General Advice for my situation

[icemanfish]

Hi All!

I've been thinking about getting a HT for a long time now, but only recently came into money that might enable it. Since then, I've been consulting surgeons, reading about the forum, and attempting to understand how my particular situation applies to various available treatments. I just want to say how grateful I am to have come across this site, which is a treasure trove of honest advice and experiences in the internet's sea of misinformation, advertising and hype. So far, I've come away with a few solid conclusions:

1.) If I got a HT, it would be in Turkey, and I would budget £5,000 (5.855 EUR) for it. I initially thought the best idea would be to stay in the UK, relying on our consumer protections, but after looking into a very dodgy-seeming clinic in London that was asking for only £2,000 and seemed to be more focused on protecting their reputation with fake reviews than offering a quality service and honest advice, I decided to look abroad. I have consulted two surgeries that seemed to be appropriate for my price range: Dr Resul Yaman and Turan/Gur at FUECAPILAR. Yaman quoted me £2,800 for an all-in package with 4,500 grafts, to be completed in one day. I was initially worried about the 'Hair mill'-esque implications of this, but I've come to the conclusion that he offers a quality service for the price, but that I shouldn't expect anything as extraordinary as what De Freitas can offer. The assistant I was talking to was also honest about failure rates, what I should expect etc. Dr. Turan reccomended I take a step back and take Finasteride and Minoxodil 5% for 6-9 months. I greatly appreciate the honesty here and it speaks to the integrity of the doctor, but taking a heavy regimen of medication for the remainder of my life is not an acceptable solution for me (see below) and I'd prefer not to wait another half a year, when I feel like I'm at the right stage of my life to undertake this kind of surgery. So, currently I'm just looking at the proposal made by Yaman.

2.) I should only realistically expect the result being a 'mature hairline', and not necessarily maximum density. I'm thinking this is simply more reliably achievable than aiming for a complete transformation via one surgery, especially with my unwillingness to commit to a heavy regimen of medication, and the thing I'm most self-conscious about is the crown at the moment.

3.) That I'm not willing to accept the side effects of Finasteride, and I can't realistically commit to a regimen of topical minoxidil. When I first started reading about Hair transplants, I thought they were simply a more expensive, permanent version of these, and that getting a HT precludes the need for other medical solutions. I can see that the informed opinion here is that you kinda need to use medication alongside your HT, else the rest of your existing hair will fall out anyway and you'll need another one down the road. Still, the side effects, no matter how rare, are to me personally pretty unacceptable for Fin - I just can't accept the potential hormonal effects that it has; my personal perspective is that I'd rather go shaved than risk that. I also can't allow commiting to topical minoxidil, despite it seeming like the obvious solutions, as my work and social circumstances do not allow for me to be consistent with it - there would be regular periods of going two weeks without it. As such, the only realistic option for me is oral minoxidil, or some alternative like laser therapy (though I'm not sure how good laser therapy really is, and if it's another thing like topical minoxidil that I'd need to stick to for the rest of my life). I also wouldn't necessarily mind having to take a second transplant down the line to 'refresh', or else go shaved at some point.

So, that's what I've gathered. Now, I'd like to arm you guys with some info about my particular case and some images of my current situation (see blow), and ask some specific questions I've got about getting a HT under these conditions.

So, aside from the images, I think it's important to note that I've never had a HT before, that I don't smoke or drink (ever), I exercise regularly and don't have any serious health conditions. I first noticed my hair thinning in 2014 - I'm 30 now. It feels like it's been very gradually progressing over the course of many years - I've heard other people say that it's common to lose 50-100 hairs a day, and I don't think I've ever experienced that, but maybe I'm just unobservant in the shower.

1.) Do you think getting a HT is a good idea for me at all? I've seen some discussion to the effect that if you aren't willing to do Fin then it's not worth bothering with, but I'm still kinda keen, even if it would only delay my baldness by a decade or so. I'd be interested to hear people's thoughts and advice.

2.) If I did go through with it, is Yaman a good choice for my particular case? He's one of this site's recommended doctors, but I know he's definitely more on the 'budget' end of things there, and people have posted results with him that are imperfect, but I think I'm willing to accept the risk of those, from what I've seen. As I say, I'm not expecting miracles at this stage.

3.) Is my Donor area strong enough for the potential of multiple surgeries? It's always hard to tell from images alone, I know, but I've seen some people offer some very useful advice on this based on image albums that have been uploaded.

4.) Is going for a HT with no intention of including a consistent medical regimen alongside it a completely stupid idea? I'm currently thinking that's the majority opinion, but I'm still stubbornly attached to the idea of a HT being a permanent 'fix' to fully let it go. If it is, feel free to tell me straight so I can feel encouraged to start on something.

I would welcome any other comments/ advice/corrections as well. And, if I do go through with a HT, I'll be sure to provide you guys with an account of how it goes to repay you!

[Melvin- Admin]

Man, I would recommend trying to shave your head first. Honestly, I see a lot of red flags with you as a patient. 
 

1. Aggressive balding

2. Low budget (especially with needing a lot of grafts)

3. Low adherence to medication

I don’t see you being satisfied for a long period of time. If you can’t adhere to meds, you have to be willing to get multiple procedures as your hair starts to thin. But with your budget, seems highly unlikely. My suggestion, try to shave your head and see how it looks. That might be your best option. 

[general-etwan]

As with the above comment, it’s hard to endorse a HT or hair recovery strategy if you hold such a hardline perspective of finasteride.

I’ll just say that a few years ago I was under the same interpretation of finasteride as you seem to be right now. The truth is though that most of that fear is misplaced. Finasteride side effects are very very rare, and so most likely you’ll end up like the 95% of men who experience none at all. And even if you’re one of the 5% that do get sides, it’s likely that they’ll be minor and manageable. The things that I can say I’ve noticed is slightly decreased morning wood…and if that’s the price I have to pay for regrowing hair, sign me up all day. I’ve been on finasteride for almost 5 months and I’m going great and only wish I had started taking it earlier. I’d urge you to reevaluate your feelings about finasteride if you’d like to recover hair and/or have a procedure. Otherwise, it’s shave or wear hair systems. 

Edited May 11, 2022 by general-etwan

[Mike10]

My suspicion is that there are some representatives from Merck on this forum. There is no way of knowing for sure of course.But the fact is everytime anybody has made up his mind to not take Fin, somebody has to jump in.

Permanent sides may be very rare on Fin. I would not say that sides per se are very rare on Fin  in the long term. 

Edited May 11, 2022 by Mike10

[BaldDude]

10 minutes ago, Mike10 said:

My suspicion is that there are some representatives from Merck on this forum. There is no way of knowing for sure of course.But the fact is everytime anybody has made up his mind to not take Fin, somebody has to jump in.

Permanent sides may be very rare on Fin. I would not say that sides per se are very rare on Fin  in the long term. 

I doubt it since a generic version is now available.

[RTC]

21 minutes ago, BaldBobby said:

I doubt it since a generic version is now available.

Agreed

[NARMAK]

23 minutes ago, Mike10 said:

My suspicion is that there are some representatives from Merck on this forum. There is no way of knowing for sure of course.But the fact is everytime anybody has made up his mind to not take Fin, somebody has to jump in.

Permanent sides may be very rare on Fin. I would not say that sides per se are very rare on Fin  in the long term. 

Considering almost everytime Finasteride used to get mentioned, you'd see somebody jumping in to say how side affects are guaranteed, i find it refreshing to see more posts in support of using Finasteride to manage hair loss and posting a much more realistic outcome for the majority of users. 

Even taking the 95% figure above, i would wager out of the 5% figure, only 2% would likely have persistent side affects and probably only a fraction of that without underlying issues that need to be addressed. 

I didn't take Finasteride for over 10 years because of fear mongering and when i properly sat down to look at the science, i actually ended up on even stronger medication in the form of Dutasteride. I'm coming up to 12 months soon and i will be posting my experience with images too hopefully. 

I think if you are unsure, it's best to get a thorough blood test done to rule out any other potential issues that need to be addressed. 

Then you start off with micro dosing and increase it slowly over time to help your tapered use allow your body time to adjust to the reduction in DHT.  Do this until you can tolerate 1mg everyday or find your tolerance. 

There's also topical versions people can try which apparently have reduced systemic side affects but again require a much bigger commitment imo to adhere to much like applying topical Minoxodil and why studies usually show people stop those treatments often. 

"Jumping in everybody has made their mind to use Fin" is imo moreso to counter balance the reason the poster may be giving which could even in some cases may make them reconsider using it to help their hair loss situation. 

If a person imo doesn't wish to use Finasteride, i 100% respect their decision not to do so. I just hope the person had the right information to come to the conclusion for themselves rather than an unbalanced bias PoV others maybe presented to them influencing that decision. 

[Melvin- Admin]

52 minutes ago, Mike10 said:

My suspicion is that there are some representatives from Merck on this forum. There is no way of knowing for sure of course.But the fact is everytime anybody has made up his mind to not take Fin, somebody has to jump in.

Permanent sides may be very rare on Fin. I would not say that sides per se are very rare on Fin  in the long term. 

The forum is very fair and balanced on finasteride. To date, it’s the most effective drug, of course, better when combined with minoxidil. Of course side effects happen. I have stated on multiple occasions that I got sides and discontinued use. But what makes no sense is someone not even trying it.

If you try it and get sides, fair enough, stop using it. The majority don’t get sides. Though, the numbers are massively underreported. I would estimate about a quarter of men experience side effects. Still, 75% save their hair. Definitely worth trying in my opinion. 

Now, I’m not gonna say finasteride is a MUST, but if you’re not willing to be on fin, you better have the cash to invest in multiple procedures. If you’re not willing to do either, then surgery isn’t the best option. 

[Mike10]

44 minutes ago, Melvin- Moderator said:

The forum is very fair and balanced on finasteride. To date, it’s the most effective drug, of course, better when combined with minoxidil. Of course side effects happen. I have stated on multiple occasions that I got sides and discontinued use. But what makes no sense is someone not even trying it.

If you try it and get sides, fair enough, stop using it. The majority don’t get sides. Though, the numbers are massively underreported. I would estimate about a quarter of men experience side effects. Still, 75% save their hair. Definitely worth trying in my opinion. 

Now, I’m not gonna say finasteride is a MUST, but if you’re not willing to be on fin, you better have the cash to invest in multiple procedures. If you’re not willing to do either, then surgery isn’t the best option. 

Fair enough, I can  generally agree with  that. One last word from me. What you are saying is quite different to what some other posters say who are constantly pushing the drug, overstatiing its effects and understating the sides. At the end, it should be up to the user to make the decision based on all the information available and that decision should also be respected.  

Edited May 11, 2022 by Mike10

[Vann]

My opinion, get tested, whether that’s blood, hormones, or a biopsy of your hair. Start seeing your PCP (primary care physician) or dermatologist. 

i am sure you already tried this but I’m also speaking from where I started.

fortunately… I started taking finasteride when I was younger and I can say it doesn’t feel like you’re taking the drug because if you have aggressive hair loss it doesn’t seem like it’s working. However, I probably would have a lot less hair to show… thing is, when you’re younger you already have ‘higher’ hormone levels so it’s hard to say if I had any sexual side effects. 
 

even if I did I can’t say it’s from  the drug, something already pre existing, or a placebo effect. I stuck with finasteride for about 4ish years and I have been on dutasteride for 2. No side effects, no issues, nothing that was significant enough to call bad. 
 

however, in the beginning for the first 6 months I did experience some changes that caused for some swelling in the groin (minor discomfort) when switching from fin to Dut. I want to say it really lasted in the first month or so but randomly I would experience it within the first 6 months. After that it was like ok it feels like I’m back on fin (in terms of how I felt)

now, to address your unwillingness to take any medications… it could’ve saved you many follicles that would’ve fallen out early. Yes, it is not permanent… however it seems you have very aggressive alopecia in your early/mid twenties. If you had delayed this perhaps you could slow or halt the progression to the point where you could do some minor adjustment. It’s hard to say since we can’t see the future. If you have any hair loss in your family that could be an indicator.

Long story short…. Your hair density on the sides and back look like they could be coarse but it’s hard to say… given your budget and response to medication I would stay away from any surgical procedures. As they could leave you for worse then you originally started. 
 

if you do choose any surgical options I definitely think FUT is something you may want to consider.

Edited May 11, 2022 by Vann

[Legend007]

I work for Merck .. I get paid $1 dollar for any posts that says they will try finasteride. That’s why I speak up about it..

for every post that says bad things about finasteride I lose .50 cents . 

It’s a tough job ,, but I’m rich enough to get a hair transplant because of this side gig . thanks Merck .. 

[NARMAK]

Also, just to add. 

A LOT of stuff i hear around Finasteride getting blamed for side affects conveniently doesn't get looked at being the fault of just a normal aging process. 

That's why there's men into their 30s and 40s that experience more ED issues and we live very u healthy lifestyles where people are overweight and obese, don't get the micronutrients into their diets that help promote healthy growth of hair etc. 

That's why i think a lot of people need to realise not only the importance of medication in hair loss prevention but also the person's responsibility towards their health in general to be in the best position as we age. 

[Legend007]

Merck just deposited another dollar into my bank account just now . Thanks to the above post . Thanks Narmak

[LaserCaps]

43 minutes ago, Legend007 said:

Merck just deposited another dollar into my bank account just now . Thanks to the above post . Thanks Narmak

I've been on it for 30 years! And, while every year there seems more and more negative info, I will continue taking it for another 30.  Can you imagine an hair consultant with no hair? Now, Does that mean you'll get $30K for my comment? I hope so.

[Legend007]

Yes lasercap.. I think Merck will give me a bonus of $30 for ur 30 years of endorsement.Thank u 🙏 kind sir.. 

 

And for the OP u have food donor hair .. if Melvin can get his hair back .. I think u have a better chance .. ur donor is thick n full .. u still have a chance .. but damn if u bald this quickly at 30.. n u still don’t get it into ur head that ur hair needs preventive medication, even more stronger than finasteride .. u might have to go the combo dutasteride, minoxidil , n lasers n all kinds of stuff kinda route just to slow things down .. so u do u, u already the answers to your issues .. 

[icemanfish]

Thanks everyone for your honest advice. Sounds like I need to have a good long talk with a dermatologist, reanalyse my options with regards to medication and increase my budget (which sounds like this forum's version of Lawyer up, hit the gym, delete facebook). Increasing my budget is feasible - it just means that I'll need to delay making a start with it until I'm a bit more comfortable financially - but it sounds like that might be a good idea anyway. I guess I can try out the shaved look in the meantime 😎.

God bless all of you, including those trying to change my mind on Fin. I wouldn't want you to say anything other than what you truly believe is the best advice for my situation, so it's all appreciated. I'll keep you updated with what I end up doing.

[NARMAK]

1 hour ago, icemanfish said:

Thanks everyone for your honest advice. Sounds like I need to have a good long talk with a dermatologist, reanalyse my options with regards to medication and increase my budget (which sounds like this forum's version of Lawyer up, hit the gym, delete facebook). Increasing my budget is feasible - it just means that I'll need to delay making a start with it until I'm a bit more comfortable financially - but it sounds like that might be a good idea anyway. I guess I can try out the shaved look in the meantime 😎.

God bless all of you, including those trying to change my mind on Fin. I wouldn't want you to say anything other than what you truly believe is the best advice for my situation, so it's all appreciated. I'll keep you updated with what I end up doing.

Honestly, if you start Finasteride, Minoxodil, Microneedling etc. i don't recommend anybody go get a hair transplant until they roughly see how things shake out after 12 months. 

It means you usually will have a lot more stability hopefully if it's working for you and better chance of an outcome. 

[BaldDude]

1 hour ago, NARMAK said:

Honestly, if you start Finasteride, Minoxodil, Microneedling etc. i don't recommend anybody go get a hair transplant until they roughly see how things shake out after 12 months. 

It means you usually will have a lot more stability hopefully if it's working for you and better chance of an outcome. 

I agree, but a HT may be the only thing that puts hair on an empty spot.

[mafpe]

there is hair system but... it's also quite a chore to keep one on, and trying to style it so people don't realise that it is one

[Melvin- Admin]

4 hours ago, icemanfish said:

Thanks everyone for your honest advice. Sounds like I need to have a good long talk with a dermatologist, reanalyse my options with regards to medication and increase my budget (which sounds like this forum's version of Lawyer up, hit the gym, delete facebook). Increasing my budget is feasible - it just means that I'll need to delay making a start with it until I'm a bit more comfortable financially - but it sounds like that might be a good idea anyway. I guess I can try out the shaved look in the meantime 😎.

God bless all of you, including those trying to change my mind on Fin. I wouldn't want you to say anything other than what you truly believe is the best advice for my situation, so it's all appreciated. I'll keep you updated with what I end up doing.

If I were to do everything all over again. I would not start with oral finasteride. I would start off on topical finasteride. I would also start off on a 3-day split. Monday, Wednesday, Friday split. Now, to ensure it stays on the scalp long enough I wouldn't wash my hair every day. I would wash my hair maybe 2-3 x per week. If I could advise my 22 year old self, this is what I would say. Not all topicals are created equal. I would stay away from the cheap crap. I would only try topicals compounded by an actual pharmacy. In my opinion, Xyonhealth appears to be the front runner. 

[NARMAK]

1 hour ago, BaldBobby said:

I agree, but a HT may be the only thing that puts hair on an empty spot.

I get what you're saying and generally that holds true for slick bald areas. 

However, there's some doozy examples of recovery on the so called Big 3. Ridiculous recovery even. 

I would say if you are Norwood 6/7, Finasteride probably still has a chance to help thicken up even the donor and keep it strong as we've seen.