young age DPA and hair transplant

[kazura]

 

Hey guys,

i'm 24/25 yo male who suffer from DPA for 3 years. I cannot take fina due to side effects(maybe i will take it for 6 or 9 month after HT). Could i ask u did anyone have blond hair DPA and decided to make HT? which clinics do you recommend for such case? what about shock loss? did u split ur HT for just hairline and midscalp, how many grafts? I do not expect a miraculous result, just wanna been able to have nice short haircut?

 

does HT make sense in my case?

[Melvin- Admin]

I would say do not get a HT just yet, at least not until you’ve stabilized with medication. You can try topical fin and oral minoxidil. It seems to work better according to Dr. Bisanga. 

[JayLDD]

Disagree with waiting, OP has less than the equivalent of 1500 grafts across the whole head and the remaining hairs are largely cosmetically insignificant and heavily miniaturised judging from the top angle photo.  Those hairs are destined to fall out whether or not he waits and currently aren't providing enough to be overly concerned about. If he had sides with fin its not worth risking further issues with topical and minox on its own is objectively useless for more than a few years at maintaining hair without an effective DHT blocker.

OP imo you should likely consider FUT and go with a clinic that is skilled at large mega-sessions, 5000+ grafts. Hattingen in Europe and Hasson/Wong would be the first options I'd contact. The fact that you are aware of the limitations of your hairtype and aren't expecting a miraculous result suggests that you'll likely be satisfied as long as you max out safe levels of coverage in one procedure at a high-level clinic that is skilled in doing so. With a competent clinic if your yield is strong it isn't going to matter if shock loss occurs, which it may considering you're not on finasteride and the hairs already appear weak and mostly miniaturised.

[UnbaldEagle]

I hope I'm not disrespectful, but OP has a fairly large head (= more area to cover with transplanted hair only, if we go with JayLDD's suggestions I don't think 5-6K grafts would suffice), however it seems to me that the crown area at least could very well be salvaged with a combination of fin + minox w/dermarolling. Btw OP, I don't quite get it, if you experienced side effects, why would you consider taking it after HT? And why for only 6-9 months? Surely that can only be detrimental. Or what you meant is you're afraid of potential sides but you never took it yet? Anyway, there's topical fin which according to a recent study, has a slightly smaller efficacy albeit almost no incidence of side effects. Topical dutasteride is even safer as it is a larger molecule and thus unable to get past the subcutaneous layer and won't go systemic (there was a topical dut w/ microneedling study a few years ago with very promising results). 

But really, why not try to thicken up your existing hair with treatment, see if works, I reckon you have a good chance at that as you don't yet have a full bald spot around your crown, just lots of minituarized hair that could still be brought back to terminal as you're young and your hair loss started 3 years ago. 

[UnbaldEagle]

And then maybe if treatment works, you could get a HT to fill in the temples (in a mindful and conservative manner), create some temple points as they seem to have completely vanished, perhaps add a bit of density here and there.

Going for a megasession at age 24 without even trying to save your native hair, relying on transplanted hair solely (and not even knowing for sure if you have DPA and not DUPA) is kinda haphazard imo.

[Louisjams]

I dunno....OP is fairly young but could consider FUT IMHO. I worry about his age. 

[Raphael84]

@kazura

There are many more elements to a successful surgery, or an appropriate candidate, than we may realise. 
At 24 years of age, with aggressive loss and without medication, proceeding with surgery does present risks. 
Whatever your decision may be, I would recommend that an in person consultation with your preferred doctor before considering proceeding with any surgery, is essential for you. 

Considering your age, you have experienced quite aggressive loss. This also means that much of your loss will be reasonably recent, and therefore you may well respond positively to medication. As Melvin has mentioned, topical finasteride is an option, but if you are not prepared to consider finasteride at all, then perhaps look into oral minoxidil. Any positive response to medication, could have positive impacts n terms of your thinking/decision for potential surgery, and your result of surgery should you proceed.
Taking finasteride for 6 - 9 months post surgery does not really have any logic. If you concern is shock loss, then medication would be recommended pre surgery to stabilise your hair and strengthen as much as possible to better deal with the "trauma" of surgery, or have more chance of growing back if you were to experience possible shock loss. 

At 24, the real motivation for medication would be to avoid further loss in terms of your lower crown dropping, and your lateral humps (sides) dropping further. This is very likely. If your loss began at 18 for example, you have only been losing hair for 6 years. You will continue to lose hair for considerably more than a further 6 years without medication. This would then mean that your graft demands would be higher, but your "safe donor area" would be smaller and any transplanted hairs may become disconnected to your sides and back.

What may appear as the "safe donor area" now at 24, without medication is almost certainly going to look really quite different at 34, 44 etc. This means that any hair extracted from areas that may experience thinning/loss in the future, would be lost from the recipient area.

Also, for any patient who may be experiencing aggressive DUPA loss, may have higher levels of miniaturisation in their donor area which may affect growth, yield and/or longevity of any procedure. This is again where medication may help.

Rushing into surgery is rarely the correct approach, be that for the short, or long term. It is hard for younger patients to think past their 30´s. Take the appropriate steps before jumping into surgery. 

I wish you the very best.