help me get over the hump and schedule surgery

[multiplier]

Some of you know my story, but I'll give the condensed version. Ten years ago I got surgery of 800-900 grafts spread throughout my frontal 2/3, done by MHR. I have always been on Proscar and more recently minox, but the loss has continued slowly. This is the most revealing current picture -

 

imgur: the simple image sharer

 

I am in a weird spot where I'm not sure if I have any choice but to get another surgery otherwise the grafts in the front are going to begin to look very strange and sparse. I have spoken with 3 of the top doctors recommended on this forum. All of them have said I have about average donor density and room for a 3000-4000 graft procedure to start with.

 

So what am I waiting for? I'm not really sure. The first time I had the surgery, it was a big emotional deal to stay hidden away from 6 months while the shockloss grew back, which not all of it did. But I guess since most of my frontal hair is FUT, it's unlikely to suffer from that this time around.

 

Just in general it's the fear that I will be told that 4000 is really all the donor hair I've got. I get that transplanted... and then what? What happens if/when more hair falls out? I suffer form the same fear as many people on this board: I don't want to eventually look like a freak.

 

I know transplants have come a long way since 2001. I know the HRN docs are concerned with planning for the future. I just want to know in my heart that I'm a decent candidate for this, the work will look decent, and it won't be something I'll regret.

 

Any words of advice? I could use the encouragement.

[Thehairupthere]

Like you said the top doctors on this site plan for the future and if they believe that you will go on to lose more native hair than they will let you know about it, and will plan with you how to go about it when you cross that bridge. You may have a few thousand grafts available and 3000-4000 grafts is a lot; it will make a drastic change in your appearance where I dont' believe you will need much more work if at all after you get that transplanted. You may also be able to get a few extra hundred grafts or more through the FUE procedure if you needed to after that procedure, but again you'll cross that bridge when you get there. If you are deciding between the top docs you are definitely in good hands and they will steer you in the right direction, so it really comes down to when you are ready and comfortable to proceed, but rest assured you will recieve top notch care.

[multiplier]

Thanks thehairupthere, it's good to know that places like True/Dorin and others are meticulous about planning for a patient's future. I think it's a big part of building the relationship with the patient and avoiding misunderstandings.

 

Anyone else have insights here? Thanks!

[aseda1979]

You can get a FUE if you run low on donor density as hairupthere said, but 4k grafts will do wonders to your head, from what I see in the pic you posted.

 

If 4k looks very good on guys with no hair, imagine what that would do to you...

 

I'd say go for it...

[NEWHAIRPLEASE]

Multiplier

Im in the same boat, I had a transplant when I was 19. I am now 37. I have quite a bit of native hair left, however some of my minis are starting to show. I went to a consult with Dr Konior and he completely put me at ease! Now, obviously I'd rather not have to have another surgery, but I could not be more excited about the Dr I chose and the way he was one on one. I waited for 18 years to have another one, so trust me you can do it! I'll be going in for my surgery in July

[Anouar]

Multiplier, I had my first 12 years ago With Dr. Limmer sr. I had a thousand grafts. I went through a lot of pain and after the grafts grew in, well lets say I still looked like I was losing my hair. With ample amount of conceiler, I carried on. My wife hated the conceilers and said they were obvious. I continued with the conceilers and hairspray for 10 years. I knew I wanted another surgery. I wanted somebody that can deliver the goods. Today, I gotta say Im very happy I did it. I'm free of conceilers and hairspray and just think I almost didn't go for it. Research carefully and filter through the B.S. One thing I never let persuade me was doctor results posted by doctors themselves

[gillenator]

multiplier,

 

One of my four strip procedures was with an MHR doctor. Big mistake. My other three were with talented docs so my final result is good. FYI, MHR got officially acquired by Bosley last year. Many former MHR offices were closed because the two giant chains competed against each other in many larger cities in the US. MHR no longer exists!

 

How old are you? And what extent of hairloss are there in both sides of your family history? IMO, it appears that you could end up in a more advanced class on the Norwood scale.

 

If you are still slowly losing hair and still on both hairloss meds (finasteride, minoxidil), than you must plan the placement/distribution of the new grafts in a way that will take into account further thinning and loss, "based on the pattern of loss" that you have.

 

The doctor should also be able to inspect your scalp for the areas that have active miniturization going on. Those areas of hair are DHT receptive and can be lost in the future even though there is some visible growth at present. Basically the doctor is looking for areas that have decreases in hair shaft diameter due to the miniturization process from MPB.

 

Just don't get overly aggressive with density in any area. Most of us only need 50% of original density to attain "the illusion of coverage". You can get by with less to look natural, even if you thin further.

 

If you hit your maximum harvest from strip methods, I agree, you can consider FUE extractions which can also be harvested from some of the parietal areas. Most strips are excised from the occipital zone. But you need a full physical exam and assesment of every donor area.

 

Best wishes to you friend...

[multiplier]

Can't thank you guys enough. It has been hard being in limbo the last 2 years, watching my hair get thinner and greyer and meanwhile caking on concealer and brushing my hair to the side every day, convincing no one I'm sure. I do have diffuse thinning and some baldness on both sides of the family, but then again none of them used Fin + Minox. I'm hoping sticking with those + surgery will put me back in a good place where I don't always feel like I'm so self-aware.

 

One thing I hope is an advantage, and tell me if it's not - I have no desire to transplant to my temples, even though they're very receded. I think doing so is a waste of donor for certain people, no? I would like to strengthen the area around and behind the hairline all the way to the back third, but am not interested in the frontal hairline of a teenager (I'm 36 years old). I'm also expecting that if I leave the back crown mostly alone for now that I still may have to use Toppik there from time to time. That is not the end of the world. What feels like the end of the world now is that I can't even part my hair in any remotely flattering fashion without it looking extremely brittle and silly.

 

The reason I'm saying this is to let you know I'm pretty realistic and conservative. I don't have the thickest donor, but the three topmost respected doctors have said I'm a candidate that would benefit from a procedure of 3000 (estimated) to start with. That makes me optimistic.

[Hal]

Hey Multiplier,

 

We we taking about this in another thread, but I have to say I'm with the others that say you would benefit from a 4,000 graft (give or take) procedure.

 

I look it at your situation like this:

 

Your crown doesn't look to bad and you've indicated that you would most likely leave it alone for now-- I think that's a wise choice.

 

So if you put the 4,000 grafts in the hairline and towards the back (hairline, core, and top of the head) I don't see how you could go wrong as long as long you had a top flight surgeon.

 

Consider:

 

Those 4,000 grafts would give you a nice appearance of hair. Obviously, the density is going to be a factor-- but it should provide you with a nice, reconstructed hairline and a stable pattern once everything grew in.

 

Now your existing hair in the target areas is going to be a bonus, adding density.

 

But even if you suffer shock loss from hell and have problems growing it back, the 4,000 grafts will still be there and I think that will give you a better appearance and more style choices (and less worry) than your current situation.

 

So personally I think you're in good shape and will benefit from the procedure. It's sort of a win-win in my view. A good bet as these things go.

 

You will have to shave down and it will most likely be a long first 6 months or so, but I'm sure you can tough it out for the results that you'll be getting.

 

Just my 2 cents.

 

Hal

[hairthere]

Sounds like you have managed your expectations really well. With your attitude, a great doctor, and the right amount of grafts I think you could exceed those expectations AND get off the concealer. You already had one procedure, so just pull the trigger. Best of luck!

[multiplier]

Thanks guys. I think my outlook is realistic.

 

But the crazy part - I was sitting in a bar earlier reading your responses on my iPhone, then I got on the subway and stood next to a guy who had classic fencepost-style transplants in the front third of his scalp, sparse and sticking straight up. His hair was very short and when he turned to the side, I saw the huge U-shaped scar in the back. The skin also looked lumpy and uneven like there was excess tissue. Previous to seeing this, I had been in a good mood. It's amazing what a close-up view of transplants-gone-wrong can do

 

I'm telling myself he probably got them done 15 years ago and has never had a second round of transplants either because he's broke or has no donor hair. And maybe he never took Propecia or Rogaine. But still. I wonder if the way he looked is an image that crosses all our minds late at night when we wonder where our hairloss will lead.

[kathie47]

Maybe he didn't do his research and went for the cheapest doctor he could find. You have done your research and while going to a reputable doctor doesn't guarantee perfect results, it certainly diminishes the chances of anything horrible happening. I'm sure it's a tough image to get out of your head, but don't let it stop you from doing something you want to do.