Prof101

@digi it was a typo. I meant to say that I AM heading to Norwood 5 and maybe more. I am on propecia and have been stable for the last couple of years but it s not a guarantee. @SadMan2021 These consulations (all) were in person @aaron1234 I am 44. I had a HT 10 years ago of 750 FUe only in crown.

When I grow my hair my donor area does not look thin at all. But if I run my hands in the donor I can tell it is not dense enough.

I am heading to NW6 it seems. Although my hair been stable due to propecia for the last 5 yrs.* Irrespective, even if I never loose any more hair I was told I need at least 3500-4500 to get decent coverage. I first saw a top doctor in NY (forgetting his name), he told me that my donor is not dense enough. But he said that my hair caliber is thick and bit wavy that he can give me a decent hairline but not enough for the crown. He thought I could do max 3000-3500. Then I saw a doctor with similar opinion. Then I saw a doctor who said that my copious body hair allows anything, but I don't like the BHT idea. Never looks natural. Then I saw Hasson and Wang lately, and was shocked. Rhey explained that not only do I have a weak donor area but they actually think my hair is thin in addition. A prior minor surgery long time ago left a lot of dots and reduced density (10 years ago technique was less efficient). So shaving is also problematic and my head does not look decent shaved. So I am left with no options it seems. What bad luck. I thought about donor harvesting, but it seems that with my donor area, there will be a lot of harvesting needed and might not look good. So I am not sure who to turn to. Sorry for the ramble, just depressed. I always imagined that eventually I wiill have a surgery...

@captaincalicoCongrats. Did you see Dr. Mwamba in person before doing the surgery? I think I saw somewhere a picture of him taking detailed measurements of the scalp, but can't find the link anymore. Did you do that before deciding to get a HT?

Is there any difference between the Brussels and Atlanta offices? He has a beautiful measurement system (similar to Zarev) in Brussels and not sure whether he has that in Atlanta.

Wow. Just wow. Don't want to pester, but if you have one just like this but showing your hairline would be great. The reason is that I am just very impressed about how natural your hairline looked like and this deserves to go down in the books

Good thing is that I don't even notice density issues in your donor. But from your understanding why is density an issue with BHT, impossible to pack as close to each other as head hair? Going for BHT to donor or receipient area?

Any updates @ajbd069? What I like about your results is that they look very natural. Hope to see updates soon.

I consulted with a couple of doctors. I think the topic is related to Hair, at least in my case. My ear stick out only if I shave my head. Not noticeable at all when I have hair. So I wanted to do something about it. I forgot the details but there are two methods one is surgical the other is not (does not involve large incisions). Most docs offer the first not the second, since the first is more permanent. The second was developed and is more commonly used in Germany AFAIK. Anyway, the thing to know is that with the surgical procedure at least takes time to heal. They apparently pin your ears all the way, and count on the muscle memory to push back the ears further out. So while the downtime is short the final result is months away AFAI understood.

This is what the industry needs and I am surprised they don't have it either. I have been to TOP top doctors, and the evaluation of my hair has varied so wildly. Here are examples: Doctor 1 assessment: Black hair. Average to low density. Hair thickness above average. Wavy. Donor area: 3.5. Doctor 2 assessment: Dark brown. Low density. Low thickness. straight hair. Poor candidate. 2-2.5K. Doctor 3 assessment. Black hair. (actually said very black, asian straight hair). Hair density: average. Hair thickness: above average. Donor Area: 4-4.5. And we are talking about an operation that is life changing and cost >20K. I need to go and see Dr. Bisanga. 100%.

Congrats Gimpoli on the improvement. Based on your results of transplanting chest to donor, and hypothetically, how far would you be willing to take this had you needed more hair to the top of your head? This would give us an idea of how natural you feel those chest hairs are on your donor area... I am assuming you wouldn't go 100% body hair would you? So far visibly your donor hair is surprisingly homogenous, but I am assuming close up one must see/feel a difference. Glad to see this post I am 3X hairier than you and always wondered about filling donor.

Sorry for the many question we are asking, but you are the Zarev patient. He usually gives numbers of hair density, either as FU per cm2 or hairs per cm2, did he tell you how much you have? Also did he take hair all the way below the donor area, close to nape?

@HugoX Congrats. Fantastic. Question: Are you buzzing the lower sides and back? (about an inch or two around your ears and all he way back). If so why? I wonder whether it is an aesthetic choice due to thinning of donor area. Either way, its looks good. Nothing wrong with it. Also did he tell you your density FU/Cm2?

What makes Eugenix capable of working with patients with smaller donor zoner/supply when others don't? I am in the same boat as you man. Except more advanced. I would be extremely careful.I wonder whether the fact that it is thinning without a lot of recession makes it harder (since the size of the recipient is larger).

I going to ask a dermatologist, will circle back on this.

I managed to schedule an appointment with a doctor in the region. It was hard to find one who does scalp analysis. I bought this kit before I scheduled with him and definitely was not going to rely on my observations alone. Agreed. But pictures don't lie, so I am more informed now and prepared for the conversation. I will in addition contact a dermatologist. Thanks for the comment.

@hairlossPA Your hunch is right, I was told on this forum most surgeons don't. The more curious we get, the more diligent they will have to become. So yes it would be good to keep this thread alive. I linked a study below about fibrosis in the donor region and its impact on a HT. Evaluation of Perifollicular Inflammation of Donor Area during Hair Transplantation in Androgenetic Alopecia and its Comparison with Controls

Here is how my donor area looks like in a sun-lit room.

@Westview @DenverBuff1989 is correct. This is what I used. Now here is my disappointing density. The area is 0.2cm2. I have an average of 60FU/cm2 to nearly 100FU/cm2 in some areas (surprisingly, just below the donor area and nape area is the most dense). It appears I have a decent number of 3s and 4s. I will follow it up with an attachement of a regular picture of my donor area from my iphone. One thing I can't do on my own is to measure the hair thickness, going to ask Dr. Mohebi to do that for me. Hoping he would be willing to do a test transplant on me soon. I also measured my donor area surface: What is considered as safe area is around 120 cm^2. If I proceed to NW6, I am far from that now, the recipient area is 150cm2. So all this does not look good at all. I am very disappointed with the outcome of the measurement. I hope more of you will do such measurements, I was about to go under the knife just a month ago, with a doc (not Mohebi) who looked at my pictures only online and said let's do 3K. He evaluated my hair as being high density but thin. I think if anything it could be the other way around. Anyway, had I done this, I would have completely depleted my area. If I assume an average of 70U/cm2, and that I need to keep 40FU/cm2, and assuming I won't touch the area below the safe zone (which is denser and looks very thick and healthy) then I only have around 3600FU to donate. I need to measure the below the safe zone and see how large it is. Neither side of my family lost hair from below the donor area. First Photo: Side donor area (above ear: worrisome density) Second: Back donor area (sample 1: worrisome density) Third photo : Back donor area (sample 2: OK density) Fourth: Nape area (good density) Fifth: Below the "safe zone" but above the nape. (highest density) Thoughts?

I got it because I am contemplating going for a HT. I have many findings to share. I bought it mostly to be able to get an idea of the density, but I will keep that for a follow-up post. By the way these are cheap online microscopes (digital) but work very well, and I wonder why more people are not getting self-examined this way. Yellow Dots: I am seeing strange yellow dots around the follicles in the balding area. The only thing I found online (pretty useful actually) is about exactly this, Yellow Dots under trichoscopy (2017): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674712/ "In androgenetic alopecia, in turn, yellow dots are seen in more advanced stages of the disease with a sebaceous component predominance" "It is believed that, in this condition, yellow dots result from the presence of engorged sebaceous glands that remain functioning despite the progress of the miniaturization process of the follicles, leading to the formation of intraepidermal sebaceous lakes" Now I am starting to wonder the (1) I wonder whether they raise concerns about FUE success rate (2) To what extent is baldness actually directly related to these engorged sebaceous glands. I do not see this much in the donor area (see 2 attached, named donor). But I see it quite frequently in the thinning area, particularly on the crown, but also zone 2-3 (the rest of the attached). The paper shows few pictures and mine look even more pronounced then the ones in the study. Any thoughts? I wish some doctor can comment on this. Updated: - After some search yes it seems this is the hallmark of seborrhoeic dermatitis. There is a whole debate about the relation between this and baldness. Don't want to start it here. - On realself suregons responded to this question saying that there would not be an issue with transplant. But being who I am, I want to test out a small transplant and study the success rate. I will post a follow up on my hair density.

Hi AB, Can you please tell us about scars in the donor body hair area? Chest and beard? That would be immensely helpful. I am as hairy as a chimp, but it is the scars that scare me (and the hair quality).

Great to know. I am impressed with Bisanga, Anyone you know of in the US who does this/willing to? I wish I don't have to cross the Atlantic for hair measurement.

Hi, This is a great website. I wish I remembered about it. Was wasting time somewhere else. I want a HT but I want to be extremely careful with planning. But many clinics just talk numbers: You need X grafts FUE in that area, let's go. Please let me know if you know of a doctor that is known to be willing to closely examine the scalp (Like Zarev has done in one of his presentations) and so actual measurements. Clearly this would cost me. But I want to do it. It is not just about density, but also hair caliber, and a close examination of thinning areas and photographs of evolution. I am also thinking about doing a test transplant, to double check that my grafts grow with no problem. Not sure if someone would be willing to do ... I actually had a small transplant 10 years ago (about 750), but it was poorly documented through pictures, so I cannot recall how much growth I had. I am now digging out pictures to document my evolution and make a video out of it. I have an interesting story for another time. Thanks

Any thoughts please? It is a common problem I think. How come you all care about hairline and not crown. Nothing uglier than a crown, just ask a girl.

I just came back from a consultation with a top Dr that I respect. He brought me very bad news that made me pretty depressed. I am not sure I agree with his ideas about what is most aesthetic though, and thus my question. I am currently somewhere around Norwood IV , in the long run will be heading to type VI it seems like it. I am 34. I want to hide the crown because I think it is UGLY! Since I know I will not have enough donor to cover everything on top, I am fine in the future to start from a receding hairline and NOT try to have a low hairline. My best bet is to try to look like Type 3 in the future. The doctor won't operate on me UNLESS if I go for a hairline and completely forget about my crown. He said that it is MORE normal to have a full top/hairline but empty crown than full crown with empty top. I am not sure I agree since type 3 is common. Given my preferences how about instead, using these 4K grafts I have available to instead go for crown now, and when I start thinning more I go for a MUCH lower hairline so I try to look like type 3 instead of looking like female pattern baldness (full hairline, and bald top/crown). Why is it that surgeons prefer to work on the hairline rather than devise a plan according to something less aggressive on top but more aggressive in the back of the head. I do not want to live with a a balding crown. My pictures are here (look much worse than what people see, since wet+flash): http://www.hairrestorationnetwork.com/eve/172505-crown-fue-looking-advice.html