24 - Taking the plunge, please review

[itsabouttime]

Hi everyone, firstly of course, thanks to everyone who took/takes the time to make this community what it is, pretty much all information I've explored since starting this journey came from this site.

 

Now to my situation - I'm 24, started noticing things brewing at 19, throughout the stressful 4 years at university, I had quite drastic shedding. It has been almost 2 years since then and things are just now starting to slow down.

 

I have been on rogaine for 2 years, and was on spironolactone for 1 year, ending 1 year ago.

 

I am fortunately now in a position, finally, to remedy the situation. I will not let finances be a hindrance, financing or otherwise. I also refuse to wait any longer, I understand that at this age, I will probably require another surgery down the road, but that is fine. I've made peace with the fact that this is a situation in my life, and will continue to be. I have no problem taking the necessary steps to accomodate this fact. Another surgery 10 years from now is just fine.

 

I would like a full head of hair restored, of course it won't be as thick as my younger years, but even under light, I don't want odd-looking visibility of scalp. I hope this is realistic, as the hair on the top of the sides of my head and the back are still quite thick and dense.

 

I'm from Toronto, and after lots of research, it appears that Dr. Rahal is the best bet.

 

I am ready to take the plunge, and had the online consultation with Dr. Rahal. My pictures are included below. He recommended 3500 grafts for hairline and all the way to the back.

 

It would be great to hear what you all think about the situation, Dr. Rahal, my level of balding, whlie tieing in your own experiences.

 

Thanks again.

[MrJobi]

Welcome

 

Looks like you would need abour 4000 or so grafts but it is hard to tell from one photo.

Rahal has been producing some nice results.

 

You might want to look into propecia

[itsabouttime]

Ye I'm bracing myself for possibly more grafts needed, whatever it takes. I just hope it fills in nice.

 

I'm really curious how results look under light, as pretty much all pics I see everywhere seem to be done just right.

 

thanks.

[thanatopsis_awry]

First, Dr. Rahal is great. Could say he is among the best of the best.

 

I would strongly second looking into propecia, and perhaps placing a premium this go around on the frontal regions, which I'll explain more later....also, your level of balding looks like a diffuse NW5 to me, but I can't really tell how thinned, or dense, your hairline is -- though you say Rahal recommended working on it so I assume it has thinned as well.

 

With 3500 grafts I don't think your end-goals of "full head of hair restored" and good density will be accomplished...at least not THIS go around alone.

 

The crown can be like a blackhole for grafts; if, say, you took 2k grafts to fix up your frontal 1/3rd, or even but 1500, that would leave 2k to work on your crown...this seems a bit light to me given your state. Personally, I would rather see if a synergistic combo of propecia and rogaine can work some magic on my specific crown (which it very well could), and focus work elsewhere and strive for density...with 3500 grafts, for instance, I think you need to determine where and what type of premium you place on density and coverage.

 

It is tough to say with greater confidence, however, given just one pic -- though it shows your crown/vertex quite well.

[itsabouttime]

Thanks for the honest responses.

 

I have been using rogaine for 2 years now. Also, the spironolactone, which is basically a topical propecia, I used for 1 year. I predict they slowed things down quite a bit, but without much regrowth.

 

Of course, after the surgery, I have no problem taking propecia if need be.

 

Perhaps by goals are a bit unrealistic this time around, but I'm sure I'd be happy with the significant difference now, until the second go down the road.

[thanatopsis_awry]

Ya, if you really want and expect "density", then 3500 spread throughout such a large area won't achieve it; HOWEVER, it could provide you with very good "coverage", which could set you up nicely for a 2nd procedure later on where you beef up the density.

 

A very important thing is your donor, btw -- how dense, vast, and how lax...this will determine how many grafts you have in the tank.

[Bill - Seemiller]

itsabouttime,

 

Welcome to our discussion forum. Our members have already given you some excellent advice to consider.

 

In my opinion, I feel it would be better for you at this time to try a Propecia / Rogaine combo for at least a year. Propecia is great for slowing down or maybe even stopping hair loss. These treatments together give you the greatest chance of regrowing some hair as well.

 

My concern for you is for future hair loss. Though 3500-4000 grafts will most likely satisfy your current hair loss condition, it appears from your picture that you have hair miniaturization in other areas. In a few years, will most likely lose that too leaving you with a nice hairy crown and a balding/bald frontal area.

 

Therefore, once you undergo hair transplant surgery for your crown, in the event that you lose more hair (which is very probable), subsequent hair transplant surgeries will be needed in order to:

 

1. give you the hair coverage and density that is desired and possible

2. keep your transplanted hair in the crown looking natural

 

In your case especially, a LONG term hair restoration plan must be set. Be sure to discuss with Dr. Rahal the future of your hair loss and what can be done about it. Planning financially for subsquent hair transplantation procedures is an important part of planning.

 

In my opinion, a non surgical treatment of Propecia / Rogaine may be your best bet FOR NOW in an attempt to slow down or stop your current hair loss condition. you might even regrow some hair.

 

Best wishes,

 

Bill