Hair Transplant at a young age

[watde]

Hello,

I am seeing negative comments about having hair transplant at a young age and I understand the idea of it looking unnatural with the progressive lose of the hair during the years.

but what if I am on medication?

I started losing my hair at age 16 I am currently 21 and been applying minoxidil daily for 3 years and finasteride 1mg for 2 years.

minoxidil grew hair back at first but hair loss continued, I eventually started incorporating Finasteride, I still lost hair with it and currently I believe I am NW5.

I am microneedeling and used topical Dutasteride I haven't seen any progress and I am switching to Oral Dut soon once a week with finasteride.

I have contacted some clinics this week which are perceived highly in Turkey and around the world 

currently waiting for their responses but got 2 clinic responses for now :

HLC - I am supposed to have call with their patient manager 

Eugenix -   gave a me a quote of 4000 grafts (500 are beard grafts)

My hair is usually buzzed to zero, grew it only for the consultations.

 

Edited August 24, 2022 by watde

[Melvin- Admin]

At 21, I’m afraid to say you’re probably destined to be a Norwood 7. The fact that you’re on strong medication and still losing hair, means you’re not the best candidate. Here’s the reality, you’re not going to be able to restore all your hair. 
 

At 41, this is usually acceptable. At 21, it’s not. So you have to ask yourself. Do you really want to invest thousands of dollars, time, and still look balding? If you’re okay with having some hair, but not all, then you may be a candidate. But if you’re looking to forget about baldness and live your 20s with hair. I have to say it’s not likely. 

[watde]

2 minutes ago, Melvin- Moderator said:

At 21, I’m afraid to say you’re probably destined to be a Norwood 7. The fact that you’re on strong medication and still losing hair, means you’re not the best candidate. Here’s the reality, you’re not going to be able to restore all your hair. 
 

At 41, this is usually acceptable. At 21, it’s not. So you have to ask yourself. Do you really want to invest thousands of dollars, time, and still look balding? If you’re okay with having some hair, but not all, then you may be a candidate. But if you’re looking to forget about baldness and live your 20s with hair. I have to say it’s not likely. 

I would say my goal is to restore the hairline and top with a good density while having the crown look thinner with the combination of SMP

what is your opinion on this?

[Melvin- Admin]

30 minutes ago, watde said:

I would say my goal is to restore the hairline and top with a good density while having the crown look thinner with the combination of SMP

what is your opinion on this?

What do you consider good density? Can you share a picture of something you’d be happy with. Keep in mind everything on top will be gone. 

[watde]

57 minutes ago, Melvin- Moderator said:

What do you consider good density? Can you share a picture of something you’d be happy with. Keep in mind everything on top will be gone. 

I would say I'd like to aim for results such as the first video at my current state with a thinner crown yet still having hair there, for the second one it is something I would be happy with as well but with a bit more coverage at the crown to still have hair there.

Do you think I am realistic with my expectation? if so what should I expect?

https://youtu.be/WiurqrTEYBs

https://www.youtube.com/watch?v=XdHEjeL7tow 

 

[watde]

Also I'd I am open to a more conservative hairline considering I will have coverage on crown and top.

[HairEnthusiast101]

Curious how your donor looks. Any photos?

[NARMAK]

23 minutes ago, watde said:

Also I'd I am open to a more conservative hairline considering I will have coverage on crown and top.

I'm going to be honest, your hair loss is extremely aggressive and you're only 21 whilst you're using medication. There's bo way to tell how things might shake out if you got a transplant now and how much you would have to chase. Bear in mind your progress is after using treatments for years too your hairs still at a very critical stage. I would 100% wait until 25 minimum and keep doing what you're doing. That sucks to hear, i 100% know but the alternative of getting a HT right now may leave you in a much worse position. I would honestly say for yourself to start using hair fibres etc. to minimise the visual impact or alternatively buzz it all down but keep your routine going. 

[civic]

From the photo it looks like there is still good amount of hair. Sorry to hear that meds don't work for you. Have you tried vitamims such as D3, zinc, biotin? Todays youth have more difficult life due to social media, dating apps etc.  this causes a huge amount of stress. I would strongly recomend all natural approach, & to try to stay away from instagram, tiktok, tinder etc.  Those apps are 50% cause of hair loss at the minimum -).

Edited August 24, 2022 by civic

[GoliGoliGoli]

There are always 3 things to consider when getting a HT regardless of age/Norwood Level/Medication usage or no medication usage. Those 3 things are as follows:

 

1. Do you understand that you will need 2-4 HT's throughout your lifetime? 

2. Do you have enough donor (Combined scalp and beard) to ensure you can accomplish 2-4 HT's?

3. Do you have enough money in the bank to ensure you can accomplish 2-4 HT's?

 

Only a Dr can answer #2, and only you can answer #'s 1 and 3. In fact even you probably can't answer #3 unless you come from a very wealthy family. 

But the point is, I don't think it's such a big problem to get a HT at 19 as long as you understand you're going to keep balding and will need to keep chasing it with HT's if your donor can suffice. And considering you're NW4 at 19 means it's likely you will get to NW7 fairly early. 

[watde]

55 minutes ago, JoDimaggio22 said:

Curious how your donor looks. Any photos?

52 minutes ago, NARMAK said:

I'm going to be honest, your hair loss is extremely aggressive and you're only 21 whilst you're using medication. There's bo way to tell how things might shake out if you got a transplant now and how much you would have to chase. Bear in mind your progress is after using treatments for years too your hairs still at a very critical stage. I would 100% wait until 25 minimum and keep doing what you're doing. That sucks to hear, i 100% know but the alternative of getting a HT right now may leave you in a much worse position. I would honestly say for yourself to start using hair fibres etc. to minimise the visual impact or alternatively buzz it all down but keep your routine going. 

Why? could you elaborate more?

 

52 minutes ago, civic said:

From the photo it looks like there is still good amount of hair. Sorry to hear that meds don't work for you. Have you tried vitamims such as D3, zinc, biotin? Todays youth have more difficult life due to social media, dating apps etc.  this causes a huge amount of stress. I would strongly recomend all natural approach, & to try to stay away from instagram, tiktok, tinder etc.  Those apps are 50% cause of hair loss at the minimum -).

Have tried it, without any change.

 

46 minutes ago, GoliGoliGoli said:

There are always 3 things to consider when getting a HT regardless of age/Norwood Level/Medication usage or no medication usage. Those 3 things are as follows:

 

1. Do you understand that you will need 2-4 HT's throughout your lifetime? 

2. Do you have enough donor (Combined scalp and beard) to ensure you can accomplish 2-4 HT's?

3. Do you have enough money in the bank to ensure you can accomplish 2-4 HT's?

 

Only a Dr can answer #2, and only you can answer #'s 1 and 3. In fact even you probably can't answer #3 unless you come from a very wealthy family. 

But the point is, I don't think it's such a big problem to get a HT at 19 as long as you understand you're going to keep balding and will need to keep chasing it with HT's if your donor can suffice. And considering you're NW4 at 19 means it's likely you will get to NW7 fairly early. 

I am aware, I didn't think that it would with one operation.

Money currently I have enough to pay considering price of 3euro~\per graft for a high amount of grafts and could finance more for futures operations.

 

[NARMAK]

27 minutes ago, watde said:

Why? could you elaborate more?

 

Have tried it, without any change.

 

I am aware, I didn't think that it would with one operation.

Money currently I have enough to pay considering price of 3euro~\per graft for a high amount of grafts and could finance more for futures operations.

 

Basically you are diffuse thinning and the pattern looks like it could get to a Norwood 6 unless the hair loss stopped and all the hairs in the area became more terminal but given that you been on medication for years now and it hasn't, that's not a good sign. 

If you went for a hair transplant, not only would there be the potential for shock loss of those weak native hair but on a permanent basis too if anybody works in between the areas. It's very high risk, and that's why it's usually not recommended to get a hair transplant until your mid 20s whilst having been on medication for some time or even having extremely slow hair loss. In your case, the loss is aggressive. 

I am the last person that wants to tell a guy not to fight for hair which is why i think your routine is doing practically everything you would need. It's just that your response to it seems to not have matched up to what would would hope it can accomplish just yet and that's why it's important to allow more time rather than take a risk. I recommend saving up as much money as you can and researching doctors that specialise in your hair type and re-evaluate for when you hit 25. 

I know everybody thinks the 20s are their prime years, but you got a life way beyond and double that coming up. The goals long term not short. If you also are willing to stay the course, use fibres for now, i do think the longer term outlook might be better for you. 

[FixMyHair213]

I'm someone who's usually pretty optimistic but honestly this looks really bad. your pretty much destined for nw7, and it looks like the donor is thinning as well. I understand how hard it must be especially at such a young age but have you tried going bald. also the fact that finasteride is not stopping or at least slowing down the loss is not good. there are clinics that can probably get your hair back to a state in which there is decent coverage however you have to ask yourself is it worth the thousands and the fact is you will probably need multiple surgeries as you continue to lose hair. In my opinion going bald is the best thing to do in this case. your case couldve been acceptable if you were a lot older but at 21 its a very different story. have you visited a dermatologist and got everything checked out?

Edited August 24, 2022 by FixMyHair213
adding extra information

[1978matt]

Afro hair is usually lower density than caucasian which explains why the donor looks like it may be thinning, but it's too early to say how stable it will be long term.

You're best off getting on the oral DUT and waiting at least 2 years to assess the effectiveness.  Also if possible, take monthly pictures to monitor deterioration.

If you live near a reputable HT doc it would be good to have them look at the donor, or use the 2 year period to see some of the top doctors in person.

[watde]

1 hour ago, NARMAK said:

Basically you are diffuse thinning and the pattern looks like it could get to a Norwood 6 unless the hair loss stopped and all the hairs in the area became more terminal but given that you been on medication for years now and it hasn't, that's not a good sign. 

If you went for a hair transplant, not only would there be the potential for shock loss of those weak native hair but on a permanent basis too if anybody works in between the areas. It's very high risk, and that's why it's usually not recommended to get a hair transplant until your mid 20s whilst having been on medication for some time or even having extremely slow hair loss. In your case, the loss is aggressive. 

I am the last person that wants to tell a guy not to fight for hair which is why i think your routine is doing practically everything you would need. It's just that your response to it seems to not have matched up to what would would hope it can accomplish just yet and that's why it's important to allow more time rather than take a risk. I recommend saving up as much money as you can and researching doctors that specialise in your hair type and re-evaluate for when you hit 25. 

I know everybody thinks the 20s are their prime years, but you got a life way beyond and double that coming up. The goals long term not short. If you also are willing to stay the course, use fibres for now, i do think the longer term outlook might be better for you. 

Would you be able to mention doctors who do you think have an experience with cases such as mine?

In a scenario where I manage to keep my hair as it is until I am 25 do you think it would be an option then?

or the idea of being 25 is where my hair had basically should reach it's peak shed? and it would be safe to assume my hair loss had stabilized? concerning aggressive loss early. 

1 hour ago, FixMyHair213 said:

I'm someone who's usually pretty optimistic but honestly this looks really bad. your pretty much destined for nw7, and it looks like the donor is thinning as well. I understand how hard it must be especially at such a young age but have you tried going bald. also the fact that finasteride is not stopping or at least slowing down the loss is not good. there are clinics that can probably get your hair back to a state in which there is decent coverage however you have to ask yourself is it worth the thousands and the fact is you will probably need multiple surgeries as you continue to lose hair. In my opinion going bald is the best thing to do in this case. your case couldve been acceptable if you were a lot older but at 21 its a very different story. have you visited a dermatologist and got everything checked out?

I have, all concluded in MPB

 

21 minutes ago, 1978matt said:

Afro hair is usually lower density than caucasian which explains why the donor looks like it may be thinning, but it's too early to say how stable it will be long term.

You're best off getting on the oral DUT and waiting at least 2 years to assess the effectiveness.  Also if possible, take monthly pictures to monitor deterioration.

If you live near a reputable HT doc it would be good to have them look at the donor, or use the 2 year period to see some of the top doctors in person.

My hair isn't afro, wavy a bit once it reaches long hair length.

and sadly no reputable hair surgeons where I live (Israel).

 

 

Acknowledging the opinions I receive here I am inclining into SMP procedure which could be my safest route as of now.

[Dillpickle123]

If eugenix is willing to take on the case then it means they’re aware of what can happen maybe using more beard grafts to save scalp grafts but at 21 you look like your already a nw 5 have you tried dut? 

[MissMyLongHair]

I think you should take 0.5mg dut daily rather than once a week, you need maximum firepower.

[mafpe]

I'm sorry to say but you might want to go bald... i've almost never say this here since most cases can be 'helped'...

You're currently 21, and with your head atm, that's already aggresively balding... coupled woth the fact that you are on meds for more than a year already, you're either a non responder or your balding is so aggresive that the meds are unable to halt nor slow the process...

A hair transplant almost always have "transparency" effect, especially when shown under light. With how advanced your balding is, you would not have enough hair for a dense transplant. You can circumvent this by using concealers and other methods like partial hair system and any other means. But yes you wont have any real density otherwise.

My reason for saying you might want to go bald however, is because of the possibility of still losing trabsplanted hair. There are cases where a decade after, the transplanted hair lose thickness, and despite being a DHT resistant donor, it was slowly getting miniaturised. This isnt true for everyone but with how aggresive your balding is, i think it's probable you'll be losing them as well in the years to come. This might mean after half or a decade, you'll be back to where you are right now.

 

*edit : i'd advise on alternative route, such as SMP / hair system / shaving. Each have their own commitment though, just like HT.

Edited August 25, 2022 by mafpe

[StillAlive]

Man, it pains me to say it, but the consensus is right. Not responding to meds and that far gone at 21? 

The smartest play would be to just shave it and work out. You are still very young so it's not inconceivable that by the time you are 40, some 'miracle cure' will have hit the market. 

If you were to chase this right now, you'd spend thousands of euros/dollars and still look like a dude with thinning hair and bald spots. Even if you went for an ideal thick NW3 ultra-conservative hairline (think Jude Law) and accepted a thinner crown, do you really want to go to all that pain for people to still see a balding dude? 

If you really want the illusion of hair and a good frame for your face, I'd go with SMP. This way you'd restore your frontal hairline and temples and achieve that Michael Mando look which may suit you really well, particularly if you get jacked in the gym. Much more preferrable than having some strange patchy hair here and there. 

[NARMAK]

9 hours ago, watde said:

Would you be able to mention doctors who do you think have an experience with cases such as mine?

In a scenario where I manage to keep my hair as it is until I am 25 do you think it would be an option then?

or the idea of being 25 is where my hair had basically should reach it's peak shed? and it would be safe to assume my hair loss had stabilized? concerning aggressive loss early. 

I have, all concluded in MPB

 

My hair isn't afro, wavy a bit once it reaches long hair length.

and sadly no reputable hair surgeons where I live (Israel).

 

 

Acknowledging the opinions I receive here I am inclining into SMP procedure which could be my safest route as of now.

I'll be perfectly honest, i'm probably not the greatest person to ask on that front because i haven't looking into that specific scenario of your hair type. 

I do not know exactly how you feel with your routine, but if you can switch to oral Dutasteride it will help block more DHT although you may very likely experience an additional shed initially changing to the new medication. However my concern also is that you're saying you're using topical Dutasteride on top of oral Finasteride presently and i don't know many people already on such an aggressive protocol still stating they lost ground. So that's why it's important to wait. If you get to 25 and the situation hasn't changed and got worse, but maybe even improved that's a positive sign but you still run the risk of shock loss, temporary or permanent is unknown. 

For now, use hair concealers as you have enough surrounding hair to achieve a visual look of coverage and keep up with the routine. 

I think the picture you posted with lighting directly on the scalp also probably made it look worse than say normal lighting which is also why people might be giving the responses above too so may be worth possibly having more diffused natural light pictures added too. 

[1978matt]

10 hours ago, watde said:

My hair isn't afro, wavy a bit once it reaches long hair length.

Fair enough but it looks and has similar properties and could be naturally low density.

Not Israel but Dr B isn't far away and seems like a good guy based on his results and postings here:

https://www.hairtransplantnetwork.com/dr-taleb-barghouthi

[SimpleLife]

Bro go bald, take it from someone who did a HT at 23yrs, its not worth it, especially not in your scenario
 

In case you cant accept it, consider SMP (you have an olive skincolour so it will blend in perfectly), but accepting baldness is the best

[GoliGoliGoli]

11 minutes ago, SimpleLife said:

Bro go bald, take it from someone who did a HT at 23yrs, its not worth it, especially not in your scenario
 

In case you cant accept it, consider SMP (you have an olive skincolour so it will blend in perfectly), but accepting baldness is the best

Do you have a thread documenting your experience? Would be very curious to know 

[davidn]

This is a No No. Don't do it. I know how horrible it is but what you do have right now is a normal skin. Sure its hard to be the bald guy at 21, but whats harder is to (barring verteporfin :D) never have smooth skin again. People make this deal when the probability of shaving their head ever is low, but you have weak donor, extensive baldness and you don't respond to medication, and once you're cut you're cut, so shaving is out. And you will get a very glorified combover at best which will not look good in your 20s.

 

 

 

 

 

Edited August 25, 2022 by davidn

[watde]

Some clinics replied by now

HLC - claimed a good front could be done but rejected due to age

Eugenix - Quoted 4000 Grafts

BHR Clinic - expressed the same opinion as here, age is too young and further loss would provide unnatural results.

DR Felipe Pittella - Received two options for up to 8000 grafts  you can see them here 

https://i.imgur.com/TYiINh7.png

I have seen the opinions here and not keen to jump on any offer presented, but to take opinions from well known clinics as well and evaluate my standing.

I would like to receive your opinions about the offers and will update when more clinics reply

8 hours ago, davidn said:

This is a No No. Don't do it. I know how horrible it is but what you do have right now is a normal skin. Sure its hard to be the bald guy at 21, but whats harder is to (barring verteporfin :D) never have smooth skin again. People make this deal when the probability of shaving their head ever is low, but you have weak donor, extensive baldness and you don't respond to medication, and once you're cut you're cut, so shaving is out. And you will get a very glorified combover at best which will not look good in your 20s.

 

 

 

 

 

 

9 hours ago, SimpleLife said:

Bro go bald, take it from someone who did a HT at 23yrs, its not worth it, especially not in your scenario
 

In case you cant accept it, consider SMP (you have an olive skincolour so it will blend in perfectly), but accepting baldness is the best

 

12 hours ago, 1978matt said:

Fair enough but it looks and has similar properties and could be naturally low density.

Not Israel but Dr B isn't far away and seems like a good guy based on his results and postings here:

https://www.hairtransplantnetwork.com/dr-taleb-barghouthi

 

14 hours ago, NARMAK said:

I'll be perfectly honest, i'm probably not the greatest person to ask on that front because i haven't looking into that specific scenario of your hair type. 

I do not know exactly how you feel with your routine, but if you can switch to oral Dutasteride it will help block more DHT although you may very likely experience an additional shed initially changing to the new medication. However my concern also is that you're saying you're using topical Dutasteride on top of oral Finasteride presently and i don't know many people already on such an aggressive protocol still stating they lost ground. So that's why it's important to wait. If you get to 25 and the situation hasn't changed and got worse, but maybe even improved that's a positive sign but you still run the risk of shock loss, temporary or permanent is unknown. 

For now, use hair concealers as you have enough surrounding hair to achieve a visual look of coverage and keep up with the routine. 

I think the picture you posted with lighting directly on the scalp also probably made it look worse than say normal lighting which is also why people might be giving the responses above too so may be worth possibly having more diffused natural light pictures added too. 

 

14 hours ago, StillAlive said:

Man, it pains me to say it, but the consensus is right. Not responding to meds and that far gone at 21? 

The smartest play would be to just shave it and work out. You are still very young so it's not inconceivable that by the time you are 40, some 'miracle cure' will have hit the market. 

If you were to chase this right now, you'd spend thousands of euros/dollars and still look like a dude with thinning hair and bald spots. Even if you went for an ideal thick NW3 ultra-conservative hairline (think Jude Law) and accepted a thinner crown, do you really want to go to all that pain for people to still see a balding dude? 

If you really want the illusion of hair and a good frame for your face, I'd go with SMP. This way you'd restore your frontal hairline and temples and achieve that Michael Mando look which may suit you really well, particularly if you get jacked in the gym. Much more preferrable than having some strange patchy hair here and there. 

 

On 8/25/2022 at 12:11 AM, FixMyHair213 said:

I'm someone who's usually pretty optimistic but honestly this looks really bad. your pretty much destined for nw7, and it looks like the donor is thinning as well. I understand how hard it must be especially at such a young age but have you tried going bald. also the fact that finasteride is not stopping or at least slowing down the loss is not good. there are clinics that can probably get your hair back to a state in which there is decent coverage however you have to ask yourself is it worth the thousands and the fact is you will probably need multiple surgeries as you continue to lose hair. In my opinion going bald is the best thing to do in this case. your case couldve been acceptable if you were a lot older but at 21 its a very different story. have you visited a dermatologist and got everything checked out?

 

On 8/24/2022 at 10:40 PM, civic said:

From the photo it looks like there is still good amount of hair. Sorry to hear that meds don't work for you. Have you tried vitamims such as D3, zinc, biotin? Todays youth have more difficult life due to social media, dating apps etc.  this causes a huge amount of stress. I would strongly recomend all natural approach, & to try to stay away from instagram, tiktok, tinder etc.  Those apps are 50% cause of hair loss at the minimum -).

 

On 8/24/2022 at 7:44 PM, Melvin- Moderator said:

At 21, I’m afraid to say you’re probably destined to be a Norwood 7. The fact that you’re on strong medication and still losing hair, means you’re not the best candidate. Here’s the reality, you’re not going to be able to restore all your hair. 
 

At 41, this is usually acceptable. At 21, it’s not. So you have to ask yourself. Do you really want to invest thousands of dollars, time, and still look balding? If you’re okay with having some hair, but not all, then you may be a candidate. But if you’re looking to forget about baldness and live your 20s with hair. I have to say it’s not likely.