NW 3 crossroads - HT or hair system?

[HelpfulFriend]

Hey all,

I'm 31, NW3, and have been on fin and minox for 6 years which has mostly slowed my loss.

I'm at the stage where I want the frontal portion fixed, and am considering a HT 

I have an extremely aggressive family history of balding, and I've been debating the risks.

I'm concerned about one day losing too much hair despite taking meds (as they don't stop, only slow loss progression) - and I was toying with the idea of a partial hair system.

My thinking: I could use a partial system for my front and then see how my loss plays out. Has anyone done this or have any thoughts?

Just something that came to mind when I was second guessing looking for a HT

[LaserCaps]

Can you post your photos? First thing we need to do is identify the pattern.  Look at the Norwood chart and look at a 5a.  Lightly cover the whole head with a pencil. This means a patient can have hair, but you can see the pattern when looking through the hair.  Pls confirm the NW3.  Do you have miniaturized hair? Or is it completely devoid of hair? It's all in the details.

Are you retaining or are you still losing hair despite the medications? Not clear. If you have experienced retention, you will continue enjoying the effect for as long as you stay on the medication.  So, please, don't stop.  You may want to add PRP and Laser to the mix.  These two can help reverse the thinning. 

I'll share my example with you.  Close to what you're experiencing.  

When my son was 18, I showed him photos of all my relatives.  My grandfather was bald, so was my dad.  I am following closely behind. I explained the hair loss process and suggested he gets on Fin.  Has been on it ever since. He is now 29 and is enjoying a full set of hair.  

A couple of things to consider about the system.  We cannot compete with the density of a system. 2nd. if you decide to stop the meds altogether, you could incorporate the system into the equation, but in reverse to what you're thinking.  I would do a small system for the crown.  If you do have enough donor, I would transplant the front. This will provide naturalness and help hide the system.  (That's if you can handle using a system).

[NARMAK]

The above post has some good information but personally i would add Microneedling into the mix with a derma pen once a week at 1mm to 1.5mm, as this has shown to boost your growth results and i would perhaps post your dosage of Finasteride. 

Are you on the full 1mg per day dose? If you are, it's potentially time to start considering the addition of Dutasteride 0.5 once a week replacing the Finasteride 1x a week and then slowly more till you feel you stopping any further loss. 

[Melvin- Admin]

I think getting a system as a Norwood 3 is unnecessary. Are you really a Norwood 3? Or a Diffused Norwood 7? I too thought I was a Norwood 3, when in reality I was a diffuse Norwood 6/7. Can you share some pictures?

[deeznuts]

I think it's more the opposite where you get a system for the crown but use your natural hair for the hairline with a transplant.

I think hair transplants end up being cheaper over time as well since hair systems are a subscription model and subscription models are great at nickel and diming you until you're broke

[THE TRUTH]

Lol same here. 

For like 2 years I was thinking hey no big deal I'm only a Norwood 2. 

While in reality I was a Norwood 4-5 severe diffuse thinner. 😂🔥

I had hair everywhere. No hairline recession nor slick bald spot on the crown. 

But I was diffusely thinning throughout the whole top. 

[Melvin- Admin]

3 minutes ago, deeznuts said:

I think it's more the opposite where you get a system for the crown but use your natural hair for the hairline with a transplant.

I think hair transplants end up being cheaper over time as well since hair systems are a subscription model and subscription models are great at nickel and diming you until you're broke

^ this. Systems rarely look natural in the front. The ones that do are called “Hollywood systems” you have to get them replaced every 3 weeks, which adds up in the long run. 

[NARMAK]

12 minutes ago, deeznuts said:

I think it's more the opposite where you get a system for the crown but use your natural hair for the hairline with a transplant.

I think hair transplants end up being cheaper over time as well since hair systems are a subscription model and subscription models are great at nickel and diming you until you're broke

I have a friend who isn't willing to hop on medication for fear of side affects and i've run through the gamut of things from scientific studies etc. but he chose not to use and recently got a hair system. To maintain it with the provider is a hefty fee but he said his barber was going to help him for a cheaper cost and that eventually he'd get a HT. I warned him of the pitfalls of losing more hair in the meantime and in some ways, it's even more expensive for him to be on the hair system than if he was on Finasteride. 

Personally i don't think it's a bad option for those unsuitable for a HT, but it is what it is 

[Al - Moderator]

It's probably much better to get a hair transplant for the front and then if you lose too much in the crown you can get a partial system for the crown. This way the front is real hair and nobody would ever know the crown is not your real hair.

 

[Savemyhairline]

I’ve always wondered how sanitary hair systems are, for your actual scalp. Assuming you are wearing it for weeks/months at a time, aren’t oils building up on your scalp that need to be cleaned? In my mind systems are a last resort if you cannot reasonably get a full head of hair with medication and transplants, though with a large percentage of men I believe this isn’t the case. To me having to worry about it and renewing it is a lot more of a pain than fin/min and even multiple hair transplants.

[GoliGoliGoli]

I don't know much about hair systems, but I have to imagine that it would feel annoying and hot and kind of gross on the head. Maybe I'm wrong. TBH it's not something I would personally consider.

As others have mentioned their is also the long term cost and upkeep. Hair transplants are pretty darn cheap if you go to the reputable Doc's in Mexico or Turkey, so I would bite the bullet and get some real hair on your dome. I'm on no medication and just have resigned myself to needing at least 2, maybe a 3rd down the line. But as mentioned if you go to a reputable place in Mexico or Turkey it's far more affordable. In the meantime just use Caboki or another brand of hair fibers they work really well for me. 

 

 

[GoliGoliGoli]

2 minutes ago, Savemyhairline said:

I’ve always wondered how sanitary hair systems are, for your actual scalp. Assuming you are wearing it for weeks/months at a time, aren’t oils building up on your scalp that need to be cleaned? In my mind systems are a last resort if you cannot reasonably get a full head of hair with medication and transplants, though with a large percentage of men I believe this isn’t the case. To me having to worry about it and renewing it is a lot more of a pain than fin/min and even multiple hair transplants.

This is another good point. Don't hair systems attach with basically a glue like adhesive? I would be worried about putting anything like that on your head every day for years on end due to toxicity and general annoyance, even if they claim their is no potential for toxicity. As I brought up in another recent thread, Talcum powder was used on babies for decades until it was found to be fairly carcinogenic

[Savemyhairline]

3 minutes ago, GoliGoliGoli said:

This is another good point. Don't hair systems attach with basically a glue like adhesive? I would be worried about putting anything like that on your head every day for years on end due to toxicity and general annoyance, even if they claim their is no potential for toxicity. As I brought up in another recent thread, Talcum powder was used on babies for decades until it was found to be fairly carcinogenic

Even just your own perspiration just sitting there on your scalp for months can’t be good, we shower all the time for a reason. Some perspiration of course is good for the skin but if you went out and took a run, you wouldn’t go a month without showering.

[Rahal Hair Transplant]

Helpfulfriend,

If you have any photos that you can present showing your areas of hair loss that would really help.  I also suggest posting some photos showing the sides and back of your scalp so I can see what your donor area looks like.

Without photos, it’s really difficult to advise you but typically people with advanced balding discuss combining hair transplants with a hairpiece. I understand that you are concerned about future hair loss but if finasteride has been working for you all of these years, I expect it will continue to at least for sometime.

Other than finasteride, which you are already using and minoxidil - all of the others such as microneedling and others are simply adjunct treatments and will provide you with very little if any benefit. This is my very strong opinion.  That said, my opinion is based on scientific fact, evidence and speaking with many hair restoration physicians over the years. In my opinion, don’t waste your time or money on treatments that will provide you with very little benefit.

Now, as to whether not hair transplant surgeries right for you, you sound like a good candidate and you may not need to combine over the hairpiece depending on certain circumstances and your ultimate goals. But I really can’t provide you with any real specifics unless I see some photos.

I will say this however, the only other potential treatment that might help you and work in conjunction with hair transplant surgery would be scalp micropigmentation.  This micro tattooing procedure Mix the appearance of hair stubble in the areas it’s provided and can also aid in the appearance of density when combined with hair transplant surgery.  of course, there are ideal circumstances for this to be affective but this is something you can speak with a doctor about.

I hope this helps.

Rahal Hair Transplant 

Edited July 7, 2022 by Rahal Hair Transplant

[NARMAK]

I'm just wary of a hair system for when you decide to go swimming, or for example end up in a situation where you might have somebody do something with your hair. It would give me anxiety in those situations i reckon and also the fact that to avoid those issues, usually you have to pay top dollar for the systems you can swim in, are a bit more permeable and let the scalp breathe more as well as maybe the high end adhesive that doesn't wreck the scalp as much. 

Imo, hair systems are genuinely the last resort for me because they have more inflexibility and in some ways, if you told a guy to spend like £500 on a hair system and then like £100 every few months, they'll eventually start seeing those hair mill adverts for £1000 or £2000 as bargains. Sad but think this happens a lot. 

[Eugenix Hair Sciences]

On 7/7/2022 at 7:19 PM, HelpfulFriend said:

Hey all,

I'm 31, NW3, and have been on fin and minox for 6 years which has mostly slowed my loss.

I'm at the stage where I want the frontal portion fixed, and am considering a HT 

I have an extremely aggressive family history of balding, and I've been debating the risks.

I'm concerned about one day losing too much hair despite taking meds (as they don't stop, only slow loss progression) - and I was toying with the idea of a partial hair system.

My thinking: I could use a partial system for my front and then see how my loss plays out. Has anyone done this or have any thoughts?

Just something that came to mind when I was second guessing looking for a HT

If you are somewhere around Grade III on the Norwood Hamilton Scale of baldness then you shouldn't go for a hair system. You will lose more hair behind the hair system more aggressively due to the hair system. Can you share some pictures of your scalp for evaluation?

[HelpfulFriend]

Hello everyone, thank you so much for your input - this is why I really do love this forum.

@LaserCap @Rahal Hair Transplant @Melvin- Moderator - I've attached some photos here. For reference, I see a dermatologist every 6 months, and I have maintained my hair for the past 6 years. More or less the same.

I had the back and other areas of my hair looked at under a microscope about 6 months ago, and no where showed miniaturization other than the front (which you can see in the second photo). Which was odd, as it was more-or-less consistent for 6 years with no change.

One thing to note, is that I did try dermarolling in these areas, as I was seeing if I could get some new hair to sprout on the exterior. If anything, this needling (1.5mm) seemed to have really thinned my hair out, and it hasn't come back in this spot. 

I only thought of the system as I know a person who has a partial front system, we train (boxing) together, and it looks really good.

Note: the first photo is from about a year ago but the hair over-head looks more or less the same, just a bit less volume.

I guess I am ultimately worried about meds and HT not being able to keep up with my genetics  

[Eugenix Hair Sciences]

You are Grade 2 on the Norwood Hamilton scale of baldness. You shall require:

Frontal zone: 1500 to 1700 grafts approximately

For the rest of your scalp, you shall require finasteride to prolong baldness.

[AndyDouglas]

Honestly? I think you're fine to wait a few more years - continue the fin and minox and then re-assess.

Regarding hair systems, I wore one for 2 years as a NW3 in my late 30s and though it helped me hide my hair loss and weigh up my options (which ultimately led me to a HT), I do personally think that hair systems are a last resort. Not everyone is cut out for the ongoing weekly maintenance - and there is a lot of regular maintenance to get it right.

There is also the psychological/emotional weight of hair systems - for example, sitting with constant anxiety in social situations/public transport/airplanes someone may be suspicious about your hair or lean in too close, not being free to go for camping/road trips or any holidays beyond 3-4 days without maintenance, not being able to jump in a swimming pool without a fear that the hair system will slide right off of your head... and of course, intimacy. 

This a whole lot to sit with (I did it for 2 years) and for someone with the density and hair that you have, it's simply not worth it.

[THE TRUTH]

You aren't even a Norwood 3. 

You are Norwood 1.5 to 2 maximum. Your hair doesn't even look bad bro. 

Honestly I wouldn't even bother with transplants at this stage. 

Just stay on oral Finasteride/Dutasteride and you're good to go.