5000 grafts for future Norwood 6?

[neohead]

Hi!

 

First off, let me thank the people here. This community is a great resource. I feel much more empowered to make such a tough decision with all the aggregated information and help here.

 

I have had a consultation with a reputed coalition surgeon in the US but I wanted to post here just to check if someone would have a different useful opinion before I make a decision.

 

I am a 27 year old South Asian. I started balding slowly about 4 years ago at the crown and a receding hairline on the sides. I used to have a decently thick head of hair so was not very noticeable in the beginning. But I moved to the US a year ago and the balding progressed faster after that. My current pictures are attached.

 

Almost every male member on my father's side of the family has eventually progressed to a Norwood Class 6 or sometime 7, some sooner, some later. And I am willing to believe I will be a Norwood Class 6 someday, if not 7 (this is my own assessment after the consult with the surgeon). I am currently thinning in a Norwood 5 pattern. I have not taken any medication, and am not inclined to try medication as I believe they will have limited effect.

 

The surgeon I consulted has recommended 5000 grafts FUT for now, with the _possibility_ of another surgery later. He said that the pattern is very apparent at this stage and we don't need to wait.

 

I wanted to check with people here on what they think about going with the surgery now with 5000 grafts with focus on the Norwood 5 pattern, and doing a corrective surgery later in life for the Norwood 6/7 if my hair loss indeed progresses to that stage?

 

One reason I am more concerned about this is because the FUT will take away the option of shaving my head, and future hair loss (Norwood 6/7 minus Norwood 5) could look ugly making another surgery necessary. I don't think FUE as the first surgery is a viable option for my level of hair loss.

 

Specifically, I have these questions I will clear with the surgeon next but any help with these would be greatly appreciated too:

 

Q1: Are FUT strips wider if the number of grafts is more? Does it affect healing time? I understand the answer depends on my donor hair density and it is difficult to assess that from the pictures, but I am just looking for a general answer.

 

Q2: For the second surgery, will it be FUE or another FUT. What are the complications? What if there are not enough donor hair at the back of my head? I do have closely matching body hair.

 

Q3: If I do have to shave my head later in life, what options are available to hide/pigment the scar. Please note I have brown skin.

 

Thank you very much.

[scar5]

 

a) I have had a consultation with a reputed coalition surgeon in the US ..

 

b) Almost every male member on my father's side.. a Norwood Class 6..

 

c) I have not taken any medication, and am not inclined to..

 

d) The surgeon I consulted has recommended 5000 grafts FUT for now..

 

e) FUT will take away the option of shaving my head,..

 

 

 

Q1: Are FUT strips wider if the number of grafts is more?

 

Q2: For the second surgery, will it be FUE or another FUT.

 

Q3: If I do have to shave my head later in life, what options are available to hide/pigment the scar.

 

.

 

STOP IMMEDIATELY!! DO NOT PASS GO!!

 

You have eloquently paraphrased the expression, "Recipe for Disaster"

 

You have lost a huge amount of hair.

You are losing more.

You are not on meds.

You are worried about not being able to shave later in your life

you are asking about options to hide the scar later AND

A lovely 'Well-Respected' US based surgeon has suggested a big strip (FUT) for you on the basis that 'We know you are going bald"

 

This is a devastatingly shocking and should be a powerful reminder to all considering HT surgery in the US and Canada at this time.

 

This is how desperate these US docs are now getting.

They are willing to give this guy a strip scar - with all that he said.

Unbelievable. They are really stooping low now.

 

First) Medications, rather medication. Fin or Propecia (same thing). You can buy in generically online very cheaply. If you don't like its effects you can quit. Minixidil may help with your crown a little - it may also give you a bit of a bloated and wrinkly face, but I think guys confuse aging with minox too. But definitely fin. Try fincar and chop it into quarters, take one quarter a day.

 

Second) I suggest you get to a place where technicians can perform FUE extractions like India or Turkey and be very diligent in your research. They can exploit your fear of a strip scar! On teh other hand, they can help you in ways you will not regret later.

 

Third) If you insist on not taking meds or have an adverse reaction to them, I would consider resigning yourself to being bald - perhaps shaving, (have your tried) or a low density FUE plus a bit of SMP. YOUr darker skin might help but they are pirates so beware!

 

Key Fact

Unfortunately, technicians cannot extract FUE grafts in the US making FUE unprofitable and unsustainable for most surgeons there. Hence- strip survives, but I have no words for this doctor who wants to slice your head open.

Edited January 19, 2015 by scar5
You have lost a huge amount of (omit:losing) hair.

[farmcat]

I am no expert, I have had strip surgery (in the 1990's), never had FUE.

 

I am not sure why you believe that FUE isn't a viable option from the start. I have read some of the "debates", but have seen quite a few before/afters of advanced norwoods who only had FUE and they had great results.

 

1). Im not sure I am understanding your question, but I think the scalp laxity is what really makes a difference on how the scar heals. If your scalp is very tight I think your scar could stretch and give you a wider scar (not certain on this?)

 

2). You can have more than one strip surgery (I did), again, probably depends on scalp laxity.....but I feel FUE allows you to take from the sides of your head as well, strip really doesn't.

 

3). I have seen SMP into scars that looked pretty good (in pictures) but realistically, that scar is from ear to ear in a semi circle shape, I bet once you have it (like me) shaving your head isn't really an option

 

I will say I had my strip a long time ago, I would bet technology is much better. I will also say that I think strip is much more traumatic to the scalp and can cause numbness that lasts quite a while and my hair below my strip scar is much thinner than above, and I do believe that the surgery is what caused that. I don't know if the surgery affected the blood supply in that area or what, but it is definitely thinner. I have never had FUE so I can't really say much first hand about that, but if/when I do anything in the future, FUE is the only way I will go.

 

Like I said, other members seem very knowledgable on here, I would take their word over mine, just make sure you are not taking advice from someone who is pushing any particular doctors as they will obviously be biased.

[KO]

I second what Scar5 said. The first thing you should do is to take medications like finasteride or dutasteride. You might think you're bald now, but you'll get even balder, and NW7 and beyond is quite possible.

 

I have no opinion on FUT vs FUE, but if you want the option of shaving your head, that usually rules out FUT. However FUT will give you great hair, especially as you seem to have thick, glossy hair, which is good. FUE may also solve your problem, but there are a more limited number of surgeons doing great FUE on higher norwoods.

 

I'm interested to learn what you end up doing as I have similar situation and characteristics as yours.

 

Also, remember to not use flash when taking photos.

[Sean]

Neohead, what you described, just take it easy and avoid FUT.

 

Do FUE if anything in a smart strategic way. Have you contacted Dr. Umar in california for an online consult? He does cases of a larger magnitude via FUE. There are surgeons in Turkey and Europe that may assist your needs in an affordable way. Dr. DeReys and other surgeons ising manual extractions may maximise your graft yield allowing you to utilize grafts effectively. I would avoid FUT if you have even the slightest concern of strip scarring. Good luck!

[ontop]

My advise would get on Meds for a few yrs such as Min / Fin & see where your at then.

 

Remember its best to hold on what you have left now via Meds as HT will always be a option in the future as its not going away anytime soon.

 

Good luck.

[ontop]

My advise would get on Meds for a few yrs such as Min / Fin & see where your at then.

 

Remember its best to hold on what you have left now via Meds as HT will always be a option in the future as its not going away anytime soon.

 

Good luck.

[neohead]

Thank you everyone for your much helpful guidance and advice. I realize I was indeed stressed about the scar and a little about the length of the healing process. But now that I am not considering FUT so seriously, after the advice above, I am more relaxed. This was super helpful to me. You guys are my rockstars!!

 

I did not discuss these concerns with the doctor in too much detail because I just wanted to get an assessment of how many grafts he would recommend first and then think over its implications. My main concern with the scar is that looking at the levels of hair loss in my family, I do not think that hair transplant will be able to cover me for life. And eventually, shaving my head will be better. To be honest, I do not want a shaved head look right now; my body frame and face will not be able to pull it off as good looking. But maybe in 10-12 years time, and at my hair loss level at that time, it might look better to shave everything.

 

I think I do want something done to the front to make it look better for the rest of my 20s and maybe early 30s. I am thinking FUE with around 3000 grafts for the front will be a good idea for later this year. My parents live in India, so getting this done in India will be easy. I just have to think more about the cost advantage of getting this done in India vs the slight advantage of more artistic results of the surgeons I see in the US. If in India, I am considering Dr. Tejinder Bhatti.

 

I will definitely post here on what I decide. For now, I have definitely turned off the option for FUT.

 

Thank you again so much.

[neohead]

Oh and yes, I am starting medication too. Trying to find the best way to get Finasteride. Fincar seems cheap enough and I can bring it with me from my visits to India. Already ordered Kirkland Minox.

[KO]

Most people on this site, and myself, will urge you to focus on a surgeon whose work you respect rather than going by location or cost. People fly halfway across the world and can pay $10-25k to get these done. So if you like Dr. Bhatti's work, then it could be a good option, but I would not pick a doctor just because you are of Indian origin and can get it done there cheaper.

 

I think 3000 grafts over the frontal area will be quite good for the first session.

[Spanker]

You've received good advice. Fue is your best bet if your donor has enough to offer.

[neohead]

Acknowledged. Thank you. I only brought up the India aspect because India and Turkey were suggested in earlier replies as doing large FUE sessions.

 

I am still considering the price and the aesthetics trade-off. FUE in the US is costing me 7 USD per graft whereas it is 2 USD in India, and the results, while still better in the US, look almost comparable. I am tempted to get the frontal work done in the US and then later sessions (crown, and later follow ups) in India.

[KO]

Check out the European doctors: Feriduni, Bisanga, Lorenzo, and Mwamba (among others) or the ones in Turkey: Erdogan, and Demirsoy (among others). They will all be cheaper than US.

[wazaam]

KO is Lorenzo's FUE prices cheaper than US docs? I was always under the impression that he was the most expensive?

[KO]

Cheaper for sure, 6EU for 1st 1K, 4EU for next 1k, 2.5EU thereafter. Bisang and Feridunis have comparable rates as well.