22 year old male NW3, Seeking Guidance: Considering Hair Transplant for Receding Temples

[wh300]

Greetings to the Hair Restoration Network community,

I hope this message finds you all well. I'm reaching out to seek guidance and advice regarding my ongoing hair restoration journey.

Since March of this year, I've been diligently following a treatment regimen that includes topical finasteride and minoxidil. Recently (June), I made the switch to 1 mg of oral finasteride daily and 1.25 mg of oral minoxidil daily. While I'm hopeful about these measures, the receding temples have become a significant source of concern for me. The way these receding temples frame my face has led me to constantly wear hats, as I feel they make me look noticeably older than I am. I've provided a collection of photos spanning from 2021, 2022, and now 2023, in order to show the progression and changes in my hair.

This issue has taken a toll on my psychological well-being, and I wake up daily with worries about my hair.

A bit about my background: My father, who is now 60, has maintained a Norwood 1 hairline until about 40-45 & Norwood 2 hairline since he was around 45. However, I seem to have inherited hair loss tendencies from my mother's side. In that lineage, a high Norwood pattern has been common, with individuals (grandad and uncle) reaching NW4-5 by around the age of 28. Remarkably, I find myself at a NW3 (I think) at the age of just 22.

At this point, I am contemplating the possibility of a hair transplant to address my receding temples. After thorough research, I've been considering Pekiner for the initial procedure, following approximately a year on medication. For any subsequent transplants, my attention has turned to Dr. Zarev,I caught him on his way to a conference in Bangkok and we had a long phone call talking about my future hair transplants. I would not be able to see him for 2.5 years he said and I'm not sure I can wait that long to address the temples so I would like to get it done sooner and then go to him for any future loss, provided that he believes achieving a favorable result is feasible given my family's history of hair loss. An important aspect to consider is that my hair is naturally fine in texture. Given these circumstances, I am keen to hear your insights and advice as I deliberate on this significant step forward. I genuinely appreciate any time and support you can provide. If you could spare a moment to offer your thoughts on my situation, I would be immensely grateful. Your experiences and insights could make a world of difference to me as I navigate this journey. Thank you in advance for your assistance and understanding.

 

I will also provide pics of my donor since they wont allow videos but I have a pretty thick and dense donor, lopsidedpair on reddit said its pretty above average. if there's a way to provide videos or anything else you guys need just let me know please. 

I have been posting on reddit for a while but I feel the people here are a little bit more educated and a little older. I feel hopeful and with some proper decision making I can keep a full head of hair for life and have better hair when I'm 30, 40, 50 than I do now. 

 

Warm regards, wh300

 

[Al - Moderator]

I reposted one pic below. This doesn't look too bad to me. You have some slight recession, but it looks like you have thick hair everywhere else. Just stay on the meds for now. Stop wearing the hat. You don't have a lot of hair loss to be worried about covering it up. You may look younger with the hat, but you won't look better. There's a difference.

[Gatsby]

You are a great responder to meds and at 22 I would not be looking at surgery. You have a great head of hair but I know your psychological urges are real for surgery. However it would be like trying to catch a tiger by the tail if you were to have surgery at 22. If the meds (and I say 'if') don't maintain your hair you will be forever playing catch up surgically at such a young age. You will end up having many surgeries every time your hair creeps back if it in fact does. You will have to hope that you don't max out your donor and will have to factor in the costs lifelong with this approach. Are you prepared for the real risks of surgery such as permanent shock loss, poor yield, etc? These do happen and you have to be willing to accept this going in regardless of who the surgeon is. A hair transplant will never look as natural as your hair does right now. Keep the great head of hair you have now with medication. All the best!

Edited August 31, 2023 by Gatsby

[wh300]

31 minutes ago, BeHappy said:

I reposted one pic below. This doesn't look too bad to me. You have some slight recession, but it looks like you have thick hair everywhere else. Just stay on the meds for now. Stop wearing the hat. You don't have a lot of hair loss to be worried about covering it up. You may look younger with the hat, but you won't look better. There's a difference.

Thank you for taking the time to respond to my post. I genuinely appreciate your input and perspective.

It's reassuring to hear that the recession might not be as severe as it seems, and I understand the point you're making about the hat. Your distinction between looking younger and looking better is a valuable one, and I'll definitely take that into consideration moving forward. I do agree hair loss is not excessive, and I'm grateful for that. But for my age is seems like it is a bit out of the norm. The challenge for me lies in the temple areas, which have significantly altered the way I used to style my hair during my late teens and the way it frames my face. While I'm thankful that my overall hair thickness is reasonable, the temple recession has impacted my confidence and self-perception and limited the hair styles i feel confident in to really 0-1. Considering my situation, I'm leaning towards exploring the option of a hair transplant for the temple area after about a year of continued treatment. I'm wondering if you might have any insights or recommendations for creating a plan that addresses these specific concerns? I'm still in the process of researching potential clinics and doctors, and any guidance would be incredibly valuable to me. Thank you again for reaching out and sharing your thoughts. It's great to have a supportive community like this to turn to during such decisions.

[hairman22]

i would wait to see Zarev. Maybe then a small procedure.Your hairline isnt that bad at all. Zarev could do a small procedure in a few years & then you have lot of grafts left for the future if needed.

Go to somewhere else & it reduces your donor supply.

[wh300]

13 minutes ago, Gatsby said:

You are a great responder to meds and at 22 I would not be looking at surgery. You have a great head of hair but I know your psychological urges are real for surgery. However it would be like trying to catch a tiger by the tail if you were to have surgery at 22. If the meds (and I say 'if') don't maintain your hair you will be forever playing catch up surgically at such a young age. You will end up having many surgeries every time your hair creeps back if it in fact does. You will have to hope that you don't max out your donor and will have to factor in the costs lifelong with this approach. Are you prepared for the real risks of surgery such as permanent shock loss, poor yield, etc? These do happen and you have to be willing to accept this going in regardless of who the surgeon is. A hair transplant will never look as natural as your hair does right now. Keep the great head of hair you have now with medication. All the best!

I want to express my gratitude for your thoughtful response. I genuinely appreciate your perspective and the time you took to share your insights. I completely understand your point about the psychological urges for surgery as it has affected my mental health greatly and the challenges of maintaining results over the years. I do plan to stay on medication for life, barring any unforeseen side effects. In fact, I'm even considering transitioning to dutasteride for stronger protection in the future. You've made a great observation about the structure of my face. While I do have thick hair elsewhere, the temples and hairline are integral to how my face is framed. It's difficult for me to find a hairstyle that I feel confident with, especially without the assistance of a hat. I truly want to look and feel my best,and I know every day I look significantly worse than I did at 17-18-19 due to the temple recession and the effect its had on the hair I can wear and feel confident in. and the temple recession has had a significant impact on my self-perception. Regarding my consideration of a hair transplant, Dr. Zarev has actually indicated that if my donor area is sufficient to cover a Norwood 6 pattern of baldness, there's no inherent reason I couldn't proceed with the procedure at my age. However, I am seeking opinions and insights from the community to gauge if this is a reasonable approach considering the complexities involved. I take your point seriously about the challenges of surgery and the potential impacts on the natural look of my current hair. Your thoughts are genuinely appreciated as I navigate these options and decisions. Thank you again for your response, and I look forward to any further insights you or others may have to offer.

[wh300]

8 minutes ago, hairman22 said:

i would wait to see Zarev. Maybe then a small procedure.Your hairline isnt that bad at all. Zarev could do a small procedure in a few years & then you have lot of grafts left for the future if needed.

Go to somewhere else & it reduces your donor supply.

Thank you for your thoughtful input and suggestion. I truly appreciate your perspective. The idea of waiting to consult with Dr. Zarev and potentially considering a smaller procedure in the future is something I'm strongly considering. Your point about preserving donor supply is well taken. I've been contemplating a procedure of around 1,500 - 2,000 grafts with either Keser or Pekiner in the next year or so, with the intention of going to Dr. Zarev for a consultation in about 2.5 years. I'm wondering if you believe a procedure of this scale would significantly deplete my donor area? I'm aiming to strike a balance between addressing my concerns as soon as possible in my youth and making prudent decisions for the long term. While I understand that my hairline isn't in a dire state, I've come to realize how much better I looked and could look with a restored hairline. My hair has been an integral part of my identity since childhood, and it's one of the few aspects of my appearance that I've held dear. That's why I'm considering these options carefully and seeking advice from those who have experienced similar situations. Your input is incredibly valuable to me, and I'm thankful for your willingness to share your thoughts.

[Turkhair]

I don’t think Zarev does hairline work even close to what Pekiner does. I am biased because I am a patient of his and my favourite part of my whole new head of hair is my hairline. It’s so natural and almost close to what I had before HT. 

Zarev is more for higher norwoods where the way he does homogenous extractions bringing those dead Norwood 6-7 people is wow

Regardless, you don’t need a hair transplant and I don’t recommend it. You should wait until you’re 30 when your final pattern emerges. The little change you will notice isn’t really worth it spending all that money and energy. 

It’s not going to bring back your confidence either and you’re still going to be disappointed wishing for something in your hairline to have been different. And even if it works out, with your aggressive hairloss you want those precious grafts to have been used to build a conservative hairline not where you want them used now.

 

[hairman22]

I do think Pekiner is good. So maybe a small procedure 1000-1500k then go to Zarev for the long term plan I think is a reasonable idea.

 

I do get when you are young it is important to have a excellent hairline. Just dont go too aggressive with it.

[Berba11]

2 hours ago, wh300 said:

My hair has been an integral part of my identity since childhood

At the risk of sounding insensitive, personally I'd be working on that rather than getting a HT. Objectively, your hair is nothing to do with you "identity" - the very concept of an identity is flawed to begin with and it's not remotely clear what you mean by this in any case. You're a just a bloke with a personality of your own like any other. If the state of your "identity" flimsily rests upon the condition of your hair then it's simply not a very good or robust identity to begin with.

As someone who has had a HT, I'd have to say that I'm much more conscious of my hair now that I have some again then I ever was when I was just buzzing it off. I'm delighted to have hair again but I was never insecure about it to begin with and my hair didn't form part of my "identity". It didn't have any bearing on my personality; my interests, my desires etc. It is, after all, just hair. I genuinely gave my hair less thought before my HT because I didn't really have to deal with having hair - and I'm saying that as someone who was not and is not insecure about their hair. Had I been insecure about my hair loss, I imagine I'd have been just as insecure in some way about the results of a HT.

My point ultimately being that you shouldn't be relying on a surgery to make yourself feel better (or concocting personal identities around impermanent trivialities like your hair). Find a way to feel better first, and then address the hair loss (if you really must) *last* from a position of clarity and relative contentment. Surgery should always be a last resort in any case (and it's good that you're treating your hair loss through early intervention & asking for advice here before doing anything too hasty).

Lastly, your hair looks great as it is and you seem to be responding to the medical intervention really well. Your "me at 22 on treatment" pictures show a strong hairline with natural recession points that look masculine and mature. It looks better than your 15/16 years juvenile hairline in my opinion (you're not going to want that hairline at 50!). If you can maintain this hairline with preventative interventions then you'll save yourself a small fortunate & hassle with HT surgeries.

[GoliGoliGoli]

6 hours ago, wh300 said:

. Regarding my consideration of a hair transplant, Dr. Zarev has actually indicated that if my donor area is sufficient to cover a Norwood 6 pattern of baldness, there's no inherent reason I couldn't proceed with the procedure at my age. 

The thing is even if there is no "inherent" reason you can't get a HT now, you really don't want to be in a position where you are forced to keep getting more HT's just to stay looking natural as your loss progresses. It's much better to look naturally balding than unnaturally badling. This is what I believe Gatsby means when he refers to "chasing a tiger by its tail", you don't want to be in a posistion where you are FORCED to get more HT's. What if you run out of money? What if you have a life event that means you can't keep going back for more HT's?

Personally I don't think people should really be getting HT's unless they need like 2000 grafts or more (Give or take). That's because HT's don't recreate full natural density, so you're better off waiting until you have some serious surface area to cover so that the result is a serious aesthetic improvement and not just some "meh" minor aesthetic improvement that 99% of people wont even notice. In your case you would need like... 400 grafts or something. It isn't at all worth it. Wait until you're 30 and make a decision then. 

 

 

Edited August 31, 2023 by GoliGoliGoli

[Melvin- Admin]

I disagree with some of the input here. As someone who went bald young, I understand the implications and the psychology. 

My dad is 66 with a Norwood 2 level of hair loss, but his uncle was bald. Sadly, I followed suit. 

20 years old

 

Fast forward just 8 years at 28 years old

 

Ok, so what’s the point of me showing you my progression? Well, what matters to you at 22, is different than what matters at 32, 42, 52, etc. Your current situation, while not ideal for a 22 year old, is actually pretty good. If you reach my age (38), you’ll be in the 80th percentile in hair. The name of the game for you should be maintaining. Maintain what you have for the next 20 years and you’ll be golden. 

Getting a hair transplant now would mean you lower your hairline. The problem with this is you will need multiple procedures to keep up. It’s clear that you’re genetically headed to Norwood 6 like me, without meds, you’ll get there in a few years. 

As a Norwood 6, a low hairline can be detrimental to keep up with subsequent hair loss. At 22 your also not psychologically developed enough to deal with a poor result. No hair transplant is ever guaranteed. Regardless of who you go too.

My suggestion is keep up with the meds and style your hair in a fringe. Great news is that your generation (Gen Z) love this hairstyle. You can do this for many years to come. Maybe down the line reconsider surgery, but not now.

[GeneralNorwood]

16 hours ago, wh300 said:

Greetings to the Hair Restoration Network community,

I hope this message finds you all well. I'm reaching out to seek guidance and advice regarding my ongoing hair restoration journey.

Since March of this year, I've been diligently following a treatment regimen that includes topical finasteride and minoxidil. Recently (June), I made the switch to 1 mg of oral finasteride daily and 1.25 mg of oral minoxidil daily. While I'm hopeful about these measures, the receding temples have become a significant source of concern for me. The way these receding temples frame my face has led me to constantly wear hats, as I feel they make me look noticeably older than I am. I've provided a collection of photos spanning from 2021, 2022, and now 2023, in order to show the progression and changes in my hair.

This issue has taken a toll on my psychological well-being, and I wake up daily with worries about my hair.

A bit about my background: My father, who is now 60, has maintained a Norwood 1 hairline until about 40-45 & Norwood 2 hairline since he was around 45. However, I seem to have inherited hair loss tendencies from my mother's side. In that lineage, a high Norwood pattern has been common, with individuals (grandad and uncle) reaching NW4-5 by around the age of 28. Remarkably, I find myself at a NW3 (I think) at the age of just 22.

At this point, I am contemplating the possibility of a hair transplant to address my receding temples. After thorough research, I've been considering Pekiner for the initial procedure, following approximately a year on medication. For any subsequent transplants, my attention has turned to Dr. Zarev,I caught him on his way to a conference in Bangkok and we had a long phone call talking about my future hair transplants. I would not be able to see him for 2.5 years he said and I'm not sure I can wait that long to address the temples so I would like to get it done sooner and then go to him for any future loss, provided that he believes achieving a favorable result is feasible given my family's history of hair loss. An important aspect to consider is that my hair is naturally fine in texture. Given these circumstances, I am keen to hear your insights and advice as I deliberate on this significant step forward. I genuinely appreciate any time and support you can provide. If you could spare a moment to offer your thoughts on my situation, I would be immensely grateful. Your experiences and insights could make a world of difference to me as I navigate this journey. Thank you in advance for your assistance and understanding.

 

I will also provide pics of my donor since they wont allow videos but I have a pretty thick and dense donor, lopsidedpair on reddit said its pretty above average. if there's a way to provide videos or anything else you guys need just let me know please. 

I have been posting on reddit for a while but I feel the people here are a little bit more educated and a little older. I feel hopeful and with some proper decision making I can keep a full head of hair for life and have better hair when I'm 30, 40, 50 than I do now. 

 

Warm regards, wh300

 

 

The thing is that your have receding hairline, however remaining hair in the frontal area are very dense. I would say it is definetly over 60+ FU per cm2. To confirm this, doctor should check your density with device called densitometer. 

There is for sure no need for lowering hairline, but only for filling up receded temples. You can't do surgery with 40 grafts/cm2 like for higher norwoods, because it will look sparse compared to native hair. You need dense packing - around 60 grafts /cm2. 

Pekiner is for sure good choice, when we are talking about dense packing. I'v seen cases of sucessful dense packing from Feriduni too. This doctors should provide you desirable density in 1 procedure. There are doctors that would rather split this kind of high density transplant in 2 procedures, where second procedure is after some time, for example one year. So you have to decide if you want to do the job in 1 or 2 procedures. If you want to do it in 1 procedure, make sure that you chose elite doctor with good ethics. 

 

Speaking of dr. Zarev, he is famous because of his work for higher Norwoods, not because of work for Nw2-Nw3 with dense packing. No cases of dense packing + long waiting list, so i would not consider him for your case. 

 

However, the best move is to wait. You are very young, we don't know how your balding will progress even on meds and for that reason some surgeons like Feriduni can decline you and it's good approach. 

 

But if you can't wait, maybe consider FUT procedure instead of FUE, to maximise your donor capacity. 

Edited August 31, 2023 by GeneralNorwood

[Gatsby]

7 hours ago, Melvin- Moderator said:

I disagree with some of the input here. As someone who went bald young, I understand the implications and the psychology. 

My dad is 66 with a Norwood 2 level of hair loss, but his uncle was bald. Sadly, I followed suit. 

20 years old

 

Fast forward just 8 years at 28 years old

 

Ok, so what’s the point of me showing you my progression? Well, what matters to you at 22, is different than what matters at 32, 42, 52, etc. Your current situation, while not ideal for a 22 year old, is actually pretty good. If you reach my age (38), you’ll be in the 80th percentile in hair. The name of the game for you should be maintaining. Maintain what you have for the next 20 years and you’ll be golden. 

Getting a hair transplant now would mean you lower your hairline. The problem with this is you will need multiple procedures to keep up. It’s clear that you’re genetically headed to Norwood 6 like me, without meds, you’ll get there in a few years. 

As a Norwood 6, a low hairline can be detrimental to keep up with subsequent hair loss. At 22 your also not psychologically developed enough to deal with a poor result. No hair transplant is ever guaranteed. Regardless of who you go too.

My suggestion is keep up with the meds and style your hair in a fringe. Great news is that your generation (Gen Z) love this hairstyle. You can do this for many years to come. Maybe down the line reconsider surgery, but not now.

This ^

[gillenator]

17 hours ago, Gatsby said:

You are a great responder to meds and at 22 I would not be looking at surgery. You have a great head of hair but I know your psychological urges are real for surgery. However it would be like trying to catch a tiger by the tail if you were to have surgery at 22. If the meds (and I say 'if') don't maintain your hair you will be forever playing catch up surgically at such a young age. You will end up having many surgeries every time your hair creeps back if it in fact does. You will have to hope that you don't max out your donor and will have to factor in the costs lifelong with this approach. Are you prepared for the real risks of surgery such as permanent shock loss, poor yield, etc? These do happen and you have to be willing to accept this going in regardless of who the surgeon is. A hair transplant will never look as natural as your hair does right now. Keep the great head of hair you have now with medication. All the best!

This is another great post from Gatsby filled with wisdom and good advice…there are many young men that have a similar profile as wh300 that should read this!