Is there any hope for me? I am confused and need help.

[Sherlockhomes]

I have had different surgeons offer very different opinions on my case and I’m wondering if anyone can shed a light on which part they took in a similar case. One surgeon said FUT would be the best solution for me given that I’m African. Another said that I should get on preventive medication and reevaluate in 12 months since I am “showing decline over a larger surface area and surgery now could even cause further shock loss”. A different surgeon suggested that my condition is beyond possible surgical restoration and suggested shaving my head and undergoing scalp micro-pigmentation. I’m very confused and would welcome any kind of direction. Thank you 

 

[TheGreatPretender]

You should listen to the doc who told you to get on Meds. You still have a lot of hair and could very easily maintain (even regrow) with Finasteride and Minoxidil.

I would start Finasteride and try it for a year, if not enough add Minoxidil. If at the end of the second year you are still unhappy then Id consider surgery.

Hair Loss is a commitement, you need to start fighting it early to maximize your chances for a good result and the drugs you take you need to be willing to commit to them for life.

[ITA]

I don't know much about afro hair, but your situation doesn't seem so tragic to me.

[Berba11]

Would be curious to know who the doctors were.

You've got diffuse thinning. Ideally you want to try and stabilise that with finasteride before plotting your next moves.

[A_4_Archan]

I think preventive measures will be best for you ..you should start medication 

[Sherlockhomes]

21 minutes ago, TheGreatPretender said:

You should listen to the doc who told you to get on Meds. You still have a lot of hair and could very easily maintain (even regrow) with Finasteride and Minoxidil.

I would start Finasteride and try it for a year, if not enough add Minoxidil. If at the end of the second year you are still unhappy then Id consider surgery.

Hair Loss is a commitement, you need to start fighting it early to maximize your chances for a good result and the drugs you take you need to be willing to commit to them for life.

Appreciate the response. I’ve been taking finasteride for almost 2yrs now. I am now considering getting oral minox as well. I was just confused at the varying opinions of the doctors. 

[Sherlockhomes]

23 minutes ago, ITA said:

I don't know much about afro hair, but your situation doesn't seem so tragic to me.

That’s great to hear. Thanks 

[Sherlockhomes]

4 minutes ago, A_4_Archan said:

I think preventive measures will be best for you ..you should start medication 

I’ve been on fin for almost 2yrs 

[TheGreatPretender]

Just now, Sherlockhomes said:

Appreciate the response. I’ve been taking finasteride for almost 2yrs now. I am now considering getting oral minox as well. I was just confused at the varying opinions of the doctors. 

Good call.

Oral Minox is certainly a solution and something you can easily try as its more potent then the topical version, obviously consult with a doctor. 

I kind of regret not starting it earlier but will as soon as I am done with my surgery. 

[Sherlockhomes]

13 minutes ago, Berba11 said:

Would be curious to know who the doctors were.

You've got diffuse thinning. Ideally you want to try and stabilise that with finasteride before plotting your next moves.

I’ve been on fin for almost 2yrs now. The doctors were in order, Siegel, Bisanga, and Rahal. 

[Berba11]

Just now, Sherlockhomes said:

I’ve been on fin for almost 2yrs now. The doctors were in order, Siegel, Bisanga, and Rahal. 

Ok that's good. Do you think your hair loss has stabilised? I don't know Siegel but the other two are great surgeons. I don't don't understand why you'd be told to get on meds if you already were for two years though. And the surgeon that said you're not a candidate... Did they explain why?

[Melvin- Admin]

Surgery at this point is very tricky. You still have a lot of hair that is thinning. It's risky. For your case, I think SMP is a better option. You could probably grow your hair out and do something like this:

 

The waves require a lot of density, but this style is much more forgiving. It gives a better illusion of density because afro hair blocks the light from the scalp as it gets longer. I guarantee no one would know that you're thinning with this style. 

[Z--]

you're in the early stages of diffuse thinning. See if you can take meds - it might get you solid regrowth.

[Rahal Hair Transplant]

@Sherlockhomes,

i’m not surprised to hear that you’ve had varying opinions on what can be done in your situation because the truth is, varying surgeons have varying degrees of experience and philosophies on how to handle hair restoration.

Now am I correct based on what you were saying that our clinic stated that surgical hair restoration isn’t something that would be a good fit for you?

I just want to say this generally speaking as I feel this is very important.

As forum members, we can certainly provide our opinion based on the information you are providing us with and do our best to help you. But nothing we say should or will replace a doctors evaluation. That said, I get it can be confusing when you get varying and conflicting opinions. Let me try to help you a little here.

I can’t speak for the other doctors, but when a doctor like Dr. Rahal evaluates a patient and needs to make a determination on what’s best for him for her, he takes in all of the information and considers all the variables (many of which are not presented here).

Some of the important ones include,

* donor area - what does your donor hair look like as I see photos of the recipient area but not the donor.  

* their age

* their current level of hair loss

* their inevitable hair loss pattern which Isn’t always predictable especially at young ages,

* their hair characteristics

* Family history of hair loss

AND… The below is one of the most important and most unaddressed topics on this forum in my opinion…

* a patient goals - this is a HUGE one because the truth is, many prospective patients will come in and after speaking with them, it’s clear that their goals far exceed what’s realistic in their case.  For example, The ops hair still looks pretty good and consists of a lot of density that many of us on this forum would probably do anything for.  BUT, the op has an advanced developing hair loss pattern that is only going to get worse especially without medication.  So let’s say for example that somebody with the ops hair loss is very upset about his current level of thinning and desperately wants to thicken up his hair even though it’s only mildly thinning at this point.  I personally would be inclined to think that surgical hair restoration may not be for him because there’s no way that he would be happy long-term with what can be provided realistically.  Now keep in mind I’m not making any assumptions about this particular poster, I am making a general statement to show why a particular individuals hair restoration goals are just not realistic and makes them not a good candidate for surgery.

So like I said, I’m not making any assumptions, I’m only stating generally speaking that there are many variables that need to be considered by the surgeon to determine the best course of action for them.  Sometimes, surgical hair restoration is not the best course of action  

Now… Without knowing any particular details and from a patient point of view, my inclination would be to suggest that the op consider non-surgical treatments such as finasteride and minoxidil (please consult a doctor before taking any prescription medication) as they may help to slow down, stop or even reverse some of the effects of male pattern baldness.

All that to say, I trust Dr. Rahal and his judgment and I say that not because I work for and with him but because I have informally worked with him in someway for over 15 years and I personally feel that he is one of the most skilled, ethical, passionate and dedicated surgeons and people I’ve ever met.  These are the reasons why I approached him about formally working with him in the first place.

I hope this helps.

Rahal Hair Transplant

 

Edited June 14, 2023 by Rahal Hair Transplant

[Sherlockhomes]

10 minutes ago, Rahal Hair Transplant said:

@Sherlockhomes,

i’m not surprised to hear that you’ve had varying opinions on what can be done in your situation because the truth is, varying surgeons have varying degrees of experience and philosophies on how to handle hair restoration.

Now am I correct based on what you were saying that our clinic stated that surgical hair restoration isn’t something that would be a good fit for you?

I just want to say this generally speaking as I feel this is very important.

As forum members, we can certainly provide our opinion based on the information you are providing us with and do our best to help you. But nothing we say should or will replace a doctors evaluation. That said, I get it can be confusing when you get varying and conflicting opinions. Let me try to help you a little here.

I can’t speak for the other doctors, but when a doctor like Dr. Rahal evaluates a patient and needs to make a determination on what’s best for him for her, he takes in all of the information and considers all the variables (many of which are not presented here).

Some of the important ones include,

* donor area - what does your donor hair look like as I see photos of the recipient area but not the donor.  

* their age

* their current level of hair loss

* their inevitable hair loss pattern which Isn’t always predictable especially at young ages,

* their hair characteristics

* Family history of hair loss

AND… The below is one of the most important and most unaddressed topics on this forum in my opinion…

* a patient goals - this is a HUGE one because the truth is, many prospective patients will come in and after speaking with them, it’s clear that their goals far exceed what’s realistic in their case.  For example, The ops hair still looks pretty good and consists of a lot of density that many of us on this forum would probably do anything for.  BUT, the op has an advanced developing hair loss pattern that is only going to get worse especially without medication.  So let’s say for example that somebody with the ops hair loss is very upset about his current level of thinning and desperately wants to thicken up his hair even though it’s only mildly thinning at this point.  I personally would be inclined to think that surgical hair restoration may not be for him because there’s no way that he would be happy long-term with what can be provided realistically.  Now keep in mind I’m not making any assumptions about this particular poster, I am making a general statement to show why a particular individuals hair restoration goals are just not realistic and makes them not a good candidate for surgery.

So like I said, I’m not making any assumptions, I’m only stating generally speaking that there are many variables that need to be considered by the surgeon to determine the best course of action for them.  Sometimes, surgical hair restoration is not the best course of action  

Now… Without knowing any particular details and from a patient point of view, my inclination would be to suggest that the op consider non-surgical treatments such as finasteride and minoxidil (please consult a doctor before taking any prescription medication) as they may help to slow down, stop or even reverse some of the effects of male pattern baldness.

All that to say, I trust Dr. Rahal and his judgment and I say that not because I work for and with him but because I have informally worked with him in someway for over 15 years and I personally feel that he is one of the most skilled, ethical, passionate and dedicated surgeons and people I’ve ever met.  These are the reasons why I approached him about formally working with him in the first place.

I hope this helps.

Rahal Hair Transplant

 

 

I appreciate the detailed reply and honesty from you and Dr Rahal, thank you. I have included some pictures to better illustrate why I was confused and created this post. The picture in the blue shirt is from November 2019, the black shirt is from September 2020. Both were pre finasteride, I started taking finasteride around august 2021. The pictures in the red plaid and black jacket are from April of this year. You can see that the frontal area grew in a bit better, and I thought I could use surgery to thicken it up and be fine as the back and top had stayed consistent. To then hear in the consultations opinions from her FUT to you’re already in an advanced stage of hair loss and surgery is not for you was very confusing to me. That’s also obviously why I’m not a doctor as I’m sure there are lots of details, beyond the ones you mentioned, that I might not have factored in. I just came out of the consultations confused and disillusioned. That’s what drove me to create this post. 

[Sherlockhomes]

23 hours ago, Melvin- Moderator said:

Surgery at this point is very tricky. You still have a lot of hair that is thinning. It's risky. For your case, I think SMP is a better option. You could probably grow your hair out and do something like this:

 

The waves require a lot of density, but this style is much more forgiving. It gives a better illusion of density because afro hair blocks the light from the scalp as it gets longer. I guarantee no one would know that you're thinning with this style. 

I have booked more consultations with dermatologists in my area. I’ll ask them about SMP and see what they say. I’d never heard of it till you mentioned it here. Would that prevent me from being able to get a HT in the future if eventually I’m deemed a good candidate. For reference this is my picture from April this year before I cut my hair last.