41yo embarking on 1st HT

[Ernie]

[ATTACH][/ATTACH]I'm in process of getting consults with the best docs- thank you all for this great forum. I've let my hair grow out from a 0 buzzcut. I'd like to know if you guys think I can be aggressive with my first HT? Front 1/3rd. Would be great to get a 60-70grafts/cm2 hairline.

 

Is this just wishful thinking? FYI I'll be 41yo in two weeks. Pics attached. Small scars in back of head from car accident, so I'll be going the FUT route.

 

Been on prophecies since I was 23 (1mg daily)

[Ernie]

more pics, sorry...

 

all pics taken in harsh bathroom light. how many grafts do you think i'll need for dense, aggressive frontal 1/3rd?

[Ernie]

My hair before shaving it a month and a half ago is attached here, if it helps you with your advice...

[Dutchie]

I think you're an excellent candidate. You're the right age, looks like you have tons of donor hair at the back. You probably have good density too, plus what looks like a permanent forelock.

 

I would go with 1,000 grafts to fill the front scalp and leave it at that for now

[Dutchie]

But remember I'm not an expert, so that advice could be completely wrong.

 

There's a lot more knowledgable guys than me on this forum

[Ernie]

I was thinking closer to 3000 grafts. Anybody's thoughts on this?

[Janna]

[ATTACH][/ATTACH]I'm in process of getting consults with the best docs- thank you all for this great forum. I've let my hair grow out from a 0 buzzcut. I'd like to know if you guys think I can be aggressive with my first HT? Front 1/3rd. Would be great to get a 60-70grafts/cm2 hairline.

 

Is this just wishful thinking? FYI I'll be 41yo in two weeks. Pics attached. Small scars in back of head from car accident, so I'll be going the FUT route.

 

Been on prophecies since I was 23 (1mg daily)

 

I'd advise against going for such an agressive density of 60/70 per cm2.

I believe there aren't too many top physicians who would consent to that.

You have native hairs in the frontal core,1500-2000 grafts in the thinning area should give you a good transformation, imo. Let us know what comes of your consultations.

[chrisdav]

I would advise against it too and agree with Janna.

[Ernie]

Hmm.. This is a bit unexpected. Was hearing 2500-3000 a week ago on this forum.

[Dutchie]

3,000 grafts in frontal 3rd sounds WAY too much, sorry.

I would go with 1,500 as absolute max

[Pete-from-Farjo]

I would suggest a max of 2000 grafts would be sufficient. That should blend nicely with your native frontal hair. You're at a good age for your first transplant and your donor appears good. Best of luck with it.

[Indi9]

1500...1800 Max. Beyond that will be difficult as they would need to align with rest of the hair density to avoid looking odd. Beware of shockloss...when u have more...there is more at stake

Will be interesting to hear back from you on what the leading docs say

[thatoldchestnut]

I'd say that what people were estimating before sounds about right tbh. 2500 would have been my guess for a dense frontal restoration. You won't need an average of 60-70 grafts/cm2 to achieve a dense frontal third though, pretty sure 50ish would suffice. Best of luck

[Stig]

I agree with the 2,000 - 2,500 number. I think Dr Rahal would be a fine choice for your particular case where you can be slightly more aggressive on the frontal third and he will give you a great hairline.

[Ernie]

Stig, Rahal is in my top 3 :-)

[Ernie]

One of "the top 5" has suggested 3500-4000 grafts. Huh? Granted this was done by way of looking at photos. 60+ grafts / cm2 would be achievable.

 

Thoughts?

[mav23100gunther]

One of "the top 5" has suggested 3500-4000 grafts. Huh? Granted this was done by way of looking at photos. 60+ grafts / cm2 would be achievable.

 

Thoughts?

 

Sounds like Erdogan?

[mav23100gunther]

It looks like you have some minutirization in the mid-scalp and it will take a lot more grafts to fill in those temples than one would think, however 60+ dense packing is a waste as you will probably achieve a minimal difference than if you go with a lower number. I would think less than 2k is probably not enough, so my sweet spot would be 2,500 to 3,000 if you have the donor supply, otherwise go with a lower more conservative approach. Your best bet is to place more weight on what the surgeon suggests.

[TakingThePlunge]

You got some great advice above! My initial feeling when I looked at your pics was 2000 grafts, maybe less. I don't think 2500 would be excessive but I'd advise not going above that. You've got enough hair to achieve an excellent result.

 

When it comes to density, don't get hung up on numbers.50 to 55 grafts per square cm is typically all you need to create the illusion of density and will allow to conserve those precious grafts for the future.

[Ernie]

When it comes to density, don't get hung up on numbers.50 to 55 grafts per square cm is typically all you need to create the illusion of density and will allow to conserve those precious grafts for the future.

 

Even if my hair diameter is "quite fine", as opposed to coarse or moderate?

[Dr Blake Bloxham]

Ernie,

 

I think the reason why you've received a bit of a range of estimates is because:

 

1) There are several different strategies you could potential pursue here

 

2) The strength of your frontal forelock really plays a role in what you may need to achieve your goals.

 

First, I think all the estimates you've received are reasonable. However, they each are probably aimed at a slightly different goal. If you only wanted to reconnect the hairline from the forelock (the "tuft" of hair you still have in the middle of your hairline region) to the sides, something like 1,500 to 1,700 grafts would likely be appropriate. If you wanted to connect the hairline and fill in around and behind the central tuft (as you appear to have some thinning there), something like 2,000 to 2,500 grafts may be appropriate. If you wanted to do the above plan and continue to work back into the anterior crown/vertex -- where it appears you may have some thinning as well -- then a higher graft count (like the 3,000 estimates) may be appropriate. No real right or wrong answer. Just different approaches.

 

The real question mark here is the strength of the hair you have hanging on in the front there. It isn't clear whether this is stable or not. If it is not likely that you will ever lose it, then it can be worked around. If it looks compromised, then grafts may be required to "beef it up" and make sure it blends evenly with the rest of the work (and doesn't leave you with an unnatural hole in the transplanted area if you lose it in the future). This could add or detract a significant number of grafts, and therefore really change the estimate.

 

I hope this helps and maybe sheds some light on the different estimates. Best of luck in your research.

[Ernie]

If you only wanted to reconnect the hairline from the forelock (the "tuft" of hair you still have in the middle of your hairline region) to the sides, something like 1,500 to 1,700 grafts would likely be appropriate. If you wanted to connect the hairline and fill in around and behind the central tuft (as you appear to have some thinning there), something like 2,000 to 2,500 grafts may be appropriate. If you wanted to do the above plan and continue to work back into the anterior crown/vertex -- where it appears you may have some thinning as well -- then a higher graft count (like the 3,000 estimates) may be appropriate. No real right or wrong answer. Just different approaches.

 

Thanks for the insight on this -- to be clear, I wanted to connect the hairline, and fill in around and behind the forelock (mid-scalp area is it called?). I don't "trust" my forelock's staying power, so it would probably need to be reinforced as well.

 

I'd like to leave the very top of my head, and towards the vertex, until later (2nd HT somewhere down the line) -- for financial reasons I suppose