Small right temple transplant at 21 - would I be signing myself up for a lifetime commitment to surgery?

[MissMyLongHair]

I am 20 years old, took Finasteride for 2.5 years, from ages 17-19. Switched to Dutasteride 0.5 mg daily 14 months ago for stronger prevention. Added Oral Min 2.5mg daily 2 months ago. Hair has maintained well, no significant regrowth however.

I've consulted with a few surgeons and been told by all who replied (Farjo, Konior, Bloxham, Bisanga) that surgery would be an unwise decision as it is impossible to know how much I will lose in the future and because in my message to them I wrote I do not want to have more than 1-2 transplants in my life. I also believe without Dutasteride I'd be destined for a Norwood 6-7 by age 30 if not younger, looking at my male relatives and considering the fact I started receding at 15.

However, if I were willing to commit to more than just 1-2 surgeries in my life, would it still be a bad idea to transplant around 500 grafts to the right temple? Would it be unreasonable to expect I'd only need one surgery a decade if further loss occurred? I'm not sure I could emotionally and financially deal with a new surgery every 3-4 years. I also plan to increase my Dutasteride dosage up to 2.5mg as I get older if necessary to ensure I don't lose any more native hair.

My goal is to be able to grow my hair to shoulder length again without this unpleasant right temple recession (for a 20 year old). I've taken a brief look at frontal hairpieces too, however I wouldn't feel comfortable wearing one.

Thanks for your help.

Edited March 12, 2022 by MissMyLongHair

[Britanium]

Keep taking the meds and hopefully retaining and then reassess in a few years. The Clinics/Drs are giving you the right advice here. Any ht will not match your original density as your probably aware, and you would also have the shock loss risk factor. Most ethical clinics will not do any work until your at least around 25, this does allow enough time to see if you keep maintaining on meds and will give a idea of where your heading if not. 

Edited March 9, 2022 by J.A.C

[NARMAK]

Firstly the fact that you're on medication is a great step because you recognised the potential hair loss progression and pre-empted it at much as possible. 

The largest concern atm is your age and that maybe you haven't fully researched enough to inform yourself on what that would mean long term if your hair loss did progress even whilst on Dutasteride and Oral Minoxidil. In fact, the Oral Minoxodil has only been 2 months. That's barely enough time for a single hair cycle, so you need to give it 12 months. 

Right now, the best thing for you genuinely imo is to give oral minoxodil 12 months and maybe add Nizoral or a 2% ketoconazole shampoo into the mix and also add Microneedling with a derma pen at 1-1.5mm into your regimen. 

Save up and basically keep an eye on your hair loss progression from now till around 25. If you can prove you haven't got worse and stayed the same or improved it will be a good sign to top clinics to consider you for a hair transplant as it shows you halted/stabilised your hair loss. 

Right now, genuinely even at 20 years old, your hair loss hides a lot betted than mine did just by a simple styling. I completely lost the triangle temple points by 17/18 and you still have yours so it frames well and the styling can hide the right temporal loss. 

I would honestly ask you to manage things with medication and add what i said. Just take your time and save up. 

[MissMyLongHair]

4 minutes ago, J.A.C said:

Keep taking the meds and hopefully retaining and then reassess in a few years. The Clinics/Drs are giving you the right advice here. Any ht will not match your original density as your probably aware, and you would also have the shock loss risk factor. Most ethical clinics will not do any work until your at least around 25, this does allow enough time to see if you keep maintaining on meds and will give a idea of where your heading if not. 

 

Thanks, I am indeed aware transplants don't replicate native density (admittedly I wasn't aiming for that with the temple, just some coverage for a youthful appearance), however the potential for shock loss slipped my mind. I'll just wait it out as everyone has advised, though if things stay the same I reckon I may not even want a transplant in the future. I've had this recession since 15 and it has remained the exact same since then thanks to medication, however I've also become more comfortable with it - some times I don't even bother with the mini-combover. Provided it doesn't progress perhaps I'll become more content with it as I age.

[Britanium]

Just now, MissMyLongHair said:

 

Thanks, I am indeed aware transplants don't replicate native density (admittedly I wasn't aiming for that with the temple, just some coverage for a youthful appearance), however the potential for shock loss slipped my mind. I'll just wait it out as everyone has advised, though if things stay the same I reckon I may not even want a transplant in the future. I've had this recession since 15 and it has remained the exact same since then thanks to medication, however I've also become more comfortable with it - some times I don't even bother with the mini-combover. Provided it doesn't progress perhaps I'll become more content with it as I age.

Yeh your actually in a very good position having been so proactive! 👍🏽

[Melvin- Admin]

Forget about surgery. Maintaining is the name of the game. Right now you’re on a good prevention stack. You may want to consider micro needling and perhaps even laser therapy.

[Ryan Daniel]

Oh gosh. I wouldn't even worry about anything if I were you. 

Please take a break from looking at the mirror and worrying about how thin it is or something. You have a luxurious head of hair

You are also using medication, which is more than anyone can ask you to do. You're totally fine sir

If you want my opinion, I would try and sport a tight haircut.  Clean up the sides and around the ear, keep it close, it will frame the face alot. You have strong temple points nothing to worry about!  Cut abit from the top and more along the back, blow dry the hair to either left or right. Abit of product for texture and you are good to go my friend! 

Keep taking the meds and keep thinking positive. Enjoy it 

[Mike10]

You do not even have hair loss ! Are you self medicating or have you been properly diagnosed with MPB by a doctor?  

[MissMyLongHair]

13 minutes ago, Mike10 said:

You do not even have hair loss ! Are you self medicating or have you been properly diagnosed with MPB by a doctor?  

There's definitely loss, although I suppose the average age of users here is a bit older so perhaps they don't consider it quite as noticeable. In all honesty, I did lie about my age in order to get my hands on Finasteride at 17. I had no income at the time and was earning peanuts doing online surveys just to pay for my monthly supply, stressful times haha.

The Dutasteride is prescribed from a legitimate online pharmacy here in the UK, the Oral Min I purchase from a grey market pharmacy. Not ideal, however I cannot afford the consultation and prescription costs from legitimate dermatologists/transplant surgeons.

Edited March 9, 2022 by MissMyLongHair

[Mike10]

1 hour ago, MissMyLongHair said:

There's definitely loss, although I suppose the average age of users here is a bit older so perhaps they don't consider it quite as noticeable. In all honesty, I did lie about my age in order to get my hands on Finasteride at 17. I had no income at the time and was earning peanuts doing online surveys just to pay for my monthly supply, stressful times haha.

The Dutasteride is prescribed from a legitimate online pharmacy here in the UK, the Oral Min I purchase from a grey market pharmacy. Not ideal, however I cannot afford the consultation and prescription costs from legitimate dermatologists/transplant surgeons.

I do not see any loss. Did any Dr diagnose hair loss? Or are you self diagnosing and medicating? 

[MissMyLongHair]

33 minutes ago, Mike10 said:

I do not see any loss. Did any Dr diagnose hair loss? Or are you self diagnosing and medicating? 

I diagnosed it.

[JJJStrong]

2 hours ago, MissMyLongHair said:

There's definitely loss, although I suppose the average age of users here is a bit older so perhaps they don't consider it quite as noticeable. In all honesty, I did lie about my age in order to get my hands on Finasteride at 17. I had no income at the time and was earning peanuts doing online surveys just to pay for my monthly supply, stressful times haha.

The Dutasteride is prescribed from a legitimate online pharmacy here in the UK, the Oral Min I purchase from a grey market pharmacy. Not ideal, however I cannot afford the consultation and prescription costs from legitimate dermatologists/transplant surgeons.

If the 250 GBP consultation cost for a legitimate prescription for oral minoxidil in the UK is something which you cannot afford, I sincerely hope you have looked into what a hair transplant procedure at elite clinics like the ones listed cost. We're talking tens of thousands of dollars for the US clinics.

[HappyMan2021]

too young for surgery 😪

[NARMAK]

1 hour ago, JJJStrong said:

If the 250 GBP consultation cost for a legitimate prescription for oral minoxidil in the UK is something which you cannot afford, I sincerely hope you have looked into what a hair transplant procedure at elite clinics like the ones listed cost. We're talking tens of thousands of dollars for the US clinics.

Honestly, i earn money and that's ridiculous imo to pay to get Oral Minoxodil. I would rather pay for an entire year or two worth of topical Minoxidil for that amount. 

OP, i do believe your right temple does look a bit worse than your left and taking Finasteride pre-emptively shouldn't really affect you overly negatively at a low dose. 

I don't take the same stance as some on here because technically by the time you actually realise about most hair loss, you're already at about a 50% loss. I feel being pre-emptive is better but Finasteride can inhibit DHT and the function it can offer towards production of certain masculine development like beards etc. so it's a double edged sword 

That said, if i could go back in time, i would definitely have started around 18-21 myself. I think i haven't lost a lot and visually it doesn't seem to be much but i have a sneaking suspicion i did lose some density and that's where usually you don't see things as obviously imo. 

[SeanT1]

Glad you're taking medicine sir.
You're catching your hair loss quite early!

I tried a hair piece when I was 22, it made me more self conscious than without it. 
They're an absolute nightmare to take care of.  I now absolutely hate glue.
Despite what a lot of people say, I don't think hair pieces are good for your scalp AT ALL.

25 now and got my first hair transplant in 2021, it's brought back my hairline, quite happy.

Several hair transplant doctors will turn you away if you're under the age of 24.
You should wait a bit longer and see what the medication does to you.  If you don't see any more hair loss, it's doing its job.
 

Edited March 10, 2022 by SeanToman

[Gatsby]

You are way ahead of the pack at your age being on 5ari's! 👏If you were even to find an unethical doctor to create a temple point (that's assuming he knows how) then you will be chasing that temple for the rest of your life with grafts you eventually will run out of. It would be like holding a tiger by the tail! The great head of hair that you have now no successful hair transplant will ever be able to recreate. Stick with your stack for the time being. Temple points I might add are an art that very few surgeons know how to do properly. All the best!

[Dillpickle123]

If I were you I would get a fade on the sides and comb it over to the right side to hide it a bit or play around with fibers 

[Mike10]

18 hours ago, MissMyLongHair said:

I diagnosed it.

You gotta do what you gotta do. But I disagree with the approach of taking such heavy medication at such young age, especially without medical supervision and a proper diagnosis of MPB. I find the whole posters quite ridiculous applauding this. 

[NARMAK]

16 minutes ago, Mike10 said:

You gotta do what you gotta do. But I disagree with the approach of taking such heavy medication at such young age, especially without medical supervision and a proper diagnosis of MPB. I find the whole posters quite ridiculous applauding this. 

Getting a diagnosis for hair loss isn't exactly the easiest in most developed countries imo and not everybody will even consult with hair transplant clinics for assessments if they're in their early teens/20s because they can't afford it. 

As i said above, by the time you notice it, usually 50% is already lost and you're playing catch up. There's nothing wrong with being more pro-active imo around hair loss. There's no significant proven scientific study that says taking Finasteride will stifle any meaningful development of a biologically born male for example. 

If i could do back, Finasteride 1mg 3x a week at 18 would easily be what i'd have done and probably increased to everyday after 3-6 months if no side affects 

[Berba11]

You have an incredibly small amount of hair loss, if any at all. Certainly don't go and get a HT for this level of 'loss' - a pointless waste of money. I'd say that even if you were 31, rather than 21, but at the very least you need to wait a few years. It's your call, ultimately.

Also, good that you're taking preventative measures regarding finasteride etc, but be careful. If you're on minox, finasteride AND dutasteride, without any supervision... well, just be mindful that that's a fair whack of strong interventions. How have you been assessing what is working versus what isn't? If you're just piling intervention upon intervention without establishing what's working at what dosage then you aren't going about this very scientifically, you may be spending more money that you need to and you may risk harming yourself in some way. Just don't get too carried away is all - your health is more important than your hair!