What procedure should I have?

[dio88]

I'm 29, aggressive hair loss, started around 21. Father's side grandfather is NW7, father is NW5. I do like to wear my hair short, not like military grade, I really don't know what clip, I'll ask my hair-cutter next time! I would want to create something reasonable, mature, but also make it look like I don't necessarily need another HT. So a moderate/reasonable hairline and fill in the temples a little bit. My primary focus would be to work on the frontal 2/3rd and work on the crown in the future. Obviously, ideal would be to touch upon everywhere, but trying to stay realistic.

 

I'm not on fin or rogaine. Fin made me feel very lethargic and depressed. Doctor said this isn't normal, but once I stopped days later I was fine.

 

Open to suggestions. Based on the east coast but willing to travel wherever in the world.

[Sean]

Honestly, key word is aggressive. I would hold off and see how it looks st 35. You do not want to chase repairs or hairloss. I am on the receiving end and I can tell you i am close to being destroyed if the screw ups are not addressed. I am so sick of suffering alll these years. If only my procedures were done correctly and under expertise from the start. Wrong surgical protocols can lead to disaster.

[Shera]

I'm 29, aggressive hair loss, started around 21. Father's side grandfather is NW7, father is NW5. I do like to wear my hair short, not like military grade, I really don't know what clip, I'll ask my hair-cutter next time! I would want to create something reasonable, mature, but also make it look like I don't necessarily need another HT. So a moderate/reasonable hairline and fill in the temples a little bit. My primary focus would be to work on the frontal 2/3rd and work on the crown in the future. Obviously, ideal would be to touch upon everywhere, but trying to stay realistic.

 

I'm not on fin or rogaine. Fin made me feel very lethargic and depressed. Doctor said this isn't normal, but once I stopped days later I was fine.

 

Open to suggestions. Based on the east coast but willing to travel wherever in the world.

 

Hi Dio88,

 

It would be useful to have clear pics of your donor area at the back of your head to allow for a more accurate assessment.

[dio88]

Hi Dio88,

 

It would be useful to have clear pics of your donor area at the back of your head to allow for a more accurate assessment.

 

Hey I attached it. I never had a procedure done. That weird line is because I was wearing a hat right before taking the pictures.

[dio88]

Honestly, key word is aggressive. I would hold off and see how it looks st 35. You do not want to chase repairs or hairloss. I am on the receiving end and I can tell you i am close to being destroyed if the screw ups are not addressed. I am so sick of suffering alll these years. If only my procedures were done correctly and under expertise from the start. Wrong surgical protocols can lead to disaster.

 

I understand your concerns but closing 30 in a few months and I no longer have the ability to style it.

 

What was your hair transplant journey like? When did you do it? Where? What procedures/grafts? Maybe it's more about being conservative at the start and planning well?

 

I am hesitant to do FUT but it seems most say it's the way to go with aggressive hair loss.

[dio88]

Honestly, key word is aggressive. I would hold off and see how it looks st 35. You do not want to chase repairs or hairloss. I am on the receiving end and I can tell you i am close to being destroyed if the screw ups are not addressed. I am so sick of suffering alll these years. If only my procedures were done correctly and under expertise from the start. Wrong surgical protocols can lead to disaster.

 

I understand your concerns but closing 30 in a few months and I no longer have the ability to style it.

 

What was your hair transplant journey like? When did you do it? Where? What procedures/grafts? Maybe it's more about being conservative at the start and planning well?

 

I am hesitant to do FUT but it seems most say it's the way to go with aggressive hair loss. I do not want a scar that's visible. I know FUE isn't technically scarless but I've seen in person individuals who have done 4,000+ FUE procedure and can barely tell, even when they're shaved down pretty short.

[Shera]

Hey I attached it. I never had a procedure done. That weird line is because I was wearing a hat right before taking the pictures.

 

Hi Dio88,

 

I would say your donor area is good to go for FUE if you are concerned about the scar with FUT. There are countless examples on this website alone of good FUE results from a decent donor similar to your own.

 

Saying that, it would be good if you could perhaps give Finasteride another go, you do stand to lose more native hair judging from your family history and Finasteride is perhaps the only solution to delay this.

 

If you were to go for FUE surgery then I would recommend 3500 to 4000+ grafts to restore your hairline (mature, no lowering), slight fill to your temple points, fill in your temple areas and a light scattering on your crown with whats left.

Your mid 'tuft' area is still strong so I would leave this area alone, that's a big bonus.

 

Wait a year or so to see how this turns out and either accept the change or go for another pass to increase the density.

 

To conclude, in my opinion you are a candidate for FUE but due to your extensive balding you will most probably need more than one surgery. You are likely to get just one decent shot at this, so choose your surgeon carefully.

 

Please find below some rough estimate pics showing the proposed areas of graft placement.

 

As for delaying it for another 5 years, you are nearly 30 now and in your prime. If you are unhappy with the way you look now, do you really want to sustain this unhappiness for another 5 years or do you wish to address it and move on. I know which option I would choose.

 

I hope that helps you, I wish you all the best.

[dio88]

Hi Dio88,

 

I would say your donor area is good to go for FUE if you are concerned about the scar with FUT. There are countless examples on this website alone of good FUE results from a decent donor similar to your own.

 

Saying that, it would be good if you could perhaps give Finasteride another go, you do stand to lose more native hair judging from your family history and Finasteride is perhaps the only solution to delay this.

 

If you were to go for FUE surgery then I would recommend 3500 to 4000+ grafts to restore your hairline (mature, no lowering), slight fill to your temple points, fill in your temple areas and a light scattering on your crown with whats left.

Your mid 'tuft' area is still strong so I would leave this area alone, that's a big bonus.

 

Wait a year or so to see how this turns out and either accept the change or go for another pass to increase the density.

 

To conclude, in my opinion you are a candidate for FUE but due to your extensive balding you will most probably need more than one surgery. You are likely to get just one decent shot at this, so choose your surgeon carefully.

 

Please find below some rough estimate pics showing the proposed areas of graft placement.

 

As for delaying it for another 5 years, you are nearly 30 now and in your prime. If you are unhappy with the way you look now, do you really want to sustain this unhappiness for another 5 years or do you wish to address it and move on. I know which option I would choose.

 

I hope that helps you, I wish you all the best.

 

Thank you for this. I appreciate the detailed response and images. Another reputable clinic advised that they would do the first FUE procedure at 2500-3000 grafts and do the frontal 1/3. Then the second surgery they will try to harvest around 2500 grafts to add density in the mid-scalp and the frontal crown.

 

Is there a reason they are capping their graft amount on the first FUE to 2500-3000 and not pushing to 4,000? Is there more of a risk @ 4,000 grafts?

 

Also, should I have posted this in another section of the forum? I was hoping to get more feedback.

 

EDIT: Also, I'm going to start taking half the dose of finasteride and start out @ 3x a week for now and start going full dose 3x a week (1.25mg).

[Shera]

Thank you for this. I appreciate the detailed response and images. Another reputable clinic advised that they would do the first FUE procedure at 2500-3000 grafts and do the frontal 1/3. Then the second surgery they will try to harvest around 2500 grafts to add density in the mid-scalp and the frontal crown.

 

Is there a reason they are capping their graft amount on the first FUE to 2500-3000 and not pushing to 4,000? Is there more of a risk @ 4,000 grafts?

 

Also, should I have posted this in another section of the forum? I was hoping to get more feedback.

 

EDIT: Also, I'm going to start taking half the dose of finasteride and start out @ 3x a week for now and start going full dose 3x a week (1.25mg).

 

The plan offered to you is good. There is always the risk of over harvesting when large numbers of FUE grafts are extracted, it really depends on the skill and experience of the surgeon along with the patient donor. The last thing you need is to damage existing remaining grafts in your donor by over exuberance. As well as damaging grafts, if the holes are punched too close together there is the added risk of them joining up thus creating one big hole increasing the risk of scarring. 4000 or thereabouts is generally the limit if the donor is good. This can be more accurately assessed in person.

 

Its good that you are giving Finasteride another chance, your approach sound like a plan.