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Posted (edited)

Hi Guys.

So after fretting about my hair loss for years, this weekend I started booking online consultations for a HT. I was really excited to rebuild my hairline and take charge of the narrative. So imagine my shock when a respected hair restoration clinic sent an email back based on my photos saying I was not a good candidate for a hair restoration procedure because my final pattern of loss is aggressive and my donor reserves are limited – thanks in part to a retrograde loss pattern. I had not noticed any thinning  from the bottom up. (And I've never heard of retrograde alopecia until now.) Maybe I'm in denial, but I'm wondering if my quarantine cut, shaving my neck too high (when trying to clean up stray hairs), and the sun bleaching my neck hairs (I always wear a cap when I walk my dog) created the illusion of thinning at the bottom.

Earlier today, I snapped a bunch of pics of my back stoop in direct sunlight to get a good, well-illuminated look of my donor area. Curious if it's as bad as the doc thought and if I should really abandon my dreams of getting a HT to restore my hairline.

I've never tried finasteride, and I'm not comfortable with it. I've been aware it was an option for years, but have a drug phobia and knew I'd be too freaked out about the sides. Yet had I tried it and been able to tolerate it starting years ago, I'd have a much better situation to work with now! I recently got some topical minoxidil foam (Kirkland 5% foam), which I had procrastinated starting also for fear of systemic absorption and cardiac sides. I did notice some mild chest pain the days I used it but I think the chances of that being psychosomatic were high.

I read about topical minoxidil/finasteride formulations that doctors claim will result in fewer sides. Is there truth to this? I read that plasma levels of finasteride from topical formulations were comparable to taking oral finasteride, which seems to indicate systemic sides would be just as likely. I spoke with Dr. Bisanga's folks and they mentioned a finasteride scalp gel that was formulated to stay local in the scalp, which sounded promising.

I'm thinking if I start using the topical minoxidil and maybe spring for one of those iRestore caps, it could improve my situation. I'm starting to consider even taking the plunge on finasteride and trying a low dose (either 1 mg/2-3 days or .5/2 days) to see if I tolerate it and feel relatively normal. I have a feeling finasteride would greatly improve my crown and the quality of the donor hairs in the back.
Would love to hear your thoughts. Does my safe donor zone look that small? If I'm unwilling to take finasteride, or if I can't tolerate it, should I even bother with a hair transplant? Thank you!! Really love this site. It's been an invaluable resource for me.

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Edited by DJNordwood

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Yeah, I've always had fine hair, so I'm not sure if it's normal or if it's also miniaturizing. Going to grow it out to better determine what I have to work with.

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Sorry but I tend to agree that your donor area does not look that strong. I think a FUT scar would be noticeable and FUE would leave your hair looking over harvested.

 

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But yes grow it out and consult with a few more respected Drs. Just be realistic in what you could achieve. 

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I reached out to several on here and sent these new pics to another doctor I was talking to. Would love to determine if it's worth enduring the stress and expense of using meds/devices if I'm SOL on FUE/FUT. I didn't even know that was a possibility. I thought that was for people that were just REALLY BALD lol. But I guess I'm already pretty close hahaha.

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Be interesting to what the other Drs say. Please keep us updated. Meds are good for retention of what you have already. Have you got any other pics of when it was longer ? 

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I do, but not so well lit and close of the back. I've kept it buzzed for several months now, not that I think things have progressed much. Here's what I could find in my phone from end of March.

 

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Posted (edited)

It looks like you may have some donor for FUE when grown out. You also seem to have a strong beard ? And as Melvin rightly pointed out you do have high sides. You do have hair already in your frontal third. So depending on what the Drs say it MAY be possible to achieve decent enough coverage. It’s just looking at the sides (in the car) you would not want to thin those areas out much more. 
Meds would help retain what you have. 

Edited by JohnAC71
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When you guys say the sides are high, you mean the deep recession at the temples?

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Your donor area which does depend on the person seems good. The sides of your head show you have hair still high up. If you was to look at Norwood levels you will see the usual patterns of baldness which are typical. 
For you it seems you don’t have as big of a area to cover when you show the top of your head. So in effect it would require less grafts. 

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Posted (edited)

Have a search online for images that show the different Norwood levels you will see what I mean. 

Edited by JohnAC71
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Ohhh okay, now I get it. The top is a IV and the sides are like late II maybe.

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I certainly wouldn’t lose hope yet, maybe seeing it grown out a bit and another Dr may be able to get a good result. 

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I requested several consultations to see what other think. If I don't take finasteride, it might not be worth doing though, right?

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Posted (edited)

It’s really worth taking to retain what you have got. You don’t want to keep heading further in to the higher Norwood if you can help it. 
As your probably aware we all progress at different stages and may appear to slow down as we get older but nobody can really tell where we might end up.

We certainly can get a good idea though. And as you appear to be heading toward the higher Norwoods then yes you want to do what you can. 

 

Edited by JohnAC71

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Hiya DJ

I was refused by a UK clinic 7 years ago so I can relate to the feeling of rejection when deemed an unsuitable candidate.. Thankfully however.. They made a wrong call... 

You're suitable... Contingent on you ring fencing the HT with finasteride.. Low dose 1.25 mg Mon wed fri almost guarantees no sides and most probably will add to your sex life not detract.. 

I was a slick bald NW 6 with high sides just like yourself and average at best donor.. With some retrograde alopecia present above the ears.. 

My clinic Eugenix just uploaded my 7 month progess update on youtube a few hours ago.. Go take a look and good luck with your journey 

Z

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Posted (edited)

Thanks, Zoomster! Why do you say it'll add to my sex life? Just because I'll have more hair and be feeling good? Lol

And thanks John and Melvin! I love how supportive this forum is.

Edited by DJNordwood

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Your more than welcome. The Zoomster is one reason I mentioned Eugenix earlier ! Awesome result. 

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Posted (edited)

Yeah, I just checked out pics of his job. It looks great! My brother got a job at Alvi Armani about 18 months ago. He has a nice dense hairline in the front but some thinning in the crown, but it doesn't even matter. That front hairline makes such a strong impression and is what people are seeing 90% of the time.

Edited by DJNordwood

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Haha... No... I think the generally perceived opinion on Fin is that it might help retain hair alright.. But you can kiss goodbye to a strong libido and say hello to erectile problems.. 

I and another prospective Irish Eugenix  patient I met for a coffee during the summer is having the same experience as me... No sexual sides and if anything it's added not taken away to the  libido side of things.. Its not zero risk though.. for some the sides are very real but I'd almost certainly say its not while on the low dose regime like I mentioned earlier 

Z

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It’s the hairline that matters when getting a good Ht. this is what you and everyone else sees. And framing the face will make all the difference! Also that it is age appropriate. We all talk about the frontal third and that’s what most of the grafts are going towards. And then spread less and less as they go back to the crown.

 

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Please don’t be disheartened by a surgeons assessment of your donor from a few photos you have sent online - pictures can be so misleading, even more so with short buzzed fine hair in the sunlight.
 

An in person consultation is what you require - this is the most accurate way one can assess the true state of affairs! 
 

To me you look like a promising candidate, with a high sided nw6 pattern - plenty of great nw6 transformations on here for you to get an idea of what is able to be done these days, combined with some bht grafts, I think under a good surgeons hands, you will be a very happy patient when the time comes. 
 

Keep using the resources on this forum as much as possible, there’s so much great information available, and will really help guide you in the right direction! 

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Your donor looks fine. The hair on the donor zone are less prone to dihydrotestosterone. The hair on the temporary zone are more prone to it. Hence, taking Finasteride can definitely help in all cases. Provided you are willing to take the medication. 

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You would do well to choose these guys ! (Eugenix) definitely worth consulting with them. 
 

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