Transplant #3 -- Probably my last one- need advice

[fortune11]

Hi All

 

This forum has been of great help for my previous 2 transplants - 1) with shapiro in 04 and then 2) with zeiring in 11. each time i kept it to a basic level - 1500-2000 grafts each time targeted towards the front

 

this has helped me keep my frontal hair profile reasonable (the attached picture is taken under bright lights but other wise in regular sunlight the frontal part of the head looks much fuller)

 

however, the bald spot on the head has continued to grow bigger and also because each time a strip was taken the skin on the crown got stretched and possibly contributed to this expansion

 

i use rogaine occasionally and do not want to ever take propecia . i am in my early 40s.

 

My question for the vetererans and experts here is this -- if you were going for a last transplant , given my bald spot, 1) what style would you choose -- fut /fue? 2) what doctor would you choose for a mega session and for that area of the head and 3) what realistic expectations can i have given my limited donor area and the vast area of the crown that needs to be covered? in this context, any styling suggestions are also welcome.

 

thank you all

[Mickey85]

Hmmm hard to tell with these photos. Have any clearer ones?

[Jotronic]

Are you taking Propecia? How old are you?

[fortune11]

here are some additional photos - the front angle is after washing with a volumizing shampoo

 

i am in my early 40s

[fortune11]

also, i am not taking any propecia andy do not ever intend to (this is a hard constraint, and yes, i have heard all the great arguments about propecia and its minimal side effects from everyone, including ron shapiro and ziering).

[fortune11]

any response? feedback?

 

thx

[Eman]

Personally, if I had done strip in the past--I would do the same for the next HT. But that is if you do not mind the recovery time associated with strip.

 

From your pics, it's hard to tell what your hair truly looks like due to the low quality and the lighting. But if this were my last HT I would maximize the session and cover as much surface area as possible. Build up the hairline in the front third, add some to the middle third and try to get some coverage in the crown (the "black hole" of your head).

 

And when I say maximize, I mean getting as many grafts as possible safely from the donor using one of the top docs recommended here.

 

That is what I would do...

[Spanker]

really hard to say without knowing how many grafts you have left. Personally, if this were my last session, I would go as big as possible. With the right Characteristics, you could have 5000 grafts left. I would work back towards the crown and seen how far it will take you. You will likely not get great crown coverage, and may have to leave some of the area untouched, but with a nice megasession, would should have a good chance of being finished up.

 

I would look at H and W.

[Mountinvan]

Spanker--looks like you had a very nice result with Konior. I am wondering why you are not recommending him? Also how did you come up with 5,000 grafts left (possibly)--was it from his pics?:confused:

[JohnnyDrama]

Spanker--looks like you had a very nice result with Konior. I am wondering why you are not recommending him? Also how did you come up with 5,000 grafts left (possibly)--was it from his pics?:confused:

 

I think where Spanker is coming from is purely from a session size point of view. He mentions around 5,000 grafts or thereabouts. H&W, at a guess, have probably done more 5k plus cases than any other clinic (at least they have published more anyway).

[Levrais]

As others as said, its hard to know how much donor you have available. However, if you don't have enough scalp donor to get good coverage, you could consider clinics that also use beard and body hair.

[fortune11]

thanks all.

 

i am strongly considering H&W for their "mega" reputation, although as spanker points out crown is tough to cover completely.

 

my previous HT was w zeiring who claims to have a specialized "zeiring whorl" technique to make the crown placement natural. while i am happy with how he handled my FUT (all the hair you see in the front / hairline is thanks to zeiring + shapiro transplants totaling ~3800-4000 grafts, i am an eventual norwood 5+ or even a 6), i am also thinking other good HT doctors have their own similar ways to make the crown look natural, perhaps it is just that they don't actively market the name per se.

 

one concern i have w FUT is the scar for this "mega" crown work will have to be long and how will it stretch . although seeing SMP results (micro pigmentation) i am beginning to think scars are fixable down the road with that, whatever the scar result.

 

given my age (40s), i think leaving a bit of crown uncovered will not hurt from a looking-close-to-your-age-but-with-hair perspective if you can call it that.

 

what doctors would the group recommend that are truly "crown specialists"? or maybe i am wrong to use such a term since a good HT doctor would be good on the crown regardless?

[fortune11]

so i met with one of the reputed surgeons in SoCal recently who told me that he could 1500 - maybe 2000 at best for the crown given my donor supply.

 

if this is the best that is possible, this means i am well below average donor supply since my previous 2 HTs were a total of 3800 FUT in aggregate.

 

he mentioned the issue was scalp laxity in my case.

 

have people noticed scalp laxity to be such a big issue that it limits donor supply to that well below average (reading these posts i gather average lifetime supply is 7000-9000 follicles)

 

any feedback appreciated , thanks

[StaggerLee123]

It would take a massive amount of grafts to make a difference in your crown. Dr Wong is the man to see for crown work and I would consult with him and Joe Tillman for some realistic advice. Depending on the amount of grafts you have left I suspect the best that could be hoped for is to reduce the balding area in your crown. Scalp laxity exercises can improve strip harvesting.

 

Your pics aren't very good but you have your hair combed forward in a Cesar style which gives the crown the least flattering appearance. Have you ever tried growing your hair out a little and combing it back over your crown? That might make what you have go a little farther.

[fortune11]

Reviving this old thread here as I ultimately ended up having my third HT --- went back to Dr Ron Shapiro for ~1930 FUT session. The big constraint in my case was donor supply and (lack of) scalp laxity, as other doctors had also pointed out before. Focused on the mid scalp area and left the crown alone for the most part . Also some touch up hairline work.

 

I will post the details in a separate thread (to come soon) .

 

Thanks for all the suggestions guys.