22 yo Considering HT (Looking for Advice)

[Locke]

Hello everyone,

I'm a 22yo male and I've been experiencing hair loss since I was about 18. Initially one side of my frontal hairline was receding and I believed at the time I was just born that way. Then it just kept moving farther and farther back until the point I'm at now.


This is what I looked like when I was 19. 1st year of university.


This is me at 20. 2nd year of university

Back then I had enough hair in the front that I could part it to the sides and cover my receding hairline. Thus, it looked like I was not losing any hair at all.

In my 3rd of university I decided to try rogaine and finasteride. I was on them for about 6 months and it seemed like my hair was still falling out. I think the meds may have slowed down the pace at which I was losing my hair but I had a huge problem with them...

The problem was that I would apply the rogaine (5%) in the night then go to sleep, which was fine, but then when I applied it in the morning it made my hair feel all sticky, thin, and gross. So for the 6 months I was doing this I wore a hat all the time to cover this up.

Now I'm at the point where I'm seriously considering a hair transplant.











In terms of styling my hair, I can't do anything at this point. From the medical opinions I have sought so far here is what I'm looking at....

Prices
Dr. Armani = 3,040 grafts at $21,280

Dr. Wong = 3,000 grafts at $13,650 (have to pay for flight on top of that with $500 reimbursed by H&W)

Dr. Rahal = 2,500 grafts at $9,975

My Thought/Fears
Ideally I'd like to have an FUE transplant done but the price is really putting me off. Let's assume I have unlimited funds. FUE will leave me with no scar which is a big plus for me but does it yield results as good as strip? I've also heard that Dr. Armani has a tendency to place to many hairs in the frontal hairline which may mean not enough donor hairs left for other areas. Seeing as how all the Dr's quoted me the same number of follicles, I'm not sure how true that is.

Dr. Rahal and Dr. Wong both seem to produce amazing results as well. Dr. Rahal is the closest to me after Armani (I'm from Toronto). However, I don't really want to have a scar on the back of my head for the rest of my life. I like to keep my hair short and I'm not sure how the scar will impact that. With that being said, if I could get my hair to look like it did when I was 19 or before that, I could bear living with the scar.

What is everyone's opinion on the matter given this information and knowing the surgeons?

Questions about Hair Transplants
How long does it take to heal? I will be traveling in Asia in June 9 through August 1st. Is it a bad idea to have a hair transplant done early or mid-May?

A hair transplant will fill in the hair I'm missing but the hair behind it will continue to recede. At what point do you go in for a 2nd hair transplant? I don't want to have a nice hairline then big patches behind it.

How do you cope with the post-surgery look? Do you just wear a cap? If I'm traveling I would be fine wearing a bandanna 24/7.

In Addition
I first sought an opinion on a hair transplant from an Alvi Armani representative when I was 20 and he said to wait until I was older. At that point my hair looked fine though. I hope no one replies telling me to not have a transplant done because I'm "too young". As I see it, I have much worse hair loss than many pictures I've seen for men 30yo and beyond.

Once I'm done university in a week I will be buzzing/shaving my head to see how it looks. If I do not like it, then I'm going to schedule a hair transplant immediately.

If you'd like to hear more about my story/motivation for doing this I will post it in the 'Introduce Yourself' thread.

Thank you to everyone who replies!

[Winston]

Welcome to the forum. Hair transplantation is a big decision and choosing the best hair transplant surgeon for you is not easy either. Both Dr. Wong and Dr. Rahal are highly recommended on this forum and are on the IAHRS so I think they both make great choices. I’m not sure if you stated that you are no longer using Propecia, but if this is the case you should consider getting back on the drug if you plan on having a transplant.
All hair transplants cause scars and if you need a lot of grafts it’s common knowledge that having a strip is probably the best way to go. As long as you’re committed to never shaving your head and if you plan to wear your hair at it’s current length in the back you should have no problem. If price is the only reason you’re choosing to have a strip then you should take a few steps back to reevaluate your decision because it will last you a lifetime.

[mattj]

You made it sound like you had a problem with the Finasteride but didn't mention what it was. Unless it causes you real, intolerable problems, it's best to use it.

To be quite honest, I think you should probably rule out FUE. You already have an area to cover which is large by FUE session standards, and it is unfortunately likely that you will lose more hair in the future. I might represent a strip doc but I don't shy away from suggesting FUE for cases when I feel it's more appropriate, but in your case I think strip would make best use of your donor.

At a month post-op you will still be healing but I don't think it would interfere with your travel plans. That bandana will come in handy to keep your healing scalp from being exposed to the sun.

[Delphi]

From what I have read healing depends on several factors and is not easy to know if you’ll heal within a couple of weeks or have some visible sign of the transplant for several months. Usually the longer lasting signs are in the scar area and fade in time. Winston is right about getting on Propecia if you can. I’d say FUE is always an option but it has its limitations so if you want lots of coverage from one surgery strip will be a more practical option and less expensive.

[Locke]

Welcome to the forum. Hair transplantation is a big decision and choosing the best hair transplant surgeon for you is not easy either. Both Dr. Wong and Dr. Rahal are highly recommended on this forum and are on the IAHRS so I think they both make great choices. I’m not sure if you stated that you are no longer using Propecia, but if this is the case you should consider getting back on the drug if you plan on having a transplant.
All hair transplants cause scars and if you need a lot of grafts it’s common knowledge that having a strip is probably the best way to go. As long as you’re committed to never shaving your head and if you plan to wear your hair at it’s current length in the back you should have no problem. If price is the only reason you’re choosing to have a strip then you should take a few steps back to reevaluate your decision because it will last you a lifetime.

I am no longer using Propecia but I think I will start it once again and see if I can stabilize it. But what if it doesn't stabilize? Shouldn't I go ahead and have a hair transplant and use the meds at the same time? Then if they don't work and the hair behind the first surgery is disappearing I can have another surgery done.

What's the reason for committing to not shaving ones head? Because the scars will be present or it damages the donor hair?

You made it sound like you had a problem with the Finasteride but didn't mention what it was. Unless it causes you real, intolerable problems, it's best to use it.

To be quite honest, I think you should probably rule out FUE. You already have an area to cover which is large by FUE session standards, and it is unfortunately likely that you will lose more hair in the future. I might represent a strip doc but I don't shy away from suggesting FUE for cases when I feel it's more appropriate, but in your case I think strip would make best use of your donor.

At a month post-op you will still be healing but I don't think it would interfere with your travel plans. That bandana will come in handy to keep your healing scalp from being exposed to the sun.

I didn't have a problem with finasteride really, besides not really seeing any outstanding results. The problem I had was with using the Rogaine solution that made my hair feel really oily and unbearable to go into public with. I think using the foam would solve this problem though and I could start using the meds again. I know I worded that sentence poorly.

Thanks for your input about FUE! I really appreciate it

[mattj]

I think that the foam will be just as bad for leaving your hair in a condition unsuitable for going out in public. I'm pretty sure most Rogaine users probably apply it at night before bed, and then wash their hair in the morning.

[Locke]

I think that the foam will be just as bad for leaving your hair in a condition unsuitable for going out in public. I'm pretty sure most Rogaine users probably apply it at night before bed, and then wash their hair in the morning.

Really? I was under the impression that it'd just wash off in the shower but I guess I was wrong. I'm fine with applying it before bed.

My master plan was to use the Rogaine foam in the morning, shower and wash it out so it's fine to go out into public then apply the Rogaine solution before bed.

I guess I'll have to make some adjustments.

[blowmeup]

The foam is not too bad. You can get up a little earlier than you normally do and use the foam and let it dry. Then towel your hair after about and hour and comb. This should make it look good. Some people use it only at night and get results also.

[mattj]

Some people use it only at night and get results also.

This is what I meant. Allow it to do it's thing during the night, and then have clean hair during the day.

[Winston]

I don't think it’s really necessary to use Rogaine twice per day and if it is making your hair look worse when you apply in the morning it almost defeats the purpose of using it. Using it only at night as blowmeup and mattj suggested is reasonable and you should benefit just as much.

[PayDay]

You need to get your butt back on Propecia. If you keep the hair you still have it will make your hair transplant look much fuller overall.

[CIT_Girl]

What's the reason for committing to not shaving ones head? Because the scars will be present or it damages the donor hair?

If you opt for a strip transplant, it's likely you will never be able to shave your head without having a visible linear scar. This is why Dr. Cole typically cautions that strip transplants are never a good option for men under age 30. Even with FUE, it's possible you will experience hypopigmentation (the small white spots where follicular units have been removed), which may be visible if you shave your head extremely closely. This is why you should think very hard before proceeding with any sort of ht surgery. I don't think Winston was implying that shaving your head would have any impact on the condition of your donor hair.

The biggest concern with you having a hair transplant at such a young age (even though you don't want to hear it ) is that it's hard to determine, at this point, to what extent your hair loss will progress. It's difficult to say how much (or little) donor hair you will ultimately be left with and, therefore, if you do choose to proceed, you need to be extremely cautious. You definitely don't want a doctor who creates an aggressively low or densely-packed hairline in case your hair loss progresses and your donor supply is further depleted.

[Locke]

If you opt for a strip transplant, it's likely you will never be able to shave your head without having a visible linear scar. This is why Dr. Cole typically cautions that strip transplants are never a good option for men under age 30. Even with FUE, it's possible you will experience hypopigmentation (the small white spots where follicular units have been removed), which may be visible if you shave your head extremely closely. This is why you should think very hard before proceeding with any sort of ht surgery. I don't think Winston was implying that shaving your head would have any impact on the condition of your donor hair.

The biggest concern with you having a hair transplant at such a young age (even though you don't want to hear it ) is that it's hard to determine, at this point, to what extent your hair loss will progress. It's difficult to say how much (or little) donor hair you will ultimately be left with and, therefore, if you do choose to proceed, you need to be extremely cautious. You definitely don't want a doctor who creates an aggressively low or densely-packed hairline in case your hair loss progresses and your donor supply is further depleted.

Thank you for the insightful post. Gives me a lot to think about.

[hindsight2020]

I got 2 HT's done when I was 24 (about 3200 grafts). I had a different balding patten than you, but roughly felt the same way with the same amount of hairloss. I was balding in my early 20's while most, if not all of my friends, had thick full heads of hair.

Even though both transplants were successful, I constantly was worried about wind, lighting, people touching ym hair, ect. On a good day, my hair looked normal/thinning at best. Even when I thought to myself "Damn it looks good today, great decision to get a HT!!!" ... it was still noticeable that I didn't have a thick head of hair, it was just enough to cover up bald spots.

This is the important part. 6 years later, I am now 30. Half of my friends are balding or bald. I continued to bald and now have a permanent scar on the back of my head, and obvious red bumps on the top of my head that you can now see form the continued hairloss. I am so envious of my friends who are naturally balding (which comes with age). All I want to do is be able to trim my hair down short again, or shave it completely off.

But I cant. Not without revealing how naive I was to assume I would be ok later in life if I could just correct my baldness when I was 24. Sure for a couple of years it did the job, but now I am either stuck getting more and more transplants to keep the coverup going... or shaving it off and revealing my scars.

What I would give to go back to a naturally bald head.

[Locke]

I got 2 HT's done when I was 24 (about 3200 grafts). I had a different balding patten than you, but roughly felt the same way with the same amount of hairloss. I was balding in my early 20's while most, if not all of my friends, had thick full heads of hair.

Even though both transplants were successful, I constantly was worried about wind, lighting, people touching ym hair, ect. On a good day, my hair looked normal/thinning at best. Even when I thought to myself "Damn it looks good today, great decision to get a HT!!!" ... it was still noticeable that I didn't have a thick head of hair, it was just enough to cover up bald spots.

This is the important part. 6 years later, I am now 30. Half of my friends are balding or bald. I continued to bald and now have a permanent scar on the back of my head, and obvious red bumps on the top of my head that you can now see form the continued hairloss. I am so envious of my friends who are naturally balding (which comes with age). All I want to do is be able to trim my hair down short again, or shave it completely off.

But I cant. Not without revealing how naive I was to assume I would be ok later in life if I could just correct my baldness when I was 24. Sure for a couple of years it did the job, but now I am either stuck getting more and more transplants to keep the coverup going... or shaving it off and revealing my scars.

What I would give to go back to a naturally bald head.

Yeah that was my concern. If you get the HT done and make the front look nice but the hair behind it is receeding...at what point do you get another HT done?

Maybe just wait until all the hair is gone before getting a HT?