Please check out this thread. Can really use the community's advice.

[zenmunk]

Thought I'd throw up some pics to show my hair loss situation. I'd appreciate any constructive input from the community.

 

- Do you think I'm on the right track with the following plan?

 

- Do you think the proposed hairline in the pics works?

 

As you can tell, I have fine hair. I've read that may be an advantage toward achieving a natural hairline result, but will also require more grafts to achieve density when compared to those with coarser hair. I expect dense packing is in order considering how fine my hair is, but I know there are limitations. That's why I believe a relatively conservative hairline is best, not to mention age-appropriate (I'll be 39 this month).

 

I've been quoted as needing around 1300 grafts to do the job at an in-person consultation.

 

- Do you guys think that's an accurate quote for my situation?

 

I'm going the FUE route. If necessary, I'm prepared to have a second FUE procedure done to address poor growth from the first.

 

Been on propecia for 13 years with few observable side effects. It's stabilized my hair loss since I started it.

 

The chin-to-chest and 3/4 pics shows the hairline I'd like. Chin-to-chest also outlines, in orange, the area behind my hairline which needs some grafts to improve density.

 

The profile pics and pic of the back of my head show the donor area outlined in green. I want the FUE extraction pattern to be spread out to use as much of that entire area as possible. In other words, despite the relatively small number of grafts needed, I don't want the extraction pattern limited to only the occipital region. I'm not concerned with the doc venturing outside of the safe zone, and I'm willing to sign something to that effect. The donor area goal is to minimize the appearance of white dot scarring and thinning as much as possible by using the widest extraction pattern and smallest punches.

 

Thought a pic of my hair grown out would be helpful, too.

 

Thanks in advance.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited November 2, 2011 by zenmunk

[Gish]

Hey, if you don't mind saying, who gave you the estimate?

 

Much of the work I have seen posted that was performed on people with a similar pattern of recession received a number of graphs close to 1300. Some even less.

 

I think the choice of hairline is very tasteful. A perfect nw1 can look quite goofy on grown men.

 

On another note, I'm very interested in the fact that you have been on finasteride for 13 years. Do you have any pictures from when you first started treatment? Have you been using anything else at all? It is rare to come across a long term user of finasteride with pictures.

 

The merck data shows that most men will be back at base line ~10 years after starting fin. 13 years without any further recession would be extremely impressive.

Edited October 3, 2011 by Gish

[corvettester]

To me, the most revealing photo is the last one. Personally, if I were you, I'd want to close off my temples/corners a little more. With your amount of hair loss, at age 39, you could afford to be a little more aggressive, in my opinion.

 

I think you'll end up wanting more than 1,300 grafts FUE, probably closer to 2,300 when it's all said and done because it looks like you want to address some thinning a bit further past the hairline, behind the forelock. That will give you an age appropriate hairline and close off the temples with sufficient density.

 

However, with the design that you've proposed, I do think 1,300 is enough, but I'm not sure it will give you sufficient density. I'd shoot for 1,800 if I were you, save yourself the second pass.

 

Either way, you're in a very auspicious position to have an excellent result. This is due to your minimal hair loss and favorable hair characteristics. I'd be more aggressive if I were you, but that is just my opinion. Good luck with your decision.

 

 

Corvettester

Edited October 4, 2011 by Unregistered

[zenmunk]

Hey, if you don't mind saying, who gave you the estimate?

 

I actually received graft estimates from two clinics. The online/phone consult was with Matt from SMG. He said, based on my pics, that 1200-1600 would be appropriate, and the number would be narrowed down in-person. The in-person consult was with Dr. Feller. I'm in NYC, so it was quite convenient for me to visit his office. He said that 1300 should do the job.

 

I think the choice of hairline is very tasteful. A perfect nw1 can look quite goofy on grown men.

 

Thanks, man. Yeah, I would never shoot for something that aggressive. Those days are long gone for me.

 

On another note, I'm very interested in the fact that you have been on finasteride for 13 years. Do you have any pictures from when you first started treatment? Have you been using anything else at all? It is rare to come across a long term user of finasteride with pictures.

 

The merck data shows that most men will be back at base line ~10 years after starting fin. 13 years without any further recession would be extremely impressive.

 

I took one or two Polaroids (yup, I said Polaroids lol) of my hairline before starting the meds. I wanted to document my starting point and compare it to my 1 yr. results. Unfortunately, I don't know where those pics are now. Been a long time. Sorry that I don't have them to share. I realize it would've been interesting for you guys to see the difference.

 

However, I'm quite confident that the propecia pretty much halted my hair loss. If you look at the last pic that I posted (with my hair grown out) you will notice a thinner area which corresponds to the area outlined in orange in the first pic. I'd say that over a one year period of time that area has thinned slightly, and I mean slightly. Other than that, I haven't lost any hair; those pics pretty much represent how my hair looked 13 years ago.

 

My theory is the loss was due largely to stress. Prior to starting the meds that area was thinner than the rest of my hair, so it's been fighting pretty hard to hang on. Two years ago some personal stuff happened which made my life a living hell. The first year is when I noticed the thinning, but then it stabilized, and I haven't noticed any further thinning/loss over the second year.

 

So, I can't claim no further recession in 13 years, but I can claim almost none, so perhaps that qualifies as moderately impressive.

 

To me, the most revealing photo is the last one. Personally, if I were you, I'd want to close off my temples/corners a little more. With your amount of hair loss, at age 39, you could afford to be a little more aggressive, in my opinion.

 

I think you'll end up wanting more than 1,300 grafts FUE, probably closer to 2,300 when it's all said and done because it looks like you want to address some thinning a bit further past the hairline, behind the forelock. That will give you an age appropriate hairline and close off the temples with sufficient density.

 

Yeah, believe me, I've debated how aggressive I should be with the temples/corners. I think I'll start more conservatively and see how it goes. I always have the option to do more later.

 

However, with the design that you've proposed, I do think 1,300 is enough, but I'm not sure it will give you sufficient density. I'd shoot for 1,800 if I were you, save yourself the second pass.

 

I'll take your 1800 graft per one procedure suggestion under serious consideration. I have a feeling that 1300 may not cut it at the end of the day, regardless. I mean, if the yield isn't as good as I'd like with the first procedure, then I'm gonna have to address it with more grafts anyway. And, we all know statistically FUE falls a bit short.

 

Either way, you're a very auspicious position to have an excellent result. This is due to your minimal hair loss and favorable hair characteristics. I'd be more aggressive if I were you, but that is just my opinion. Good luck with your decision.

 

Thanks! Very happy to hear it!

 

Gish and corvettester, thanks a lot for your input. Much appreciated!

[Sean]

Thought I'd throw up some pics to show my hair loss situation. I'd appreciate any constructive input from the community.

 

- Do you think I'm on the right track with the following plan?

 

- Do you think the proposed hairline in the pics works?

 

 

I've been quoted as needing around 1300 grafts to do the job at an in-person consultation.

 

- Do you guys think that's an accurate quote for my situation?

 

 

 

 

 

Zenmunk, your posts have been valuable. I think you are on the right track with the plan. Since you are going for a conservative approach based on your age as well, I think the proposed hairline in the pic does work well. What are your ultimate styling goals? How would you want to style your hair afterwards? Would you comb your hair back or part it or stick it up, grow it long, etc? You can tweak the hairline just a little bit based on your styling goals.

 

If you have been quoted 1300 grafts, that might be sufficient or you may need just a little bit more, depending on your density and other factors. Your mid frontal area seems strong, it seems you need to just focus on the frontal left/right sides for the most part. So, that will save you lots of grafts as well. Another thing to think about is what if out of those 1300 grafts, they were able to extract lots of 2's, 3's maybe even 4's? So, 1300 grafts may or may be sufficient based on that as well. If majority of the 1300 grafts turn out to be singles then obviously there wouldn't be that much density, although giving a natural hairline, there would be a thinner look towards the back of the hairline. However, I think they will be able to extract ones, twos, threes, and possibly fours in the mix as your donor area/hair looks really good.

 

I think fine hair is a good tool to make hairlines, but also graft placement based on density. I think most surgeons use One's to create hairlines to keep them natural, and then use 2's and 3's etc in the mix as they move on back. You may have good density though, it seems like it when looking at your mid front and donor area. You seem to have plenty of space to extract grafts and the area really does look good.

 

Your idea of spreading the extraction throughout the back in the donor sounds good. I think it is a very smart idea.

 

You saw my 3000 graft FUE pics, I had a way larger area to cover and density did help me. You definitely have a lesser area to cover, and with the right density, 1300-1600 give or take may be all you may really need. See how that works, if you need a second pass, you can some in later to tweak a few more. You got great hair characteristics and you don't even have to worry about the crown it seems. Wish you the best, I look forward to seeing your updates when you go for it.

Edited October 4, 2011 by Sean

[zenmunk]

Zenmunk, your posts have been valuable. I think you are on the right track with the plan. Since you are going for a conservative approach based on your age as well, I think the proposed hairline in the pic does work well. What are your ultimate styling goals? How would you want to style your hair afterwards? Would you comb your hair back or part it or stick it up, grow it long, etc? You can tweak the hairline just a little bit based on your styling goals.

 

Thanks, Sean, I appreciate that. Glad you think the proposed hair line is on point (for a conservative approach). I think, based on my recession, it would put my hair line pretty much where it would've been had I not lost hair beyond a mature Norwood II. In other words, the lines tie in well at the temple points/triangles and still frame my face fairly well. I think less is more in my case, with my particular kind of recession, and will allow for the most natural result.

 

Styling goals...good question. I'd love to have the option to do all of the above, actually. My hairstyles vary a lot over time. Currently, I'm buzzed to a zero guard, but in the last pic posted my hair was pretty long, like shoulder length (that was like a couple months ago). I've also worn it short and messy on top and slicked back as well. If possible, I'd like to hold on to that variety. How do you think that affects graft count/hair line design?

 

Another thing to think about is what if out of those 1300 grafts, they were able to extract lots of 2's, 3's maybe even 4's? So, 1300 grafts may or may be sufficient based on that as well. If majority of the 1300 grafts turn out to be singles then obviously there wouldn't be that much density, although giving a natural hairline, there would be a thinner look towards the back of the hairline. However, I think they will be able to extract ones, twos, threes, and possibly fours in the mix as your donor area/hair looks really good.

 

I think fine hair is a good tool to make hairlines, but also graft placement based on density. I think most surgeons use One's to create hairlines to keep them natural, and then use 2's and 3's etc in the mix as they move on back. You may have good density though, it seems like it when looking at your mid front and donor area. You seem to have plenty of space to extract grafts and the area really does look good.

 

Good points. I don't know what the graft groupings may be, but I'm glad that my density seems good. Since I only have on average 0.5" or 1.3cm to fill around my hairline, I think the doc will probably have to stick with ones for most, if not all, of it. However, I think he can safely use multi-hair grafts in the area outlined in orange in the first pic.

 

Even with dense packing, I expect that will undoubtedly leave me with a thinner result toward the back of the hairline, because my hair is fine. Unfortunately, I think that's unavoidable, but I don't mind sacrificing some density for the most natural result.

 

Since many men suffering from MPB recede the way I have, a thinner appearance toward the back of the hairline is pretty natural. I'm OK with that as long as it's not too thin; in that case, I'd go in for a second pass.

 

Your idea of spreading the extraction throughout the back in the donor sounds good. I think it is a very smart idea.

 

Thanks, yeah, I think it's crucial to utilize as much of the area outlined in green as possible especially considering my long-term plan. Minimizing the appearance of white dot scarring and donor thinning is very important to me. Even if it's only 1300 grafts, I want those extractions really spread out.

 

You saw my 3000 graft FUE pics, I had a way larger area to cover and density did help me. You definitely have a lesser area to cover, and with the right density, 1300-1600 give or take may be all you may really need. See how that works, if you need a second pass, you can some in later to tweak a few more. You got great hair characteristics and you don't even have to worry about the crown it seems. Wish you the best, I look forward to seeing your updates when you go for it.

 

I hope I don't need more than 1300-1600. We shall see. Thanks a lot for your input, Sean. I really appreciate it.

[zenmunk]

Good advice. Thanks, Spex! That's pretty much been my plan except I was hoping 1300-1600 grafts would do the job. I am prepared for a second pass, so if it becomes necessary, either because of less than adequate yield or less than adequate density due to insufficient graft numbers, then I will go for it.