Need Help - What is my pattern and shall I get HT#2

[sadhairlossman]

Hi all,

 

At 25, I got an HT#1 3200 grafts (7000 hairs) @ Ron Shapiro 10 years ago. The goal was to give me coverage and place grafts all over in anticipation of further recession such that I will have a thinning look but decent coverage. The results were great however despite fin/rogaine the recession continued. Also, crown/top receded quite a bit. Today, I am in need of more hair again. What patter am I? 6 or 7?

 

I still can pull a decent look by creatively wearing my hair. I need advice if at 35 I should go for another HT and if so how many grafts and what game plan. The next post has pics from 10 years ago,

 

Attached are latest pics

Edited October 23, 2017 by sadhairlossman

[sadhairlossman]

10 years old pre- post- pics

 

First pic is ugly duckling phase. Next are 6 months post op and then 2 years out. Then Pre op and post op pics

[sadhairlossman]

bump, any ideas friends?

[sadhairlossman]

i guess we only care to see success stories... where the love?

[Gasthoerer]

Your pics are poor, bur from what I see: Your donor Looks fine and yes, another transplant would help.

[Steeeve]

Which procedure did you undergo? FUE or FUT? From your pictures it’s hard to tell what your donor looks like, however, if you really want to know if you’re still a candidate (and I don’t know why you wouldn’t be) you should go consult with a doctor or two (or three or four ) if I were in your shoes, though, it would be time to go for another pass.

[Shera]

Hi Sadhairlossman,

 

To summarise, you had a HT 10 years ago of 3200 grafts to rebuild your hairline and provide coverage to your mid-scalp. At this point I will assume you went for a strip FUT surgery.

 

The surgery was successful and now 10 years on your native hair has continued to recede and and only the previously transplanted hair is now providing coverage to your front hairline and mid scalp. Furthermore your crown area has also thinned out over this same time period.

 

Judging from the quality of the photos you have provided I would guess that your donor area is very good. I would also guess that you have adequate grafts that can be taken from your beard and chest if need be. Clear pics of these areas would be useful in a consultation.

 

So bearing the above in mind, I would go for another pass across your hairline and temple points (if required, photos are not clear?) mid-scalp and your crown area. At 35 years old I would go for approximately 3500 scalp grafts and possibly 1000 body grafts. I don't think you will need to address the hairline and mid-scalp again but you may need a further top up in the crown area if you continue to recede here.

 

I hope that's useful for you, feel free to contact me if you need me to be more precise.

[Spanker]

Your donor looks good in the very fuzzy pics. If that a true, I agree. 3500 grafts in your frontal half area. That would make a huge difference. Also, you need to shorten your sides IMO. It will make your hair on top appear to have more volume.

[sadhairlossman]

Thank yiu gentleman. Attached are pics of the donor area where the scar is at different lengths. Pics have been taken in the past 4 months with shorter and now longer hair.

 

I would appreciate if you can comment on the donor situation based on these non fuzzy (hopefully) pics

[sadhairlossman]

Thank you sir. I do have an abundant and solid source of body hair supply. Do you think bidy hairs add good volume and successfully grow on scalp?

Hi Sadhairlossman,

 

To summarise, you had a HT 10 years ago of 3200 grafts to rebuild your hairline and provide coverage to your mid-scalp. At this point I will assume you went for a strip FUT surgery.

 

The surgery was successful and now 10 years on your native hair has continued to recede and and only the previously transplanted hair is now providing coverage to your front hairline and mid scalp. Furthermore your crown area has also thinned out over this same time period.

 

Judging from the quality of the photos you have provided I would guess that your donor area is very good. I would also guess that you have adequate grafts that can be taken from your beard and chest if need be. Clear pics of these areas would be useful in a consultation.

 

So bearing the above in mind, I would go for another pass across your hairline and temple points (if required, photos are not clear?) mid-scalp and your crown area. At 35 years old I would go for approximately 3500 scalp grafts and possibly 1000 body grafts. I don't think you will need to address the hairline and mid-scalp again but you may need a further top up in the crown area if you continue to recede here.

 

I hope that's useful for you, feel free to contact me if you need me to be more precise.

[sadhairlossman]

Thank you sir. I began thinking about HT#2 a few months ago and was worried about my donor. I am not sure how to determine if my donor is good or bad hence I left it grow and monitor if the sides and back grow and look as full as they did years ago.

 

For the other posters above, I had a FUT as FUE was in infancy stage at the time and I was okay with strip.

 

Your donor looks good in the very fuzzy pics. If that a true, I agree. 3500 grafts in your frontal half area. That would make a huge difference. Also, you need to shorten your sides IMO. It will make your hair on top appear to have more volume.

[Steeeve]

Agree with everyone above. Your donor looks good. One or two more passes on that scalp of yours and you’re golden.

[sadhairlossman]

Agree with everyone above. Your donor looks good. One or two more passes on that scalp of yours and you’re golden.

 

Thanks! Do you guys recommend fur or fut given that I need quite a bit? I have spoken to a couple of docs and just like Shera pointed out they recommend 3500-4500 l. Some suggest a hybrid if fut+Fue and some suggest fue only or fue and body hair. Is there a disadvantage if I go fue only from yield requirement standpoint?

[mattj]

Firstly, (as you probably already know) it is very common for patients to seek a second procedure. Some go on to have even more transplants if necessary.

So you aren't in a rare place for thinking about round 2.

 

Your donor looks good and the average person's donor will have more total available grafts than you've already had transplanted, so I see no reason to doubt that you have the donor availability.

 

Since you've already had FUT and have quite a large area to cover, I think you're best bet is to have FUT again. You would still have FUE available as an option afterwards, as well of course as body hair. I do really think that body hair is best left as a last option, after scalp donor has been maxed out.

[Shera]

Thank you sir. I do have an abundant and solid source of body hair supply. Do you think bidy hairs add good volume and successfully grow on scalp?

 

Body grafts are usually used in tandem with scalp grafts in a 5:1 or 4:1 ratio if scalp grafts are insufficient to cover a larger area. Body graft are more likely to have just a single hair unlike scalp hairs that can have upto 5 with the average being about 2.2.

 

Body grafts are more expensive because of the additional skill and resource needed to extract them. Some patients who have very limited scalp donor supply have gone on to have great aesthetic results utilising mainly body hair. The beard (under chin shadow area) and the mid chest have been proven to give the best result.

 

In your case judging from the clearer pics of your donor, it will not be a necessity, more an additional option.

[sadhairlossman]

Firstly, (as you probably already know) it is very common for patients to seek a second procedure. Some go on to have even more transplants if necessary.

So you aren't in a rare place for thinking about round 2.

 

Your donor looks good and the average person's donor will have more total available grafts than you've already had transplanted, so I see no reason to doubt that you have the donor availability.

 

Since you've already had FUT and have quite a large area to cover, I think you're best bet is to have FUT again. You would still have FUE available as an option afterwards, as well of course as body hair. I do really think that body hair is best left as a last option, after scalp donor has been maxed out.

 

If I go for FUE and a FUT later, does that have an impact on the yeild from FUT as the strip wouldve been depleted a bit already.

[sadhairlossman]

Body grafts are usually used in tandem with scalp grafts in a 5:1 or 4:1 ratio if scalp grafts are insufficient to cover a larger area. Body graft are more likely to have just a single hair unlike scalp hairs that can have upto 5 with the average being about 2.2.

 

Body grafts are more expensive because of the additional skill and resource needed to extract them. Some patients who have very limited scalp donor supply have gone on to have great aesthetic results utilising mainly body hair. The beard (under chin shadow area) and the mid chest have been proven to give the best result.

 

In your case judging from the clearer pics of your donor, it will not be a necessity, more an additional option.

 

Thanks Shera. Do you think going FUE is a better approach? It took me 10 years to feel my scalp. I do want more yield/coverage/grafts hence open to FUT however would love to skip it if possible. Any thoughts?

[mattj]

If I go for FUE and a FUT later, does that have an impact on the yeild from FUT as the strip wouldve been depleted a bit already.

 

The total number of grafts from the strip would be lower if you have FUE first, but the FUE extractions would be taken from right across the donor area and many of them will be outside of where the strip is taken from.

[Shera]

Thanks Shera. Do you think going FUE is a better approach? It took me 10 years to feel my scalp. I do want more yield/coverage/grafts hence open to FUT however would love to skip it if possible. Any thoughts?

 

If it took 10 years for you to feel your scalp after your previous FUT then I would personally opt for FUE. In your case you have more than enough grafts available for a 3500+ FUE procedure and you will have enough banked for future smaller procedures.

 

In the hands of a highly skilled and experienced surgeon, without getting into a debate, I believe the yield between FUT and FUE is very small if any at all. That's my opinion gained from my own result and the results of the many patient journeys I have managed.

[sadhairlossman]

If it took 10 years for you to feel your scalp after your previous FUT then I would personally opt for FUE. In your case you have more than enough grafts available for a 3500+ FUE procedure and you will have enough banked for future smaller procedures.

 

In the hands of a highly skilled and experienced surgeon, without getting into a debate, I believe the yield between FUT and FUE is very small if any at all. That's my opinion gained from my own result and the results of the many patient journeys I have managed.

 

Thank you Lion/Tiger/Shera!