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Old 11-12-2017, 04:04 AM
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Default 30 yr old : Need advice on crown restoration : Pls help !

30 yrs old Indian male, had previous FUT HT in 2012 for frontal hairline. The crown section which had already started thinning by 2012 has progressively thinned a lot more. There are still a bunch/lot of miniaturised native hairs in the crown section and its's not gone totally bald yet.
pics album: Hair Restoration Social Network - Hair Loss and Transplant Photos
I have been in two minds whether to address this region or not today after getting the HT surgeons feedback. I understand crown is a black-hole of donor grafts and even though I get it covered, it would most probably circumferentially expand further tomorrow. Hence am clearly not looking for any super-packed density today, only a conservative no. of grafts. At my age, undoubtedly the thinning crown is a detriment to a confident look, hence that's why wanted to get it addressed if possible.

1) The main high concern though I have in covering the crown is the permanent shock-loss post HT which might happen for the weak miniaturising native hairs in that section This is a concern voiced by HT surgeons also.
2) Also I am equally lot more concerned about potential shock-loss to adjacent hairs in mid-scalp region which are healthy as of today. I am really skeptic that they don't suffer a shock loss (temporary or permanent) and HT becomes a trigger of their thinning out

Here are inputs received from HT surgeons:-
Dr. Radha: Keep/address crown as last priority and save donor grafts for frontal third. Wait for an yr or two and revisit if the area thins out more. If really want to get it done today need ~1000 grafts
Dr. Bhatti: @ age of 30 should save on donor grafts as max possible. Covering crown today might result in net same look after 1 yr post temporary/permanent shockloss to existing native hairs. Either go for minm 1000-1200 grafts today or let it be and revisit when it has thinned out more.
Dr. Prashant Yadav: ~500 beard grafts for crown (no scalp grafts) to just give minimal coverage today.
Dr. Venkatram Mysore: Hold off for today. Instead go for PRP session for addressing the crown.
Eugenix Hair Sciences: 1000-1200 grafts for crown. Only temporary shock loss might be there, no permanent.

Based on my pics and above Dr. suggestions, would like a honest input/feedback from forum members whether or what are the resultant possibilities (both positive & negative) of getting the crown section addressed today or not.
If YES, what's the approx minm number of grafts I need to give it a denser visual coverage post 1 yr after taking into account chances of shock loss. Can the shock-loss be alleviated somehow ?..
If NO, what's the alternatives as of today to prevent crown progression and perhaps regrow hair in existing thinned region.
Medicines:
I have been on Finasteride 0.5 mg per day off & on[mostly regular] over the past 5 yrs. Never started on minoxidil after initial few months in 2012 since I was tired of the twice daily application and given the fact I read the effects are only temporary at best and any laxity in regime lands oneself back to older baldness schedule.
1. Pls advise any other medications/treatment regimen which would help me save on crown progression?
2. Also pls give your honest feedback if I should go back and restart/retry Minoxidil asap ? Is it worth it in the long run?
Treatments:
I am thinking of going from PRP sessions for helping on crown but again have seen mixed feedback about it on the forum. Please provide inputs for same?

Any other medications/treatment suggestable @ this age for me to help on saving the native hairs & further crown progression, pls do let know.

Last edited by T20; 11-12-2017 at 04:53 AM.
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Old 11-12-2017, 11:24 AM
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Thanks for your informative post, I agree with most of the Drs, I would not transplant in the crown yet as you still have native hair there the crown is a hard area to transplant grafts don’t seem to do very well once transplanted there, I feel the survival rate is much lower than say hairline work. I’ve tried PRP and to be honest I saw no benefits at all but everyone’s different, I would up your fin dose to the reccomended 1mg per day and see how you get on
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Old 11-12-2017, 02:56 PM
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Use toppik until it goes further .

I would suggest using Laser as well. I know many do think it works but it does imo.
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Old 11-13-2017, 02:12 PM
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Laser not worth it. Maybe try increasing finesteride doesage. You’ll find some doctors will do your crown without a problem.
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Old 11-14-2017, 05:47 PM
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T20,

I took a peek at your 3 pics and wished there would have been some photos of your hairline as well.

But just based on your crown pics, it is apparent at your young age that you will completely lose everything in your crown, and it appears that you already are aware of this.

The majority doctor opinion is to wait on the crown and/or to not use more than say 1,000 grafts in that area. IMHO, you won't get much visual benefit from that. And chances are, you will have some shock loss to the remaining native hair in the crown. Even if you don't, you will lose that hair in a matter of time. Shock loss is related to how your scalp responds to the level of trauma caused by the countless number of incisions. There is no way to predict how your scalp will respond to the trauma.

We also have no idea of what donor reserves you have but I agree with the doctors who have advised you to use the majority of your scalp donor for the frontal zone. They are saying this for a reason and it must be related to what they are seeing your needs are for the frontal third.

If I were in your situation, I would give some thought to using beard hair in the crown if you must have your own hair there. If your beard hair has a more curly characteristic, then you want to think twice as there may be some visual incompatibility.

You will never have enough scalp donor to cover both the crown and the front. So managing your donor for now and the future is very critical for you.

Another option would be to wear a high quality partial system just for the crown which would put you in a much better place having your scalp donor reserved for the front. I know a number of guys who have done this with great success.

IMHO, minoxidil will not do much if anything at this point in time since most of your crown is already gone. If anything, it could cause you to lose the remaining hair that you have in the crown. The same is for PRP, don't think you will benefit from it because your loss has already progressed beyond what these treatments might do for you.

I would feel totally different if you were in the beginning stages of you hair loss journey.

Hope this has been of some help to you even though it can be difficult to hear. Yet you must know that your limitations exceed your overall potential because of the loss you have sustained so far and the fact that you are still very young with more loss in the future.

But be careful my friend because by the time you are say 40 or so, you may just want to cut your hair very short such as a buzzed cut and maybe that is something to try now and see what you think?

Wish you the best as I know these decisions are not easy.
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Old 11-15-2017, 12:20 AM
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I think toppik will work as perfect camouflage in your case for time being IMO
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Old 11-15-2017, 09:54 AM
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Quote:
Originally Posted by gillenator View Post
T20,

Another option would be to wear a high quality partial system just for the crown which would put you in a much better place having your scalp donor reserved for the front. I know a number of guys who have done this with great success.
Gillenator, I have seen you mention this approach on various hair loss forums and I am very interested in wearing a partial "circular" hair system for the crown.

I am wondering why this approach is not utilized more often; especially for those on the higher end of the Norwood scale. I tried looking for results for this type of hair restoration and I could not find much results/information. Would you be able to share any results?
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Old 11-15-2017, 10:14 AM
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http://http://www.hairrestorationnetwork.com/eve/145324-%2Aphotos%2A-placing-grafts-front-hair-system.html


http://http://www.hairrestorationnetwork.com/eve/174588-raymond-konior-md-%96-chicago-%96-hairline-restoration-hair-piece-patient.html



Above are two examples of this approach and they look extremely natural to me. The second link is something along the lines of what I am considering. My only concern would be possible damage to the remaining hair under the hair system as my hair loss in the mid-scalp/crown is not as advanced as that individual, not yet at least.

Last edited by HereForTheHair; 11-15-2017 at 10:26 AM.
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