Planning a hair transplant to restore thickness- thoughts?

[Harry90]

Hi all

I'm a 30 year old just new to the forum. I've been experiencing thinning at the top for a few years now and in the last few months have been considering going down the hair transplant route.

I've been on different forums and checked out different doctors since the New Year and would be keen on getting a transplant possibly some time in the Summer. 

The goal would be restore the crown/scalp/front of head. From being an observer of the forum I know most would suggest trying Finasteride first which I have yet to try (worries about side effects albeit only a small percentage of people get). I currently don't take any medication but am coming round to the idea of Topical Finasteride as I've read it has pretty much the same positive effects with reduced chances of the bad ones. 

This year though seems like a good chance to get the transplant. I've recently submitted pictures for online consultations with a number of doctors (Bissanga, Ferreira, Lupanzula, Maras, Pekiner, Lorenzo, H & W, Rahal- most of whom I'm waiting to hear back on.

From what I've been hearing in terms of cost and expertise and the fact I'm living in England, somewhere in Europe would be my preferred option at the minute.

I've attached a few pictures anyway and would be keen to hear whether you guys think I'd be a good candidate for a transplant and roughly how many grafts would be needed to restore the crown/scalp/front. In the first pic the hair a bit shorter and after the shower whereas the later pics are more recent and the hair is longer (haven't been able to get to the barbers due to lockdown

Cheers

[Curious25]

Welcome to the forum. 

From your pics, you are presenting to be diffusely losing hair in a NW5 pattern at current. Given your age, some would cautiously assume NW 5 is looking to be your ultimatum, potentially NW 6 if your lateral humps and crown dip a bit later on in life. 

The feedback you’ll probably receive from all your online consultations is to start on medication, see what happens at 6-12 months .... (you’ll likely thicken some of the thinning areas from your mid-scalp to crown) and then they would propose to restore your hairline and frontal region using between 2000-2500 grafts.
 

Assuming your donor is average at worst, you’re by no means in a helpless position, and you’ve clearly done your research as you’ve reached out to some great clinics. 

Hair wise - medication would work fantastic for your particular case. Life wise - only you can be the judge of that, so again be sure to do your due diligence before committing to any such decisions. 

IMO if topical finasteride works - the chances of experiencing negative side effects would be the same as if you were to take it orally. If you are prone to experiencing side effects from oral finasteride, and you don’t experience any sides whatsoever from the topical - IMO it’s not having any positive effect on your hair either. That’s just from observing hundreds of threads online. Others may suggest differently. 
 

Good luck and let us know how you get on! 

Edited March 28, 2021 by Curious25

[j1mmy]

Hey Harry,

Step 1, try medication - finasteride and minoxidil are ideal for diffuse thinners like yourself, and myself. Given your area of loss, and degree of loss, medication is your slap in the face first step.

If you suffer from dandruff, nizoral shampoo 1-2 times per week can also be a useful tool in your arsenal.

Finasteride - Propecia 1mg, and with a pill cutter you can even cut the pill into 4 to ease your mind starting slowly - 0,25 twice a week, then 3 times a week, etc. This will most likely slam on the brakes of your hair loss. If this is something working for you, you can eventually buy Proscar 5mg instead, and split that, as a cost-effective long term hair loss treatment. IF you experienced something you don't like, go back to the previous dose. The vast majority of people who do experience side effects experience them temporarily, i.e. they pass. 
This is your first and most powerful weapon. 

Minoxidil - once per day, at night is the most convenient I and others have found. Foam is usually better tolerated than liquid, even if more expensive. If you are a good responder to this, a proportion of "lost" hairs can be regrown. The downside is putting something on your head every day. 
This is your auxiliary weapon, as consistency and convenience becomes difficult over years, and results may fade, as it is not attacking the cause of hair loss, DHT, like finasteride is. 

Both medications will likely cause the sensation of "shedding" for up to 8 weeks, to allow for the hair cycle to re-initiate and make way for better times. So things get worse before they get better. 

[Harry90]

Cheers lads for your replies - appreciate the detail and information.

You both seems to be on the same wavelength as a couple of the doctors that have replied to my consultation pictures. H&W suggested using Propecia 3 times a week and see how that went first. Bissanga also said try Finasteride/Minoxidil until the end of the year to see if there was any good progression before going down the transplant route with them.

I also got a reply from Lupanzula and spoke to their representative who strongly suggested Finasteride but seemed willing to go ahead with a transplant (grafts roughly 3000-3500) with or without me on Finasteride. He did mention that to prevent further loss and best transplant results to get on Finasteride.

I guess the dilemma I have is that I want what seems to be the ready made fix (which has the best chance of restoring my hair density of a a few years ago). And that would be a transplant with a quality surgeon mentioned in my original post. The finasteride definitely would help but I'm not sure it by itself would achieve the results I want and I guess with some restrictions looking likely for the rest of 2021 my favoured option would be to get the transplant late Summer (the hair would be well on its way then when restrictions lifted next year). Spending the money for a transplant wouldn't be a huge issue as I've saved enough money not being able to go clubbing the last year 😏

Would you still rule out a transplant for now despite that logic -  I guess I want much improved hair by roughly this time next year. Do you guys think a transplant supplemented with Finasteride would provide that?

Thanks and appreciate the feedback

[Melvin- Admin]

Yes, I would rule out getting an HT at the moment. Allow the medication to work. You have diffuse hair loss which means you’re susceptible to shock loss. You don’t want to end up looking the same or worse.

[Harry90]

Cheers Melvin for the feedback

I guess then that's the main reason doctors want the person to be using Finasteride for quite some time before a transplant - to prevent any chance of the procedure being a failure? Would this permanent shock loss be a regular(ish) occurence without Finasteride. I've read a few threads where lads have got a transplant and only started to take Fin after their procedure.

I'm going to look into Topical Finasteride over the weekend in the forums and find a common brand that people are using that is proving to be effective.

Say in 9-12 months time were I to have quite good results on Fin but still not happy with the density would it then be sensible to consider a HT? Or is my crown/scalp in that inbetween position where the hair isn't far gone enough to require it?

Really the ultimate goal is to have the option of a shorter haircut (should I choose that) where the hair is thick, no bald spots, holds up well in the rain etc (similar to what I had maybe in 2015)    -   or is all this just wishful thinking? 😂

Thanks again

[Melvin- Admin]

1 hour ago, Harry90 said:

Cheers Melvin for the feedback

I guess then that's the main reason doctors want the person to be using Finasteride for quite some time before a transplant - to prevent any chance of the procedure being a failure? Would this permanent shock loss be a regular(ish) occurence without Finasteride. I've read a few threads where lads have got a transplant and only started to take Fin after their procedure.

I'm going to look into Topical Finasteride over the weekend in the forums and find a common brand that people are using that is proving to be effective.

Say in 9-12 months time were I to have quite good results on Fin but still not happy with the density would it then be sensible to consider a HT? Or is my crown/scalp in that inbetween position where the hair isn't far gone enough to require it?

Really the ultimate goal is to have the option of a shorter haircut (should I choose that) where the hair is thick, no bald spots, holds up well in the rain etc (similar to what I had maybe in 2015)    -   or is all this just wishful thinking? 😂

Thanks again

Yea permanent shock loss has happened without finasteride. You have a lot of hair right now, and most of it is thinning and very susceptible to being shocked permanently. If at 12 months you're not happy with regrowth or you still want an HT. I would say start with the hairline and forget about the crown. You need to have ultra-high density to have a short haircut. Generally, with hair transplants you need some hair length to layer over and have the illusion of density. 

[Harry90]

Thanks lads

I should say by a shorter haircut I mean usually the top (for the last 8 years roughly) has been kept maybe 7-8 cms long and usually a fade round the sides and back. I think possibly I've been a bit over enthusiastic and thought a simple HT would be the solution without acknowledging it might not be as successful as hoped.

I guess I have to be patient for now and try the Finasteride until this time next year and take it from there.

Appreciate the feedback on the thread and will I'm sure be dipping in and out over the next year