Over 50.. Considering another surgery

[JWard]

Hello friends…

 

I’m a 56 year old male from S.California. I frequented this forum about 10 years ago before my surgeries with Dr. Keane in 2007 (3900 frontal/mid-scalp grafts). Now nature has taken its course and my crown (and its surrounding areas) have depleted a lot. I no longer can comb my hair back to cover it and I always wear a hat in public. I’ve been on Rogaine and Finesteride since 10/2016 with no noticeable improvement. I might be too old for these treatments to work now?

 

This year, if my current regimen doesn’t prove helpful, I’m considering crown restoration. I’m worried however that the surgery may cause shock loss to my remaining hair. Please review my album. What would you do?

 

Thanks a lot!

[Spanker]

I'd love to see a pre-op pic.

I don't think the hair looks bad at all. I really wonder why you are just getting on fin after having a surgery 10 years ago.

 

The color of you hair and contrast to your scalp is very good so I think that you have a lot going for you. Also, 4 months is not enough time to see a big improvement. Especially at your age and in the crown.

 

If you have another 3500 grafts, you have room to place them and would give a great result, but even 2500 would look good. I think you could use a boost in your frontal half too, so if you have the money and the grafts, go for it,

[voxman]

I agree - it's not half as bad as you think. I see no reason to go out without a hat (unless you're in show business of course, then it's all over for you) .

 

You look like a suitable candidate for a very good outcome.

[ArochaHair]

I believe your crown is good with the only area I'd personally consider addressing being the vertex/top of the crown where scalp is more clearly seen. If you've only started finasteride in the past few months however you should stay the course and see how it works for you by this time next year. You may not need anything.

[JWard]

Thank you for the replies thus far. I'll take another picture of the sides to better depict the loss. I was using fin after my surgeries but the sexual side effects were intense. Now in my mid 50s it's not as important. Stayed tuned...

[milo12]

Hello friends…

 

I might be too old for these treatments to work now?

!

 

Hello JWard,

 

There are many older gentlemen who have had great hair transplant procedures done. Believe it or not the best hair transplant procedure I have ever seen was done on an older person in his upper 60s!

 

56 is not old trust me! Get your feet wet and try out a transplant. You got nothing to lose but more hair if you think about it. Do research options.

 

For example, I am asking guys here who have had transplants done if they need more transplants. Why? Because I want to know if I get one myself that I am able to get another transplant to add density. Adding density to a thinning area that has already been transplanted previously is important for me. This is my goal.

 

Good luck. You will do fine!

[voxman]

Get your feet wet and try out a transplant.

 

Yeah - try one out! You may like it enough to get more! :cool:

[JWard]

Yeah - try one out! You may like it enough to get more

 

Haha! Remember I've had two already.. 10 years ago! They can be addicting!

 

Ok, I uploaded three more pictures. Two sides.. one front. As you can see I heavily rely on my frontal hair to camouflage the back. My hair shaft diameter is really thin too, probably due to my age and a thyroid issue I was diagnosed with a few years back. The see-through effect is very evident... trust me!

[gillenator]

JWard,

 

We have some things in common, thin crown and most of the work done in the frontal zone. Had 4 separate procedures for a grand total of 6900 grafts. Doubtful I will have any more work done.

 

A couple of things. Think about future loss in the frontal zone and mid-scalp. You might also benefit from some partial SMP in your crown which would potentially take the light reflection off that area. Trust me, it would make a visual difference.

 

You might also consider blending some chest or beard grafts in your crown and you don't need to hit the area with a high level of density.

 

And agree that you have not been on finasteride long enough to fairly evaluate its efficiency. Give it a full 12 months and then see.

 

Donor management is key...you're still a young man my friend...:cool:

[voxman]

Haha! Remember I've had two already.. 10 years ago!

 

Uh yeah...I knew that, I actually read the entire 1st thread. I just like to see who else has.

[Spanker]

After looking at your new pics, I stand by my initial guess at 3500. With the right doc and a successful yield that should finish you off.

[JWard]

Thanks for your estimate. As I stated, I'm a concerned about shockloss to the surrounding hair.

 

Would most doctors elect to entirely "fill in" a primary section or sporadically place grafts around my existing hair?.. (most of those being transplants from my previous surgeries)

[hsrp10]

If you go with a respected and elite hair restoration surgeon they will carefully fill in the gaps in your existing hair using extremely high magnification and employing techniques such as stick and place (Dr. Konior and Dr. Gable for example).

 

However, if you wanted to lower the hairline or fill in the temple corner areas they could do dense packing in the areas that currently have no hair.

As I like to mention, it's best to densely fill in bald areas with dense packing the first time than to try to go back in consecutive procedures to place additional grafts in between areas already growing.

 

The same would apply for your crown depending on how much native hair is left and how miniaturized it is.

The crown often takes a LOT of grafts to fill in, so make sure you're perfectly happy with your current hairline and front before using a lot of grafts for the crown.

[milo12]

Thanks for your estimate. As I stated, I'm a concerned about shockloss to the surrounding hair.

 

Would most doctors elect to entirely "fill in" a primary section or sporadically place grafts around my existing hair?.. (most of those being transplants from my previous surgeries)

 

There are doctors that can actually fill in the gaps. From my research Feller and Konior specialize in that area. Check them out and see for yourself if these doctors suit you.

[JWard]

Thank you for those suggestions. I think Dr. Konior may be my best option here. I've reviewed a few of his videos and I like his approach to HT. Of course, my current Rog/Fin regimen needs to be played out. I think I'm seeing results at the 4 month mark?, but still unsure...

 

Does Dr. Konior have a long waiting list? (rep?) I'd like to put that possibility into motion soon,

 

Thanks again

[milo12]

I think Dr. Konior may be my best option here.

 

Does Dr. Konior have a long waiting list? (rep?) I'd like to put that possibility into motion soon,

 

Thanks again

 

Hello JWard,

 

You are very welcome.

 

All top 5 transplant surgeons have long waiting lists, including Konior since they are in constant demand. Give the office a call and ask. But I doubt they will give a direct answer. They will ask for photos and set up an interview. It depends on that. It is a process.

 

Don't worry you will be fine. Good luck!

[gillenator]

It usually takes 3-4 months before finasteride begins to effectively inhibit DHT and why it takes a good 12 months before fairly evaluating its efficiency.

 

The more diffused native is, the more susceptible it is to shock loss. On the other hand, transplanted hair is usually not as susceptible to shock loss.