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Advice for second hair transplant procedure

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Hey guys hope you are good. I had a hair transplant 2 years back around 1800 grafts for hairline. It was a very successfull one and i couldnt be more pleased than i am rite now. But since then i have lost decent amount of hair in midscalp and crown . And some are in minituraizing stage.They have stopped growing.

So obviously i contacted my doctor and planned a visit.He saw my scalp and suggested 1000 grafts in midscalp (i have lost hair in midscalp in horse shoe pattern just behind hairline where doctor has decided to put 1000 grafts and the rest of midscalp will remain untouched ) and 600 in crown.

with density of about 30cm per square.

So whats your take on it:

1. Should i go for it considering i will loose more hairs in midscalp which are minituarizing.

2.Or should i plan my surgery in such a way that i transplant hair in midscalp in such a way that it would cover the hairs that will go in few years.

3.And what are the precautions if any for 2nd hair procedure. i heard that 2nd hair transplant grows slowly and all

4. i want to have this hair transplant:) How should i manage it?

thankyou.

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It would be much easier to offer advice if you uploaded some photos. You described your hair situation well, but without actually seeing your hair any advice wouldn't be truly worthwhile.

 

I will say that typically, 600 grafts seems like a small number to tackle any loss from the crown that is causing someone concern.


I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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Are you not taking preventive treatments such as finasteride? The crown and midscalp tend to benefit the most from a finasteride regimen.


Hair loss patient and transplant veteran. Once a Norwood 3A.

Received 2,700 grafts with coalition doctor on 8/13/2010

Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011

Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016

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It would be much easier to offer advice if you uploaded some photos. You described your hair situation well, but without actually seeing your hair any advice wouldn't be truly worthwhile.

 

I will say that typically, 600 grafts seems like a small number to tackle any loss from the crown that is causing someone concern.

 

This is the top view.. Mind you that when i style my hair it covers all these gaps coz of layering. Whats your opinion?

2017-07-05-11-00-09.jpg.e072291f1ba3d645f7fecc025a0a8221.jpg

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Are you not taking preventive treatments such as finasteride? The crown and midscalp tend to benefit the most from a finasteride regimen.

 

I have been on mintop 5cent for last 7 years.. I dont use finasteride because it caused me the side effects. See my picture what do you think would be sufficient grafts to covermidscalp and crown?

 

Thankyou

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I have been on mintop 5cent for last 7 years.. I dont use finasteride because it caused me the side effects. See my picture what do you think would be sufficient grafts to covermidscalp and crown?

 

Thankyou

I'd work with a doctor to explore a finasteride regimen of some sort, you don't have to take the amount normally prescribed, perhaps a scaled back prescription is in order and is better than nothing.

 

As for your scalp, the crown is notorious for needing more than you think, and 600 grafts sounds mighty scant for the job.

 

I'd think a minimal of 1500 if to 2000 plus are in order by the looks of your see through thinning in the region.


Hair loss patient and transplant veteran. Once a Norwood 3A.

Received 2,700 grafts with coalition doctor on 8/13/2010

Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011

Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016

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This is the top view.. Mind you that when i style my hair it covers all these gaps coz of layering. Whats your opinion?

 

You have diffuse pattern loss over the whole top of your head. 1600 grafts wouldn't make much of a difference over such a large area.


I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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I have quite a similiar pattern (DPA) but I am in a much better situation like you (area with strong loss is much smaller).

 

After live consultations with 3 recommend clinics I have recevied the quote for 1800, 2400 and 2500 FU for the crown. After reviewing only my pictures (and before seeing it in realilty) the quotes were 0 (too early), 0 (too early), 1000.

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You have diffuse pattern loss over the whole top of your head. 1600 grafts wouldn't make much of a difference over such a large area.

 

What do you think will 1200 grafts in midscalp would be sufficient?

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I have quite a similiar pattern (DPA) but I am in a much better situation like you (area with strong loss is much smaller).

 

After live consultations with 3 recommend clinics I have recevied the quote for 1800, 2400 and 2500 FU for the crown. After reviewing only my pictures (and before seeing it in realilty) the quotes were 0 (too early), 0 (too early), 1000.

 

So what decision you have taken? And any advice?

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What do you think will 1200 grafts in midscalp would be sufficient?
You need to consult a reputable physician, likely in person, to assess that properly.

Hair loss patient and transplant veteran. Once a Norwood 3A.

Received 2,700 grafts with coalition doctor on 8/13/2010

Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011

Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016

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So what decision you have taken? And any advice?

 

I have not make a final decision because I am not sure what to do at the front and if I should go FUE or FUT.

If I do the crown I will go for 2400-2500. My donor is good, so I should have the grafts.

 

In your case my advice is:

- Do at least three consultations with different clinics.

- 1-2 clinics should be FUE and (!) FUT clinics

- Most crisitcal point is that you do not use FIN (Ask the clinic if you have enough donor to fill the entire top)

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What do you think will 1200 grafts in midscalp would be sufficient?

 

Personally, I don't think so. It's a large area and you are virtually guaranteed to lose a lot of the existing hair in that area over time. If some of the hairs are miniaturizing, the procedure itself could cause some of the hair to be permanently lost. I feel that with your kind of diffuse loss over a wide area, only larger procedures make any long-term sense.

 

But I am basing that on only one photo.


I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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Personally, I don't think so. It's a large area and you are virtually guaranteed to lose a lot of the existing hair in that area over time. If some of the hairs are miniaturizing, the procedure itself could cause some of the hair to be permanently lost. I feel that with your kind of diffuse loss over a wide area, only larger procedures make any long-term sense.

 

But I am basing that on only one photo.

 

This.

 

As someone who has had three hair transplants who cannot take finasteride I will tell you now you will loose all the hair around where the transplanted hair will be. Ethical hair transplant doctors will not tell you this unless you ask which was a sad situation for me. If you have had hair transplanted in the hairline then I understand you will want to do something about the mid scalp as it will start to look odd. Here are your options.

 

1. Leave it as it is and use concealers. Hold on for as long as possible - there are some promising treatments coming out in the next 3 years. I know people have been saying that for 20+ years but the science and laws in Japan give me hope something will come out soon. Impatience and hair transplantation are not a good combination. I would take this option if I were you as you can always peruse the below options if a few years pass and nothing comes out. Remember you will loose all that mid scalp hair within a year if you transplant in that area.

 

2. You could go ahead with what you are saying and transplant into mid scalp and crown. But as others have stated you will need more than 1500 grafts and probably a mixture of body hair also. I would say 3000 grafts would be the absolute MINIMUM.

 

3 You could just repair the mid scalp and leave the crown thus preserving more grafts. Preserving grafts is key.

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Your plan is to cover the midscalp in a horseshoe pattern around the center tuft with 1000 grafts and also put 600 grafts into the crown. I think this is a decent plan and here's why I think so.

 

With your extensive pattern you don't want to use too many grafts in a small area because you don't know how much the balding area will widen over the years. You need to assume you may be nearing NW 7 at some point and plan for that. This means keeping a lot of grafts in reserve for future use. You can always go back for more in the future and thicken it up if your sides don't widen and drop and add some in the center area when/if that area goes. 600 grafts in the crown is a very small amount, but it makes sure you won't have a totally bald crown, even if it's only very light coverage.

 

I think you should look at some NW 6 and NW 7 patients who opted to get full coverage (meaning they wanted some coverage in the crown as well as the frontal half) and see what they achieved. You'll see they have some thin, but decent coverage throughout the frontal zone while getting a very light coverage through the crown area. I think that is what you should be planning for long term even though you aren't at that stage yet.

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Personally, I don't think so. It's a large area and you are virtually guaranteed to lose a lot of the existing hair in that area over time. If some of the hairs are miniaturizing, the procedure itself could cause some of the hair to be permanently lost. I feel that with your kind of diffuse loss over a wide area, only larger procedures make any long-term sense.

 

But I am basing that on only one photo.

 

The thing is the hairline hairs and my side midscalp hairs which are helathy converge so nicely in midscalp together that it doesnt give balding look. The only hairs that i have left in midscalp are so thin and doesnt have any volume. So even shock loss occurs i could replace them just after 3 months post surgery. My concern is will shock loss occur in previously transplanted hairline hairs or already existing side midcalp area where incisions wont be made. I hope you get my point.

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Your plan is to cover the midscalp in a horseshoe pattern around the center tuft with 1000 grafts and also put 600 grafts into the crown. I think this is a decent plan and here's why I think so.

 

With your extensive pattern you don't want to use too many grafts in a small area because you don't know how much the balding area will widen over the years. You need to assume you may be nearing NW 7 at some point and plan for that. This means keeping a lot of grafts in reserve for future use. You can always go back for more in the future and thicken it up if your sides don't widen and drop and add some in the center area when/if that area goes. 600 grafts in the crown is a very small amount, but it makes sure you won't have a totally bald crown, even if it's only very light coverage.

 

I think you should look at some NW 6 and NW 7 patients who opted to get full coverage (meaning they wanted some coverage in the crown as well as the frontal half) and see what they achieved. You'll see they have some thin, but decent coverage throughout the frontal zone while getting a very light coverage through the crown area. I think that is what you should be planning for long term even though you aren't at that stage yet.

 

The thing is the hairline hairs and my side midscalp hairs which are helathy converge so nicely in midscalp together that it doesnt give balding look. The only hairs that i have left in midscalp are so thin and doesnt have any volume. So even shock loss occurs i could replace them just after 3 months post surgery. My concern is will shock loss occur in previously transplanted hairline hairs or already existing side midcalp area where incisions wont be made.

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Your plan is to cover the midscalp in a horseshoe pattern around the center tuft with 1000 grafts and also put 600 grafts into the crown. I think this is a decent plan and here's why I think so.

 

With your extensive pattern you don't want to use too many grafts in a small area because you don't know how much the balding area will widen over the years. You need to assume you may be nearing NW 7 at some point and plan for that. This means keeping a lot of grafts in reserve for future use. You can always go back for more in the future and thicken it up if your sides don't widen and drop and add some in the center area when/if that area goes. 600 grafts in the crown is a very small amount, but it makes sure you won't have a totally bald crown, even if it's only very light coverage.

 

I think you should look at some NW 6 and NW 7 patients who opted to get full coverage (meaning they wanted some coverage in the crown as well as the frontal half) and see what they achieved. You'll see they have some thin, but decent coverage throughout the frontal zone while getting a very light coverage through the crown area. I think that is what you should be planning for long term even though you aren't at that stage yet.

As i explained that i would undergo transplant in horse shoe zone behind hairline where there are no hairs. So all i want to ask is can permanent shock loss occur in the previously transplanted hairline hairs and the healthy side mid scalp hairs? Thats my main concern. Because the hairs that i have remaining in midscalp whic can be lost via shock loss are so thin and less that it dont give any volume. So even if i loose those hairs i would gain that volume through the horse shoe transplant that i will undergo. What so you think?

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As i explained that i would undergo transplant in horse shoe zone behind hairline where there are no hairs. So all i want to ask is can permanent shock loss occur in the previously transplanted hairline hairs and the healthy side mid scalp hairs? Thats my main concern. Because the hairs that i have remaining in midscalp whic can be lost via shock loss are so thin and less that it dont give any volume. So even if i loose those hairs i would gain that volume through the horse shoe transplant that i will undergo. What so you think?

 

What do you think?

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Previously transplanted hairs shouldn't be affected by shockloss, assuming that the surgeon is careful. Stronger existing native hairs should be fine too. I don't doubt that you could achieve great improvement with a HT, I just think you need a higher number of grafts, going by what I see in your photo.


I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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