Hair transplant suggestions

[Rick_]

Hi Everyone! I'd like to get your suggestions about getting a hair transplant. I've been researching passively over the past few years and I recently found this forum(1-2 years back), I'm okay with splurging, but obviously within reasonable limits. Could you please recommend me surgeons? I live in New York City, NY, and I'm open to travelling.

Summary

I'm 28 years old, and I've been using minoxidil since I turned 20(that's when I noticed early signs of hair loss). When I was 24 I stopped minoxidil for like 3 months and I lost a decent chunk of my hair. Then I got back on minoxidil and have been using it up to now. My dad is a norwood 7 and was between norwood 6 - norwood 7 when he was 28. My paternal grandfather is also a norwood 7, and I think his progression was similar to my dads. My maternal grandfather is the polar opposite, even at 60(age when he passed away) he had thick black hair with few white hairs. His hair was very similar to Ronald Reagan's hair. Obviously, I inherited from the wrong grandfather lol.

Also, I recently found out(1-2 years back) that I have seborrheic dermatitis. But, I can keep it in control if I keep my hair short and shampoo frequently or if I have long hair then I need to shampoo daily. Sorry if I'm sharing too much, I just wanted you guys to have a holistic point of view.

I've attached pics of my hair, both wet and dry.

Questions:

1. Should/Can I get a transplant. Basically, after the hair transplant will it look like I have no hair loss?
2. How many grafts do I need(approx)?
3. How many grafts does my donor area have(approx)?

 

Edited September 6, 2021 by Rick_
Added more pics

[JDEE0]

You have what looks to be a fairly decent donor area in terms of density (hard to really say as your hair is somewhat long, but looks dense) with a fairly coarse and wavy texture (it seems to me at least) which is all good news for a HT.

The clear problem with your case is that you seem to be a diffuse thinner, well, at least in the crown and rear to mid scalp, but I think probably all over the top some degree. 

Minoxidil isn't doing anything to address the root cause of MPB (which is a genetic androgen sensitivity) and using it on it's own will, at best, buy you a few years in the vast majority of cases. Maybe if someone had a really really slight pre disposition to MPB they could use it alone and have it work for longer, but in your case, its certainly not enough.

You need to think about using Finasteride to be honest. Without it that crown will open up, no question, and it looks like a fairly wide pattern of baldness beginning to emerge there. I think left unchecked you're destined to become a NW5 at least, and you're only 28 now, so I think medication is a must in your case to progress forwards for the time being.

The good news is that the hair looks like its not too far down the line of the miniaturisation process, fair chance it could be thickened up and provide good coverage again and stay that way for a long time.

 

[JDEE0]

And as far as surgeons go, what's your budget, how far are you willing to travel?

[Rick_]

@JDEE0

Thanks for your reply. I've attached pics with short hair. Those were taken recently, but the most recent ones are the long hair ones. 
I was suggested Finasteride, but when the doctor told me about the side effects I was reluctant to use it. 
As far as for the budget, I'm willing to give it my all. If(the chances are high) the results don't turn out great/good, I can at least console myself that I gave it my all haha.
Similar to my budget, I'm willing to travel anywhere.

[JDEE0]

Yeah, your donor and hair characteristics are really good from what I can see. Crown is on its way out though. To be completely honest, I don't think it will have much if any hair left in it by the time you reach your mid 30's. Unless you take meds that is, then you will potentially be able to re-grow it back to a normal thickness and keep it that way for decades. 

You really should consider it. Read the actual studies, sides are rare, but do exist and go away upon discontinuation according to every placebo controlled study ever carried out on the drug, and according to all medical literature published on the subject. There's really no reason to be scared to at least give it a go in reality. Dr. Lorenzo's website has some good concise information on scientific data relating to finasteride side effects, good place to start and then broaden your understanding by studying other credible sources of info and reading the actual studies in depth - just find the finasteride section here: https://injertocapilar.com/faqs/?lang=en

Good attitude budget wise. I'll put it this way, Europe and North America are the two hubs of quality hair transplantation. Both have a small number of doctors who are all very good and offer similar levels of skill and quality, but in general European Dr's are going to be around half the price for the same level of skill. So, whilst it's perfectly reasonable to stay in the U.S., you can get the same level of results for half the cost in Europe.

My favourite European Dr's: Dr. Bisanga, Dr. Feriduni, Dr. Lupanzula, Dr. Bruno Pinto, Dr. Rafael De Freitas, Dr. Ximena Vila, Dr. Juan Couto and Dr. Bruno Ferreira. 

U.S./Canada: Dr. Konior, Hasson and Wong, Dr. Cooley, Dr. Shapiro, Dr. Rahal, True and Dorin (there are more but I'm in the UK so I don't keep too much track of them, others will be of more help for additional options).

Do some research and take a look into them. 

 

Edited September 6, 2021 by JDEE0

[SD1984]

Well if your Father was a NW7 when he was 28 and you are 28 now then clearly the bald gene hasn't effected you as strongly. That being said, your pattern still indicates a high norwood. In ten years with no meds I'd say a NW6 is very possible. Good news is you have great donor. Bad news is diffuse thinning. Really not too many areas to implant so many grafts. Personally I would either try Fin, and if you really are against that then stick with hair fibers for several years to come until a HT is more appropriate after further loss.

[Rick_]

@JDEE0
Cool, thanks for info about finasteride. I'll do some research about finasteride. So, I should be able to get back some thickness if I start taking finasteride, that is if I don't see any side effects?
 

@SD1984
Yeah, I was a little skeptical about HT since my hair loss is a diffusing type. The hair fibers I found online look awful, I rather shave or get a hairpiece.
To be honest, I want to get my confidence back. I was always conscious about my hair whenever I stepped outside the house, which I'm sure most of you know this very well. I don't want to be conscious about my hair anymore and here's my thought: No offense but, I don't see much point in getting an HT in my late 30s or early 40s(again no offense intended), I would just shave, grow a beard and live with it. But, I want to look young(who doesn't lol) while I'm young and for once look my age lol.

[Gatsby]

It's definitley a personal decision. This is only my opinion but if you are able to take Finasteride then you have a great chance of not only stabilizing your current hair loss but also regain some ground in the crown area as well. Your donor hair too can strengthen and down the track if you do have surgery it will be an advantage to prevent not only further hair loss but also help in strengthening your donor. All the best!

[Rick_]

I'm not sure if it's evident, but I also have a weird receding hairline. Weird 'cause the left side is receding while the right is fine. There's an overall diffusing with hair at the crown almost gone.

Edited September 7, 2021 by Rick_

[Future Hair Doc]

If you're in NYC, you definitely need to consult with Dr. Robert Dorin. He's highly recommended on here and is an Elite Coalition member.  Feel free to reach out anytime buddy.

[Britanium]

Have you seen the forums recommended list:

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

 

[WhiteyUK]

14 hours ago, Rick_ said:

thought: No offense but, I don't see much point in getting an HT in my late 30s or early 40s(again no offense intended), I would just shave, grow a beard and live with it. But, I want to l

Believe me ... you will care

[JDEE0]

15 hours ago, Rick_ said:

@JDEE0
Cool, thanks for info about finasteride. I'll do some research about finasteride. So, I should be able to get back some thickness if I start taking finasteride, that is if I don't see any side effects?
 

@SD1984
Yeah, I was a little skeptical about HT since my hair loss is a diffusing type. The hair fibers I found online look awful, I rather shave or get a hairpiece.
To be honest, I want to get my confidence back. I was always conscious about my hair whenever I stepped outside the house, which I'm sure most of you know this very well. I don't want to be conscious about my hair anymore and here's my thought: No offense but, I don't see much point in getting an HT in my late 30s or early 40s(again no offense intended), I would just shave, grow a beard and live with it. But, I want to look young(who doesn't lol) while I'm young and for once look my age lol.

You should be able to gain some thickness back, yes, and in fact at least be at or above baseline in 10 years time (i.e. either better than now, or without any worsening) if we go by the most recent and longest study of over 500 men spanning a 10 year period. Generally, the less miniaturised the hair, it seems the more likely you are to have a significant recovery - yours don't seem too far gone at all for this to maybe happen. 

You could also try micro needling along with your minoxidil/perhaps use oral minoxidil - I've seen numerous people re-grow a full head of hair doing this with similar staring points as yourself.

Also, c'mon man, you know that's not true. This statement is almost cliche amongst these forums at this point, and it's a telltale sign that you need to take a step back and re-evaluate things. You're only thinking about the immediate, which is stupid and unrealistic to be blunt. people who are losing their hair at 18, 19 or 20 and desperately want a transplant say the same thing about the age you're at now, believe me I've seen them say 'I won't care when I'm 30+ so it doesn't matter if I'm going to keep balding' and then proceed to ignore all advice.

We're the same age, and I know for a fact I'm gonna care about the way I look in my late 30's (which is less than a decade away for both of us, its not a long time at all) and beyond. I could understand to some degree if you said when you were in your 60's or 70's (I still think you will even then, by the way), but 30's and 40's isn't even old. What if you find yourself to be single at 37 or 38, say your gf/wife disappears, are you suddenly going to feel happy and confident being bald and looking 'old' as you said? Not saying dating/women is the main motivation behind a HT, just proposing a scenario in which you might think oh yeah, I will still care.

Besides, go look up the age of most of the people you grew up listening to, or watching in certain shows/movies, who are still relevant today and popular - I bet most are at least getting to or in their late 30's and don't seem anything near old to you.

[Rick_]

@JDEE0 @Newyear newhair
First off, I greatly appreciate the responses. I think my response sounded too glib.

I'll try to express my feelings and my thought process to my best. I'm not good at expressing, so please bear with me.
I was obsessed with my hair loss when I found out and tried my best to find a solution. That's when I found out about minoxidil and 2 years later about finasteride(which till this day I haven't taken it). I found out about finasteride 2 years later, 'cause my doctor assured me that my hair loss is controllable with minoxidil and that I shouldn't worry.

I agree with both of you but, what I noticed is that over the past few years I've been caring less about my hair loss(still cared enough to hide it). The main reason I continued using minoxidil was 'cause of my diffusing hair loss, it wasn't that evident like how it is with the other type of hair loss. And, like a fool, I thought having this diffusing hair loss is better 'cause you can't really see the hair loss(not very visible receding hairline) and the loss of thickness which I hid decently with hair cuts.

But in the past 2 years I've lost so much that the hair that's left looks kind of bad(to me, others might disagree which is fine), that is compared to how my hair was 4-5 years back when I was still losing, but it looked good enough to me to continue minoxidil and be hopeful for an HT in the future.

In mid 2020 I shaved my head to see whether I could pull off the shaved/bald look and to be honest it wasn't that bad, it doesn't matter but I feel like I need to mention that I got compliments/compliment, maybe they were just trying to be nice(no one knows about my hair loss except for my family and I didn't get any complements from my family). I shaved again in January 2021, and I felt better than the last shave, or maybe it was the same, but I remember that I felt good 'cause I didn't have to care so much about my hair anymore. It was a relief to be honest, 'cause I would constantly think of whether people could see my hair loss and things like that, which made me extremely paranoid. Maybe I was okay with the shaved/bald look 'cause I experimented with it during the pandemic. I did go out, but to be fair, it wasn't like pre-covid times, so there's a possibility that I would not feel the same after the covid, but the relief was authentic.

The point I was trying to make was that if I can't find a temporary solution, let's say taking finasteride comes with side effects, then in the next few years my hair loss is going to get progressively bad, and I think within 5 years I'll be a NW 6. By next year, I think I'll just shave my head and go with that look since my hair will look even more depressing that it is right now. But, if finasteride brings my hair back to how it was pre-covid then yeah, I will care about my hair in the future since I will gain that hope back and get an HT at the right time(suggested by the doctors, you guys and obviously my opinion).

If my hair gets bad I'll get sad, but I'll not be depressed and yeah, once in a while I'll wish to look young that includes having more muscle, fewer wrinkles and more energy and such. I'll deal with it as "that's how life is, you're getting old, it is natural" and try to be happy with my life.
Or I could get depressed when I'm older, but I think the chances of that happening is low(if it does, then I screwed up I guess).

This is my personal opinion, and I'm not trying to bash/ridicule anyone, everyone deals with this differently and I sincerely hope that they are happy with their decision. If you guys still think I'm not thinking in the right way then I'll take a few days and think about it. For now, I've requested consultation with doctors in NY and I'll share their responses here to get guidance.

Apologies for the long post!

[JDEE0]

27 minutes ago, Rick_ said:

@JDEE0 @Newyear newhair
First off, I greatly appreciate the responses. I think my response sounded too glib.

I'll try to express my feelings and my thought process to my best. I'm not good at expressing, so please bear with me.
I was obsessed with my hair loss when I found out and tried my best to find a solution. That's when I found out about minoxidil and 2 years later about finasteride(which till this day I haven't taken it). I found out about finasteride 2 years later, 'cause my doctor assured me that my hair loss is controllable with minoxidil and that I shouldn't worry.

I agree with both of you but, what I noticed is that over the past few years I've been caring less about my hair loss(still cared enough to hide it). The main reason I continued using minoxidil was 'cause of my diffusing hair loss, it wasn't that evident like how it is with the other type of hair loss. And, like a fool, I thought having this diffusing hair loss is better 'cause you can't really see the hair loss(not very visible receding hairline) and the loss of thickness which I hid decently with hair cuts.

But in the past 2 years I've lost so much that the hair that's left looks kind of bad(to me, others might disagree which is fine), that is compared to how my hair was 4-5 years back when I was still losing, but it looked good enough to me to continue minoxidil and be hopeful for an HT in the future.

In mid 2020 I shaved my head to see whether I could pull off the shaved/bald look and to be honest it wasn't that bad, it doesn't matter but I feel like I need to mention that I got compliments/compliment, maybe they were just trying to be nice(no one knows about my hair loss except for my family and I didn't get any complements from my family). I shaved again in January 2021, and I felt better than the last shave, or maybe it was the same, but I remember that I felt good 'cause I didn't have to care so much about my hair anymore. It was a relief to be honest, 'cause I would constantly think of whether people could see my hair loss and things like that, which made me extremely paranoid. Maybe I was okay with the shaved/bald look 'cause I experimented with it during the pandemic. I did go out, but to be fair, it wasn't like pre-covid times, so there's a possibility that I would not feel the same after the covid, but the relief was authentic.

The point I was trying to make was that if I can't find a temporary solution, let's say taking finasteride comes with side effects, then in the next few years my hair loss is going to get progressively bad, and I think within 5 years I'll be a NW 6. By next year, I think I'll just shave my head and go with that look since my hair will look even more depressing that it is right now. But, if finasteride brings my hair back to how it was pre-covid then yeah, I will care about my hair in the future since I will gain that hope back and get an HT at the right time(suggested by the doctors, you guys and obviously my opinion).

If my hair gets bad I'll get sad, but I'll not be depressed and yeah, once in a while I'll wish to look young that includes having more muscle, fewer wrinkles and more energy and such. I'll deal with it as "that's how life is, you're getting old, it is natural" and try to be happy with my life.
Or I could get depressed when I'm older, but I think the chances of that happening is low(if it does, then I screwed up I guess).

This is my personal opinion, and I'm not trying to bash/ridicule anyone, everyone deals with this differently and I sincerely hope that they are happy with their decision. If you guys still think I'm not thinking in the right way then I'll take a few days and think about it. For now, I've requested consultation with doctors in NY and I'll share their responses here to get guidance.

Apologies for the long post!

No worries, no need to explain yourself or be apologetic - I wasn't trying to have a dig at you or anything, just give you some advice as I can see you're new to all of this and you need some guidance to make sure you put your best foot forwards from here on out and don't end up regretting things.

Yeah, GP's are notoriously bad when it comes to anything hair loss (or indeed anything endocrine/hormone) related. Most have no idea what they're talking about, which is fair enough as it's just not something they learn much of, but I'm not surprised that one told you that minoxidil is the end solution to your problems. Min can help, but as I've said, it does nothing to address the cause of the problem, so you most certainly still have a lot to worry about if that's all that's being used as loss will continue to progress. 

Hey, there's absolutely nothing wrong with accepting your baldness and going down the shave and move on route - I actually have a lot of respect for those who are able to just do that and not look back and it's without doubt the easier option if its something you can come to terms with and be happy. So, if that's something that you think you could do without much issue, then I would certainly recommend doing so. 

A HT is for someone who is completely sure that they want hair, and they want it for as long as they live. The problem is that it inevitably leaves scarring on the head, either in the forms of thousands of tiny white dots or a big long smile shaped scar. As a result, it's obviously not ideal to shave your head and be bald ever at any point after this really, so you should only do it if you're committed to meds and further procedures over the course of your life in my opinion. 

I think your approach is good - try the fin, stay on it for a while, and once you get to a point you know its preventing further loss (which is pretty much guaranteed) and you're happy to stay on it long term, then by all means go ahead with the HT. I myself have been on it for two years and am now booked in for my HT at the end of the year as I'm completely happy at this point to stay on it indefinitely. 

[WhiteyUK]

Also no problem here... was simply saying you will still care about your appearance in your 40’s...

I shaved my head from around 30 until I got a ht last year aged 45, I was only receding and not completely bald, I’d have had a ht earlier but didn’t know how readily available they and how affordable ( always thought they cost 10’s of thousands of pounds )

And now 11 months on couldn’t be happier with the results and the compliments I get, so many people can’t believe my age 😀

stick in and good luck

[Rick_]

I've requested for a consult with the doctors mentioned in the https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN-MOB in the US and Europe. Some of them have got back stating that I'm not eligible for an HT given my progression and suggested me to start on finasteride and check back after a year on finasteride. I've decided to give it a try, but, you need a prescription for it in the US. I've been trying to meet Dr Dorin to get the prescription for it and also get an analysis done on my donor area.

Could you guys suggest on how to reach Dr Dorin and also some reputable sources for finasteride(I've heard quality issues about finasteride from different suppliers)?

[JDEE0]

You can just order from an online pharmacy - you fill out a basic 30 second questionnaire and a dr. writes you a prescription which allows you to purchase there and then. 

Well, at least this is the case in the UK, I assume it's the same in the states. 

9 minutes ago, Rick_ said:

I've requested for a consult with the doctors mentioned in the https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN-MOB in the US and Europe. Some of them have got back stating that I'm not eligible for an HT given my progression and suggested me to start on finasteride and check back after a year on finasteride. I've decided to give it a try, but, you need a prescription for it in the US. I've been trying to meet Dr Dorin to get the prescription for it and also get an analysis done on my donor area.

Could you guys suggest on how to reach Dr Dorin and also some reputable sources for finasteride(I've heard quality issues about finasteride from different suppliers)?

 

[yesplease]

On 9/8/2021 at 12:22 AM, Newyear newhair said:

Also no problem here... was simply saying you will still care about your appearance in your 40’s...

I shaved my head from around 30 until I got a ht last year aged 45, I was only receding and not completely bald, I’d have had a ht earlier but didn’t know how readily available they and how affordable ( always thought they cost 10’s of thousands of pounds )

And now 11 months on couldn’t be happier with the results and the compliments I get, so many people can’t believe my age 😀

stick in and good luck

Hi, did you create a thread about your HT? I’m of a similar age and possibly hairloss, just curious. Thx 

[WhiteyUK]

27 minutes ago, yesplease said:

Hi, did you create a thread about your HT? I’m of a similar age and possibly hairloss, just curious. Thx 

I will be doing my 12 month update in a few weeks.

any questions feel free

[Carl Counts]

First of all I want to wish you the best no matter what you decide. That being said PLEASE do a LOT of thorough research on the doctor you decide upon to do your hair transplant. Do not make the mistakes that I made prior to getting butchered. Be careful choosing a doctor based on location, recommendations from various websites and a doctor that belongs to prestigious sounding medical boards. I made all those mistakes and got butchered big time and now have life time disfigurement. Choosing a doctor based on location is asking to get butchered. Choosing a doctor recommended on many sites simply means he does a LOT of paid advertising. A good doctor should not have to advertise at all as his work should speak for itself. Furthermore, prestigious sounding medical boards like international society of hair transplant surgeons means NOTHING. It means he pays his yearly dues to that medical board. A good doctor should be willing to answer all your questions about his experience and qualifications. He should also be willing to let you meet and follow his patients to allow you to evaluate the results. Even watch a surgery

 

[Britanium]

@Rick_Hey how’s the consultations going ? Thanks 🙏 

[Melvin- Admin]

@Carl CountsI already let you have your thread. Do not spam the forum with your unsolicited video. You can update your own thread if anyone is interested in your video. 

[Rick_]

@JohnAC71No updates from what I mentioned earlier. I'm going to get a prescription from a General physician for Finasteride and try it out.

[Britanium]

1 minute ago, Rick_ said:

@JohnAC71No updates from what I mentioned earlier. I'm going to get a prescription from a General physician for Finasteride and try it out.

Hope it helps 👍🏼