Please discuss/advise..

I am 38 (probably more like NW6, but not exactly - see pic) and fighting with myself as far as how much of the scalp should I get HT done. So far, I am leaning toward getting just enough to cover my frontal half. (Area A in picture) I dont think being agressive and filling up the entire bald scalp is necessary for the following reasons:

1. frontal half is very critical to change one's look. While I agree the crown will make a little bit more diff, the (perceived)difference in look between getting a frontal and rear is not much ..

2. if one's job is not in entertainment industry/show biz or does not need to wear very short hair, it shouldnt be that big a deal

3. close to double the cost, frontal might need about 1500-2500, for the entire top, could be 3500-4000 (H&W could probably fit about 7000)

4. potential to look terrible either way. After say 10 yrs, if loss continued further back and down, there could be a new gap between transplanted hair and original hair at which point there may or may not be enough donor hair / strip available to close the gap, should max out in the first HT by doing entire bald scalp.

So, to overcome #4, I was planning to having a sort of a band of decreasing density in the rear of frontal half(in the area B) to resolve unnatural look of dense (transplanted)hair abruptly ending in clean bald head near crown area. I have actually seen some pictures of patients performed by a popular surgeon on this site who had this look.

So what do you guys say ?

Attached Images

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hey pd. IT LOOKS like you have good donor hair, and i know that only a doc knows, but from my experience, i think you could do a good frontal transplant. I think though that you wuld need about 4000 in the front.see a good doc, again, your donor hair looks good, so there is good potential for good results.

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juanc
1000 grafts with dr rosanelli
1000 grafts with Dr. Peterson
1600 (july 17) with Dr. Ochs

I think what you do should depend on your scalp laxity and donor area availability.

If those are favorable, then you will have more options.

I know its annoying when people type this, but I think a qualified hair doc would be in a better position to answer your questions.

PD,

That's a good shot for the top of the head, but I'd like to see your sides and back, i.e. your donor area. But you do seem to have thick and curly hair on the sides which tend to give great results with a HT.

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My Hair Transplant with Dr. Paul Shapiro

Juanc/Ronald/Aaron,

Thanks for your opinions guys..

I was told by HT doc I visited that I do have reasonable amount of donor hair TODAY.. but long term you never know, I had amazing dense hair on the top 20 years ago, see what happened ;-)

I would also love to hear on my idea that filling up every bit of scalp is not necessarily the right strategy..

Aaron, you did the best thing going to Dr. Shapiro... Good Luck man!

I think your strategy is a good one and also realistic. Of course, everyone is one is different, but if you are content with having a thin crown then it would definitely be wise to pack more towards the front. In fact, it seems that most surgeons usually place higher densities in front as it is already.

Thanks PD. I'm definitely playing the waiting game now. But I'm optimistic about this round.

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My Hair Transplant with Dr. Paul Shapiro

I opted to just fill in the front, thats the profile that everyone sees anyway. So a good strategy would be to start a conservative hair line in the front, and work your way back. Also
your curly hair will be beneficial for "Creating the illusion" of density, if you place a density of about 40-45 hairsper sq cen.in the front you should get a great result and if u have high sides that should help even further.

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juanc
1000 grafts with dr rosanelli
1000 grafts with Dr. Peterson
1600 (july 17) with Dr. Ochs

You should discuss this in detail with a surgeon. Ask them (and satisfy yourself) whether this plan will look natural:

a) from all angles
b) in all lighting
c) with further hair loss
d) with different hairstyles

and any combination of a-d

If there is further hair loss the pattern you have drawn might be overbalanced toward the front and if so people are likely to notice that.

The front 1/3 to 1/2 will take about 4000 grafts minimum to give reasonable illusion of density given the advanced hairloss you have.

You will do yourself a favor to do at least that amount on the first pass.

Best of luck.

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Dec. 2004 - 1938 Grafts via Strip
Feb. 2009 - 1002 Grafts via FUE

Yes. 4K will only do frotn half and you will want more density.

My front was done with 4.5K grafts and density is low. If spread out any further, would be a total mess. If packed tighter, would also be a disaster becuase it wouldnt be connected as well on top.

Its a balancing act. Only get 4K+ done, period. Only a few docs do this regularly. Even with that many grafts, you will want more.

Given future loss, chasing the crown can be a very bad idea.

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My Hair Loss Web Site - Hair Transplant with Dr. Wong