26m -seek advice and graft estimate

[Polorolo123]

Hi All

I’ve been reading through the forum a while now and finally made an account ha.

So I’ve hit that point where I want to pull the trigger on getting a hair transplant as it’s reached that okay I think it’s time point.
i have been following the journey of a lot of your guys cases!

Some are just wow. You’d never have thought it was possible.
 

I was on fin but ultimately got sides. Idk if it was in my head but it was fine a few months then boom. Bad moods, feeling down and borderline depressed among the other side effects. 
Which sucks! 
Now use minoxidil however. 
 

I understand that given the circumstance I will likely need more than one procedure and have to go again at some point in the future. 
I do feel I have realistic expectation on what I want, a conservative hairline and I’m okay with using fibers to enhance the look. 
 

I currently use fibers which ultimately have been a life saver for me however fibers don’t give you a hairline! 
 

I wondered if anyone could give a rough graft estimate? I know it’s all guess work but I’m curious.
And any particular surgeons you’d consult with if you were in my place? 

 

I’ve added pics some in harsher lighting for a more transparent view on the current situation. 

 

 

Edited May 23 by Polorolo123
Explaining the difference in pics/lighting.

[Fox243]

1 hour ago, Polorolo123 said:

Hi All

I’ve been reading through the forum a while now and finally made an account ha.

So I’ve hit that point where I want to pull the trigger on getting a hair transplant as it’s reached that okay I think it’s time point.
i have been following the journey of a lot of your guys cases!

Some are just wow. You’d never have thought it was possible.
 

I was on fin but ultimately got sides. Idk if it was in my head but it was fine a few months then boom. Bad moods, feeling down and borderline depressed among the other side effects. 
Which sucks! 
Now use minoxidil however. 
 

I understand that given the circumstance I will likely need more than one procedure and have to go again at some point in the future. 
I do feel I have realistic expectation on what I want, a conservative hairline and I’m okay with using fibers to enhance the look. 
 

I currently use fibers which ultimately have been a life saver for me however fibers don’t give you a hairline! 
 

I wondered if anyone could give a rough graft estimate? I know it’s all guess work but I’m curious.
And any particular surgeons you’d consult with if you were in my place? 

 

I’ve added pics some in harsher lighting for a more transparent view on the current situation. 

 

 

Probably 6k-7k. For any NW5 or above, it's always the holy trinity: Zarev, Pittella, and Sethi.

[Rawkerboi]

Very unfortunate that you got side effects from Finasteride. Finasteride really help's to maintain existing hair.

You have a severe Hairloss at the age of 26, need to plan your HT properly, please don't rush and get consultation from various doctors.

Rough estimate will be 6k Plus for good density. It's a large area to cover so ideally you will need two surgery to achieve good illusion of density.

Dr. Zarev is master of such cases but you will be 31 or 32 to get his hands on your head.

 

[Shadman]

@Polorolo123 how's your beard ?

[Raphael84]

At 26, your loss has evolved quite aggressively and any approach should really have long term as the priority. 

Due the graft demands in place, the status of your donor area will be important. If there are any signs of decline in your donor or thinning around the ears for example.

With potentially years ahead of decline, your lateral humps that have maintained could drop and transplant may become disconnected and so an effective regimen of medication would likely be important to support any transplant. For many, topical minoxidil alone isnt the most effective and so if DHT blockers can not be considered, look to maximise effectiveness of other options.

Based on your first image, if you were to respond well to oral minoxidil, you may see some improvement from meds. You can discuss viability with your doctor.

Wishing you the best.

[Polorolo123]

4 hours ago, Rawkerboi said:

Very unfortunate that you got side effects from Finasteride. Finasteride really help's to maintain existing hair.

You have a severe Hairloss at the age of 26, need to plan your HT properly, please don't rush and get consultation from various doctors.

Rough estimate will be 6k Plus for good density. It's a large area to cover so ideally you will need two surgery to achieve good illusion of density.

Dr. Zarev is master of such cases but you will be 31 or 32 to get his hands on your head.

 

Yeah it sucksss. 
 

I was thinking a similar number! Just wanted to see if others agree because as you mentioned I need to plan for the future so wasnt sure if my guess was too aggressive. 
 

zarev would be a dreamm doc to go for but another 5 years 😭

[Polorolo123]

2 hours ago, Shadman said:

@Polorolo123 how's your beard ?

I’ve got a good full beard which so I suppose always a possibility to use that as donor also?  

[Polorolo123]

2 hours ago, Raphael84 said:

At 26, your loss has evolved quite aggressively and any approach should really have long term as the priority. 

Due the graft demands in place, the status of your donor area will be important. If there are any signs of decline in your donor or thinning around the ears for example.

With potentially years ahead of decline, your lateral humps that have maintained could drop and transplant may become disconnected and so an effective regimen of medication would likely be important to support any transplant. For many, topical minoxidil alone isnt the most effective and so if DHT blockers can not be considered, look to maximise effectiveness of other options.

Based on your first image, if you were to respond well to oral minoxidil, you may see some improvement from meds. You can discuss viability with your doctor.

Wishing you the best.

Thanks for the response and exactly what’s been on my mind. The best approach to consider for the long term. Leaving options open for a future transplant also. 
 

I will look into oral minox also 

[Gatsby]

You will definitely need a life plan approach to MPB and you can really up your chances if you can afford to see either Zarev, Sethi or Pittella. I really want to stress that it's not cheap being a Norwood 7 as it's a lot of real estate. Trust me I should know. Despite not being able to tolerate finasteride you could see if you can tolerate topical finasteride. However the positives are that you are not a repair patient with aggressive hair loss at a young age. I would stay on oral minoxidil under the guidance of a good dermatologist for at least one year to see how you respond by then. Beard grafts will definitely be required IMHO however you really want to hold off for as long as possible. As stated before the lateral humps and the crown can really open up and what will look potentially great in terms of results now could leave you marooned in 10 - 15 years from now. In short the problem is that while Norwood 7 surgery has come a long way in just the past 5-10 years you are trying to hit a moving target. Wishing you all the best.