How can I make it a one time procedure with results lasting a lifetime ?

[My HT]

Hi guys..

First of all thanks to everyone who have shared their experiences on this forum. I have been researching for past many months and finally know enough about the procedures, expectations and doctors/clinics.

My question is direct. I will break it down in parts for easier understanding. Requesting guys who are clearly more experienced than me on 'hairloss' to please answer my question. It will help me make my decision.

My case

I am 36 years old. Loosing hair since I was 18 years old. Currently around Norwood 3 or 3.5. The hair loss progression has been slow. As of now, most of times I don't notice any hairloss but at times I do. My looks have no effect on my profession or married life. However, I guess everyone wants to look their best. that's why I am opting for a hair transplant. I have not been on finasteride or any other medication. I tried finasteride only once recently, but have stopped after 2 weeks of consumption. I was having anxiety. But, it may or may not be due to finasteride. It may be in my mind. I really cannot tell.

What I have realized

Hairloss has little to do with your lifestyle. Even the fittest athletes like Rafael Nadal, Wayne Rooney, Tiger Woods etc. get affected. They had hair transplants. However, over time, hair loss progressed. On some occasions, transplanted hair also start thinning out. I myself am into lot of sports, don't smoke, social drinker, no drugs, etc. I don't really take sress. I sleep 8 hours everyday.

Question 1

Can I really make hair transplant a one time procedure ? I can afford a good surgeon (thanks to this forum, I have identified one). But I don't see myself as a person who can have multiple procedure. 

If I choose the best clinic, best doctor, can it be done ? How can I plan for it ?

Wayne Rooney and Nadal could'nt do it. They clearly are exponentially richer than me. But yes, they had their procedure in their 20s. 

Question 2

With finasteride, can I really avoid hairloss of my existing hair ?

I don't want to take medication for lifetime. Can I take it for an year or two after transplant and taper it down ? 

My hairloss progression is currently slow.  I am afraid finasteride can aggravate my hairloss progression. Especially, if I decide to taper it down or leave it in future. As per my research, finasteride may also become ineffective after using it over years. I may or may not develop side effects, that's another thing to consider.

 

Question 3

Is there really any age when hairloss naturally becomes stable ?

I have lived with hairloss for nearly 18 years now. How can I tell that my hairloss has reached to it's max or peaked out. Or when will it peak out ?

 

 

 

[My HT]

Bump. The thread went down unnoticed.

Guys.. requesting for advice please.

[NARMAK]

Firstly don't expect a "Lifetime Hair Transplant". 

Especially if yoy aren't on Finasteride as male pattern hair loss is progressive and very few people manage to prevent all scalp DHT but you can definitely try help slow it down. 

Finasteride blocks 41% scalp DHT at 1mg everyday and Dutasteride blocks 51% scalp DHT. You have that added on in addition to whatever your hair follicles naturally block. I like to say 30-50% as a ballpark guess but nobody truly knows as i don't think a method has been developed. 

You should probably know that you can "Nocebo" yourself into side affects where what you think will happen and constantly focus on mentally manifests. The same way we explain how people given sugar pills somehow perform a bit better than people who know they're on absolutely nothing. 

At Norwood 3ish, you can get a good long term result but if you're not on Finasteride, there's a good chance you'll be back for a 2nd procedure a lot sooner. 

The way to make a first procedure last longer is also to settle for a much more mature and high hairline reinforcement. 

[ciaus]

On 4/30/2022 at 1:27 PM, My HT said:

I don't want to take medication for lifetime.

Then you're almost definitely going to need more than one hair transplant. Even alot of guys that take finasteride still need multiple transplants. Finasteride is a management tool first and foremost. A few lucky guys jump on it very early and it stops their loss in its tracks too. For alot more guys it slows the loss rate down, potentially alot, and reduces the total number and frequency of hair transplants they need over their lifetime.

 

On 4/30/2022 at 1:27 PM, My HT said:

My hairloss progression is currently slow.  I am afraid finasteride can aggravate my hairloss progression.

There's alot of nonsense and misinformation about finasteride online, from the sounds of your 'research' you've consumed a decent amount of it. You are better off just working with your doctor and trying not psyche yourself out into manufacturing side effects that only a minority of guys actually get from finasteride. Otherwise, you are maximizing the potential that you are going to need more than one hair transplant over the course of your life.
 

On 4/30/2022 at 1:27 PM, My HT said:

Is there really any age when hairloss naturally becomes stable ?

Around the time you are so old and ugly you stop caring about your hair and more about dying.

While you are married now, and just want to 'look your best'. You are still relatively young with many years left before you'll stop caring about how you look. And marriage hasn't been a 'til death do you part' institution for decades now. Half of them end in divorce and more people are not bothering with it at all. You could say there's better chances of you hanging on to your hair than your marriage. So you got to factor in the potential that in 10 or 20 years you might be trying to attract another mate, and 'looking your best' is going to be critical for your confidence and appeal to the opposite sex, not just a good attitude to have.

Bottom line is you need to get serious about whether or not you want to address your hair loss. The one-and-done hair transplant is a relative rarity, unless you wait until your collecting social security and you also still have enough hair and money to do something about it. If you are going to address it, give finasteride serious consideration and an honest chance, and accept that it will be a life-long commitment for as long as you want to hang on to your hair, and you still may need several transplants, but not as many as would have needed had you not taken it at all.

 

[Rolandas]

It really depends on your hair loss. If it's NW3 or so and there's no more hair loss in the family, then I don't see why would you need more than 1 surgery if its done well.

Ofc there's no 100% survival even in best hands, hence you might need a 2nd one just to fill in weak spots If you're not 100% happy.

Finasteride doesn't necessarily stop completely your hair loss and you will likely recede further, albeit much slower. This will of course depend on your individual hair loss severity.

[Euphoria]

Without finasteride, there won’t be one HT

That’s what happened to all the celebrities you mentioned, they didn’t take any medication and lost the native hairs 

 

[BaldDude]

“Wambier explains that, generally, this hair loss begins at puberty and it gradually continues until about 50 years of age. Once you reach that age, hair loss doesn’t stop, though — it accelerates. The peak age for hair loss, in fact, is generally between the ages of 50 and 60.”

https://melmagazine.com/en-us/story/what-age-hair-loss-stop-stabilize

[My HT]

11 hours ago, Euphoria said:

Without finasteride, there won’t be one HT

That’s what happened to all the celebrities you mentioned, they didn’t take any medication and lost the native hairs 

 

I think it was a good transplant for Nadal. That is the max result a transplant can give. If he combs his head, his hair looks good. But in court, due to sweat and his hair getting unsettled the bald spots show.

 

10 hours ago, BaldBobby said:

“Wambier explains that, generally, this hair loss begins at puberty and it gradually continues until about 50 years of age. Once you reach that age, hair loss doesn’t stop, though — it accelerates. The peak age for hair loss, in fact, is generally between the ages of 50 and 60.”

https://melmagazine.com/en-us/story/what-age-hair-loss-stop-stabilize

So.. Is there a way to know whether or not your hair loss has stabilized ?

 

12 hours ago, Rolandas said:

It really depends on your hair loss. If it's NW3 or so and there's no more hair loss in the family, then I don't see why would you need more than 1 surgery if its done well.

Ofc there's no 100% survival even in best hands, hence you might need a 2nd one just to fill in weak spots If you're not 100% happy.

Finasteride doesn't necessarily stop completely your hair loss and you will likely recede further, albeit much slower. This will of course depend on your individual hair loss severity.

My father had decent hair. He developed hair thinning only in his 40s. But both my paternal and maternal grad father are Norwood 6. Both maternal and paternal uncles are again Norwood 6.

[BaldDude]

7 hours ago, My HT said:

So.. Is there a way to know whether or not your hair loss has stabilized ?

I guess once you turn 70

[Rahal Hair Transplant]

MyHT,

If when you say “lasts a lifetime” you’re referring to the permanency of transplanted hair, for the most part yes, your hair transplant will last a lifetime.  That said, if you’re referring to a “one and done” procedure, nobody can make that guarantee.

if you are an excellent responder to finasteride and/or the progression of male pattern baldness has reached its genetic limit, it’s possible one or two procedures may be all that’s needed since you won’t have to worry about ongoing hereditary baldness.  Now, if you decide to stop taking finasteride or hair loss continues for one reason or another, you may need subsequent procedures to keep your hair looking how you want it.

That said, at 35 years of age and having experienced hair loss since you were 18, slow progressive hair loss(and only a Norwood 3ish), you’re likely in a good position to undergo hair transplant surgery and quite possibly not need subsequent procedures due to ongoing hair loss.  You very well may be reaching your genetic limit.

Now this is just an educated guess based strictly on the information you’ve provided.  There’s also family history of hair loss and that unknown factor that nobody can predict.  But as far as candidates for the procedure go, I suspect you’re a good one.

For more accurate information, posting photos of your donor abs recipient area would be helpful.  I also suggest consulting an experienced surgeon.  

Best wishes,

Rahal Hair Transplant. 

Edited May 4, 2022 by Rahal Hair Transplant

[Rahal Hair Transplant]

And as far as an age where genetic hair loss stops, there really isn’t one.   It’s  different for everybody.  Instead I refer to what I call the genetic limit which is when each individual has reached their max point of baldness that has been genetically programmed.

Not everyone will reach a Norwood class 7. Some people stop balding long before that or at the very least it slows down so substantially that one doesn’t appear to advance to the next stage of hair loss.

for example.  I’m 45 years old and I’ve stopped experiencing any obvious hair loss in my earl 30’s.  My last hair transplant was in 2007 and my hair still looks the same now in 2022.   And I’m. It on finasteride or any nonsurgical solution.  But genetically I’m between a Norwood 5A and 6.   But most people don’t think I’ve ever experienced any hair loss when they look at me (with my hair long) ans with it shorter I only to appear to have some mild thinning in the crown and immediately above the occipital region of the scalp.

best wishes,

Rahal Hair Transplant 

[My HT]

1 hour ago, Rahal Hair Transplant said:

 

if you are an excellent responder to finasteride and/or the progression of male pattern baldness has reached its genetic limit,

Thank you.. This is exactly what I wanted to know. Before I undergo a hair transplant, I want to determine if I am a good responder to finasteride and if my progression of male pattern baldness has reached it's genetic limit.

How can I pre-determine these before I have my hair transplant ?

[Rahal Hair Transplant]

My HT,

i’m glad I could help. But keep in mind that there really is no tool or product that I’m aware of that can help you determine whether or not you reached genetic limit.   Unfortunately, the only real way to determine this is time. But that means you have to wait 10 years to see if you’ve lost anymore hair over that period of time. That’s not logical or feasible especially if you want to restore your hair long before that which I suspect you do like anybody else would.

that said, it’s more of a matter of whether or not you’re willing to take the risk. I’d say your odds are pretty good considering you are only a Norwood 3 at 35 years of age and you have been losing your hair since 18. I’d say the odds of you advancing to Norwood six or seven is pretty slim at this point.

I apologize if you’ve already stated this but when did you start using finasteride and have you seen any changes since you started using it? It’s recommended to use finasteride for at least six months to a year before evaluating its efficacy.  And while many hope that finasteride will help them regrow hair, it is much better at slowing down or stopping the progression of male pattern baldness.   In your case, it may be difficult to determine how well it’s working if your hair loss progression is already going exceptionally slow.  But if you only just started on it or have started within the last year, it’s not a bad idea to wait the full year to see how it’s working for you.

I hope this helps 

Rahal Hair Transplant

[StillAlive]

You can never be 100% certain.

However, if by the time you are 40, you are NW3-4, it's fairly safe to assume that you won't hit NW6-7 before you are 65 or 70. So even if you forego medication completely and get a good 4000 grafts to fix your hairline and front, it's quite possible that you are going to stay with the result, not really caring about any crown loss that occurs further down the road.

It's really all down to your perception of your self. Personally, after fixing my hairline and front, I don't feel like I'll be very bothered by a bald crown, exactly because it won't be staring out at me every time I look in the mirror. And if I am, I know that I can always fill it in later.

So essentially, depending on your expectations, 'one and done' is quite possible. 

[GoliGoliGoli]

OP sounds a lot like me. I am 33.5 and will be close to 34 when I got in for my HT. I am a NW 3V maybe NW 3.5. Started balding around 25 and loss has been fairly slow. I never have lost clumps of hair or looked down in the shower and seen a lot of hairs. No interest in taking anything besides Topical Min (Which from initial results I seem to be responding well to).

It's important that whoever you choose for your transplant understands that you want a HT you can age into well. As someone else mentioned going with a fairly conservative/mature after restoration is a good idea as it preserves grafts and wont leave you looking weird if you continue losing. 

I am also going with Dr Nader who seems to be have the best quality/price ratio of anyone in North America. I just can't justify spending 25,000 for similar results in the US/Canada/Europe. So if I eventually need a 2nd HT, no biggie I'm still way under what a lot of people spend for a single HT. 

[Rasputin]

Of course you can, but it's easier if you're already a norwood 6, stable for years.

Now, if you were supposed to be a norwood 3 only and stay this way, then it is possible as well. But we can't know that. Maybe just guessing, looking at your dad's pattern, or other male family members.

Wayne Rooney has a decent result. I'm quite sure he doesn't take finasteride, so had to do several procedures but considering is high level of baldness, and his hair that looks really thin, you look at him now (many years after his first HT) and he doesn't look bald at all. His temple points were not reconstructed though so he could even enhance his result. He also most probably never used BHT, and he has a better beard than most men.

Different story for Nadal. I think his results for 2 procedures are quite disappointing, but this is "normal". He's mediterranean and got this typical diffuse thinning. The issue is that probably the fue he got "killed" all of his thinning native hairs so he might look as if not much has been done, but in reality, the hair he got now will not fall as it is from the safe zone. He will still need another procedure. I don't know about his beard.

Edited August 21, 2022 by Rasputin

[sunsurfhair]

Brutal truth - the likelihood of it being one procedure especially with out DHT blocking meds (if you can tolerate and don’t get significant sides) is very unlikely. Even as a class 3V. It’s not an impossibility but it’s quite a low likelihood. If you’re conservative in your hairline and other enhancements such as temple points, you increase your chances for one and done or at least a longer duration before a new surgery. 
 

There are many guys who slam fin / dut / minox / keto and still unfortunately continue to lose. That’s just nature. Also, most times they can’t get the density good enough on a first pass - meaning you may want a second smaller pass to really thicken up the first result or tweak and treat problem areas. 
 

I would just set your expectations that this is the reality. I’m sure all the celebs we see are getting what I believe are micro FUE sessions - smaller sessions they can hide quite well after they had their more significant surgery for the ones who had greater loss. 
 

TLDR: it’s like playing Vegas - best surgeons , meds etc increase odds, but it’s always still a gamble

Edited August 21, 2022 by sunsurfhair

[sunsurfhair]

5 hours ago, Rasputin said:

Of course you can, but it's easier if you're already a norwood 6, stable for years.

Now, if you were supposed to be a norwood 3 only and stay this way, then it is possible as well. But we can't know that. Maybe just guessing, looking at your dad's pattern, or other male family members.

Wayne Rooney has a decent result. I'm quite sure he doesn't take finasteride, so had to do several procedures but considering is high level of baldness, and his hair that looks really thin, you look at him now (many years after his first HT) and he doesn't look bald at all. His temple points were not reconstructed though so he could even enhance his result. He also most probably never used BHT, and he has a better beard than most men.

Different story for Nadal. I think his results for 2 procedures are quite disappointing, but this is "normal". He's mediterranean and got this typical diffuse thinning. The issue is that probably the fue he got "killed" all of his thinning native hairs so he might look as if not much has been done, but in reality, the hair he got now will not fall as it is from the safe zone. He will still need another procedure. I don't know about his beard.

I agree. That’s another valid point. Unfortunately the trauma to the scalp can affect native hairs that are typically in the process of being on their way out or more sensitive. I didn’t think he ended up w such a great result either. 

[Rasputin]

By the way, just check this out. This guy is a french singer, and he had his hair transplant more than 20 years ago (I don't know exactly when, could be even more than that, maybe more than 30 years ago).

No idea if he's taking finasteride(my guess is no) so you can definitely see (his name is Michel Fugain if you want to check more pictures) that he is supposed to be a norwood 7 or more (I think he even have retrograde alopecia).

But notice how his transplanted hairs are still here and quite strong. I don't think he's the only exemple but the "donor dominance" is something quite sure by now. That's why I sometimes don't understand the theory that BHT would became eventually more like scalp hair, that would be "recipient influence".

This guy is a full norwood 7, even more. If you're norwood 5, or 6 with good beard, you can have a decent result with no finasteride.

I don't even know why bother with it (and the unofficial 30% chance of sides effects) if you have a beard (unless you want to keep your whole beard, or you really want to avoid the progression of balding and several procedures)

Beauty is amazing, but health is beauty.