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Ponytail or Man Bun post hair transplant. Need Advice (Pics)


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Hello all,

My name is Rich and i'm a long time reader, first time poster. Apologies if this is in the wrong area.

 

I am looking for advice for my current hair situation. Up until last year I had long hair, it was good quality and I loved it but always knew my hairline was receding. I covered this up by using hair concealer to spray the receded area dark brown and used microfibres to thicken the fringe that was there.

I then had to cut my hair for a new job in the Middle East. Biggest regret of my life, however it has given the financial chance to sort out my hair transplant.

 

My situation:

I leave my job next year so will not be cutting my hair for the next 15 months - Long hair is all I want (I am looking for the 'Jared Leto at the Oscars' look). For that reason I am looking for Doctors who will fix my hairline but will not require me to fully shave my head. Either a 'patchy FUE' or 'recipient unshaven FUE' are my options and I have done some research. My donor area and crown are still strong for now.

 

I would just like any messages from people who have had unshaven FUE and their experiences, or anyone who has grown their hair long into a ponytail or bun after a Hair Transplant.

 

I have been given a quote of 1500 - 1800 by Bisanga in Belgium and am waiting on a response from Lupanzula (Belgium). The latter one if my preference because he does all the work himself and explicitly states how he uses only 1 hair grafts for the first two rows of the hairline to achieve a natural look. Also I am aiming for only a strip of hair to be taken away and I have read that a strip can only harvest 1500 grafts before you need to shave the whole donor area. Does this sound correct.

I did contact Feriduni but have not heard a response yet (he has been rated highly in terms of hairline)

I also contacted Kesser (The surgeon who does the placements in to recipient area over the course of a few days to minimise shock loss) and Dr Mwamba as he seems to be known for Unshaven procedures.

Are there any other doctors (Outside of America) that I should be considering?

 

A few of my concerns:

 

Shock loss - I am not on any medication for hair loss and refuse to even consider finasteride due to side effects. I am a naturally nervous person so I would probably imagine side effects that weren't even there. How likely is it that I will lose the remaining fringe that I have left?

 

Hairline - Does it need lowering at all? In my opinion to keep a natural look and because I wont be spiking it up or anything, the hairline doesn't really need to be lowered, but I have never had to design my own hairline and would love other people's input.

Also how easy is it to strengthen/thicken/add density to the small bit of fringe I still have without shaving it?

 

Expectations - I am not looking for the worlds thickest fringe. Like I said I went three years covering my hairline with products so all I am looking for is enough hair so that I can pull it in to a bun with confidence. Does the 1500 - 1800 estimate seem realistic? Erdogan quoted me 2800 - 3200 but ive heard he is known for dense packing which is not what I want.

 

Traction - Would implanted hair be as strong as normal hair? If left to grow for a year and then swept backwards in to a ponytail or bun will grafted hair respond the same way to this traction or would it be pulled out easier?

 

Concealer Products - What is the long term effect of some of these products such as Toppik. They seem to be safe enough but I assume putting too much of anything on your hair can weaken it?

 

Thank you to anyone who has taken their time to read all of this.

Is there anything else I should be considering for this decision?

 

Rich

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I would consider a more stylish, shorter haircut. I honestly think it would look better.

 

Toppik is perfectly safe to use.

 

With a bun pulled back, you are also risking traction alopecia.

 

I would cultivate your own style, instead of trying to be Jared Leto.....

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Ok the man bun part isn't necessary, but I do have my heart set on regrowing my hair.

 

I feel there are a lot of benefits to just wearing it down also as it would hide any possible scarring at the back in my donor area.

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I can't take a pill that effects my hormones for the next 40/50 years of my life.

In my late 20s/30s im not prepared to risk the sexual side effects.

 

So you want hair like Jared Leto's, but aren't prepared to take a drug that costs under $100 a year for which only 2-5% have any experience with side effects? Your hair will almost definitely progress at least to a Norwood 5 level, a 1500 graft transplant isn't going to age well without finasteride. Typically if you go past a mildly receded mature hairline and have visible miniaturisation at the front you will lose everything on top.

 

Honestly you have fairly extensive frontal balding, in my opinion anything under 2000 grafts is unrealistic unless you have extremely conservative expectations, which by the sounds of things you don't.

 

So what should you do? If you're interested in maintaining healthy looking hair in the medium and long term, then finasteride is a must, and far more worthwhile than a transplant. In fact don't even consider a transplant if you're not prepared to get on finasteride. If you do get on the fina, realistically 1500 grafts for a hairline in front of a drastically thinning and receded forelock isn't going to do a whole lot, for coverage and density comparable to what you reference you're looking to at least 2500 grafts, and the Erdogan quote sounds more realistic. Keser does the best hairline work of any of the surgeons you mentioned in my opinion.

 

Quite frankly the 1500 graft quoted from Bisanga seems downright idiotic considering you're not even on finasteride. You'd likely look worse by the time the transplant grew grew from further loss. For a believable hairline I think you would need to lower the centre very slightly at least. The traction issue would likely be the same as for regular hair, although its typically considered to be problematic in general and could lead to more hairloss issues. The required density and perfection in design to get away with a transplant man bun on top of the potential traction hairloss issue makes this goal unrealistic.

 

But if there's one thing to take away, it's that you should reconsider your thoughts on medication. I think that when you lose your hairline completely and look five to ten years older as a man who is virtually bald in a few years you would regret not risking the very low chance of side effects.

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I don't think my goals are too high - I of course know that I would never be able to achieve that level of coverage, it was mainly just a nod to the style I was hoping for including the use of concealer and fibres.

 

JeanLDD - from looking at your story you had the same reservations as me before starting finasteride - what was it ultimately that made you take the plunge and start treatment?

I think for me the scare stories are very high on these forums (I understand people advertise the scare stories far more than the success stories). It's also the fear that I could suddenly develop side effects 4 or 5 years down the line and then lose all the hard work if I discontinued use. Do you not have any fears yourself about the long term use of the drug?

 

I am working in the Middle East and don't really have the greatest belief in their medical systems to deal with sexual side effects of finasteride with being in a reserved country. I would not trust them to prescribe finasteride to me here as I know they have more lax rules on medications and drugs and this could possibly exacerbate the chance of suffering from side effects. Can you purchase 8 - 10 weeks worth of finasteride at once?

 

Im assuming I already know the answer to this but I guess beginning a course of minoxidil, nizoral and periodic PRP therapy would not be enough to secure a transplant?

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I would suggest trying fin. If you can tolerate it, then it will help you long term and in the event of a transplant. If you can't tolerate it, or don't want to try it, i would go for 2000-2500 grafts and a reasonably conservative hairline. There is no certainty at how your hair loss will progress, so it's a chance you'll have to take.

 

Just my 2 cents worth, but nothing looks sadder, than a man who is balding and trying to grow their hair long, or having it in a ponytail.......:o:o

 

A short, stylish cut, with enhance the hair you have and make you look younger. You look like you have the face shape to carry a shorter cut.

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You can get 2500 graft from Strip easily without any other shaving. If you are a long hair guy this is optimal and should be your 1st choice.

I'm serious.  Just look at my face.

 

My Hair Regimen: Lather, Rinse, Repeat.

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A balding friend of mine tried to keep his long hair intact with transplants and no meds. Now it looks much, much worse than if he had just cut it short in the first place. He has come to the realization that: a) he should have gone on fin a long time ago; b) transplants with aggressive hairloss and no meds is a disaster in the waiting.

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OP,

 

I think a HT can definitely improve your frontal area, however you need to have realistic expectations about grafts and have your hair loss under control. I would listen to the advice of Jean and others who are telling you to at least give Fin a shot. You will continue to lose hair and those native hairs behind the potentially transplanted area will begin to recede further. It will not look good. I’ve been through 3 HT’s so this is coming from personal experience.

HT#1 - Dr. Rahal (Jan 2012) - 4700 grafts

HT#2 - Dr. Rahal (Jan 2014) - 1800 grafts

HT#3 - Dr. Konior (Jan 2018) - 1200 grafts

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Hi Rich,

 

As previously mentioned, you are risking traction Alopecia if you tie your hair back too tight. A looser tie should be OK though.

 

Any possible scarring post surgery will be hidden by a grade 2-3 FUE (grade 3-5 FUT depending on resulting linear scar), there is no need for you to grow your hair long to hide possible scarring.

 

Finasteride is proven to help one maintain their existing native hair. I understand your concerns but there is the option of taking a lower dose with less frequency. Or you could stop and start as others do, at the same time monitoring for any noticeable changes. You can purchase a year or two supply of Finasteride if you wish, there are no travel restrictions in taking the drug to the middle east.

 

Saying that I think 2200-2500 grafts will be required to restore your hairline and filling in your temple areas. This should give you the result you are hoping for. You may need to still use the concealer you have mentioned to finish of your Hollywood look.

 

You need to be conservative with your available grafts. At 29/30 year of age, you will most probably need another 1 or 2 more procedures further down the line as you continue to lose your native hair. Again, the use of Finasteride will theoretically delay this.

 

Looks like you've got some thinking to do.

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I don't think my goals are too high - I of course know that I would never be able to achieve that level of coverage, it was mainly just a nod to the style I was hoping for including the use of concealer and fibres.

 

JeanLDD - from looking at your story you had the same reservations as me before starting finasteride - what was it ultimately that made you take the plunge and start treatment?

I think for me the scare stories are very high on these forums (I understand people advertise the scare stories far more than the success stories). It's also the fear that I could suddenly develop side effects 4 or 5 years down the line and then lose all the hard work if I discontinued use. Do you not have any fears yourself about the long term use of the drug?

 

I am working in the Middle East and don't really have the greatest belief in their medical systems to deal with sexual side effects of finasteride with being in a reserved country. I would not trust them to prescribe finasteride to me here as I know they have more lax rules on medications and drugs and this could possibly exacerbate the chance of suffering from side effects. Can you purchase 8 - 10 weeks worth of finasteride at once?

 

Im assuming I already know the answer to this but I guess beginning a course of minoxidil, nizoral and periodic PRP therapy would not be enough to secure a transplant?

 

PRP is proven to aid in healing but I've yet to see genuine evidence it does anything at all in preventing hairloss issues on its own, minox studies usually show it keeping you above baseline for around 2-3 years at which point loss will continue in a linear fashion, it doesn't stop the causal issue like finasteride. Nizoral is worthwhile as an adjunct treatment with fin but on its own is unlikely to help much.

 

" from looking at your story you had the same reservations as me before starting finasteride - what was it ultimately that made you take the plunge and start treatment?"

 

 

Consider also that I was 21 at the time, there was a while I still thought maybe it would stop at just a receded hairline, but at the point where there was clear diffusing throughout the whole scalp and a major thin patch in the crown (which filled in mostly after I got on fin) I realised I would genuinely be completely bald by the time I was 23 at the rate I was losing hair. I can tell you've not come to that realisation yet, but the fact is you will go completely bald, and when it hits you you're likely to do so I think you'll do a complete 180 on the drug like I did.

 

The other thing that came to mind was that the scaremongers telling you to never try finasteride are all completely bald or going to lose their hair, while those on finasteride are likely to halt their hairloss issues for close to a decade in most cases. An army of unattractive, angry bald men afraid to deal with their problems, vs the people who took the plunge on a drug with a 2-5% chance of short term side effects, and a thousand or so globally with permanent issues out of millions of users. I took the plunge in part because quite frankly I think the former group are pathetic and didn't want to be that kind of person, and knew the latter was being more logical. Small chance of sides vs guarantee of going bald. Hmm.

 

 

"Do you not have any fears yourself about the long term use of the drug?"

 

No, because I haven't seen any viable evidence that they can occur through long term use of the drug if they didn't happen at all in the short term. There seem to be too many cases to ignore where people who have used the drug for years stop cold turkey for whatever reason and have major endoctrine system issues from doing getting off it after long term use, but I have no plans to ever get off it.

 

Also again it's back to the issue I put forth above, in terms of probabilities I have reason to be far more scared of going bald (which is guaranteed if I get off fin) than I am of risking finasteride sides.

 

On your issue of not trusting the medical system, I would just use brand name propecia. Personally I quarter 1mg propecia pills.

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I agree with Vox. I’m not sure why you aren’t going Fut since you plan to wear your hair longer in the back.

 

Even if one does not grow 'Rock and Roll' style long hair, a person with a 'normal' type style should have little to no concerns about a scar.

 

I know the military shaves and faded sides and backs are popular but even though, it's a consideration about maximizing grafts and achieving possible results.

I'm serious.  Just look at my face.

 

My Hair Regimen: Lather, Rinse, Repeat.

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