Pics posted...Advice please guys.

[gillenator]

Ray,

If you are responding well to finasteride, then I do not think 28 is too young for the procedure however I would be careful in not getting talked into doing a large session for your first procedure.

Why? It appears that your frontal zone is diffusing along with some recession in the temporal lobe areas. Because of the diffusing pattern, a large session can potentially shock some of that hair out. And even though the hair is diffusing, it is in fact providing you some coverage.

Your crown appears to be slightly diffusing as well however it is in good shape at present and would not recommend any grafts in that region for the same reason, potential shock. Staying on the meds will help you keep your crown in hair and hopefully for years to come.

Keep researching and eventually you will know what doctor is best suited for your needs and first procedure.

[mattj]

You could certainly eliminate the recession and thicken up some of the front. Whether the frontal third could be addressed is difficult to say. Based on what I see, the density might still be high enough that it would be risky to plant grafts into the area. It's not totally clear. I do think you're a good candidate and could achieve a very worthwhile improvement from a procedure.

[ray1]

gillenator and mattj,

Thank you for the advice and opinions.

Regarding the crown, it has been like that for as long as i remember, even before i started meds 4 years ago so hopefully it holds

This is my dilemma regarding the front, as you can see it has thinned out in the front, possibly 1inch back from the hairline. (last pic shows this)

This only gives me a styling option of combing my hair forward, anything else and my hairline and frontal 3rd is see through.

I really want to have a styling option if i have a HT...and would love to have added density in the frontal 3rd so i can achieve this. however i know the risk of shock loss

I really dont know how to tackle this.

Regards

[gillenator]

You're welcome Ray. This is why you want to consider approaching this from a more conservative approach. Fewer recipient incisions equate to less overall trauma to the scalp and to the recipient area. Some will state that since you have responded well to finasteride for the past 4 years that you will not sustain shockloss or very little. It cannot be predicted and finasteride does not IMHO reduce the chances for shockloss because shockloss is more related to the trauma from the procedure.

A fair number of women who experience genetic hairloss lose their hair in a very pronounced diffusing pattern and typically throughout their scalp. Its classes of loss are noted on the Ludwig scale.

Many HT surgeons will advise doing smaller sessions for the same reason, risk of potential shock.

[ray1]

Thank you once again.

I was hoping to improve the hairline and density from the front of the hairline to around an inch back in one go.

I see this may not be possible due to shock loss.

I was hoping a procedure would give me styling options as the only option at the min is to comb my hair forward due to the thinning.

Regards

[mattj]

I think clearer photos are needed. Ones which give a better idea of the density in the area.

[gillenator]

Thank you once again.

I was hoping to improve the hairline and density from the front of the hairline to around an inch back in one go.

I see this may not be possible due to shock loss.

I was hoping a procedure would give me styling options as the only option at the min is to comb my hair forward due to the thinning.

Regards

It's not that you cannot improve your hairline and frontal zone, but rather that you are aware of the potential of shockloss for your situation, and is a part of the risk. As I stated, it cannot be predicted and why approaching your goals in smaller sessions helps reduce the level of trauma, and as a result, help "reduce the level" of potential shockloss.

We are not stating that you are not a candidate nor that your goals for restoration cannot be fulfilled. It has to do more with the approach or game plan to get you there.

[ray1]

Cheers guys.

I have the funds for a procedure now but if i needed another one due to shock loss in the frontal 3rd it could take a few more years to save for this.

Maybe i shall wait and save the cost of having 2 procedures if needed. A back up plan if you will

I will try and post more clear photos.

Regards

[mattj]

It would be highly unusual for a transplant to trigger shockloss and cause you to need an immediate second procedure. The doctor would be careful to avoid this situation and would limit the extent that they go into the thinning area.

[gillenator]

Sympathetic shockloss is usually a result of the trauma and the stronger hair does grow back after going through the dormant phase and re-entering the growth phase. Stronger hair meaning the native hair that still has a fair degree of caliber left to it.

It's the more debilitated, more pronounced diffused hair that may not come back and subsequently referred to as permanent shockloss. And this is why the more advanced diffused thinners run a higher risk.