What’s BEST? Old question but interested in informed answers based on new knowledge

[Wcayr]

There have been thousand of messages seeking and giving advice on everything related to the topic. Many of them may have been out of date. Things change. What is the answer to the question below based on the LATEST views and advances?

 

QUESTION. What is the best option for a crown issue for a 51 year old male with no surgeries Norwood scale between type IV and type V (closer to V) but limited to crown?

 

Additional info. Some receding hairline but very limited. The only non-surgical experience was taking finasteride for a year (with no visible difference, discontinued after a year) and minoxidil for a few months (stopped because didn’t see any difference). Currently have relatively long hair to cover some of the damage in the crown. Shaving hair for surgery or having anything noticeable after surgery (even without shaving) is a real problem because of work. There is no way to hide under a hat for two or three months until redness disappears or the hair grows longer. This has stopped me in the past from doing anything. I’m in the NY metro area but not all that limited to location. Having to do more than one surgery is what I’d really like to avoid partly cause I can’t wear a hat to work. Went to NY City to see a couple of surgeons two years ago. They told me I was a good candidate. Don’t they always? One of them is mentioned in this forum and is of the more conservative school. The other I didn’t trust at all.

 

What’s the best way to proceed? Or should I wait for the newer treatment to come to market? A-cell or whatever it’s called? Other surgical options or new medications? These are not new questions for the forum, but the state of the medical science has changed and there is more history now, including history of what can go wrong.

[Mickey85]

Photos would go a long way in helping determine your case champ Things can always go wrong regardless of how good the surgeon is..

[Wcayr]

Thanks Mickey85. I have to figure out how to take a picture of my head.

 

While I did mention things that can go wrong, and it is a concern, my question is really about what's considered to be the state of the art these days.

 

Is there a generally preferred treatment that is recommended unless the case is unusual?

 

There's a long list of choices including FUE, FUT, PRP, acell, finasteride, minoxidil, megasessions or not, shaving or not, side scar or back, strip or other, robotic devices and a lot more. It's confusing. What's the one recommended in a general case (such as mine or more general)? There're contradictory views. I think some posters may be paid to promote some methods or doctors. They honestly believe what they right, but they're still biased. It's not easy to get an answer. Many are so atatched to the methods they've used that the new treatments could be neglected. In medicine, there's usually the "first line of defense" recommendation that is adjusted if it doesn't work or the case is unusual and requires something else. Is something like that here too that's based on the latest knowledge?

[1978matt]

Hard to tell without photos. You are a good candidate if you have good quality donor hair, reasonable expectations, over 35, and are taking hair loss medications.

 

A lot of Drs do not require you to shave down. You would have to for FUE extraction, but even then it can be possible on smaller sessions to mask this area with longer hair.

 

Although you didn't get any regrowth with finasteride it is beneficial to keep using it to prevent further loss (It's generally better for maintaining hair rather than regrowing it).

 

If you did this I don't see why a dr wouldn't agree to adding some hairs to the crown. You should get it done conservatively so that if hairloss progresses you wont be left with a noticeable 'island' in the middle of your crown.

 

I've heard of platelet rich plasma (PRP) being injected into the scalp to induce hair regrowth. However, you have to come back a year later for another session. I can't vouch for how effective it is as I've never looked into it.

 

In order to hide your crown you may want to either 1)Grow your hair to cover it, 2)take time off work, or 3)Take time off work and use concealers to hide redness (subject to drs ok).

[Jotronic]

Agreed. I can appreciate you giving your details but more info is needed. Photos can help determine your type of hair as well as density and your actual pattern of loss.

[Shampoo]

The best option is to bite the bullet and "Just Do It". Forget about the post-op worries. The time passes quickly, it's well worth it. I am about your age and I too put off getting surgery for the exact same reasons. After surgery my post-op worries were completely unfounded. It really was not an issue. Almost everyone is supportive, some are curious about costs, pain, ect....But no one was mean-spirited. Ya gotta just get to the point where you dont care, know you are doing something to improve yourself and not allow others prevent you from improving yourself.

 

If I was in NY I would first go see Dr. Feller who is an amazing surgeon that routinely gets amazing results. I've heard Dr. Feller can be "cocky" but who cares if you end up with a great head of hair the rest of your life? Also my surgeon is Dr. Wong and I think he is the "king of crown", in fact that's one of the reasons I choose him, because after careful study I concluded Dr. Wong is one of the very best crown specialists. Watch video below.