35 yo, should I do a FUE HT on the crown now or wait? (photos)

At this stage the FUE hair Transplant is possible to restore the crown. You should know that the hair loss might continue and you will need a second transplant. If the baldness area is in advanced stage you will need 2 sessions for full coverage with good density. It comes the same. You donor area has a good level of density. We estimate 1700-2000 grafts for the crown.

Hair loss has many causes, including stress, medications, autoimmune, genetic, trauma, etc. Medical treatments can work and options would include finasteride (propecia), minoxidil (rogaine), PRP (platelet rich plasma), laser light therapy, and vitamins. It is often uncertain which medical therapy will help which patient and so a combination of therapies is typically recommended to maximize benefit. A hair transplant is a surgical option and is appropriate for certain conditions and individuals. 
The goal of a hair transplant is to provide fuller coverage while preserving a natural appearance. An assessment takes into account such factors as the apparent thickness and curl of your donor hairs, the color contrast between your scalp and hair, your hair loss pattern, your age, and many other factors. The state of the art technique is FUE (follicular unit extraction), performed with a hybrid blunt punch that minimizes graft transection while allowing for the use of the smallest possible punches to minimize donor site scarring while maximizing regrowth.
In your situation, getting on some maintenance treatment would be in your best interest. You can also consider PRP treatments to the crown before a hair transplant. If you do proceed to a crown hair transplant, I would recommend 1000 - 1500 FUE grafts to give you more density but to preserve your donor area for potential future procedures.
Gary Linkov, MD
Hair Specialist
Manhattan

Hi There,
FUE hair transplantation is a great option for restoring hair to the scalp. In your case, you have good donor site density and would be a good FUE candidate, particularly because you keep your hair short in the back. Determining whether now is the best time for an FUE is a great question. Although there is no perfect way to predict hair loss, you can estimate hair loss by looking at other male family members. This will give you an idea of where your hair loss will "end up." With that information, I recommend consulting with an experienced hair transplant surgeon. You can then discuss your family hair loss, as well as your current hair loss, to determine if FUEs to the crown only would lead to natural results. If you anticipate that you will keep the frontal hair, then placing grafts in the crown area may be helpful and natural. However, if you feel that you will lose hair in the front, it may be helpful to spread grafts along the frontal area to bolster the hairline, in addition to the crown, for a more natural result.
Hope that helps!

Hello and thank you for your question, I’m happy to see you are asking questions, it makes it easier to decide once you’re informed. I’m curious as to why you’re against medications, because you’re a good candidate for it. You could also go ahead with the transplant. I suggest seeing a reputable doctor and decide which is the best path for you to take. I wish you the best.Dr. T

You’re wise to think about all these things. Wise people are generally the most satisfied with the decisions they make about surgery vs waiting. There is no right or wrong decision - but there is a very high chance you’ll be pretty satisfied long term with a decision to proceed to transplant. But as you have pointed out, you might need small touch ups in the future you are correct. 
You certainly could consider low level laser and see where it takes you in a year or two and reconsider whether or not you want surgery when you reach age 37. You could also consider topical minoxidil or topical finasteride (or both) 2-3 times per week but I understand that you may have given these careful thought already.  
The reality is that if you choose your surgeon appropriately and don’t overdo the crown you’ll have lots of grafts available to touch up if needed. 1500-2000 follicular units now could give reasonable coverage (provided the surgery is successful and survival is high) and you’ll have 2000-4000 + grafts available for the future. That's alot of grafts. The crown can use up grafts quickly so one needs to think about improved coverage rather than matching the high density of your frontal areas. That, in my opinion, would be unwise, and a waste of grafts. 
I would like to re-emphasize though that you are certainly a very very good candidate for minoxidil, laser or topical finasteride with all the vellus hairs that are in your crown. Treatment even a few times per week with minoxidil, laser or topical finasteride certainly could bring about some significant benefits. 

At age 35 it is a good time to proceed with hair restoration surgery for the crown. The crown would require approximately 2500 grafts to repair.

If you haven't tried minoxidil or finasteride yet, you should first give it a try before jumping to a hair transplant. I had my crown transplanted and didn't chase it, but in about 20 years, I did it one more time.