Hal

I don't want to hijack MPB's thread, but Charlie Sheen wears a system. He's has a very receded hairline with a fairly large middle patch. It's all shaved down. You see him with a Fedora on public outings a lot-- that's when he's not wearing his system. In interviews, etc. he wears his system-- it's a piece. (Link removed by moderator due to promotional content) Hal

It has been positive so far, Orlhair. Still a long way to go to final results but so far things have smooth and pain free. We'll have to see how things shape up a month or so down the road and beyond (shock loss, scar healing, etc.) But I'm hopeful. You hear a lot about the dreaded first week after surgery, but its all been one big non issue for me. I credit a lot of that to my surgeon and his staff. Really, you're in the best of hands. I'm still working on a detailed write up and will post when I get it done. I guess I'm the typical "recent transplant" guy-- haunting these boards with my experience. But that's to be expected. Par for the course I guess. Hal

Ok-- I see where you're at. Just my opinion, but from what I see I would think a 3,000 graft procedure in the front through the central core should do you nicely. I don't think you have any problem with donor supply for that amount. You would have to shave down and because you appear to be a diffuse thinner, you might experience shock loss to existing hair up front. My approach in your shoes would be that a 3,000+ procedure would stand on its on even if I lost everything else up front and through the core. I think you'd have to play it like rather than augmenting existing hair and hoping for the best. That would seem to me the best way to use available grafts and try to cover my bets as best I could (against future loss). But this is me shooting from the hip--of course you'll have to evaluated by the doc of your choice and come up with a plan of attack if you decide to go ahead with the HT. You'll have to get evaluated, research your options, and then make the call. The other thing I would say is make sure you choose wisely in your surgeon. You want this done right the first time and make the best use of available grafts. I've tried all sorts of cover products through the years but like Pro-Thik best. It makes a hell of a mess though with the residue/spray getting all over everything. But there are ways around that as I've learned. Hal

Hey MPB-- I read your story and there's no doubt-- you are in a difficult situation. You're only 21 and a Norwood II-- and Propecia is off the table. My opinion is that a transplant at this time is NOT a good idea. You could fill in that receding hairline but you have no idea how much more hair you're going to lose behind it. It may look good for a few years and then start to look odd as you lose the hair behind the transplants. At that point, you're in the classic hair transplant trap-- you will be chasing your hairline with multiple procedures. You could easily end up with multiple scars, depleted donor supply, and an odd looking balding pattern. Don't believe anyone who says a hair transplant for you now is "being pro-active" or that by having one you'll be "staying ahead of the game". It's a recipe for disaster. You don't know at this point how far your hair loss will go. It may be that you're just getting your adult hairline and there will be some recession and it stops there. Or it could go further. IMHO, a HT at this point with so many unknowns is just not worth the risk. This is just me, but if I were you, I'd keep up with Rogaine and check in to available (proven) hair growth/ hair mait. products (vitamins, shampoos, etc.) Maybe they work, maybe the don't. But as you say, your options are limited. It's tough, but a wait and see strategy coupled with a mait. regime is your best option right now. A HT should be off the table. Just my view. Hal

Multiplier, I guess the first step is to actually be examined and determine the number of grafts available. Phone consults are great, but in your case it sounds like you're going to have to go in to get an accurate read on where you stand. That said, it would seem to me that you should have enough donor left with only 800 previous grafts for another procedure. The logistics of a hair transplant (recovery phase, time off work, etc.) can be a bear to deal with with. Everyone is different with different circumstances of course. I work in an office but have arranged things so I can wear a hat for 6 to 8 weeks if need be. I also kept my hair on the high sides so I can go back to my normal hairstyle while the grafts grow in down the line. I was lucky that way with my balding pattern. At least that's the plan right now. We'll see how that goes down the line. I haven't see any pictures besides the avatar, but it doesn't look bad to me-- do you use product? if so, what? Hal

Smartguy, Dr. Shapiro did a Trichophytic closure with sutures on me. Here's the great part-- the Doc is in my neck of the woods next week (traveling from Minnesota) and he will remove the sutures himself locally. Here's the specs from the surgery (I was off on the graft count I posted earlier): Graft/Hair count breakdown: 3675 grafts/7294 hairs 1's - 872 2's - 2035 3's - 720 4's - 48 We were shooting for 4,000 but of course there are numerous factors that play in to this. Hal

Multiplier-- Doc said I had about 4,000 grafts left (supply) and that to fill in my crown would take about 1,500 or so. Right now I have grafts at the very top of my head and a little further down. My bald spot when its all said and done will be about the size of a baseball. I will be able to "shingle" it over with some of the new hair. In fact I did that for years before I lost the very top that's now been restored. I'll see how it goes once the donor scar heals and I see the grow in results before deciding on more procedures. But to answer your question, no, there was no recommendation for other procedures. Basically, I asked what could be done down the line and the Doc took me through the options.The overall attitude was one step at time. See how things progress with this procedure. As for meds, I'm against them. I'm not taking propecia and have no plans to start. I don't like the idea of playing with my body's chemistry. I realize some people take the meds with great results and no sides. However, I think there are lots of people who have problems-- in a % far higher than the drug. manufac. currently says. Anyway, in my case with my hair hair loss, its not worth the risk. It's not like a have a frontal core or crown that I'm trying to keep. I've already lost that! (although now I have it back I explained this to the Doc and he said he understood my position and concerns over the drug. He also stated that he had seen some great results with it. There was no recommendation to start meds. He accepted my decision and that was basically it. What are your plans Multiplier? I haven't yet searched back through your posts so I'm not sure where you're at. Hal

Post op so far has been going great-- no numbness, little pain, no feeling of scalp tightness. Attached are some pre-op and post op images of the new hairline. I took the post op pictures today right after I got out of the shower so my hair is wet. This is 3,800 grafts. Doc said I have average scalp laxity and average density in the donor. Still a long way to go and many hurdles. I guess I'm in the "honeymoon phase". But I know the "ugly duckling" phase is out there, waiting! I'm going to be sorry once those hairs fall out and go in to a resting mode. I received an e mail asking why I chose SMG: I am simply ecstatic at how things have gone so far. Everyone at the Shapiro Medical Group was caring, considerate, helpful, and highly professional. When I decided to have the surgery, there were only 4 surgeons on my list—in order they were: Ron Shapiro, H&W, and Paul Shapiro. I chose Ron Shapiro because of his outstanding reputation and skill as a surgeon. This man literally has written the book on hair transplantation. He is in demand all over the world and frequently travels, teaching and lecturing on technique. He and his clinic have a worldwide reputation for excellence. But beyond that the Doc is a genuinely caring man—he is considerate, patient, and only wants the best result possible for each of his patients. I truly believe that. In short, I believe that Dr. Shapiro is the “gold standard” in hair transplantation. It’s like getting financial advice directly from Warren Buffet. Or having Bill Gates set up your PC. There are other skilled surgeons out there, but I don’t believe you can go any better. As we all know, so many things can happen when having a transplant—once you’re cut, you’re cut. It’s impossible to eliminate all risk but you can minimize it. I wanted the best surgeon and the best clinic I am currently composing a full write up and will post by the end of this coming weekend. Thanks guys for all the support and good wishes-- its appreciated. Hal

Thanks guys-- I am back in the hotel after an all day session at Shapiro Medical Group. I don't want to sound like a commercial, but the experience was fantastic. So many things that I was worried about turned out to be one big fat non issue. The staff was great, pain was pretty much non existent except for a few pin pricks. Dr. RON was and is everything that's been said about him-- a top flight surgeon and a caring, nice guy. He stayed with me and discussed results and other issues after every one had gone home-- and it was after 9:00 p.M. You can't go any better. I have a long way to go post op off course, but right now I am very confident my results will be in line with my expectations. I will right up a more detailed report after I get home and have a chance to unwind. Hal

Well, I can't put this off anymore. I leave tomorrow morning for Minneapolis and my procedure is Tuesday under the hands of Dr. Ron Shapiro. This has been a long time coming. I well remember being concerned about a slight receding hairline WAY back in 1986. I went to a clinic thinking about plugs (gasp!) to fill it in. I remember the doc saying explaining the procedure, and him telling me about the forehead bandage after it was all done "You'll look like Gaddafi..." he said, laughing. Funny all those years ago and the guy is still around and still causing trouble. Thank God I didn't have anything done. Not only did I lose the entire hairline, but if there were old fashioned plugs up there all by themselves? I shudder to think what I would have done and spent chasing my hairline with multiple procedures throughout the 90's... I did leave with something interesting, though. It was a sort of a roll on bottle. They put crushed Minoxidyl tablets in a solution. You shook it up and then applied twice per day to your scalp. This was the forerunner of Rogain. $50 bucks for a small bottle. In 1993 I really started losing a good amount of hair. A bald spot opened up on my crown. Again I considered having something done. Again I decided against it. Again Thank God. Well, that was years ago. I have no hairline at all and a bald spot on the crown. I'm basically a Norwood 5A/borderline 6. Everything has finally lined up-- the right stage of balding, the right age, the right Doctor, the right financial situation, the right expectations, the right time of life. As I said, it's time. 25 years and I leave tomorrow. Hal

I am flying home the next day after surgery. Originally, my flight left Minneapolis at noon, which would have given me plenty of time to get up the next morning and get back to office for a quick check and a wash before heading to the airport. However, the airline re-arranged the flight schedule and now I'm leaving at 9:30 a.m. that morning. I was notified of that a few weeks ago. It's a non stop flight back and there's no other one back on that airline before the evening. So I'm stuck with a mad scramble the day after surgery. I chose the non stop so I can get home as soon as possible with minimum hassle. Obviously I'm going to be wearing a baseball cap and I didn't want to have to do that for 10+ hours while changing planes and dealing with airport crowds, etc. (I did buy an extra large oversized ball cap just to be safe). I hope the meds don't knock me for a loop-- my main goal is to get back and hibernate for the next ten days before going back to work. I've tried to anticipate things-- for instance: I wear crew neck t shirts but obviously you can't do that for at least a 5 or 6 days after the transplant because you don't want to drag a shirt over your head. So I bought some oversize tank tee's that you can get out off without pulling them over your head.But you know, I'm just not a tank top kind of guy:) There's a whole bunch of stuff like that-- what challenges have you faced so far that you didn't think off prior? Is your scalp still feeling tight? Hal

Thanks Smartguy, and the same to you. Yeah, the anticipation is not exactly loads of fun is it? But I believe it will all be worth it. You choose the right doctor, learn what is possible and what to expect, and then make the decision. What really puts my mind at ease is the thought that I have a virgin scalp and Ron Shapiro and his team will be working on me. Hard to go wrong there. Good luck and please be sure to keep posting your progress. And by all means, if you have any tips to share during that tough post op first week or so, please share. Hal

Smartguy, I'm right there with you in spirit, but about 10 days behind you in actual practice. I go in about a week from tomorrow with the famous Dr. Ron Shapiro for a 4000 graft procedure. It's your turn right now getting through the tough first week. But it will pass. Good luck and keep your eyes on the prize. Hal

I would not be happy with those results. I looked at your images and from the immediate post op pictures, it looked like you should have ended up with a pretty solid hairline. However, the 8 month update images do not live up to that promise, IMHO. If the 8 month images were say, 4 month images, I would say you were on your way and that it should thicken up in a few more months. It's possible you are a slow grower. Perhaps a few more months might see a dramatic improvement in overall density. It's just that at 8 months, I would have expected more coverage. You also mention on your site that you had artificial "hair implants" (never a good idea) that fell out. Is it possible that this procedure left scar tissue or is somehow responsible for poor or slow growth of the current real transplants? At this point, I suppose you will have have to wait a few more months and get to the full year point before making any further moves. If you do decide to go under the knife again, I would not be afraid to seek out other top docs like Sharpiro, H&W, or Feller. Don't be put off by the travel. As many other will tell you, it's worth it. Easy for me to say, but hang in there. Current images don't look bad and it's a step up from pre-op. However density is currently an issue and it looks like you have to have more work done in the future if you want to thicken that up. Hal

I have to echo the thoughts expressed here. Your results are fantastic. It's like looking at two different people in the photos. Enjoy your new hair and confidence. Hal

\ As you should be. Conventional wisdom has it that when Propecia really kicks in and starts to work, you will see some shedding. The idea is that these hairs will come back thicker and stronger. So basically, if it works for you, your hair will get worse (thinner) before it gets better. Many guys start Propecia and then panic when the shed starts. They stop the drug and for a while, are worse off than when they started. There are reports that for some of these guys, the hair never comes back. As for sides: there is a growing body of evidence that people experiencing sides are a lot higher than the drug company's claims. And that for some, the sides are perm. even after stopping the drug. Then again, others have great results with no sides and no real issues. I think its a real crap shoot. You roll the dice and take your chances. Know what you're getting in to and then make the call. Don't believe its risk free and you can "just stop taking it" and things will be fine. That's true in some cases, but not in all. Hal

I'm not 100% sure, but I think the Prince has had some work done to the old noggin already. As for Harry, he has a decent head of hair and I don't think he's in any danger of going down the path of his older brother. Harry's big issue is that he's got Rosacea. Hal

Ultimately, you have to make the call and live with the decision. What I mean by the "right time" for an HT is when age, experience, financial conditions, known (and proven) surgeon/clinic skill, known balding pattern, known donor supply/condition, expectations, and degree of hair loss all dovetail together and an informed decision can be made. In a nut shell, you want to be a 45 year old guy in a solid financial situation whose balding is fairly well along and who is not concerned about getting chicks at the clubs. Or whose concerned what his 20 something buddies are saying at the pool party. (that's a little tongue in cheek, but you get what I'm saying I hope) But anyway--- My advice to a guy in your shoes would be to at least be on Propecia for at least 18 months to 2 years. That way you can really see what it can do for you. You'll see if there are any sides and what degree of stabilization/re-growth you get. I should also say that I'm not a big fan of playing with your body's chemistry and wouldn't take Propecia myself, but that's another conversation. Ultimately, you are going to be counting on Propecia for quite a lot, correct? If you move ahead with the transplant to the temples, you need to be sure you will not lose hair behind the transplant and end up chasing your hair loss. That's the big danger. Because if that happens, you're going to end up with multiple surgeries, multiple scars, a depleted donor area, (probably) a tight and/or numb scalp, and I be willing to bet you wouldn't be happy with the results. Plus the fact that the state of your hair will consume you for the next 10 or 15 years. And of course a huge financial drain. So if you go ahead with the transplant, you're going to have to depend on Propecia-- for life. You'll be worried about sides or if it will one day stop working. Those thoughts are going to be constantly with you. Are you prepared for that? is that any better than worrying about your current recession? see what I mean by trading one set of issues/concerns for another? You also mention that you can mostly hide your recession with longer hair but that it takes a lot of work. I'm assuming fussing in the morning, maybe using a cover product, etc. Maybe worrying about wind, water, and weather. Well, welcome to the club! you needn't feel special about it. So your current hair loss is not that bad and you can mostly hide it with longer hair, which you state is your preference anyway. You're on Propecia, which you've recently started. You've started your research and seem willing listen and learn. You've also showed good judgment in looking to a top rated clinic (H&W) for a possible future procedure. For the present, I think you're in good shape. Give the Propecia (if that's your choice to take it) another year to 18 months and the re-evaluate a surgical option. That would be my call, but again, you have to make the decision and live with it. Hal

You are still taking one heck of a chance. In effect, you're rolling the dice, hoping everything works out right. Maybe your plan will work, maybe it won't. Reading over your replies in the thread, my concerns for you are as follows: 1). You say you are miserable and want to "enjoy your 20's" and not worry about your hair. Many is the guy who has thought that only to find out that a hair transplant was just the start of their worries. My concern is that you won't be happy with the transplant, or you'll start to loss more hair behind it. Instead of "solving" your hair problems, you'll just be trading one set of concerns/problems for another. This by the way is the same thing that guys who opt for hair pieces go through. I just don't think you have the right mental attitude. 2). You don't see to be looking at the long term. Its as if you think life stops at 30 or something. As other have pointed out, life can do funny things to even the best considered plans. You may not believe this, but your hair issues may one day take a back seat to other priorities. 10 or 15 years from now, you'll probably look back and wonder why you wasted so much time worrying about this issue. That's not to say it still won't bug you and that you'll want to do something about it-- only that it won't seem like the end of the world as it does now. A hair transplant can be the right choice for the right candidate at the right time in life. I just don't think that's you at this point. I understand that's not what you want to hear-- basically, you think a transplant is going to solve your hair problems, at least for the short term. And for the future? well, you'll deal with that as it comes up and surely there will be options. Isn't that about the situation? As I said in my earlier post, that kind of thinking (and those expectations) just throw up a lot of red flags-- at least to me. Hal

Where to start? You're a young guy-- and you're receding. Your friends and family have noticed-- they've even made comments. And man, those comments sting, don't they? You go around looking at other guys great hairlines and think "why me"? You're worried about getting laid-- hey, girls like hair. And if you don't do something about about your receding hairline soon, you're going to end up a monk. Man, you'd give anything if you could just have that hairline you had a few years ago, when you were 17 or 18. In fact, that's what you're hoping for with a hair transplant. You don't need a lot-- just fill in the temples. With this transplant, you're being pro active. You're going to to "stay ahead of your hair loss". And if you need another transplant down the road due to more hair loss, so what? you'll just get another. But that's years away and not much of a concern right now, is it? _______________________________ How am I doing? does that about sum it up? If you get a transplant now, you might very well end up chasing your future hair loss for the next 20 years. Maybe Propecia will stop any loss. Maybe it won't. Maybe you'll decide for some reason to stop taking it. And if you lose more hair behind the temple transplants, then what? More surgery? Suppose you have shock loss around your temple area and donor? Are you prepared for that? Getting another procedure down the road seems easy enough right now, but suppose your circumstances or priorities change and its not feasible? I don't know you, but you seem awfully young and blase' about the procedure and potential scarring, etc. Personally, I think a person your age with your degree of loss is crazy to go under the knife. You should be a least a Norwood 5 and have a very clear picture of your balding pattern. But that's me. I see a number of red flags and think you could easily be one of those guys who ends up regretting their procedure and ends up on these boards asking advice on how to "reverse a hair transplant". Ultimately you have to do your research and make your own call. But if you're chasing your teen hairline and concerned about not getting laid because of your receding hairline, then you're making a huge mistake. Hal

You know what must be worse? It's those guys that have a great head of hair all their lives and then they hit a certain point in their mid 50's or so and start to thin out. It must be a shock-- all their adult lives they've taken it for granted that they've got good hair-- balding happens to "other guys". Then WHAM! This I think must be worse than losing it gradually. Actors who this has happened to include Martin Sheen (who even now still has a pretty good head of hair, just not like he did) and William DeVane. But to answer your question: yes it is not only possible but very likely to start balding in your 30's and beyond.

Normalguy-- I have to agree with Scar5. A few points: 1). You have a nicely shaped head as been mentioned-- and it appears you have a darker complexion. In short, I think you look fine and can pull off the shaved down/shaved head look. 2). The numbers of graphs that you mention will not give you the coverage that you desire. I believe that a procedure will allow you to "frame the face" but that it will still be scant. So I think you'll find yourself in a situation where your hair will look good to you only under certain circumstances. What do I mean? No wind, low lighting, indoor events. Lot's of fussing and primping, using a lot of cover product. It's not the way to go. You'll get tired of all that and constantly be concerned if the hair is arranged properly. There's too much real estate and not enough graphs to go around. 3). You will lose the ability to shave down because of the scar. This is a very big deal for a guy in your situation. Why? because the best look for you is either very shaved down or totally shaved. A transplant will take that option away and I believe you're going to regret it. You're going to wind up having to keep your hair long, and its most likely going to look very thin and scraggly. 4). Given all the above and the way you can carry off the shaved look, I personally don't think you're a good candidate for a HT. This is of course my opinion, and I don't claim to be some sort of guru on the subject of hair transplantation. Personally, if I were you and in your circumstances, I'd save the money and keep the remaining hair short. I might even look in to the Artistry Concepts tattoo solution. Hair transplants with the right surgeon and the right candidate can be a viable option for hair loss. Given your images and the info you posted, I just don't see you as a good candidate. I think you'd be making a big mistake. I think you'd end up unhappy with a scar to hide and forced to wear a hairstyle that you'd hate and did not flatter you. I think you'd find yourself in a situation where you wish you could just shave it down and be done with and go back to normal. Only at that point, it wouldn't be an option. I think you would be one of those guys who would be back posting how miserable you are a year or so down the road and looking for solutions to "reverse" a hair transplant. Sorry to be so blunt, but there it is. Think it over-- don't rush in to anything. Hal

Hey Jay-- I can tell you that I am 47 years old and a Norwood 5A/ very early Norwood 6. I am scheduled for a transplant with Dr. Ron Shapiro in a few months and I do not plan on taking Propecia. Now or Ever. Personally, I think its a bad idea to play around with your body's chemistry. As been mentioned, many men take the drug with little or no side effects. However, others do have sides, and there are growing reports of people whose sides have not gone away even when stopping the medication. I agree with the other posters that everyone's case is different and you have to make the call based on your own individual circumstances. For example, although opposed to playing around with my body's hormones, I might take the chance if I was a 20 something guy who was just starting to lose his hair and go thin. As it is, my balding pattern has been pretty stable for quite a long while. I suppose I could always lose more hair, but I'm pretty far along and mother nature can't do a whole lot more to my follicles. So for me, it's not worth the risk. One thing I don't understand is people who start meds right before or right after a transplant. Now supposedly Propecia is supposed to help grow out your transplant faster and help with any shock loss. I'm not sure I'm on board with that. Additionally, I think right before or after a transplant is the WORST time to start meds. Talk about muddying the waters. You have surgery on your scalp. You're healing. You have an initial shed of newly transplanted grafts which is followed by re-growth after a few months. You also might have shock loss to contend with. Now you're going to throw meds in the mix that might cause a shed? How are you to tell what's what? Is it the meds, the surgery? is it poor growth, what? And if you have sides, then what? too much stuff all at once thrown at the old bod. No thanks. Not a good choice, IMHO. Finally, I'm personally not convinced that Propecia is all that safe. Yeah, the drug company says its safe and side effects are very low. And they'll keep saying that until they change their story to something different. Wouldn't be the first time. So that's where I'm at. Hal

Phil, For what its worth, I thought the first procedure looked great. Two points: 1). I really couldn't see what you were talking about on the left temple issue. It looked fine to me from the photos. However, I realize these things are very subjective. 2). The scar showing like that would concern me. I wonder if its because you have darker hair and it looks like you have a tanned complexion. Obviously, this would make the scar stand out a little more. Of course, the short buzz job would also tend to bring the scar out. I think you made the right call about a slight revision with regards to this issue. I'm curious-- with your hair that short, were you able to conceal the scar with product? a little Prothick or Couvre? I'd be eager to hear about your experiences in this area. One other thing-- It seems the strip taken is rather high in the very back of your head. I'm no expert, but I would have thought the "safe zone" would be about a half inch or so lower. What are your thought about this? Overall, I think you came out very well. A great hairline (even without the touch up) and very good coverage. If that scar is concealed a little more I think you'll be batting 1000. Good luck. Hal

Some great advice, Butterfly. I also believe that you are NOT a candidate for a hair transplant at this point. Do not get talked in to anything or somehow get it in your head that a HT will allow you to "stay ahead of the game". That kind of thinking has been the doom of many in your situation. I can also tell you that the psychology of hair loss for someone your age is all too predictable. You're worried about your hair of course. You're constantly checking out your friends, relatives, and strangers hairlines. You wonder if anyone "notices" your own hairline. Will your friends say anything? make cracks or jokes? how about your family? What about girls? will you ever get laid again? will your hair loss make you a miserable social outcast? :eek: I could go on but you get the idea. My point is that its all been done before. I can't tell you not to worry or be concerned but try to adopt a more balanced view of things. Try the meds as advised and see what happens. I can tell you that 5 or so years from now you are probably going to say "If I just had the hairline I had a few years ago, I wouldn't complain about anything...". and 5 years after THAT, you'll say the same thing. And 5 more years AFTER THAT, when your in your early 30's, hair loss suddenly won't seem as big a crisis because you'll have more important to things to worry about. You'll wonder why you spent so much time and energy stressing over your hair. There's a well traveled road in front of you in terms of the psychology my friend-- I urge you not to take it. It's a complete dead end that goes no where. Hal