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Old 03-11-2018, 10:45 AM
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Default HT Pre Op Queries - 31yrs Male, NW-3V, Dr Bhatti

Hi All,

I am 31 years old and soon going to be 32 in the next few months, have been losing hair for the past 5 years. I have tried using both Minoxidil and Finpecia for about a year together and then stopped about 6 months back, as I just couldn't see myself doing it any further for the rest of my life. I'm not sure if it did stop my hair loss or helped regrow some, as there was nothing noticeable to my eye.

I've been following this forum for about 2 years as a silent spectator while deciding if I really needed a hair transplant (Parents being against it) or should I wait further or look for an alternate solution (Hair System?). I've really been stressed for the past few years due to the hair loss and it did impact my self confidence, with some individuals (friends/colleagues) making jokes in public about the balding spot didn't help either. Being unmarried and balding is not making it easier for me.

The forum helped me reading through all the patient's reviews and their journeys. I then decided I do need a HT, so it finally came down between Dr Bhatti and Dr Lorenzo, but considering the cost (wasn't that important factor) and Chandigarh also being my home town, I opted for Dr Bhatti and fixed my appointment with him over email for the next month.

After discussing with Dr Bhatti over the email, he mentioned I'm Norwood 3V and that I would need 1500 grafts for the front, 1000 grafts to cover my crown. My hair other than the balding spot is reasonably thick, I have attached the pictures to give a fair idea.

Need everyones honest view on the frontal hairline, should I lower it further or continue with the same? Do you think 1000 grafts will be enough for the crown?

How much density should I be aiming for at the front and the crown while making sure I do not waste my donor area (as I may at some time in future need it again, I hope not - but still)

Should I consider transplanting my chest hair instead for the crown, instead of wasting the donor area at the back? If yes, will it look unnatural considering the hair surrounding it is thick and original hair (instead of the chest hair)?

I will of course be discussing this with Dr Bhatti in person (didn't feel like bombarding him with so many questions over email), but I will be in a better situation if I have everyones view and I got almost a month to ponder over it.

Would love everyones view

PS: I'm suffering from Hypothyroidism (under control via pills).
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Old 03-11-2018, 11:53 AM
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you don't use any beard or body hair for hair transplantation unless your donor is completely maxed out and have no other choice - first its texture is different from scalp hair, 2nd - it's viability and growth rate for transplantation is far less than grafts from your scalp. Body or beard hair should be your LAST not first option.
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Old 03-11-2018, 12:05 PM
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Originally Posted by home1212 View Post
you don't use any beard or body hair for hair transplantation unless your donor is completely maxed out and have no other choice - first its texture is different from scalp hair, 2nd - it's viability and growth rate for transplantation is far less than grafts from your scalp. Body or beard hair should be your LAST not first option.
Thanks home1212 for your reply and clarifying my doubt, I'll go with the scalp donor. What are your views on the hairline, do you think I should lower it a bit or stick to what it is now? and what density should I aim for both front and the crown (considering reserving grafts for future transplant if needed)?
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Old 03-11-2018, 12:23 PM
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I think you have a very decent, age appropriate hairline with slight temple recession. If it were me, I would not lower it at all, but focus on enhancing and making it stronger by transplanting where you may have some miniaturization going on and possibly filling in the middle of the hairline where you have some loss - not to make it look too symmetrical but with an irregular pattern found in natural hairlines. A surgeon with excellent skills and artistry will undoubtedly do an excellent job reinforcing your current hairline without dropping it to a point where it will not serve you well in your 40's, 50's or 60's. That's what you need to consider and keep in mind. For your crown, I may consider putting that off for now and seeing where your hair loss pattern is going as you are still young. Try meds, minox, other natural supplements along with DHT blockers etc. Alternatively, your surgeon may want to address the crown now, but since MPB is continuous and progressive , you may have to address it again as you continue to lose hair. At the end of the day, as long as you make informed decisions, and not ones based on fear or panic, you will have a better plan of attack to address your hair loss going forward. Best of luck to you.
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Old 03-11-2018, 12:36 PM
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Originally Posted by home1212 View Post
I think you have a very decent, age appropriate hairline with slight temple recession. If it were me, I would not lower it at all, but focus on enhancing and making it stronger by transplanting where you may have some miniaturization going on and possibly filling in the middle of the hairline where you have some loss - not to make it look too symmetrical but with an irregular pattern found in natural hairlines. A surgeon with excellent skills and artistry will undoubtedly do an excellent job reinforcing your current hairline without dropping it to a point where it will not serve you well in your 40's, 50's or 60's. That's what you need to consider and keep in mind. For your crown, I may consider putting that off for now and seeing where your hair loss pattern is going as you are still young. Try meds, minox, other natural supplements along with DHT blockers etc. Alternatively, your surgeon may want to address the crown now, but since MPB is continuous and progressive , you may have to address it again as you continue to lose hair. At the end of the day, as long as you make informed decisions, and not ones based on fear or panic, you will have a better plan of attack to address your hair loss going forward. Best of luck to you.
Thank you so much for your advice and wishes, I'm glad I found this forum I was intending to stick with my current hairline as well, as it isn't that bad except for the hair loss at the front/middle and reinforcing it as you mentioned should work. My current plan is to get the crown done, but not waste too many grafts on it and then if required I can restart the Fin pills, but Minox is something I want to avoid as it is an everyday task. Thanks again.
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Old 03-11-2018, 03:55 PM
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If you fill in the front middle hairline section it will look like you've lowered your hairline slightly simply because there's hardly anything there now. That's all I would do in the front for now. As for the crown I'd do 1000 grafts and see where that gets you. You don't want to use too much up in the crown yet. I think 1000 in the area that size is fine. If I was doing FUE then I'd possibly split the 1000 crown grafts between head and body grafts, perhaps 500 chest or beard grafts if the hair in those areas are good quality and 500 head grafts. This way you don't worry about depleting your head donor with further hair loss down the road. That's just me, though. It looks like you have plenty of thick donor hair.
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Old 03-11-2018, 04:02 PM
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You've got a lot of hair still so that's good. I would urge you to get back on finasteride long term and stay on it. There's no point in getting a transplant now, only to lose more native hair in the next few years.

Good luck
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Old 03-11-2018, 04:34 PM
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If you have friends making fun of your hair loss, you need new friends!
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Old 03-14-2018, 08:55 AM
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Quote:
Originally Posted by BeHappy View Post
If you fill in the front middle hairline section it will look like you've lowered your hairline slightly simply because there's hardly anything there now. That's all I would do in the front for now. As for the crown I'd do 1000 grafts and see where that gets you. You don't want to use too much up in the crown yet. I think 1000 in the area that size is fine. If I was doing FUE then I'd possibly split the 1000 crown grafts between head and body grafts, perhaps 500 chest or beard grafts if the hair in those areas are good quality and 500 head grafts. This way you don't worry about depleting your head donor with further hair loss down the road. That's just me, though. It looks like you have plenty of thick donor hair.
Thanks mate, the bald spot on the crown convinced me to go for transplant, even though there is hair loss in the front along with gaps between hair, I can pretty much hide it by styling it. Luckily got good donor area which is why I don't want to waste it. I honestly don't mind going bald at 50+ (maybe my views will change later ) but I feel Im still young to go bald

I was thinking about the use of chest/bear grafts but home1212 mentioned regarding the difference in texture, viability and growth rate being low for the non-scalp grafts. Maybe will check the doc on the day of consultation about his views.

Since I got a bit of space/gap between the hairs at the front (a bit upper of hairline), it's not exactly a bald area, not sure if one can transplant hair between existing hairs without causing trauma to the existing hair. I couldn't find anything substantial in my research, are you aware by any chance?
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Old 03-14-2018, 09:01 AM
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Quote:
Originally Posted by splitting hairs View Post
You've got a lot of hair still so that's good. I would urge you to get back on finasteride long term and stay on it. There's no point in getting a transplant now, only to lose more native hair in the next few years.

Good luck
I tried fincpecia which is sold under Cipla brand along with minoxidil 5% solution for almost a year, I could not find any success with new hair. So not sure if there is any point to continue in a hope of a miracle, It might have helped in reducing my hair loss further but that too I don't know for sure. I don't mind taking finpecia again post hair transplant if needed to keep my native hair but I don't think I have it in me to stick with Minoxidil 5% solution on long term.
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