Hair Transplant Risks for Existing Hair

[jakos]

Hi all!

I came across this forum a couple days ago, this is a real gem and want to thank everyone who take their time to give advice to people who need it.

Let me briefly describe my condition.

 

Background

• age 30
• i always had very dense hair, but also remember losing a ton of hair since more than 10 years ago, my pillow always had many many hairs when I woke up, even when I was 17-18
• I remember seeing in shock a hair loss on my vertex when I saw my security camera footage when I was like 21
• genetic factors: not very sure. my dad has no hair loss at all, but his father did. also my other grandpa didn't have but my uncle mildly has (but he's blonde anyway) apart from that i don't have many male relatives
• recently visited a dermatologist, she examined my hair and concluded I have male type genetic hair loss (nw 3 vertex) - not sure now, if this describes my current condition or my potential hair loss limits
• i do conventional blood tests regularly and everything seems ok there
• never took meds or a supplement; mainly because my hair looks fine in the mirror and I wasn't too much worried about it

 

Hair Condition (pics attached)

• I think my condition is a bit different from what I see here mostly, because I don't think my hairline receded noticeably, and it is somewhat intact. Also, no part of my scalp is entirely bald, some have denser hair, some have less, and some have next to nothing (I think)
• I lost (and still losing I think but more slowly now) density in every part of my hair apart from sides and back; i.e. entire top area
• Have seborrheic dermatitis, gets well and worse occasionally, also affecting my scalp sometimes
• The back of my scalp is very densely haired, i mean it feels like a brush when I put my hand there

 

Current Status

• Well I am Turkish and I think having a HT is not a big thing since i know some guys (and also those who know a guy) who did it and had great results, even in hair mills and in clinics led by technicians 
• I thought it would work well on me without much risk because a) I have a good donor area b) hairline already defined so no need to create a new one
• I am about to relocate to Spain in a month, so I thought it would make sense to rush it, get a HT in a decent clinic and make a fresh start in Spain since I already have free time to spare for healing home
• After spending hours in this forum I became more informed about also the risks of a HT and more aware of the future implications in not expert hands. Actually here is where I was about to get a HT: also know guys who got a HT there, they are very happy with the results but of course it's been less than a year so no one knows the ultimate outcome. Btw she offered 4 - 4.5k grafts with motorized FUE
• I have 4-5 k euros to spare for a HT in Turkey, the main reason I didn't see a proper doctor is they are fully booked for upcoming months, and I thought it would be good to just get a HT and be done with it before moving to another country. But after spending time here of course now I feel like an ignorant idiot for thinking that ...

 

Finasteride

• I had  quickly decided to ignore it initially, seeing horrible comments regarding PTS
• The dermatologist I saw actually said PTS is not proven, it's like a horrible story getting viral.
• She said she and her colleagues prescribed Fin for decades, without adverse outcomes. She says of course there can be side affects, but thinks PTS is a bullshit...
• So I feel kinda ready to start taking Fin in relatively small doses, but can't say I don't have second thoughts about it

 

Questions

• Wandering how you would evaluate my condition and what would you suggest.
• Do you think I'm a good candidate for a HT? If so, do you suggest specific doctors in Turkey (actually have an appointment with Bicer in 2 weeks)
• Do you think i'm a fool for considering rushing a HT, and especially in sub-par clinics? Do you think there are potential risks? (mainly shock loss in my current hair I think, I'm not very concerned about overharvesting in my donor - but should I?)

 

 

 

 

[NARMAK]

Hi, yes this forum is definitely a gem. 

Firstly, i would recommend you take Finasteride, even if you want to start at only 1mg 3x a week to see how you tolerate it and then increase to 1x a day if you handle it well. This should help stabilise further hair loss 

Losing 50-150 hairs a day is considered within a "normal" range but people freak out because they start focusing more on the hair fall. 

I would say for you, it might be a good thing to try Minoxidil too for your midscalp as Finasteride doesn't help with regrowth as much as helping to stop the further hair loss or slow it down as much as possible for you. 

I would also add Microneedling with a derma pen into the treatment options. After 1 year, you may see solid regrowth on the top crown and mid scalp making it much more effective to maybe do a hair transplant only for the front and save you grafts. 

[jakos]

3 hours ago, NARMAK said:

Hi, yes this forum is definitely a gem. 

Firstly, i would recommend you take Finasteride, even if you want to start at only 1mg 3x a week to see how you tolerate it and then increase to 1x a day if you handle it well. This should help stabilise further hair loss 

Losing 50-150 hairs a day is considered within a "normal" range but people freak out because they start focusing more on the hair fall. 

I would say for you, it might be a good thing to try Minoxidil too for your midscalp as Finasteride doesn't help with regrowth as much as helping to stop the further hair loss or slow it down as much as possible for you. 

I would also add Microneedling with a derma pen into the treatment options. After 1 year, you may see solid regrowth on the top crown and mid scalp making it much more effective to maybe do a hair transplant only for the front and save you grafts. 

Hi NARMAK, thanks for the reply. Seriously considering Fin and others. The only major issue is that i will be moving to a new country and a new job, I am only worried that I may not be able to understand if any psychological side effect is due to Fin or simply from the movement itself  So maybe its better to start once I settle things there.

 

Do you think a HT would cause significant risk to my existing hair?
 

Lastly, the doc told me I'm NW 3 Vortex - any idea if this describes my current hair loss level or its potential limits? 

 

Thanks!

 

 

 

 

[digi23]

4 hours ago, jakos said:

Hi all!

I came across this forum a couple days ago, this is a real gem and want to thank everyone who take their time to give advice to people who need it.

Let me briefly describe my condition.

 

Background

• age 30
• i always had very dense hair, but also remember losing a ton of hair since more than 10 years ago, my pillow always had many many hairs when I woke up, even when I was 17-18
• I remember seeing in shock a hair loss on my vertex when I saw my security camera footage when I was like 21
• genetic factors: not very sure. my dad has no hair loss at all, but his father did. also my other grandpa didn't have but my uncle mildly has (but he's blonde anyway) apart from that i don't have many male relatives
• recently visited a dermatologist, she examined my hair and concluded I have male type genetic hair loss (nw 3 vertex) - not sure now, if this describes my current condition or my potential hair loss limits
• i do conventional blood tests regularly and everything seems ok there
• never took meds or a supplement; mainly because my hair looks fine in the mirror and I wasn't too much worried about it

 

Hair Condition (pics attached)

• I think my condition is a bit different from what I see here mostly, because I don't think my hairline receded noticeably, and it is somewhat intact. Also, no part of my scalp is entirely bald, some have denser hair, some have less, and some have next to nothing (I think)
• I lost (and still losing I think but more slowly now) density in every part of my hair apart from sides and back; i.e. entire top area
• Have seborrheic dermatitis, gets well and worse occasionally, also affecting my scalp sometimes
• The back of my scalp is very densely haired, i mean it feels like a brush when I put my hand there

 

Current Status

• Well I am Turkish and I think having a HT is not a big thing since i know some guys (and also those who know a guy) who did it and had great results, even in hair mills and in clinics led by technicians 
• I thought it would work well on me without much risk because a) I have a good donor area b) hairline already defined so no need to create a new one
• I am about to relocate to Spain in a month, so I thought it would make sense to rush it, get a HT in a decent clinic and make a fresh start in Spain since I already have free time to spare for healing home
• After spending hours in this forum I became more informed about also the risks of a HT and more aware of the future implications in not expert hands. Actually here is where I was about to get a HT: http://instagram.com/asumanhairtransplant/ also know guys who got a HT there, they are very happy with the results but of course it's been less than a year so no one knows the ultimate outcome. Btw she offered 4 - 4.5k grafts with motorized FUE
• I have 4-5 k euros to spare for a HT in Turkey, the main reason I didn't see a proper doctor is they are fully booked for upcoming months, and I thought it would be good to just get a HT and be done with it before moving to another country. But after spending time here of course now I feel like an ignorant idiot for thinking that ...

 

Finasteride

• I had  quickly decided to ignore it initially, seeing horrible comments regarding PTS
• The dermatologist I saw actually said PTS is not proven, it's like a horrible story getting viral.
• She said she and her colleagues prescribed Fin for decades, without adverse outcomes. She says of course there can be side affects, but thinks PTS is a bullshit...
• So I feel kinda ready to start taking Fin in relatively small doses, but can't say I don't have second thoughts about it

 

Questions

• Wandering how you would evaluate my condition and what would you suggest.
• Do you think I'm a good candidate for a HT? If so, do you suggest specific doctors in Turkey (actually have an appointment with Bicer in 2 weeks)
• Do you think i'm a fool for considering rushing a HT, and especially in sub-par clinics? Do you think there are potential risks? (mainly shock loss in my current hair I think, I'm not very concerned about overharvesting in my donor - but should I?)

 

 

 

 

Your donor looks very good, you seem to be thinning in the front and midscalp aswell, just that it started at the crown region.

You look to be heading Norwood 6, which is quite advanced hairloss.

If you go for a hair transplant you might want to try Finasteride to keep what you have and strenghten your existing hair. 

Dr Bicer is a excellent choice and she can give you a plan for the future and guide you in more detail.

[mmokin]

a hair transplant would not be a good idea if you arent planning to stay on finasteride, you will 100% be full bald less than a decade from now at your rate of thinning, not only that but the trauma from surgery could get you to a nw6 even faster. 

[NARMAK]

1 hour ago, jakos said:

Hi NARMAK, thanks for the reply. Seriously considering Fin and others. The only major issue is that i will be moving to a new country and a new job, I am only worried that I may not be able to understand if any psychological side effect is due to Fin or simply from the movement itself  So maybe its better to start once I settle things there.

 

Do you think a HT would cause significant risk to my existing hair?
 

Lastly, the doc told me I'm NW 3 Vortex - any idea if this describes my current hair loss level or its potential limits? 

 

Thanks!

 

 

 

 

Personally i would say its smart to wait and be settled because you can then tell if the side affects are related more to Finasteride than the move and stress etc. 

Regarding a HT, there's no 100% answer. You're best going to get a consultation but as others have said, it's better to take medication like Finasteride if you can to maintain for as long as possible the hair that's not transplanted. 

I personally think the front pictures look more like say a Norwood 2 but the fact your midscalp and crown are that thin is possibly why they called you a Norwood 3.

Topical Minoxidil doesn't really have any major sides listed like Finasteride people worry about so maybe you could start that. 

I personally think giving it a year on medication and treatments whilst you do research and save up for a good HT is the best course of action. I'm just a bit older than you, so don't get me wrong, i'm aware of wanting to sometimes get things done, but sometimes time is your friend in these instances. 

You'll be making a lifelong choice. Do it right. 

[Mike10]

That is just rubbish coming from your dermatologist. I do not like that at all. Anyway, if you want a HT, you have to strongly consider Fin in your case. Even then there are risks involved. If you can deal wih a shaved head, that is the way to go. 

[Tao]

I think that's pretty much how I looked at around age 30.  Because I still had a hairline, I didn't really notice my crown hairloss until I saw an overhead shot of myself (which was frankly pretty much of a shock). I didn't take finasteride but I did try minoxidil for awhile.  Then I quit that and lost a ton, including almost all of my hairline too.  I think I was a solid Norwood 5 or worse by age 40.  In retrospect, I might have tried finasteride to see what hair i could keep.  In your case, I'd recommend you try it for a year and see if it thickens up your crown (that's where it seems to work the best).  Then go from there. If you lose more hair up front and want to address it, then focus your HT on the hairline (that has the biggest impact as that's what people see when they look at you) and keep grafts in reserve for working your way back into the crown (the black hole of grafts).  Well, at least this was my route and it worked out well.  I'd also get several online consults with Drs. recommended on this forum and see what they recommend.  Good luck! 

[jakos]

48 minutes ago, NARMAK said:

Personally i would say its smart to wait and be settled because you can then tell if the side affects are related more to Finasteride than the move and stress etc. 

Regarding a HT, there's no 100% answer. You're best going to get a consultation but as others have said, it's better to take medication like Finasteride if you can to maintain for as long as possible the hair that's not transplanted. 

I personally think the front pictures look more like say a Norwood 2 but the fact your midscalp and crown are that thin is possibly why they called you a Norwood 3.

Topical Minoxidil doesn't really have any major sides listed like Finasteride people worry about so maybe you could start that. 

I personally think giving it a year on medication and treatments whilst you do research and save up for a good HT is the best course of action. I'm just a bit older than you, so don't get me wrong, i'm aware of wanting to sometimes get things done, but sometimes time is your friend in these instances. 

You'll be making a lifelong choice. Do it right. 

thanks NARMAK, your comments are much appreciated and I can see the logic behind it.

Fortunately, i don't really need to save for an operation, I have savings that can cover a more expensive HT and actually can't think of a better way to spend it if that will make a difference, since I am single

Actually I am wondering the risks of getting a (or several) HT; since I want to believe that my donor can provide many grafts as to cover entire area than can become bald in the future (from hairline to the crown). do you think this is unrealistic? or can the donor area also be lost in the future? actually this will be my primary question to the doctor as well. So i feel like i am missing an obvious risk that HT poses here.

Regarding Fin and others, I feel more comfortable as the more I read and listen to scientific content by medical professionals, so will probably start that.

 

 

[jakos]

50 minutes ago, Mike10 said:

That is just rubbish coming from your dermatologist. I do not like that at all. Anyway, if you want a HT, you have to strongly consider Fin in your case. Even then there are risks involved. If you can deal wih a shaved head, that is the way to go. 

Hey Mike, do you refer to the dermatologist's comments on Fin or something else?

And may I ask what particular risks do you mean? I don't want to miss out anything... 

Thanks for your comment!

[jakos]

22 minutes ago, Tao said:

I think that's pretty much how I looked at around age 30.  Because I still had a hairline, I didn't really notice my crown hairloss until I saw an overhead shot of myself (which was frankly pretty much of a shock). I didn't take finasteride but I did try minoxidil for awhile.  Then I quit that and lost a ton, including almost all of my hairline too.  I think I was a solid Norwood 5 or worse by age 40.  In retrospect, I might have tried finasteride to see what hair i could keep.  In your case, I'd recommend you try it for a year and see if it thickens up your crown (that's where it seems to work the best).  Then go from there. If you lose more hair up front and want to address it, then focus your HT on the hairline (that has the biggest impact as that's what people see when they look at you) and keep grafts in reserve for working your way back into the crown (the black hole of grafts).  Well, at least this was my route and it worked out well.  I'd also get several online consults with Drs. recommended on this forum and see what they recommend.  Good luck! 

The fact that you may end up losing more hair when you stop minoxidil is worrying, but I am still considering it and Fin together. Will probably give it a go anyway.

Honestly, I think I would be more content with a loose hair 10 years later; but I know that I'm probably overestimating that  

Do you also have/had dense donor area? Does it enable enough grafts to cover much of the hair losing area including the crown?

Thanks!

[Mike10]

1 hour ago, jakos said:

Hey Mike, do you refer to the dermatologist's comments on Fin or something else?

And may I ask what particular risks do you mean? I don't want to miss out anything... 

Thanks for your comment!

Yes indeed. To deny the existence of PFS and existence of side effects. Everybody has to reach his own conclusions on this medication.I always find this report by Dr Feller quite objective. https://fellermedical.com/proven-hair-loss-drugs/

You should also know some health authorities have issued warnings on finansteride. Also confidential documents reviewed by Reuters accuse Merck of exaggerating the drug’s safety record. https://www.reuters.com/investigates/special-report/usa-courts-secrecy-propecia/

That is for full disclosure. The popular belief here is that you pop this pill and you are set for life. The truth is a bit more complicated. 

However, if you want to do a HT, you should hop on Fin for at least 1 year before the procedure IMO. There are still going to be some uncertainties nevertheless, as regards long term efficiency and side effects. I hope that helps you going forward. A HT is never without risks and even while on Fin it is rarely going to be only one procedure.

 

 

Edited January 15, 2022 by Mike10

[Tao]

1 hour ago, jakos said:

The fact that you may end up losing more hair when you stop minoxidil is worrying, but I am still considering it and Fin together. Will probably give it a go anyway.

Honestly, I think I would be more content with a loose hair 10 years later; but I know that I'm probably overestimating that  

Do you also have/had dense donor area? Does it enable enough grafts to cover much of the hair losing area including the crown?

Thanks!

I do have good donor hair.  My hair thickness meant less grafts covered more.  And then Dr. Konior was my surgeon and he does a great job of maximizing what you have, as good HT docs do.  My crown is almost fully covered now though I could use one more pass to get it all the way.  I'm 54 though and a little balding back there doesn't bother me, especially given where I started from.

[NARMAK]

2 hours ago, jakos said:

thanks NARMAK, your comments are much appreciated and I can see the logic behind it.

Fortunately, i don't really need to save for an operation, I have savings that can cover a more expensive HT and actually can't think of a better way to spend it if that will make a difference, since I am single

Actually I am wondering the risks of getting a (or several) HT; since I want to believe that my donor can provide many grafts as to cover entire area than can become bald in the future (from hairline to the crown). do you think this is unrealistic? or can the donor area also be lost in the future? actually this will be my primary question to the doctor as well. So i feel like i am missing an obvious risk that HT poses here.

Regarding Fin and others, I feel more comfortable as the more I read and listen to scientific content by medical professionals, so will probably start that.

 

 

The donor area generally is considered safe and lasts a lifetime but here's the problem and always the biggest one. 

You only have a limited amount of grafts ever that can be taken from the back of your head and put anywhere else and 100% don't always grow from whatever is implanted. 

If i could go back in time, i would have probably started Finasteride at 18 and just saved up for a hair transplant just to get as little work as possible done. I actually like the idea of having my hair on the back stay there as much as possible until we somehow figure out how to make unlimited clone hair or something to use. 

Yes, you only need 50% to give the "illusion of density" but actually feeling a nice thick head of hair is always better. So i'd say begin your medication, Minoxidil and Microneedling. Keep progress pictures from every month if you can, same lighting, angles etc. and then if hopefully you can regrow and maintain the mid scalp and crown, you won't need to use much hair for a transplant. 

I wish we did have cloned hairs and i wish we could pay to have them transplanted over like 2 years to get back the best hairline we ever could, but i don't think it's going to happen anytime soon and i'd rather enjoy the next 20 years with what i can.