24y/o, balding since 3 years, how many grafts would I need for hair transplant

[Neppal]

I am also on oral Finasteride since 30 days ago, 2mg, 4 times a week, dermaroller 0.5mm 4 times a week, and topical minoxidil 4 times a week.

 

Edited June 18, 2022 by Neppal
A

[Vertexhairclinic]

Hi @Neppal

This is Hala, working for @DrTBarghouthi

I tagged Dr Taleb so he could give you an advice regarding your case.

 

Kind regards,

Hala

[NARMAK]

2 hours ago, Neppal said:

I am also on oral Finasteride since 30 days ago, 2mg, 4 times a week, dermaroller 0.5mm 4 times a week, and topical minoxidil 4 times a week.

You only starting Finasteride 30 days ago. You need to give it at least 12 months but given you'rein your mid 20s, i'd even say up to 24 months. This should let you properly evaluate your hair loss and after that time, you hopefully have saved enough money to choose the best place and can get a better idea of how many grafts you will need. 

Don't rush into a hair transplant. It's something that needs to be properly researched and the right place chosen. Not just some hair mill in Turkey who will ruin your finite donor. 

[Neppal]

Thank you for your suggestion. I started losing hair 3 years ago when I used to wear a motorcycle helmet for long hours. I stopped using helmets and since then, I noticed my hair had stopped falling. I stopped using helmets (2years ago), and i am positive that my hair has been the same as the above photo the whole time, no hair loss since then. Would you suggest HT for my condition? It is cheaper to get HT at my place, 0.7$-1$ Per graft. Would 1500 grafts be enough if I ever went for HT?

[Neppal]

54 minutes ago, NARMAK said:

You only starting Finasteride 30 days ago. You need to give it at least 12 months but given you'rein your mid 20s, i'd even say up to 24 months. This should let you properly evaluate your hair loss and after that time, you hopefully have saved enough money to choose the best place and can get a better idea of how many grafts you will need. 

Don't rush into a hair transplant. It's something that needs to be properly researched and the right place chosen. Not just some hair mill in Turkey who will ruin your finite donor. 

Thank you for your suggestion. I started losing hair 3 years ago when I used to wear a motorcycle helmet for long hours. I stopped using helmets and since then, I noticed my hair had stopped falling. I stopped using helmets (2years ago), and i am positive that my hair has been the same as the above photo the whole time, no hair loss since then. Would you suggest HT for my condition? It is cheaper to get HT at my place, 0.7$-1$ Per graft. Would 1500 grafts be enough if I ever went for HT?

[TommyLucchese]

Did a doctor recommend your finasteride dosing? 2mg is double what people would normally take. 

You should take clear photos from every angle and then wait 1 year, then take more pics and evaluate how successful the medication has been. Then when you consult with doctors you will know if your loss is stable. Plus you will hopefully regain some hair which would mean you don't need as many grafts.

[THE TRUTH]

Most doctors will tell you that you need 4000-5000 grafts. This is complete BS because they will destroy your donor and you will have no growth of the transplanted hairs and thus waste your  limited resources forever. 

I would not try to implant more than 2500-3000 grafts. 3k grafts with the right surgeon and with optimal survival can make a huge improvement.

Be careful which doctor your choose. 

Very few doctors know how to perform a surgery correctly on diffuse thinners without compromising the native hairs in between and without trying to dense pack too much which so often results in zero survival... 

Surgery is always a huge gamble. 

I would do a TON of research on this forum. Take your time. 

Trust me, a bad or even "a subpar" result can impact  your life  extremelu negatively forever...

Definitely try medication first for at least 6 months !! 

Dutasteride 0.5mg daily. 

Oral minoxidil 2.5mg daily 

Optionnal: Fluridil or RU58841 in topical application once daily

Discuss these options with a good doctor who specializes in hairloss (HT surgeon or trichologist). Not some local general practicioner...

If you are very lucky and get a hyper response to medication like those guys on Tressless,  you may even avoid surgery or minimize the number of grafts that you require. 

[NARMAK]

3 hours ago, Neppal said:

Thank you for your suggestion. I started losing hair 3 years ago when I used to wear a motorcycle helmet for long hours. I stopped using helmets and since then, I noticed my hair had stopped falling. I stopped using helmets (2years ago), and i am positive that my hair has been the same as the above photo the whole time, no hair loss since then. Would you suggest HT for my condition? It is cheaper to get HT at my place, 0.7$-1$ Per graft. Would 1500 grafts be enough if I ever went for HT?

Firstly i can't verify your motorcycle helmets etc. were responsible for the hair loss but scientifically speaking it is highly unlikely for that to cause permanent hair loss. DHT affected hair loss which is the basis of Androgenic Alopecia is usually the culprit but perhaps if your hair follicles were suffering from oxygen deprivation and also suffering some form of trauma when the helmet was on may have gone into telogen effluvium shedding a lot sooner. Then alongside your hair loss from DHT it looked a lot worse, stabilised for a bit then continued a bit. 

Ultimately your hair loss should respond well to medication as usually more diffuse thinning patterns. Of course, ultimately you have the power to decide where you want to go but i would strongly heed the advice on here and learn as much as possible about getting it done to the right place. 

[civic]

I don't think you need any surgery. What you have can be reversed with fin/minox/ drmaroller. At this age & diffuse pattern, Zero grafts is the best approach .  I was in your situation in 2009 & the doc i went to prescribed meds & said not to bother with ht till a decade or so later.

Edited June 15, 2022 by civic

[Eugenix Hair Sciences]

7 hours ago, Neppal said:

I am also on oral Finasteride since 30 days ago, 2mg, 4 times a week, dermaroller 0.5mm 4 times a week, and topical minoxidil 4 times a week.

You need to take medications for at least 12 months. Finasteride will help you tremendously. Instead of taking 2 mg for 4 days a week, you should take 1 mg everyday. You should also use Minoxidil everyday. You have diffusive hair loss. You should consider going in for a transplant after a year of using the medications.

[Adier]

I have a similar case like yours may be a tad better. I was too thinking of doing a transplant before i bumped in here and realised my situation could improve tremendously with medications and a good diet. I mean you can still opt for a transplant but take the medications for 8-10 months and see for yourself. People who are way worse come back from the dead. Transplant you can do anytime assuming your donor is good. But if you do make gains from medications which you certainly will i believe it's better to avoid a transplant and be on medications. Good luck.

[Neppal]

On 6/15/2022 at 8:45 PM, TommyLucchese said:

Did a doctor recommend your finasteride dosing? 2mg is double what people would normally take. 

You should take clear photos from every angle and then wait 1 year, then take more pics and evaluate how successful the medication has been. Then when you consult with doctors you will know if your loss is stable. Plus you will hopefully regain some hair which would mean you don't need as many grafts.

No, I have never been to a doctor. Lowest dose of finasteride available at my place is 5 mg, and I’ve been cutting that. 

[John1991]

I would recommend against jumping on dutasteride like "The GOAT of botched jobs" suggested.  That's even more likely to produce negative side effects than fin.  It is more effective at preserving and thickening hair, though.

[HappyMan2021]

I'm really not sure you are a qualified candidate for a hair transplant. You are only 24 and already have severe balding. Your balding is probably not stable yet, and who knows when it will be. 

You will definitely need 2 surgeries, maybe 3 or even 4, for an "adequate" result. It may not be worth the mental and financial investment you put into it. 

[Dillpickle123]

Lower your finasteride but buying a pill cutter cut it into 4 pieces and take that for a year and reassess this isn’t from wearing a helmet it’s genetic hair loss and you need a lot of grafts but maybe some will come back after medical intervention 

[sukh123]

On 6/15/2022 at 6:44 PM, The GOAT of botched jobs said:

Most doctors will tell you that you need 4000-5000 grafts. This is complete BS because they will destroy your donor and you will have no growth of the transplanted hairs and thus waste your  limited resources forever. 

I would not try to implant more than 2500-3000 grafts. 3k grafts with the right surgeon and with optimal survival can make a huge improvement.

Be careful which doctor your choose. 

Very few doctors know how to perform a surgery correctly on diffuse thinners without compromising the native hairs in between and without trying to dense pack too much which so often results in zero survival... 

Surgery is always a huge gamble. 

I would do a TON of research on this forum. Take your time. 

Trust me, a bad or even "a subpar" result can impact  your life  extremelu negatively forever...

Definitely try medication first for at least 6 months !! 

Dutasteride 0.5mg daily. 

Oral minoxidil 2.5mg daily 

Optionnal: Fluridil or RU58841 in topical application once daily

Discuss these options with a good doctor who specializes in hairloss (HT surgeon or trichologist). Not some local general practicioner...

If you are very lucky and get a hyper response to medication like those guys on Tressless,  you may even avoid surgery or minimize the number of grafts that you require. 

“No growth of transplanted hair “ talk about exaggeration to the max. I can see why your name is that now, don’t make what probably happened to you as if everyone will suffer the same . 

[sukh123]

On 6/15/2022 at 6:44 PM, The GOAT of botched jobs said:

Most doctors will tell you that you need 4000-5000 grafts. This is complete BS because they will destroy your donor and you will have no growth of the transplanted hairs and thus waste your  limited resources forever. 

I would not try to implant more than 2500-3000 grafts. 3k grafts with the right surgeon and with optimal survival can make a huge improvement.

Be careful which doctor your choose. 

Very few doctors know how to perform a surgery correctly on diffuse thinners without compromising the native hairs in between and without trying to dense pack too much which so often results in zero survival... 

Surgery is always a huge gamble. 

I would do a TON of research on this forum. Take your time. 

Trust me, a bad or even "a subpar" result can impact  your life  extremelu negatively forever...

Definitely try medication first for at least 6 months !! 

Dutasteride 0.5mg daily. 

Oral minoxidil 2.5mg daily 

Optionnal: Fluridil or RU58841 in topical application once daily

Discuss these options with a good doctor who specializes in hairloss (HT surgeon or trichologist). Not some local general practicioner...

If you are very lucky and get a hyper response to medication like those guys on Tressless,  you may even avoid surgery or minimize the number of grafts that you require. 

 

1 hour ago, HappyMan2021 said:

I'm really not sure you are a qualified candidate for a hair transplant. You are only 24 and already have severe balding. Your balding is probably not stable yet, and who knows when it will be. 

You will definitely need 2 surgeries, maybe 3 or even 4, for an "adequate" result. It may not be worth the mental and financial investment you put into it. 

Another one over exaggerating , if he can stabilese or even get regrowth with this regime , he would need two surgeries if done by a good surgeon to get good density and coverage not “4” lol 

 

 

 

 

 

[THE TRUTH]

10 hours ago, sukh123 said:

“No growth of transplanted hair “ talk about exaggeration to the max. I can see why your name is that now, don’t make what probably happened to you as if everyone will suffer the same . 

 

The real goal is not to get surgery.

If you've done your research and understand how all this works, then you should understand that the REAL goal is to avoid surgery. 

Surgery is always a huge risk no matter how "reputable" is your clinic....It should be considered last resort and certainly not the immediate go-to...

Especially for difficult cases such as this one (Norwood 4 with severe and advanced diffuse thinning)...

He should try a very strong pharmaceutical stack for at least 6 months and then from there do his research diligently and decide whether he wants to gamble his limited donor area and accept scarring and moth eaten look in exchange of more coverage on top (not even close to full coverage and this being the best case scenario).

Be careful. Take your time. 

 

[sully]

Do you want to fill your top ? can you please share your donor area it just looks like mine and i want to know how many grafts you need for example 

[Mike10]

At 24 and as a diffuse thinner you're just not a good candidate. Also, what happens if you will have to drop Fin at some point for some reason or another,  you will be fXXXed

[THE TRUTH]

17 minutes ago, Mike10 said:

At 24 and as a diffuse thinner you're just not a good candidate. Also, what happens if you will have to drop Fin at some point for some reason or another,  you will be fXXXed

So true. Agree 100%. 

Here is what I would do. 

Get on oral Dutasteride 0.5mg, oral minoxidil 2.5mg daily and a topical anti androgen once daily (RU58841 or fluridil) and give yourself 6 months. 

I guess it will reverse and thicken your diffuse thinning to SOME degree. Not give you full regrowth but chances are your hair will look somewhat better. It will strengthen it and thicken it and hence minimize any potential permanent shock loss that may happen later down the road if you ever decide to get surgery....

From there I would start saving for a VERY good HT surgeon and I would do a ton of research. A ton of research. Spend your life researching like crazy. Deliberately search for bad reviews and subpar results.  Look for people with similar balding pattern to yours. Go with the best of the best. Ask the doctors to provide detailed cases.  Avoid hairmills or recommended clinics with history of subpar results. 

And more importantly do a small test procedure first ! This is what I always recommend. 

Like 500 grafts in order to test the survival rate.  If it turns out good, it would continue with 2-3 minor surgeries. Never go all at once. You risk poor survival and wasting your limited grafts forever. 

Go conservative, don't rush, take your time, take a step by step approach. 

Fighting and reversing genetic hairloss is a lifelong ultramarathon.