Help (conflicting advice been given!)

[Diego2k12]

Hi guys,

 

Just a quickie really. I am 26 years old living in the UK and have always had issues with my hair. The last 2-3 years I have noticed my crown really disappearing. This summer, with myself being a teacher and having some time off I decided to see what I could do to sort this out.

 

I visited Ziering in Leeds and when speaking to the consultant he said that I would need a FUT with 2750 grafts. Not really comfortable with what he said I decided to do what many people suggest on here and research.

 

I emailed both Spex and booked an appointment with Dr Farjo for the end of August.

 

Spex got back to me and said my donor area was VERY weak and as such said I would be better looking at SMP.

 

Mick from Farjo also got back to me and he said that my donor area is very weak and as such should look towards pigmentation aswell.

 

I do trust the judgments of both Spex and Mick but just want to gain different opinions before I do look down the pigmentation route.

 

Please see photos attached for any advice.

 

Thanks

[Thehairupthere]

Have you considered using rogaine and finasteride? It seems like you have a good amount of miniaturizing hair which could regrow if given the chance. At your age I would give it a shot for a year and reevaluate.

[mattj]

I've lost count of the number of times I've spoken with people who were quoted 2750 grafts by that clinic. Everything from Norwood 3s to Norwood 7s get that same figure.

 

2750 would make very little difference on your balding pattern and I have to agree with Spex and Mick. Your donor area is unlikely to supply enough grafts to give you a result you'd be happy with.

[Mick from Farjo]

Spex,

 

Thank you for the kind words..appreciated.

 

I did tell Diego that we would be happy to see him to discuss all aspects but that we did not feel that from looking at the pictures that surgery would be a likely outcome.

 

Mick

[Sean]

Hi guys,

 

Just a quickie really. I am 26 years old living in the UK and have always had issues with my hair. The last 2-3 years I have noticed my crown really disappearing. This summer, with myself being a teacher and having some time off I decided to see what I could do to sort this out.

 

I visited Ziering in Leeds and when speaking to the consultant he said that I would need a FUT with 2750 grafts. Not really comfortable with what he said I decided to do what many people suggest on here and research.

 

I emailed both Spex and booked an appointment with Dr Farjo for the end of August.

 

Spex got back to me and said my donor area was VERY weak and as such said I would be better looking at SMP.

 

Mick from Farjo also got back to me and he said that my donor area is very weak and as such should look towards pigmentation aswell.

 

I do trust the judgments of both Spex and Mick but just want to gain different opinions before I do look down the pigmentation route.

 

Please see photos attached for any advice.

 

Thanks

 

Diego, I am not an expert, nor consultant, nor doctor, but a researcher and a patient myself and just 3-4 years older than you. I had my procedure at the beginning of age 29. I will give you my take on what I can see from your photos. You do seem to have quite extensive hair loss at your age, however, you can try a few things to see if it does improve the situation. I still think you can manage it in various ways and other options. Have you tried any medications such as propecia or rogaine and have been consistently on either or both for about a year straight? It may help improve or regain some hairs you might have recently lost within a year or so. If you are a good responder, it will also help you preserve them long term with daily use. If that works, then move to phase 2 which means you may be able to have a better transplant result as you may be a good responder to treatment.

 

Otherwise:

Or you can use SMP as a combo with restoration in the long run later to enhance your result. Or you can go for the best type of transplant that suits your donor and consider a less dense result and wait for future technologies to improve on that. Or you can consider working on the front, your hairline area more, and reserve a little bit of the midscalp or crown for later on as things progress. You may have to sacrifice your crown work because it is a black hole that will eat up a large number of your precious grafts (maybe twice as much or more who knows). It takes more grafts to nail the crown with adequate coverage vs any other area.

 

I honestly don't know what to make of your donor area as the pictures of your left and right side of donor are not in good quality. The picture of the back of your head has varying shadows. You seem to have a short haircut on the sides kind of buzzed so it is hard to tell (what clip/guard are you using). If you grow it out, you may be able to tell and see how it is. Who knows, you may have good hair groupings per graft back there? You will never know unless you walk into an office and have a clinic test your donor out just to make sure. So, I really suggest you see Dr. Farjo's first to have them analyze everything to rule out if there is a donor issue or not. You have an appointment with them at the end of the month so definitely go to it. If your donor area is truly not strong, then I would avoid Strip/FUT by all means as it may make it very visible and if it scar also stretches, you wont have enough grafts to cover or repair it. Do not get cut left to right if your donor truly has an issue. HOWEVER, you may be able to mix and match with a little FUE here and there with other combinations of technologies and keep doing it if need be long term. These days I have seen some things I wouldn't have imagined seeing in the past. It may need a long term effort on you part and involve a step by step approach for you.

 

I really don't think you should just jump into SMP right off the bat. I do think some results are impressive (in terms of scar repair) but you should hold off until you see long term results with SMP covering from front to back. I just want to make sure SMP does not hamper you from any future technology as it does involve making some sort of puncture in the skin to add pigment. I don't know if this could be detrimental to the quality of a future hair transplant result should you decide to add hair in the same zone in the future if something new comes out or if it compromises treatment of your hair loss in the future as having any puncture to the skin over and over again, from what I have read, may increase the epithilium of the skin which may hinder hair transplant results. For example: if you get a hairtransplant somewhere, a doctor reworking in the same recipient zone will have to work in an already worked zone and that can hamper the result as the skin gets tougher. They may have to use bigger incisions and you have to just be prepared for everything for the long term. Again, this is from what I have read and heard. I am not an expert. Maybe someone else could chime in and explain. I would personally wait as there are a lot of treatments being testing more now, some people are testing SMP, some modified PRP techniques, some other regeneration techniques, and so forth. If anything, something better may come out within next 2-4 years. You never know.

 

You should have hope. Anything is possible if you plan it accordingly. Technology is advancing. Things are getting better. Combination treatments are becoming more and more effective along with a hair transplants (ones that can cater to your physiology). Please look for patients here in similar scenarios as you or see if you can locate to meet in person. You never know what other things can occur within the next 2 years in this industry and you might be able to take care of things with better ammo. In any case, best of luck to you and hope you get the hair you want in the future.

 

By the way, there is no way 2750 grafts would give you decent coverage from front to back alone for the size of area/class of norwood.

 

Good Luck.

[Diego2k12]

@spex thanks for the words of advice pal, much appreciated.

 

@Thehairupthere I have got a private prescription for finasteride and may look to buy it.

 

@mattj & mick, cheers for the information

 

@sean, much appreciated with the advice. You have taken your time to write that, which I have read and will take my time over SMP. It won't be a rush decision. I think I will keep my appointment with Dr. Farjo, yes Mick has said I won't be a suitable candidate looking at my pictures but with Dr Farjo's advice hopefully he can tell me where to go.

 

Any more advice much appreciated from anyone.

 

Thanks

 

Diego

[Bill - Seemiller]

Diego,

 

I tend to agree with the others that your donor area appears rather thin. Thus, I doubt you'll achieve the kind of coverage and density you want with hair transplant surgery alone.

 

Depending on your goals, there are a number of options to explore. If you enjoy sporting the cropped look, a combination of FUE and SMP might be worth considering. If you have phenomenal scalp elasticity (which can't be seen in the photos), FUT may not be out of the question, but you'll most likely have to keep your hair longer and you'll have to develop reasonable expectations as to what can be realistically achieved. FUT, FUE and SMP may not be entirely out of the question either depending on your goals and scalp elasticity.

 

On the other hand, while not usually a popular suggesting, today's hair replacement systems can look incredibly natural. The downside is that they do require a lot of maintenance and usually look their best under optimal conditions. Heavy rain and strong winds could be problematic.

 

As also stated, non-surgical treatments like Propecia and Rogaine might help to strengthen and thicken up those existing hairs on top of your scalp.

 

Ultimately, you'll have to decide what your goals are and understand that each procedure mentioned is not a "cure" for hair loss. Each procedure has a long list of advantages, disadvantages and potential problems associated with them.

 

If there's anything else I can do to help, don't hesitate to ask.

 

Best wishes,

 

Bill

[zenmunk]

Great advice on this thread. I agree with Bill when he says, "If you enjoy sporting the cropped look, a combination of FUE and SMP might be worth considering."

 

If I were you, I'd do the following:

 

1) Get on Finasteride and Rogaine, and see how they work

 

2) Consult with the best Docs especially regarding the condition of my donor

 

3) If my donor allows for FUE, then follow the interesting strategy outlined by "TC17" in this older thread: http://www.hairrestorationnetwork.com/eve/140863-does-getting-fue-done-first-decrease-total-yield.html

 

The exchanges between "TC17" and "the B spot" are particularly informative. In a nutshell, they are exploring how one may use FUE to establish a decent hairline to frame the face and have sufficient coverage for the rest of the balding area to sport a very short hairstyle. The shorter the hair, the better the illusion of density.

 

This case was used as an example of how a man with less hair than you was able to get impressive coverage after one surgery of 3250 grafts FUT:

 

Hair Restoration Site for Abby

 

Post HT, he kept his hair very short for at least the first 9 months of growth. FUT and FUE are not the same animal, and your hair characteristics appear finer than the man in the example which could work against you (requiring more grafts), but it gives you an idea of what could be accomplished if you go to one of the best FUE docs (assuming you have enough grafts in the donor bank to make it possible). If you're indeed a candidate for FUE, you should be prepared to have a minimum of two FUE procedures at least 8 months apart to do the job.

 

4) Definitely follow Spex's advice regarding temporary SMP with Milena Lardi. With a successful FUE it would be awesome. Without FUE it might also equal a big positive change. And, if it's not for you, it will fade to nothing in about two years.

 

Good luck,

 

z

Edited August 10, 2012 by zenmunk

[Spanker]

I think you have a nice head. Have you considered trying to rock the shaved look for a while and see how it fits you?

[Capster]

Spanker has a good point. You seem to have a perfect head for a shaved look and as you wear your hair buzzed short, why not give it a go and see how you feel. Nothing to lose.

All the best.

[Sparky]

Agreed with Spex and Mick, quite a thin donor. Definitely wouldn't do strip, can't imagine how long you would have to have your hair to cover even the thinnest of scars.

 

Good thing that you did your research and didn't have a strip from Ziering, the fact they they recommended that is bizarre, well they get a load of money from it.

 

As you have progressed to this stage of hairloss, it won't hurt to spend a lot more time researching this before you do anything. Propecia and Regaine would be a good idea for now though.

[Diego2k12]

Hi guys,

 

Thanks for the all useful information. Everyone on here is so helpful.

 

I usually have my hair at number 2 shaved so may go for a shorter shave next time.

 

I am researching what people have said and am looking towards SMP but just from a distance at the moment, i.e just contacting clincs, etc.

 

Thanks for all that said about the strip due to my donor area. @Bill, I have looked towards hair pieces but I am sure how I will feel knowing I am basically wearing a wig. (or membrane or whatever they call it)

 

For everyone else who has contributed..thanking you. Its good to hear people are saying about the FUE/SMP.

 

I am still keeping my appointment with Dr. Farjo.

 

Cheers

[fitnessjunkie]

Hi all,

 

This is an interesting thread, and I feel I'm suffering from the same issue as you Diego with a potential weak donor supply and significant crown loss.

 

Sorry for hi-jacking your thread, but I would like to briefly talk about my story to. Here's the link to my photos:

http://www.hairrestorationnetwork.com/eve/167066-26-years-old-contemplating-hair-transplant.html

 

For now, I'm looking to stay on propecia and minoxidil every day for 12 months and re-assess how my hair has changed over the year. I am however, very interested in perhaps taking the FUE/SMP (temporary ink from Beauty Medical?) in 12-18 months time. I would like to re-shape my hair line with FUE, and perhaps get the crown filled in with a few graphs... or at the very least SMP. I am into fitness modelling which includes photography/getting up on stage etc and so framing the face is very important. FUT is unlikely to be an option for me and not something I am too interested in. I just want to wear my hair shaved as it currently is, or cropped with a bit of a fringe but shaved everywhere else.

 

Interested in how your situation plays out and what you decide to go with Diego!

 

All the best!

[almostdone99]

I agree with spanker.... IMHO, the minox and fin are half-measures (maintain existing hair, with a small likelihood of regrowth); the routine of applying the topical and taking pills is a drudgery. You seem to have nice-shaped head and might look good with a buzz? Wish my head was as nicely shaped, but I still am shooting for the buzz look after SMP. Anyhow, if the buzz look doesn't satisfy you....look into a combo of ht and smp. Ultimately, the probability of long-term satisfaction with the combo(smp and ht with tons of doctor research) is much higher than with topicals, pills, cracking eggs on your head,licking banana peels, snorting ginseng, etc.....

[RCWest]

I agree with the rest. Having surgery would do more harm than good. Try Finasteride and Minoxidil for a year and see what happens. I've seen people who weren't candidates for surgery have such a turn around with meds that they could have surgery.

[myst]

Remember, Finasteride isn't for everyone. Stop using it about a week, if something doesn't feel right. Rogaine, I would totally stay away from. Those two products made my life hell! The best advice ever would be to leave it alone until you're ready for a hair transplant.