24M Hair Transplant Recommendation or Advice - NW4 or NW5

[MZiyad98]

Hi All,

I have been experiencing hair loss since the age of 16. Both my parent's side experience baldness, hence it was easy to identify that I was facing androgenetic alopecia. I will explain my hair care journey for the past 6 years to this date and hopefully someone can provide an appropriate advise to move forward. For better understanding, I will be rating my hair fall intensity on a scale of 1 to 5,

1 - Passive

2 - Not passive

3 - Considerable

4 - More than considerable

5 - Aggressive.

 

So back in 2015 (17M), I was facing hair shedding at a level of 1, which did not bother me much at that time. I still had a full set of thick hair and my scalp was pretty much covered by it. The following year (2016), the hair fall had progressed to level 2, which started to get my attention and trigger my flight/fight response. I had done some research online and referred to whatever content that was available on the internet. After understanding the whole concept of baldness, I decided to consult a doctor in Dubai, UAE. The doctor advised to apply minoxidil 5% tropically two times a day. That marked my first step towards hair care routine(2017). Although I was able to maintain certain physical appearance of having a full set of hair over by head, my hair had started thinning and crown area had started to be visible at this point. Devoted to this routine for the next two years, however, I only witnessed different range of hair fall (mix of level 3 to level 5 hair fall, in a cyclic manner), receding hair line and balding crown. By 2020, It was clear that minoxidil alone wouldn't solve my problem and proceeded to consult the doctor. Propecia 1 mg (finasteride), one pill every day, was added to my hair care routine that year. Same level of devotion for the next two years, however, was not fruitful to my expectations. Hair fall still continued, hair line receded and crown area was 80% bald. Decided to try out PRP and had my first session on Nov 2021. Did a total of 6 sessions, 3 weeks apart, and performed derma rolling once a week by myself. I would say the procedure did not yield much even after 5 months of observation. Through out this journey, I had only seen growth of small tin strands of hair (both on the front and crown area) which never got thicker or increased the illusion of density.

 

Now in 2022(24M), here I am, 80% bald on my crown area, 60% bald in my front hair line, 50% bald patch running in the middle which is partially covered by lengthy strands of hair what is left on the sides. Experiencing hair fall at a level of 2. Applying minoxidil once a day after shower, restarted taking Propecia after a three month break.

 

Hope the below pictures provide better understanding of my hair fall journey.

 

The point of this post is to get advise on moving forward. I am mentally prepared to undergo HT some time this year. I just want to know if there's any specific procedure I should look into, any pre-procedural preparations I need to practice, anything else I have to try out. Furthermore, to which year can I expect to go back after having the HT?

 

I am settled in the UAE and India is my native country. Hence travelling to India is a convenient option. Eugenix is a common place I have come across while researching on the topic. Any specific package I should consider?

[Dillpickle123]

It all depends on budget for eugenix it looks like you would need a lot of grafts but they are one of the best do you have a budget?

[HappyMan2021]

you are too young for a HT, sorry. And you are REALLY too young for any work on your crown. 

[ciaus]

Despite the finasteride you've been continuing to lose pretty dramatically, and you're still very young. I wouldn't consider any hair transplants until you stabilize your loss, and that may not be possible. Maybe dutasteride can succeed in doing that, since finasteride doesn't appear to be enough. But even under optimal conditions, assuming you start dutasteride and that halts your loss, I'd recommend waiting at least until you have a few years of the loss not getting worse before considering a hair transplant.

You don't want to start cutting into your head moving hairs around with a transplant, which will create scars all over the back and side areas, and then continue losing hair around and behind the transplanted hairs on top. That's going to create a whole other level of problems, where you are not just trying to hide the hair loss, but also trying to hide the transplant scars and un-natural hair density patterns on the top of your head. 

[Gatsby]

I agree that at 24 without stabilizing your hair loss then I definitely would not move forward with permanent, life altering surgery. I would consider dutasteride under medial supervision. Also in the future if you do opt for a hair transplant you will need a solid beard to augment this (IMHO). You need to start with a life long plan. I understand your anxiety now at 24 from my own experience. But I can promise you that anxiety will be just as real at 44 or 54. You will only be left with even greater anxiety and regrets if you go under the punch now. Patience and all the best!

[Gokuhairline]

jesus....sorry but this is insane.....people really lose that much that fast ? 

[Fox243]

Hey man, I’m in the same exact scenario but at 22. I have a worse hairline/frontal density but my crown isn’t receded as far back as yours. Would love to chat offline, but for now my plan is to hold onto my thin hair for as many years as possible with fin and hope something like Verteporfin or hairclone comes out. If they don’t within 3 years or so, I’ll start looking into a transplant despite not having stabilized on fin. If they can make a NW7 a NW2.5-3, not sure why they can’t do that for us.
 

I do think people tend to be pessimistic given that they’ve been burned decades ago but yield and usability of other types of grafts (Ie beard) has allowed it such that everyone can at least have a natural balding pattern at the very worst IMO.

[Fox243]

To answer your questions, I’d look into FUT since you’re a young balder. You’d probably go back to between 2018 and 2019 with a conservative surgeon. You can also try Dut tho I’m personally wary since it blocks way too much DHT (and also type 1, which is expressed in the brain).

[civic]

I think in such case it is best to consider hair system, you are very young & already NW6, i honestly would not continue finasteride or rogaine, they only slow down & not prevent furhter loss. By age 40, you can already imagine what will remain of donor area (even with fin or dut). No point messing with hormones when probability of sucsess is slim to none. Please do not fall for any clinic that will promise full coverage. I am just being honest, and not trying to crush your dream. But you have to be real with yourself, & not end up with irreparable regret.

Edited March 14, 2022 by civic

[Mike10]

I agree with civic

[MZiyad98]

18 hours ago, Dillpickle123 said:

It all depends on budget for eugenix it looks like you would need a lot of grafts but they are one of the best do you have a budget?

How man grafts should I expect? I can afford around 3000 USD / 10,000 AED / 200,000 INR for a single surgery.

[MZiyad98]

15 hours ago, ciaus said:

Despite the finasteride you've been continuing to lose pretty dramatically, and you're still very young. I wouldn't consider any hair transplants until you stabilize your loss, and that may not be possible. Maybe dutasteride can succeed in doing that, since finasteride doesn't appear to be enough. But even under optimal conditions, assuming you start dutasteride and that halts your loss, I'd recommend waiting at least until you have a few years of the loss not getting worse before considering a hair transplant.

You don't want to start cutting into your head moving hairs around with a transplant, which will create scars all over the back and side areas, and then continue losing hair around and behind the transplanted hairs on top. That's going to create a whole other level of problems, where you are not just trying to hide the hair loss, but also trying to hide the transplant scars and un-natural hair density patterns on the top of your head. 

What is considered as "stabilized hair loss". I am at a stage where my hair fall has reduced to an all time low compared to the past five years. Have very thin strands of hairs here and there that would actually be great if there was anything I could do to make it thicker. From what I understand, waiting till I reach a certain age is meant to wait for all the hair that was effected by DHT to shed. However, I feel like I have reached / I am close to that stage at the moment.

[MZiyad98]

14 hours ago, Gatsby said:

I agree that at 24 without stabilizing your hair loss then I definitely would not move forward with permanent, life altering surgery. I would consider dutasteride under medial supervision. Also in the future if you do opt for a hair transplant you will need a solid beard to augment this (IMHO). You need to start with a life long plan. I understand your anxiety now at 24 from my own experience. But I can promise you that anxiety will be just as real at 44 or 54. You will only be left with even greater anxiety and regrets if you go under the punch now. Patience and all the best!

 

9 hours ago, civic said:

I think in such case it is best to consider hair system, you are very young & already NW6, i honestly would not continue finasteride or rogaine, they only slow down & not prevent furhter loss. By age 40, you can already imagine what will remain of donor area (even with fin or dut). No point messing with hormones when probability of sucsess is slim to none. Please do not fall for any clinic that will promise full coverage. I am just being honest, and not trying to crush your dream. But you have to be real with yourself, & not end up with irreparable regret.

@Gatsby What is considered as "stabilized hair loss". I am at a stage where my hair fall has reduced to an all time low compared to the past five years. Have very thin strands of hairs here and there that would actually be great if there was anything I could do to make it thicker. From what I understand, waiting till I reach a certain age is meant to wait for all the hair that was effected by DHT to shed. However, I feel like I have reached / I am close to that stage at the moment. 

 

@civic My Dad (M62) uses a hair system / wig and has never been able to take it off. I personally would opt to shave off my entire head. To me HT just seems to be last resort before considering to shave my entire head. 

 

Ideally, I would like to try out something that would help to make the newly grown thin hair strands thicker. My current plan is to monitor the hair fall level for the next six months and accordingly proceed to HT. In the mean time, will try to adopt something (if any) to increase the thickness of the existing hairs.

[MZiyad98]

10 hours ago, Fox243 said:

To answer your questions, I’d look into FUT since you’re a young balder. You’d probably go back to between 2018 and 2019 with a conservative surgeon. You can also try Dut tho I’m personally wary since it blocks way too much DHT (and also type 1, which is expressed in the brain).

Curious to know why you proposed FUT than FUE.

[ciaus]

5 minutes ago, MZiyad98 said:

What is considered as "stabilized hair loss". I am at a stage where my hair fall has reduced to an all time low compared to the past five years. Have very thin strands of hairs here and there that would actually be great if there was anything I could do to make it thicker. From what I understand, waiting till I reach a certain age is meant to wait for all the hair that was effected by DHT to shed. However, I feel like I have reached / I am close to that stage at the moment.

 

You're on the way to being a NW 5a at least. The big question is how much of your remaining hair follicles are still vulnerable to DHT. And unfortunately there's no way to know that for certain. The hair that is thinning and already gone was clearly the most vulnerable. But depending on how genetically sensitive the rest are, it could take another 10,20, or 30 years for your other hairs to more gradually thin and disappear. And you will still be a relatively young/middle-aged guy with years, if not decades, of living with the consequences of what you decide now.

If this was my head at this very young age, I'd resign myself to letting nature run its course and just shave it off. If you want to still hold out hope, stay on finasteride or start dutasteride, and still shave your head for the next 5, or better, 10 years. And keep a regular picture record, every 6 months or a year. Where you let it grow out for a few days or up to week, and take photos at the same angles, lighting to help track your progress, if any.

 

 

 

 

[Z--]

I have a Middle Eastern background, and the pattern of loss you've got is fairly typical for the Middle East/India. I'm around the same boat as you. What'll likely happen next (based on my own experience) is that that the front will thin out next. Probably won't be as bad as the back, but I think you're headed to a NW5a or NW6. 

Good News: (i) you're able to tolerate Finasteride and you've done all that you can from a drug/medical perspective, (ii) your donor looks great and there doesn't look to be too much dip and (iii) you have time.

Bad News:  (i) you're way, way too young to be doing a transplant, (ii) the pictures from the last three years indicate that you're still on track to lose more, and (iii) you need to save up more $$ for a quality transplant doctor. 

I'm about five years older than you are, and I'd implore you to wait until your very late 20s (e.g. 28 - 29) before proceeding with a hair transplant. I thought my loss was bad and couldn't get any worse around 26, and boy, was I wrong. Many ethical doctors refused to operate on me until I was older and balder...I'd implore you to do the same. 

Otherwise, keep an eye out on H&W ($$$), Konior ($$$$), Eugenix ($$) and Vertex Hair ($$). Given the level of loss, I'd look into FUT first and then FUE. If you've got beard hair, that would prob be helpful too.

Good luck!

[HappyMan2021]

14 hours ago, civic said:

I think in such case it is best to consider hair system, you are very young & already NW6, i honestly would not continue finasteride or rogaine, they only slow down & not prevent furhter loss.

I agree with this. Perhaps OP can may be happy with the end-result of a HT journey, but he is looking at multiple years, multiple surgeries, and tens of thousands of dollars. 

[Fox243]

I’m really confused why people are so wary of having young people have transplants. If NW7s can get transplants, why can’t young people?
 

Not to hijack the thread, but many doctors, such as Eugenix, Dr. Bloxham, and Hasson and Wong were more than willing to do transplants on me despite me being a NW4-5 at 22. Some were more wary Ie Dr. Konior, but he was still willing to do the front half and leave the crown alone for now.

 

 

[HappyMan2021]

9 minutes ago, Fox243 said:

I’m really confused why people are so wary of having young people have transplants. If NW7s can get transplants, why can’t young people?
 

Not to hijack the thread, but many doctors, such as Eugenix, Dr. Bloxham, and Hasson and Wong were more than willing to do transplants on me despite me being a NW4-5 at 22. Some were more wary Ie Dr. Konior, but he was still willing to do the front half and leave the crown alone for now.

if you think its ok for a young 22 yr old such as yourself to get a HT, and you've already been quoted by multiple doctors, why haven't you pulled the trigger yet?

[Fox243]

23 minutes ago, SadMan2021 said:

if you think its ok for a young 22 yr old such as yourself to get a HT, and you've already been quoted by multiple doctors, why haven't you pulled the trigger yet?

I don’t think it’s okay – I’m unsure. On one hand, many veterans on the forum tell me to either shave, wear a hair system, or stick it out with propecia for several more years. On the other hand, many clinics gave me the green light as long as I have realistic expectations.

 

I’m trying to figure out why this discrepancy exists. I’m also hoping things such as Verteporfin come out soon so I can have a scarless surgery. 

[Fox243]

@Melvin- ModeratorI would appreciate it if you can set up some sort of interview at some point with an above doctor and ask them what their perspective is on young, aggressive bald era. Perhaps their views have changed over the recent years.

[ciaus]

28 minutes ago, Fox243 said:

I’m really confused why people are so wary of having young people have transplants. If NW7s can get transplants, why can’t young people?

 

Time is an even more critical factor when the hair loss is aggressive at a very young age. There's a big difference between a middle-aged NW7 man that has been losing hair for a few decades with a stable donor area, and a young guy that's finished puberty not even a decade ago with an already aggressive hair loss pattern that might end up even worse than a NW7, where he ends up with significant thinning even in the donor area as well.

[Fox243]

6 minutes ago, ciaus said:

 

Time is an even more critical factor when the hair loss is aggressive at a very young age. There's a big difference between a middle-aged NW7 man that has been losing hair for a few decades with a stable donor area, and a young guy that's finished puberty not even a decade ago with an already aggressive hair loss pattern that might end up even worse than a NW7, where he ends up with significant thinning even in the donor area as well.

Gotcha so the risk comes down to whether your donor thins too much. I’ll ask the doctors I consulted about this and see what they think. 

[MZiyad98]

23 hours ago, Z-- said:

I have a Middle Eastern background, and the pattern of loss you've got is fairly typical for the Middle East/India. I'm around the same boat as you. What'll likely happen next (based on my own experience) is that that the front will thin out next. Probably won't be as bad as the back, but I think you're headed to a NW5a or NW6. 

Good News: (i) you're able to tolerate Finasteride and you've done all that you can from a drug/medical perspective, (ii) your donor looks great and there doesn't look to be too much dip and (iii) you have time.

Bad News:  (i) you're way, way too young to be doing a transplant, (ii) the pictures from the last three years indicate that you're still on track to lose more, and (iii) you need to save up more $$ for a quality transplant doctor. 

I'm about five years older than you are, and I'd implore you to wait until your very late 20s (e.g. 28 - 29) before proceeding with a hair transplant. I thought my loss was bad and couldn't get any worse around 26, and boy, was I wrong. Many ethical doctors refused to operate on me until I was older and balder...I'd implore you to do the same. 

Otherwise, keep an eye out on H&W ($$$), Konior ($$$$), Eugenix ($$) and Vertex Hair ($$). Given the level of loss, I'd look into FUT first and then FUE. If you've got beard hair, that would prob be helpful too.

Good luck!

Keeping in mind what others have commented here, I will try to have a consultation session with Eugenix doc to see if the doctor advises the same. If its negative, I will go for shaving the entire head. If its positive, will keep the treatment to the end of the year to provide ample time for hair loss observation.

[MZiyad98]

19 hours ago, SadMan2021 said:

I agree with this. Perhaps OP can may be happy with the end-result of a HT journey, but he is looking at multiple years, multiple surgeries, and tens of thousands of dollars. 

I was well aware of this before even entering the medication. My understanding is that transplanting the hair that was not effected by HT will be capable to cover my head. The one's effected by DHT will eventually shed off. Comparing to my hair loss pattern in the last couple of months, I believe that the condition has stabilized, or there isnt much hair to fall off in the first place. If doing an HT now will last for the next 10 to 15 years, I would still proceed with the treatment and decide to shave it entirely off after that. Going for any option that can give me the "young" look while I am still young.