Confused about why I got rejected for a transplant

[Dan07]

Please see the attached pics to see what my hair looks like.

Earlier today I made the long journey to my consultation but the doctor refused to operate on me - instead recommending that I try things like hair fibers or even shaving it all off and getting it tattooed.

Now, I'm 25 years old and my hair has been getting really thin over the past 2 years. Prior to this, I had the thickest Italian hair imaginable.

I'm already taking Rogain, tried hair fibers but found them horrible, refuse to take finasteride... basically, I've already researched all of this and have explored the other options available.

I always knew that I would ultimately get multiple transplants in my life time to correct my hair loss and I just felt that now was the right time to get the first one.

But, the doctor told me that he wouldn't do it and that other (good) doctors would say the same thing?

He didn't really explain himself very well though to be honest, so not only am I really disappointed but I'm still extremely confused.

What he was basically saying is that, if he was to transplant the hair, then later on the hair loss would continue to get worse and it would look bad.

But - my counter to that is that I'm already aware of that and know that I will have to go back multiple times. I'm fully prepared for that.

His response to that, though, was how I can only transplant so many grafts in a lifetime.

But, it's not like we'll be taking all of the grafts this time. What's the difference between doing 1500 now, 2500 later and 2500 even later or whatever... rather than doing it all in one go???

I don't understand what he's saying. Why can't I just get it done multiple times so that I don't have to go fully bald before I can do something about it??

Oh and by the way, my hair at the back and the top of my head's back/middle section is fully thick and looking at my family history is unlikely to ever thin. This is something the Doctor agreed with me on.

Please help me here guys!

[hal]

It's guys like you who end up back on these boards asking for help and advice on how to repair an earlier transplant.

You have a finite amount of hair on your head available for transplant. Transplantation is technical expertise buts its also an art.

How to frame a face, how to create an illusion of density. How to create a natural looking hairline.

A surgeon could do a transplant on you now-- fill in the thin spots, etc. And you might be happy for a few years-- if it works out. If you don't suffer transections and permanent shock loss-- and wind up with less hair than you started with pre transplant.

But anyway, what's going to happen is you are going to lose your existing hair around the transplants and its going to look awful. Then what? more transplants? you end up "chasing a hairline", spending tens of thousands of dollars for multiple transplant sessions.

Ah, but not me, you say. I'm going to meet this problem head on. I'm going to stay ahead of the game. I'll get limited transplants, "top up" when I need to, and have a half way decent head of hair through my 20's. Because that's what counts. After 30, who cares? I want to get the most action out of my best looking years and having hair is part of that. I'll worry about the rest down the line...

How far off am I?

Because this board and industry is full of guys like that who got a transplant too early and are now crying in their beer.

You don't want to take Propecia? ok. I completely get that. There are risks, side effects, and everyone whose considering meds should take a long hard look and do their research.

BUt on the other hand, Propecia is your best right now. It could thicken up the hair you have and save it. Might be the best short term (5 years or so) solution.

Otherwise, shave the head.

You know, everyone is always looking for options, and there are only a few choices:

Live with it
Shave your head
get a transplant
Get a hairpiece
Go on meds
Use a filler-- fibers or spray thickener

For you, getting a hairpiece is probably a dumb idea. Really, they tend to cause more problems then they solve. You're too young for a transplant and have too much hair. You don't want to go on meds.

So what's left?

Hal

[Dan07]

I'm sorry I thought I explained myself well but I still really don't understand why chasing it is a bad thing?

"Spending tens of thousands of dollars for multiple transplant sessions."

That's what I was planning on doing?

Why should you get it done all in one go rather than in stages? Sure the hair is finite but the transplanted hairs stay permanent?

[Louish]

For now wear them longer and see how much more recession you get in the next 5 years, you can't plan now because you are still in the most unpredictable phase ( your 20s) Maybe you will need those hair not to look bald instead of having a lower hairline. For now you still have a good head of hair. That is why he refused you. Be thankful he did.

[Dan07]

For now wear them longer and see how much more recession you get in the next 5 years, you can't plan now because you are still in the most unpredictable phase ( your 20s) Maybe you will need those hair not to look bald instead of having a lower hairline. For now you still have a good head of hair. That is why he refused you. Be thankful he did.

Ok, thanks. I think what you're saying is that, even though the hairs stay permanent and that doctors can do wonders on even large patches of missing hair nowadays, when I'm older, the surgeons would want to shape the hair in a different way, a way that blends everything in better or something. It's kinda hard to describe but, yeah, starting too early means that it won't go together as well.

The things is though, when are you supposed to wait until? My Dad continued to lose his hair till 45+!

All of my Mum's side have thick hair and no hair loss. It's only my Dad that has this issue and he seems to have passed it on to me. He receded to a strip in the middle by his early 30s and then by ~45 the strip going half way up his head went too (I think that's a N4A). Looking at my own hair, this is what I thought would happen to me and, like I said, the Doctor told me he agreed.

Also, would it really look 'that bad' to do it in stages? I mean, sure it would look better but waiting all of that time is just really not practical in some cases. If it wouldn't be too bad then it doesn't sound like a bad trade off tbh.

[Louish]

It has to be in stages anyway, it's just that you need to be in a more stable period to plan hairline placement and density not to deplete donor for a dense and low hairline when you are receding a lot behind it. Early 30s is a minimum and only if your hairloss is kinda stable.

[markusbdc]

Can you post pics of the crown area of your head? You actually look pretty good hairwise from the frontal view....

[mattj]

Can you post more shots from above? I see that you have diffuse hairloss which isn't that advanced. Basically, your hair (from what I can see) still looks too dense for a HT. With a diffuse hairloss pattern, the doctor needs to carefully place the grafts around existing hairs. If that existing hair is still quite dense - as appears to be the case with you - there is the risk of damaging those existing hairs and the result might not be any better than when you started.

I think the doctor you met did you a good service by refusing to perform surgery on you.

[Dan07]

Oh crap. Ok, I don't normally look at the top my head as much but it looks like it's starting to really thin too! All the way to the very back!

In some angles and stuff it looks fine to me, but then others it looks really bad! It looks like it's happening in like 2 patterns. There's a semi circle area at the front and then a circle at the crown at the back.

Erm, advice please? And I really wish the doctor warned me about this! He said it will probably just be the front.

[Dan07]

Here's some more pics of the front in different lighting conditions etc.

[UK_]

looks good well done!

[hal]

You are going to lose the entire front third of your hair and then its going to go all the way back to the crown.

Until that happens, no transplant. Down the line a good doc can give you a good, natural look. However, if you hop in the chair now you're going to regret it.

If you're willing to risk it, your best option right now is meds. Understand what you're getting in to and what to expect if you go that route.

[markusbdc]

Your hair density actually looks pretty good. I think if you grew your hair longer you would look great. I have seen a lot of guys who look thin with very short hair but with longer hair you can't tell there is any thinning at all. If you feel totally compelled to do something I would do the ol' "big 3" finasteride, minox and nizoral shampoo. I took fin for 20+ years with no side effects and it did wonders for maintaining my hair. No doc is going to transplant you at this point and that is a good thing because transplants are for very thin/balding areas which you really don't have. Its like the old saying says.."hair transplants do the least for the guys who need it most" In other words if you have a smallish baldish area with really thick hair on the back and sides you can expect a great result. You really arent that kind of guy.....

[mattj]

Yeah, you'll find that if you grow your hair longer, the thinning will be less visible. Your hair is currently at the length where the thinning will be the most obvious - which happens to be a good length for consultations. It's a good thing that your hair is still too dense to justify a hair transplant. So to minimize the appearance of thinning you either need to go longer or just buzz it down.

[Dan07]

Ok thanks guys. I think I'm going to try finasteride and I'm already taking Rogaine. I have also just bought some nizoral shampoo - the label says just use it once a week but is this correct for hair loss purposes?

I'm also going to try growing my hair. I was shaving it all the way down to stubble and the only reason it's longer now is due to the consultation. But, yeah, it didn't really look too great like that and I think it's starting to make me look much older than I am.

What I'm concerned about, though, is how messed up the front is. Not sure how I could make it look ok. I mean it's very thin, the sides are receding and not only is it thin, but it's all in clumps and uneven. The front really frames the face and is definitely what I'm most bothered about. So yeah, I'm not sure how I could make it look natural growing it. I'm also completely useless with hair styling haha. I'm thinking I could go to a stylist but knowing my luck they will mess me up!