jc636

Hello Melvin! I am really curious how your results will turn out, specifically the crown. Was your crown implanted exclusively with the 1500 beard grafts only or were scalp grafts placed there as well? I am curious because I have a surgery scheduled for Eugenix this coming August during which I will have 800-1k grafts of only beard hair transplanted to my thinning crown. I have consulted with Aditya at Eugenix and she explained that even after beard hair my crown might look thin and that beard hair is more wiry but that there would be improvement. This is why I am curious about your results. Your hair texture is similar to mine, I have black Hispanic hair as well so I am curious how the beard hair would look in the crown when fully grown. I have a decent amount of scalp hair in my crown still so I think it could be blended well, I am just wanting to add density. Here is a current photo of how my crown looks now.

12 hours ago, Westview said:

Because you have no idea what Norwood you're headed for in the future.  If you're gonna be a Norwood 3, 4 or 5 you'll probably be okay, but if you're headed for a 6 or a 7 you will have wasted valuable donor hair on a small crown area of your head, and you're gonna look real awkward with just that patch on your crown.

I suppose you could always go for a repair job and transplant those 1,000 grafts to another part of your head again, but why go through all that??

Why not be patient and see how your baldness pattern progresses first, and then make the necessary transplant(s).

For now I'd stick to meds and Toppik as others have suggested.

Also I think most ethical doctors wouldnt touch your head because of unknown future Norwood progress.

 

Just my $0.02 worth

Hmmm. I don't have norwood 6/7 in my family history but I suppose anything is possible. This loss has been like this for 5 years now with no further progression. I'm actually considering getting 1k of beard hair in that spot and not even messing with my scalp donor until absolutely needed.

1 minute ago, aaron1234 said:

It will likely shock out the native hairs in that area, possibly making it look more bald than it does now.  

A lot of people have said that. I wonder how common that is. Have modern techniques reduce the incidence of that? With the use of implanter pens and things like that?

3 hours ago, Westview said:

I wouldnt do that if I were you

Why not?

21 hours ago, Dr. Suhail Khokhar said:

Your hair loss looks stabilized on min and fin, I think a hair transplant in your case is fine. I thought you might have been under 30. 

I think I'm going to get a small procedure done of 1k grafts to the crown.

1 hour ago, aaron1234 said:

Huge bald spot 🤣.  Don't get a HT dude.  Just get on fin.

I'm on fin lol.

47 minutes ago, Dr. Suhail Khokhar said:

How old are you? I agree with the consensus that you should probably hold off on a transplant at this point. 

I’m already 35. Not getting any younger at this point.

4 hours ago, Melvin-Moderator said:

No grafts, use toppik.

I’ve been using dermmatch with success.

2 hours ago, JohnAC71 said:

Not sure I would even do a transplant at this stage. Are you on Fin/Minox? 
How’s the rest of your hair looking? 

I’ve been taking minoxidil and started on finasteride about 5 months ago. The rest is fine. Probably mature Norwood 2 in the front.

4 hours ago, Dr. Suhail Khokhar said:

I think 1.5k grafts sounds about right. Are you on any meds at the moment? 

I take finasteride and minoxidil.

5 hours ago, makehairgreatagain said:

It doesn't look that bad from the picture you provided. It's going to all depend on the doctor you go with as it's the most challenging part of the head to work on. It's also known as the "black hole" as you can always be adding in grafts to improve the appearance. Do you have other pictures? It looks like you'd need on the lower end of the 2k mark.

Yes. This photo was taken in the sunlight.

Were you a norwood 5 or 6? That is a large number of grafts for one sessions. Congrats.

Decided to finally do something about the massive bald spot on my crown as I’m tired of dealing with it. I’ve gotten estimates of 2-3k grafts. Since I have some hair there, would I need that many? Should I be worried about shocking the hair I have there out of existence leaving me in the same situation I’m in now but with less donor?

I’ve used been using dermmatch for 5 years and no one has any clue I have hair loss of any kind. That is why I want a transplant. It would be nice to get out of the shower and not have to do anything to my hair.

After applying dermmatch

30 minutes ago, DenverBuff1989 said:

I would guesstimate that 1k is nowhere near enough and you would need 2k, or potentially even more. Looks like pretty significant crown loss. As someone said above and is a super common phrase, the crown is indeed known as a black hole for grafts. Also crown loss often times is worse than what the picture shows. 

Looks like you do still have some hair there, you aren't completely bald. This could ironically be a bit of a hindrance. IMO some doctors are hesitant to do work on the crown for fear of shock loss and permanently destroying hair that remains there. I'm sure you can find a doctor regardless tho. With enough convincing and being aggressive enough, every doctor will bow down to the almighty dollar. 

Curious if you have tried using Toppik or another concealer? Your loss seems to extensive for concealer to blend in well, but you never know. 

Rogaine and Finasteride/Dutasteride allegedly work much better on the crown than the hairline, but I have been using both on my crown for years and nothing has come of it. IMO Rogaine is a total scam, idk anyone it legit works for. 

I use dermmatch. After applying it to the crown the untrained eye can’t tell there’s any loss. There’s a thin layer of vellous hair that the camera doesn’t show well The dermmatch makes these hairs thicker.

8 hours ago, Melvin-Moderator said:

Will it make a difference? Yes, is it enough to look like you’re not balding? No. What are your expectations?

My goal is to look like I’m not balding 

Will 1,000 grafts make a difference or would I need 2,000-3,000 grafts.

3 hours ago, Curious25 said:

I don't think many top surgeons would aim to fill your crown region with a density of 50FU/cm2 - its too much, and frankly an unnecessary amount to achieve the illusion of density. Native density is also very rarely 100FU/cm2 - 70FU/cm2-80FU/cm2 tends to be the average scalp density for white caucasian men. 

Anyway, going off your picture I think you could definitely get a nice result that you would be satisfied with using around about 1000 grafts, it all depends on what your groupings are like and your hair calibre - these two factors go a long way in determining graft count. A high HGI will stand you well, as crown transplantations usually consist of only multi hair grafts. 

Two doctors who stand out massively for me with regards to being crown restoration wizards are Dr Konior and Dr Wong - with the former seemingly able to work magic using alot fewer grafts than most. 

Doctor Wong is actually my top choice being as I am on the west coast. 

25 minutes ago, Melvin-Moderator said:

Are you sure thats 20 cm2? That looks a lot larger to me.

I’ve roughly outlined the approximate area in which I’m looking for coverage. If you look at the patch of loss you will see that the edges fade from 100% density and gets thinner the more towards the center you go. Normal density is approx 100 fu’s per cm. When hair dips below 50 fu’s per cm is when it is noticeable. Using this, a surgeon would start to fill the area starting at the point where the density is below 50 fu’s to create a natural seamless pattern and the illusion of coverage. That is why I don’t draw the line at the point where it starts to get only slightly thin, instead i draw it where it becomes drastically thin which is the approximate area where a surgeon would start to place grafts. Of course more grafts could be placed there, but if it is the illusion of coverage the goal, then shouldn’t the least amount of grafts be used for the sake of donor mgmt?

1 hour ago, Melvin-Moderator said:

The crown can easily take 2,000-3,000 grafts, depending on the size.  

What about the size you can see in my photos? It’s about a 20 sq cm area.

7 minutes ago, makehairgreatagain said:

Have you received any information back on graft estimates. You posted that one picture, so that's what I'm going off of.

I posted a second photo in my first response to you to compare and contrast. It is more zoomed in with better resolution of the existing hair.

@makehairgreatagain You said you had 2k. Was this purely crown or did some of the grafts go elsewhere?

28 minutes ago, ciaus said:

How old are you and have you tried to stabilize your crown loss with finasteride? Like @makehairgreatagain said its a potential blackhole, using up alot of your grafts in the long run if you keep losing.

The loss is stabilized for many years already. I’ve already decided I’m getting surgery and am aware of the risks I’m just playing around with some numbers and wanted to get some other input. 👍🏽

5 hours ago, makehairgreatagain said:

Mine was similar to yours. I had 2000 grafts. Beware that the crown is called the black hole for a reason because you can always be adding more grafts. You want to make sure you go to a surgeon who does excellent crown specific work and have realistic expectations on what can be achieved 

That’s a lot more than I expected. The area is only a 20 square cm patch with some hair maybe 25% density left from normal. It appears a lot worse because of the contrast with the rest of my hair which is very dense. I was told it takes 50 follicular units to give the appearance of density.
20 x 50 = 1,000 grafts

Am I missing something here?

There is also some hair still there albeit a thin layer (maybe 25 fu’s)
I’m coming up with much less than 2k grafts.