29 Yr old male

[rlucas]

Hello All,

Long time reader, first time caller. I have been reading this forum for a few years and must say it is comforting to have a place where you can research information through doctors and patients about such a sensitive topic.

About me: I am a 29 yr old male and have been thinning since I was about 21. I had been using both finasteride and rogaine for years, but discontinued the finasteride because I was having some sexual side effects and it was causing alot of acne on my forehead for some reason. I have stuck with rogaine, but continue to see the thinning on the crown of my head which I almost find more bothersome than the thinning in the front. I have begun brushing my hair certain ways to hide the thinness and am extremely insecure when its messy because in my opinion you can really see how thin it is.

When I was around 25, I visited a Bosely center in Midtown, but got the impression that the associate I met with was more of a salesman and less of a doctor, which ultimately turned me off by the whole process.

I am clueless when it comes to doctors, which is why I am posting here. Of course I know the Dr. Bernstein's group, but other than that I would love some suggestions.

I am worried of course that if and when I had the procedure, would my hairline look really fake because my hair is soo fine and straight? I don't think I would have unrealistic expectations, but I would certainly want to choose a doctor who has dealt with my hair type and see his results prior to any surgery. I only have basic knowledge of thee strip and FUE surgery. I realize the FUE is more expensive, but for something like this I think I would be willing to extend myself.

I have attached a few photos. Any advice or suggestion is greatly appreciated

Dan

[California13]

Your not in too bad of shape, and just from the looks of things, would probably be a good candidate for a hair transplant. My only problem with your post is that you stopped propecia. I would highly recommend starting it again, perhaps trying half a dose a day. I know you had side effects, but a hair transplant at your age will be tough, because you will likely experience future hair loss. Propecia would protect against this better than rogaine.

[mattj]

It's a good thing you went with your instincts and nixed the Bosley transplant.

Your hair characteristics are no obstacle to a good transplant result. Being fine and straight, you'd be best off planning for density at the higher end of the scale to ensure good coverage and a natural look, but your characteristics are far from uncommon and any highly regarded doctor is going to have experience with hair like yours.

My advice would be to carry on researching and make sure you know what you will be undertaking; be aware of the potential risks and settle on a doctor based on his reputation, his results (as in does he deliver the type of aesthetics that appeal to you) and secondary to that his location and price.

[Dr. Glenn Charles]

Here a few things to think about. It is generally easier for a hair restoration physician to create a natural hairline with fine hair. However, it is more difficult and takes more work to create good density compared to patients who have coarse hair. It appears from your photos that you have good donor hair and if your expectations are realistic than you would most likely be a good candidate for hair transplant surgery.

[rlucas]

I really appreciate all the advice.

Can anyone recommend some surgeons that I could set up consultations to further my research. I am located about 30 miles north of NYC and would also be willing to travel for a procedure.

Again thank you.

[mattj]

The highly respected Dr Feller is located in New York.

[rlucas]

The highly respected Dr Feller is located in New York.

I actually used to live about 10 minutes from his office prior to moving 6 months ago. Thank you very much

How can one research other reputable doctors, especially considering I do not know anyone personally that has undergone this procedure?

[Limmer HTC]

response

Dan:

I fully agree with what Dr. Charles noted above. One of my biggest concerns for you is that future hair loss is going to happen as you cannot take a DHT blocker. Not if, but when this occurs you must realize you will be faced with addition transplantation.
Have you seen Dr. Bernstein? If not, I believe you could get a lot of your questions answer by him or Robin Unger in NYC.

Brad Limmer, MD/jac

[rlucas]

Dan:

I fully agree with what Dr. Charles noted above. One of my biggest concerns for you is that future hair loss is going to happen as you cannot take a DHT blocker. Not if, but when this occurs you must realize you will be faced with addition transplantation.
Have you seen Dr. Bernstein? If not, I believe you could get a lot of your questions answer by him or Robin Unger in NYC.

Brad Limmer, MD/jac

Dr. Limmer,

I have not consulted any physicians other than my dermatologist who had initially prescribed me propecia. Based on that experience, I would much rather stay away from propecia because of the noted side effects and that I have read some very negative things about after I noticed my minor issues.

I am very familiar with the area where Dr. Feller is located, but if some here feel as if Dr. Bernstein or Dr. Unger are better suited for consultation purposes, please let me know. I feel as if I have been at a stalemate for a few years and am at the very least ready to speak with a physician/surgeon.

Believe me this is not something I will blindly jump into without doing my due diligence. Again, I appreciate any support and advice given. Thank you

[Limmer HTC]

Dr. Feller

rlucas:
I'm sure Dr. Feller can take care of all your needs and answer all your questions. I just have never met him, while Dr. Bernstein and Dr. Unger are MDs I've known for quite a long time. Good luck pursuing your answers and don't be afraid to meet with a couple of physicians.
Brad Limmer, MD/jac

[rlucas]

Rather than posting a new thread, I assumed posting in this one would be more appropriate since I had posted pictures, even though it has been about a year. I still do not take propecia and only use rogaine. Propecia had previously given me sexual side effects and I had read some troubling things about it in the past couple of years, which I realize is a concern if I would want to get the surgery.

Over this past summer I went for a consultation (prefer not to say the name of the doctor) and discussed my options. He was a very nice, easy to talk to and very receptive and understanding about my hesitations regarding the procedure.

He stated that he would work on my front and do about 1500 grafts on both temples and fill in the thinness in the middle. He said he would not do anything with the crown, which I can't say I was too pleased about. He seemed as if he was saying there wouldn't be enough transplant hair.

My main concern, and why I am posting, is he seemed to be pushing me toward the strip rather than the FUE, which were both the same price per graft. He claimed that the FUE actually created more scarring compared to the strip. I was curious as to whether others here feel the same given their experience and in depth knowledge of the two?

I am going to get another consultation with a different surgeon in NYC and discuss this and other questions with him, but I would appreciate an impartial view and maybe some suggestions as to what other questions I could ask at the upcoming consultation.

Thank you in advance, it is greatly appreciated.

[Tracy C]

He stated that he would work on my front and do about 1500 grafts on both temples and fill in the thinness in the middle. He said he would not do anything with the crown, which I can't say I was too pleased about. He seemed as if he was saying there wouldn't be enough transplant hair.

It is reasonable to assume that the doctor is a little more reluctant to work on the crown area because you are not willing to take Propecia (1mg Finasteride) to stabilize the area. If a doctor would work on the crown of a patient who will not take Propecia, that patient can possibly find themselves with an island of hair surrounded by a ring of no hair as the crown continues to thin - and the crown will very likely continue to thin.

The crown and mid anterior are the two areas most likely to respond and stabilize with medications. This takes a long time - a very long time. These areas are not likely to stabilize if you are unwilling to take the medication needed to stabilize them.

I cannot relate to concerns about possible negative side effects of Propecia because they do not apply to me. But I do wonder if these negative side effects are actually as bad or as frequent as you have read. My hair restoration doctor has been using Propecia for over ten years. He says he has not experienced any negative side effects. I know a few other men who are taking Propecia, they tell me they have not experienced negative side effects either.

My main concern, and why I am posting, is he seemed to be pushing me toward the strip rather than the FUE, which were both the same price per graft. He claimed that the FUE actually created more scarring compared to the strip. I was curious as to whether others here feel the same given their experience and in depth knowledge of the two?

I do not have in depth knowledge of both. I have read that FUE can create more scarring - though they are tiny dots instead of a line. I have also read that doctors can achieve a better cosmetic result in lesser time with the strip method, then save FUE for future procedures as needed to avoid tightening your scalp. This seems like a reasonable plan to me.

BTW, from your pictures you don't look so bad. I know some women who have it much worse.

[rlucas]

So I recently went for a second consultation with a different, and also very reputable surgeon, and he sent me a notice of our consultation indicating the following:


Pattern of Loss
Classification:
Present: . . . . . . . . . . . . . Norwood Class 3
Character:
Hair Thickness. . . . . . . . Fine

"I suggest restoring your frontal hairline and adding coverage to the front and top of your scalp. I recommend transplanting approximately 2,500 follicular unit grafts. We will reassess the need for additional grafts after we have seen the results of the first session. It generally takes about one year to see full growth from the procedure."

He was, more or less, there addressing my concerns and, as discussed in this thread, my hesitation to do go back on propecia. He stated that, while propecia is recommended, it is not a prerequisite for surgery and that a successful surgery can still be had. Being that it has been 2 yrs since I have started this thread, I don't believe I have lost too much in that span, but he did indicate that I obviously will down the road. I am happy to post more pics if anyone is that interested.

I am fairly certain I will see him again and schedule the surgery, but would like to know what the typical time frame for the post surgery redness, scabbing, etc? I, like I'm sure many here have dealt with, would like to take some time off work to avoid any indication that I have had surgery, which I realize is difficult, but I just wanted some insight as to what the time frame is/was for individuals who have had a similar number of grafts.

Again, any feedback is greatly appreciated.

[mattj]

The scabbing should be gone in around two weeks. Two weeks is when it's safe to actively remove any scabbing which hasn't already fallen off by itself. (This is according to Dr Rahal's post-op instructions; other doctors are often less cautious and allow the washing away of scabs sooner).

Redness (fading to pinkness) can linger around for longer - maybe months. The worst of it should have faded within a few weeks to a month.

How large is the area to be covered by those 2500 grafts? I ask this because the smaller the area the easier it can be to hide it by brushing hair forward over the recipient area. This is assuming that you are having frontal work done and have enough native hair behind this area to style forward, which I realise might not be the case.

[ryan555]

Go see Dr. Feller in Great Neck. He's one of the best in the world and definitely the best in the NYC area. Bernstein is very good too but I think he is too conservative. All of his work looks too thin for my taste.