help! considering a transplant. Pics inside

[handle1]

I'm 34 and have been losing my hair since 19 or so. I can identify with a lot of the "youngsters"angst who post on the site.

I started using 2% minoxidil. 14 years ago. Since then I've used propecia for 5 years (1998-2003) and just recently started dutasteride. I'm pretty sure I'm a lost cause when it comes to hair. My father is 70 and probably a norwood 6. Loss has been slow but gradual.

Since I'm back on the dating scene I'm feeling a little more self concious about my appearence and how I look. In the past I have been successful in covering up my thinning by using dermatch with toppik and combing my hair forward. However, I'm really paranoid that I'm developing a "combover" style which I want to get away from. A more obvious baldspot has formed in the last year or so. I wanted to post some pics to get a general idea on whether or not I would/should consider getting a transplant on my crown.

I would probably get a FUE and only a small amount of grafts since I just want enough to get Toppik coverage on the crown. I know I will continue to lose more hair, but I'm really at a all time low at this point of my life.

I just wanted to get some advice from some of the other guys that have been in the fight for awhile. Is this a bad idea? How many grafts should I consider?

 

[CCS]

your hair loss does not look severe at all, though it is enough to affect dating. how long did that hole take to form? if it was gradual and you are now 34, you can get ahead of the game with some grafts, and enjoy some dating before you lose more hair later. i am a bit worried about grafts accelerating your hair loss.

topik is good for making many thin hairs look thick, not for helping with a small number of thick hairs. it may still help though. if you get 30 grafts per cm2, in 3 square inches, that is about 500-600 grafts. they will need maybe 6 months to start growing out.

 

[tpeter]

How is your hairline?

If thats all u lost from 19 to 34 a hair transplant might not be a bad idea.

 

[CCS]

yeah, I was a bit worried because propecia was not working for you, but the fact is you are a different type of baling person than most people on this site. Many people here started doing some serious balding at age 19 and are fighting for their youth. You look like you might be a Norwood 2 in front (just guessing) now and reach a Norwood 2.5 at 3 in front by age 50, with a 3 or maybe 4 inch bald spot in the back. I highly doubt you will make it to a solid Norwood 5 by the time you die. So even if propecia does nothing for you, your best bet may just be to out run you baldness with hair grafts. Just make sure you get a good doctor. That is the only factor that will make or break you.

 

[Guest]

Handle1,

Welcome to this community and congrats on your first post here.

I also share in the concern that you have been on Propecia that long with the crown going. Or, did your crown look this way when you started Propecia and has not got any worse OR are you switching to dutasteride because your crown is losing more? Have you tried a stronger minoxidil level?

I concur to start with a smaller session due to potential shockloss. You can always add to it later on. Best wishes to you.

 

[LookingGood!]

your hair loss does not look severe at all, though it is enough to affect dating. how long did that hole take to form? if it was gradual and you are now 34, you can get ahead of the game with some grafts, and enjoy some dating before you lose more hair later. i am a bit worried about grafts accelerating your hair loss.

topik is good for making many thin hairs look thick, not for helping with a small number of thick hairs. it may still help though. if you get 30 grafts per cm2, in 3 square inches, that is about 500-600 grafts. they will need maybe 6 months to start growing out.

How will grafts accelerate his loss? If you are talking about shockloss in hairs that are already miniaturized, well then they are on their way out anyway and are cosmetically insignificant.

A good crown Doctor where the results are very superb is Jerry Wong. Hassan and Wong, if you want to go the strip route. FUE into the crown...Feller and Cole are good choices to check out.

 

[handle1]

I also share in the concern that you have been on Propecia that long with the crown going. Or, did your crown look this way when you started Propecia and has not got any worse OR are you switching to dutasteride because your crown is losing more? Have you tried a stronger minoxidil level?
.

Thanks guys for your help!

My crown has steadily been going since 21. In 1998 I started propecia and had decent results after 3 months but still gradually lost my crown. I added dutasteride. last year as a last ditch effort but I'm still not having much luck growing it back. I will say that the condition of my hair has improved overall since starting dutasteride. I also use Dr. Lee's 5% minoxidil twice a day and have been since 1998. Sometimes I use 15% but its strong stuff.

I'm lucky to have what I have. My brother is 7 years older then me and has a larger bald spot (norwood 4/5). My hair seems to be in better condition and not as fine as his. I'm still worried that I may fall in my dad's loss pattern, maybe I'm just getting a late start on it. I noticed my brother's lost excelled around my age.

I would like to get some small work in my crown in anticipation that HM will be around in 5-6 years. I'm worried though about future lost and whether or not I have enough donor hair to cover everything if I go norwood 6. I have to be honest with myself and anticipate that this may be the case. Would a top Doctor like Cole be able to tell how much lose may be in store for me?

Below are some pics of the front and top when its wet/dry.

 

[Guest]

Handle1,

Although your brother is a class 4/5 at 41 years of age, you may not advance as quickly as him because you are on hairloss meds. I truly hope dutasteride provides you better results but you'll need to give it one year or so to fairly evaluate how you respond to it. IMO, it appears unlikely that you will regrow anything meaningful in your crown, so doing what you can to slow down the loss is the best approach you are taking.

In reality, none of us nor any physician (no offense) can exactly predict the rate or extent of one's hairloss. What they can inform you of is their own clinical observations of their own patients and of course the information shared within the medical community. IMO, most of them will encourage you to consider family history just like you are doing with your father and brother. And as you said earlier, one really has to plan restoration within their own donor limitations, some patients also considering body donor.

So really Handle1, you are prudent in recognizing that you have the potential to progress to class 6 without the availibility of cloning. We cannot change our finite donor at present so everyone owes it to themselves to get a comprehensive evaluation of their donor zones from a competent surgeon "before" any decisions are made. At least that way you will be able to correlate where you would want those grafts and at what density levels.

This really gets down to each patient's individual goals. But remember, you stated you want to start with the crown. That then "commits" you to that area in the future as male pattern baldness progresses. If you know that class 6 is likely, that means you are going to eventually lose the frontal zone as well. From my observations over the years, I can tell you that most patients cannot achieve complete coverage working from scalp donor exclusively. Most can attain that level of coverage by using chest hair, leg hair, etc in addition to their scalp reserves. But I do not know how much BH you have nor your views on BHTs. That's the other variable.

From my experience, most guys want enough donor resources for the frontal zone even if it means they have to compromise density coverage in the crown. So many of then will only go to maybe 15 to 20 cm2 in the crown and plan for 30 to 40 cm2 in the frontal zone establishing a higher hairline and still achieving a nice frame to their face. Then, there's usually enough to add to the midscalp too. But something has to give and that's where goal plannig becomes so critical between you and your surgeon. What are the other variables in attaining the illusion of coverage? Each of our own individual hair characteristics such as degree of coarseness (caliper), color contrast, any wave characteristics, etc.

Honestly, if I were in your situation, I might add 200 to 300 grafts tops to that thinning area, and then use Toppik or your product of choice to cosmetically thicken the area if necessary. I think you'll see how your male pattern baldness progresses or hopefully slows down over the next several years while being on the meds. I wish you the best Handle in your decisions.

 

[CCS]

sad as what the eagle sad sounds, he is right. your thin area looks a lot bigger when wet, but you might be able to get by on topik on the outside and just put the grafts on the inside. I have 30 grafts/cm2 in the front of my head. It is thin, but it is a lot better than nothing, and at 2 inches long, you might be able to get away with it. One thing I like about waiting a year is you have a better chance of regrowing your hair naturally before you get grafts. Use the minoxidil and maybe some copper peptides an definitely some topical spironolactone. Topical spironolactone can block the androgen receptors in your scalp thereby giving your scalp the effect of maybe half as much DHT, without the systemic side effects.

If you do get grafts in your crown, and it recedes more, you will have to keep filling it in or have a funny looking island, if you care how you look later in life.

If you want to outrun your hairloss for the next 5 years and accept a weird hair pattern later, you could go for more density, but it will be 6 months before the hairs start to grow out and another six months before they reach maturity (full diameter). Also, you have to wait for them to grow out 6 months after the procedure before you can do a second procedure. My point is, even if you throw money and grafts at your crown, it will not be at a respectable density for 18 months, and I don't know how much the rest of your hair will thin in that time. Right now my fear looks like it is taking place: I'll never have perfect hair because the hair on top of my head is thinning faster than my new grafts are growing in, or so it seems. It is tempting to try to outrun the loss, but I really think you should start a wider variety of topicals.

Masking the crown until then is an issue. 300 grafts might provide enough hairs to carry the topik, and it might not. Topik is best for people with diffuse hair loss, many thin hairs, not so much 20 thick grafts per cm2.

I personally am getting my body hair lasered off to compensate for my hair loss, but maybe I should save it for transplants. I'm not convinced though that the scars won't be noticeable.

 

[Guest]

CCS,

You might want to wait on the removal of your BH. I was initially very skeptical of BHTs and I guess the jury is still out because of the wide variances in yield.

But I am seeing more and more consistency in cases being done with successful yields and I believe it is attributable to the skill and experience of the surgeon peforming the extractions. There are a few more docs like Dr. Umar who appear to be doing some good BH work. I am only a proponent of using BH for repair work and/or for blending with scalp donor in lesser visual impact areas.

And if HM does not become viable, there will be that much more additional experience in BHTs with more surgeons offering it and hopefully at a decent cost like Dr. Arvind.

All I am saying is that I hate to see you spend your hard earned money on BH removal and then regret it later that you did not save it for donor reserves. Once you destroy it, it's gone forever. Just something to think about.