Hair Transplant or Not???

[Dirty Hairy]

Hello everyone! I am 26 years old and I am thinning to a Norwood 6. (My dad is a slick bald Nw6) I can already see it thinned out but it's not too terrible yet but DEFINITELY noticeable. I keep my hair cut short. When I buzz my hair to the lowest the trimmer can go without shaving it, you can't really tell I am balding. I also do some acting on the side and I get asked a lot, what does your hair look like when it is grown out. I naturally have curly hair, so I tell them curly (bc I don't want to tell them it is thinning). I have been taking 1.25mg Finasteride since January/February and have not noticed any more loss of hair or shedding. I am also on Minoxidyl twice a day and Nizoral 2 times a week. I am contemplating on getting a hair transplant for my hairline and frontal 1/3 of my head, (possibly temporal area as well). My question(s) are, 1) Do you think it would be wise for me to get a hair transplant right now, or wait it out?
2) If I get a Hair Transplant, how would it effect future treatments like (Aderans, Histogen, and/or Replicel and others)?
3) And lastly, Is it very common for the Hairs around the transplanted area to be shocked and fall out?

Thank you in advance for any help you could give me. It would really mean a lot to me. Have a wonderful day!

[Follicle Death Row]

I'm in the exact same situation. My father is norwood 6 and I'm 26 with slight some hairline recession but also the dreaded diffuse loss in the, gulp, norwood 5/6 pattern. I'm planning on waiting it out for the time being and am not sure if I am a candidate for hair transplantation or not. I think I'm too young at 26 and I'll wait until closer to 30 to reassess.

I know the whole FUT vs FUE debate has been doing the rounds again so I don't want to get into that here but you're probably best served waiting for awhile I feel.

I've seen it written by one of the top docs that if you have a very distinct border/margin between the thinning hair and the thick non miniturising terminal hair then your pattern of hairloss can be defined. However when a potential future norwood 5/6 goes for transplantation the very best time to transplant in order to maximise the amount of donor available over a lifetime is at the norwood 4 stage or after, not earlier. Why? Well you don't hear this being discussed but it's the patients that get a big first procedure that get the most grafts in total lifetime. With a virgin scalp, laxity is at it's max and a wide strip can be harvested. After this there's a scar and the scalp is tighter. Laxity is reduced but some will come back in time. At norwood 4, it's possible for some to get 5000 in the 1st procedure, 3000 the next time and 1500-2000 the last time. Difficult to get up to 9000-10000 if a strip of 1500 is taken the first time for the hairline imo. Just a consideration for the future norwood 5/6s who are thinking of HTs.

[Follicle Death Row]

Oh yeah the specific questions. Here's what I think:

1) I think wait for now, though you may feel the pattern is established.

2) Only an opinion but I think transplantation will affect the future treatments to a degree. Recipient site formation will damage highly miniturised follicles which may come back with these treatments and if that's the case you'd have to be relying on true follicular neogenesis for more hair. I have no idea if these treatments will do that.

3) Depends. If they're on their last legs they'll shed and won't come back. Some surgeons just put a load of grafts into these areas knowing they'll probably shed for good.

Best of luck.

[Dirty Hairy]

Thanks so much for your reply and help...I believe I will end up waiting to see what the future products can produce. I do have another question....I see up here quite often that even though there will be new things coming out for hair, a lot of guys are saying they are still going to get a transplant to their hairline. Why is this? Thanks in advance.

[Follicle Death Row]

Well I guess there's a couple of aspects. Firstly as the temples tend to go first they could be slick bald by the time these treatments come out. Perhaps these treatements can't cause true follicular neogenesis or the remaining cells can't be reactivated, hence the lack of hair regrowth in this area and the need for transplantation in the hairline.

Secondly even if they can grow the hair back in this area there's a worry that it will be difficult to exert control of hair growth at the hairline and the transition between hair and forehead. Also there are some concerns that the precise angulation of the regrown hairs in the hairline might be slightly off and not resemble pre mpb thus giving a slightly erratic "off" look.

Of course this is just conjecture but the consensus seems to be that we may still need transplantation in the first cm of the hairline.

Hope that helps. Still everyone has a breaking point and if you really feel you can't wait much longer then hair transplantation may be for you.

[konfusion]

I would also recommend waiting for some more time, let's say until you are in your 30's. Also I believe HT's do not work very well for thinning areas, the best result is achieved when the recipient area is slick bald. I might be wrong though. My doctor said that they would not perform a HT on me because it is very hard to increase density in regions still have hair.

[FlightTL]

3) And lastly, Is it very common for the Hairs around the transplanted area to be shocked and fall out?

FUE is something I am strongly considering, simply because I cut my hair short and want to keep doing so. I am just scared of scarring (aka white dots).