, in the meantime you could up the anti with some further non surgical treatment options, and perhaps add in some dermarolling, some laser, and PRP. 
There are quite a few online testimonies floating around demonstrating temple regrowth from dermarolling, so given your already evident propensity to respond and regrow, this could well be another option that you benefit from. 
 

I wish you well, and congrats on the progress you have made so far, it’s fantastic. 

[UndecidedHTP]

On 7/2/2020 at 1:18 AM, Gabreille Nelson Mukhia said:

Finasteride seems to have worked wonders in your case. You seem to have an amazing recovery in the mid-scalp and the crown. 

For the frontal zone, you can opt for a transplantation procedure (the number of grafts would be dependent on the hairline that you choose.

The age of 23 is considered okay for a transplantation procedure. However, if the current look does not bother you much then you can opt for transplantation whenever you feel is the correct age for you. Since you are taking Finasteride, you are not going to have any further progression of baldness. 

 

Hi @Gabreille Nelson Mukhia,

Thanks for your reply - That's great to hear. I certainly am interested in improving the frontal zone via a transplant. However, given the positive and supportive response I've received on this thread regarding my receptiveness to my treatment, I think it may be wise to stick with my current treatment for now with the possible addition of some of the recommendations by other members and leaving the hair transplant to improve my frontal zone for a couple of years to properly assess my hair loss. Thanks once again!

[UndecidedHTP]

22 hours ago, 1978matt said:

I'm not sure of the protocols but I think you take it in addition to finasteride.  0.5mg DUT once or twice a week or something.  There are two GPs here you can ask about it:

Aston Kutcher took it for a few years but I think gave up when he was trying for a kid.  There's an interview on youtube where he discusses it.

It looks like you're on the Belgravia Centre medications list by the looks of it.  A bit pricey and there may be cheaper ways to obtain Fin and Min.  Azelaic Acid is good for dermaitis as I've used it on my nose area with great results.  Not sure if it is really useful for hairloss unless you have/had scalp dermitis issues.

 

Hi @1978matt, 

That's brilliant - I will look into it more and will contact a GP to see if it can help in my case. I really appreciate the recommendation.

I do currently get my treatment from the Belgravia Centre. Although I have considered purchasing Finasteride and Minoxidil elsewhere for cheaper, given the effectiveness of the results so far in my case, I don't really want to change anything and potentially compromise the results / stabilisation / regrowth I have had. I guess my mindset may change in the future if e.g. the effectiveness dramatically changes.

With regards to the Azeliac Acid, this is what Belgravia has told me the effect is - 'Azelaic Acid is an anti-androgen, which means it helps to block DHT - the product in the body that causes genetic hair loss, ensuring the increased blood flow is 'hair-friendly'. It also has anti-inflammatory effects which are useful for other conditions such as Alopecia Areata and Traction Alopecia.'

Thanks for your engagement! 

[UndecidedHTP]

20 hours ago, LaserCap said:

It is evident you are a great responder to medication.  Only a small percentage of people actually get to enhance the hair.  Please continue and take as prescribed. Propecia/Fiasteride is 1mg per day.  There is a reason for that.Taking it once or twice a week means there are 3-4 days in which the med is not in your system.  I should tell you, there is plenty of documented info regarding Rogaine.  Seems to work for about 7 years and then loses some of its efficacy.  Regardless, if you see more shedding than normal, just continue using it as you always did.

You are young and seem to have a good head or your shoulders. Caution is always best, particularly when the meds have done their job.  The reason why there is a preference to wait until the age of 25+ is for the doctor to determine the pattern.  Identifying it is huge.  It can help make decisions as to how to proceed.  If a preliminary 6 pattern becomes evident, the doctor would not discuss working the crown, for example. His job would be to discuss medical therapy and to work the front, designing a conservative hairline, (conducive to a pattern appropriate result for a 6). Let me give you another example.

A 19 year old arrives and is enjoying a very juvenile hairline.  He is panicking as his hairline is starting to recede.  The doctor agrees with him and puts grafts in the middle of the hairline.  10 years later the patient has a row of hair in the middle of the forehead but the native hair has receded 2 inches.  (I've seen it, it happens).  (It is worth mentioning.  Typically the patient is always right.  In hair restoration, however, this is not the case.  You truly have to rely on the doctor to be ethical and really look out for your best interest). 

Most believe there is synergy when medical therapies are combined.  Propecia, Rogaine, Laser and PRP are the modalities we typically discuss when dealing with this condition.  Add laser, for example.  Give it a year and post another set of photos.  We can have this same discussion then.

Hi @LaserCap, 

That's really helpful in making my decision and I really appreciate your advice. I am beginning to think that my plan of action should be to delay my hair transplant for at least 2 years and during that time: (1) monitor and document my hair progression over e.g. every 3 months to see my progress / loss; and (2) Continue to speak to doctors who I feel have my best interests at heart and get their thoughts on a 'long-term plan'. Hopefully by the time I come around to having a hair transplant (if I think it is still a good idea), I will have a clearer idea of my hair loss pattern and the rate of hair loss I have. 

With regards to laser, it is something I have previously considered. Do you or any other members have any thoughts on the HairMax LaserBand 41 by any chance please? No worries if not. I am able to get it at a largely discounted price due to my treatment plan and it is something I am not considering once again. Thanks a lot. 

[UndecidedHTP]

15 hours ago, BeHappy said:

Since you are young and the medication is working well so far, then I would keep doing what you are doing and hold off on a hair transplant.

 

Hi @BeHappy - Thanks for your reply. As this appears to be the consensus, it seems like a sensible route to take for now. 

[UndecidedHTP]

13 hours ago, Melvin-Moderator said:

WOW that is just 6 months. You should definitely give it another 6 months, it may look even better. Proof that if you catch it early you can save it. 

Hi @Melvin-Moderator - Thanks for your advice!

For sure - although I often regret that I did not begin treatment earlier (maybe even my hairline would still be there if I had!), I am definitely grateful for the results I currently have and the fact that I started before it was too late!

[UndecidedHTP]

14 hours ago, Curious25 said:

First of all, I would like to mention that your rationalising is as excellent as your response has been to the meds. As has been earlier mentioned, you appear to have a very composed and analytical thought process behind this decision, so from that alone I feel you will be victorious in your battle against hair loss. 

Once you have experienced hair loss, it is always natural to want more hair, and you have clearly been Inspired to continue with the pursuit of ‘perfection’ from witnessing first hand the impressive results you have gained over the last 9 months. You are now at a point where you’ve probably reached (or reaching) the upper limit of results to be expected from the meds, as it is unlikely your recession will grow back from your current routine, so I do understand both the logic and desire to undergoe a HT.

‘Hey we’ve came this far, so why not finish it off and go stick the icing on the cake?’ 

Not only this, but combined with the logistical benefits whilst having the 8-9 month period of down time to have the intervention now, as opposed to 2 and a bit years due to work commitments - it really is as though all ducks are lining up, and you have an even further motive to pull the trigger and go for it! 

But let’s break it down. 
 

There is no denying the fact that your hair loss has unfortunately been aggressive for your age, and the medications are merely just masking this. So what I mean by this, is that you need to make your decisions based on your before photos, not your current situation.

I’d be inclined to suggest that right now, you’re in a pretty liveable situation, not just because of the fact of how vast an improvement you’ve experienced - but because aside from the temple recession, you now have a decent head of hair, which the majority of the population wouldn’t look twice at. 

The types of questions I would be asking myself , would be along the lines of, what would October 2019 you have said to yourself, if you were sporting back then, the hair you have today? I imagine you’d have been jumping for joy. That alone , is a victory - without the financial expense of surgery, or usage of grafts.

I would advise to continue with the current routine, and see how you get on over the next two years. Efficacy can sometimes reduce after prolonged usage, and DHT sensitivity can also increase. The older you are, the more accurately one can establish final patterns and likelihood of future loss, which ultimately means you can implement a better informed strategy in relation to usage and placement of grafts. Your goals, equally, are likely to change as you age. 

So, in the meantime you could up the anti with some further non surgical treatment options, and perhaps add in some dermarolling, some laser, and PRP. 
There are quite a few online testimonies floating around demonstrating temple regrowth from dermarolling, so given your already evident propensity to respond and regrow, this could well be another option that you benefit from. 
 

I wish you well, and congrats on the progress you have made so far, it’s fantastic. 

Hi @Curious25, 

I think you've exactly hit the nail on the head with your comments and I really appreciate your input. Your understanding of why a transplant is tempting for me is spot on, but as you've explained, I am very pleased with my progress so far and the success of my treatment - Truthfully, I never really expected it to work!

As a result, I agree with you that I should probably continue with my current routine right now instead of having a transplant. Hopefully by delaying the decision, I'll have a better understanding of (i) the extent of my hair loss and final patterns, (ii) whether it will remain stable and likelihood of future loss; and (iii) whether my treatment will retain efficacy. I agree that having this information may prove crucial to ensure that my grafts are inserted into the right areas to maximise my chances of keeping my hair for the duration of my life. 

Making a decision based on my before photos and not my current situation is also a very helpful suggestion as ultimately my DHT affected area is quite large. It is definitely something I will bear in mind when talking to doctors to ensure we tackle the right areas. 

With regards to the non-surgical treatment options you have suggested, I had a few queries if possible please (and no problem if not!): 

1. I haven't really looked into dermarolling that much but I have seen many using it. Would you recommend any particular product for derma rolling which stands out as being particularly effective or are there many I can choose from on the market?
2. With regards to lasers,  I have been reviewing HairMax LaserBand 41 for quite some time. I wondered whether you had any knowledge of whether this would be a good option? I am able to get a good discount on this product through my treatment programme. I originally resisted purchasing it as I wanted to see if the combination treatment worked out first. However, I am now looking into it once again. 

Thank you very much for your helpful solutions (great food for thought) and your review of my current situation. It has really helped my decision making and I appreciate it a lot. 

[Curious25]

You are more than welcome, and I am glad you have been of some help. 
 

Dermarolling is something that I myself am not very well read up on, I’ve mainly been a back seat observer of certain threads etc - @CosmoKramer has a good thread, and I believe within that thread there are some detailed discussions surrounding optimum frequency, length of needles etc. 
 

I use an old model laser helmet I purchased years ago now, so I have no doubt there are likely much begged alternatives available on the market. Again, I am not the most informed on the topic, however I believe the greater the number of diodes the better, more or less. I think @LaserCap may be in a better position to advice on this, 

Keep us all updated ! You should perhaps create a thread monitoring your progress, I imagine there would be a great deal of interest from within the community, given your results. 

 

 

 

[LaserCap]

3 hours ago, UndecidedHTP said:

Hi @LaserCap, 

That's really helpful in making my decision and I really appreciate your advice. I am beginning to think that my plan of action should be to delay my hair transplant for at least 2 years and during that time: (1) monitor and document my hair progression over e.g. every 3 months to see my progress / loss; and (2) Continue to speak to doctors who I feel have my best interests at heart and get their thoughts on a 'long-term plan'. Hopefully by the time I come around to having a hair transplant (if I think it is still a good idea), I will have a clearer idea of my hair loss pattern and the rate of hair loss I have. 

With regards to laser, it is something I have previously considered. Do you or any other members have any thoughts on the HairMax LaserBand 41 by any chance please? No worries if not. I am able to get it at a largely discounted price due to my treatment plan and it is something I am not considering once again. Thanks a lot. 

Hair Max is labor intensive.  You have to leave it in an area for 4 seconds, move an inch, do the same, until you do the whole head. I once held a LaserBand and fell accidentally.  The thing broke to pieces.  I thought of it more as a toy than anything else.  I actually use LaserCap.  It is by prescription only.  There are studies on the cap and it carries a lifetime guarantee.  Call Dr. Arocha or Dr. Alexander. They are providers.