hair transplant: Nonlinear Function
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hair transplant

This page is from my personal notes, and has not been specifically reviewed for public consumption. It might be incomplete, wrong, outdated, or stupid. Caveat lector.

At ~33 my hairline has been receding and is starting to thin in front. I have a few options:

  1. Accept hair loss and go bald.

  2. Accept hair loss and just embrace the look.

  3. Try to style my hair to hide it, e.g., keep it long on the top.

  4. Take hair-loss prevention drugs.

  5. Permanently fix the problem with a transplant.

    I'm currently doing (3). I generally think that we should age gracefully and accept what we can't change, so I would default to (1) or (2). I'm inclined against drugs since you have to take them forever and they can have significant side effects. I certainly don't want a fake-looking hair transplant. But if a high-quality transplant would permanently fix my hairline without drugs, that seems worth considering.

Q: What balding pattern do I have? A: Seems like about a Norwood 3 or maybe 4.

Q: Am I a good candidate for transplantation? A: I don't see any red flags. The hair on the back of my head is quite thick, so there's probably a donor pool. The main issue seems to be timing. My hair loss might not have stabilized yet. I could wait a few years, or it seems like this might be ascertainable with a miniaturization study (https://parsamohebi.com/hair-loss/men-hair-loss/hair-miniaturization/).

Q: Do hair transplant require taking drugs? (finasteride or minoxidil) A: It looks like it's not intrinsically a requirement, but some doctors recommend drugs to prevent further hair loss. So I could probably get away without drugs but I'd need to make sure my hair loss has stabilized and that my surgeon is on board with this strategy.

This is an interesting series of articles on the mechanism of hair loss, arguing for what seems to be a minority viewpoint that scalp tension is actually the cause: https://perfecthairhealth.com/hair-transplants-debunk-scalp-tension-hair-loss/ It claims that hair transplants 'work' only to the extent that they transplant small patches of scalp along with the follicle. It also suggests that transplanted hairs might fall out after a while if you don't also take finasteride. There's a $150 membership, but it seems from reddit comments that the basic advice is to do regular scalp massage and microneedling. It seems like some people get results, but they're not reliable or drastic enough to be worth devoting 30-60 minutes per day to. Regardless of the mechanism, transplants seem to have stronger empirical results.

Doctor recommendations:

Should I try taking drugs first? Finasteride has potential side effects but many/most people don't experience them.

It would be good to at least do a consult with someone local for a physical examination.

Consultation forms:

Not clear if my hair loss has stabilized. Certainly I have much more hair than my dad or grandfather ended up with. So debatably a hair transplant would not help at this point?

I could wait another year or two to see if/how things stabilize. If my hair is similar then, I might be a good candidate for a transplant (but I'd still expect to lose most of it eventually like my dad has, so a transplant is temporary).

Alternatively I can try to start taking low-dose finasteride and minoxidil. If I can tolerate these and they help, then I might not need a transplant, or the transplant might be more effective. This seems worth trying.

Plan:

  1. Ask Jess on Wednesday if he can prescribe or recommends anyone
  2. Backup plan is to try forhims.
  3. I have topical minoxidil arriving tomorrow so I can test how plausible it is for me to apply it. But I think a pill is really going to work better for me if possible.
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