Hello Peter,I can see from the photos you provided that your front and middle scalp are starting to thin, as is the area on the top (vertex) following the common hereditary hair loss pattern. What you need to understand is that this pattern will almost certainly continue and it will likely get quite worse in the next 5 to 10 years. A 500 graft transplant will do very little for you, except fill out a little bit of hair at the front, but the hair around it will continue to disappear leaving you with just 500 hairs in the front and mid scalp, probably within the next 5 years. In just a few years you'll need another procedure. You need to have a predictable and stable hair pattern in order to properly plan a transplant procedure that will last for decades and still look good when you are 30, 40 and 50. Remember that you may only have 5000-6000 stable donor hairs in the "hair bank" (the "hair bank" is the scalp on the back of your head where the hair is typically resistant to hair loss). It is best for you to save both your money and your donor hair follicles in the "bank" for a later time, when the final pattern of hair loss is known and we can design a really great hair restoration for you.In the mean time, your only real options for treatment are the medications Minoxidil (Rogaine) and Finasteride (Propecia). You should definitely be using those before ever considering a hair transplant. Finasteride (a pill) is the most effective option, especially in someone as young as you are - you may be able to really slow down the rate of hair loss as well as get thicker and fuller hair. You have to take it for at least a year to see the full effect, and should probably continue taking Finasteride indefinitely, even after a hair transplant. You can combine it with Minoxidil (a topical lotion) for even better results. If you are worried about the side effects of Finasteride that you've read about, don't - the risk is less than 4%. I've written a detailed answer about the side effects of Finasteride to another patient on Realself and you should read that - I've put lots of information there for you.Finally, watch out for "hair regeneration" treatments, including platelet rich plasma injections. There is no objective medical or scientific evidence that any of them work at all, their claims are largely false, and you'll just be throwing away good money. Save your money for the ONLY treatments that are actually known to work: Minoxidil, Finasteride and hair transplants.I hope this helps. Good luck!
