I was curious, if drugs like propecia only slow mpb and genes usually overcome them after time and you get hair transplants, what do you do later on when the drugs looses it’s effect and you loose hair in the non transplanted areas, and by chance you don’t have the donor hair to compensate. Thank you for your time.
Great question! The treatment of male pattern baldness with drugs and possible transplants requires a good Master Plan with your doctor. The Master Plan will balance the eventual worst case scenario for your balding pattern (only 7% of men go all the way to a Norwood Class 7 pattern — see illustration at right), the donor supply, and the reconstruction. For example, a person who has a Class 3A balding pattern at 35 years old, has a worst case scenario of a Class 5A pattern, but probably wont get there if he is treated with Propecia (finasteride 1mg) and is a good responder. I find that I can restore almost all Class 5A patterns with reasonable hair density, good laxity and average or better than average hair weight. When you discuss your balding problem with your doctor, this should become the central focus on your consultation.
Like you suggest, going into transplants blindly could not work in your favor if your hair loss pattern eventually works to a Class 7 pattern. With that said, people who may evolve into a Class 7 pattern could accept coverage in the front and top, leaving the crown out of the reconstruction if their pattern goes too far. A frontal reconstruction with a Class 7 pattern looks great in the mirror and is a reasonable option for the worst of the balding patients.