Is a 36yo NW3-V a good transplant candidate? Is there a good way to estimate how much hair will be lost in remaining years?

If you are losing hair and want treatment options you should schedule a consultation with a doctor for the exact reason of possibly losing more hair in the future.  You need an examination and a face to face discussion of what to expect with the realistic results your doctor can provide.

Based on your description, it sounds like you may be an ideal hair transplant candidate. To best determine your candidacy, you should meet with a qualified hair restoration surgeon for a consultation. The fact that you’ve been medically managing your hair loss for the past 12 years has likely been the reason your hair loss hasn’t progressed further than stage 3. Hair transplants are a great and natural-looking way to restore your hair. But you are correct that hair transplants don’t stop further hair loss. For that, you would need to continue medical management. Since you have been having success with medical management for the past 12 years, it is likely you may continue to have success. It is possible that later down the road, you may need an additional surgery to cover the areas of baldness that have developed. One thing I would add is that 9,000 grafts seems like a very high donor density.

Hair replacement for balding--grafting vs F-M flap and when? Balding is always progressive--Clint Eastwood etc. I have done both procedures for more than 35 years and you should investigate both techniques before starting. NO grafts if that is what u choose until the front is completed!!

You need to undergo a miniaturization study that evaluates your scalp and hair microscopically.  We do it in the office and you can tell where you are heading from hear. We can also determine the number of hair grafts that is available to you throughout your life. 

Hello in California,Sounds like you've done all the right things to try and slow down your hair loss.  Although you can get an idea of how much hair loss you may eventually experience by looking at close relatives on both your mother's and father's side, it is not a very accurate.  You could still have a lot of hair loss even if your relatives don't.  Having said that, if you are already 36 and just a Norwood 3V, it looks as if your hair loss may not be very aggressive, but keep in mind that the medications may also be working hard to help you.Hereditary hair loss in men starts at or right after puberty and continues from then.  In some people it is a very slow on going process, and in others it goes through a rapid phase with significant hair loss in the first decade or two, and then the hair loss slows down and the hair pattern becomes stable in your 30's and 40's.  It is just really hard to predict this behavior ahead of time.The bottom line is this:  You will eventually lose more hair in the temples and front, we just can't be sure how much. Most of us are reluctant to treat only the vertex, unless we can be really sure that there will be no further hair loss up front.  You want the largest number and best hair follicles to be saved for restoring the front hair line, the mid scalp, and the temples because most people who see you (including yourself in the mirror) will see only your front hair line and temples.  The front and temples are most important for framing your face.  Few people will see the vertex of your scalp.  If the loss of hair in the vertex is really bothering you, you could opt to have your vertex transplanted now, but you have to make sure you save enough donor hair to eventually do the front and temples.  Another thing to keep in mind is if you have your vertex grafted now, and you have further hair loss around the vertex in the next 10 to 20 years, you could end up with an unwanted halo - where you have a round area of restored hair in the vertex, surrounded by a margin of bald scalp.  It looks really bad and will need a lot of hair grafts to fix. Finally, keep in mind that 9000 available donor follicles is likely an over-estimation.  It is highly unlikely that a surgeon will be able to get 9000 follicular units out of your occipital scalp in multiple sessions, but you probably have a good 6000.I hope this helps you to figure out what to do.

Thank you for asking this question.

Please post pictures for us to give better advice. As per your description, you are an ideal candidate for a hair transplant. Without pictures it is almost impossible to suggest anything. Regarding the progression of the existing hair, please continue finasteride and minoxidil. Every drug works for a specific tenure and then the body builds a resistance towards is. Once you feel you are not getting any benefit from minoxidil, you might want to try PRP (platelet Rich Plasma); in which 15 to 20 ml blood is drawn from you and plasma is centrifuged. This concentrate plasma is then injected all over the scalp. PRP shows best result when repeated every 2 weeks for at least 6 times in a row; which should give you benefit of about 12 to 14 months. Please be informed that all these preventive methods will only postpone the progression towards baldness. There is nothing as such which can ever stabilize the hair-loss.

Good luck!

Regards, Dr. Amit Gupta

Hair loss is progressive. It generally slows down in the mid-thirties and further in the 40s, but your Mater Plan must take into account not the probably situation but your worst case scenario. You need that plan with your doctor