Thoughts on my situation?

[JayLDD]

33 minutes ago, Rafael Manelli said:

You've got some good points but I beg to differ on the matter that I've seen plenty of guys who bald at the crown first. In other words, they develop a big bald spot before the hairline recedes. Ergo, a strong front with a bald crown can look natural, as it occurs in nature. It looks natural but it doesn't look particularly good. Obviously. None of us think balding looks particularly good otherwise we wouldn't be here. 

 

I've seen a thinning and even heavily thinning crown before with a NW1, but I've never seen a clean "bald" crown with a dense NW1. Also transplants in the hairline at a NW1 need to have high and uniform density to appear natural, if you're heavily balding in the crown this isn't going to be the case on a natural hairline. 

Again I don't totally disagree with you but it truly comes down to money, expectations and risk management/planning. If the money or the planning for potential risks isn't there then its a bad idea, period. 

If I was in his position I would get the surgery, but I'm reasonably comfortable financially and could have afforded 3-4 transplants with good doctors if I absolutely had to over a 10 year period. 

[Mat16]

4 hours ago, JayLDD said:

If he has an endless budget, I would certainly agree. 

If he's a regular person being on the hook for a surgery with a high level surgeon every 2-3 years at 24 years this isn't particularly realistic. 

There's risk of a poor result too which would further the requirement of chasing losses. You should always have money for both the procedure AND a backup in my opinion, higher order for someone at his age. 

A "great hairline" with a bald crown doesn't work. No one has a black hole at the back with a dense NW1 hairline. If he goes for a high density NW1 for it to appear natural he will have to at least provide thin but relatively complete coverage in the midscalp and crown. Certainly the midscalp as well.

I think your techo-optimism is doing a lot of heavy lifting. But again, if he has the money (his parents happy to shell out 50k no questions asked for example) I would personally go for it. 

Currently the science in this area is an embarrassment when it comes to the future, the only promising treatments involve essentially cloning grafts and transplanting them. Which of course would be wildly expensive. Same goes for any wildcards that arrive, even if they eventually exist you have no idea whether or not they'll be affordable. 

Well I am not really in a situation where I could evaluate how I will manage financially in the future. I’m sure though that the first round would be very fine. I have got some quotes from some surgeons before and it was around 3000-3500€. And they were recommended surgeons on this forum. But the idea to have a better hairline (I’m not saying I want classic Norwood 1, I just want to strengthen my current one, not necessary lower it) is really appealing to me.

[Mat16]

18 hours ago, Rafael Manelli said:

You're a Norwood 2 with receded temple points. Your hair looks straight and fine. You're receding young, and it might be aggressive. Finasteride has been ruled out. 

None of these are good signs. 

Diagnosis complete. That'll be $99 thanks. Jk

Try topical dutasteride. It might restore those shrinkers at the front. 

People telling you to wait until some arbitrary age to get an HT are just regurgitating what they've heard, to be honest. It's not that they're wrong, strictly speaking, but it's not a bit lazy in terms of advice. 

What's the point of waiting? So you can see how bad it'll get in ten years? It could still get worse even in 20 years. And if you wait to become a Norwood 5 and then get 5000 grafts, how is that any different from getting 5000 grafts now and then eventually becoming nw5 (but with transplants)? It's the same end result but you don't have to deal with many years of highly visible baldness if you get the transplant upfront. This isn't the advice most people will give you but take it or leave it. 

Your hair is falling out. It will continue to fall out without DHT meds. Topical finasteride or dutasteride is your best bet. Personally I'd suggest dut. It's stronger and apparently less systemic, so fewer sides. 

Your hair still looks pretty good. But I understand wanting back a wicked Norwood 1. You could get it, you know. It could be done. If you keep your hair that short, you probably want a fue rather than a fut. If you lock yourself into a Norwood 1 hairline, you're going to have to risk the possibility you'll need to keep getting surgeries to recoup any further loss you experience, and eventually you may run out of grafts have to settle for a bald crown. 

My opinion is it's worth settling for a bald crown in ten or twenty years, while maintaining a great hairline until then and after. I'd rather have that, than tolerate balding for ten years, only to restore a modest nw3 hairline and dense crown afterwards. But that's just me. 

Personally I'm a techno optimist. I'd be surprised if any of this matters in twenty years. Better/more solutions will be available. People will say don't rely on future technology, but that's just me. 

If all else fails you can just get a prosthesis. 

Also I would like to ask, if there is a typical regimen regarding topical dut. I am curious if it is alright to use it for example just once/twice or three times a week and not everyday.

[Rafael Manelli]

1 minute ago, Mat16 said:

Also I would like to ask, if there is a typical regimen regarding topical dut. I am curious if it is alright to use it for example just once/twice or three times a week and not everyday.

I don't know. 

Dutasteride has a much, much, much longer half life than fin. It stays in your system a lot longer. So I believe many people just take it once a week. But don't quote me on that. 

[JayLDD]

21 hours ago, Mat16 said:

Well I am not really in a situation where I could evaluate how I will manage financially in the future. I’m sure though that the first round would be very fine. I have got some quotes from some surgeons before and it was around 3000-3500€. And they were recommended surgeons on this forum. But the idea to have a better hairline (I’m not saying I want classic Norwood 1, I just want to strengthen my current one, not necessary lower it) is really appealing to me.

Simply put there’s no “strengthening” a hairline when you’re not on Finasteride if you don’t have money to chase losses. You require broad areas of coverage so you can comfortably hide further losses as you lose more hair.

A small surgery to strengthen what you have is a huge waste of time and puts you on the hook for more surgery. You’ll have a small band of resistant transplanted hair and everything behind it will disappear. Stupid idea and doctors shouldn’t even entertain it. 

With the amount of money you just described I wouldn’t get surgery for at least 3-5 years in your position. Wait until you have broad losses and then go for procedures that create broad coverage with 3-5000 grafts as your losses go further into NW3+. 

 

 

[Mat16]

22 hours ago, JayLDD said:

Simply put there’s no “strengthening” a hairline when you’re not on Finasteride if you don’t have money to chase losses. You require broad areas of coverage so you can comfortably hide further losses as you lose more hair.

A small surgery to strengthen what you have is a huge waste of time and puts you on the hook for more surgery. You’ll have a small band of resistant transplanted hair and everything behind it will disappear. Stupid idea and doctors shouldn’t even entertain it. 

With the amount of money you just described I wouldn’t get surgery for at least 3-5 years in your position. Wait until you have broad losses and then go for procedures that create broad coverage with 3-5000 grafts as your losses go further into NW3+. 

 

 

I will try to acquire topical dutasteride and try that out for a while. That’s kind of my last hope so I really wish it’ll work for me so I can jump into the operating chair asap 😀

[JayLDD]

9 hours ago, Mat16 said:

I will try to acquire topical dutasteride and try that out for a while. That’s kind of my last hope so I really wish it’ll work for me so I can jump into the operating chair asap 😀

Topical dut or fin definitely seems the best option to try for now.