H&W say it’s too “early” for hair transplant?

[SurfsUp]

Hey all,

First time poster, and wish I’d found this place years ago. 
 

TL;DR

H&W said “too early” for a transplant, and recommended XYON DHT gel and oral minoxidil (even though I already take oral minoxidil), and said I have diffuse thinning with no area worse than the others (despite the pics showing the crown and temples being pretty obviously worse).

All other physicians have recommended  ~1700 to 2500 (for the front).

Has anyone else run into this?

Longer version

I recently sent in a consult requests with Hasson & Wong, and they came back and said that they feel it is a little early for a hair restoration procedure. 

They said I have a diffuse loss pattern which indicates thinning over a larger area with no one particular area that is significantly worse than the other, and that that type of loss is usually best suited for medication at this stage.

They then went on to recommend the XYON DHY topical gel, and 2.5 mg oral minoxidil.

But here’s the thing… they didn’t inquire as to some basics, such as my age, whether I’m currently taking any meds, etc. 

I’ve been on 7.5 mg / week of finastride for nearly 2 years, and topical 5% minoxidil for ~6 year, and switch to oral minoxidil about 9 months ago (2.5mg / day). (And I think I lost some hair with the switch from topical to oral).

Additionally, when they said there’s “no one particular area that is significantly worse than the other,” they must’ve missed the pics of the temples and crown, which are blatantly worse than the rest.

Moreover, they are the only practice to reject the prospect of a transplant at this point. All the other practices gave a “yeah, no problem, probably 1700 to 2500 grafts for the front.”

Now, I’m not necessarily trying to get a transplant for the hell of it, but given the pharma option is far from a solution, a transplant seems to make sense.

Has anyone else gotten such a response?

[Proportions]

Age?

[Proportions]

I got rejected for a transplant at age 24, solely because I was "too young", but I got approved for one now at 29.

 

If H&W was the only clinic to reject you, why not just go with another one of the clinics that said yes? 

Edited October 25, 2023 by Proportions

[Gatsby]

H+W are correct. 29 gives a much better indication of your future hair loss pattern than 24. Also 5ari medication should always be the first port of call. 

[SurfsUp]

1 hour ago, Proportions said:

Age?

42

[Proportions]

Just now, SurfsUp said:

42

Interesting. Do they want you to wait until you're 70? 😄

[SurfsUp]

25 minutes ago, Gatsby said:

H+W are correct. 29 gives a much better indication of your future hair loss pattern than 24. Also 5ari medication should always be the first port of call. 

I’m on 2.5 mg of oral Finasteride (about 18 months) and 5mg of oral minox (recent switch to 5mg from 2.5 mg, which I was on for 9 months, and I was on topical 5% for 6 years prior to that).

[SurfsUp]

1 minute ago, Proportions said:

Interesting. Do they want you to wait until you're 70? 😄

Right? I don’t get it. 

I’m fortunate enough to live a couple hours from H&W, and given the mostly positive reviews here and elsewhere, it just seems like

the right place to go for me.

Which was why the rejection came as a surprise. 

I also don’t want to simply reject their assessment, because maybe they’re right and I’m just unlucky with diffuse thinning (even though I only see my temples and crown as needing attention).

 

I’m going to try and get an in-person consult with them.

[Legend007]

I think it’s cuz u don’t have a bald area, it’s just thinning, n will be bald later:

if they do it now, it’s going to make ur current native hair fall out faster wherever they transplant the new hair.

from my own personal experience, i had a thinning hairline, where the hairs were still there, but it just won’t grow that long anymore n wasn’t cosmetically pleasing.. and when they transplant into it, for the first year, those thinning native  hairs helped the transplanted hair, so I had a nice strong frontal hairline for a good year after the transplant.. but all those native hairs died out pretty quickly after that n only the transplanted hair is left in the hairline, so it doesn’t look full anymore.. 

That’s just the nature of the beast, cost n gain is minimalized when u still have native hair there .. 

[SurfsUp]

6 minutes ago, Legend007 said:

I think it’s cuz u don’t have a bald area, it’s just thinning, n will be bald later:

if they do it now, it’s going to make ur current native hair fall out faster wherever they transplant the new hair.

from my own personal experience, i had a thinning hairline, where the hairs were still there, but it just won’t grow that long anymore n wasn’t cosmetically pleasing.. and when they transplant into it, for the first year, those thinning native  hairs helped the transplanted hair, so I had a nice strong frontal hairline for a good year after the transplant.. but all those native hairs died out pretty quickly after that n only the transplanted hair is left in the hairline, so it doesn’t look full anymore.. 

That’s just the nature of the beast, cost n gain is minimalized when u still have native hair there .. 

Woah… I had no idea that was a thing at all. 
 

I’ve heard of shock loss, which happens a little, but was supposed to be temporary.

However, what you just described sounds sort of like the implanted hairs kind of suck the life out of the native hairs until they’re toast (likely not that actual interaction, but something akin to that).

That’s concerning. Thanks for the tip. I’ll have to look into this more. 

We need stem cell hair regrowth, stat!

[Sunset Dune]

1 hour ago, Legend007 said:

I think it’s cuz u don’t have a bald area, it’s just thinning, n will be bald later:

if they do it now, it’s going to make ur current native hair fall out faster wherever they transplant the new hair.

from my own personal experience, i had a thinning hairline, where the hairs were still there, but it just won’t grow that long anymore n wasn’t cosmetically pleasing.. and when they transplant into it, for the first year, those thinning native  hairs helped the transplanted hair, so I had a nice strong frontal hairline for a good year after the transplant.. but all those native hairs died out pretty quickly after that n only the transplanted hair is left in the hairline, so it doesn’t look full anymore.. 

That’s just the nature of the beast, cost n gain is minimalized when u still have native hair there .. 

weren’t you taking any medication to prevent the thinning native hairs from falling out?

[Legend007]

Of course I’ve been taking finasteride, but when ur hair is going it’s gonna be gone.. new vs old hair, only the strong survive .. it’s common sense really.. 

If u look at me , I’m a norwood 1 still right now, but is it full like back then, nah .. I’m very grateful I had a successful hairtransplant from h n w.. but I’m still heka scared all the time bout my hairloss, all my hairs are thinner n don’t grow that long, it’s just aging n natural.  I haven’t had a haircut for months. Back then I had to get a haircut every 3 weeks.. 

without a hairtransplant and meds, I most definitely be having noticeable bald spots, thank goodness that hasn’t happened yet n I’m 44.. 

Please post some pics, let’s see what’s going on with ya, so we can have a better assessment of the situation.. no one likes to just give general advice .