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Shifty

Advice por favor: Type of procedure and how many grafts

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I have a appt with Diep next year. really not sure if I should go FUT or FUE.

 

42 yrs old -  hair loss happened really fast (between ages 39 and 41) no longer losing hair  - good skin laxity as far as I can tell - decent donor

 

I started taking fin along with minox a month ago. started using derma roller 2 weeks ago. I have been taking vitamins of all kinds for years. I do see small hairs growing near the temples where there wasn't any before so I am holding out hope things change a little for the better in the frontal and on top over the next few months with this regimen.

 

Dr. Diep stated 2500 FUE was what we are looking at with the possibility of more.

Do you guys think its possible to get decent coverage with 2500 (hopefully more he said he might be able to get up to 3500 depending on donor) FUE both front and top? Not to hot on the idea of FUT but also not to hot on the idea of more than 1 surgery, both are clearly on the table. I also have always kept my hair buzzed on sides and back. I want to keep the age appropriate hair line, I've always had the Eddie Munster "V".

 

Thanks for the info, just preparing myself mentally for fue or fut.

 

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What technique to use will depend on you and the hair styling choices you consider once there is more hair.  The way I see it, if you are doing transplants is because you want to let the hair grow.  If that's the case, FUT.  It is less expensive, the grafts are more robust. But, most important, is the fact that you have access to the entire donor area.  You may be able to do more FUT procedures until you run out of elasticity.  You can then move to FUE, (and can place grafts on the scar to help camouflage).

You seem to have kept a decent bridge,  Seems the forelock is intact but you are starting to thin in the area right behind it, based on the photo you posted.  Make sure the doctors blends grafts through that area to avoid an unnatural looking pattern should you go on and lose the native hair.

It is imperative you get on medical therapy, (Propecia, Rogaine, laser and PRP).  Avoid transplants to the crown until you are happy in the front and middle.  If you look at the way most patients lose their hair, with a pattern similar to your own, you will note that the crown is the weakest area.  That's because it is spherical unlike the front and top where all the hair grows forward and shingles.

Unfortunately you did not post photos of the back, (donor area).  Not sure how far down you are dipping.  \

Eventually, depending on the outcome, you could consider SMP.

 

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13 minutes ago, LaserCap said:

What technique to use will depend on you and the hair styling choices you consider once there is more hair.  The way I see it, if you are doing transplants is because you want to let the hair grow.  If that's the case, FUT.  It is less expensive, the grafts are more robust. But, most important, is the fact that you have access to the entire donor area.  You may be able to do more FUT procedures until you run out of elasticity.  You can then move to FUE, (and can place grafts on the scar to help camouflage).

You seem to have kept a decent bridge,  Seems the forelock is intact but you are starting to thin in the area right behind it, based on the photo you posted.  Make sure the doctors blends grafts through that area to avoid an unnatural looking pattern should you go on and lose the native hair.

It is imperative you get on medical therapy, (Propecia, Rogaine, laser and PRP).  Avoid transplants to the crown until you are happy in the front and middle.  If you look at the way most patients lose their hair, with a pattern similar to your own, you will note that the crown is the weakest area.  That's because it is spherical unlike the front and top where all the hair grows forward and shingles.

Unfortunately you did not post photos of the back, (donor area).  Not sure how far down you are dipping.  \

Eventually, depending on the outcome, you could consider SMP.

 

I stopped losing hair,  so I do not think any more will fall out unless the transplant makes it via shock loss. As far as hair loss goes I have that going for me lol. 

The back doesn't go down much at all if any. basically what you see here is all the areas needing work.

I do use laser, minoxidil and finesteride as I stated, even though I stopped losing hair.

In regards to FUT, I like to fade my sides and back, pretty sure I would be losing that ability if I did an FUT just weighting that give and take in my head.

The crown is what aggravates me the most. Which sucks because everyone says do they front first.....I don't think  I would ever do SMP.

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The front is patchy and trust me that’s way more important than the back. I would say you need around 4K-5k grafts. Best way to maximize your donor is to do FUT first then FUE. You can have the strip slightly higher on the occipital ridge, which would allow you to do a low fade. Also, that amount is for both the front and back.


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @hairtransplantnetwork1 FacebookPintrest, Linkedin and YouTube.

 

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Do you guys think its possible to get decent coverage with 2500  (hopefully more he said he might be able to get up to 3500

Hey Shifty... this depends. Can you post some pics of the type of result you're after. "Decent coverage" is open to interpretation. I can give some feedback then. 

 

 

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22 hours ago, Melvin-Moderator said:

The front is patchy and trust me that’s way more important than the back. I would say you need around 4K-5k grafts. Best way to maximize your donor is to do FUT first then FUE. You can have the strip slightly higher on the occipital ridge, which would allow you to do a low fade. Also, that amount is for both the front and back.

Ive been looking at before and afters recently like its my job lol I just dont see what I'm needing as being 5k. I am thinking more like 3500. Unless you are saying for beautiful full results not just great results 5k is needed?

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1 hour ago, Shifty said:

Ive been looking at before and afters recently like its my job lol I just dont see what I'm needing as being 5k. I am thinking more like 3500. Unless you are saying for beautiful full results not just great results 5k is needed?

2,500 for the front and at least 2,500 for the crown, remember the crown requires almost double the amount of grafts as the front to achieve visible density, this is why the crown is referred to as a “black hole” for grafts.


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @hairtransplantnetwork1 FacebookPintrest, Linkedin and YouTube.

 

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Hey Shifty, 

3200 - 3500 will cover half your head...but not the crown. You will need another 2000 for the crown and it's still going to be thin. Maybe look into smp. What concerns me if your hair loss pattern. Your sides are starting to thin And when they go...you're in trouble.

If you're aggressive with meds to slow/stop things...and understand you will need 2 additional procedures minimum, you should be able to achieve the hairline you're after...maybe a little more recession (depending on your temple points).

Great you're on fin...and derma roller...I assume rogaine with the roller? Vitamins are great for hair health only. Won't help slow things. 

Bottom line... you can achieve what you're after man. But it's going to be a lifestyle change. If you take the leap...look at every angle. Especially with your pattern. It's not a one-shot deal. 

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On 10/30/2018 at 2:31 PM, Shifty said:

I stopped losing hair,  so I do not think any more will fall out unless the transplant makes it via shock loss. As far as hair loss goes I have that going for me lol. 

You seem pretty confident that your hair loss has stopped, yet you’re only 42 and lost most of the hair between ages 39 and 41. Are you sure it’s stopped and not just paused? Is that what Diep said? Or maybe you’re basing it on family history?

It’s really important that you have a reasonable and realistic picture of where you are likely to end up before you start down the HT journey. Surprises down the road can be disastrous. 

Edited by Spaceman

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@Spaceman No one in my immediate family has hair loss like me. I am very confident it has stopped. I would run my hand though my hair and it would fall out all over the place. A doctor I visited told me it was strange how fast it was falling out. It was weird maybe it was stress related? Either way. Nothing falls out now thank God. 

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I am very confident it has stopped.

@Shifty That's my point man...It has not stopped. The only time it will stop is when you're 6-feet under :) Though It "should" slow as you age. Bottom line...you have an aggressive pattern. Most guys with your ethnic ethic background end up a class 4-5. But you're showing signs of a class 6...so the only thing we don't know is how bad it's going to get.

What triggered the shitty gene...could be stress...who knows. But you're in a war man...and the only way to win the war is a combo of meds/ht...a ht will just win the battle...but you will lose the war down the road. And then you're screwed. Make sense?

Just want to make sure you're going into this with all the info...so you can make the right decision. You can do this...but it's a life long commitment. 

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26 minutes ago, HairLossMentor said:

@Shifty That's my point man...It has not stopped. The only time it will stop is when you're 6-feet under :) Though It "should" slow as you age. Bottom line...you have an aggressive pattern. Most guys with your ethnic ethic background end up a class 4-5. But you're showing signs of a class 6...so the only thing we don't know is how bad it's going to get.

What triggered the shitty gene...could be stress...who knows. But you're in a war man...and the only way to win the war is a combo of meds/ht...a ht will just win the battle...but you will lose the war down the road. And then you're screwed. Make sense?

Just want to make sure you're going into this with all the info...so you can make the right decision. You can do this...but it's a life long commitment. 

We can agree to disagree. I will even go a step further. I have been using the proper products one should before going through with an HT, and while only a little over a month, I have seen a change in thickness as well as notice small hairs sprouting where I thought none were. Will this end being a complete reversall, we both no it won't, but its a pretty hopefull start for me since I've never used finesteride for one. 

 

I stopped losing hair early last year (2017) so its not something I just started saying just because. I am going on 2 years with zero change of hair on my head. when i realized it stopped is when I decided to try a hair system which was a complete fail for me. I went for the consult in May 2017 had the system on October 2017. Took it off  forever this Sept and started fin and minox and booked my HT for July 2019. Mind you i could have gotten an HT with the money I spent on the system ? literally thousands. 

 

Now, I've seen quite a few amazing results with fin and minox so God willing (He clearly wasn't willing before the meds) things will look more in my favor come next summer. 

 

I think the one thing we can agree on its a shitty gene. ? 

 

I will win the war. 

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Shifty,

We need to see more angles and better quality pics to make a better assessment. I can tell you my loss looked exactly like yours at 35 and I got on meds. It slowed down considerably to where I didn’t see hairs on my pillow anymore. But at 45 on meds I am a classic Nw 5-6. From just the one pic, what you have on top looks like it will go  by the time you’re 50. Just be conservative.

Edited by Shmiggy

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14 hours ago, Shmiggy said:

Shifty,

We need to see more angles and better quality pics to make a better assessment. I can tell you my loss looked exactly like yours at 35 and I got on meds. It slowed down considerably to where I didn’t see hairs on my pillow anymore. But at 45 on meds I am a classic Nw 5-6. From just the one pic, what you have on top looks like it will go  by the time you’re 50. Just be conservative.

I haven't seen a hair on my pillow in 2 years, or even in the shower drain. When it was falling out I would be standing over the sink and see them in the sink.  =/ Honestly if I knew 2/3 years ago what I know now it might not have progressed so far, I JUST started taking Fin. Such is life.

 

I will get some better angles later tonight, the suggestions and replies are much appreciated.

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On 11/4/2018 at 8:18 PM, Shmiggy said:

Shifty,

We need to see more angles and better quality pics to make a better assessment. I can tell you my loss looked exactly like yours at 35 and I got on meds. It slowed down considerably to where I didn’t see hairs on my pillow anymore. But at 45 on meds I am a classic Nw 5-6. From just the one pic, what you have on top looks like it will go  by the time you’re 50. Just be conservative.

Here some photos. I am not looking for the full frontal assault of hairline some people ultimately get. I am OK with the receding look. I have always had the Eddie Munster even as a kid so it works with me. So in essence I just need the front angles touched up. From what I have seen, I believe  (more so hope) it will take less that 2500 to accomplish what I am looking for. As I stated before, the crown is more debilitating than anything for me. Everyone is different.

 

I mentioned this in a previous post, I had a terrible reaction to the glue they used in a system I had on. It basically burned the skin off my head. It felt uncomfortable on the way home, when I woke up my whole head was on fire and wet from the reaction to the glue. Some areas were effected pretty badly, the temples no longer had hair and I even think the patchy parts in the frontal are due to that as well. I am hoping the regimen I am on now with foams, meds and such help grow it all back. Looks promising so far as I can see little hairs in places I thought for sure were dead forever. Only time will tell.

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On 11/4/2018 at 8:01 AM, Shifty said:

We can agree to disagree. I will even go a step further. I have been using the proper products one should before going through with an HT, and while only a little over a month, I have seen a change in thickness as well as notice small hairs sprouting where I thought none were. Will this end being a complete reversall, we both no it won't, but its a pretty hopefull start for me since I've never used finesteride for one. 

 

I stopped losing hair early last year (2017) so its not something I just started saying just because. I am going on 2 years with zero change of hair on my head. when i realized it stopped is when I decided to try a hair system which was a complete fail for me. I went for the consult in May 2017 had the system on October 2017. Took it off  forever this Sept and started fin and minox and booked my HT for July 2019. Mind you i could have gotten an HT with the money I spent on the system ? literally thousands. 

 

Now, I've seen quite a few amazing results with fin and minox so God willing (He clearly wasn't willing before the meds) things will look more in my favor come next summer. 

 

I think the one thing we can agree on its a shitty gene. ? 

 

I will win the war. 

Definitely a shitty gene. 

 

That said, MPB is essentially always progressive. You’d be well served to plan accordingly imo. Agree with others’ suggestions to be conservative. 

 

Good luck. 

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On 11/3/2018 at 7:49 PM, Shifty said:

@Spaceman No one in my immediate family has hair loss like me. I am very confident it has stopped. I would run my hand though my hair and it would fall out all over the place. A doctor I visited told me it was strange how fast it was falling out. It was weird maybe it was stress related? Either way. Nothing falls out now thank God. 

I’m sorry, but going by immediate family is a risky proposition at best. Below is a picture of me (33) my father (61) and my brother (41).  

Mind you I’ve had 3 hair transplants with over 5k grafts and I regularly use minoxidil and nizoral. My brother and father use nothing with no procedures, if I were to use your logic I should’ve never gone as bald as I did (Norwood 6). Unfortunately, hair loss can skip generations, that’s how genetics work. That’s why two brown eyed parents can have a baby with blue or green eyes. 

898FF0C6-0A4F-4CE0-A081-2AD56100DA70.jpeg


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @hairtransplantnetwork1 FacebookPintrest, Linkedin and YouTube.

 

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8 hours ago, Melvin-Moderator said:

I’m sorry, but going by immediate family is a risky proposition at best. Below is a picture of me (33) my father (61) and my brother (41).  

Mind you I’ve had 3 hair transplants with over 5k grafts and I regularly use minoxidil and nizoral. My brother and father use nothing with no procedures, if I were to use your logic I should’ve never gone as bald as I did (Norwood 6). Unfortunately, hair loss can skip generations, that’s how genetics work. That’s why two brown eyed parents can have a baby with blue or green eyes. 

898FF0C6-0A4F-4CE0-A081-2AD56100DA70.jpeg

Yea it's a bummer both my brother's never lost their hair ,one older and one younger ,my father was a NW 5 by the age of 30 ,all his brothers never lost their hair, same for his father  ,on my mother's side her 2 brothers never got male pattern baldness OK their hair isn't as thick as it was when they were younger ,but it's just old age where most guys hair thin  to some degree. Point is   all the male members on my family pretty much kept their hair apart form my father and me   , ha I would have been really pissed off if  my father had a full head of hair   and I lost mine ,that's just insult to injury  . 

 

Edited by Mick50
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5 hours ago, Mick50 said:

Yea it's a bummer both my brother's never lost their hair ,one older and one younger ,my father was a NW 5 by the age of 30 ,all his brothers never lost their hair, same for his father  ,on my mother's side her 2 brothers never got male pattern baldness OK their hair isn't as thick as it was when they were younger ,but it's just old age where most guys hair thin  to some degree. Point is   all the male members on my family pretty much kept their hair apart form my father and me   , ha I would have been really pissed off if  my father had a full head of hair   and I lost mine ,that's just insult to injury  . 

 

Yea my friends used to joke that id never lose my hair cause of my dad too lol


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @hairtransplantnetwork1 FacebookPintrest, Linkedin and YouTube.

 

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17 hours ago, Melvin-Moderator said:

I’m sorry, but going by immediate family is a risky proposition at best. Below is a picture of me (33) my father (61) and my brother (41).  

Mind you I’ve had 3 hair transplants with over 5k grafts and I regularly use minoxidil and nizoral. My brother and father use nothing with no procedures, if I were to use your logic I should’ve never gone as bald as I did (Norwood 6). Unfortunately, hair loss can skip generations, that’s how genetics work. That’s why two brown eyed parents can have a baby with blue or green eyes. 

 

I'm not going by anything other than my hair is NOT falling out anymore. At peak hair loss I could shake my head and see 20 hairs fall out, every time I shook my head! I am only going through this process now because I believe it has subsided. Men in my family all recede, shit i've had a receding hairline since high school (its actually natural just got worse with age) but lucky me the crown went, the only one.

 

I'm done losing hair now I'm just trying to regrow anything left over before i get a HT to minimize grafts needed.

 

Quick Q: Whats Nizoral?

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Quick Q: Whats Nizoral?

Great stuff...and you only need to use 2x weeks. The active medication is Ketoconazole, an antifungal. Some studies suggest it's actually just as effective as Rogaine (Google Rogaine/Nizoral). Combine with Rogaine and Propecia and it's a home run. Rogaine for blood flow, Nizoral for inflammation and Propecia for DHT. 

As always, check with your doc before starting.

Edited by HairLossMentor

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1 hour ago, HairLossMentor said:

Great stuff...and you only need to use 2x weeks. The active medication is Ketoconazole, an antifungal. Some studies suggest it's actually just as effective as Rogaine (Google Rogaine/Nizoral). Combine with Rogaine and Propecia and it's a home run. Rogaine for blood flow, Nizoral for inflammation and Propecia for DHT.  

As always, check with your doc before starting.

Interesting, I learn something every day. Is is topical or pill? I know if I do a search for it 100000000 different products will show up.

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I literally just purchased this online, waiting for it should arrive today or tomorrow, it has 1% Ketoconazole the active ingrediant in Nizoral. Should i throw it away and just get Nizoral? itam states use basically once every 2 weeks.

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