40yo male, just starting research...

[MrAight]

Hello all! I'm a male, age 40, experiencing thinning (coverage density), general individual follicle health decline (mix of fat & healthy/many strands, and few & thin strands), and slight receding hairline. Hairline and a half-oval area back a few inches are very thin, with rest of top & vertex still thin but less so.  Sides and back, generally healthy and not experiencing any of those issues above.

Photos attached.

This thinking has been gradually ongoing since my early 20s, from "barely noticeable to most people, except myself" to:  I'm very self conscious, have got handfuls of comments over the years, and every day I must deliberately style my hair ONE WAY in order to cover and feel comfortable about my thinning.

 

TREATMENT HISTORY:

I feel dumb for never sooner trying to nip this in the bud. So here I am, 40 and finally taking action.

About 7-isg years ago, I did try an "iRestore" laser light helmet, for about 9 months and 4-6 sessions per week, which had no perceptible effect so I stopped.

I began oral Viviscal pills nearly 1 year ago, and only took them for about 6 to 8 months (hard to remember for sure). Long story short, I ceased taking them after those 6 to 8 months, for side reasons not directly related to their performance or lack thereof. During that time and towards the end of taking them, I did not think I noticed any positive improvements. However, since stopping for a few months, I feel like I possibly had experienced a subtle improvement with hair health and "feeling", and less effort & stress while styling it, that has now reverted. I have just re-ordered my Viviscal subscription.

I recently ordered "hims" shampoo & conditioner, and also:

"Hims" topical minoxidil & finesteride mixture. Awaiting their arrival.

 

PROFESSIONAL TREATMENT:

Just visited "Maxim Hair Restoration" in Virginia for a consultation. Felt slightly rushed, but long story short, not judging them on that alone due to tangent circumstances.

I had done research on FUT, FUE, etc, and indicated I was leaning toward FUE due to less scarring, and probably more natural looking implants(?).  With FUE, they advised they could get probably ~2,200 grafts (to be safe & conservative with donor areas), that would implant into my "hairline", and then advised stem cell and/or PDO for the rest of my scalp & vertex & crown area.

This made it seem that the ~2,200 grafts would only go toward my "hairline" area and shortly back into my scalp/top, and nothing on mid scalp & crown/vertex.

I did get the name of their surgeon who would be performing the work, and will try to research today (Josh Simpson PA-C).

 

QUESTIONS:

1) Does that potential donor count sound accurate or fair, for this procedure, and considering my photos?

2) Does the implant target area & plan sound "good" & reasonable? (Hairline implants, then stem cell and or PDO over scalp & vertex).

3) At my age (40) and considering my photos:  does it seem "worth it" to first give a year or 2, to trying my above detailed plan of oral Viviscal plus Hims treatment with minoxidil & finesteride and hair care products, and to actually expect significant improvements?  Before considering FUE or FUT?

4) Opinions on FUT vs, or in conjunction with, FUE?

5) Opinions on "PDO" for hair restoration? This seems relatively new, and I'm having trouble researching.

6) Opinions on stem cells for hair restoration?

7) I am tempted, inclined, to first try nonsurgical PDO, and/or stem cells, in conjunction with my personal Viviscal & Hims plan described above. Thoughts?

And generally, I would love and appreciate any and all general responses and advice based on my photos and post!

Thanks all!

[BackFromTheBrink]

Your loss looks headed towards where I was before surgery (NW5).

My advice would be to consider getting on finesteride immediately and seeing how you respond over 6-12 months.

Id say the graft count they quoted is conservative, but probably sensible; using 2k for frontal third is likely to give good density and the best use of those grafts for an aesthetic improvement.

In terms of overall doner capacity, they'll know better than us, having examined your hair, but you would hope more would be available for a second surgery later. How you respond to finesteride will also contribute to the health of your existing hair, ans number of grafts usable.

[PizzaWolf]

The "surgeon" is a physician's assistant. That should tell you all you need to know about this clinic.

Edited January 21, 2023 by PizzaWolf

[BackFromTheBrink]

Should also say, your donor area does look relatively thin, especially on the sides. It may be they considered taking from the back of the head mainly to avoid over harvesting, and thus reducing the available follicular units.

Edited January 21, 2023 by BackFromTheBrink

[MrAight]

14 minutes ago, PizzaWolf said:

The "surgeon" is a physician's assistant. That should tell you all you need to know about this clinic. Please continue researching before getting a hair transplant. The fact that you are even considering this place is proof that you aren't even close to ready.

I appreciate your reply, thought maybe not the exact "tone" of that last sentence. 😅. Because, that place was literally the first and only that I've been to, for a consultation or any type of recon -- I already am researching, and found this place, and am reaching out here, instead of rushing in to anything!

 

I was already wary of them, because I had to ask 3 separate times in follow up emails (amongst other things) for the specific operating surgeon's name.  I wasn't going to rush into this totally bind! And do appreciate your advice.

 

All that said, I WAS interested in the non-surgical treatments I learned from them, and was specifically curious about "PDO" and stem cells (non surgical micrograft, they call it).  While more LIKELY to consider them for NON SURGICAL treatment, I'd still be wary of them and was interested in ANY feedback anyone has on those.

And not to sound like a jerk potentially, but it could be helpful to get any specific advice YOU might have instead of just glibly "you're not ready" -- I AM here and asking questions, and thinking, and posing hypothetical plans.  I AM NOT rushing in to anything.

Thanks!

[MrAight]

37 minutes ago, BackFromTheBrink said:

Your loss looks headed towards where I was before surgery (NW5).

My advice would be to consider getting on finesteride immediately and seeing how you respond over 6-12 months.

Id say the graft count they quoted is conservative, but probably sensible; using 2k for frontal third is likely to give good density and the best use of those grafts for an aesthetic improvement.

In terms of overall doner capacity, they'll know better than us, having examined your hair, but you would hope more would be available for a second surgery later. How you respond to finesteride will also contribute to the health of your existing hair, ans number of grafts usable.

Thank you for all this!  I definitely had been leaning toward the non surgical self-care plans I detailed, and waiting on any surgery stuff.  And like I replied to the other guy here, I was already getting turned off from this particular "Maxim" place for surgical procedures.

 

Mind if I ask, how are you doing with your hair situation?  What's your general story and progress?

[BackFromTheBrink]

8 minutes ago, MrAight said:

Thank you for all this!  I definitely had been leaning toward the non surgical self-care plans I detailed, and waiting on any surgery stuff.  And like I replied to the other guy here, I was already getting turned off from this particular "Maxim" place for surgical procedures.

 

Mind if I ask, how are you doing with your hair situation?  What's your general story and progress?

I'm doing ok - if you look at my profile you'll be able to see pictures of my hair from yesterday.

I would say that the non surgery options are good to consider first. However, hair vitamins and the like are (in my opinion) not likely to lead to any significant improvement. The only FDA approved treatments are minoxidyl and finesteride. Worth researching them both.

 

Best of luck with your journey and research.

[PizzaWolf]

I edited my post because it did sound glib. You really should disregard anything this clinic told you and start fresh with your research, though. It's a money grab.

There's no direct photo of the back if your head, so it's difficult to gauge the exact state of your donor.