Need advice. Should I do hair transplant or wait.

[SteveJ]

I have a booked hair transplant in about a month but I'm having second thoughts about doing it or postponing it. I'm 25y and I've been on minoxidil for 1.5y, finasteride almost 9 months and about a month ago I started taking dutasteride every few days. Since starting finasteride my hair has not gotten any better or much worse. (I assume that without medications it would have been a lot worse, I have siblings who were completly bald at my age). I know that for a hair transplant it is advised that your hairloss should be stabilized but how would you define that. what does stabilized mean? since taking finasteride my hairline has not receded much but I do notice every shower or every time I brush my hair that I'm still losing hair. Hair on the top has gotten much thiner which is noticable when my hair is wet. I'm worried about doing HT now while still losing hair. I know that some hair loss is normal for everyone, but I got to the point that I no longer know is the amount of hair I lose every shower or every time I brush my hair normal or not. 
I need your advice, what should I expect for the future state of my hair if I proceed with the surgery now> how would you define stabilized hair loss?  Thank you for any advice

[Maorizio]

Losing hairs in shower, pillow, brushing or whatever is normal cause we supposed to shed 100 and even 150 hairs a day.

Hair loss stability is when there is no excessive shedding and new thinning areas.

If your family history is aggressive as you describe then it’s probably that you did stabilise it with finasteride.

[SteveJ]

1 minute ago, Maorizio said:

Losing hairs in shower, pillow, brushing or whatever is normal cause we supposed to shed 100 and even 150 hairs a day.

Hair loss stability is when there is no excessive shedding and new thinning areas.

If your family history is aggressive as you describe then it’s probably that you did stabilise it with finasteride.

Thank you for your response. I know some shedding is normal but mine has been constant since starting finasteride almost as if it didn't decrease it but kept it the same which still worries me. only 'proof' that medications are working is when I compare my hair with my siblings at my age.

[Maorizio]

Just now, SteveJ said:

Thank you for your response. I know some shedding is normal but mine has been constant since starting finasteride almost as if it didn't decrease it but kept it the same which still worries me. only 'proof' that medications are working is when I compare my hair with my siblings at my age.

If your brothers go completely bald by their 20s it’s mean super aggressive genetics.

If you really anxious about the stability of your hair loss, postpone the HT for a year, that will give you a real indication, just make sure to examine yourself properly.

There are no guarantees in this thing, it is what it is, HT should be done when you have a lost cause areas, fin/dut/min won’t regrow slick bald areas.

[SteveJ]

3 minutes ago, Maorizio said:

There are no guarantees in this thing, it is what it is, HT should be done when you have a lost cause areas, fin/dut/min won’t regrow slick bald areas.

I never expected medications to regrow bald areas but at least stop the hair loss and thining. You are right that it is normal to still lose hair daily due to shedding, which I probably confuse with hair loss, but I have also noticed that hair on the crown has gotten 'less dense' which I assume finasteride should have stopped.

Thanks for your advice,

[Maorizio]

1 minute ago, SteveJ said:

I never expected medications to regrow bald areas but at least stop the hair loss and thining. You are right that it is normal to still lose hair daily due to shedding, which I probably confuse with hair loss, but I have also noticed that hair on the crown has gotten 'less dense' which I assume finasteride should have stopped.

Thanks for your advice,

That’s where you wrong, from what I have seen, people with aggressive genetics only delay the inevitable, even with nuclear regimen including dutasteride and other strong stuff.

Going completely bald in mid 20s is very rare, do your thinking if you are willing to start this battle or accept it, I wish there was a 100% working treatment but there is none.

[Berba11]

Need more info @SteveJ: Which surgeon are you going to? Are you intending to stick with the medication long term? What is the current state of your hair loss/what is the surgical plan?

My initial reaction is that, at 25, you should be giving the medication a longer run. Hair loss is more aggressive in your 20's and you've not really been on finasteride long enough to know if it's working. If you were a bit older - in your 30's for example - it would be less of an issue as your hair loss will be slowing down a bit more anyway and you'd have a better idea of where you stand.

Lastly, can you share some good quality pictures so we can see what you're dealing with?

[SteveJ]

1 hour ago, Berba11 said:

Need more info @SteveJ: Which surgeon are you going to? Are you intending to stick with the medication long term? What is the current state of your hair loss/what is the surgical plan?

Thank you for your advice. I have already accepted that I will have to stick with medication long term if I do HT so that is not an issue. Surgical plan (HLC) is 2000-2500 grafts for restoring the hairline which I do think is a loot given my age and the fact that I might still lose hair on the crown despite medications so it wouldn't look natural.

[Berba11]

16 hours ago, SteveJ said:

Thank you for your advice. I have already accepted that I will have to stick with medication long term if I do HT so that is not an issue. Surgical plan (HLC) is 2000-2500 grafts for restoring the hairline which I do think is a loot given my age and the fact that I might still lose hair on the crown despite medications so it wouldn't look natural.

So I'm guessing then that you're about a NW2? Most NW2's still have enough of a hairline to get the aesthetic benefits of a framed face (which is essentially what a HT does), and if that's the case, pulling the trigger on a HT so young probably isn't advisable. Without pictures though I can only guess.

[A_4_Archan]

If you are yourself unsure about this than i would say postponing this would be a wise thing to do...when you are in a confused state of mind,always delay the decision. And yeah delaying will do no harm to you and infact it would be more helpful considering your age and unstable hairloss pattern plus your current state of mind.

I hope this helps.

[justamaz1]

I was balding by age 20 and I continued to lose hair for the next 30 years. I tried hair transplants at a number of locations in So. California, over many years, and most were successful. The problem was that you eventually lose donor area's and then those locations become very thin. You just don't have enough donor hair, if you have male pattern baldness, which will cover most of the top of your head.  It was just a constant cover-up, avoiding windy days and activities. Tired of limiting my life, like that, I just shaved my head at age 50.  My regret is that I didn't do it sooner and that I wasted the time and money on transplants. I can't say that it's wrong for everyone, but it was for me.