Just my luck - hair begins to thin 6 months out from HT

[HelpfulFriend]

Hey all,

Bit of background: I've been on Fin and Minox for about 6 years. Hair has held at baseline, hasn't moved since I started (which was great). 

As of about 7 months ago, my frontal lock started to thin. Where I've drawn in red, was normal and full last year.

I also get my hair checked every 6 months by a dermatologist, and she's confirmed it's thinning in these areas - and has compared them to previous photos.

I'm getting a HT in November, and now I'm just stressing that I've started another round of recession despite the meds.

Should I be worried about going ahead with the surgery? I don't want to postpone as I'm seeing a really good Dr with a long wait. Could really use that crystal ball right about now 

Edited September 28, 2022 by HelpfulFriend

[StillAlive]

Dude it is way way way too early for you to get an HT. 

Yes you have some temporal recession but the prudent approach would be to continue on meds until you are stable and THEN get an HT. Otherwise you are essentially booking your second one behind it to fill in the gaps. 

[MissMyLongHair]

Only after 6 years? Now I'm terrified for the future, even as a Dutasteride user. Can I ask how old you are?

[HelpfulFriend]

On 9/27/2022 at 7:16 PM, StillAlive said:

Dude it is way way way too early for you to get an HT. 

Yes you have some temporal recession but the prudent approach would be to continue on meds until you are stable and THEN get an HT. Otherwise you are essentially booking your second one behind it to fill in the gaps. 

Hey mate, thanks for the reply.

The pictures don't really show the extent. I've cut off a lot of my face, but the front and temples have both recessed quite a bit. I've sent full photos to conservative surgeons, and they've all said I'm NW 3. 

Apologies for the bad pics. I just wanted to highlight the thinning points.

I was stable for 6 years, now I'm not. So I don't know if I will ever be stable again. That's the part that is really making it hard for me.

Edited October 1, 2022 by HelpfulFriend

[HelpfulFriend]

3 hours ago, MissMyLongHair said:

Only after 6 years? Now I'm terrified for the future, even as a Dutasteride user. Can I ask how old you are?

I'm 31, 32 in a few months.

Yeah it sucks. At least with DUT you're on a much, much stronger med, so I wouldn't stress too much man. I might just be unlucky 

[Mike10]

you guys just need to do a lot more research. This was to be expected. Most men continue to lose ground with time despite of Propecia. And you hair looks totally fine at age 32. You do not need a HT.    

[HelpfulFriend]

On 9/28/2022 at 11:31 AM, Mike10 said:

you guys just need to do a lot more research. This was to be expected. Most men continue to lose ground with time despite of Propecia. And you hair looks totally fine at age 32. You do not need a HT.    

I get that there's a lot of people in my range, around my age. But I don't really want to spend my 30's being NW 3. I've been at this level since I was mid-20's, and would love to get back to even a NW 1 haha.

Conservative doctor's have said I am bordering on NW 3 and are happy to take me as a patient. 

Edited October 1, 2022 by HelpfulFriend

[HelpfulFriend]

For reference I've added a side profile picture - the others I took were unintentionally misleading

[Mike10]

47 minutes ago, HelpfulFriend said:

I get that there's a lot of people in my range, around my age. But I don't really want to spend my 30's being NW 3. I've been at this level since I was mid-20's, and would love to get back to even a NW 1 haha.

Conservative doctor's like Konior and Shapiro have said I am bordering on NW 3 and are happy to take me as a patient. 

they just want to see you in that chair.once you do it, you are committed for further HTs. Now, I do not see a NW3 in your case. I am 41 and have been estimated as a NW2 by several Top Drs. But you pics could be misleading. How many grafts did tehy estimate? 

[Gatsby]

It would be a huge mistake to have surgery. Medication for the past six years has held your hairline until recently. What has your dermatologist recommended? You could try tweaking the medication, etc.

[NARMAK]

Finasteride may have helped you alongside Minoxidil for 6 years, but if you are slipping, then it may either be time to switch up to Dutasteride a few times a week or the majority of the days to block more DHT. You will probably shed more hair thought initially so be warned. 

[Boomerang]

Personally I wouldn’t be going for HT if my hair were like yours. They look great in pics.

first step should be the steps to stabilise the recession. 
I would trace back my steps what has changed in last 6 months in terms of lifestyle, regularity of hairloss prevention protocols, etc 

then maybe add micro needling and dut once a week.

see for 3 months how you respond. There’s a good chance that you thinning hair will thicken up. 
 

Good luck!

[HelpfulFriend]

11 hours ago, Mike10 said:

they just want to see you in that chair.once you do it, you are committed for further HTs. Now, I do not see a NW3 in your case. I am 41 and have been estimated as a NW2 by several Top Drs. But you pics could be misleading. How many grafts did tehy estimate? 

You raise a good point. They were all very conservative, roughly 1000-1500 grafts.

[HelpfulFriend]

10 hours ago, Gatsby said:

It would be a huge mistake to have surgery. Medication for the past six years has held your hairline until recently. What has your dermatologist recommended? You could try tweaking the medication, etc.

Thanks Gatsby, I've always valued your input on these forums.

I do get that it's risky, I just really want a better hairline for my 30's. I'd love to experience life without a hat. The pics are a bit misleading, it looks more recessed with full photos.

My dermatologist offered to up my oral Minox dosage (I'm at 2.5), which I've declined. I don't want to go any higher. They've simply suggested a small FUE if I want to fill the corners in.

Do you think the risk vs reward just isn't there for a transplant?

Edited September 28, 2022 by HelpfulFriend

[HelpfulFriend]

6 hours ago, Boomerang said:

Personally I wouldn’t be going for HT if my hair were like yours. They look great in pics.

first step should be the steps to stabilise the recession. 
I would trace back my steps what has changed in last 6 months in terms of lifestyle, regularity of hairloss prevention protocols, etc 

then maybe add micro needling and dut once a week.

see for 3 months how you respond. There’s a good chance that you thinning hair will thicken up. 
 

Good luck!

Thanks Boomerang,

That's a good point. I can't really think of anything that has changed, but i have teased the idea of DUT recently.

[pkipling]

Not to be the lone dissenting voice, but I totally understand why you'd want to address this - and it doesn't seem that outlandish to me for you to do so. I understand the arguments on both sides, but the surgeons you've mentioned are quite reputable and don't strike me as the types to take you on if they felt it was unethical. There are sound arguments for why you should and should not get a procedure - and I don't think there's a definitive right answer in this case. The main point of concern for me would be if you're currently in the midst of ongoing significant hair loss? If that's the case, I do understand wanting to wait and see how this current phase ends up and where it eventually settles next. Have you addressed this with the surgeons you mentioned? Did they give the recommendation before or after the current hair loss progression? 

That said - here are a few of my thoughts/arguments as to why it doesn't otherwise seem crazy to me for you to want to move forward with this:

Yes, your hair looks great and there are many men who would be thrilled to have hair like yours and wouldn't want to risk messing with it. But just because other people have it worse doesn't mean your situation isn't worth addressing if it's important to you... And given that they're recommending a very conservative approach paints a different picture here, it adds to why I don't think it would necessarily be a horrible decision for you. 

You're also not that young - and getting a hair transplant at 32 isn't the same as getting one at 22. 

Hair loss is progressive and even with medication, it may never stop completely. So just because it hasn't stabilized 100% forever doesn't mean that you're on track to be a NW6. 

As for setting yourself up for potentially needing more procedures in the future, I think that's a general rule for every single person getting/considering a hair transplant. We should all expect to need at least one followup procedure in the future. It's great if that doesn't turn out to be the case, but also shouldn't be a surprise when/if that happens. 

[Boomerang]

9 hours ago, HelpfulFriend said:

Thanks Boomerang,

That's a good point. I can't really think of anything that has changed, but i have teased the idea of DUT recently.

There was a topic on this platform couple of months ago ‘does Dut nuke hairline’ , I think that was the topic. Might be helpful.

I don’t take Dut but NARMAK can give you some advise on that.

I know micro needling does wonders for hairline, might want to try that one a week.

👍🏼

[John1991]

4 hours ago, pkipling said:

Not to be the lone dissenting voice, but I totally understand why you'd want to address this - and it doesn't seem that outlandish to me for you to do so. I understand the arguments on both sides, but the surgeons you've mentioned are quite reputable and don't strike me as the types to take you on if they felt it was unethical. There are sound arguments for why you should and should not get a procedure - and I don't think there's a definitive right answer in this case. The main point of concern for me would be if you're currently in the midst of ongoing significant hair loss? If that's the case, I do understand wanting to wait and see how this current phase ends up and where it eventually settles next. Have you addressed this with the surgeons you mentioned? Did they give the recommendation before or after the current hair loss progression? 

That said - here are a few of my thoughts/arguments as to why it doesn't otherwise seem crazy to me for you to want to move forward with this:

Yes, your hair looks great and there are many men who would be thrilled to have hair like yours and wouldn't want to risk messing with it. But just because other people have it worse doesn't mean your situation isn't worth addressing if it's important to you... And given that they're recommending a very conservative approach paints a different picture here, it adds to why I don't think it would necessarily be a horrible decision for you. 

You're also not that young - and getting a hair transplant at 32 isn't the same as getting one at 22. 

Hair loss is progressive and even with medication, it may never stop completely. So just because it hasn't stabilized 100% forever doesn't mean that you're on track to be a NW6. 

As for setting yourself up for potentially needing more procedures in the future, I think that's a general rule for every single person getting/considering a hair transplant. We should all expect to need at least one followup procedure in the future. It's great if that doesn't turn out to be the case, but also shouldn't be a surprise when/if that happens. 

This.  Dude, just because it's slowly happening doesn't mean it's a huge problem or something that would make a transplant unwise.  I do think just "filling in the temples" isn't enough, though.  You need to have the doc shave the entire frontal hairline area and reinforce behind your new hairline.  It should be more like 2500-3000 grafts I'd imagine.  Not 1000.  Honestly, those pictures look like the hairline of a normal guy who has the level of recession you have.  Many on this message board are insanely paranoid and fanatically obsessive about the slightest imperfections.  Don't do that to yourself.  

Edited September 29, 2022 by John1991

[Gatsby]

9 hours ago, HelpfulFriend said:

Thanks Gatsby, I've always valued your input on these forums.

I do get that it's risky, I just really want a better hairline for my 30's. I'd love to experience life without a hat. The pics are a bit misleading, it looks more recessed with full photos.

My dermatologist offered to up my oral Minox dosage (I'm at 2.5), which I've declined. I don't want to go any higher. They've simply suggested a small FUE if I want to fill the corners in.

Do you think the risk vs reward just isn't there for a transplant?

I think at this stage yes.

[GoliGoliGoli]

43 minutes ago, John1991 said:

This.  Dude, just because it's slowly happening doesn't mean it's a huge problem or something that would make a transplant unwise.  I do think just "filling in the temples" isn't enough, though.  You need to have the doc shave the entire frontal hairline area and reinforce behind your new hairline.  It should be more like 2500-3000 grafts I'd imagine.  Not 1000.  Honestly, those pictures look like the hairline of a normal guy who has the level of recession you have.  Many on this message board are insanely paranoid and fanatically obsessive about the slightest imperfections.  Don't do that to yourself.  

Uh what? Their is no need for him to do anything besides fill in the corners. You're suggesting some randomly over-aggressive path forward for no reason 

[HelpfulFriend]

5 hours ago, pkipling said:

Not to be the lone dissenting voice, but I totally understand why you'd want to address this - and it doesn't seem that outlandish to me for you to do so. I understand the arguments on both sides, but the surgeons you've mentioned are quite reputable and don't strike me as the types to take you on if they felt it was unethical. There are sound arguments for why you should and should not get a procedure - and I don't think there's a definitive right answer in this case. The main point of concern for me would be if you're currently in the midst of ongoing significant hair loss? If that's the case, I do understand wanting to wait and see how this current phase ends up and where it eventually settles next. Have you addressed this with the surgeons you mentioned? Did they give the recommendation before or after the current hair loss progression? 

That said - here are a few of my thoughts/arguments as to why it doesn't otherwise seem crazy to me for you to want to move forward with this:

Yes, your hair looks great and there are many men who would be thrilled to have hair like yours and wouldn't want to risk messing with it. But just because other people have it worse doesn't mean your situation isn't worth addressing if it's important to you... And given that they're recommending a very conservative approach paints a different picture here, it adds to why I don't think it would necessarily be a horrible decision for you. 

You're also not that young - and getting a hair transplant at 32 isn't the same as getting one at 22. 

Hair loss is progressive and even with medication, it may never stop completely. So just because it hasn't stabilized 100% forever doesn't mean that you're on track to be a NW6. 

As for setting yourself up for potentially needing more procedures in the future, I think that's a general rule for every single person getting/considering a hair transplant. We should all expect to need at least one followup procedure in the future. It's great if that doesn't turn out to be the case, but also shouldn't be a surprise when/if that happens. 

Thanks a lot for this message.

You've eloquently explained exactly where my head is at - if I had written something like this for the jump, it would have been a lot clearer.

The main point of concern for me would be if you're currently in the midst of ongoing significant hair loss? - this is the crux of the issue. Will I get a HT, then continue to lose ground? Or, will this HT serve me for many years to come, and meds will keep me somewhat stable. I've asked surgeons, and they've said it's very hard to tell, and that they do have patients who are currently thinning come into their practice. 

I've been at this NW pattern for years, mixing with all my friends who are all NW 1, wearing hats, shunning from formal events, and so on. Maybe it is in my head, to an extent, but I'd just love to experience my 30's without stressing about hair. I feel as though if people saw me in person, hair pulled back, they wouldn't so readily be happy with how my hair looks. As mentioned, conservative doctors had no hesitation in suggesting a procedure.

I guess it's about a risk vs reward, am I willing to risk a bigger problem down the road for the procedure.

Thanks again for the message.

[HelpfulFriend]

Hi @Rahal Hair Transplant hope you don't mind me tagging you. I was just wondering if you had a preliminary assessment for my case? I.e. whether you'd recommend surgery, and whether your team performs surgery on those who have current thinning?

I only ask as I've seen lots of valuable input you have across the forum, and you've helped me out on many posts.

Thanks in advance 

Edited September 29, 2022 by HelpfulFriend

[Mike10]

On 9/28/2022 at 4:14 PM, HelpfulFriend said:

You raise a good point. They were all very conservative, roughly 1000-1500 grafts.

that is what I thought.No way, you’re NW3 with that small grafts account, even if you go conservative. As I said, they just want to see you in that chair.

[Mike10]

14 hours ago, HelpfulFriend said:

Thanks a lot for this message.

You've eloquently explained exactly where my head is at - if I had written something like this for the jump, it would have been a lot clearer.

The main point of concern for me would be if you're currently in the midst of ongoing significant hair loss? - this is the crux of the issue. Will I get a HT, then continue to lose ground? Or, will this HT serve me for many years to come, and meds will keep me somewhat stable. I've asked surgeons, and they've said it's very hard to tell, and that they do have patients who are currently thinning come into their practice. 

I've been at this NW pattern for years, mixing with all my friends who are all NW 1, wearing hats, shunning from formal events, and so on. Maybe it is in my head, to an extent, but I'd just love to experience my 30's without stressing about hair. I feel as though if people saw me in person, hair pulled back, they wouldn't so readily be happy with how my hair looks. As mentioned, conservative doctors had no hesitation in suggesting a procedure.

I guess it's about a risk vs reward, am I willing to risk a bigger problem down the road for the procedure.

Thanks again for the message.

You do corner recession work, sooner or later you will look like a fool when you will loose hair behind the transplanted area. That is is inevitably.You get to be prepared for the long run and your appearance will still matter to you in your 40s. Haïr loss is pogressive throughout your life.

Girls do not care whether you are NW1 or NW2, trust me on that

Edited September 29, 2022 by Mike10

[GoliGoliGoli]

29 minutes ago, Mike10 said:

You do corner recession work, sooner or later you will look like a fool when you will loose hair behind the transplanted area. That is is inevitably.You get to be prepared for the long run and your appearance will still matter to you in your 40s. Haïr loss is pogressive throughout your life.

Girls do not care whether you are NW1 or NW2, trust me on that

People on this forum love making definitive proclamations about what will or wont happen in a given situation, and love to toss around terms like "inevitable". Hair loss is specific to each individuals genetics. My grandpa was Norwood 3 at 31, and Norwood 3 at 52 (Have pictures to prove it). This was obviously way before Fin or Min was on the market. Some people stabilize naturally. 

This guy is on Fin and has fairly unaggressiveness hair loss. Say he gets the corners done and he does continue to recede behind the corners, he can always go in for a touch up procedure. Hair loss happens slowly, it's not like all of a sudden he's going to wake up and everything behind the corners will be gone. 

 

Edit: With that said, I'm also not advocating he get a HT either. The risk/reward profile is heavy on the risk side in his case given that his loss is minimal. I also agree that girls don't really care about the difference between NW1 and NW2. But I just think overall the advice Mike10 is giving is overly general. 

Edited September 29, 2022 by GoliGoliGoli