Jumping on the bandwagon...

[Guest HLBD]

Well, I've been a member of this forum for some time and I've tried to contribute where I could. With so many others sharing photos of their condition, I feel it's only fair that I add my own for comment.

 

I've been classified a NW 3 with diffuse loss in the frontal third. I have no evidence of loss in the crown. My family history is that of frontal baldness, on my father's side with diffuse loss on my mother's side - currently, I follow my father's pattern of loss exactlly; we started loosing at the same time and our loss is contained in the frontal third. I've been on propecia for about two years and on Rogaine foam for 6 months. I've not noticed any regrowth, but no loss either - I'm not certain if that is because of the medication or just genetics (my father and I have both had aggressive loss early and then not much loss after that). I have been balding since I was seventeen, I am twenty-nine now.

 

So, what do you guys think? How many grafts, etc would you say? I've been thinking about having another procedure - I've had a very bad one with MHR when I was twenty. I've been pondering having another procedure for a while... Firstly, I am unsure of which doc I want to go to (though Dr. Rahal keeps coming to the top of the list. He not only has impecable skill, but I've heared he has an excellent bedside manner, which I have found missing in some docs and I respect greatly), but mainly I am apprehensive due to the first poor procedure. I know that a great doc with new tech could drastically improve my situation, I just can't get over my gut feelings...

 

Any comments would be appreciated.

 

Thanks guys!

 

 

 

[Guest HLBD]

Well, I've been a member of this forum for some time and I've tried to contribute where I could. With so many others sharing photos of their condition, I feel it's only fair that I add my own for comment.

 

I've been classified a NW 3 with diffuse loss in the frontal third. I have no evidence of loss in the crown. My family history is that of frontal baldness, on my father's side with diffuse loss on my mother's side - currently, I follow my father's pattern of loss exactlly; we started loosing at the same time and our loss is contained in the frontal third. I've been on propecia for about two years and on Rogaine foam for 6 months. I've not noticed any regrowth, but no loss either - I'm not certain if that is because of the medication or just genetics (my father and I have both had aggressive loss early and then not much loss after that). I have been balding since I was seventeen, I am twenty-nine now.

 

So, what do you guys think? How many grafts, etc would you say? I've been thinking about having another procedure - I've had a very bad one with MHR when I was twenty. I've been pondering having another procedure for a while... Firstly, I am unsure of which doc I want to go to (though Dr. Rahal keeps coming to the top of the list. He not only has impecable skill, but I've heared he has an excellent bedside manner, which I have found missing in some docs and I respect greatly), but mainly I am apprehensive due to the first poor procedure. I know that a great doc with new tech could drastically improve my situation, I just can't get over my gut feelings...

 

Any comments would be appreciated.

 

Thanks guys!

 

 

 

[NW4recession]

Your hair loss is similar to mine. Where were the grafts placed from your first procedure? I think you could restore your hairline with 2000 grafts, but may have to go back for another procedure years later if your hairline continues to recede. If your crown stays in tact, you should not have to worry about running out of grafts.

[Guest HLBD]

The original grafts were all placed at the hairline - 1000 minigrafts (though another dermatologist told me that there was no way that there was 1000 grafts used).

[the B spot]

I think maybe 1200 grafts would set you straight for the time being.

 

I am sure your realize that your hairloss is likely to continue and if your hairline was stabilized/filled in a bit, you would look great---- perhaps in 5-6 years you could be a bit more aggressive if meds continue to halt your progression.

 

Of course, this is just an estimate from pics---I would do a consult in person to be sure your planning properly.

 

At 29, on meds for 2 years and your level of loss, perhaps you can afford to be more aggressive.

 

Take Care,

Jason

[thanatopsis_awry]

Hopefully your loss really remains contained to your frontal region for a good while, which it seems it may very well. Looking at your pics, I would probably want to shoot for ~2k, but it's tough to say -- the long hair can mask things.

 

Considering your MPB started at but 17, you are in a very fortunate position @ 29, imo, with "stabalized" losses.

[bverotti]

I would guestimate around 1900 grafts or so to do the job.

First lines require high density and the further backwards generaly lower density is placed.

[flyby]

Screw waiting any longer HLBD. Especially since you already popped you HT cherry . You're a great candidate with your loss pattern. Similar to mine. Dr. Rahal, Alexander or Shapiro could do wonders with your mellon. I concur that 2000 seems about right since your frontal 1/3 doesn't look to diffuse. I hear ya about the aprehension. I had a Bosley procedure about 11 years ago. Results didn't look bad since I had a fair amount of existing hair. Donar scar wasn't all that great but not noticible since I have very thick hair in the back and have never gone too short. I finally got over my apprehension on getting a new and improved HT. Went to Dr. Alexander for 2739 on 12/5. For me it's been a piece of cake and I'm extremely happy I took that leap. I'm coming up on 4 months and there's already been major improvement. Can't wait to see what it looks like in another 5 months.

 

Look forward to seeing uour results.

[Guest josh - b]

interesting graft quotes, especially bspots 1200.

It seems to me that in an era of such dense packing that top docs such as h+w, rahal etc wouldn't quote anything under 2500 for your particular case hlbd.

Have you done any online consults?

I'd very interested to hear the recommendations.

[the B spot]

Your absolutely right Josh--my total is a bit on the low side-- but he didn't say lower the hairline, square temples, etc.... so that is why I said 1200....it would bolster his existing hairline, fill in the power alleys a bit and let him decide what to do for #2---- of course he could get 2000-2500 in there and really set things off, but at 29, might be a bit of push right off the bat, IMO.

 

Take Care,

Jason

[Guest HLBD]

Thanks for the input guys - I really appreciate it!

 

Than,

 

Yes, I consider myself very fortunate (well, considering I have friends that started balding way after I did and are NW6s now). There is always a bright side, I suppose. Also, my derm - and, although I don't have a HUGE amount of respect for him, the MHR doc both were rather amazed at the density and the amount of donor area. They both remarked, 'Whoa! Beautiful donor.', so...

 

I would tend to believe that going closer to 2,000 would probably be best for density and illusion of fullness and keep me set for quite some time. I do appreciate your feedback b spot, but I think I'd like a little more density and can afford to be a bit more aggressive. Like I said, I've been balding for nearly 12 years and on propecia for two. Plus, my family history leans towards not-very-aggressive frontal loss and my derm took a look at my scalp under the microscope and has told me that she thinks that any further loss I see will be more very light diffuse loss in the frontal third, which will most likely be minimized - if not eliminated by the propecia - which is also consistent with my father's pattern of loss. All that in mind, I think I can afford to be a bit more aggressive. Now, mind you, I CERTAINLY think that anything of 2000 - 2500 (closer to 2000) would be overkill for my situation as it stands currently.

 

josh, no I haven't yet gotten any online consults, but that will be my next task and I will post on this thread.

 

flyby, good luck on your procedure! Dr. Alexander is a wizard. You are going to look 'fly'! Yeah, the apprehension is a killer. I mean, I think I'm ready one moment and then I start to think, <i>but what if it's like last time?</i> I mean, I know it won't be, but tell that to my gut...

 

b spot, bverotti - thanks for the feedback! It's great to have some input from consultants/advocates!

 

Maybe this thread will open some debate, namely: how important is personal hair loss history (i.e., how long you have been loosing hair in relation to your current loss) when considering how aggressive you may be with your restoration plan and what is the importance of this personal history in relation to other considerations: age (being the most presented), medications and how long you have been on them, family history, etc.

 

Any thoughts, ladies and or gents?

 

Would love to get more opinions on my situation as well - seems like there may be a few more guys with similar patterns and circumstances.

[Jupiter]

ur hairs cool dude

[Dr. Timothy Carman]

HLDB-

 

I have reviewed your photos and the comments submitted by forum members. They have provided you valuable input.

You raised some important questions in your last post regarding personal hair loss history, family hair loss history, age, and use of medications shown to be effective in slowing the process of androgenic alopecia. All of these areas are pertinent to making an informed decision regarding the appropriateness of entertaining a hair restoration procedure. They are a standard part of the initial consult, along with information regarding any relevant medical history (such as thyroid conditions, diabetes, etc.).

From your initial post I have gathered that you have been taking advantage of medical therapy, and that alone is a very powerful tool.

As you have been utilizing finasteride for 2 years and Rogaine for 6 months, I would venture to say that it would be an appropriate observation that you have achieved your maximum results, and that you could anticipate continued maintenance of you current condition.

In addition, your personal and family history suggest to me that you would certainly be a candidate for a future procedure, especially given the observation that your donor area is "beautiful..!!".

As for the number of grafts needed, this is best ascertained most accurately in the personal consult. The amount of grafts required depends on the design of the hairline you and your physician decide upon in that consult. Given the apparent good density of your remaining hair, it appears that a highly refined follicular unit grafting procedure would be appropriate. I am going out on a limb here, but, on the basis of the photos you provide, I would estimate that you would require no more than 2000 grafts. Please understand, however, that this estimate is just that, and again, is based on a photo only. This estimate can vary by 2-300 grafts, based on your actual head circumference, the need to "reinforce" the current hairline of your frontal forelock area, the frontal forelock area itself, etc.

I hope that this helps. As recommended by our forum members, take your time, do your research, and, with the forum's support and your due diligence, I'm sure you will find an appropriate surgeon with whom you are comfortable so that your experience and surgical outcome are both positive and productive.

Best of luck to you.

 

Sincerely,

Timothy Carman, MD

[david from stockport]

Speaking as someone who was a NW7 by 29 I think you have a great hair of hair just maybe try a shorter style and save your money - even buzz it and bet it looks great.

Dont think you need worry for a few years yet and by then who knows what will be on the market.

If you have the money burning a hole in your pocket open a savings account with it and if your hair starts to go baddly the money is there -if not you have a nice little nest egg!!

take care David

[Bill - Seemiller]

HLBD,

 

You are truly asking some great questions and receiving excellent answers from veteran forum members and physicians.

 

From everything you have presented, you appear to be in great shape and a potential candidate for hair transplant surgery. Age and family history of hair loss ought to play a role in determining how "conservative" or "liberal" your hair restoration goals should be at this point, but given your seemingly good donor hair, your low level of hair loss at 29, and the fact that you had previouis work done, consulting with a few elite physicians is a good next step. In my opinion based on statistics alone, that based on your age and your low level of hair loss, you will most likely not progress to higher levels of hair loss such as NW5-7.

 

Dr. Carman,

 

It's nice to see you on the forum. Thanks for your participation!

 

Bill

[JoDirt]

i agree.. >2000 will give you great looking frontal hairline which compliment your full back hair.

[Guest HLBD]

Thank you all for you input!

 

A special thank you to you, Dr. Carman! It is terrific to get professional feedback from a hair restoration surgeon and you offer some wonderful advice. Thank you again for taking the time to respond to my thread.

 

Jupiter,

 

Thanks for the compliment. I'm trying for a shaggy look, but I could pull it off much better with my hairline repaired and the forelock stabilized.

 

david,

 

I do think I am very fortunate, but I still know the pain of hair loss - especially at a very young age. When I say that I was loosing hair at 17, I mean it was noticeable and I was made fun of... Now that I've gotten a little older, I think I've gotten to where I look at things from a bit of a better perspective; my first transplant was out of desperation and for other people, my next one will be for me - I've seen the best results from candidates for HT I've seen with this attitude and they are happier in general. I don't expect miracles, but it never hurts to do something for yourself and improve your self-esteem. I like my hair now, but I would love to LOVE my hair and from the input I have gotten on this forum and medical professionals so far, that seems entirely possible with only a little bit of effort. So... why not?

 

Bill,

 

It's always great to have your input. You add an analytical and friendly outlook to everything and I for one - though I am sure I am not alone - appreciate it.

 

I am also glad to see this discussion be so productive. I don't know if some men, and perhaps even physicians, speak enough about personal hair loss history. I mean, I think I would think twice if a man had started loosing his hair only two or three years ago and wanted a transplant. As one surgeon mentioned, and I believe it was on this forum, propecia COULD mask the native aggression of the hair loss making it difficult to tell how aggressive the loss could become should the medication loose efficacy or become unavailable to the patient. Although hair loss can accelerate and stabilize at different periods, I think that there is clearly a point, given enough time without interference, where you can get a good "baseline" (if you will) on how aggressive the loss is and is likely to become in the future and can become invaluable data with which to judge how aggressive or conservative one should be with their hair restoration plan - taking into account all other variables also, of course.

 

Thanks guys!

 

Great discussion! Maybe we can keep it going on this forum. I certainly have not seen it in any prevalence on other forums and IMHO, it deserves more thought in relation to HTs for possible candidates.

 

P.S. - My next step will be (as adviced) to consult with some top docs.