Seeking Hair Transplant Advice - Hairline Density and Longevity

[Arisual]

Hello All,

New to this forum, little overwhelmed with finding information and still learning to navigate. I’m writing this post to summarize my hair loss journey to date, and to solicit advice on a path forward. I'm 32.

Intervention protocols to date:

• 1/1/2018 – oiling with pumpkin seed, peppermint, castor, vit E, coconut
• 3/5/19 – Beta Sisterol
• 7/28/19 – Microneedling
• 8/22/19 – Finasteride 1mg daily
• 12/9/19 – Finasteride reduction .5mg daily
• 1/6/20 – Finasteride reduction .5mg EOD
• 4/22/20 – Nizoral / 10 min head massage 2-3x weekly
• 5/1/2 – Minoxidil foam 1x daily
• 7/1/20 – Finasteride break
• 7/28/20 – Finasteride start .25mg MWF
• 2/17/21 – Minoxidil stop 

I adjusted my doses and protocol based on side effects. Finasteride causes 30% reduction in libido which I can deal with, but the puffy nipples and slight gyno in right nipple is where I’ve continued to reduce dosages to mitigate sides. Minoxidil caused headaches that became more frequent over time, noticed most in the evening. I'm unable to continue Minoxidil. 

At this point, my hair loss seems to be stable on .25mg Fin EOD, there may be slight recession at temples continuing. Crown seems stable/thicker than where I started. 
I’m interested in getting a hair transplant, especially during COVID where I can heal without being in public. I would like my hairline dropped and thickened. I’m not sure if I should start this process now or wait until the recession is worse; future proofing is a concern. I plan to maintain my current protocol (more or less low dose Fin) if the sides stay where they are. I’m open to travel and am looking for the most experienced, highest opportunity of optimal results doctor; if there is something local to me in Southern California that would be ideal. 

My thought process is my MPB isn't terribly aggressive and even if I were to recede more, it would take some time. I like to slick my hair back, and when I do the scalp is visible through the temple areas. I'd like to fully pack in those areas, though I do have concern with ability to match my density as I've got very fine hair but decent density on the rest of my scalp. I'm aware donor area is limited and I can only follow this process so many times, this is where I'm seeking some advice on strategy and opinions on the density concern.

Any advice is appreciated. Thanks if you've read up to this point. 

Pictures below.

5/8/21 (Current)

 

8/15/2020

• Fin @ .25 MWF

6/20/20

5/10/20

• Nizoral/10 min head massage 4/22/20
• Minoxidil 5/1/20
• Fin break 7/1/20
• Fin start .25 MWF

 

 

2/22/20

• Fin reduction .5 mg 12/9/19
• Fin reduction .5 mg EOD 1/6/20

 

10/20/19

Hair is oiled here.

8/6/19 (Start of journey)

• Oiling 1/1/2018
• Beta Sisterol 3/5/19
• Microneedling 7/28/19
• Fin start 8/22/19

[Melvin- Admin]

I wouldn’t get any hair transplant. Wait a few more years once the loss is noticeable. Even with an oiler scalp your hair looks good. Definitely not worth doing anything besides the protocol you’re already on.

[Curious25]

I agree with Melvin, you're in good shape for 32. 

How did you calculate your libido dropping by 30%? I've never known of anyone able to put a figure on their libido before. 

[Arisual]

10 hours ago, Melvin-Moderator said:

I wouldn’t get any hair transplant. Wait a few more years once the loss is noticeable. Even with an oiler scalp your hair looks good. Definitely not worth doing anything besides the protocol you’re already on.

Thanks for the input.

8 hours ago, Curious25 said:

I agree with Melvin, you're in good shape for 32. 

How did you calculate your libido dropping by 30%? I've never known of anyone able to put a figure on their libido before. 

Ha, it's all subjective right. I know that my drive was higher before based on frequency and desire for relations with someone I've been with for years already. 

[Curious25]

4 hours ago, Arisual said:

Thanks for the input.

Ha, it's all subjective right. I know that my drive was higher before based on frequency and desire for relations with someone I've been with for years already. 

So if you usually wanted to sleep with her/him 10x a week, after taking medication this was reduced to just 7x a week for instance? 
 

The 30% drop in libido just stood out to me as quite an odd place to use a metric value lol - if you had said blood work showed it reduced your DHT by 30% etc this would make more sense, but to place percentage values on your libido I thought was impressive. 

[Arisual]

14 hours ago, Curious25 said:

So if you usually wanted to sleep with her/him 10x a week, after taking medication this was reduced to just 7x a week for instance? 
 

The 30% drop in libido just stood out to me as quite an odd place to use a metric value lol - if you had said blood work showed it reduced your DHT by 30% etc this would make more sense, but to place percentage values on your libido I thought was impressive. 

Sure, one could metricize most things. And yes along those lines is what I meant. 

Edited May 11, 2021 by Arisual

[Gatsby]

In my opinion a hair transplant now would be a huge mistake that you would have to live with every time you looked in the mirror for the rest of your advice. You have been incredibly diligent in your hair loss protocol which you can see from looking at your hair today (going by the pics). It makes far more sense to stay with what you are doing now until later down the track. All the best!

[InTheSix]

Judging by your time record, you seem like a meticulous person.. and you are probably over analyzing your hair state... frankly the hair you have currently, many (myself included) would drop a pretty penny to have.... with your regimen, I dont see an HT in the near future i.e you dont need one

[A Fue Good Men]

I’m a few years older than you but have been on hair loss boards for years. My opinion…stay on medical treatment (fin min niz) and forget about it. You have a good hairline and overall head of hair for 32.

 

if you want to be adventurous you can add dermarolling once a week but the jury is still out on that one.

 

you have far too much hair for a transplant and it would be too much risk for minimum reward. Even if your transplant is successful, chances are only you would notice it

[Arisual]

23 hours ago, Gatsby said:

In my opinion a hair transplant now would be a huge mistake that you would have to live with every time you looked in the mirror for the rest of your advice. You have been incredibly diligent in your hair loss protocol which you can see from looking at your hair today (going by the pics). It makes far more sense to stay with what you are doing now until later down the track. All the best!

Thank you for the feedback.

21 hours ago, InTheSix said:

Judging by your time record, you seem like a meticulous person.. and you are probably over analyzing your hair state... frankly the hair you have currently, many (myself included) would drop a pretty penny to have.... with your regimen, I dont see an HT in the near future i.e you dont need one

Thanks for the feedback, I am fortunate my hair loss is as slow as it is and isn't too bad though it is more noticeable in person than the photos I chose. 

21 hours ago, 5BetaReductase said:

I’m a few years older than you but have been on hair loss boards for years. My opinion…stay on medical treatment (fin min niz) and forget about it. You have a good hairline and overall head of hair for 32.

 

if you want to be adventurous you can add dermarolling once a week but the jury is still out on that one.

 

you have far too much hair for a transplant and it would be too much risk for minimum reward. Even if your transplant is successful, chances are only you would notice it

Thanks for the input, I do have a couple questions. Would a transplant have the potential to damage the surrounding area? Would a surgeon not be able to match the density with the existing hair?

[A Fue Good Men]

54 minutes ago, Arisual said:

Thank you for the feedback.

Thanks for the feedback, I am fortunate my hair loss is as slow as it is and isn't too bad though it is more noticeable in person than the photos I chose. 

Thanks for the input, I do have a couple questions. Would a transplant have the potential to damage the surrounding area? Would a surgeon not be able to match the density with the existing hair?

I am not an expert but when you try to implant between areas with existing decent density, there is a chance for damaging hairs.

 

hair transplants will almost never be able to match native density. They are the “illusion” of density 

[Arisual]

On 5/12/2021 at 9:00 PM, 5BetaReductase said:

I am not an expert but when you try to implant between areas with existing decent density, there is a chance for damaging hairs.

 

hair transplants will almost never be able to match native density. They are the “illusion” of density 

This is the feedback I'm interested in hearing more about. Thanks for the input.