36 year old male with MPB need HT advice

[KeepGrowing]

Hi Forum,

I am a 36 year old male, Started losing hair when I was 15.

Currently, I don’t take any hair loss medications, but if prescribed by a doctor am willing to take those. In my early twenties, I was using topical minoxidil but didn’t see good results so I stopped using it after 2-3 years

• On a Norwood scale what grade am I?
• Am I a good candidate for hair transplant?

I was using a hair system for a long time but I want to move away from it in favor of a more permanent solution. I realize the density won’t be as good as a hair system and I am fine with it. I would like to have a hairline with coverage in mid scalp area if possible. 

What are your thoughts on what is realistic in my situation?

Thanks for your input!

 

Edited July 21, 2023 by KeepGrowing

[LaserCaps]

Very wide pattern. Good news, the donor has only dipped a bit.  There are also miniaturized hairs noted in the perimeter of the crown which means you still have some loss coming your way, (If you've shown the propensity to lose, you'll continue losing). Donor seems fine but this can be confirmed during an in person evaluation. 

Review the Norwood chart and notice the progression.  As patterns advance, many thing happen.  The hairline recedes.  The temporal areas become deeply recessed.  The crown starts to expand, Eventually, and as you get to a class 6, it all disappears.  The pattern continues expanding, however.  That's where it seems you're heading.

Donor limitation often drives this industry. There's typically not enough to allow for density throughout the entire pattern.  It's for this reason most ethical doctors will concentrate their efforts towards the frontal area.  It's the area you see when you look at yourself in the mirror. It's also the area others see when they interact with you.  Now the crown. 

Think of the crown as a circle.  You fill it.  Because you've lost, you'll continue losing.  You go on to lose all the hair around the island worth of hair and now you've created a target area and an unnatural pattern.  My suggestion is to get on some sort of regimen to help you Halt the loss. You could, perhaps, even enhance the miniaturized hairs.  Concentrate your grafts towards the front. Have the doctor blend the grafts to the area behind the front and work back until he runs out.  

While there are engineering principles that apply to all of us universally when it comes to hairline design, (research the Rule of Thirds), I would encourage you to start with a very conservative hairline.  (Advanced patterns would never have a hairline in the middle of their forehead).  The farther back you go, the farther back the doctor can work so as to minimize the size of the crown.  Once you let it come in, you can then tweak.  It's easy to add grafts.  It's impossible to remove if you start with a juvenile placement. 

Lastly, and as you already know, hts can not compete with the density of a system. 

(Because of the length you keep, you do have the option to do both FUT and FUE.  You could exhaust all FUT and then move to FUE.  This would give you access to the entire donor area - which you'll need to accomplish as much as you can). 

 

Edited July 19, 2023 by LaserCaps
Add additional info.

[YodaHead]

@KeepGrowing - I am also same age as you and also started loosing hair around the same time. Our bald pattern is similar, however, the difference is that you have a lot better donors than me, and i have some more hair left at the top (but i am still losing thise rapidly). 
 

1. I say you are NW 7

2. Yes, you are a candidate in my opinion.

3. I recommend you look into Eugenix (India) and Dr. Pittella (Brazil). Do a video consultation with both. These are solid options for people with advanced NW. 

Since you do seem to have good donors, plus hopefully good beard—you should be able to get good enough coverage all across if you go with a conservative hairline. Of course, video consultation with the clinics i mentioned above will give you a lot better idea. 

[KeepGrowing]

Thanks @LaserCaps & @YodaHead

Is there any benefit of using hair loss medications at this point say Finasteride to recover from any hair loss or move back a grade? 

Yes, I am planning to reach out to Eugenix, will contact Dr Pitella as well.

And, I was also thinking of consulting with Dr. Laorwong, saw a ton of strong reviews of his work here. Does he specialize in high Norwood cases?

Good point on going for a conservative hairline, will dig more on this and rule of thirds.

 

[YodaHead]

1 hour ago, KeepGrowing said:

Is there any benefit of using hair loss medications at this point say Finasteride to recover from any hair loss or move back a grade? 

I don’t think you will move back a grade. You are at an advanced stage of NW and pretty much nothing at the top to protect. Having said that, are you still continually losing hair or has it stabilized? The only benefit meds would probably do in your case is to help protect the hair that you are going to continue to lose until you have reached your stable point.
If you are going to get a HT, then the meds will help—if the donor hair are taken from the outside of the “safe” donor zone. If all your donor are taken from the “safe” zone (low back/sides, beard, chest) the meds will not add much value. One example where this was discussed was here: 

 

[KeepGrowing]

This is very helpful. I think my hair loss has stabilized for the most part but there could be some minor loss in future.  

Re Eugenix - I read a bunch of reviews with promising results for advanced Norwood cases which is great and most of those were done by Dr. Sethi. Your recommendation around Eugenix, was it specific to Dr. Sethi or do they have similar results with their other doctors too? Would it be correct to assume Eugenix as a clinic can produce good results for advanced Norwood grades.