Mike, you're a younger guy (not too unlike myself ), so I urge you to move forward with caution. We've talked a bit about shock loss, and from what I remember, you had told me it was not a huge issue in your past surgeries. I had significant shock loss from my first procedure, so I will not likely touch my crown for another ten years. In your case, it seems your hair has reacted well, so maybe this would not be an issue...I also think your hairline is looking solid, but I understand your concerns. I would think 1000 grafts would provide adequate density to finish off your hairline. Best wishes.

we all make mistakes balboa: But yes this is the actual hairline and im not happy with it, that's why i want a 3rd procedure. Nothing deceptive there's just not enough density. On the other hand the procedure really made my first frontal 2/3 solid, even with a flash i can't find any indication that i'm losing my hair so that's good! I definately consider the procedure a success.

Coligion: True, i am. Did your shockloss return? How long did it take? Shockloss so far hasn't been a concern for me even though i'm a diffuse thinner (which are usually the ones getting that) and as long as it's not permanent i don't mind even if it happens. But yeah 1000-1200 to the hairline should hotfix me for sure! Still, im very tempted to hit the crown. Very.

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11/04-07 - 800-1600 ish grafts - danish clinic - poor results

12/02-08 - 2764 grafts - Dr. Devroye - good result but needs hairline density

03/12-10 - 1429 grafts - Dr. Mohmand - result pending

Feel free to visit my picture thread

My Hair Transplant Photos - Surgery with Dr. Devroye

Young lads below 25 unite!

Hit the crown, I would def do that

I would love to, and while i am probably known for being aggressive in my approach, i do still want to make the right decition.

__________________
~~~~~~~~~~~~~~~~~~~~~~~~~
11/04-07 - 800-1600 ish grafts - danish clinic - poor results

12/02-08 - 2764 grafts - Dr. Devroye - good result but needs hairline density

03/12-10 - 1429 grafts - Dr. Mohmand - result pending

Feel free to visit my picture thread

My Hair Transplant Photos - Surgery with Dr. Devroye

Young lads below 25 unite!

Dear Friends

I was asked by MTD to express my personal professional views about this case.

I think it has been a wonderful results considering you started very early in your life.

I can see that you are now touching Type Vish but then we really cant tell the true picture as you are on meds. Keeping that in mind and looking at your picture of crown, I guess you would loose all the top hairs and the donor will go down further by about a cm or so. This can also be predict by looking into your family tree and see how bald were your uncles, father or grand parents, that would be more or less the future of your baldness and only then we can predict the level of baldness you would achieve. once we are happy that we will have enough of donor area for future loss only then we proceed to next point that is

The question comes what do you want from the crown?

If you want the same density as you have on top then we are seriously looking at another 4000 plus grafts. Reason, the crown is a challenge for doctors is cause it has a birds eye view and hence you need twice as many grafts as you would need for the front. so then the problem comes you probably wont have enough donor to support your demand.
on the other hand if you want just enough of hair on the crown that you should not look bald rather thinned out look, then I am sure you would be happy with this surgery.

Seond problem, the wide scar, in order to make a good donor scar i need enough mobility that the proposed width of scar that we have marked shoud over lap by 0.5cm. This should bring the best possible donor scar. now ifyou have a density of lets suppose 100 grafts/sq cm, i would need 20 sq cm strip which will bring the number of available natural grafts to about 2000. If you have a wide scar of 0.5 cm, then i would need to take a 20 cm long and 1.5 cm wide donor strip. This is all science and maths.
If you have enough mobility to get 1.5 cm wide strip then i guess we should b able to put about 1500 grafts on crown but in a fashion that they should give an illusion of 2500 grafts. This is done by controlling the angle of exit of hair and the curvature of shaft. this is the arts part of the surgery.

1500 grafts for crown is theoretically nothing and would give just 30% more improvemnt than what you already have. the fact you have light brown colour makes the life a bit easier cause the light colour hair tend to blend better than dark colour which tend to stand out on a light colour skin.

If you keep on using the meds I am sure you would stay happy, but please do keep in mind that before commiting to crown you have enough donor area fpr front in future.

SO this is how I would eal in a case like yours

See the donor area, if you have a viable donor area that can donate about 4500 to 5000 grafts, I would be happy to take 2000 out and leave the 3000 for future for the front.

I personally woud not commit more than 1500 for the crown till you cross 40 and have no meds for more than a year.

i hope i have been able to convey my point of view, though i am not good in explaning things while writing it down so it might not convey the same concept that I have in mind and that can only be done once we are fce to face......

take care

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I am a medical advisor to Lexington International and Hairmax. What ever I say is my personal opinion.

Dr. Mohmand is recommended on the Hair Transplant Network

Dear Dr. Mohmand

This is exactly the reply i was hoping for! Thanks for taking your time to do so, it reassures me that picking you as a doctor is definitely a good choice.

I should tell you though that the picture of the crown is taken while the hair is wet, as well as with a flash, and in harsh lights, so it looks worse than it really is. Having looked at maybe 500 pictures of peoples crowns, and how they look pre/post op, i am 99% sure that 1500 grafts would give me GREAT density.

But even just an improved density is satisfying for me.

But as you say, the question is whether i have enough donor.

I think the best sollution is to evaluate on the day of surgery how things look for me, how much donor i have, how my scar looks, and my hairloss pattern. After all the hairline is PRIORITY while the crown remains luxury, but a very nice luxury i really want.

Do you require shaving?

__________________
~~~~~~~~~~~~~~~~~~~~~~~~~
11/04-07 - 800-1600 ish grafts - danish clinic - poor results

12/02-08 - 2764 grafts - Dr. Devroye - good result but needs hairline density

03/12-10 - 1429 grafts - Dr. Mohmand - result pending

Feel free to visit my picture thread

My Hair Transplant Photos - Surgery with Dr. Devroye

Young lads below 25 unite!

Mike - best of luck whatever you decide. However as I said in my previous post, and Dr Mohmand has confirmed in his post, you should proceed with caution. As you say yourself the crown is a luxury but if you have significant further loss as you get older then filling in other areas further forward may be a necessity not a luxury. As the doc says you are meds at the moment which masks the true progression of your hairloss but the meds could gradually wear off, or you might develop side effects which mean you have to stop taking them. Ultimately none of us can predict the future.

Anyway, best of luck man.

no I do not shave.
Lets do it like this I will see you, will see the donor scar, will see how much can be taken and then once we have the grafts we will see how and where to place it to maximise your out put and yet do not cross the limits.

My point is there are four stages in any ones learning curve

1) What to do
2) How to do
3) when to do

The last stage that makes you different from others is "when not to do" what ever we decide would be after indepth consultation, examination and then execution keeping things up the sleve for future

__________________
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I am a medical advisor to Lexington International and Hairmax. What ever I say is my personal opinion.

Dr. Mohmand is recommended on the Hair Transplant Network

That's a great approach i think, and it's only fair.

I'm currently waiting for some insurance money to arrive which can take weeks, so i'm holding off on scheduling with you, until i have them.

We will definitely see each other before the first week of december, that's for sure.

__________________
~~~~~~~~~~~~~~~~~~~~~~~~~
11/04-07 - 800-1600 ish grafts - danish clinic - poor results

12/02-08 - 2764 grafts - Dr. Devroye - good result but needs hairline density

03/12-10 - 1429 grafts - Dr. Mohmand - result pending

Feel free to visit my picture thread

My Hair Transplant Photos - Surgery with Dr. Devroye

Young lads below 25 unite!

Like you, I'm a diffuse thinner. Unfortunately, I don't believe much, if any, of my shock loss hair returned. In terms of benefits, I feel like I took one step forward, and two steps back with my first procedure. That is why I will remain extremely hesitant for round two. Being resistant to shock loss is a quality I envy in you