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Big HT Decision: Need Some Sound Advice


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  • Regular Member

Recently, I had a consult with Dr Rahal. I wanted to get coverage on front/mid and crown. I'm between a NW4 and 5. He said my hair was somewhat thin (which was a little surprising) and my scalp lax was a little tight, as a result I could probably only get 3600 G. And if I was lucky maybe 1200 FUE at a later date but I'd never get enough to cover the entire head. I appreciated his honesty and setting my expectations.

 

Another reputable clinic suggested I could get a session with FUT AND FUE in one session to get a little more coverage and save a little more money.

 

So I have to decide do I go with Rahal and just get front/md done? Leaving crown open and

making it less likely I'll ever have enough to ever get it covered??

 

Or

 

Do I chance a more aggressive session and try and get as much coverage in shot with a FUT and FUE session..??

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  • Senior Member

Thanks for sharing your story. Let me start of by saying you picked a great surgeon to do your transplant. What I think is most important if you are on an meds. If you are able to maintain you hair as it is right now with Proscar it will help a lot. Without meds chances are you will lose a lot of hair in the front as well as your crown getting bigger.

Looking at your pictures your front does appear that bad especially when combed forward and dry. I don't know how many grafts you would needs to be satisfied in the back since it is a bigger area. Since you have been told that you are quite tight why not do a lot of scalp exercises until you have a lot more flexibility. Perhaps then he may be able to get 5000 grafts (of course I am not a doctor but since he said 3600 is possible with a tight scalp 5000 is not unrealistic) with one session and maybe another1000- 1500 grafts fue in the future. That way I would get around 3000 grafts in the front and 3000 grafts in the back. I would keep the hairline roughly the same so you can have more grafts for density in the front and more left over for the back. It all depends on what bothers you the most. I personally wouldnt be satisfied with a big whole in the back with a good hairline. That is my opinion.

Good luck!

Representative for Hasson & Wong.

 

Dr. Victor Hasson and Dr. Jerry Wong are esteemed members of the Coalition of Independent Hair Restoration Physicians.

 

My opinions are my own and do not necessarily reflect the opinions of Hasson & Wong.

 

My Hair Loss Website - Hair Transplant with Dr. Hasson

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  • Senior Member

Perhaps you could ask and see if Dr Rahal would be willing to do the FUT and FUE in one session himself, as this can be possible. However, if he says no then it would be best to accept that advice.

 

I don't see how doing both in one session would increase the coverage though. It would be more convenient that way, sure, but the combined graft total would be the same if you chose to have the FUE procedure later, and in each case Dr Rahal could aim to get as many grafts as your donor can supply.

I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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  • Regular Member

Thanks for your replies Lorenzo, MattJ.

 

Yes, no doubt Rahal is great.

And yes, Lorenzo I agree i hate having a big bald spot on my head....I would much rather concentrate on that, keep using rogaine and fin to maintain front and later use what's left to

fill to add to the front. Man, these decisions are really tough....

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  • Regular Member

IMHO, I would get the hairline to be the same, with a good density in the front and getting lower and lower density's towards the crown. but I would not leave the crown completely empty. And depending on how it looks I might end up using Dermmatch to make up for the low density of the crown.

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  • Senior Member

Hi Wolfsatplay-

 

I agree with Lorenzo and Matt's advice, and understand you have a tough decision ahead of you in terms of graft placement! The great news is, you don't have to bare the decision alone, as Dr. Rahal is phenomenal at designing a hair "map" that looks totally natural and appropriate for the specific patient.

If it were me personally, I'd want to go with more hair to restore my hairline and mid scalp, and anything left after decent coverage in those areas would go into my crown!!! As Lorenzo said, you might be a candidate for more grafts if you are diligent with your scalp laxity exercises between now and your procedure. Likewise, Rogaine Foam personally worked wonders on my crown, so I think (if you're anything like me), you could get even more natural growth back in your crown from Fin/Rogaine. Personally, my reasoning for doing this hair design (again if it were me) is that the hairline and the mid-scalp are the areas that people see when they are looking at you.......not the crown. Furthermore, I think concealers are much easier to use in the crown than they are in the hairline. This would at least be an option for you until there are other hair loss options in the future (come on already hair cloning) to finish up your crown. But again, this is a decision you and Dr. Rahal will figure out together. In the meantime, Lorenzo provides excellent advice with the medication and the scalp laxity exercises.

 

Best of luck to you Wolfs, and keep us posted on what you choose to do!

 

Best,

 

Mike

4737 FUT with Dr. Rahal on 11/16/2012

 

Daily regimen: 1/4 Proscar (1.25 mg Finasteride), Rogaine Foam (twice daily), 1000 mcg Biotin, 1 combo Vitamin D/Calcium/Magnesium, 1500 mg Glocosamine, 750 mg MSM, 1200 mg Fish Oil, 2000 mg Vitamin C, Super B-Complex, 400 I.U Vitamin E.

 

I am not a medical professional. All views and opinions expressed in this forum are of my own.

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  • Senior Member
I would not lower my hairline down, i would keep it atbthe same level to save the grafts for better density

 

I definitely wouldn't lower the hairline either. I would use the grafts only for density into the current/existing hairline and back. Any reputable surgeon who saw a limited donor in the patient, wouldn't allow the patient to lower the hairline......or at least wouldn't if they didn't want to smear his/her good name!!!

4737 FUT with Dr. Rahal on 11/16/2012

 

Daily regimen: 1/4 Proscar (1.25 mg Finasteride), Rogaine Foam (twice daily), 1000 mcg Biotin, 1 combo Vitamin D/Calcium/Magnesium, 1500 mg Glocosamine, 750 mg MSM, 1200 mg Fish Oil, 2000 mg Vitamin C, Super B-Complex, 400 I.U Vitamin E.

 

I am not a medical professional. All views and opinions expressed in this forum are of my own.

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Glad to help, Wolfs! Keep us posted on what you and Dr. Rahal decide, will ya?? I'm excited for you buddy!!

4737 FUT with Dr. Rahal on 11/16/2012

 

Daily regimen: 1/4 Proscar (1.25 mg Finasteride), Rogaine Foam (twice daily), 1000 mcg Biotin, 1 combo Vitamin D/Calcium/Magnesium, 1500 mg Glocosamine, 750 mg MSM, 1200 mg Fish Oil, 2000 mg Vitamin C, Super B-Complex, 400 I.U Vitamin E.

 

I am not a medical professional. All views and opinions expressed in this forum are of my own.

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  • Senior Member

The photo angles aren't ideal for judging the size of the area of crown loss, but it looks like there's definitely a very big space there and you would use up a very large proportion of your donor supply to restore that area fully.

 

Do you want a full crown with basically nothing (or sparse coverage at best) from the midscalp to hairline? Based on my (admitedly limited) perspective of your hair loss and donor availability, I think that's the scenario you'd be looking at if you insisted on restoring the crown.

 

It is my observation that crown loss appears lessened if the areas in front of it are treated. You're left with a smaller expanse of visible scalp at the crown and the benefit of fullness at the top and front. In an ideal world every bald man, no matter how severe his hair loss, would have enough donor to restore the whole lot to extremely high density, but in reality a strategic approach is necessary.

 

Ultimately you know what your goals are, so consider this food for thought to help with your expectations.

I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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  • Regular Member

Thanks MattJ.

 

I'll have to make a call either way. Ultimately, the only other option for me is to use Body/facial hair to help compensate the hair grafts. That way, I could get extra hair on my head. That would mean looking at Dr. De Reyes, Dr Villnow, Dr ******, Dr Umar....But, I'm just not a hairy dude, lots to think about.....

 

wolfsatplay

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  • Senior Member

I think some people are confusing yoru second pic for a top down... I thought it was at first as well however it looks like it's a rotated picture of your donor. It looks thick to me. Personally I would would go for overall coverage and keep the hair short. I also wouldn't push it an combine a FUT with FUE although I know waiting sux it may be a safer approach.

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  • Regular Member

Even though I just want to get this over with in one shot, perhaps getting a FUE and FUT in one session is playing with fire. I don't know. You're absolutely right thought, waiting a year later for another session would suck. But, all worth it in the end...

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Plus, putting that many grafts in at once may yield other complications and may potentially affect yield, I know I know so much to think about lol... my head felt like it was going to explode from weighing all the options

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Yeah, I hear ya.

A good in Europe suggested I do a FUT session on day 1: 3800 and a FUE session day 2: 1200

But they're prepared to offer me a very good price If i agree to let them document it, so that's where

the dilemma is for me...(price vs higher risk) but i don't even know if it's higher risk because now days, it is quite common....too much to think about. I need a beer!!!!

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