Need advice on whether to proceed (pics)

[Snowed]

Hey everyone, I've skimmed these forums for a while, and I finally made an account as I'm trying to go through with a hair transplant. I'm 23 years old and decided I wanted to get a FUE transplant done. I emailed one of the advisors for a hair transplant surgeon (listed on this site, not sure if I'm supposed to just toss their name out there.) Anyways I mentioned I was only interested in a FUE, and I got a return email with a plan from the surgeon that is a FUT procedure. Also, it was recommended 3500 hair grafts for nearly @15,000 dollars total after tax. I was looking for some advice on whether this is way too many grafts for my hair being how it is. I got rated as a Norwood 3A. It also doesn't seem to make sense that he only wanted to work on the front and mid-scalp, when my hair is thinning on the crown and receding on the temples. In the pics, I combed up the hair where it's receded to kind of show it more. It seems like the mid-scalp is actually the best part right now. Any suggestions or thoughts would be appreciated.

[Blake Bloxham]

Snowed,

 

3,500 seems high, but not completely unreasonable. However, if you are only interested in FUE, perhaps the graft count and overall plan will be different in general? Maybe it would be helpful to search for physicians who perform a lot of FUE procedures or FUE exclusively and contact one of these physicians?

 

Also, a few things to keep in mind:

 

1. You are still a bit on the "young side" (by traditional hair transplant standards) for a hair transplant procedure. Because of this, I think it's important to thoroughly perform your research and make sure you aren't going to undergo a procedure at a young age that may not mature naturally as you get older.

 

2. Because of your age and current Norwood pattern, I'm wondering if you are utilizing prevent hair loss medications like Propecia (finasteride) and Rogaine (minoxidil)?

 

3. Remember that your hair restoration plan is a collaborative effort between you and the physician. The doctor is an expert and will make a recommendation based upon his/her years of experience, but you are allowed to ask for clarification and provide your own input as well. In the end, you need to be happy with the result, and if you are more interested in a conservative restoration with less grafts, then this is something to discuss during consultations.

 

Look forward to your reply!

[Snowed]

Well I might as well say who it is, I don't see why not. I was looking at doing a transplant with Dr. Rahal. I've seen his FUT and FUE and both of them looked incredible. It was mentioned by past patients that he goes pretty aggressive over being conservative. It seems that he's gotten a lot of praise here as well. I took Procerin and Provillus, neither really did much for my temples. Never used Rogaine because the crown covers pretty well with my hair above a #4. I probably should use it though. I know for certain I will never try Propecia, because I would never want to risk the sexual side effects, no matter how small the chances are. That pretty much leaves my only option for the front temples as a transplant. I'm aware that in the future, I may lose more hair, but looking at my dad and the rest of my family, it doesn't go much past the temples and maybe a little crown. I don't think anyone is full blown bald, or even close to it. I mean I'd still have more donor hair even after 3500 grafts, if I ever needed it in the future.

 

Not sure if anyone who has had a FUT would recommend a FUE instead, but looking at the scar and scalp tightness, it kind of horrifies me. I think it's a good idea to not take some chance of the back of my head becoming disfigured...I mean not all these can go perfect, right?

[chrisdav]

Snowed,

 

I am only be objective but I think you are potentially running a big risk.

 

You will lose more hair undoubtedly with the current hair loss pattern you have aged 23 years old. Without using Finasteride, that is an even bigger risk and lastly having just FUE on its own is going to limit the number of grafts in your donor supply to facilitate the demand.

 

Hair transplant can be life changing but they are not a 1 for 1 substitute for native hair.

[Mickey85]

I would take things slow. Post some close up photos of your donor, crown, mid-scalp and frontal third. Look at a variety of Doctors but do not make a decision to go through with a procedure because there are alot of factors that can come into play in your situation.

[Snowed]

I would take things slow. Post some close up photos of your donor, crown, mid-scalp and frontal third. Look at a variety of Doctors but do not make a decision to go through with a procedure because there are alot of factors that can come into play in your situation.

 

 

Here are some close ups, I hope they will suffice. Now that I have some photos taken overhead, especially in the light, it's kind of weird that I can see parts of my scalp on top...from the front, you can't even tell. Maybe it's just because the light from the flash is illuminating everything. Even with just a mirror it looks thicker.

 

 

 

Chrisdav,

 

Now as for my future hair loss potential. I was thinking that maybe Dr. Rahal predicted this, and that's why he didn't just recommend fixing my hairline. I mean if he did the front and mid portion of my head with grafts that were not susceptible to falling out later, but somehow the ones that are there now (especially mid scalp) all fell out, I would still have transplanted hair there. Lower density perhaps, but nonetheless not completely bald. Maybe I'm overlooking something, but that's why I'm here.

[Spanker]

The plan that he listed seemed very reasonable to me. With the exception that you didn't want FUT. You need to back up, do some more research, and really decide if it is for you.

[1978matt]

If I were to put money on it I'd say you would be a slick NW6 by the time you are 30. That's the way you need to think, i.e. what's the worst that can happen?

 

A good example of the way to go would be Nick153452's approach:

 

Hair Restoration Journal for Nick153452 - 2 week post op

[Blake Bloxham]

Snowed,

 

Altogether, it seems like the general consensus is that you may benefit from "pumping the brakes" a bit, weighing your options, and figuring out what type of hair restoration is right for your age and hair loss pattern. Frankly, Dr. Rahal is excellent and FUE is a great procedure for appropriate candidates, but undergoing surgery at an appropriate age with a reasonable plan and adherence to preventive measures is highly important.

 

I think this may be a good opportunity to really spend some time researching and figuring out what's best for you. We are all here to help, and I highly encourage you to ask as many questions as you need. Good luck!

[Mickey85]

Thanks for the close up pictures. Good news is your donor is at the very very least, average, and that is being very conservative in my estimate. Chances could be that you may have an above average donor density but I will play it safe for now. Unfortunately it seems your crown is thinning from the photo as well as the mid-scalp... The problem with fixing the temples now is that there might not be an optimal amount of grafts to use later for future loss. You need to tread very carefully as donor hair is finite and once it goes, it is gone unless you want to resort to beard or body hair.

 

To answer your question on FUE or strip. I personally had strip and it was the worst mistake I have made in my life. The clinic's brochures all showed a fine, pencil thin scar and no where(prior to signing the contract on the day of the surgery) does it state that a scar stretching is possible and upto patient physiology. My donor area still doesn't feel normal one and a half years later. That was my experience with strip.

[greatjob]

At 23 with your loss, I am pretty confident you are destine to progress to a high norwood level as it is evident you are thinning over the NW 5/6 pattern, and your unwillingness to get on finasteride long term, I would not advise you to have a procedure at this time.

 

I know you say your family doesn't have any high norwood levels, but that really doesn't mean much for your case. The only thing your family history can tell you with any certainty is whether or not you have the mpb gene, but it really can't predict to what degree you will suffer.

 

A transplant isn't going to prevent future loss and chances are if you plant a fairly aggressive hairline now at your age you will run out of grafts. Some people are lucky and have 4000-5000+ grafts available from fue, but most are not. Just as some people are lucky and have 7000-8000+ grafts from strip but most are not. My personal advice since you are unwilling to take meds is to wait until you are at least 30 until you have a better understanding of your future balding pattern.

[Calgacus]

My brother had a hair transplant at your age. He didnt go on finasteride. He ended up losing ALL his hair.

Even his transplanted hair.

Food for thought.

[Snowed]

Thanks for the close up pictures. Good news is your donor is at the very very least, average, and that is being very conservative in my estimate. Chances could be that you may have an above average donor density but I will play it safe for now. Unfortunately it seems your crown is thinning from the photo as well as the mid-scalp... The problem with fixing the temples now is that there might not be an optimal amount of grafts to use later for future loss. You need to tread very carefully as donor hair is finite and once it goes, it is gone unless you want to resort to beard or body hair.

 

To answer your question on FUE or strip. I personally had strip and it was the worst mistake I have made in my life. The clinic's brochures all showed a fine, pencil thin scar and no where(prior to signing the contract on the day of the surgery) does it state that a scar stretching is possible and upto patient physiology. My donor area still doesn't feel normal one and a half years later. That was my experience with strip.

 

If I might ask, who was your surgeon? And do you think that your scar is really only susceptible to stretching while it's healing, or when it's literally just a scar do you think it can get bigger? I was wondering if you could also post a picture of your scar/donor area. I'm really interested in seeing it.

 

A couple of more things that came to mind...I'm really, really leery of FUT anyways because of cases like that, but after looking at Dr. Rahal's track record for thin scars, I feel a *little* more comfortable letting him and only him MAYBE do a FUT. I mean I'd rather have a FUE done honestly, but like you said, donor hair is limited. Have you thought about filling in your scar with FUE? If I did go through with a FUT and then later on my hair (namely my crown, since front and mid scalp would have the donor hair implanted from a FUT) started thinning more, I could then go with a FUE...maybe for the crown and to fill in the scar at some point if it's an issue. I don't see myself having my hair so short on the back that the scar would be visible, unless the worst happened with it.

 

By the way, thanks for getting back to me on this, all of you. It feels good hearing personally from others who have been in my shoes before.

[Snowed]

At 23 with your loss, I am pretty confident you are destine to progress to a high norwood level as it is evident you are thinning over the NW 5/6 pattern, and your unwillingness to get on finasteride long term, I would not advise you to have a procedure at this time.

 

I know you say your family doesn't have any high norwood levels, but that really doesn't mean much for your case. The only thing your family history can tell you with any certainty is whether or not you have the mpb gene, but it really can't predict to what degree you will suffer.

 

A transplant isn't going to prevent future loss and chances are if you plant a fairly aggressive hairline now at your age you will run out of grafts. Some people are lucky and have 4000-5000+ grafts available from fue, but most are not. Just as some people are lucky and have 7000-8000+ grafts from strip but most are not. My personal advice since you are unwilling to take meds is to wait until you are at least 30 until you have a better understanding of your future balding pattern.

 

I see what you're saying. Yeah, I mean I'd rather have to BIC my head down the road than risk possible permanent ED and sexual problems. I just cannot bring myself to risk that for something like hair. Not my sex life lol.

 

It seems that by going with a FUT I'd have more donor availability, with the risk of the scar stretching that FUE doesn't have...but I carefully chose a doctor that I trust and that is really reputable. In your opinion, maybe if I didn't go with such an aggressive hairline and just got a conservative 3500 grafts placed evenly across the front and then the mid scalp area, that would leave me with enough coverage to not look like a stellar hairline in front and then bald on the crown and mid scalp later if it did progress to such a Norwood level? I feel I'd probably have enough grafts left over to hit up the mid scalp area/crown again and have a modest hairline as I'm older if I took this route.

 

 

My brother had a hair transplant at your age. He didnt go on finasteride. He ended up losing ALL his hair.

Even his transplanted hair.

Food for thought.

 

What level Norwood did he end up progressing to? That sucks that he lost it all...but I mean if he never got a HT in the first place, wouldn't it still have all fallen out? He's just out a lot of money then on top of his hair...which really is a shame.

[ali1991]

My brother had a hair transplant at your age. He didnt go on finasteride. He ended up losing ALL his hair.

Even his transplanted hair.

Food for thought.

 

Sorry to hear that if true, but sounds like it may be exaggerated a bit IMO.

[Calgacus]

Sorry to hear that if true, but sounds like it may be exaggerated a bit IMO.

 

What reason would I have to exaggerate? I am only divulging information about a case that I understand to be 100% true.

 

Take it or leave it, pal.

[ali1991]

I appreciate the advice, but I've read transplant hair never goes away, it is permanent, someone correct me if I'm wrong.

 

So how did "All" of your bro's transplanted hair go away?

 

Sorry If I'm missing something.

[Calgacus]

I appreciate the advice, but I've read transplant hair never goes away, it is permanent, someone correct me if I'm wrong.

 

So how did "All" of your bro's transplanted hair go away?

 

Sorry If I'm missing something.

 

Because his HT was done before his MPB stabilised, it turned out that the transplanted 'donor' hair was just as susceptible to dht as the already balding area. Essentially the 'donor' hair that was taken from the back was going to fall out in the long run, and, because of the shockloss, the whole balding process was sped up.

 

Now he is a cueball with a smiley face scar on the back of his loafer.

 

But hey, its your barnet, buddy. Do as you please. What do I know.

[Calgacus]

What level Norwood did he end up progressing to? That sucks that he lost it all...but I mean if he never got a HT in the first place, wouldn't it still have all fallen out? He's just out a lot of money then on top of his hair...which really is a shame.

 

He ended up NW7. Who knows how it would have gone had he tried out the medical route first before rushing (or being rushed) straight into surgery?!!