imissthebarber

Be careful dude, hair loss will progress without meds especially for someone at your age and stage of hair loss. The fact you have dense donor is good but a 10K yield from FUE sounds very unlikely. Are you sure the doc is not just telling you what you want to hear, or trying to make sure you don't go for a strip? This thread below states that the likely max for FUE is around 5k. Strip has drawbacks as well I'm not saying you should do that, you have to make your own choices but please make sure you have done your research first. Thread about FUE

Don't be too aggressive with the hairline as it needs to look age appropriate as you get older, also to conserve grafts. Having said that you will get more cosmetic impact at the front. Are you meds? How long have you been on them? At your age unfortunately it is likely that MPB will progress, so you need to plan with that in mind. There's another thread around at the moment saying that with FUE the max number of grafts you can get is 5000. That would probably be enough for you for now but if your hair loss continues then you might need to go for a strip later. If you are going to do both strip and FUE then you need to think carefully whether it would be better to do strip first. Graft survival % is thought to be higher with strip and you can get more coverage initially and it is cheaper. However, if you are lucky and your hair loss stabilises then with FUE you should be able to clip your hair shorter than with strip.

The multimedia presentation on this site says 4500-7500 if I remember correctly (?) as a safe number for strip. 10,000 is very unusual.

Jason thanks for the detailed post. I'm sure this is a question a lot of people having been wondering about and often the response is it depends on the patients characteristics. I understand that, but it is useful to get a ball park figure.

I think this should be discussed more as one of the risks. However, bear in mind subsequent surgeries do tend to get smaller than the initial surgery, and the range of available grafts via FUT is usually thought to be around 5000-8000 (give or take depending who you ask). In one sense whether they are taken from 1 or multiple surgeries does not make that much difference in how many are available.

I think this is optimistic unless you are expecting to do it over multiple days. How old are you? I'm not sure how much coverage you will get from a FUE session in the range you stated.

You had a big session there dude so I would be more cautious and leave the staples in longer if possible. Check with your doc about this. For example Bill recently left his in for 3.5 weeks in order to do all he could to get a thinner scar (admittedly he was a repeat candidate and the risk is higher after the first surgery). A few more days of discomfort is worth it to reduce any risk of scar stretch.

I'm sure we can all agree that we would like to see further advances. I think it is important to remember though that what we are hoping for is technically a bigger leap forward than it was from plugs to modern FUT techniques. What I mean is essentially FUT is just a refinement of a proven (though limited) approach.

Frosty - you've found a good place to ask some questions but judging from the questions you are asking I would certainly encourage you to do more research so that you are comfortable with whatever you decide and fully aware of the risks. It sounds like you are doing this but it is worth repeating. Depending on your physiology, head size, scalp laxity and hair density you could expect to have in the region of 5000-8000 total grafts available via strip. (depending on who you ask you might hear a slightly different range but I think most people agree this is the ball-park). As others have mentioned these need to cover future hair loss in a natural looking way. There are several things you need to weigh up like is your long term aim complete coverage or density. If you lose any more hair then you can't expect to have both all over.

hounddog - Hey man I hope you are happy with the final outcome. I see quite a few comments on here about how the patient is to blame if they don't do the research, and if they don't go to a doc recommended here. At the end of the day you weren't the one holding the knife! Any doc, recommended or not, is still bound by medical ethics specifically the hippocratic oath to do no harm. Don't be too hard on yourself. It sounds like you have started taking the road in the right direction.

Jason - I was interested to read this statement. I have seen some comments from other long-term members about this. They say that you should really wait close to a year even for different areas mainly so that the laxity can come back, also so the first HT can fully grow in to assess the head as a whole and how a further HT should address it. I can definitely see the attraction of less down-time but surely there is more of a risk of scar-stretch? Is there any difference for wait times between different areas that are next to the originally transplanted area(e.g. temples to hairline) and ones that are apart e.g. (hairline and crown)?

I'm interested to hear opinions about this as well. If it was totally slick below the part that was addressed would it really look natural, or would it look like you had a slick crown too low since the higher part of the crown would not be slick? I read that Dr Paul Shapiro takes the approach of dividing the crown into thirds. The top thirds they do with density around 30grafts/cm2 the middle third with 20 and the bottom third with 10. I can see how this makes sense but, I also wonder how much it ties you into wearing your hair reasonably long.

Another question worth asking is to what extent would shock loss be an issue both in the recipient and donor areas? If the hair is not MPB resistant I would imagine there is more risk of shock loss.

As you can see some things are a matter of opinion. Some people think the guy in the link looks better, others disagree. However, to repeat what someone else said I think everyone could agree that having a result that does not look natural is definitely worse than just buzzing. I'm not saying this would happen to you but you need to think carefully about the risks. Good luck dude.

Smaller will certainly be cheaper!

Unfortunately there is no perfect solution. Each of the things that is proven to be effective has drawbacks. For the HT option there is the up-front cost, limited donor availability and resultant scar. For propecia it is potential side effects. You should absolutely be aware of possible side effects of propecia. I don't know if this gives you any confidence but propecia is an FDA approved product for treating hair loss in the US which means that the authorities have decided the side effects are an acceptable risk. This is the choice you have to make yourself. If you are unsure search for propecia on this forum and you will find many discussions about this. I'm not sure if you have tried minoxidil. I have read that that is most effective in your patients who have been losing hair for less than 5 years so you might be a good candidate. Propecia should not cost nearly what you stated. Maybe someone else will comment on what they are paying. I think in the UK high street it works out to around $50-60/month but cheaper online. Some people try to get a proscar prescrip then split the 5mg tabs into quarters. It is the same chemical med in a higher dose for prostate cancer sufferers and this can also help reduce the cost.

Mick I missed this post at the time, do you know if the video is available online, perhaps on youtube or the bbc website?

I think, or should I say I hope, that everyone realises that you will end up with one long scar (FUT) or multiple small ones (FUE).

Doc echoing many others my thoughts and prayers are with you and your daughter. I guess that ski trip seems a long way off but I really hope you get to enjoy it as your consultant suggested.

It isn't all bad news. This is just the supply and demand issue of HT's. You need to work out what you would be happy with. Also the real figure will be less than 430 because the shape is not as regular as a rectangle. I still say 375 is a ball-park for a guy with an average sized head gone to a NW7. You then need to work out which zones to target with what density and what zones to leave. Also meds may well help once you have understood possible side effects and are comfortable with them. To state the obvious your plan should suit you know and take into account ageing and potential further hair loss.

TC17 Your relatives sounds like they have been really accomodating letting you measure them! OK, I can buy the measurements you gave 9.5 inches x 7 inches. To put that in to cm it is 24cm x 18cm (to closest cm) which equals 432cm2. Now as you said the 9.5 inches is at the longest point, at the shortest point it might be a lot less. If you want more slightly more accurate calcs I would suggest you divide the scalp into different regions which are easier to calculate and measure each one. e.g. a circle in the crown, a rectangle on the top, rectangles on the lateral hump, triangles in the temples. In your calcs you multiplied by 2.54 but you need to multiply by 2.54^2 to do the calcs that way. All the best dude, I hope you get a good result.

You should recheck your calculations because I'm sure that you have it wrong. I believe the average surface area of hair on a man who has not suffered any hair loss is around 500cm2. A NW7 could lose around 75% (or maybe even more) of that, leaving let's say 125cm2 of hair and 375cm2 of bald area. It is highly likely that the surgeon would not want to cover the whole bald area and would go for a conservative hairline but even so the total area to cover would be vastly more than you calculate. The crown alone can be 175cm2.

Agree with what the others have said. Give the meds time, try shaving, wait, wait a bit longer. I know this sounds hard but to a lot of guys who have gone this way, shaving probably seems like a great option that is no longer available to them. Also stick around on the forums. Even if you don't like the advice you get at first the guys here have been there and got the T-shirt.

As others have said it is a marathon not a sprint. You've got to give it time before making decisions on a further HT. I know that is easier said than done believe me!

I know your situation seems tough right now. Do your research carefully about finasteride because although lots of people report using it with no problems you will find some who are worried about side effects. As a short term measure you might want to try using a concealer like dermmatch or nanogen (similar is Toppik). This can be quite effective in areas where there is still some hair. Most people don't want to be permanently dependent on these products but they can help.