Five years, four transplants: lots of progress but more to go

[7Shel]

I wanted to summarize my hair transplant journey from 2012 to now and get some direction on where I'm headed.

 

- Hair started receding at 21

- Stable until age 28, when my hairline receded quite a bit further, I was thinning behind that, and I developed a small patch of alopecia

- Began taking 1 mg of Propecia every third day around this time

- Had my first FUT session at 29

- Have had three more FUT sessions since then (last was 2 years ago)

 

In total, I've had about 6700 grafts. My first three surgeries addressed my hairline and frontal region (2300, 2000 and 1500 grafts respectively).My fourth surgery (950 grafts) addressed the area near my part on the left side of my head and the crown, which had previously not been an issue but started thinning between surgery three and four. About a month before my fourth surgery, I stopped taking Propecia due to severe sexual side effects (my doctor was aware of this). Haven't taken it since and have no plans to resume. Just can't do it again, unfortunately.

 

I've attached a lot of photos that show progress through the various stages. In retrospect, I wish I had taken more because I think I've lost a lot of hair in my crown since my fourth surgery two years ago.

 

Summary of photos are as follows:

 

1 and 2: morning of the first surgery.

 

3: immediately after first surgery

 

4 and 5: morning of second surgery (13 months after first procedure)

 

6 and 7: one month before fourth surgery (wish I had some in between)

 

Rest are from this week. *Note that I was coloring my hair in the past but no longer do. This week's pictures are also taken with some gel in my hair for styling.*

 

So, it's been quite a long journey. I'm obviously in a much better place and am quite pleased with the overall progress, but I'm now realistically looking at another procedure to address my crown hair loss. As I said, I can't deal with Propecia again. I'm going to continue with more transplants until I tap out of donor supply. Additionally, I feel like my hairline doesn't look that soft and could maybe use more density. I'd be curious to hear overall opinions on my situation. Based on my hair characteristics, I think I have enough donor supply for another FUT session, but would be interested to know what a realistic target is. Going to probably see my surgeon again in a few weeks to discuss.

Edited August 11, 2017 by 7Shel

[Spanker]

I wouldn't do anything at this point. Since your are not going to do fin, your donor management is extremely important. And since it really doesn't look like you need anything (you look good and normal) I would not do anything,

[gillenator]

Totally agree with Spanker...and since you are still quite young 7Shel, you definitely want some donor to cover future loss which is bound to happen.

[7Shel]

How do I determine when I should proceed? To me, it's no longer a question of "if." I think I fully recognize that my crown is going to continue to thin. The question is how long to wait. I honestly wasn't very concerned about it until both my mother and girlfriend separately commented. As I'm sure everyone has experience with, that started me down the path of scrutinizing my hair several times per day. It's like reliving the times before my first transplant, which obviously sucks. Do you think my donor supply is still in good shape? Are my concerns about my hairline valid or I am judging it too harshly?

[7Shel]

My donor area still feels very thick. The photo above was taken 5 days after a haircut, in fact. It's generally even bulkier. I can barely tell a difference between now and pre-transplant.

 

The hairline is overall solid. I mean, I have dark hair, light skin, and I don't comb it forward at all. It still looks pretty good. You can only see the "stubble" appearance close up. It's not a huge concern, but I'd like it to look a little more natural. I understand what you mean, though. I think the bigger issue is my crown. I need to plan accordingly for that.

[7Shel]

Interesting. Going to have to check into PRP. Since the last surgery two years ago, I haven't been paying much attention to results/trends. It kind of took the comments from my mom and girlfriend to renew my focus.

 

As for donor shock loss, I didn't experience any at all after each procedure. Very lucky, for sure.

[7Shel]

No problem at all! Thanks for the suggestion. Absolutely going to consider it.

[Triple7]

I agree with Spanker. You have come a long way and look great in my opinion. Noone would be able to tell that you had a transplant. If you look normal/natural I say leave it alone.

[mattj]

I think your result looks quite stunning. I can see the obvious difference between procedures 1 and 2, but after that it's difficult to see (with the photos provided) what you needed done in the following two transplants. The overall result looks like a great success though.

 

Although I can see definite loss from your crown, I don't think it is cosmetically significant and I think that doctors would be very hesitant to treat the area due to how minimal the thinning is. So my advice would be to wait, and that advice would be identical even if you'd had no procedures at all. You just don't need it.

[Bill - Seemiller]

I agree with the others who have already given you advice, I would hold off if I were you and not get any additional hair transplant procedure is. In my opinion, your hair looks great and if you are not going to take Propecia than you will definitely want to keep some dollar hair in reserve for the possibility of future work.

 

When I first read this topic, I actually thought one of my old posts was resurrected because like you, I had for hair transplants in the period of five years. But that was about 9600 grafts and I am satisfied with my results.

 

Best wishes,

 

Bill

[7Shel]

Thank you for the responses, Matt and Bill. I appreciate the kind words. I think part of my confusion is knowing when the right time is. I understand the importance of preserving donor supply, but am not quite sure how I judge when my crown becomes very cosmetically significant and it's safe to get more work done. I guess there's no exact answer. I'll take the sound advice from veterans on this board and obviously listen to my doctor if I schedule a follow-up exam to assess my current situation.

[Hairhope4ever]

7shel,

 

Your story is inspirational, and I can personally relate to it.

 

Well done! You have come a long way, and you look fantastic. I am having my 6th procedure in October of this year with Dr. Sanusi Umar in Redondo Beach (2nd with him), and I feel like I am almost at the end of my journey as well.

 

Good luck going forward bud.

 

 

 

http://hairtransplanttestimonial.blogspot.com/

[gillenator]

I also think your hair looks great, especially the frontal third. And considering you have a wide color contrast, that's a nice overall result.

 

Because your crown is diffusing and slightly thin, the risk you run is shock loss to the crown and having more loss than if you treated it non-surgically.

 

Have you ever tried minoxidil in your crown? That alone might help thicken it up.

 

You're still young so you definitely want to manage what donor reserves you have left for the future.

 

But again, I would wait on doing any more surgery if it were me.

[7Shel]

I also think your hair looks great, especially the frontal third. And considering you have a wide color contrast, that's a nice overall result.

 

Because your crown is diffusing and slightly thin, the risk you run is shock loss to the crown and having more loss than if you treated it non-surgically.

 

Have you ever tried minoxidil in your crown? That alone might help thicken it up.

 

You're still young so you definitely want to manage what donor reserves you have left for the future.

 

But again, I would wait on doing any more surgery if it were me.

 

I did try minoxidil. Gave it a few weeks and unfortunately experienced heart palpitations. Didn't want to continue after that.

 

Just want to make sure I understand shock loss. I definitely do with respect to the donor area, but is the risk in my crown simply that transplanting around hair that's already miniaturizing would shock that hair out permanently and the grafts that were placed around it would thus not cover enough area? In effect, I would be left with an island of transplanted hair and nothing around it. If I then didn't have adequate donor supply left, I'd be out of luck (barring something like FUE or beard hair)? Otherwise, I would wait and see what happens. If the hair loss looks stable after several more years or only gets slightly worse, I can either choose to leave things alone indefinitely or safely proceed with more work and not risk shock loss? Am I interpreting my options correctly?

[gillenator]

Well it is certainly a challenging dilemma because of the risk of shock loss. The hair that is in the most advanced stages of diffusion is the most at risk, generally speaking.

 

The real challenge for you is that your loss is minimal and why risk losing what's presently there?

 

If it were me, I would have my entire crown microscopically examined by my HT doctor and determine the extent of the diffusion. This exam will also determine how much of the area is under miniaturization and the areas affected by potential loss in the future.

 

But we all individually have to decide to what extent the current amount of loss is unacceptable. Some guys would be thankful to have the amount of hair that you presently have in the crown and others not so.

 

If you feel that you cannot live this way any longer, then I would approach adding grafts with FUE on a smaller number to minimize the trauma and corresponding level of shock.

 

The nice thing about FUE is that you control how much work you want done. I think that even 150 grafts or so would make a visual difference in that small spot.