Norwood 4 or 5! Honest opinion please.

[springstepper]

Hello guys, newbie here and wanted to share my hair issues. 47 years old, physician, live in WI. had a full head of hair till early 40's and the hair loss has been progressive for the last 4 years. I use a biotin shampoo and hair oil but havent tried any medication. Totally changed  my look to the extent where I am not me anymore. hairline receded and diffuse thinning / miniaturization on mid scalp and crown. Scalp visible. I have narrowed it down and consulted with Drs Bloxham, Hasson and Wong, and Dr. Diep. H&W suggested a 4000 plus graft, Dr. Diep  5000 - 6000, but Dr Bloxham argued that I should do just 2600 in one go or I increase the risk of shock loss. I know I am ready for a transplant and wanted to get your expertise to  to decide between these 3 docs. Your help is really appreciated. 

Edited June 15, 2021 by springstepper

[Zoomster]

No 1 i would suggest you get on finasteride as it looks like youre NW 6 bound pretty sharpish and also it helps avoid or minimise shock loss.

No 2 id book a ticket to vancouver .

 

Good luck

Z

[O Hare 57]

Start Fin now.  If your serious about dealing with this I would guess, (my opinion)  6000+ grafts needed 2-4 years of your life recovering from surgeries and 20 to  30 grand on surgery.  Diffuse thinning is hell.  Hard not to get some shock loss even with great surgeon.  A small surgery to rebuild your hairline might be a good place to start.  Your in for a long haul.  Good luck...

[Future Hair Doc]

Get on finasteride/minoxidil ASAP. You're a NW5 going to NW6. Are you looking for FUT or FUE? @Dr Blake Bloxhamis great. I can personally recommend him and have referred many of patients his way. They've all been extremely happy with their results and care. 

Edited June 15, 2021 by Dr. Suhail Khokhar

[springstepper]

Thanks very much for ur advise gentlemen! Much appreciated. 
I am decided to not go the finestride route, i had muted orgasms from a dht blocking hair oil and it was extremely scary! I recovered thankfully after stopping. Is there anything else i can do- PRP, exosomes, theres a dr prasad somewhere who does exosomes! 

[Britanium]

Nothing apart from Fin will stop your progression in to the higher Norwood levels. Topical or oral would help. But can understand your reasons for not taking it. I was happy to accept my Norwood 6 and just have transplanted hair on my scalp.

 

[Melvin- Admin]

I wouldn’t get any surgery until you’ve stabilized your hair loss. You are a diffuse Norwood 6. You still have a great deal of hair, but it’s thinning. If you get on medication now, you may be able to avoid surgery for a few more years.

[Coady]

Have to get on topical finasteride and minoxidil at least 6 months before Considering surgery. You still have a lot of hair, why not see how u get on with the medications first? You never know u might not  even need surgery after. 

Edited June 17, 2021 by Coady

[A Fue Good Men]

On 6/15/2021 at 9:37 AM, springstepper said:

Thanks very much for ur advise gentlemen! Much appreciated. 
I am decided to not go the finestride route, i had muted orgasms from a dht blocking hair oil and it was extremely scary! I recovered thankfully after stopping. Is there anything else i can do- PRP, exosomes, theres a dr prasad somewhere who does exosomes! 

What was in the “dht blocking” hair oil? What’s your background in terms of type of physician? I’d imagine you have lots of information at your disposal regarding finasteride, it’s studies, and side effects 

[springstepper]

Well this oil was some kind of a Mielle with saw palmetto and other stuff, and I never thought I d get the sides but I did - completely pleasureless orgasms. Well i gave it up cold turkey and lord behold it fixed itself. 

I am a primary care physician, and now run a small health care consultancy. I feel Finestride is a hit n miss with the sides, and there isnt an algorithm to deduce your risk. I am not completely a risk averse person but seems there are ore than few with sides and thats not acceptable to me so I am going to refrain. However; it may be completely fine for the others or most. I have a never treated a hair loss patient so I dont have anecdotal evidence for any of this., but I did see BPH patients and the risk of sides is acceptable for a pathological reason...not for cosmetic.

 Just a mild DHT block caused me sexual sides and so Finestride may too. Its the same mechanism. Thats it. I am not questioning its efficacy, obviously it works for so many physicians are prescribing it. I just feel some may be susceptible to sides, and the possibility is pretty real. So if someone wants to take that chance for just cosmetic reasons, then more power to them. 

I have my appointment settled with HnW for December 6, so that would be nice, and in the meanwhile I will research this inside out to see if there is any other mechanism that may prevent further hair loss. 

Edited June 18, 2021 by springstepper