What should I do?

[SaltyCaptain592]

I had my consultation today. Im a 29 (30 in may) YO male. Doctor recommended me 1400-1500 grafts. He said either FUT or FUE. Im just scared that if i do FUT and I lose more hair in the future and shave my head id see a huge scar. But I also hear FUE could ruin the donor area for any future work. I really dont want to take finasteride as i dont like the idea of being on a pill for the rest of my life. Any advice? Am I overthinking it? IDK, i just dont want to make a bad decision you know?

Edited August 1, 2022 by Hans - Webmaster
Images removed at OP request.

[HappyMan2021]

58 minutes ago, SaltyCaptain592 said:

Im just scared that if i do FUT and I lose more hair in the future and shave my head id see a huge scar. But I also hear FUE could ruin the donor area for any future work.

not to worry you but you can get botched just as easily with FUE as you can FUT 🤣 . A hair transplant is a major decision no matter how you slice it.

Who is the doctor/clinic?

58 minutes ago, SaltyCaptain592 said:

I really dont want to take finasteride as i dont like the idea of being on a pill for the rest of my life

I honestly don't see what the big deal is. If you have no sides from Fin then its no different than taking a blood pressure or high cholesterol med. 

You look to be a NW 3 or NW 4 and you are still in your 20s. You will definitely lose more hair if you don't get on meds. MPB is progressive. 

Edited February 10, 2022 by SadMan2021

[SaltyCaptain592]

2 hours ago, SadMan2021 said:

not to worry you but you can get botched just as easily with FUE as you can FUT 🤣 . A hair transplant is a major decision no matter how you slice it.

Who is the doctor/clinic?

I honestly don't see what the big deal is. If you have no sides from Fin then its no different than taking a blood pressure or high cholesterol med. 

You look to be a NW 3 or NW 4 and you are still in your 20s. You will definitely lose more hair if you don't get on meds. MPB is progressive. 

def not norwood 4. when i have my hair without pulling it up, you cant even tell im balding. I know i will lose more hair but when is it the right time to get a hair transplant? Im not elon musk where i swimming in gold and can get as many as I want. I want to optimize my money, time, and hair. 

[Drish]

There is no point in having a transplant if you don't plan to preserve your existing hair. Hair restoration approach has to be holistic. You will need multiple transplants down the road even on meds. But chances are they are going to be spaced much far apart in time if you're on fin. This gives you great leverage in managing your hair loss and your donor for the days you'll live. If there are no sides, I find nothing wrong in taking a pill for the rest of life. Just like your body needs the water you drink, your hair needs a DHT suppressor.

[Rahal Hair Transplant]

@SaltyCaptain592

if you’re thinking of completely shaving your head then you probably shouldn’t undergo hair transplant surgery at all.  FUE scarring is essentially undetectable of your hair is cropped short.  But if you’re shaving it completely, you will see tiny dots all over the sides and back how your scalp. How visible they are will depend on a number of factors.

In my opinion, you should decide whether you want to go forward with FUT or FUE before you get started.   In my opinion the inky real reason to move forward with FUT over FUE would be cost or if you think you’ll  need a lot of future work because your hair loss has not been stabilized with meds.   In other words, those with advanced degrees of balding might be able to obtain a larger number of grafts overall and long term if they start with FUT until the doctor can’t harvest anymore and then switch to FUE.

The above aside however, most patients with average or dense donor hair can start and finish with FUE and still obtain thousands of grafts and eliminate the linear scarring FUT produces.

I hope this helps 

Rahal Hair Transplant

[Gatsby]

If you have any thoughts in the future in shaving your head then really think long and hard about surgery. FUT scarring will be far more obvious if you shave your head but (even with SMP) FUE scars also from the thousands of punctated wounds that heal. You have so much hair right now that I think it would be a mistake not to try taking finasteride now (although this is a personal choice of course) before your MPB progresses. You need to be educated and spend a lot time researching hair restoration. If you have any doubts now then I don't recommend jumping into surgery. You need to be at a point where you are 100% relaxed and committed to a life long procedure with more than likely one or two more surgeries to come over the lifespan. Wishing you all the best and keep asking lots of questions.

[NARMAK]

12 hours ago, SaltyCaptain592 said:

I had my consultation today. Im a 29 (30 in may) YO male. Doctor recommended me 1400-1500 grafts. He said either FUT or FUE. Im just scared that if i do FUT and I lose more hair in the future and shave my head id see a huge scar. But I also hear FUE could ruin the donor area for any future work. I really dont want to take finasteride as i dont like the idea of being on a pill for the rest of my life. Any advice? Am I overthinking it? IDK, i just dont want to make a bad decision you know?

Firstly i would say the doctor is being smart and conservative with the hairline design. Especially since you say you won't take Finasteride. 

Can i just ask why? 

You say you don't want to pop a pill the rest of your life, but is taking 5 seconds of your time to take a pill and get on with your life not far more convenient than you constantly spending a significant amount more time to hide your continued balding if you don't decide to shave it off? 

I think a lot of guys are afraid of sexual side affects due to scaremongering. Not science backed studies that show its in a minority of cases. 

For you, i would even argue getting on it to maintain what you have would do wonders for you long term. If for whatever reason you get side affects, you simply stop and the vast majority of men return to normal. Only a very few with other underlying medical issues have it persist. 

I didn't take it for 10+ years, and all i can think of now is that i wish i'd have started 10 years earlier on medication. Luckily, still not started too late and for you, probably not either. 

[jackiema]

I think it's generally recommended you go on fin for about a 1 before you do a HT. If you get a hairtransplant, the balding will just continue behind it and you'll need more surgery. What's wrong with taking medication every day (or for many guys, they don't even take it every day). People taking vitamins and other meds every day all the time. 

[SaltyCaptain592]

Thanks for the replies guys. Can some post a pic of what it looks like to lose hair behind a transplant? Not the very extreme cases but the normal everyday cases. 

[NARMAK]

1 hour ago, SaltyCaptain592 said:

Thanks for the replies guys. Can some post a pic of what it looks like to lose hair behind a transplant? Not the very extreme cases but the normal everyday cases. 

The problem is there's no real "everyday cases" example but Matt Dominance YouTube channel recently had a subscriber who didn't use Finasteride, got a hair transplant and then continued to lose hair and basically ended up using a hair system to get the results he wanted visually. 

I think you should take medication to really mitigate the risk of long term hair loss progression and basically as i mentioned stop if there's side affects. 

[HappyMan2021]

10 minutes ago, NARMAK said:

The problem is there's no real "everyday cases" example but Matt Dominance YouTube channel recently had a subscriber who didn't use Finasteride, got a hair transplant and then continued to lose hair and basically ended up using a hair system to get the results he wanted visually. 

wow, do you have a link or way you can share the subscriber comments in question? It would suck so much to go thru the HT journey just to end up with a system all along

[Dillpickle123]

5 hours ago, SaltyCaptain592 said:

Thanks for the replies guys. Can some post a pic of what it looks like to lose hair behind a transplant? Not the very extreme cases but the normal everyday cases. 

Try fin if I was you since it looks like your gonna need more than one surgery is do fut first then fue or u can do fut and get it covered by smp or fue later on 

[Gokuhairline]

i am not an expert but 1,400 may not be enough,..also looks like you temporal peaks are disappearing and dipping....so make sure you take that into consideration. good luck

[NARMAK]

15 hours ago, SadMan2021 said:

wow, do you have a link or way you can share the subscriber comments in question? It would suck so much to go thru the HT journey just to end up with a system all along

That's the video and it doesn't look like the guy actually had any horrible side affects but somehow wasn't able to sleep after taking Finasteride. Well, my solutions to take it earlier in the day if that's the case but oh well. 

Personally i think it was a huge waste of money and depleting his donor area for nothing because the hair has to be shaved anyways and the back would now be less dense too. 

[SaltyCaptain592]

Guys I have another question. I want to be conservative and not over harvest my donor area in order to keep it going for further uses. I am by no means trying to look like my teenager self. What I am for long term is the illusion of hair on my head/avoid looking bald. I read this on reddit:

 

"If you are early in your hair loss and you decide to have HT, DO NOT USE UP ALL OF YOUR DONOR AT ONCE. People are getting 3-4K grafts moved on their first surgery for early hair loss. Many people only have 4-5K usable grafts in their entire donor (despite what you may read on various surgeon's sites) that they can move without exhausting the donor or making it look overharvested. You do not have to use all of your donor hair. I still have plenty of donor hair left after 2 operations in case I want to have HT number 3 someday in the future. Clinics love it when pts want a giant FUT or, more commonly, FUE, because they make way more money that way. They do not give a shit about how you will fare when you get into trouble in 5, 10, 20 years and they are long gone. I often suggest that people break the work into several smaller surgeries to allow you to see how things go, how things grow, and how they feel about HT before using up their entire donor supply."

I want to avoid doing the above mentioned. One doc mentioned doing 1200 grafts my first surgery in order to be conservative. Is that okay for me at this point? Im aiming to preserve for future use. Sorry for sounding like a newb but i want to be fully informed before taking a life altering decision. 

[NARMAK]

2 hours ago, SaltyCaptain592 said:

Guys I have another question. I want to be conservative and not over harvest my donor area in order to keep it going for further uses. I am by no means trying to look like my teenager self. What I am for long term is the illusion of hair on my head/avoid looking bald. I read this on reddit:

 

"If you are early in your hair loss and you decide to have HT, DO NOT USE UP ALL OF YOUR DONOR AT ONCE. People are getting 3-4K grafts moved on their first surgery for early hair loss. Many people only have 4-5K usable grafts in their entire donor (despite what you may read on various surgeon's sites) that they can move without exhausting the donor or making it look overharvested. You do not have to use all of your donor hair. I still have plenty of donor hair left after 2 operations in case I want to have HT number 3 someday in the future. Clinics love it when pts want a giant FUT or, more commonly, FUE, because they make way more money that way. They do not give a shit about how you will fare when you get into trouble in 5, 10, 20 years and they are long gone. I often suggest that people break the work into several smaller surgeries to allow you to see how things go, how things grow, and how they feel about HT before using up their entire donor supply."

I want to avoid doing the above mentioned. One doc mentioned doing 1200 grafts my first surgery in order to be conservative. Is that okay for me at this point? Im aiming to preserve for future use. Sorry for sounding like a newb but i want to be fully informed before taking a life altering decision. 

It's good you're doing research. Just be wary of Reddit. It has a lot of people on there that don't always have a clue about what the signs are of a hair mill and they usually praise people's results when there's issues like thick multi hair grafts in the frontal hairline. 

The advice to be conservative with your donor and mindful of the future progression is wise advice. Particularly if you are younger and it hasn't halted or slowed down to a crawl. I think the line you drew and your expectations are realistic. 1500 grafts in the right hands placed correctly can be very effective in that illusion of density. 

I would probably ask you to send some consultations out to the recommended clinics and it will give you a good average. 

[Rahal Hair Transplant]

Salty,

I apologize if you’ve already answered this but are you currently using Finesse ride or anything to help maintain the existing hair you have? I saw somebody post Stating that there is no point in proceeding with hair transplant surgery if you have no intention in trying to maintain your existing hair.  That makes me think that you aren’t currently using medication or that you have something against using it.

don’t get me wrong, there are many hair loss suffering men who proceed with surgical hair restoration and don’t use any medication. However, you certainly run the risk of losing additional hair and important that you Plan for the long term by keeping it on her hair and reserve for subsequent procedures as needed.

I also saw your post asking if somebody would post a picture showing what it would look like if somebody loses more hair after their hair transplant.  While I’m sure I could find pictures to demonstrate this, every situation is different.

The truth is, if the surgeon does it right, there will be no dramatic line or stopping point between the hair transplant and existing hair. Instead, hair should be transplanted in and around existing natural hair so that there is a gradual fade from the transplant into the natural hair as appropriate.  That way, if existing natural hair is lost in those areas, the transplanted hair will gradually go from thick to thin and look natural instead of a drastic break that will look unnatural and obvious.

So even though the long-term plan may include subsequent procedures, in the event a patient can’t follow through with the long-term plan immediately or ever due to some unforeseen circumstance, each hair transplant procedure should stand alone and look natural even if it’s not as thick as you would want it.

I hope this helps.

Rahal Hair Transplant

[SaltyCaptain592]

On 3/4/2022 at 8:48 AM, Rahal Hair Transplant said:

Salty,

I apologize if you’ve already answered this but are you currently using Finesse ride or anything to help maintain the existing hair you have? I saw somebody post Stating that there is no point in proceeding with hair transplant surgery if you have no intention in trying to maintain your existing hair.  That makes me think that you aren’t currently using medication or that you have something against using it.

don’t get me wrong, there are many hair loss suffering men who proceed with surgical hair restoration and don’t use any medication. However, you certainly run the risk of losing additional hair and important that you Plan for the long term by keeping it on her hair and reserve for subsequent procedures as needed.

I also saw your post asking if somebody would post a picture showing what it would look like if somebody loses more hair after their hair transplant.  While I’m sure I could find pictures to demonstrate this, every situation is different.

The truth is, if the surgeon does it right, there will be no dramatic line or stopping point between the hair transplant and existing hair. Instead, hair should be transplanted in and around existing natural hair so that there is a gradual fade from the transplant into the natural hair as appropriate.  That way, if existing natural hair is lost in those areas, the transplanted hair will gradually go from thick to thin and look natural instead of a drastic break that will look unnatural and obvious.

So even though the long-term plan may include subsequent procedures, in the event a patient can’t follow through with the long-term plan immediately or ever due to some unforeseen circumstance, each hair transplant procedure should stand alone and look natural even if it’s not as thick as you would want it.

I hope this helps.

Rahal Hair Transplant

You hit it on the head. This is exactly what Im trying to do. Side effects or not, i just dont want to put a man-made chemical into my body for perpetuity. If that hair has to go, then so be it. Id rather my body avoid any foreign chemicals not natural to its body. Thats why I didnt even take the Covid vaccine either. I just dont trust Big Pharma. Good diet + exercise can prevent a lot except for balding haha. 

[Gokuhairline]

37 minutes ago, SaltyCaptain592 said:

Good diet + exercise can prevent a lot except for balding haha.

+ creatine also helps growth post transplant. don't believe the doubters. 

[NARMAK]

49 minutes ago, SaltyCaptain592 said:

You hit it on the head. This is exactly what Im trying to do. Side effects or not, i just dont want to put a man-made chemical into my body for perpetuity. If that hair has to go, then so be it. Id rather my body avoid any foreign chemicals not natural to its body. Thats why I didnt even take the Covid vaccine either. I just dont trust Big Pharma. Good diet + exercise can prevent a lot except for balding haha. 

Oh boy. I'm not going to prattle off on the vaccine comment, but honestly hand on heart ask yourself how much of what you said about not ingesting foreign chemicals into your body is actually true. 

Almost every single thing produced today has a chemical element and isn't "natural" in some way, shape or form. 

I respect your decision not to use Finasteride but suddenly if the DHT was switched to cancer and the pill gave you a 51% resistance increase and ability to add to your bodies natural resistance, i do wonder how many more people would start taking it. 

My point is, you already probably use medication that has a ton of side affect risks at times. You are also able to completely stop the use of Finasteride and 99.9% of people probably return to normal within months. 

[SaltyCaptain592]

5 hours ago, NARMAK said:

Oh boy. I'm not going to prattle off on the vaccine comment, but honestly hand on heart ask yourself how much of what you said about not ingesting foreign chemicals into your body is actually true. 

Almost every single thing produced today has a chemical element and isn't "natural" in some way, shape or form. 

I respect your decision not to use Finasteride but suddenly if the DHT was switched to cancer and the pill gave you a 51% resistance increase and ability to add to your bodies natural resistance, i do wonder how many more people would start taking it. 

My point is, you already probably use medication that has a ton of side affect risks at times. You are also able to completely stop the use of Finasteride and 99.9% of people probably return to normal within months. 

As i said i avoid what I can. No sodas, preservatives, fast food such as mcdonalds and BK etc. Make most of my food at home. Ive yet to get sick in three years, never got COVID despite traveling to two different continents. All my vitals are great except for my hair. 

[NARMAK]

4 minutes ago, SaltyCaptain592 said:

As i said i avoid what I can. No sodas, preservatives, fast food such as mcdonalds and BK etc. Make most of my food at home. Ive yet to get sick in three years, never got COVID despite traveling to two different continents. All my vitals are great except for my hair. 

I definitely think it's good that you take care of yourself man. More willpower than i have lol, and probably a lot of others. 

I genuinely do wish you and everybody i come across the best in getting the results you want. 

This forum is about education and information. I do definitely try my best to be as balanced as i can and stick to the science where its clear as possible, long term and generally peer reviewed. That's why from my own experience of not having been on medication like Finasteride for probably a decade earlier due to opinions of people that weren't science backed, i avoided it and then when properly researching again decided to take Dutasteride which is probably the most nuclear DHT blocking medication. 

That said, not everyone is like myself or the others willing to or can tolerate Finasteride etc. and in your case specifically i respect if you don't wish to try it. I think your original hairline design was also extremely sensible and conservative for your hair loss now and potentially in the future. So i do hope to follow your journey should you finally get to that stage of a hair transplant and be rooting for you to get a great result! 

All the best. 

[SaltyCaptain592]

On 3/5/2022 at 5:03 PM, NARMAK said:

I definitely think it's good that you take care of yourself man. More willpower than i have lol, and probably a lot of others. 

I genuinely do wish you and everybody i come across the best in getting the results you want. 

This forum is about education and information. I do definitely try my best to be as balanced as i can and stick to the science where its clear as possible, long term and generally peer reviewed. That's why from my own experience of not having been on medication like Finasteride for probably a decade earlier due to opinions of people that weren't science backed, i avoided it and then when properly researching again decided to take Dutasteride which is probably the most nuclear DHT blocking medication. 

That said, not everyone is like myself or the others willing to or can tolerate Finasteride etc. and in your case specifically i respect if you don't wish to try it. I think your original hairline design was also extremely sensible and conservative for your hair loss now and potentially in the future. So i do hope to follow your journey should you finally get to that stage of a hair transplant and be rooting for you to get a great result! 

All the best. 

No worries man. Thanks for the info. Just gotta get the courage to get it done now.