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So I’m set to have a 1,500 graft hair transplant in May and I’m pretty stoked (23, NW 3.5.) I have thick hair and no diffuse thinning but my temples and hairline is messed up and like many of you I have let my hair loss severely impact me. For those who have had one… Most importantly are you happy with the results? Is there anything you wish you knew prior before having yours? Anyone that has thoughts/tips/or stories much appreciated. Beyond excited to have my hair back but would love a little more information about what I’m getting myself into

23 is a bit young for a hair transplant. Have you and your surgeon built a Personalized Master Plan for your future short-term and long-term hair loss? What is your lifetime supply of grafts (each of us is different) and if you don’t know this, then you might get into trouble in the future. Look at this important link and imagine it was you: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/ . I wrote the following post for this man here: https://baldingblog.com/22-year-old-received-a-hair-transplant-of-2800-grafts-from-reddit/ explaining the concept of a Master Plan and its importance.

You seem to have significant recession. I doubt that minoxidil will work but used with microneedling it might. Get a good doctor who will build a Personalized Master Plan for your hair loss with you. A hair transplant is a sure option worth considering

This 10 year study of finasteride in Japanese men is very significant. (1) it revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years, (2) younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.

https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

We evaluated the long-term (10-year) efficacy and safety of AGA treatment with 1 mg/day finasteride in a large study population (532 patients), as the first study of this kind in Japan, to our knowledge. A high objective efficacy was demonstrated by the MGPA, which revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years. Furthermore, the outcome was similar to or better than that reported by other studies in Japan [8-10,13,17]. Differences have been known to occur in the progression of AGA symptoms between Japanese and Caucasian men [8,18]. This efficacy of the investigated treatment in Japanese men exceeded that reported in other studies in Caucasians. The superior response of Japanese men with AGA was reported to likely be attributable to their hair characteristics (greater diameter, black color, and lower density), which facilitated the detection of slight changes [10,19-23]. A novel finding observed in this study was the significant difference in the improvement of AGA following finasteride treatment between the N-H: I/II/III and N-H: IV/V/VI/VII groups at the first visit. The ROC analysis revealed a similar difference, that was performed to classify patients with improvement (MGPA?5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III (AUC: 0.746). Furthermore, the MGPA of the total study population and the N-H: I/II/III group at the first visit significantly improved from treatment year 5 to 10 (P<0.001). This efficacy was different from that of a 5-year study in Japanese men, which reported that the efficacy began to plateau after 4 years of treatment [10]. Several studies have reported that AGA progresses in N-H classification with age, [7,11,12,18] and that younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.

I’m pretty close if not completely norwood 7+. I realize this severely limits what I can expect from a hair transplant. I am currently 40 years old, and have been balding since 20. So I’ve been on fin and minox on and off throughout the years. I know there’s only so much you can say if you don’t see me personally, but I just wanted your opinion as an expert. At a norwood 7, would it be possible to have graft or FUE done to the “top” of my head so that I have coverage on the top enough to create an “undercut” look. Currently, I shave my head completely. If I had the transplant done, I would still plan on shaving the sides and “under” the top. I realize this would possibly make scarring visible and obvious, which I understand is a very important thing to consider. I would think micropigmentation would help with this, right?

I was just curious if you had ever performed this kind of look, and whether or not you thought it would be viable with such advanced hair loss.

I have performed hair transplants on hundreds of Class 7 pattern patients. Some have had a very high number of transplantable grafts and some have not. See: https://baldingblog.com/question-about-class-6-pattern-of-balding/. If you want to consult with me, write to me at williamrassman33@gmail.com. To evaluate you correctly, I need to see some photos to show your balding, and one of them should be a frontal view with your hair pulled back and your eyebrows lifted high so that the creases on the forehead show up. This will show me anatomical landmarks to measure where your hairline belongs and more about the shape. Tell me what you don’t like about your hairline and overall hair situation. Please include your phone number and the best times to reach you.

This is a great result from taking finasteride which tends to work better in the crown than elsewhere on the scalp.