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34 Year Old Asian-American Male - Thoughts on My Balding / Donor Area?


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Hi all -- I'm relatively new to this specific forum, but I've been on another forum since 2013. So just want to put out a disclaimer that I'm not a complete newb when it comes to this stuff. 😄

As the title suggests I'm a 34 year old Asian-American male and if I had to diagnose my balding I'd say I'm probably a NW3A or NW4A. My front hairline is thinning pretty bad and I recently just noticed that my crown seems to be going too. (ugh!)

CURRENT HAIR LOSS PREVENTION REGIMENT:

I've been only on Minoxidil for nearly 6 years (started on January 2016 when I was 28 years old). I only apply it once per day as opposed to the recommended twice daily. The reason is because it's just too much of a hassle for me to apply it every morning so it's only a night time routine. Moreover I've never had dry scalp/dandruff before and ever since I've been on Minoxidil I've been flakey AF. I contemplated taking Finasteride and in fact got a prescription for it and even picked up the bottle from the pharmacy, but I ultimately decided it wasn't worth it due to the potential sexual side effects. So it'll only ever be Minoxidil for me in terms of medical intervention.

MY HAIR LOSS / FAMILY HAIR LOSS HISTORY:

I started noticing my hair was thinning back in college when I was 20. At the time I wore a lot of hats so the precise age of when I started balding is unknown, but it's possible I started thinning out when I was 18 or 19, but 20 was when I definitively noticed it for the first time.

My father is pretty much completely bald now. He's a NW7, but then again he's also 70 years old, so that's not much of a surprise. I did peruse some of our old family photos recently and it seems to me by the time he was 31 years old he was essentially at the same balding pattern as where I am now (if not worse). My father has about 4 other brothers and unfortunately he's the only that's bald... 🙄

My older brother (39 years old) is bald too and based on old family photos it seems he started thinning out really aggressively at around 19/20. Compared to my brother, his balding was definitely wayyyyy worse than mine. It was so bad that he started shaving his head by the time he was 23 or 24. Even though he continues to keep it shaved, based on his stubble pattern I would say he's also a firm NW7 now.

MY CURRENT HAIR SITUATION:

Luckily for me, I've been able to style my hair in a way that conceals my balding/thinning in the front hairline for all these years. Everyone I've ever confessed that I'm balding to are always genuinely surprised and shocked to hear that and claim they can't even tell.. That usually makes me feel good about my hair loss situation, but there's really no way of telling if they are being genuine or not. I always wonder if they actually CAN TELL but just choose not to tell me in order to make me feel better... 🤔

The idea of a hair transplant was already on my mind back in my early 20s, but I always felt that I was too young to go down that path. For me, surgery was a very extreme measure and it should only an absolute last resort. In my opinion, as long as I could continue to conceal the thinning/balding then I was winning. However recently I started to notice that it has been becoming more difficult to style my hair to conceal my frontal thinning/balding. Now that I'm upon my mid-30s I feel like now is the right time to seriously explore the hair transplant route. Moreover my company is still allowing us to "Work For Home" so it'd be a wasted opportunity if I didn't take advantage of this time to get it done.

Anyways, sorry for the rambling...back on topic! Just wanted to get some opinion and insight on what you fine folks think of my hair situation.

MY QUESTIONS TO ALL OF YOU:

1. How would you rate my current hair loss and what do you think my future outlook is?

2. How many grafts do you think it would take to restore my front hairline? (I'm pretty realistic and not trying to restore it to my teenage years, ideally looking to retain a mature/proper hairline for my age. Ideally I'd like to be able to slick my front back.)

3. How is my donor area? Am I an ideal candidate for a hair transplant? I'm only considering FUE(I never noticed, but I've kinda got a weird Nightwing logo (the DC Comics character) on the back of my head, which kinda worries me...)

PHOTOS BELOW: (They were all taken WITHOUT flash, except the final 3 on the bottom. These photos were also taken the day after I just got a haircut.)

Here is a baseline photo of myself. This was back in May 2021. As you can see, to the untrained eye my hair seems fine.

(By the way, I grow the top part of my hair out pretty long in order to use it for the 'ol snazzy Trump combover effect. 😅)

2073089578_Me-May2021.jpg.fb4eb0e5016457030541c980efd05f78.jpg

But here is the reality of my hairline...

492898789_HomeHair1.thumb.jpg.d99cdf49bfd30e8ebfc2a78a2c7f0b2a.jpg

1818956252_HomeHair2.thumb.jpg.179470ba603eab62512d4b5fc4d104db.jpg

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1166257917_AptHair1.thumb.jpg.083fb4f0b60d7822eff22d911edd280c.jpg

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THESE PHOTOS BELOW ARE TAKEN WITH FLASH***

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Edited by Balding Bad
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With the highest of Norwoods in your family, I would be considering topical fin maybe ? Just a thought as you have got so much hair still at present.

Its difficult to tell with your donor area, looks like it’s ok I’m some pics but not so great in others.

I reckon 2 -2.5k upfront would do wonders in the right Drs/Clinics hands 😊

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12 minutes ago, JohnAC71 said:

With the highest of Norwoods in your family, I would be considering topical fin maybe ? Just a thought as you have got so much hair still at present.

Its difficult to tell with your donor area, looks like it’s ok I’m some pics but not so great in others.

I reckon 2 -2.5k upfront would do wonders in the right Drs/Clinics hands 😊

I would like to have a family one day and don't want to risk any potential complications with Fin. I would probably be open to the idea of Fin once I have my kids though...but in the meantime it's simply not a viable option for me.

I have a colleague who is currently on topical Fin and he says he's got some mild sexual side effects, so that's kinda scary to me...

That's great that you think 2-2.5k grafts would be sufficient for my front. That's what I was thinking myself. 😁

11 minutes ago, JohnAC71 said:

As your experienced already, which clinics would you be considering? 

Strongly considering Dr. Ron Shapiro with Shapiro Medical Group in Minnesota since they've got a stellar reputation with natural looking frontal hairlines. My consultation is scheduled for next month. I'm kinda pumped and that's honestly why I have these pics. So I figured it'd be a good opportunity to get some additional feedback from this forum! 😎

Edited by Balding Bad
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Just now, JohnAC71 said:

Exciting times ! Great you have a face to face consultation booked up 👍🏽 Be really interesting to hear what he thinks 🤔

I'm sorry, I should have clarified. My consultation is going to be over the phone since I am located on the East Coast of the US... 😞

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4 minutes ago, Balding Bad said:

I'm sorry, I should have clarified. My consultation is going to be over the phone since I am located on the East Coast of the US... 😞

Ah ok 👌 

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Hi Heisenberg, I strongly suggest you at least attempt finasteride. You should switch to the liquid minoxidil without alcohol and propylene glycol. If you're getting side effects from oral finasteride, which about 5% of people get, then switch to topical finasteride. Feel free to reach out anytime

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7 hours ago, Balding Bad said:

1. How would you rate my current hair loss and what do you think my future outlook is?

2. How many grafts do you think it would take to restore my front hairline? (I'm pretty realistic and not trying to restore it to my teenage years, ideally looking to retain a mature/proper hairline for my age. Ideally I'd like to be able to slick my front back.)

3. How is my donor area? Am I an ideal candidate for a hair transplant? I'm only considering FUE(I never noticed, but I've kinda got a weird Nightwing logo (the DC Comics character) on the back of my head, which kinda worries me...)

 

1) Considering what you have told us with regards to your father and brother, you are doing very well. Either minoxidil is doing wonders for you, or you aren't genetically as predisposed to MPB as your father and brother - I would probably steer more towards this answer, as opposed to crediting it all on minoxidil, as you haven't been addressing the route course. 

2) I would follow the outline of your hairline that you still have, and assuming you have characteristics similar to other asian patients, I would roughly guess that between 2000-3000 would sit you well, depending how far into your native hair the surgeon chooses to go. 

3) Very hard to tell from your pictures - you really need a microscopic examination for the answer to this, however, visually it looks ok. 

It'll be interesting to see how you get on with some in person consultations, if you are able to get them booked in! 

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3 hours ago, Dr. Suhail Khokhar said:

Hi Heisenberg, I strongly suggest you at least attempt finasteride. You should switch to the liquid minoxidil without alcohol and propylene glycol. If you're getting side effects from oral finasteride, which about 5% of people get, then switch to topical finasteride. Feel free to reach out anytime

By the sounds of it, he's pretty well read up on hair loss - I imagine he's gone through his own personal risk v reward analysis hundreds of time in his head, so this is a pretty unhelpful input if you have read through his original post. 

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6 hours ago, Dr. Suhail Khokhar said:

Hi Heisenberg, I strongly suggest you at least attempt finasteride. You should switch to the liquid minoxidil without alcohol and propylene glycol. If you're getting side effects from oral finasteride, which about 5% of people get, then switch to topical finasteride. Feel free to reach out anytime

Hi Dr. Khokhar -- appreciate the suggestion.

Where would I be able to find some alcohol and propylene glycol free minoxidil? I am currently using the generic Kirkland brand.

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3 hours ago, Curious25 said:

1) Considering what you have told us with regards to your father and brother, you are doing very well. Either minoxidil is doing wonders for you, or you aren't genetically as predisposed to MPB as your father and brother - I would probably steer more towards this answer, as opposed to crediting it all on minoxidil, as you haven't been addressing the route course. 

2) I would follow the outline of your hairline that you still have, and assuming you have characteristics similar to other asian patients, I would roughly guess that between 2000-3000 would sit you well, depending how far into your native hair the surgeon chooses to go. 

3) Very hard to tell from your pictures - you really need a microscopic examination for the answer to this, however, visually it looks ok. 

It'll be interesting to see how you get on with some in person consultations, if you are able to get them booked in! 

Yeah to be completely honest, even though my front hairline is clearly in bad shape I am still overall grateful I have as much hair as I do and that I'm able to use the existing hair that I have for a nice concealer effect. Part of me feels like it's a mixture of having slightly better genes and minoxidil doing it's thing. The two together are providing a good synergy in at least slowing down my hair loss.

The goal is to rebuild the current hairline. I would not dare try to lower it or try to fill in the temples. I'm very realistic and I don't want to exhaust my precious donor area when there's no telling where I'll be in 10 years from now.

Yeah, the photos of my donor area were kinda hard to take since I'm taking them by myself. It's been kinda muggy where I live recently, but I'd like to try to take photos again of my donor area when I have some pretty solid lighting.

Anyways appreciate your insight/feedback @Curious25😎

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Howdy gang -- it's been just almost a week since I started this topic, but wanted to do a follow up now that my hair is 1 week longer.

My main question is about my donor area. We rarely see the back of our heads and because of that I recently only discovered this weird shape in the back.

1.) Wanted to get some insight on whether or not my donor area would make me a suitable/ideal candidate for an FUE HT and if this "pattern" is of any concern?

2.) Any thoughts on my crown? Does it look okay or is it thinning out?

The image below highlights what I'm referring to. Not too sure if this particular photo best illustrates it, but I've got kind of a Nightwing logo going on (or I guess it looks like a thong based on how I highlighted it 🤣). The hairs in that area just seem notably thinner... It seems more notable in the photo where I tilt my head down.

For reference, all these photos were taken with no flash under natural lighting and the overhead bulb in the bathroom. I had just woken up so my hair is technically in "bed head" mode. I didn't style it or anything.

So first batch is dry hair and then 2nd batch is immediately after I showered, so it's wet.

2021360596_Donor10-19PATTERN.thumb.jpg.c4c58dd02e16dd4252a06b73f5b70fe7.jpg

**THIS IMAGE BELOW WAS TAKEN WITH PARTIAL NATURAL LIGHTING COMING IN FROM THE LEFTHAND SIDE.

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**THE REST OF THE IMAGES BELOW ARE TAKEN WITH NATURAL LIGHTING DIRECTLY ON THE BACK OF MY HEAD.

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**THESE PHOTOS BELOW ARE TAKEN AFTER SHOWER, SO HAIR IS WET.

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Edited by Balding Bad
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