hair transplant for diffused hair

[northface]

hi,

i've been a long reader of this forum but I'm ready to start researching on hair transplants. I know that a lot of you guys have experience on this forum so I know that I'm in the right place. I have diffused thinning..really thin..but i still have somewhat of a hairline..so I am not receding. Most of the before and after photos that I see on the websites are usually people who have pretty much peaked in their recession and get a complete new hairline. Is it possible through FUE (in 2-3 sessions) add hair to the existing diffused hair so that I don't have to go bald before I can receive a hair transplant? Sorry, I know I'm blabbering but I'm really worried about having to go all the way bald and then getting a "transformation." Thanks in advance!

[gillenator]

Dear Northface,

 

Welcome to the hairloss community! Sure it is possible to have several FUE sessions with diffused thinning. My ecouragement to you is to start with "smaller sessions". This approach will help to minimize shock loss to the surrounding hair in the recipient area. Please note that I did not say "prevent" shock loss. Expect some level of it due to the trauma caused to the scalp. Some patients experience severe shock loss, others some, still others minimal. In addition the diffused hair you may lose as a result of this trauma may not come back.

 

HT doctors do hold to some varying philosophies regarding the types of recipient incisions they utilize, and even the instrumentation used to create the sites. You want your sites to be as least invasive as possible especially with a diffused thinning pattern. The fewer sites, the less potential trauma. Make sense?

 

Smaller sessions will also provide you the benefit of a more "gradual" appearance transition wich you also stated as a concern.

 

Do you know which hairloss classification you are in and where your hairloss is potentially headed (family history, etc)? Are you taking Propecia or some form of finasteride? Might you have the "ludwig" pattern of genetic hairloss not depicted on the Norwood scale?

 

Lastly, get evaluated for this type of diffused thinning with a proven HT surgeon who has done many cases in a diffused zone. Also ask the hairloss community for feedback from patients with diffused thinning and what their corresponding results have been in treating it. Best wishes to you Northface in your pursuit of seeking resolve!

[Robert_]

northface,

 

One of the problems with hair transplantation is the matter of shock loss. This occurs in the recipient area (I have even heard of it occuring in the donor area, though not as much). When the grafts are placed, the surrounding hairs can fall out due to the trauma of the new grafts being introduced. I would have to say that usually this subsides and the patient gets most of their existing hair back. The ones that don't come back are probably so DHT-atrophied that they were about to jump ship anyway. The trouble is, with a diffuse thinner such as yourself, there is no real clear patch of bald scalp to implant grafts in. It would just be placing grafts all over the scalp between those existing hairs. I would be concerned that the resulting shock loss could leave you with a lot of grafts and little actual hair. A physician's advise would be better than my own, however and if you are truly curious for many points of view, then you are welcome to post pictures using the "photo album" software on the forums.

 

Another concern I have with your plan is the immediate use of FUE/FIT. Though there is the fact that the strip method of extraction leaves a long, thin scar, the FUE method leaves smaller scars where the grafts are individually extracted. Though this is great for people with little scalp laxity and previous strip work, I am kind of cautious that a person would be more limited in how much donor area that they can deplete before they start really thinning the donor area out. You say that you are already predisposed to difuse thinning. I have seen diffuse thinners where the thinning did extend to the back and sides of the head. Do you possibly see this occurring with you?

 

I do not mean to confuse you, but there are many, many variables to consider before jumping into a hair transplant procedure (though a great physician should address all of these concerns right away). I invite you to post some pictures so everyone can take a look at your situation. You can photoshop your face out of the pictures, of course. To use the "photo album" feature, just go to "New" and select "photo album." Follow the steps and upload your pictures. It's that easy.

 

Also, don't forget to take a look at this for more information on hair transplant procedures. It will give you more familiarity with the strip and FUE methods of extraction too.

 

Good luck.

 

-Robert

[gillenator]

Yes whether you elect to choose strip or fue, the scalp tissue will repair itself during the healing process and in that process formate some level of scar tissue. A real big issue for some patients is how visible is the scarring? I do understand that over-harvesting with fue/fit can potentially cause the donor area to appear less dense or even sparse, so there are some trade-offs. Or in the case(s) of previous open donor patients where possibly a strip excision would produce better aesthetic results rather than thin the donor area further with extractions.

 

Most virgin patients who pursue fue/fit technology want to prevent as much "visible" scarring as possible especially in the donor area (linear scar). Patients who desire the shortest hair styles namely a number one or two guide, have the greatest potential to do so by utilizing fue/fit technology. I have seen in person dozens of fue/fit patients immediately after the procedure, and as long as three years post-op. In most of the matured cases (roughly 90% or better), I could not tell where the extractions were taken by the naked eye. This then allows the patient to even potentially be able to shave their head one day if they elected to do so. I am sure there will always be a few exceptions to these cases. Patients then who desire to wear their hair extremely short could not do so without the strip scar showing. In addition, patients having the ludwig pattern of loss, the areas of future loss can impede into the donor area and that too can potentially show the linear scar. I am not implying that Northface has this type of loss but some do.

 

I also believe that there is potential to harvest more terminal hair with most patients in areas of the scalp that a strip harvest cannot without leaving visible scarring with a short hair style, namely above the ear(s). This too is an attractive benefit for younger men (twenty-five and older) to be able to one day cropt cut their hair in the event their hairloss becomes alot more dramatic with age.

 

Now do not get me wrong, I am not saying that either method of harvest is right or wrong, it really depends on each and every patients' goals including cost considerations. For me, I never intend to shave my head or wear shorter hair, so the strip method has worked very well for me. I may end up doing a fue/fit procedure one day but again I may do another strip, have not decided yet. It is a personal decision based on case situation as well as your goals.

 

Great idea for the pics as suggested. Best wishes to all!

[northface]

thank you so much!! you guys are great..i really appreciate the time you guys took to write those long explanations. I now have a good understanding of what I should be looking forward to. Right now, I would say I am in between a ludwig type 1 and type 2.. and as Robert was saying, I do have thinning on the sides AND the back.. it seems live I have been dealt with maybe the worst transplant conditions available. In addition, my hair is very thin (and I have read all the posts on thin hair transplants) and so I could potentially be a poor candidate for a hair transplant. The donor area would be hard to find because I am losing hair all over my head..it's quite strange. My mom is a serious problem with hair loss and she's definitely a ludwig 3. I forgot to mention I am male and so i guess i have female pattern baldness? I am on 1 mg fin everyday and not using minox yet. I am very tempted to start minox soon if my hair loss is still progressing at a fast rate. In the mean time, I am going to sit and wait a little longer before I make a final decision. I especialy want to put up some pictures before I do anything as well. Thank you again for your respones and I will try to put up some pictures as soon as possible becuase I know everyone on this forum is so helpful! thanks again

[Robert_]

Not a problem. Gillinator brought up some very good points to consider that I had not thought of. Don't get discouraged. Consider implementing Minoxidil into your regimen, but give it serious thought, as it takes diligence and the understanding that you will be on it for a very long time. Many people do not like the idea of being "tied" to it.

 

Post some pictures when you are ready. You will get quite a few responses with different opinions on your condition. Let me know if you have any questions on how to do so.

 

Best of luck,

 

-Robert

[Guest]

http://hair-restoration-info.com/eve/forums?a=tpc&s=5696015661&f=7466060861&m=522108843

 

this link is my progress follwing 2 HT's. I have poor hair characteristics (i.e fine, thin, sparse donor) as well as diffuse thinning leading to a NW6 (before HT). Check out my pics and see if you are similar to me. Although i will never regain a full head of hair, there is definitely a way to improve your outlook. good luck

[northface]

 

here are my pics..from what I understand I am not a good candidate yet..and i have talked with some other people who have had some diffuse thinning transplants..so the big thing I have to worry about is shock loss..am i right? how can i be sure i have enough donor to keep up with my hair loss?

[gillenator]

Northface,

 

Thanks for putting up your photo. I read one of your earlier posts on this thread denoting that you do in fact have the ludwig pattern of hairloss and so does your mother. Are you younger in age, say under 30? Also, do you have any maternal/paternal family members who are male gender with the same pattern of loss, ludwig? Older brothers, maternal uncles, etc?

 

The reason I ask is because it appears that the photo is reflecting lots of light with your darker hair color and it does not appear to be greying. Unless you are coloring your hair, I am presuming that you are a younger man?

 

The critical thing that stuck out in my mind is that you stated this thinning has invaded the sides and back of your scalp which implies your terminal hair typically used for transplatation is being affected. Have you been evaluated for androgenetic alopecia areata? Many female hairloss sufferers sustain this type of loss, and I have noticed approximately 3% of men with alopecia areata.

 

If you are younger, under 30 years old, and do in fact get diagnosed with alopecia areata, I would strongly advise you to wait on doing any HT procedures for now. Why? I have seen too many times alopecia areata patients, both female and male lose substantially more hair both in the donor and recipient zones. Subsequently the multiple incisions from a HT procedure can shock terminal hair that "does not" always grow back. In fact their form of hairloss does not subside at all in most cases I have seen. I have witnessed some resolve with patients utilizing minoxidil but far and few between. Yes there are some exceptions but I hate to see patients chase their hairloss and never really get where they want to be. Along the way you can end up spending thousands of your hard earned money and possibly in the end regret you ever got started in the first place.

 

This can be very difficult to accept if you do have alopecia areata however one should consider both the upside and downside. You really need to get in for an in-person examination by an experienced HT doctor and/or dermatologist experienced in diagnosing various forms of hairloss. Try to get at least three opinions. They can use video telescopic equipment or a simple densomoter to see how much of your entire scalp is being invaded. If other people have advised you that patients with the ludwig patterns of thinning or alopecia areata do not make good candidates for hair restoration, they are probably referring to the fact that your usable donor if any will not be enough to attain adequate coverage in a lifetime.

 

If you are determined a candidate for hair restoration, be sure to consider your future needs since available donor and future affected areas of loss are at question. Then possibly do a "test" procedure to see if the surrounding donor hair shocks out a little or alot. DO NOT do a strip, only consider FUE if you are a HT candidate.

 

My mother has the alopecia areata form of hairloss denoted by the ludwig pattern and she has been in hair systems for over 50 years now. I am so glad that she did not spend her hard earned money on HTs because ultimately she would have still ended up in hair systems. The technology was terrible in the 50's, 60's anyways.

 

My point is to get "diagnosed properly" up front so you have a better understanding of your own situation "before" you start considering your complete options for resolve. Feel free to e-mail me or write me with your phone number if you want to discuss at length. In no way am I trying to sell you anything but I will offer you an open door as I know patients with these types of hairloss can have many questions. Either way I wish you the very best Northface.

[northface]

Hi Gillenator,

 

I appreciate the thorough response. I am only 23. The thinning I had mentioned was an overall thinning of the hair, BUT there is no real hairloss on teh sdies and teh back..which somewaht exhibits a horsehoe pattern like the norwood scale. However, since im' still young, I really don't know. My mom's brother also has some mpb but it's not too serious, definitely not as serious as me when he was my age. So youre saying that it is possible for a derm to examine the hair areas to determine if they aer being attacked by mpb? I guess that would be my first step right? And then..if I find that I will have donor area, then I can think about getting a FUE/FIT? Should I visit a HT or a derm doctor to determine my donor area?

thanks in advance..

 

northface

[gillenator]

Hi Northface,

 

I am very glad to hear there is no real hairloss in the donor areas, still you are young so yes by all means still get some in-person examinations. And yes it is possible to have your entire head examined to evaluate which areas are being affected.

 

Now not all derms are experienced in genetic hairloss but you will find them on the internet by doing a search for derms with clinical depth in this field. Also when you contact HT surgeons, ask them specifically how much experience they have in treating hairloss patients with the ludwig pattern. Do not limit your research with one or the other, get several opinions.

 

Then once you have your situation confirmed, you will have a much better understanding of how to proceed. And yes I would suggest FUE technology just in case you do have more dramatic thinning in the donor areas in the future since you are so young right now. Should that occur later in life, you would be able to buzz-cut your head. Keep us in the loop! Take care.