M/24 What do you think is the best option for me?

[Dboozer]

I am age 24 been on finasteride and minoxidil for 3 years. My hair stabilized it's hair loss around July of 2019. This is about how my hair looked when I was 22, only slightly more recession since then.

I am looking to get a hair transplant by the end of this year, what do you would be a good option for me and how many grafts?

[NARMAK]

Hi @Dboozer

There's a bunch of clinics listed on the site that you could ask to offer a potential free consultation and get their professional assessment. Your crown looks a bit thin but there's a possibility that's the lighting, hair colour and skin tone exaggerating that effect and naturally crowns are not actually as dense as other parts of our head. The blackhole of hair transplants as some call it. 

I got classed as a Norwood 2, you can kinda see my thread in this part of the forum and my temporal points are much weaker than yours look. Whilst the point itself has receded back, yours still look relatively thicker overall and point out a bit at least. 

However your frontal and temporal points are where things mainly differ and that's where it could be that they say Norwood 2 or Norwood 3. Definitely no more than Norwood 3 and i've seen patients get between 1200-2200 grafts (depending on hair calibre) to probably get that transplant done. 

Bottom line, it's all about the type of restoration you want doing. At your age, my focus would instantly be on having it lowered down and whatnot, but taking into account potential future hair loss, it usually is said to be a better idea to be more conservative just in case even using Finasteride etc. you need a further procedure down the line. You look like you'd probably have a shot with beard hair too if needed. 

 

Most likely, the corners getting "filled" and a fencing around that frontal hairline around what you have now might get recommended. 

 

[HappyMan2021]

I wager you will have further hair loss, even on Fin. If you must have a hair transplant at such a young, non-recommended age, I advise a conservative approach. 

[Melvin- Admin]

I would hold off surgery, you’re still really young. Best to grow your hair and style it better for better coverage.

[NARMAK]

3 hours ago, SadMan2021 said:

I wager you will have further hair loss, even on Fin. If you must have a hair transplant at such a young, non-recommended age, I advise a conservative approach. 

Whilst i respect the opinion of further hairloss, i wouldn't really say there's a massive issue in his case because he said he's been on medication and the hair loss stabilised for the last 2+ years now. 

I think Dr Blake Bloxham is probably one of the few respected guys out there who even said he disagreed with the whole age gating for a HT. Albeit sensibly as anybody at that age should consider, not lowering the hairline massively and using up a ton of grafts. However, the frontal hairline usually is always the first sort of place that is addressed and then over time any additional HTs deal with behind that area for coverage if necessary. 

I've also read stories of people seemingly stable in their later 30s and then a rapid acceleration a few years later, so there's really no guarantee but medication and 5 year studies have shown stability remains on Finasteride for 64% of people. So i think OP could go for something conservative. 

[Dboozer]

Thanks for the response everyone. Seems like the consensus is to wait off.

My question is if my hairloss is stabilized for next so years, although realistically I do expect some gradual loss, what would be a good age for me to consider the procedure?

[NARMAK]

10 hours ago, Dboozer said:

Thanks for the response everyone. Seems like the consensus is to wait off.

My question is if my hairloss is stabilized for next so years, although realistically I do expect some gradual loss, what would be a good age for me to consider the procedure?

Personally there's no "best age" imo people can recommend as sometimes even on medication things can be stable and then deteriorate further. 

I would say generally the "rule" most go by is that the hair loss in 20els and 30s is faster and then slows down. Personally i would look at your hair loss and if you're on medication whether it is stable or you need to adjust doses. By that i mean if you are for example on Finasteride 1mg but 3x a week rather than once a day. So maybe you can increase the dose and it would potentially help block more DHT. 

At 1mg a day, i believe Scalp DHT is reduced but it varies between Finasteride and Dutasteride. In fact, here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/#:~:text=A related clinical study stated,DHT levels by ~41%.

It stated "A related clinical study stated that 0.5 mg/day of dutasteride could lower scalp DHT levels by more than 51%, and 5 mg/day of finasteride could lower scalp DHT levels by ~41%." 

Usually the dosage of Finasteride is 1mg a day for hair loss. So, if 5mg/day is giving you 41% reduction and you take 1mg a day, it could mean you are blocking less scalp DHT, but it's not going to be significantly lower but there's about a 10% or so greater benefit according to the study for Dutasteride but people can get more side affects from tanking their DHT that much. As a mature adult, it's not always possible to know how it will affect you until you try of course but if you tolerated Finasteride, it could be a good indication albeit not a guarantee. 

The primary issue with DHT affecting our hair is nobody at present to my knowledge can say "Your hair follicles at X location are sensitive to DHT at this level and reducing it by X amount will ensure reduced hair loss rate or complete stability" 

Over time, some people apparently have greater sensitivity in their follicles to DHT appear so its difficult to predict. You can only be proactive about prevention and then, if you have done that well, i think when usually somebody gets to 30, it's usually slowing down. 

I'm 31 and going to be 32 shortly for reference and i only started Dutasteride just over 7 months ago. Feel extremely fortunate that i didn't appear to be as negatively affected in that time period as i could have been. In the 7 plus months, i've noticed positives to medication indicating its helped stop and actually help in some areas. Full results are usually 12 months and beyond even with medication but i know for a fact, i can't regrow hair even if i take Dutasteride, Minoxidil and Microneedle on areas like my temporal points. I need a transplant and to lower the hairline a little i need to do that too.

I would say save up, put a bit of money aside and adjust to Minoxidil and Microneedling since you have already been on medication for over 12 months and maximised your results with that if you are taking it everyday at 1mg or so. Then really consider your long term goal, who you want to select and the plan if things receded behind the frontal area. 

[Rahal Hair Transplant]

Your hair looks pretty good and thick in the photos. But as a very tough estimate considering some additional moderate recession I’d suggest 3500 to 4000 grafts would give you a nice, youthful looking hairline with some added density in the thinning areas throughout the rest of your scalp.  In my opinion, consult a few reputable hair restoration surgeons to get a better idea of what to expect and discuss a long-term her restoration plan.

best wishes,

Rahal Hair Transplant