Defining Realistic Expectations

[delancey]

Hi everybody!

 

I would like to hear a definition of what having realistic expectations means to you. I'm a Norwood 5 going on 6 with approximately 8-9,000 grafts available via FUT and FUE. I am almost 29 years old and have lost a considerable amount of hair in the last two years. My donor laxity is 1.6, and I have medium-fine blonde hair. Average donor: 70/90/70.

 

One thing that wasn't obvious to me at the beginning is how important one's hair characteristics are. For example, a person with coarse and curly hair will have a much better result than someone with fine, straight dark hair, where there is a high color contrast. In all honesty, the best results that I see have been of guys with just these positive characteristics.

 

However, there are also exceptions. For instance, Jotronic appears to have rather fine, straight hair with a strong color contrast. And yet, his result is one of the better ones out there.

 

My expectations:

 

Full coverage (including the crown)

Conservative hair line (Norwood 2.5)

I expect to be able to wear my hair relatively short (1 cm on the sides, 3 cm on top).

It is important that the crown be given an illusion of coverage (if there is such a thing). I don't want to look bald in the crown (thinning is fine).

I'm not expecting a huge mop of hair but I still want a nice age appropriate appearance.

 

What should I expect as far as my crown is concerned? Are my expectations in check?

 

My hair characteristics:

Density: 70/90/70

Donor availability: 8000-9000 grafts FUT and FUE

Medium-fine hair

Blonde

Straight

Norwood 5 going on 6

Crown will dip in a few years; it's just a matter of time.

 

 

Thanks for your input guys.

 

Cheers!

Edited April 5, 2014 by delancey

[Shacked]

First things first, get on finasteride and minoxodil 5% for at least 6 months prior to any HT.

Meds in combo can have regrowth as well as slow hair loss.

 

Propecia Rogaine Finasteride Results Before and After Photos | Bernstein Medical

 

Listening to the few negative voices on the www regarding finasteride put me off for a year. I wish I didn't listen. Hairs have stopped falling when I comb my hair in less than 3 months on the medication. I have had zero side effects, and from what I gather most people on here have no issues.

[delancey]

Hi Shacked,

 

Thanks for your reply. I am currently taking Propecia but I am experiencing side effects, so I only take 1 mg 1-2 times per week.

[Shacked]

I can't comment with any authority on side effects, but it seems that some people ride out minor side effects and they dissipate after a while. Also, I greatly believe in the power of the mind, and your perception can become biased once you start taking something from which you are expecting side effects.

 

e.g. people say they get some pain in the testicles and they get freaked out. People get this randomly throughout their lives anyway and think nothing of it.

 

People say that their ejactulates become less and watery. Both of these factors are massively variable before finasteride even gets involved.

 

I am not trying to trivialize your side effects. But I think taking it everyday if you eventually can will help a lot. Maybe 0.5mg everyday? Also, get on minoxidil.

[delancey]

Yes, I'll definitely get on Minox. I did experience the minor side effects that you mentioned, including chest pain and testicular pain; however, this disappeared after a while. Unfortunately, the main side effect was not in my head, as I was not experiencing morning erections anymore. I'm planning on getting a prescription for .5 mg daily. Or .25 mg daily. What do you think?

[Shacked]

You shouldn't listen to my opinion on dosage. You should ask a dermatologist or doctor who has experience in prescribing fin. If the only side effect was lack of morning boner, get a girlfriend and wake up next to her each morning. Problem solved!

If everything else worked fine after "morning boner" I'd still take it. But I know my body pretty well and have a huge sex drive, so have noticed little negative effects.

[delancey]

Cheers! Thanks for the input.

[Jotronic]

However, there are also exceptions. For instance, Jotronic appears to have rather fine, straight hair with a strong color contrast. And yet, his result is one of the better ones out there.

 

Thank you for your comment. Part of the reason for my result is because I don't try hair styles that are meant for those with more hair than I have. I can pull off many hair styles, certainly more now than when I was 25, but I stay within the boundaries set by my situation. Another reason is because of not only the sheer numbers of grafts that were placed but also how the grafts were placed. There was a strategy with each session and for that, Dr. Wong is a genius. These factors help to overcome the natural limitations of contrast between hair and scalp color and the fine nature of my hair. I must admit that the old work that was performed before Dr. Wong helps with the appearance of volume behind my hairline as it aids in "propping up" the newer work.

 

My donor laxity is 1.6, and I have medium-fine blonde hair. Average donor: 70/90/70.

 

Where did you get a measurement for scalp laxity?

 

I think your expectations are realistic if only your hair loss is stabilized. If you are a NW5 now at 28 then there is a strong chance you'll hit a NW6 or worse in the future and that is where the danger lies.

 

How long have you been on the reduced intake frequency? I would recommend against getting a prescription for .25mg or .5mg and I don't think you can get such dosages to begin with. A pill cutter, as far as I know, is the only way to get such low dosages but if you have not been taking the medication at your current intake frequency for long I'd say give it more time. This is how we recommend patient take finasteride if they have had the side effects and they have not dissipated with daily intake. If your current strategy does not work out for you after about two months then you may want to consider finding a source for topical finasteride. It is rare but you may find it somewhere. We have it compounded by a local pharmacy and it seems to be working well (as well as oral fin) with no side effects to date but you will have to have a prescription from us and that can only happen if you step foot in our office. Hopefully there are others out there that have a source that is easier to get.

 

Again, your surgical expectations seem reasonable and attainable. Just do what you can to arrest your loss first else you risk regretting every having surgery to begin with.

[lucldh]

If your current strategy does not work out for you after about two months then you may want to consider finding a source for topical finasteride. It is rare but you may find it somewhere. We have it compounded by a local pharmacy and it seems to be working well (as well as oral fin) with no side effects to date but you will have to have a prescription from us and that can only happen if you step foot in our office. Hopefully there are others out there that have a source that is easier to get.

 

hey I am from India and I have contacted you some time ago. I was quite impressed by your honest answers and showing me the right way. I am a diffused thinner. Is topical version of Finasteride available and does it work as good as oral one? If yes, is there a way, I can have it shipped in India?

[JimmyNeutron]

Realistic expectations for a NW 5-7 means that you are willing to still appear as if you are balding, but you're not exactly bald yet. So after your HT, you'll get the reaction from people "You're balding" Instead of "Damn man, you're bald as hell!"

 

Now if you are a NW2-3, things are different, with a couple of HT's, you could be at a solid NW1 or a thin NW1, still great IMO.

 

For NW4's, like myself, we're in the middle. We need a couple of HT's to get to a solid NW2/2.5.

 

This post is half jest half serious by the way.

[Since21]

I expect to be able to wear my hair relatively short (1 cm on the sides, 3 cm on top).

 

Here is what one surgeon said about styling to help with the illusion of density:

 

Hair is deliberately transplanted at lower than naturally-occurring densities and so we depend on some illusion to make it look fuller than it actually is. Transplanted hair will always look fuller when 2-3 inches long, dry, separated, and styled to layer like shingles on a roof. It will always look thinner when cut short, spiked up, parted through, wet or clumped with product.

 

So your expectations might be a little unrealistic in terms of how you envision styling it. Hell, I'm almost 5 months from my first HT out and I have Ryan Gosling's hairstyle in mind, so we all do it. As Joe said, he doesn't try hair styles that are meant for those with more hair than he has and stays within the boundaries of his situation.

 

Here's a case with similar hair characteristic as yours with 4,278 grafts:

 

http://www.hairrestorationnetwork.com/eve/174636-eman%92s-hair-transplant-journey-5-5-years-after-hair-transplant-dr-rahal.html

[Baldietwo]

Hi Delancey,

 

Set your expectations very low and then be amazed when you see the result. That's the best way to go. Having too high expectations is just going to end in dissapointment.

 

 

• You will never get back the lush thick hair you had when you were young. It will be see-through in strong light
  
• You will not have a low hairline. It's likely to be high to very high, but it's more than enough to give you a decently framed face (which is what you should be aiming for)
  
• You may not have enough donor to do anything about the crown. If you do have enough it is likely to be very scarse.
  

 

 

I am (or rather was) myself a N5 heading towards a NW6. My hairloss pattern was pretty much identical to what you have.

 

I'm 8 months our from my 1st HT now and I have another one scheduled for the rest of this year to cover the crown. I'll have pretty much exhausted my donor hair for this 2nd procedure and the crown coverage is going to be quite sparse. Howver, it will mean I won't have a shiny bald scalp which is my goal.

 

Have a look at my blog and posts for pictures (links in my signature). I've been quite lazy with updating the blog with new pictures...will do soon! The most recent ones you'll find in the journey post.

[Since21]

You will not have a low hairline. It's likely to be high to very high, but it's more than enough to give you a decently framed face (which is what you should be aiming for)

 

 

What was your hairline height set at, Baldietwo?

[Baldietwo]

What was your hairline height set at, Baldietwo?

 

It's set at about 8cm. Which is 1/3 of the length of my face (hairline to chin).

 

I have a relatively long and thin face and that counts in my favour. Thinner face means less grafts needed.

 

My hairline is high but my goal is complete coverage so something had to give. I've got some length on it now so it looks lower.

[delancey]

Thank you for your comment. Part of the reason for my result is because I don't try hair styles that are meant for those with more hair than I have. I can pull off many hair styles, certainly more now than when I was 25, but I stay within the boundaries set by my situation. Another reason is because of not only the sheer numbers of grafts that were placed but also how the grafts were placed. There was a strategy with each session and for that, Dr. Wong is a genius. These factors help to overcome the natural limitations of contrast between hair and scalp color and the fine nature of my hair. I must admit that the old work that was performed before Dr. Wong helps with the appearance of volume behind my hairline as it aids in "propping up" the newer work.

 

 

 

Where did you get a measurement for scalp laxity?

 

I think your expectations are realistic if only your hair loss is stabilized. If you are a NW5 now at 28 then there is a strong chance you'll hit a NW6 or worse in the future and that is where the danger lies.

 

How long have you been on the reduced intake frequency? I would recommend against getting a prescription for .25mg or .5mg and I don't think you can get such dosages to begin with. A pill cutter, as far as I know, is the only way to get such low dosages but if you have not been taking the medication at your current intake frequency for long I'd say give it more time. This is how we recommend patient take finasteride if they have had the side effects and they have not dissipated with daily intake. If your current strategy does not work out for you after about two months then you may want to consider finding a source for topical finasteride. It is rare but you may find it somewhere. We have it compounded by a local pharmacy and it seems to be working well (as well as oral fin) with no side effects to date but you will have to have a prescription from us and that can only happen if you step foot in our office. Hopefully there are others out there that have a source that is easier to get.

 

Again, your surgical expectations seem reasonable and attainable. Just do what you can to arrest your loss first else you risk regretting every having surgery to begin with.

 

Hi Joe,

 

Thank you for your response; I really appreciate it. I visited Dr Bisanga, and he told me that I have a laxity of 1.5-1.6. Is this good?

 

He drew a very conservative hairline (NW3) and I am fine with that. But like you said, I am already a NW5 (going on 6). I asked if I should wait with having grafts placed in the crown and he told me that I don't have to wait. Is this because my crown loss is already quite defined?

Also, do you think I can get a good result with around 8,000 grafts ?

 

 

Thanks again! I really appreciate it!

[delancey]

It's set at about 8cm. Which is 1/3 of the length of my face (hairline to chin).

 

I have a relatively long and thin face and that counts in my favour. Thinner face means less grafts needed.

 

My hairline is high but my goal is complete coverage so something had to give. I've got some length on it now so it looks lower.

 

Hey Baldietwo,

 

How is your HT coming along?