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Asked to add density, but clinic wants me to lower hairline as well. Do I need it? 20M


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I'm 20 years old, diagnosed by traction alopecia by my dermatologist (Sikh pattern from religious turban all my life, males on both sides of family show little to no MPB until 35-40+). Dad still has thick hair at 50.

There is a 1cm area on my hairline where the density has noticeably decreased, although it used to match the rest. I consulted Eugenix and they recommended 1200-1500 grafts to restore the density and also suggested lowering the hairline. However, my initial request was simply to improve the density of my existing hairline. 

They advised me to start taking Finasteride, but I am uncertain about this since my hairline and density has remained stable since 2020, when I stopped tying my hair tightly. Currently, I only lose about 10-20 hairs per day. I'm willing to take it in the future when the MPB kicks in but I want to avoid taking it before I need to.


My concern is that I don't think my hairline was ever lower than where it is right now, and lowering it would look unnatural. Would no doctor be willing to do a procedure without significant hair loss? Am I really NW II?

I see plenty of people IRL and models with the little M hairline at NW0, I seem to have the same natural hairline shape???? I don't really care about making it straight.

I've attached a picture from the clinic and another recent selfie with how my long hair looks when I don't pull it back and part in the middle.
 IMG_3546.jpg.aa6d45c0a03b14ffeb846e0fde1635bb.jpg

6D048F0C-A038-4433-9389-D4A9221F7812.JPG

Edited by singh
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@singh Imo you are right and you don't need to lower your hairline and you can just densify it...you are just 20 and you need to preserve grafts for future hairloss (if it occurs)

About medication i can understand you are hesitant to use it..finasteride do help alot but as you said if you don't think that you are losing hairs and there is no such pattern than you can delay the medication ...but for that you have to be extremely sure that you are not using ground...around 100 hairs will fall everyday and thats natural...

Edited by A_4_Archan
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@StillAlive Hey man thanks but over the last 3 years only some tiny hair has come back. My hair is affecting my social life so I wanna get this over with, I'm kinda tired of wearing hats. Luckily I haven't lost any since I stopped pulling though

Edited by singh
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@A_4_Archan Exactly, I don't want to go overboard with grafts right now for futureproofing. I'll monitor my hair till I'm 30+ and ready for fin to preserve my hair.

How many grafts do you think I'll need just to add density? I want to have enough to slickback my hair without it looking weird since my hair is really thick starting from the last point of hair loss.

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I concur…definitely no need to lower your hairline…it can be reinforced without lowering it.

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Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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You would be surprised by how nice adding definition would be, again, don’t lower it, just reinforce it.

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Gillenator

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I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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As you age your expectations for what is a "natural" hairline also change. You are only 20 years old and we don't know how your hair loss will progress yet(if it occurs). This "affecting your confidence" line at 20 years old with no true hair loss is a problem in and of itself. I don't mean to sound condescending but I don't think you know what "affecting your confidence" means when it comes to hair loss. True hair loss sufferers (Norwood 3+) will look at your pictures above and think you got a thick head of hair. Go to the gym and build some muscle and your confidence will grow. Trust me! Don't think about a hair transplant until you're around 32/33. By that age, the doctors should be able to see some type of pattern of hair loss and plan for the transplant with an intact donor area. 

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Singh, we never asked you what your family history of men with MPB is…do any of the men have an advanced class of MPB?

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Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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@singh i think 500-700 will be enough as your hair seems to be thick ...i have marked the hairline which would be better imo and will take down the required grafts to half and will look natural Screenshot_20230704-123527.jpg.50ad03f0c2c3aeb8517eb689312f45c6.jpg

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3611 FUE Grafts With Dr Kongkiat Laorwong | Norwood 5 | 2nd May 2023 

 

 

 

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@gillenator Hey, thank's for asking. I don't have any high NWs in my maternal or paternal sides. The men 50 and older on either sides have at worst NW3 or maybe NW4 (none bald enough for me to notice). I haven't noticed any hair loss in the males under 40, maybe some hairline maturation so window peaks at max.

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@KSA91 I totally agree, and I'm working on that. It's just that I'm tired of parting my hair the same style everyday since my hairline looks obnoxious when my hair is slicked back and a few people have made comments on it as well. I'm already in the gym and bulking. I just need a transplant so that my will look good in professional settings when I don't have hair long enough to tie it back in the future. 

My family doesn't have a history of hair loss before 40 so I'm not too worried and I'll hop on finesteride right when it starts. 

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I'm guessing the clinic doesn't want to be bothered doing a small procedure because it's not worth their time doing a few hundred grafts. They'd probably rather work on someone who needs thousands of grafts and make a lot more money for their time. Don't go there. Find someone else who is willing to do small procedures.

 

Edited by BeHappy
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I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here.

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You are way too young to undergo any Hair Transplant just get ON Finasteride. 

Implanting any hairs on your Hairline may increase chance of shock loss too.. 

No need to lower your Hairline it's perfectly Natural. 

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@Rawkerboi I don't have androgenic alopecia and no one in my family seems to suffer from it. No high norwoods on both sides in old age too. Given that, if I get a transplant today or 4 years down the line wouldnt much much difference. I'll definitely be talking about shockloss when I undergo the surgery

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Don't lower your hairline, it's already low enough. :)

If your family doesn't suffer from hairloss and you just want to reinforce your hair then I don't see why you shouldn't get a transplant if you really want one.  By the way your current hair looks nice!

Edited by SeanToman
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On 7/4/2023 at 4:07 AM, singh said:

@gillenator Hey, thank's for asking. I don't have any high NWs in my maternal or paternal sides. The men 50 and older on either sides have at worst NW3 or maybe NW4 (none bald enough for me to notice). I haven't noticed any hair loss in the males under 40, maybe some hairline maturation so window peaks at max.

Well that’s good to hear and chances are your hair loss won’t be in the advanced classes.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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16 hours ago, MildSeven said:

Why dont give 1 year more time to recover your traction alopecia ?

at least it will get better by 25-30% you can save more graft as well save your money...

I've waited since 2021 and I have noticed 1-2 inch long short but thick hair in my hairline. I doubt it's going to get much better. 

I won't find time to be back in India for a few years since I go to college in the States and I certainly can't afford a surgery there or flights + surgery in Turkey

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