Need Advice on Hair Transplant

[budhair]

Hi everyone. I have been reading wonderful stories of hair restoration on this forum since last one month. I did my research on FUE through this website and by meeting and emailing various doctors which I came to know via this forum.

 

I am 38 years old male and have been losing hairs since the age of 24. Since then I am using hair system which is fixed to my head via glue and tape. In other words, I never let the world know that I was losing hairs as I started using the patch at very early stage of baldness. I love fitness and try my best to feel and look young. Every now and then I use to get compliments in my peers as how young and fit I look. But at the same time I know that I got something fake fixed on my head. Nowadays there is this uneasiness in my head thinking what people might be thinking of me who make out this fake hair patch on my head. So with all these mixed thought processes, I am thinking to go with hair transplant. I mailed my pictures to various doctors who assessed my case differently. As per them I have Stage VI baldness. I also have very thin and silky hairs. I want to get my full head covered and I am not comfortable to leave out my crown area. I am not looking for very aggressive or dense hairline. It should be just enough to cover my head.

 

As per Dr. Bhatti of Darling Buds, it can be done in two sessions 6 months apart. In first session he may extract 3000 grafts from the back and 500 grafts from beard. In second he will extract 1500 grafts from the back.

 

As per Dr. Madhu and Dr. Suneet Soni, 3500-4000 grafts can be taken out by strip method (FUT) only and they did not recommend FUE because of limited donor area. These 4000 grafts will only cover four finger area of my front head.

 

As per Dr. Arika Gupta of Euginex, 2000 grafts from beard hair and 4000 grafts from the head will be extracted in back to back sessions ( 2 days) and another 2000 grafts from the head after 1 month. This makes total of 8000 grafts.

 

As per Dr. Gaurang Krishna of Medlinks either 3000 grafts each in two sessions 6 months apart or 2500 grafts on 1st day and another 2500 on 2nd day. Out of these 1200-1500 grafts will be of beard hairs.

 

Now with all this information I am totally confused. My points of concern are:-

1. How may grafts I actually need to fully cover my bald area?

2. Do I actually have enough donor grafts to meet this expectation?

3. What kind of density I can expect after the transplant?

4. Do I actually a right candidate for HT?

5. What about my looks? Will I look older after HT than what I look now

Guys please help me out on this. I am attaching pictures of my head for assessment.

Thanks in advance.

[MayiraP0chu]

Budhair!

 

As a man who is used to wearing a hair piece all his life, no surgeon in the world can satisfy you if you are looking for a hair piece like density. Especially in a NW6.

 

That being said, to answer your questions,

 

1. Dr. Arika Bansal has estimated right. And I STRONGLY believe she's your doctor (Eugenix has made the high Norwood cases synonymous with them. In fact they reject the lower Norwood cases and sometimes mid Norwood too.) unless you are open to considering surgeons outside India.

2. You have enough grafts to cover the procedure. (Assuming you have good beard grafts as well)

3. Transplant is a game of illusion. There is no way you can get back the hair of your teens or the hair piece. With that said, if the procedure goes well, you should have pretty decent hair that is age appropriate. (But, remember, no where close to a hair piece.)

4. You are a candidate.

5. There is no connection between transplants and your youth other than the obvious cosmetic difference hair gives.

 

Wish you luck!

 

Cheers!

Edited October 12, 2017 by MayiraP0chu

[Shera]

Hi everyone. I have been reading wonderful stories of hair restoration on this forum since last one month. I did my research on FUE through this website and by meeting and emailing various doctors which I came to know via this forum.

 

I am 38 years old male and have been losing hairs since the age of 24. Since then I am using hair system which is fixed to my head via glue and tape. In other words, I never let the world know that I was losing hairs as I started using the patch at very early stage of baldness. I love fitness and try my best to feel and look young. Every now and then I use to get compliments in my peers as how young and fit I look. But at the same time I know that I got something fake fixed on my head. Nowadays there is this uneasiness in my head thinking what people might be thinking of me who make out this fake hair patch on my head. So with all these mixed thought processes, I am thinking to go with hair transplant. I mailed my pictures to various doctors who assessed my case differently. As per them I have Stage VI baldness. I also have very thin and silky hairs. I want to get my full head covered and I am not comfortable to leave out my crown area. I am not looking for very aggressive or dense hairline. It should be just enough to cover my head.

 

As per Dr. Bhatti of Darling Buds, it can be done in two sessions 6 months apart. In first session he may extract 3000 grafts from the back and 500 grafts from beard. In second he will extract 1500 grafts from the back.

 

As per Dr. Madhu and Dr. Suneet Soni, 3500-4000 grafts can be taken out by strip method (FUT) only and they did not recommend FUE because of limited donor area. These 4000 grafts will only cover four finger area of my front head.

 

As per Dr. Arika Gupta of Euginex, 2000 grafts from beard hair and 4000 grafts from the head will be extracted in back to back sessions ( 2 days) and another 2000 grafts from the head after 1 month. This makes total of 8000 grafts.

 

As per Dr. Gaurang Krishna of Medlinks either 3000 grafts each in two sessions 6 months apart or 2500 grafts on 1st day and another 2500 on 2nd day. Out of these 1200-1500 grafts will be of beard hairs.

 

Now with all this information I am totally confused. My points of concern are:-

1. How may grafts I actually need to fully cover my bald area?

2. Do I actually have enough donor grafts to meet this expectation?

3. What kind of density I can expect after the transplant?

4. Do I actually a right candidate for HT?

5. What about my looks? Will I look older after HT than what I look now

Guys please help me out on this. I am attaching pictures of my head for assessment.

Thanks in advance.

 

 

HI Budhair,

 

In response to your questions;

 

1. How may grafts I actually need to fully cover my bald area?

 

I would say about 5000-6000 grafts should give you a good aesthetic result, I have a couple of guys in the UK very similar to you, one has had the two surgeries Dr Bhatti recommends for you and the other is just a few months past his first surgery. I can send you some pics to show you the first guys final result and the second guys progress. Also you will need to utilise beard and possibly chest hair.

 

2. Do I actually have enough donor grafts to meet this expectation?

 

I think you will need the 2 surgeries at least 6 months apart to minimise the risk of over harvesting thus damaging adjacent healthy grafts and to minimise the risk of scarring. In general Dr Bhatti can usually harvest just over half the grafts in the second surgery. I think you will be looking at close to 6000 grafts once both surgeries are completed. Your scalp grafts (your donor appears to be good) along with your beard/chest grafts should just about give you enough grafts.

 

3. What kind of density I can expect after the transplant?

To create the most natural looking hairline Dr Bhatti will select only the finest 1 haired follicular units for placement in the first two rows of the hairline. Dr Bhatti will dense pack up to 55 follicular units per square centimeter (FU/cm2) for your hairline.

 

Your hairline will be planted with greater density, this density will be gradually decreased moving backward in order to provide you with more coverage. This will look the more natural when grown. I would personally recommend concentrating purely on the front and midscalp in the first session and coming back in 6 - 12 months to address the crown and maybe another pass over the previously implanted area (if required) once your donor area has recovered fully.

 

4. Do I actually a right candidate for HT?

 

Judging from past patients, I would say you are a candidate for HT, a challenging candidate but a candidate nonetheless.

 

5. What about my looks? Will I look older after HT than what I look now

 

I think with hair you are pretty much guaranteed to look younger than you do without. Speaking from personal experience, I'd say having hair has probably knocked 15 years of my own appearance.

 

I hope that clarifies a few things for you, feel free to contact me personally if you wish to do so.

 

I wish you all the best with your surgery whoever you choose to go to.

Edited October 12, 2017 by Shera

[budhair]

Thanks Mayira and Shera for valuable insight. I was wondering why some doctors recommend 6 months gap between two sessions and some doctors are comfortable with back to back sessions. Though my personal preference will be back to back sessions because I don't want to through hair regrowth cycle again and again. But will these quick sessions will be at the cost of excessive shock loss?

Thanks

[Shera]

Hi Budhair,

 

Dr Bhatti recommends at least a 6 month gap between surgeries to allow for the donor area to completely recover thus alleviating any danger of overharvesting, scarring and possible permanent damage to adjacent grafts in the donor area.

 

The better the donor area, obviously the more grafts can be obtained in a single sitting without risk. Think of it as having any other surgery on your body, would you wish to be reopened the following day for Part 2. I guess not so why do it to your head?

 

Therefore it is solely in the patients interests and the patients well being to do the surgery at least 6 months apart, there is no gain whatsoever for the Doctor. As for shock loss I would think that the surgery on the 2nd day would be on another implantation area so the risk of shock loss would not be any greater.

[AMR1]

how many grafts are you planning to have, i would not suggest back to back or even 6 months. do max session or leave at least 18 months for your new hair to settle, but now a days you can have almost 5000 grafts done in one session depending on the doctor.

 

I have just had my latest on done on Monday this week in Istanbul with Dr Cinik

 

check him out he is excellent or else check my blog.

 

http://www.emrahcinik.com/

Edited October 13, 2017 by AMR1
added info

[budhair]

As per Dr. Bhatti's mail ...he will plant 40 grafts per sq cm in front and 20 grafts per sq cm at the crown.

 

 

3. What kind of density I can expect after the transplant?

To create the most natural looking hairline Dr Bhatti will select only the finest 1 haired follicular units for placement in the first two rows of the hairline. Dr Bhatti will dense pack up to 55 follicular units per square centimeter (FU/cm2) for your hairline.

 

Your hairline will be planted with greater density, this density will be gradually decreased moving backward in order to provide you with more coverage. This will look the more natural when grown. I would personally recommend concentrating purely on the front and midscalp in the first session and coming back in 6 - 12 months to address the crown and maybe another pass over the previously implanted area (if required) once your donor area has recovered fully.

[budhair]

Thanks AMR1 for your valuable information. Since I am using hair patch now... it will be difficult for me to move around in semi bald look for such a long time:rolleyes:. Advice from other senior members will be appreciated:confused:.

[Shera]

As per Dr. Bhatti's mail ...he will plant 40 grafts per sq cm in front and 20 grafts per sq cm at the crown.

 

Hi Budhair,

 

If you have asked Dr Bhatti to specifically cover all your balding area in the first surgery then there will simply not be enough grafts to give you the density I mentioned in my post. I incorrectly assumed you would leave the crown until the second surgery as Dr Bhatti usually recommends.

 

I take it the 2nd surgery will bring you closer to the figures I mentioned, please correct me if I am wrong. I'm sorry for any confusion, I haven't spoken to Dr Bhatti about your specific case.

 

Also if you are wearing a hair patch now, I don't see how you will be able to hide the drastic change you will have following surgery. You could just make something up like you got fed up with hair and fancied a change or maybe you can pass the shaved look off for religious reasons.There are lots of others, you just need to be imaginative, maybe I should start a separate thread.

 

Anyway, I wish you all the best.

Edited October 13, 2017 by Shera
smelling pistake

[budhair]

Will finasteride be helpful now at this stage to thicken my front hairs which have become quite thin.

Thanks

[Shera]

Will finasteride be helpful now at this stage to thicken my front hairs which have become quite thin.

Thanks

 

Theoretically Finasteride should help the few hairs you have left at the front to recover and thicken.

 

I think you may well find Rashid's thread useful at the link below,

 

http://www.hairrestorationnetwork.com/eve/183189-treatment-update.html

Edited October 17, 2017 by Shera

[Pete-from-Farjo]

Your best hope for finasteride is that it may prevent your hair from dipping further at the back and sides. If loss in these areas can be stabilised then it makes planning your ht a whole lot easier.

[budhair]

Your best hope for finasteride is that it may prevent your hair from dipping further at the back and sides. If loss in these areas can be stabilised then it makes planning your ht a whole lot easier.

 

Thanks Shera and Pete for advice. However as I read more and more reviews of fin on this forum I become more concerned about it's side effects.

[mattj]

I took Finasteride for over five years and I only realised that I'd been experiencing side effects after I stopped taking it and I noticed improvements in the libido department. I haven't noticed any major loss of hair in the years since I stopped it.

 

So I'm not a huge Finasteride advocate, but I do think it's worth trying. I'm sure the side effects are more common than the medical literature says; but I also believe that the negative experiences you hear about online give a false impression of how common and severe they are. The truth is somewhere in the middle. You have to weigh up how important your hair is to you and whether the risks outweigh the benefits - and the benefits can be great.

[MattyNJ1]

I took Finasteride for over five years and I only realised that I'd been experiencing side effects after I stopped taking it and I noticed improvements in the libido department. I haven't noticed any major loss of hair in the years since I stopped it.

 

So I'm not a huge Finasteride advocate, but I do think it's worth trying. I'm sure the side effects are more common than the medical literature says; but I also believe that the negative experiences you hear about online give a false impression of how common and severe they are. The truth is somewhere in the middle. You have to weigh up how important your hair is to you and whether the risks outweigh the benefits - and the benefits can be great.

At what dosage were you taking Fin? ....I just had an incredible result in only 3 months at a very low dose (1/4 tab ED) my hair grew back 30%, it was incredible, with no sexual side effects at all......until i developed a skin related allergy just last week. Itchy skin, especially at night...no clue why or why after 2.5 months?...but iam sorting through it now. Iam very discouraged as id hoped to continue with these great results....not sure what to do now.

[mattj]

I was getting 5mg Proscar tablets and splitting them into four pieces - so 1.25mg per day.

 

I would hesitate to blame the Finasteride for the skin problem. It's unlikely that the drug would cause this after 2.5 months of use and it's not exactly a common side effect. There could be another reason for it.

 

As you've seen such a great improvement with the drug, I would encourage you to stick with it.

[Shera]

I took Finasteride for over five years and I only realised that I'd been experiencing side effects after I stopped taking it and I noticed improvements in the libido department. I haven't noticed any major loss of hair in the years since I stopped it.

 

So I'm not a huge Finasteride advocate, but I do think it's worth trying. I'm sure the side effects are more common than the medical literature says; but I also believe that the negative experiences you hear about online give a false impression of how common and severe they are. The truth is somewhere in the middle. You have to weigh up how important your hair is to you and whether the risks outweigh the benefits - and the benefits can be great.

 

Great advice Mattj. The bottom line is we are all different and as MattJ says you have to weigh up the risks and benefits. The benefits can indeed be great. The following patient came to me asking how many grafts he needed to thicken his crown. I informed him about Fin and how it had helped others delay the need for surgery. I sent him as much details I had about Fin including the potential risks to help him make an informed decision.

 

So, he decided to commence taking it and after 2 months I was taken aback by the improvement. In the first picture he may have some product in his hair, but still the improvement is quite remarkable.

[Shera]

Just looked at that pic again, it does look unreal!

[mattj]

That's a very fast and incredible response to the Fin!

[Shera]

That's a very fast and incredible response to the Fin!

 

Amazing, literally blew me away!

[MayiraP0chu]

Phew!! Incredible response indeed!

 

Diffused thinners respond to Fin better by a significant degree when compared to receders? Not basing my question solely based on this OP.

[MattyNJ1]

I was getting 5mg Proscar tablets and splitting them into four pieces - so 1.25mg per day.

 

I would hesitate to blame the Finasteride for the skin problem. It's unlikely that the drug would cause this after 2.5 months of use and it's not exactly a common side effect. There could be another reason for it.

 

As you've seen such a great improvement with the drug, I would encourage you to stick with it.

 

Well you happen to be right! ....only last night after 3 weeks of hives and crazy allergic reactions driving me insane i figured it out, and it wasn't the Fin thankfully...i was eliminating things out of my diet like milk and dairy! ...i stopped the Fin as i was convinced it was either diet or the Rx....only to finally realize last night, the culprit was literally right under my nose!.... a New goose down comforter my gf bought for the bed!! ....sweet relief! what a crazy ordeal. That dame blanket smh...

[mattj]

I had a feeling you'd find some other cause. It's got to be a relief that you can continue with the treatment.

[budhair]

I was getting 5mg Proscar tablets and splitting them into four pieces - so 1.25mg per day.

 

I would hesitate to blame the Finasteride for the skin problem. It's unlikely that the drug would cause this after 2.5 months of use and it's not exactly a common side effect. There could be another reason for it.

 

As you've seen such a great improvement with the drug, I would encourage you to stick with it.

 

Will it help if I start with .5 mg finasteride. Will it give same results with less chances of side effects.

If I think of start taking it then how long I have to take it to see noticable change in my hair line.

I also read in this forum that moment you stop taking it you will be back to square one.

[mattj]

Will it help if I start with .5 mg finasteride. Will it give same results with less chances of side effects.

If I think of start taking it then how long I have to take it to see noticable change in my hair line.

I also read in this forum that moment you stop taking it you will be back to square one.

 

Hi budhair,

A lot of people try starting out with a lower dose, such as .5mg per day, to reduce the chance of side effects. It can still be effective at lower doses. I've heard many experiences that back this up.

 

You might not see a noticeable difference in your hairline. Sometimes Finasteride only slows down hairloss and regrowth at the hairline is quite rare. I can remember starting the drug with high hopes, but it didn't happen. If it does slow down your hairloss then that makes it worthwhile. It can take a few months to see any difference, but six months to a year to see a real difference. It's a treatment that requires patience.

 

It is true that if you stop taking Fin, you'll lose the benefits.