Vertex-only hair transplant for mid-20s man -- good or stupid?

ropcat

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Hi guys. Here’s a hair transplant question for you all:

I’m 26; been on finasteride for five years; good success for four but now loss is accelerating. My two worst areas, not surprisingly, are the hairline and the vertex (rear balding spot).

I’m in the extremely early stages of considering a hair transplant to fill in these spots. However, my two requirements (taking into account all the advice here about hair transplants at a young age) are:
1.) A conservative approach that assumes substantial further loss (esp since my finasteride is no longer doing the job as well).
2.) A stand-alone procedure -- in other words, a hair transplant where I wouldn’t necessarily need to get another one down the road in order to avoid looking goofy. (I don’t mean a procedure that would fix my problem once and for all; I mean one where I wouldn’t end up with isolated islands of hair if I didn’t have more operations.)

Based on this, it seems to me that a hair transplant for the vertex, but not the front, might be a good way to go right now. Doing a hair transplant for the hairline would necessitate me getting further ops down the road in order to follow the future loss back across my head (something I may or may not choose to do). A hair transplant for the vertex would be contiguous to areas that will never lose their hair (back and sides), and thus would look natural forever, whether or not I get further procedures for the front and top.

The only arguments I could see against this are: 1.) depletion of valuable donor hairs for use on the vertex; 2.) possibilities for harming the remaining hair follicles that are still alive on the vertex.

Am I missing something? I’d appreciate any comments on reasons for or against getting, say, 1000 grafts on my thinning vertex and leaving the front alone for now. Thanks!
 

eastend

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I don't think your idea is a good one. First off, you still may lose hair on the back and sides, because they can "drop", i.e. recede downward. So you may still end up with an island, just at the back of the top of your head. More importantly, though, you're 26 so it's basically certain that you WILL continue to recede. This means you're going to spend a few thousand now and in a best case scenario (best case meaning you don't recede downward at the back or sides) you're going to end up a Norwood 4A.

On the other hand, I may not fully understand what you're saying. If your idea is to get a transplant that will have you end up a solid NW3, with maybe a thin spot in the crown, then I think it's a pretty good plan. NW3s are not even remotely bald, in my opinion. A 40+ year old NW3, for all intents and purposes, does not have a hair loss problem as I see it.

Either way, you're right on with planning conservatively (in my opinion), I just think you should plan it so that you achieve a good cosmetic benefit (usually this means you look good in photos or face to face), otherwise you're wasting your money. Good luck.
 

ropcat

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Thanks EastEnd. That sounds like solid advice. It seems like there's no way to have a "stand-alone" procedure at my age, given that I have no idea how much I'll lose in the future. And it's really too early in my hairloss to do something for the front, I think. Have you had hair transplants?
 
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