Opinions welcomed on my situation

[rfeng2003]

Hello,

 

I'm new to this board, and I would much welcome some of the opinions from the people on this forum on suggestions on my current status in the picture I uploaded, maybe people who were in similar situation, and what you suggest. As so far, I have 2 different opionions from 2 doctors. I have seeing a third doc tomorrow.

 

 

I recently decided that I would like to get some surgical hair restoration.

I just started finasteride (1 mg) and monoxidil. I'm 36 yo, and over the last few years my hair has seemed to rapidly start to fall out. I think I noticed my hair line receding around the age of 25, but it seemed quite slow. Now its coming out quicker it seems.

 

I had one consultation here in San Diego in person. I met the Dr for about 10 minutes, and the "sales associate" for the rest. The conclusion she came upon was that i would need about 2400 FUE grafts, mainly focusing on the front of my hair, as she said my crown was not too bad. They suggest getting coverage, then focus on density. Which I kind of agree, that I'm more concerned with the front, as that's what more people would see. I'm about 6', so i don't think too many people would typically see the top of my head too often also.

 

Another quick consultation through email with another doctor suggested I continue with the finasteride and minoixdil for another year to see where my hair is in 1 years time.

They suggested FUT since i have very large area to cover, but I really don't want the linear scar, as I wear my hair shorter on the side (#2 blade when I cut it).

 

So that is a concern, that if I do surgery now, that more hair will continue to fall out, and my head will look patchy? But if I keep taking finasteride, I'm thinking that will at least slow down the loss of hair i CURRENTLY have.

 

Thanks for the help!

[ontop]

HI & welcome to the Forum.

looking at your picture that your heading to be a high NW with defused thinning.

 

You state that you just started Medications & you say that you have more loss of hair, well this could be that Meds will cause this for several months, but this is a indication that your responding to the medication, so power through any shedding at this time.

 

Your Dr gave you some good advice in trying meds first for at least 12 mths prior before any Ht so he can see your scalp has stabilized to a certain degree in your MPB.

 

As you well know there is 2 different HT Surgeries FUT & FUE both have there pros & cons but in your situation I feel FUT would be the better route to go as you have a lot of loss & FUT could move more hair from A to B.

Downside to FUT is the scar but choosing a good HT Dr to do this is the key and if you do choose the right Dr the scar should not be a issue.

 

While your waiting on Meds to really kick in have severa l more consultations with some of the forum doctors on here & if you can see them one on one as a personal consultation all the better.

 

Take your time, lets see how you do with the medications then evaluate in 12 mths.

In the meantime have a good read up on this forum from patients & doctors so you can better educate yourself.

 

Best wishes.

[rfeng2003]

Thanks ontop for the detailed feedback!

 

I'm currently using Minoxidil as mentioned.

Do you suggest I use it over my whole top of my head,or is it only beneficial for the crown?

Am i wasting my time putting on the frontal portion and hairline?

[ontop]

Be best to concentrate on using on the thinning areas, it works all over but only where there is native hair is left.

 

Check out a member called Rashid hes around the same as yourself, proberly a little more hairloss but seems to be responding to Meds & same goes for fin as it works all over the scalp not just the crown but it wont give you back your hairline again only where there is native hair is left it proberly be effective.

like I said best give it a good year on meds to see where your at prior HT.

 

How long you been on Fin & Min?

Edited August 22, 2016 by ontop
.

[rfeng2003]

omtop, again thanks for the info.

 

i've been on meds for just a couple weeks, so I've got a ways to go

 

I'll check out Rashid's profile. Thanks

[rfeng2003]

Ontop, I was also wondering how many procedures you think I would need?

Coming into this, I thought most people get 1 procedure, unless they wanted a much more dense look.

 

Looking at my picture, how many procedures do you think I need done.

Do you think the 2400 grafts that was suggested by one doctor enough to not have to do another future procedure if I stay on the meds?

[Speegs]

Ontop, I was also wondering how many procedures you think I would need?

Coming into this, I thought most people get 1 procedure, unless they wanted a much more dense look.

 

Looking at my picture, how many procedures do you think I need done.

Do you think the 2400 grafts that was suggested by one doctor enough to not have to do another future procedure if I stay on the meds?

Welcome, realistically if you want cosmetically appealing density, you're looking at two procedures and probably close to 6000 grafts.

 

2400 sounds awfully conservative for the amount of real estate you have to cover, 2400 would be appropriate only if you had a receding hairline or frontal thinning.

 

Stay on the meds, and possibly investigate Viviscal Professional, a hair supplement many docs and dermatologists recommend to strengthen hair and encourage its life cycle.

[Speegs]

Ontop, I was also wondering how many procedures you think I would need?

Coming into this, I thought most people get 1 procedure, unless they wanted a much more dense look.

 

Looking at my picture, how many procedures do you think I need done.

Do you think the 2400 grafts that was suggested by one doctor enough to not have to do another future procedure if I stay on the meds?

Unless you have minor hair loss, it's rare that one is enough, that is a regrettable omission/ sales tactic of many forces in this industry that needs to be held accountable.

 

I have less hair loss than you and have had three procedures all in the frontal third, there are many determining factors, such as your hair texture, if it's fine or thick, and what cosmetic density you think you can live with...because typically harsh light exposes hair transplants if they aren't doubled down upon.

[ontop]

Yep being you just started meds you will look worse before your better, more or less it turns around about the 4mth mark maybe sooner, so stick it out but also be consistent, don't slack off, remember this is a lifetime medication if you want to save most of your native hair.

 

As for how many HTs you would take a guess & say you at least need 2500/3000 grafts for zone 1,2 & say about the same for mid scalp going towards the crown another 2500 grafts which will give you coverage I should think but most importantly work on the front first to frame your face.

so definitely 2 good size HTs for you maybe 3 over a lifetime, if you want to create better density.

Remeber this from me or other's is simply guess work, there are several other factors involved such as hair caliber, density of donor like have you got a lot of doubles or triples, quadruple hair folicals which will favor the overall result

..basically in a nut shell its supply & demand , caliber of hair & density of donor supply.

 

not a lot of guys is lucky enough to get away with just 1 Ht, more often than not they want to get that density or simply loose more native hair because they are not on Meds. But we are running before we can walk with you, so best to stick out your Meds & see if you respond & if you do then take it from there, speak with several HT Surgeon's & feel your way, dont rush any HT just yet, its all about being smart over a lifetime.

 

Hope this helps, keep us informed on your doing on your medications.

 

Best wishes.

Edited August 22, 2016 by ontop
.

[rfeng2003]

Thanks ontop!! Very much appreciated with your great feedback

[Shampoo]

Do you think the 2400 grafts that was suggested by one doctor enough to not have to do another future procedure if I stay on the meds?

 

I very seriously doubt you would be very happy with only 2400 grafts.

 

Like someone said you have a lot of real estate to cover.

 

If you want pretty good coverage, long term you could easily need 6K-8K grafts if you have the donor supply to make that happen. Of course if your have lower expectations maybe less grafts could work.

 

Depending on your financial situation I would suggest getting a larger session than 2400 grafts.

 

At 36 years old maybe get 4500 grafts as a starter now, and reassess in 2-4 years?

 

Your questions about how many procedures you will need basically revolves around how large of sessions you decide to go with. Larger session surgeries usually means less surgeries you will need...but there are other factors like donor supply and financial that all play a part.

 

Some clinics specialize in larger sessions and many clinics primarily like to do 1800-2500 graft sessions.

 

Without opening a FUT vs FUE debate, personally I would get a large FUT session first (FUT in US and Canada much cheaper than FUE and usually larger sessions more easily accomplished with FUT) and later down the line gravitate towards FUE. The so called "scar" can be an issue with some patients, but if you go with an elite doctor it usually will not be an issue unless you end up shaving your head or wear your hair really short. I have had 3 FUT surgeries and the so-called "scar" is 100% a total non-issue that my hair-dresser has trouble finding.

 

Also I would advise not lowering your hairline at all when you have your surgery, use all your grafts to build up the areas in and behind your current hairline.

Edited August 22, 2016 by Shampoo

[Speegs]

I very seriously doubt you would be very happy with only 2400 grafts.

 

Like someone said you have a lot of real estate to cover.

 

If you want pretty good coverage, long term you could easily need 6K-8K grafts if you have the donor supply to make that happen. Of course if your have lower expectations maybe less grafts could work.

 

Depending on your financial situation I would suggest getting a larger session than 2400 grafts.

 

At 36 years old maybe get 4500 grafts as a starter now, and reassess in 2-4 years?

 

Your questions about how many procedures you will need basically revolves around how large of sessions you decide to go with. Larger session surgeries usually means less surgeries you will need...but there are other factors like donor supply and financial that all play a part.

 

Some clinics specialize in larger sessions and many clinics primarily like to do 1800-2500 graft sessions.

 

Without opening a FUT vs FUE debate, personally I would get a large FUT session first (in US and Canada cheaper and usually larger sessions more easily accomplished with FUT) and later down the line gravitate towards FUE. The so called "scar" can be an issue with some patients, but if you go with an elite doctor it usually will not be an issue unless you end up shaving your head or wear your hair really short. I have had 3 FUT surgeries and the so-called "scar" is 100% a total non-issue that may hair-dresser has trouble finding.

 

Also I would advise not lowering your hairline at all when you have your surgery, use all your grafts to build up the areas in and behind your current hairline.

I largely agree...though i would stagger the procedure sizes out more modestly.

 

3000 a pop, two different procedures a year apart to address the front and mid scalp and then wait and see what the crown looks like with meds in play.

 

And I agree, there's no reason not to go FUT for a restoration undertaking this large.

[n00b]

I very seriously doubt you would be very happy with only 2400 grafts.

 

Like someone said you have a lot of real estate to cover.

 

If you want pretty good coverage, long term you could easily need 6K-8K grafts if you have the donor supply to make that happen. Of course if your have lower expectations maybe less grafts could work.

 

Depending on your financial situation I would suggest getting a larger session than 2400 grafts.

 

At 36 years old maybe get 4500 grafts as a starter now, and reassess in 2-4 years?

 

Your questions about how many procedures you will need basically revolves around how large of sessions you decide to go with. Larger session surgeries usually means less surgeries you will need...but there are other factors like donor supply and financial that all play a part.

 

Some clinics specialize in larger sessions and many clinics primarily like to do 1800-2500 graft sessions.

 

Without opening a FUT vs FUE debate, personally I would get a large FUT session first (in US and Canada cheaper and usually larger sessions more easily accomplished with FUT) and later down the line gravitate towards FUE. The so called "scar" can be an issue with some patients, but if you go with an elite doctor it usually will not be an issue unless you end up shaving your head or wear your hair really short. I have had 3 FUT surgeries and the so-called "scar" is 100% a total non-issue that may hair-dresser has trouble finding.

 

Also I would advise not lowering your hairline at all when you have your surgery, use all your grafts to build up the areas in and behind your current hairline.

 

I too agree with Shampoo but i wanna add one more tiny detail about scar.

Not everyone heals the same. People from different origins tend to heal similarly. For example, i believe, Caucasians heal very well whereas people with very dark skin tones tend to form keloid scars.

 

I suggest you consult with multiple doctors and get a "personalized" recommendation on donor characteristics like density, hair caliber, skin laxity and the general tendency to heal scars.