When is it too early for a transplant?

[xcactus]

I've been struggling with my temples/front hairline despite taking finasteride, daily use of minoxidil and biweekly dermapen usage. I'm not sure what more I can do to fill in my temples. The hairs along the front of my hairline seem to be getting lighter/thinner as well as those in the temple.

At what point should I start considering exploring transplant options? I'm 32 so I'm guessing things will only get worse.

Here's how it looks today:

 

For comparison, here's how it looked in 2017:

[Big Rome]

you have great hair!! You, in my humble opinion, don’t need a hair transplant.  if Fin is losing its power you could try Dutasteride? 

[TheGreatPretender]

No need for a transplant. If Finasteride isn't enough to hold ground switch to dutasteride. Transplants aren't the cure Saddly and it's always best to get it stable before even considering the thought of surgery. 

[A_4_Archan]

I would agree with what the earlier posters advised you....you don't need a HT at the moment ...keep on medication...consult a good surgeon and see if you need to alter your dosage or drug intake....and remember if you are able to just stabilise your hairloss or slow it down to some extent than its a win...if your hairline recedes further more in future than you can do it after 2/3 years...

[ScottishGuy21]

Steer clear of a transplant and exhaust meds first , the risks in your case far outweighs the benefit.
 

Your hair is still excellent. Yes in your mind you may feel a tad worried having experienced some recession but it still looks natural. 

[Rahal Hair Transplant]

@xcactus,

I totally understand being concerned about your temples.

When I was 21, I first started losing my hair and started developing the smallest thinning/balding spot in the crown and I was mortified.  I did just about everything I could to fill in the area with my real hair. When minoxidil didn’t seem to be working, I tried every lotion and potion in the book and my hair only started getting worse.

Maybe if I had done proper research when I was 21, I would have tried finasteride early and it may have helped me keep my existing hair (or at least show down my hair loss) but I doubt it would have brought every bit of hair back that I wanted.

Why? Because I was young and didn’t understand what could realistically be achieved versus what I desperately wanted.

Had I found a hair transplant doctor back then that was willing to fill in that small area, I would have been ecstatic at the time but long-term, I would have been mortified because it would have been totally inappropriate and unethical for a doctor to touch my scalp at that early stage.

Long story short, hair transplant surgery is not something you should be considering at this point.

I understand how bad you want your temples back right now but this is likely an early sign of a more progressive condition a.k.a. androgenetic alopecia that will likely bring a lot more thinning and hair loss over the years.

Hair transplant surgery is not a miracle cure and is limited in what it can achieve.

Moreover, an ethical surgeon will look at a prospective patient through the hourglass of time and do what’s best for them over the long term.

Since the degree of hair loss cannot be predicted especially at early ages, hair restoration physicians and representatives alike should really be suggesting that young hair loss sufferers talk to a doctor about proven non-surgical solutions such as finasteride and minoxidil.

To date, these are still the most effective non-surgical solutions and while they will likely not grow your hair back in your temples, they might help slow down the progression of hair loss to come if you start taking it at an early age and continue with it.

I hope this helps.

Rahal Hair Transplant

[SeanT1]

I wish I had your hairline!

How is your crown area? Is this balding?

[xcactus]

10 hours ago, Big Rome said:

you have great hair!! You, in my humble opinion, don’t need a hair transplant.  if Fin is losing its power you could try Dutasteride? 

Thank you - I'll look into dutasteride. I'm a little concerned by the potential side effects. Thankfully I have not experienced any with fin.

10 hours ago, TheGreatPretender said:

No need for a transplant. If Finasteride isn't enough to hold ground switch to dutasteride. Transplants aren't the cure Saddly and it's always best to get it stable before even considering the thought of surgery. 

That's what others have suggested. I might have to ask my dermatologist if she thinks that's a good switch to make. I've been on fin for about 4 years now and haven't had any issues, but I worry it might be losing its effectiveness. 

7 hours ago, A_4_Archan said:

I would agree with what the earlier posters advised you....you don't need a HT at the moment ...keep on medication...consult a good surgeon and see if you need to alter your dosage or drug intake....and remember if you are able to just stabilise your hairloss or slow it down to some extent than its a win...if your hairline recedes further more in future than you can do it after 2/3 years...

Yeah, this would definitely be something a little farther down the road. I just like to have a plan in place.

6 hours ago, ScottishGuy21 said:

Steer clear of a transplant and exhaust meds first , the risks in your case far outweighs the benefit.
 

Your hair is still excellent. Yes in your mind you may feel a tad worried having experienced some recession but it still looks natural. 

Thanks, it just seems like things have gotten worse in the last couple of months. I've never noticed miniaturization along the front of my hairline, but I've been more focused on the temples in the past.

5 hours ago, Rahal Hair Transplant said:

@xcactus,

I totally understand being concerned about your temples.

When I was 21, I first started losing my hair and started developing the smallest thinning/balding spot in the crown and I was mortified.  I did just about everything I could to fill in the area with my real hair. When minoxidil didn’t seem to be working, I tried every lotion and potion in the book and my hair only started getting worse.

Maybe if I had done proper research when I was 21, I would have tried finasteride early and it may have helped me keep my existing hair (or at least show down my hair loss) but I doubt it would have brought every bit of hair back that I wanted.

Why? Because I was young and didn’t understand what could realistically be achieved versus what I desperately wanted.

Had I found a hair transplant doctor back then that was willing to fill in that small area, I would have been ecstatic at the time but long-term, I would have been mortified because it would have been totally inappropriate and unethical for a doctor to touch my scalp at that early stage.

Long story short, hair transplant surgery is not something you should be considering at this point.

I understand how bad you want your temples back right now but this is likely an early sign of a more progressive condition a.k.a. androgenetic alopecia that will likely bring a lot more thinning and hair loss over the years.

Hair transplant surgery is not a miracle cure and is limited in what it can achieve.

Moreover, an ethical surgeon will look at a prospective patient through the hourglass of time and do what’s best for them over the long term.

Since the degree of hair loss cannot be predicted especially at early ages, hair restoration physicians and representatives alike should really be suggesting that young hair loss sufferers talk to a doctor about proven non-surgical solutions such as finasteride and minoxidil.

To date, these are still the most effective non-surgical solutions and while they will likely not grow your hair back in your temples, they might help slow down the progression of hair loss to come if you start taking it at an early age and continue with it.

I hope this helps.

Rahal Hair Transplant

Thanks for your response. I don't think it's something I'd do in the immediate future. But I'm a planner at heart, so I like to have a plan in place. I just don't want it to get past the point of a HT not being viable.

2 hours ago, SeanToman said:

I wish I had your hairline!

How is your crown area? Is this balding?

I'm not sure (see below) - I can never tell if this is a natural hair whorl or thinning. But it hasn't changed much since I started fin. I still apply minoxidil to it every day.

[SeanT1]

Oh your crown is fantastic, bravo.

Finasteride works wonders for holding onto existing hair. 

[MildSeven]

Your Hairline is still same as 2017 man

finasteride keeps your hair intact... no need HT now

 

 

NB: im asking your Permission To Share your pic to my fellow balding community, wanna let them know the importance of finasteride to Keep Existing hair

Edited June 20, 2023 by MildSeven

[xcactus]

On 6/19/2023 at 1:11 PM, SeanToman said:

Oh your crown is fantastic, bravo.

Finasteride works wonders for holding onto existing hair. 

Thanks. Hopefully it keeps working. I’ve heard its efficacy decreases over time but I’m not sure if that’s research-backed.

8 hours ago, MildSeven said:

Your Hairline is still same as 2017 man

finasteride keeps your hair intact... no need HT now

 

 

NB: im asking your Permission To Share your pic to my fellow balding community, wanna let them know the importance of finasteride to Keep Existing hair

Yes that is fine.

[MildSeven]

1 hour ago, xcactus said:

Thanks. Hopefully it keeps working. I’ve heard its efficacy decreases over time but I’m not sure if that’s research-backed.

The Efficacy from medication itself does not decrease overtime

BUT, Our Follicle More Sensitive to DHT overtime, so the "leaked" dht to our follicle is going to harm our follicle which used to still harmles (safe)...

 

example: lets say our DHT is 100, with finasteride it's going down to 30 (blocked 70%) , the 30 is leaking to our follicle but our follice still "okay" with the small amount (30) presence DHT

but if we were unlucky, our follicle more prone to DHT overtime,  they are become hampered by The Presence of small (30) DHT

thats why the "unlucky ones" need a stronger DHT blocker, such as Dutasteride which Block 90% DHT, the 10 Will Leak to follicle..

Hopes we're not the unlucky ones

Edited June 20, 2023 by MildSeven

[MildSeven]

@xcactus After i Reviewd one more time, Your Hairline is Better in 2023 compared to 2017, its more solid now.. good job bro

im envy you 😹, we are at same age, my hairline was worse than yours, and im regret coz not to take finasteride earlier...

Edited June 20, 2023 by MildSeven

[consequence]

The longer you can hold off, the better surgical technique and medical support gets. I would switch to dutasteride and oral minoxidil, add on ketoconazole and wait another 10 years if I were you.

[Gatsby]

I think, if anything, you could consider dutasteride (but I would go to a good dermatologist to discuss this). However for your age I think the medication is holding your hair well. If you were to lower your hairline you run the risk that it may not match your current hairline in terms of blending and naturalness. I think your hair looks great!

[Turkhair]

You have BDD and zero loss. I would dare say you’re medicating unnecessarily and never had MPB if 2017 pictures is what made you start medicating. 

[RobertoDeNiro]

Just go for some medication. Hold on as much as possible to the HT path, you do not need it at all.

 

[xcactus]

On 6/20/2023 at 2:44 PM, MildSeven said:

The Efficacy from medication itself does not decrease overtime

BUT, Our Follicle More Sensitive to DHT overtime, so the "leaked" dht to our follicle is going to harm our follicle which used to still harmles (safe)...

 

example: lets say our DHT is 100, with finasteride it's going down to 30 (blocked 70%) , the 30 is leaking to our follicle but our follice still "okay" with the small amount (30) presence DHT

but if we were unlucky, our follicle more prone to DHT overtime,  they are become hampered by The Presence of small (30) DHT

thats why the "unlucky ones" need a stronger DHT blocker, such as Dutasteride which Block 90% DHT, the 10 Will Leak to follicle..

Hopes we're not the unlucky ones

That makes sense. I will discuss dutasteride with my dermatologist the next time I go.

On 6/20/2023 at 2:47 PM, MildSeven said:

@xcactus After i Reviewd one more time, Your Hairline is Better in 2023 compared to 2017, its more solid now.. good job bro

im envy you 😹, we are at same age, my hairline was worse than yours, and im regret coz not to take finasteride earlier...

Thanks. I’m fortunate that I haven’t had any sides with fin. I was very apprehensive to start it.

On 6/20/2023 at 7:09 PM, consequence said:

The longer you can hold off, the better surgical technique and medical support gets. I would switch to dutasteride and oral minoxidil, add on ketoconazole and wait another 10 years if I were you.

Hopefully my hair can hold on for that long!

On 6/20/2023 at 8:17 PM, Gatsby said:

I think, if anything, you could consider dutasteride (but I would go to a good dermatologist to discuss this). However for your age I think the medication is holding your hair well. If you were to lower your hairline you run the risk that it may not match your current hairline in terms of blending and naturalness. I think your hair looks great!

Thank you. I’m going to discuss dutasteride with my dermatologist during my next appointment.

On 6/20/2023 at 10:28 PM, Turkhair said:

You have BDD and zero loss. I would dare say you’re medicating unnecessarily and never had MPB if 2017 pictures is what made you start medicating. 

I’ve definitely struggled with BDD. I’m working on it. But as baldness runs in the family, I’m glad I started fin as a precaution if nothing else.

On 6/21/2023 at 7:20 AM, RobertoDeNiro said:

Just go for some medication. Hold on as much as possible to the HT path, you do not need it at all.

 

Ok, that’s my plan after reading the responses here. Thanks.

[xcactus]

Back again. A colleague who had a HT told me I would be a candidate for a transplant in the temple region. Should I schedule a consult? I haven’t noticed a huge change since I first posted, but I certainly haven’t regrown any.

[Proportions]

Have you actually lost any hair? Is your hairline different than 10-15 years ago? Be honest with yourself.

 

Edited October 30, 2023 by Proportions

[Gatsby]

If you have surgery (and there will always be someone who will take you) you will destroy your natural hairline. You do not need surgery. You look good. 

[Proportions]

26 minutes ago, Gatsby said:

If you have surgery (and there will always be someone who will take you) you will destroy your natural hairline. You do not need surgery. You look good. 

If someone with a NW3 could have a successful HT with a nice result, why couldn't OP have one?

It just seems counter intuitive that people with a NW3 are encouraged to get a HT, but people with NW1-2 are discouraged. 

Edited October 30, 2023 by Proportions

[Recession1]

1 hour ago, Gatsby said:

If you have surgery (and there will always be someone who will take you) you will destroy your natural hairline. You do not need surgery. You look good. 

Why would he destroy his hairline? If he goes to one of the best surgeons he would be fine. I have seen guys who don’t even have hairloss but are born with high  hairlines and lower their hairline and they look great. Look at some of the examples Konior has done. He lowers hairlines a substantial amount and they blend great. I think where you run into issues is when you go to cheap places. 

[Recession1]

51 minutes ago, Proportions said:

If someone with a NW3 could have a successful HT with a nice result, why couldn't OP have one?

It just seems counter intuitive that people with a NW3 are encouraged to get a HT, but people with NW1-2 are discouraged. 

Agreed… it makes no sense. I see a lot of nw 3s that are getting transplants and skilled surgeons bringing their hairline back to original hairline before loss… so why would somebody 30 wait to lose a bunch of hair before they do anything. Everybody talks about the importance of meds, but it seems counterintuitive because it’s only okay to do if you lose a bunch of hair first? I thought meds were used to prevent losing more hair. I think the point of a hair transplant is to make you look great for many years to come so why wait until your bald… why not look good now and then have more surgeries if you need them… and who knows you might not ever need another  one… and if that’s the case you just waited a a bunch of years of not liking your hair. I don’t get it. 

[Gatsby]

8 hours ago, Proportions said:

If someone with a NW3 could have a successful HT with a nice result, why couldn't OP have one?

It just seems counter intuitive that people with a NW3 are encouraged to get a HT, but people with NW1-2 are discouraged. 

Because @Proportions the baseline where @xcactus is at is what an ideal hair transplant could never obtain. It's just a matured hairline and for a guy in his 30's his great head of hair looks appropriate and above all else 'natural.' I noticed you only joined last week but if you do a search or stay around on the forum you will see people who only wanted a hairline lowered and regretted the whole thing afterwards. Matching the exact hair caliber, softness, angles, color, growth rate, etc to a natural hairline will never beat one that has never been touched. Plus once you start surgery you are in it for the lifetime. The longer you can postpone it the better the outcome 9/10 (because their are always risks involved no matter how rare). An elite surgeon is attempting to match mother nature. No surgeon can beat mother nature. All the best.