Chinese hair restoration - help and advice welcome - McGrath?

[redkun9]

Hey everyone, I'm new to this forum but the wealth of information of this place is invaluable. It's great that so many people are sharing their perspectives on hair restoration, backed up with pictures and reviews of potentially sketchy "surgeons". In large part to stumbling across this forum, I'm considering a HT.

 

I'm 24 years old and Chinese. Being Asian, I have very straight hair. I began to notice that my hair was slowly losing its "semi-spiky, poofy" quality my freshman year in college. By my sophomore year, I had to give up my previous hair style because I found my hair in the front was simply too limp, thin, and not dense enough to stand up. After college graduation, I began to notice that my crown coverage was becoming sparser. My frontal area has thinned significantly and views of the scalp through the hair is possible depending on how oily my hair is, lighting, and how my hair lays.

 

Looking at my family history, I believed that hair loss was in my future, but I didn't think it'd be this much this soon. My dad and all the older males on my mom's side are basically a Norwood 6-7. I believe I'm currently a Norwood 3V. I've been on finasteride for a year, but there have been some month long periods of time where I wasn't really taking it every day. I'm considering a HT because I'd like to enjoy my 20s without awkward glances to my hairline or looking older than my age. Justified or not, the confidence (and others' judgments and impressions) based on my immediate physical appearance still affects me.

 

I've had a consultation with Dr. McGrath in Austin, Texas. He was confident that he could recreate my hairline and fill in the frontal area with a ~1,500 graft HT. He would lower my hairline a bit (I've always had a high hairline), and fill in the front area two inches back from the hairline. I expressed concerns about the "unique" aspects of Asian HTs: the predominance of single follicles per graft, the importance of "dense packing", and he reassured me about his prior experience with Asian HTs in California.

 

So what do you think? Is 1500 enough, especially given my Asian hair? I'm also concerned about future hair loss around the crown, but McGrath said I should always allow the possibility of further HTs. Before that that time comes though, he suggested the combination of propecia and low level laser therapy to maintain/improve the density on top. I'm not entirely convinced with the laser therapy, but what are your thoughts on the HT? I've done some searches on McGrath (this forum too), but does anyone have other views on his work? Warm thanks for all your advice.

[redkun9]

Hey everyone, I'm new to this forum but the wealth of information of this place is invaluable. It's great that so many people are sharing their perspectives on hair restoration, backed up with pictures and reviews of potentially sketchy "surgeons". In large part to stumbling across this forum, I'm considering a HT.

 

I'm 24 years old and Chinese. Being Asian, I have very straight hair. I began to notice that my hair was slowly losing its "semi-spiky, poofy" quality my freshman year in college. By my sophomore year, I had to give up my previous hair style because I found my hair in the front was simply too limp, thin, and not dense enough to stand up. After college graduation, I began to notice that my crown coverage was becoming sparser. My frontal area has thinned significantly and views of the scalp through the hair is possible depending on how oily my hair is, lighting, and how my hair lays.

 

Looking at my family history, I believed that hair loss was in my future, but I didn't think it'd be this much this soon. My dad and all the older males on my mom's side are basically a Norwood 6-7. I believe I'm currently a Norwood 3V. I've been on finasteride for a year, but there have been some month long periods of time where I wasn't really taking it every day. I'm considering a HT because I'd like to enjoy my 20s without awkward glances to my hairline or looking older than my age. Justified or not, the confidence (and others' judgments and impressions) based on my immediate physical appearance still affects me.

 

I've had a consultation with Dr. McGrath in Austin, Texas. He was confident that he could recreate my hairline and fill in the frontal area with a ~1,500 graft HT. He would lower my hairline a bit (I've always had a high hairline), and fill in the front area two inches back from the hairline. I expressed concerns about the "unique" aspects of Asian HTs: the predominance of single follicles per graft, the importance of "dense packing", and he reassured me about his prior experience with Asian HTs in California.

 

So what do you think? Is 1500 enough, especially given my Asian hair? I'm also concerned about future hair loss around the crown, but McGrath said I should always allow the possibility of further HTs. Before that that time comes though, he suggested the combination of propecia and low level laser therapy to maintain/improve the density on top. I'm not entirely convinced with the laser therapy, but what are your thoughts on the HT? I've done some searches on McGrath (this forum too), but does anyone have other views on his work? Warm thanks for all your advice.

[redkun9]

I don't style my hair this way (clearly), but hopefully this shows the degree of my hair loss.

[redkun9]

View from the front

[redkun9]

Top down view

[redkun9]

top down - with flash

[redkun9]

Left temple

[redkun9]

right temple

[redkun9]

profile

[hoose]

"He was confident that he could recreate my hairline and fill in the frontal area with a ~1,500 graft HT. He would lower my hairline a bit (I've always had a high hairline), and fill in the front area two inches back from the hairline."

 

Red,

 

1500 grafts would not be enough; you would not be happy with the density; I would say you would want at least 2500+ in the frontal 1/3 to provide a decent cosmetic differance; also you need to get on finasteride (Propecia/Proscar) to maintain your native hair; I would consult with some other docs;

[indian_balding26]

Red,

 

ur hairloss looks pretty much like mine....in terms of density and receding hairline....and u do a decent job covering it up with existing hair

 

having said this, i would say that you will need atleast 3500 grafts for a good coverage....i have very similar density and most top surgeons have recommended around 3500-4000 grafts for me.

 

I live in Dallas,Texas and i had consulted with a few doctors here and everyone recommended 1500 grafts to me!! stay away from these doctors.

[redkun9]

Dhoose and indian, thanks for the suggestions. Indian, what number are you planning on going with?

 

I've been on finasteride for about a year, on and off, now. Would 2500+ be too aggressive since I have existing hair in the frontal 1/3 area? It's sparse bc of a combination of thinning and loss, but there are still native hairs there. As Indian mentioned, that existing hair still does it's coverage thing (kinda), and I'm concerned that going with too many grafts could backfire. Would shock loss risk be a reason to go with around 1500?

 

I'm kinda confused with all the divergent numbers thrown out, and the "unique" issues/obstacles of asian hair compound those worries. I'm not lowering my hairline radically since I've always had a high hairline. I just want enough grafts to lower the hairline and fill in the front.

 

Are there any docs who "specialize" in asian hair?

 

cheers

[dakota3]

1500 grafts sounds like something Bosley would say!! Definitly not enough for you.

[indian_balding26]

@@redkun

 

from my research i would say 2500-3000 would do the job, why i am saying this is.....age 24-35 would be most important in terms of looking good and stuff atleast for me...there are lot of old people who are bald....looking bald below 30 is horrible! .and i want to look the best at this age, and probably it will be okay to look bald when i am older than 40! i don't think it would be too aggressive....with a decent amount of grafts in 1st HT you probably wont need to think of another HT within 5 years, else this will be a damn never ending daily issue.....

 

2 things even i am very worried about

 

1) shock loss(many times permanent)

2) my silky soft and thin hair which is definitely a problem to provide density with fewer grafts which means i may need upto 5000grafts to give same appearance while someone else with thick/curly hair may only need 3000 grafts

 

Both have no solution mate! probably shaving off our head is the best solution!

[latinlotus]

I think that 1500 grafts may not be enough. In my opinion 2000-2500 grafts should be sufficient. Keep in mind that Asian hair is thicker thus, in general, the # of grafts required is lower compared to a Caucasian.

 

Keep in mind also about the density. I have done quite a bit of research on this topic to realize that anything more than 40 grafts/cm2 is wasted, because people will not see a difference. On top of that, the higher the density over the 40 grafts/cm2, the lower the yield/growth rate of transplanted hair.

[redkun9]

Thanks for the info, Latinlotus. I really appreciate your opinion based upon the unique aspects of Asian hair. Would you remind linking to some of that research? My preliminary research lends me to believe that Asians in general would also require a lesser number of grafts, all things being equal vis a vis other Caucasians.

 

Have you read this by any chance? The study claims that "n normal Chinese scalp, an average 71.78 FUs/cm(2) and 137.08 hairs/cm(2) were calculated with a follicular density of 1.91 hairs/FU." and continues to say that "[t]he average density of 30 FUs/cm(2) implanted was suitable to reconstruct a natural frontal hairline in bald Chinese patients, which can achieve about 40% of normal hair density." I didn't purchase the article online, but I was curious how you felt about the 30 FU/cm2 number. I realize this is only the number for the hairline, and who knows how they define "suitable".

 

If you don't mind me asking, are there any doctors you've run across that do impressive "Asian" work?

[thepauliweb2008]

I'm Chinese and I had my hairline lowered by mcgrath 7 months ago. Did you end up finding a competent doctor for your procedure?

[redkun9]

Hey Ronny,

 

I've still in the "thinking about it" stage, but I'm leaning towards Dr. Rahal. Could you describe your experience with McGrath? If you could be so kind as to post some pics of McGrath's work, that'd be wonderful. Thanks!

[CuriousJungleGeorge]

1500 doesn't sound bad, to me. First, we don't really know the density of your donor area; second, we're not sure what your expectations are. I feel the top of your head doesn't need to be filled in yet, and the front being done with 1500, again, doesn't sound unreasonable. If possible, schedule a consultation with a different doctor, and see what he or she has to say.

[Raphael84]

For me you will require more than 1500. I doubt you will be happy with this density. Concerns regarding shockloss are genuine, hairs that are minimized have most chance of experiencing this. Even if this is not the case, you could well experience further loss very soon into the future, meaning a second HT. Therefore, 2500-3000+ seems a better plan, creating a hairline and reinforcing that area behind.

 

Begin with Finasteride now and this will assist in less miniturization and potentially filling in the crown area. If you feel you need a second HT to fill in the crown area afterwards, then you will have achieved more with 2 HTs.

 

IMO

[Raphael84]

Just taken a look at your crown pics. A HT into this area right now is not necessary IMO. Just be patient and see how the meds can assist!

[Raphael84]

You can not go wrong with Rahal. Get in touch with him and let him analyse your situation. He can obviously assist much more than any of us.

[Dewayne]

I'd consider Feller as well, as he seems to be an expert on different ethnic characteristics of the hair from my research.

[Dr. Alan Feller]

I don't think 1,500 grafts will even be close to enough. Look at the 23 year old chinese patient I did a few years ago in the link. He had a transplant of the same size before coming to us which literally did nothing for him.

 

Then we did 3,000 graft in the hairline alone.

 

Click the link for the results

 

3,000 on young chinese patient- Grown out- Dr. Feller

[Raphael84]

Great of you to chime in on this one Doc. With a great result included also. This will help out for sure.