31m HT Candidacy (NJ) - Including Photos!

[Glasswing]

Hi everyone! I just joined this site last night after I kept seeing people on the Hair Transplant subreddit recommend coming here instead. Hopefully I have the correct forum for the purpose of this thread, but please redirect me if it belongs elsewhere. Thank you in advance for any help, and apologies for just barging right in seeking my own personal help!

 

Long story short, I'm a 31 year old male with a receding hairline. I've been on finasteride (5mg pill cut in 1/4ths = 1.25mg/day) since 8/11/2015. I've been using minoxidil (5% foam - now only applied once daily to the hairline) since 9/21/2016. Since pictures are so much more useful than a description, let me get right into that.

 

Photos from October 2015, Age 25 (Started finasteride just 2 months prior. Pre-minoxidil. Sorry for the terrible photo quality, these were taken with an outdated webcam):

Photo from November 2015, Age 26 (in public, still indoor lighting):

Photo from May 2016, Age 26 (On finasteride for 9 months, pre-minoxidil):

Photos from December 2016, Age 27 (Included because somehow my hair looked pretty good here, better than earlier pictures. Could be the finasteride or minoxidil, but I really think it was just the lighting and poor photo quality)

Photos from March 2017, Age 27 (the last of this indoor webcam series that I took):

 

Current Photos as of May 2021, Age 31, wet hair (finally a good camera):

Current Photos as of May 2021, Age 31, dry hair:

 

Well that took forever. Sorry for so many pics, but hopefully that covers everything! If any other pics would be helpful in analysis, please let me know. I have hair-specific pics from as far back as 2011, which is when my concerns began, although they are webcam quality. Of course I could take any new current pics that are needed, as well.

Anyway, my goal is to improve my hairline, thicker at the very least. I hate how visible my scalp is in the corners of my hairline, and I'm always checking it in the mirror to make sure it's as covered as possible. Scared of a windy day, rolling the windows down, brushing against something, water, you name it. I'd like to lower these corners as well, but I feel that I don't even need to lower them that much. Currently my crown is of little concern to me, as even looking back at these pics I can hardly see a difference between 2011 and current.

I know little about surgical procedures, but I am most interested in FUE. I got a consultation (just via email), that estimated FUE would be good for me with 2,300 - 2,500 grafts. But I want to hear as many opinions as I can! What do you think of my goal? Is it realistic? In your eyes, am I a viable/good candidate for a surgical hair transplant? FUE? FUT? I have so many more questions, but I have a tendency to be overly verbose, so I will just leave it at that for now to prevent this first post from being too daunting and long-winded for anyone popping in. Please, any help is appreciated.

Edited May 9, 2021 by Glasswing

[Future Hair Doc]

It's good you're already on oral finasteride and topical minoxidil. It appears you've stabilized your hair loss. Does alopecia run in your family and if so, how bad is it?

Which surgeons have you consulted with? Here are the recommended surgeons. Since you're in NJ, you've got a few great choices from that list that are nearby. 

https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN

[Glasswing]

Just now, Dr. Suhail Khokhar said:

It's good you're already on oral finasteride and topical minoxidil. It appears you've stabilized your hair loss. Does alopecia run in your family and if so, how bad is it?

Which surgeons have you consulted with? Here are the recommended surgeons. Since you're in NJ, you've got a few great choices from that list that are nearby. 

https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN

Wow, thank you for the quick reply! My only consultation was with Dr. Wesley, but it wasn't a true consultation. It was just an initial video sent to him with an email response. I'm hoping and looking for some more in depth consultations, and I am certainly going to look into the ones in your link. Thanks for that.

In regards to whether alopecia runs in my family... well, I'll give the rundown of my male relatives:

Brother (3 years older): His hairline is also receded, but his hairline itself is stronger. As in, there is less scalp visible

Father: He has very little hair left, down to the classic horseshoe shape. Even what he has there is limited

Uncle on mother's side: I believe he is close to the horseshoe shape as well

Uncle on father's side: Full head of hair

Grandparents on both sides: As far as I remember, both had pretty good hair throughout their lives

[Future Hair Doc]

Happy to help. I also suggest you consult with @Dr Blake Bloxham. He's been putting out amazing work and is highly recommended on here too. Are you staying local? You've got great options locally. 

[Glasswing]

Thanks, I will reach out to him as well. I think I read that Blake Bloxham usually does FUT, though? I'm more interested in FUE at this point because I don't want the FUT scar, but my knowledge is still so limited. 

And yes, I would prefer to stay local (although I'd be willing to drive possibly up to 10 hours), mostly because I just can't wrap my head around the logistics of getting a hair transplant and then flying back afterward. The price for some of the transplants done in Turkey seem too good to be true and is a little worrying to me for that reason (and also enticing for the same reason), aside from the logistics. I would consider doing that only if it was a known, vetted, and reputable doctor performing the surgery.

Edited May 9, 2021 by Glasswing

[giegnosiganoe]

I'm delighted to see people starting to come from r/HairTransplants onto this forum. 90% of the discussion/pics in that subreddit are of awful HT clinics.. it's truly depressing to see how uninformed everyone is and the positions many of them end up in post op. I try to promote these forums whenever I can.

Your goal is very realistic.

Given your stability since starting medication, I would say you're a great candidate as long as you stay on it.

The consensus is that starting with FUT provides more lifetime grafts (maybe 20-30%) than FUE, but again as long as you stay on medication I don't think you'll need the extra grafts. This thread is very useful to understand in detail the tradeoffs between FUT and FUE: 

Your donor seems average, but it's hard to tell because the pic is blurry. Do you have more (and clearer) pics of your donor?

I would say the graft estimate is slightly high. I don't think you'd need more than 2000 based on the goals you described (mainly thickening, not too much lowering at the corners). You can check my recent HT thread for what 1800 grafts covered.

[Glasswing]

39 minutes ago, giegnosiganoe said:

Your donor seems average, but it's hard to tell because the pic is blurry. Do you have more (and clearer) pics of your donor?

Absolutely, would a video work better? I have a hard time getting worthwhile pics of the back of my head.

 

And thank you for the resources and analysis! I will check the links you provided. While I would be much happier just with a denser hairline where it currently lies, being the perfectionist I am I'd also love to shoot for that "perfect" hairline. I'm trying to not be too unrealistic about it though. And of course I do want to avoid overshooting and landing in the too perfect category, where it looks too juvenile for someone my age.

Edited May 9, 2021 by Glasswing

[James5150]

First of all good job on getting on the meds early to see if you can tolerate them and stabilize your loss. And good job not rushing in to surgery and seeking advice here.

The one piece of advise I can tell you so far from my research here is don’t just limit yourself to thinking you want FUE only. What is more important is your choice of surgeon. Bad FUE scarring with the wrong clinic is much worse then a paper thin strip taken out from an elite doctor. I have been impressed by Dr. Wesleys work but I wish there were more patient posted threads which is what you really need to rely on. Also, nothing against the way he publishes his results but I value clinics that post post op photos of the graft placement and donor areas.

Since you are in jersey you should schedule in person consults with Dr. Wesley, True & Dorin and also Dr. Bloxham who is pro FUT just to compare  opinions before deciding on whether to start with FUE and FUT. After that if you are confident you want FUE you should trust your gut and go with one of those doctors or be willing to travel anywhere to say Dr. Nadimi in Chicago or even Dr. Bisanga in Belgium for example. Good luck. You seem like a smart guy so I’m betting you’ll make a good decision.

Edited May 9, 2021 by James5150

[Glasswing]

50 minutes ago, James5150 said:

First of all good job on getting on the meds early to see if you can tolerate them and stabilize your loss. And good job not rushing in to surgery and seeking advice here.

The one piece of advise I can tell you so far from my research here is don’t just limit yourself to thinking you want FUE only. What is more important is your choice of surgeon. Bad FUE scarring with the wrong clinic is much worse then a paper thin strip taken out from an elite doctor. I have been impressed by Dr. Wesleys work but I wish there were more patient posted threads which is what you really need to rely on. Also, nothing against the way he publishes his results but I value clinics that post post op photos of the graft placement and donor areas.

Since you are in jersey you should schedule in person consults with Dr. Wesley, True & Dorin and also Dr. Bloxham who is pro FUT just to compare  opinions before deciding on whether to start with FUE and FUT. After that if you are confident you want FUE you should trust your gut and go with one of those doctors or be willing to travel anywhere to say Dr. Nadimi in Chicago or even Dr. Bisanga in Belgium for example. Good luck. You seem like a smart guy so I’m betting you’ll make a good decision.

I do very much want to find a surgeon that I trust and whose skills and results are well documented. I love the availability of results posted on these forums, and have been browsing them and will continue to do so. I will say, after reading the link provided by giegnosiganoe, I'm becoming even more swayed toward FUE over FUT. Some key standouts that contribute to this being the case (aside from the scarring) for me:

Less invasive, no sutures or staples: I already touched upon this, but the whole slit thing does turn me off.

Graft selection: I like the idea of a more precisely designed look to my hairline, the result of which could end up looking more natural upon closer inspection.

Exercise not prohibited for as long: Being vain in all aspects, I already don't like the idea of having to go 10 days without exercise. I exercise a lot, and while it's just a short-lived requirement, I think going longer without exercising would make it that much harder for me.

Assuming that I would (hopefully) not need an exorbitant amount of grafts, in my case the cons given don't come very close to outweighing the pros. But I will still consider it a possibility in the back of my mind. Thank you for your suggestions! And the compliment.

Side question: Are there such things as free in-person consultations? It seems like at least near where I am, it'd cost a good amount of money just to get consultations. And what about the possibility of virtual consultations?

[giegnosiganoe]

1 hour ago, Glasswing said:

Absolutely, would a video work better? I have a hard time getting worthwhile pics of the back of my head.

 

And thank you for the resources and analysis! I will check the links you provided. While I would be much happier just with a denser hairline where it currently lies, being the perfectionist I am I'd also love to shoot for that "perfect" hairline. I'm trying to not be too unrealistic about it though. And of course I do want to avoid overshooting and landing in the too perfect category, where it looks too juvenile for someone my age.

Great video. Yeah it looks average to me.

Have you ever noticed any thinning other than in your hairline?

You'll definitely be able to lower your hairline (mainly around the corners), and I would recommend it. Around 1 cm2 requires 50 grafts to be implanted. With 2000 grafts, that's 40 cm2, which is quite a large area. So you can kind of estimate how many grafts would be required based on how much you want to lower it.

[Glasswing]

8 minutes ago, giegnosiganoe said:

Great video. Yeah it looks average to me.

Have you ever noticed any thinning other than in your hairline?

You'll definitely be able to lower your hairline (mainly around the corners), and I would recommend it. Around 1 cm2 requires 50 grafts to be implanted. With 2000 grafts, that's 40 cm2, which is quite a large area. So you can kind of estimate how many grafts would be required based on how much you want to lower it.

Great, I'll take average!

I've not noticed thinning other than my hairline, no. Of course that could just be because almost the entirety of my focus is directed toward my hairline, and comparatively everything else looks stellar to me. And wow, 40 cm2 does sound like a lot, although it's a little hard to picture. Gonna have to get some graph paper and hold it up to my hairline 🙃

[James5150]

15 minutes ago, Glasswing said:

Are there such things as free in-person consultations? It seems like at least near where I am, it'd cost a good amount of money just to get consultations. And what about the possibility of virtual consultations?

      Unfortunately most doctors are too busy to be doing free in person consultations. But I also don’t think it’s right to charge exorbitant fees for it. $50-100 should be enough to spend an hour with a prospective patient that’s interested in doing a life altering procedure with you. 
      Virtual consultations would probably be your best best in that regard even though it would be better to have your donor evaluated in person, get an idea of what kind of hairline the doctor would want to draw up for you and get a feel for the doctor in general to see if you “click.” It’s tough with how much many US doctors charge for it and even tougher with changes after COVID.

[Glasswing]

27 minutes ago, James5150 said:

      Unfortunately most doctors are too busy to be doing free in person consultations. But I also don’t think it’s right to charge exorbitant fees for it. $50-100 should be enough to spend an hour with a prospective patient that’s interested in doing a life altering procedure with you. 
      Virtual consultations would probably be your best best in that regard even though it would be better to have your donor evaluated in person, get an idea of what kind of hairline the doctor would want to draw up for you and get a feel for the doctor in general to see if you “click.” It’s tough with how much many US doctors charge for it and even tougher with changes after COVID.

Yeah, it's not entirely unreasonable to charge something. But I saw a comment that said one doctor was charging $400 for in-person consultation which was pretty alarming. Hopefully that's  an anomaly.