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Norrie

Donor Area Receding - Any point?

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Posted (edited)

Hi Everyone. I am a 34 year old Caucasian male. I have begun my hair restoration research having had to shave my head last year as the hairloss had progressed rapidly. At the moment I am a Norwood 5/6. I'm definitely in the middle phase of advanced hair loss!

So far I have ordered Regaine, Nizoral and obtained a prescription for finerstride. I am meeting a local consultant in Feb to discuss options (250 euro!) and I have contacted Asmed, Bisanga and Feriduni via email.

Do you think I am a long term viable candidate for a HT as the donor area is receding (see pics) and I will have a limited number of grafts available? I will definitely need 2 HT if possible 🙂. Any advice welcome. Thanks. 

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Edited by Norrie

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Hi there , You're doing   the right thing in getting consultations from the clinics you mentioned ,as you are aware your donor doesn't look the best , but pics can be deceiving especially when the hair is as short as yours ,  so be interesting to hear what they have to say ,the upside is going form the pics you are one of the lucky guys who looks pretty good as you are ,shaped head and from  what I can see from you features face dimensions etc ,but of course I realise  a guy who's losing his hair doesn't always look at it that way, but something to consider given the donor you  have available and the area to be covered .

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Posted (edited)
1 hour ago, Mick50 said:

Hi there , You're doing   the right thing in getting consultations from the clinics you mentioned ,as you are aware your donor doesn't look the best , but pics can be deceiving especially when the hair is as short as yours ,  so be interesting to hear what they have to say ,the upside is going form the pics you are one of the lucky guys who looks pretty good as you are ,shaped head and from  what I can see from you features face dimensions etc ,but of course I realise  a guy who's losing his hair doesn't always look at it that way, but something to consider given the donor you  have available and the area to be covered .

Thanks Mick. Appreciate the feedback and the kind comments 👍

I've heard back from a few clinics: 

Dr. Acar - The donor area is limited because the thinning has spread down the back and this means the maximum number of grafts we can safety harvest in a single session will be approximately 3500 however this would include the use of beard and body hair for 60% coverage. (I agree that I might need beard and body hair) 

Dr. Cinik - Thank you for the photos. please be advised that we can perform your operation with 3500-3800 grafts and with 80-90% coverage of baldness area. (Too good to be true!)

Dr. Hamid (Chicago Hair Institute) - I estimate your frontal area needing a minimum of 1500 grafts, although a session of 2000 would be preferable for achieving good density.  FUE harvesting would certainly limit you to a session of no more than and possibly less than 2000 grafts.  Your hair length is too short for the strip harvesting method. (Low number of grafts?)

Dr. Lupanzula - Comfortably harvest 6000 grafts. Frontal including hairline: 3200 - 3500 & Crown: approx 3000

All comments welcome. 

Edited by Norrie
Incl. Dr. Lupanzula

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You have what’s called retrograde alopecia, I think you should plan more than two surgeries over a lifetime. Are you on minoxidil or finasteride?

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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 @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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8 minutes ago, Melvin-Moderator said:

You have what’s called retrograde alopecia, I think you should plan more than two surgeries over a lifetime. Are you on minoxidil or finasteride?

Hi Melvin

Thanks for your comment. I just looked up retrograde alopecia and it looks like your right. This coupled with the loss on top is disappointing admittedly. Strange that no clinic has mentioned it in their reply. 

I wouldn't have enough donor for more than 2 surgeries I would think. I have started 'The Big 3' this week. 

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It’s hard to say, the length of your hair and flash photography isn’t the best for presenting donor pictures. Try to let your hair grow out for a month then retake pictures in natural lighting. 

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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 @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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If you do go ahead with surgery I'd recommend not putting grafts into the crown (at least at first) as they are much better served in the front.

You have a decent sized area to cover and possible donor limitations so a solid strategy is vital.

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On 1/2/2019 at 8:10 PM, Melvin-Moderator said:

It’s hard to say, the length of your hair and flash photography isn’t the best for presenting donor pictures. Try to let your hair grow out for a month then retake pictures in natural lighting. 

Good idea. I take a few more under matural light and take a closer look.

22 hours ago, baldlivesmatter said:

If you do go ahead with surgery I'd recommend not putting grafts into the crown (at least at first) as they are much better served in the front.

You have a decent sized area to cover and possible donor limitations so a solid strategy is vital.

Thanks for the input. I plan on getting a long term strategy. I have an online consultation set up with Dr. Diep in February and am currently in talks with H&W (recommending FUT??) along with a highly thought of local consultant. The front and hairline were always the priority. 

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3 hours ago, Norrie said:

Good idea. I take a few more under matural light and take a closer look.

Thanks for the input. I plan on getting a long term strategy. I have an online consultation set up with Dr. Diep in February and am currently in talks with H&W (recommending FUT??) along with a highly thought of local consultant. The front and hairline were always the priority. 

Dr Diep and H&W are awesome surgeons, especially regarding FUT. I think H&W are recommending FUT due to the simple fact you risk less transection of the hairs which would be essential with a limited donor. Would you be able to handle a strip scar? That's another factor too bro.

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FUT allows you to extract more grafts from the “safest” part of your safe zone, one reason why HnW may recommend FUT. But then you’re left with the scar. You’ll need to have your scalp examined in person for signs of miniaturization to determine the extent of the retrograde alopecia and make sure you have enough lifetime donor to meet your goals. 

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7 hours ago, Kiwi Guy said:

Dr Diep and H&W are awesome surgeons, especially regarding FUT. I think H&W are recommending FUT due to the simple fact you risk less transection of the hairs which would be essential with a limited donor. Would you be able to handle a strip scar? That's another factor too bro.

Appreciate the input Kiwi Guy. A scar wouldn't bother me too much. I've seen some neat scars on here from H&W. 

7 hours ago, Spaceman said:

FUT allows you to extract more grafts from the “safest” part of your safe zone, one reason why HnW may recommend FUT. But then you’re left with the scar. You’ll need to have your scalp examined in person for signs of miniaturization to determine the extent of the retrograde alopecia and make sure you have enough lifetime donor to meet your goals. 

Thanks Spaceman. You're right, a lot will depend on the face to meeting with my local consultant. If he thinks it's feasible long term, I'll go ahead. 

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another option to consider before you go the HT route - is whether you can be happy without a hair transplant.

I know its not a common response, but I find people don't give it enough thought before jumping into a strategy that is permanent, no matter the result, and often requires future surgeries to keep up.

If I hadn't gotten nervous when I was in my 20's and gotten a HT, I would not have had to have repairs and further surgeries 2 decades later. I look back now and think the best thing I could have done was just wear my hair short as you are doing now and accept going bald as part of the aging process. Maybe I would have gotten on meds to help slow it down, etc. or looked into nutrition more.

Just a thought for you to consider, because as I said before, once you start down the HT journey, it usually is a lifetime commitment. Best of luck to you.

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Doing nothing is never bad advice, if you can accept going bald that’s the safest and cheapest option.

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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 @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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2 hours ago, home1212 said:

another option to consider before you go the HT route - is whether you can be happy without a hair transplant.

I know its not a common response, but I find people don't give it enough thought before jumping into a strategy that is permanent, no matter the result, and often requires future surgeries to keep up.

If I hadn't gotten nervous when I was in my 20's and gotten a HT, I would not have had to have repairs and further surgeries 2 decades later. I look back now and think the best thing I could have done was just wear my hair short as you are doing now and accept going bald as part of the aging process. Maybe I would have gotten on meds to help slow it down, etc. or looked into nutrition more.

Just a thought for you to consider, because as I said before, once you start down the HT journey, it usually is a lifetime commitment. Best of luck to you.

Hi home1212 and thanks for your input. It's not a common response but a very valid one and the reason I posted this thread.

I have considered shaving my head and accepting it. Hard to do tho. Luckily my missus said she doesn't care either way!

Being realistic, I will end up a Norwood 6/7 judging by my balding pattern and looking at my brother and father.  Also I would need more than 1 surgery if I decide to go ahead. It's a case of now or never and I intend to do as much research as possible before making any decision. 

3 hours ago, Melvin-Moderator said:

Doing nothing is never bad advice, if you can accept going bald that’s the safest and cheapest option.

Hi Melvin. It certainly is. However, being able to style my hair again would feel fantastic.  

I intend on getting a full scalp analysis before making my decision.

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Just heard back from Dr Yaman Resul. Attached is the following recommendation/outline. I agree i will need 2500 grafts minimum to restore the hairline but 1000 seems a bit thin for the crown.

Ive read it's the black hole of grafts and I have a substantial area to cover. Any thoughts? 

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My guess is he is throwing 1000 grafts in the crown to give a nicer transition. It won’t cover much but it won’t look like you go from hair up front to a completely bald crown. More natural look. It will still be very thin.

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7 hours ago, Shmiggy said:

My guess is he is throwing 1000 grafts in the crown to give a nicer transition. It won’t cover much but it won’t look like you go from hair up front to a completely bald crown. More natural look. It will still be very thin.

Good point. Bisanga is recommending 2 separate procedures - 3000 grafts for the frontal area and another procedure toi tackle the crown. I must raise the 'nicer transition' aspect however. 

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On 1/2/2019 at 8:10 PM, Melvin-Moderator said:

It’s hard to say, the length of your hair and flash photography isn’t the best for presenting donor pictures. Try to let your hair grow out for a month then retake pictures in natural lighting. 

Took a pic in natural light. Any comments welcome. 

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From some of the pics, it appears that some of your donor area is DHT receptive so my advice is to have a microscopic exam in your donor to see whether or not you have a stable donor supply.

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Gillenator

Independent Patient Advocate

 

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

 

Supporting Physicians: Dr. Jim Harris, Denver, CO - Dr. Robert True & Dr. Robert Dorin, New York, NY

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I'd recommend an in-person consultation with Dr Feriduni. You have to pay about 200 euros but it is very thorough (he will use a microscope on your donor to test for miniturisation too) and he is both ethical and world class so you can use whatever he says as a baseline for any other consultations you have. I went to Hattingen and the result so far is excellent I think. They also do free consultations that include microscopes. Given your donor, I'd personally avoid both FUE and Turkey.

Edited by TrixGlendevon

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