New guy needs some advice: Please Help!!

[Tryingtodecide]

Hey guys..Just to give some background info..

 

28 year male with mainly frontal hair loss. Started at 15-17 and losing ever since. Gotten to the point where my temples are fully gone and forelock too has become narrow and is continue to thin and move towards the crown. Top and crown seem to be in good shape.

 

Father had decent hair till recently and so did my uncles except one who is nw 6. Mum's side story is not so good- 4 uncles, 3 with nw 5-6 and one nw-3.

 

Currently not on any medication. Am seriously thinking on going for a HT. Goal is to get the frontal hairline back at good density and maybe move it down 1 cm. I dont think that my top and crown are DHT sensitive considering 13 years have not led to much thinning in that area. In that case looking at my pics i've lost almost as much hair as i possible could in the frontal region without being completely bald there hence my rationale for going in for a HT

 

I would really appreciate frank and straight answers to some of the questions buzzing around in my head right now..

 

 

1. Can I think of lowering my hairline a bit more and dense packing it considering after 13 yrs i've not had loss in the crown and top, thus unlikely they being affected by androgenic alopecia. In the future i would not mind having a bald crown if hair loss does progress but obviously would not want balding top.

 

2.If i consider a conservative hairline with slight lowering and mature temples how many grafts would be required to give good density and decent coverage

 

3. Looking at my donor area picture any comment whether it appears to be poor, average or better than average.

 

4. Since the forelock area is thin currently during the Ht procedure will grafts be placed amongst the original hair to bulk it up?

 

5. If after the HT i lose all the hair i have in the forelock region would i need to have a repeat procedure? Asking because the forelock itself is not too thick right now so wondering whether losing that would have enough cosmetic significance to require a 2nd procedure.

 

Any other opinion you guys have regarding my situationa and further advice? FUE or FUT? I would really appreciate it if some members took the time to see the attached pics and comment on my situation guys.. Am really troubled by my situation. Thanks in advance for the effort in looking at my pics and answering some of my questions.. Cheers!

[mattj]

Hi there,

it is by no means certain that your crown and top are safe and not sensitive to DHT, but considering how long you've been losing hair and how slow it has progressed, I think most surgeons would consider you to be a good candidate.

You're a living example of how early hairloss doesn't have to spell disaster and a Norwood 6 pattern by by the age of thirty.

 

You seem to have a realistic and achievable goal for surgery. The forelock is thin enough that surgeons would probably want to plant grafts among the native hairs to add density. It would depend on how many are added as to how dense the area would be if all native hair were to be lost in the future. A touch-up procedure for that area could be required somewhere down the line.

 

Your donor hair looks thick and probably of about average or slightly above average density.

 

As for grafts needed, some forumites might offer their opinions but it's best to see what surgeons themselves have to say. Have you had any consultations, in person or online?

[Tryingtodecide]

Hi there Matt,

 

Thank you for taking the time to reply. Much appreciated. I have indeed consulted with 3 Doctors online and have gotten the following info from them..

 

Dr. Bernstein : approximately 1500 grafts

Dr. Dorin : approximately 1500-1700

Dr. Feller : approximately 1800-2000

 

Those estimates were based on different pics to the ones i've posted : tho the sent pics had also been clicked very recently. Obviously the docs are the best to decide how many grafts would be required but I was wondering whether 1500-2000 be sufficient to give adequate density compared to my permanent hair and decent coverage? Since I have contrast between the black hair and skin I'm thought I would require as densly packed a hairline as possible. Any idea how deep (cm) the hairline should be?

 

Any advice on what sort of hairline I should be looking at if i'm allright with frontal and top coverage but dont mind crown baldness in the future? Should i choose a conservative hairline or do i have the option to be slightly aggressive regarding it?

 

Also Would i be a candidate for FUE or would that be a bridge too far due to the number of grafts required?

 

Thanks.

[hairthere]

The range you were given of 1500-2000 looks right. There's a few things to keep in mind about graft counts: 1) Your donor quality could be very thick which helps give the illusion of more hair. 2) You could have a high number of multi-hair grafts which also adds to the illusion of density. Of course, the docs you mentioned will all use single hair fus in your hairline to make it look natural.

 

You should also keep in mind that your scalp's laxity will play a part in how many grafts your doc can get.

 

But if 1500 was your worst case scenario I'd say you'd be able to have a thick, albeit conservative hairline established with backing behind it and into your forlelock if that's showing signs of thinning.

 

You are also consulting with the top three clinics in New York, imo, so you're off to a good start...

 

regarding fue, I'd only recommend it if you plan to buzz your hair very close.

[mattj]

I'd have to agree with everything hairthere said, especially regarding FUE.

 

 

I'd be interested to know if you discussed hairline position during those consultations. Maybe you drew a line on a photo? Your hairline is currently high enough above a typical juvenile location that there's lots of room for you to decide how low you want to go before going too low, and every centimetre difference in position will result in a significantly different number of grafts being needed.

I just wanted to point that out because you're still obviously undecided on how conservative you should be, so the graft quotes could change based on your final decision. At the moment you're probably looking at figures based on the opinions and philosophies of each individual doctor. You should probably contact them again when you know exactly what you want.

 

Although your hairloss started early, as it hasn't been extremely aggressive (even without medication) you're probably in as good a shape as any 28-year-old to be less conservative if that's your wish. If you are happy with conservative then it's never a bad idea to be content with a higher, more mature hairline. Plenty of happy transplant patients choose that route and achieve a great look.

[Capelli11]

If we only all had your problem with holding onto our hair with no meds for 13 years! So kudos to you! lol. In all seriousness...I agree with everything noted in the above replies. 1,500 to 2,000 grafts will suite you well and would really define your hairline. It seems you keep your hair quite long on the sides so based on that you could do FUT and have no real issue with someone spotting it. But some people dont' want the scar and the healing time is a lot more for FUT...so it is up to you and your unique situation. If you were to only need 1,500 grafts and have no real other hair loss you can go with FUE bc you will be able to have one pass with no problem...but keep in mind the yield may not be as great as FUT...but the dr's you chose above all are highly skilled at FUE. You should perhaps take at least Saw Palmetto in holding onto your remaining hair if you don't want to go for Propecia for obvious side effect potential...I mean you don't seem to need it considering you have held your hair for 13 yrs but u never know what the future brings so you always want to stay ahead of the curve! keep us posted on your consults and decision! Good luck!