Number of grafts and type of HT

[Wendell]

My questions is very centric and basic to solve my case (see last topic: fue or fut for me):

 

As a patient or as HT specialist what would you do or recommend: 1600 FUE GRAFTS OR 2300 FUT & FUE GRAFTS for a 42 year old  hispanic  man with a 55 to 60 graft density in 5 to 6 Norwood focussing 1300 or 1800 grafts on the crown and the rest to cover frontal density??????????????

 

Note: if the doctor cannot get more than 1600 for getting something for the front then use that 1600 for the crown.

 

Thank you !!!!!!!!!!!

[Wendell]

[home1212]

Pics are not that clear, but you look like a NW6 requiring extensive restoration of your entire frontal zone, midscalp vertex and crown. - if that can even be achieved with your donor. Like you, I also had extensive hair loss, and went thru 3 seperate FUE procedures focusing on the frontal zone and midscalp. I had a total of 4500-5k grafts WITHOUT touching my crown . And I dont have anywhere near the type of density you're talking about. Get a few consults with good docs, send in clear pics or do some Skype/Facetime consults. Ethical and reputable doctors will be realistic about what is possible -  

[Wendell]

I want the grafts to be fucused at the crown, in a second one surgery or maybe in the first with fue, I want some coverage at the mid-scalp and a little in the the front. I dont have and I cant have a middle density expectation but a low density hair expectation with 4 o 5 milimeters hair long.

[home1212]

i think any hair you have up front will eventually be lost as its sparse and you have miniaturization going on, your priority should not be the crown but a conservative hairline up front to frame your face, that would be the biggest cosmetic improvement if you're going to thru the process at all, otherwise I would say just keep your hair shaved/short and you eliminate the need for surgery all together.  

[Wendell]

I am planning to have two procedures , strip and fue in order to get 2500 grafts  (5500 aprox) for the entire affected area which I think if I dont have a high expectation I can get a coverage with a 5 milimeters donor hairs long. I hate that hole in the crown.  Even so the way I am now I can feel a mininum of density which I can still care. My alopicia started at the age of 20 and I m not loosing any hair jjjjjj and my front is like that a long time ago (20 years). Now I am 42.

Thank you for your attention. I would still wait for more experience from you all please and be oriented regard this hair situation. 

 

[Wendell]

[Raphael84]

Hi @Wendell

How are you?

I don't believe that I read it anywhere, but just to confirm, have you had any previous hair transplant procedures? If no, why do you feel that you would not be able to take 5000 grafts FUE? Something to consider if you intend to keep your hair reasonably short at the back and sides.

Most Drs will be far more comfortable with the approach of first addressing your hairline and frontal third and moving back to your midscalp and toward your crown. This would be a much more sensible approach and you can of course discuss density desires and concerns with your Dr. I appreciate that it is your crown that is currently bothering you the most, but you have said that you have been losing hair for over 20 years. With the correct approach, if you require two surgeries, then two years on from your procedure you can be in a completely different position.

All of this is dependent on your choice of physician of course. With extensive loss you can't afford to make a mistake with this. You will find some great surgeons on this very forum. Do your research and begin requesting some online consults with some of the best Drs to understand what may or may not be possible. 

Where are you from?

[Wendell]

3 hours ago, Raphael84 said:

Hi @Wendell

How are you?

I don't believe that I read it anywhere, but just to confirm, have you had any previous hair transplant procedures? If no, why do you feel that you would not be able to take 5000 grafts FUE? Something to consider if you intend to keep your hair reasonably short at the back and sides.

Most Drs will be far more comfortable with the approach of first addressing your hairline and frontal third and moving back to your midscalp and toward your crown. This would be a much more sensible approach and you can of course discuss density desires and concerns with your Dr. I appreciate that it is your crown that is currently bothering you the most, but you have said that you have been losing hair for over 20 years. With the correct approach, if you require two surgeries, then two years on from your procedure you can be in a completely different position.

All of this is dependent on your choice of physician of course. With extensive loss you can't afford to make a mistake with this. You will find some great surgeons on this very forum. Do your research and begin requesting some online consults with some of the best Drs to understand what may or may not be possible. 

Where are you from?

Thank you for your follow up. I appreciate it infinitly 

[Wendell]

Im a 42 year old curly hair latin man FROM THE DOMINICAN REPUBLIC. I want to have  covered the following area with 2400 FUE grafts if possible or 2500 FUT grafts if not possible. I have average density of 55 grafts  (1, 2 & 3 hairs) from which they would take 15 grafts  (Is it ok 15 ??????????????????????) remaining 40 grafts in the donor.

 

Those 2400, are they possible with only FUE the I said by spreading those hair in the affected area not including the front????????????????????????????

 

Note: I think for strip method higher density than in FUE must be left at the donor in back: what is better FUE alone or FUE and the STRIP together? ??????????????

 

3 important question, doctor, to be answer before I go into the surgery, please answer me. I will appreciate it infinitly, thanks in advanced.

 

🙏🙏🙏

Aah, one more note: BY THE MOMENT I AM NOT WORRY ABOUT THE FRONT, I ll be using monoxidil and care the front. I HAVE LIKE 10 YEARS  WITHOUT LOOSING ANY MORE HAIR,  I GUESS THEY ARE STABILIZED EVEN SO IN THE FRONT. THATS MY FAMILY PATTERN.  

[DrTBarghouthi]

Hello.

Although the photos are not too clear, you do seem like a Nw6 with an average or below average donor area. Nevertheless, you do seem to have reasonable and realistic expectations of what can be done. Such cases (especially with a poor donor), are best done in stages. Your first procedure in my opinion should focus on restoring your midscalp. This is because you have some hair in the front and restoring your mid scalp will eventually guarantee a NW5 in the worst case scenario that you even lose your front and do nothing more. 

If donor is still good, and assuming you stay on maintenance meds for the frontsl zone, I would then consider restoring the frontal zone. I would be very reluctant to do any crown work in your case as it really wont be the best value for money sort of thing. 

If you can post clearer photos that would be great. Thanks for sharing.

 

[Kiwi Guy]

Can anyone provide an example of hair restoration for a man with this particular persons level of diffuse thinning and hair loss?

Honestly I haven't seen any but I could be wrong, have you looked at scalp micropigmentation?

[DrTBarghouthi]

Yes you can definitely climb up the Norwood scale in many cases. It might not be a huge jump but if properly planned and optimized medically then somome can go from a 6 to some variant of 4 or even 3. Managing expectations is the key.

[Wendell]

6 hours ago, DrTBarghouthi said:

Yes you can definitely climb up the Norwood scale in many cases. It might not be a huge jump but if properly planned and optimized medically then somome can go from a 6 to some variant of 4 or even 3. Managing expectations is the key.

I am going to start using Rogaine now for the first time. My hair in the top was very thinning and a little bit defused. 

[Wendell]

I mean my hair was blond and thin when I was a teenager. 

[Wendell]

 

The doctor said:

Upon evaluation we found out that you have very different angles of hair all over your head. Fue procedure would be difficult in this situation as the root has different angles and outside the hair has different ones.

So FUT would be preffered so that we can see the root directly in the root.

Fut around 2500 grafts would definitely be possible but for more number of grafts we should look for body hair transplant also.

 

I asked him:

 

FUTand FUE perform combined in one or two sessions what do you think doctor? ???????

 

SO IT IS NOT POSSIBLE TO GET FROM 1000 TO 2000 FUE GRAFTS BECAUSE OF THOSE ANGLES IN THE BACK AND THOSE IN THE FRONT????????????????????

[Wendell]

SORRY FOR SO MUCH TRYING BUT NEXT MONTH I WILL BE OPERATED. THANK YOU ALL FOR THE PATIENCE.

[DrTBarghouthi]

The density isn’t great but it seems you have a good number of multiples. You do have a variety of exit angles but this may also look more pronounced because of the length that you have your donor in. A shorter shave may make things easier to see what angle the follicle is oriented under the skin. I think if you have an open mind about FUT but would like to avoid it, then it might be possible to start with an FUE and if the transection is high based on the first few grafts of each zone, then convert to FUT. Just an option that can be provided perhaps.

[Wendell]

Excellent,  doctor. I will take your advise. I am so so thankfull for all your effort and cooperation for me. 

[Wendell]

10 hours ago, DrTBarghouthi said:

Yes you can definitely climb up the Norwood scale in many cases. It might not be a huge jump but if properly planned and optimized medically then somome can go from a 6 to some variant of 4 or even 3. Managing expectations is the key.

Ok, thanks

[harry_potter1]

16 hours ago, Kiwi Guy said:

Can anyone provide an example of hair restoration for a man with this particular persons level of diffuse thinning and hair loss?

Honestly I haven't seen any but I could be wrong, have you looked at scalp micropigmentation?

H&W has few cases of treating such diffused thinning. It is probably one of the main reasons they are so highly rated. 

They kind of push the limits, but within a scientific and ethical practice