Been doing a lot of research lately, still very unsure which path is for me (FUT, FUE, which meds, etc)

[Savemyhairline]

It seems like the more research i do, the more indecisive I become. I was born with a very high hairline and pretty fine hair, though I’m quite confident it’s gotten even thinner as I’ve gotten older. I’m currently 25 and have done exactly nothing so far to combat hair loss, looking to change that now. I would strongly prefer to have hair over being bald but shaved head isn’t the end of the world for me. I have done several online consultations with various surgeons (Konior, Pekiner, Bernstein, amongst several others) and have been browsing this site along with R/tressless on a daily basis. Basically my decisions come down to this:

 

Should I use fin 1 mg 3x per week? Will this be less effective than every day? I watched the hair loss show where they said to do it 3x a week to lessen likelihood of side effects, though my doctor who prescribed it “never heard of someone doing less than 1 mg per day”. I’m also not sure if I should do oral or topical minoxidil. I need to look more into micro needling but I have been reading a lot of people doing that. 

 

As you can see, my hairline is really bad.... like to the point that I question if I’m just delaying the inevitable here and there is only one true option, shave. I’m sure there’s a way that I can have a presentable hairline for once, but at what cost I’m wondering, as I’m thinking I will need multiple hair transplant surgeries. Dr. Konior believed that FUT would suit me best for what I want (basically I just want a dense NW2) he said 3000 grafts. He quoted me $26,000. Now if this was a one and done deal, like I pay $26k and I never have to worry about my hairline/hair again, I’d say you have a deal..... however as I’ve learned through others experience here, one transplant patients are rare. I have no idea how far my hair loss will progress, especially since it looks like this at only 25, but if I’m going to have to invest $75,000 over the next several years/decades into “maybe” having a good head of hair, I really question if it’s worth it for me. If I’m going to do this, I want it done right so I’m not willing to cheap out and potentially regret it. Some of the Turkish surgeons look okay and of course charge way less, but I do see various complications arising. Also covid has made everything a pain, so traveling to Canada or Spain or wherever is another consideration if I do it. 
 

also on the FUT vs FUE, it seems like FUT is the better option for me, however if I decide to throw in the towel eventually and shave my head, that scar is gonna be a beast. The fact that I would consider shaving in the future makes me really indecisive on that.

 

Most of the doctors I’ve consulted with said i have a good donor area, which is nice to hear, but they are also only seeing pictures and not in person. If I do go through with all this, I would love to pay it forward and post results from the HT here, I’m just very unsure at the moment on what I should do.... right now I’m thinking, try 1 mg fin 3x per week and see how that goes, then proceed to topical minoxidil in a few months, see what I look like in about 6 months, then take it from there. 
 

ill say the bottom line though, if I can’t get to a reasonably dense NW2, then I’m not sure this is worth it to me. I’ve never been a huge fan of the nw3+ look, maybe if I were in my 50’s, but now I would really prefer to get to a NW2 or just shave. I also have some thinning in my crown/up top, so that will have to be addressed as well. Any input appreciated

[Savemyhairline]

My hairline as a kid, fwiw:

 

[SD1984]

Konior I think is the most expensive HT doc in the world. I'd look elsewhere as far as the surgery route goes.

As far as your hair is concerned, I have definitely seen cases where people have success on 1MG 3x a week with Fin. You can START with that, see how it goes, and then after a few months try and up your dose depending on what is happening with your hair/lack of side effects, etc. As far as your temples go they will never come back as they are completely gone. I'd suggest getting on Fin and seeing how it goes, hopefully it stabilizes and thickens things up a bit, and then 6 months or so later go in for one decent sized surgery of around 2500-3000 grafts (depending on your hair microns) to restore your frontal region.

Edited May 27, 2021 by SD1984

[Future Hair Doc]

I definitely suggest you start using oral finasteride and topical minoxidil ASAP. Chances of side effects from finasteride are about 5%. I would start at 1mg daily. Please feel free to reach out anytime. 

[Savemyhairline]

3 minutes ago, SD1984 said:

Konior I think is the most expensive HT doc in the world. I'd look elsewhere as far as the surgery route goes.

As far as your hair is concerned, I have definitely seen cases where people have success on 1MG 3x a week with Fin. You can START with that, see how it goes, and then after a few months try and up your dose depending on what is happening with your hair/lack of side effects, etc. As far as your temples go they will never come back as they are completely gone. I'd suggest getting on Fin and seeing how it goes, hopefully it stabilizes and thickens things up a bit, and then go in for one decent sized surgery of around 2500-3000 grafts to restore your hairline/temples.

Right, I don’t think I’ve ever had hair in my temples lol.... I’d love to change that. I was always teased as a kid for having a receding hairline. According to the hair loss show, 1mg per day doesn’t have any more positive effect than 3x per week, though this is the only source I’ve heard that from. 

[Future Hair Doc]

15 minutes ago, Savemyhairline said:

Right, I don’t think I’ve ever had hair in my temples lol.... I’d love to change that. I was always teased as a kid for having a receding hairline. According to the hair loss show, 1mg per day doesn’t have any more positive effect than 3x per week, though this is the only source I’ve heard that from. 

If you're having side effects from 1mg daily finasteride, you can titrate down to every other day, etc., and see how that goes. 

Edited May 27, 2021 by Dr. Suhail Khokhar

[aaron1234]

2 hours ago, Savemyhairline said:

I have no idea how far my hair loss will progress, especially since it looks like this at only 25, but if I’m going to have to invest $75,000 over the next several years/decades into “maybe” having a good head of hair, I really question if it’s worth it for me.

Speaking as someone who has undergone 7 surgeries over the last 13 years I would certainly say that is a possibility for you, especially since you have an advanced pattern at a young age.  I do agree with Dr. Konior that FUT would be best for you.  Maxing out on FUT, then FUE will net you at least 2-3,000 more lifetime grafts.  You may very well need those extra grafts down the road. 

[Savemyhairline]

1 minute ago, aaron1234 said:

Speaking as someone who has undergone 7 surgeries over the last 13 years I would certainly say that is a possibility for you, especially since you have an advanced pattern at a young age.  I do agree with Dr. Konior that FUT would be best for you.  Maxing out on FUT, then FUE will net you at least 2-3,000 more lifetime grafts.  You may very well need those extra grafts down the road. 

Honest question, was it all worth it? 7 seems really extreme 

[Melvin- Admin]

I'm gonna be brutally honest. There is absolutely no way in hell you were born with that hairline. I would say you're hair loss is aggressive for your age. Without finasteride and minoxidil you could end up a Norwood 6 by 30. 1mg of fin 3x a day will still be effective enough to slow your hair loss. Because the half life is long, you don't have to use it every day to get results. You could also use topical dutasteride which is said to be just as or even more effective. If you respond well to medication. You may not need another hair transplant for a very long time. Now, you should definitely bank on having at least one or two more hair transplants through out your life even with meds.

Now, i'm not sure if your expectations match the reality. You're a young aggressively balding guy. A dense Norwood 2 may not be possible. It all depends on how well you respond to medicine. I suggest getting on medicine for at least a year before deciding. In the end, doing nothing is never a bad choice. 

[aaron1234]

1 hour ago, Savemyhairline said:

Honest question, was it all worth it? 7 seems really extreme 

Yes, definitely worth it.  7 on the surface seems nuts, but you really only have a couple mega-sessions (more than 2,000 grafts) for the first 2 or 3 surgeries.  After that it's more fine-tuning, smaller procedures - emotionally & financially they aren't as big a deal.

[Savemyhairline]

46 minutes ago, Melvin-Moderator said:

I'm gonna be brutally honest. There is absolutely no way in hell you were born with that hairline. I would say you're hair loss is aggressive for your age. Without finasteride and minoxidil you could end up a Norwood 6 by 30. 1mg of fin 3x a day will still be effective enough to slow your hair loss. Because the half life is long, you don't have to use it every day to get results. You could also use topical dutasteride which is said to be just as or even more effective. If you respond well to medication. You may not need another hair transplant for a very long time. Now, you should definitely bank on having at least one or two more hair transplants through out your life even with meds.

Now, i'm not sure if your expectations match the reality. You're a young aggressively balding guy. A dense Norwood 2 may not be possible. It all depends on how well you respond to medicine. I suggest getting on medicine for at least a year before deciding. In the end, doing nothing is never a bad choice. 

Brutal honesty is what I’m looking for! I might have to go over to my parents house and get a picture of when I’m young and my hairline is more exposed, I think you’d be surprised! I consider myself a lucky guy in life overall, my parents gave me a lot of good things, hair was just not one of them. I appreciate the feedback. I feel if I could at the minimum get a nice mature NW2 hairline, I will be much happier, even if I continue to thin up top. I believe that the hairline is the most important part in your look as it frames the face. I of course will get on medicine if I decide to go the transplant route (aka not the shaved bald route) which is what I’m currently leaning towards. I agree in that I think taking medicine now and waiting 6-12 months is the best idea. If I want to go to Konior, who has a year long wait time, I may want to get on that sooner than later though.

Edited May 27, 2021 by Savemyhairline

[Savemyhairline]

23 minutes ago, aaron1234 said:

Yes, definitely worth it.  7 on the surface seems nuts, but you really only have a couple mega-sessions (more than 2,000 grafts) for the first 2 or 3 surgeries.  After that it's more fine-tuning, smaller procedures - emotionally & financially they aren't as big a deal.

I see, that’s reassuring. I can probably swing Dr. Konior one time for the initial 3,000 graft FUT financially, though it’s not something I can do every couple of years. I don’t know what he would charge for a “fine-tuning” but I’m going to assume it’s a lot, even if not quite as much. Perhaps starting with him is the best course, then look at other doctors for potential smaller operations in the future? Hopefully I respond well to medicine. I think I’m following my grandfathers hair loss pattern, who basically had what I had pretty well into old age, here’s him in his late 30’s. My dad has way better hair than me. My moms dad had sort of a similar hairline but more density for most of his life. I know I could end up with less hair than any of them, but nice to have some frame of reference 

[deeznuts]

Yeah that looks like you've got a diffuse Norwood 6 pattern. The crown dips pretty low back there but the lateral humps look intact which is nice. At 25, that's pretty killer so like Melvin said, that's potentially full on NW6 by 30 if you're not on any drugs. But so long as you got the lateral humps, you're not a NW7

I'm not really balding as aggressively as you so I'm not really so knowledgeable on your case, but from what I've read on these boards and from seeing other cases, you're probably not going to have great density as a diffuse NW6 and will probably be playing the donor management game. At best, the doctor will probably give you reasonable density at the hairline and you'll probably see it drop off once it gets to the mid scalp and crown. So yeah, I would curb your expectations.

Did Konior explain what his plan for you was? Was it just 3k grafts in the frontal third at this point? 

Also, define reasonable density. Is it just not having a see through scalp? Or is it being able to wear toppik and not have see through scalp? Or is it some measure of how it feels and not looking bad under harsh lights or when wet?

Edited May 27, 2021 by deeznuts

[Savemyhairline]

16 minutes ago, deeznuts said:

Yeah that looks like you've got a diffuse Norwood 6 pattern. The crown dips pretty low back there but the lateral humps look intact which is nice. At 25, that's pretty killer so like Melvin said, that's potentially full on NW6 by 30 if you're not on any drugs. But so long as you got the lateral humps, you're not a NW7

I'm not really balding as aggressively as you so I'm not really so knowledgeable on your case, but from what I've read on these boards and from seeing other cases, you're probably not going to have great density as a diffuse NW6 and will probably be playing the donor management game. At best, the doctor will probably give you reasonable density at the hairline and you'll probably see it drop off once it gets to the mid scalp and crown. So yeah, I would curb your expectations.

Did Konior explain what his plan for you was? Was it just 3k grafts in the frontal third at this point? 

Also, define reasonable density. Is it just not having a see through scalp? Or is it being able to wear toppik and not have see through scalp? Or is it some measure of how it feels and not looking bad under harsh lights or when wet?

Dr. k didn’t go into a ton of detail about specifically where the 3k would go, I would just assume frontal third based on what he said. Um, hard to say exactly as I feel like I have a lot of room to improve, not being able to see as much of the scalp would be nice. I’m not expecting super thick/dense juvenile hair or anything like that, if it could look better under harsh light that would be nice. I’m not sure exactly what Elon Musk did, but if I could get a similar hairline/density to that, that would be great. He was pretty aggressively balding in his early 20s. If my final hairline would have to be higher than that to get a reasonable amount of density (ie not look like I’m obviously balding) then I would say thanks for all the info but the juice isn’t worth the squeeze... though if I respond well to meds and it thickens my hair, perhaps it’ll be different. Maybe he’s a bad example since he’s a billionaire but basically If I can’t get to a point where I look like I’m not clearly balding, then I think I’d rather just shave.

Edited May 27, 2021 by Savemyhairline

[aaron1234]

27 minutes ago, Savemyhairline said:

 I’m not sure exactly what Elon Musk did, but if I could get a similar hairline/density to that, that would be great. 

The forum assumes that Musk did his HT with Hasson & Wong.  Definitely check them out as well.

[Savemyhairline]

5 minutes ago, aaron1234 said:

The forum assumes that Musk did his HT with Hasson & Wong.  Definitely check them out as well.

Yep I have looked into them a bit, I did see someone on this forum recently complain that the wait time/Canadian border/covid etc was an issue with them, I’m not sure if that will be the case in 6 months or a year but I’m hoping this get better on that front too.

[deeznuts]

39 minutes ago, Savemyhairline said:

Dr. k didn’t go into a ton of detail about specifically where the 3k would go, I would just assume frontal third based on what he said. Um, hard to say exactly as I feel like I have a lot of room to improve, not being able to see as much of the scalp would be nice. I’m not expecting super thick/dense juvenile hair or anything like that, if it could look better under harsh light that would be nice. I’m not sure exactly what Elon Musk did, but if I could get a similar hairline/density to that, that would be great. He was pretty aggressively balding in his early 20s. If my final hairline would have to be higher than that to get a reasonable amount of density (ie not look like I’m obviously balding) then I would say thanks for all the info but the juice isn’t worth the squeeze... though if I respond well to meds and it thickens my hair, perhaps it’ll be different.

Hmm, I wouldn't compare myself to Musk if I were you. I'm not sure if Musk is balding in his crown which is a big difference. See if you can find other diffuse NW6 guys like I believe @Melvin-Moderator is to get a good idea of what can be done. 

Edited May 27, 2021 by deeznuts

[Savemyhairline]

Just now, deeznuts said:

Hmm, I wouldn't compare myself to Musk if I were you. See if you can find other diffuse NW6 guys like I believe @Melvin-Moderator is to get a good idea of what can be done. 

Yeah that was probably not the best example, not sure why he came to mind. Idk man as I said, I want to look like I’m not balding or just shave essentially. The hairline is the most important to me, if in old age I totally lose the back but have a transplanted front like joe Biden, that would be fine by me.

[deeznuts]

Just now, Savemyhairline said:

Yeah that was probably not the best example, not sure why he came to mind. Idk man as I said, I want to look like I’m not balding or just shave essentially. The hairline is the most important to me, if in old age I totally lose the back but have a transplanted front like joe Biden, that would be fine by me.

That's actually a totally legit strategy man. I've seen posts where people suggest a hair piece for the crown and then they transplant the front and midscalp. If you try that out, you could definitely get the best of both worlds. I think you'd be able to reasonably achieve what you're looking for. A decent frontal third and a bald crown or even one that you're wearing a hairpiece over

[Savemyhairline]

2 minutes ago, deeznuts said:

That's actually a totally legit strategy man. I've seen posts where people suggest a hair piece for the crown and then they transplant the front and midscalp. If you try that out, you could definitely get the best of both worlds. I think you'd be able to reasonably achieve what you're looking for. A decent frontal third and a bald crown or even one that you're wearing a hairpiece over

Yeah, I think with white hair it looks totally fine. My moms dad essentially lost the entire crown but kept most of the front third/middle in old age. I always thought of him as having hair. The question I suppose is “when” will I lose the crown, if I get lucky and also stay on meds, perhaps it can be delayed until I’m in my 60’s or older, like what happened with my moms dad. The hair piece would probably be a last resort as I’d be too paranoid about that being detected.

[_Hairman_]

I would go and see a doctor so they can tell me how many grafts i have on my donor and then i would make my mind. 3500-4000 grafts hairline and a little bit on mid scalp. Then after a year 3000 grafts mid scalp and crown then its over. No finasteride or anything after that. You have to know your donor capacity. I did 4000 grafts like a month ago and after a years i might do the rest, depends on how the grow will be. 

Edited May 27, 2021 by _Hairman_

[nicoandgello]

Your hair looks terrible. Bottom 5% for your age. Start with dutasteride, it works way better for diffusers. I wouldn't go to Konior with that type of hairloss. I think you should fly abroad to Spain, Portugal or Belgium. You will safe 75% of your money. If you want to stay in NA go with Dr Bloxham or Dr Wong.

[1978matt]

As others suggested, you're probably a better fit for Hasson & Wong.  For the same price as Dr K, they can do around 6000 grafts.

You could sort out the front 2/3rds or your head and live with a pleasing result for a few years (5+).  As you get older it gets easier to finance top ups, as most people only start to accumulate real wealth past their 30s.  Of course that's not always the case and depends on peoples particular circumstances.

You also won't need as many grafts the 2nd and 3rd HTs.

1mg x 3 times a week is a good idea.

Later down the line you can consider some options such as:

1)Another one or two FUTs + a third FUE

2)Cutting your losses with a big FUE to fill in the scar and tidy up the top.

In option 2 you probably wont be able to shave down completely, but then again I don't see many guys who really do that, especially guys getting into their late 30s and beyond.

 

Edited May 27, 2021 by 1978matt

[_Hairman_]

1 thing i really dont understand is why US is so expensive? They are really expensive on HT. I would either go to spain or hdc cyprus. Can some1 tell me why they are so expensive over there? They are not better in HT than many good HT doctors in europe. Its insane.

[_Hairman_]

14 minutes ago, qui bono said:

 

American docs by law have to do all the extractions and incisions, whereas other countries can hire techs to do the extractions, so presumably the fact the US docs are involved in every part of the operation means they demand a higher price.

The American health care system generally too is known to be phenomenally higher priced than normal, with cosmetic surgery in general fetching a bigger price tag than that.

well my doc did the extractions and made the holes on my head, the techs only sorted the grafts and places the grafts in to the holes that the doc made, the angle and so on.

So i can still not get it why you overpay in US. So if he placed the grafts in to my head he would do the whole thing alone. 

Edited May 27, 2021 by _Hairman_