Please Validate my Expectations!

[elicochin]

Hello Everyone,

I wanted to check in with the helpful folks here for some advice as I start my hair restoration journey. I'm 52, although my hair loss began around 25. I think I'm now a NW6, although my hair loss/balding has been stable for the last 10 years or so. I've never taken any hair loss medication of any kind ever. I have been trimming (never liked the shaven look) for the last 10 years or so. These pictures are very recent.

I have been lurking around this forum for the last 5 years and never really gotten serious about it until now. I have also began researching FUE options and surgeons based in the US and in India. Most importantly I would like to get some real-life feedback from this forum and I think it will give me final boost I am looking for.  As you can see I have some hair left on my top, but my crown is completely empty.

I also came across the Scalp Micro Pigmentation and was very encouraged to see some of the results combined with FUE. I understand that I can't expect to have anything close to a NW2 again, but I would be satisfied with light-moderate density all over, at which time I could buzz it down and add SMP for additional volume. I would like to have a mature hair line and temple areas with light coverage on the crown.

Any advice would be greatly appreciated. I am tired of my current look and would like to do everything I can to change it in a logical and sensible way.

Questions and advises I am looking for:

• Am I a Nor-wood 5 or 6?
• I am looking for an age appropriate hairline so What can I expect from FUE in my current state?
• Can I get a FUE without taking any medicines? what are the pros and Cons?
• Your thoughts on combining FUE with SMP (may be a year later)
• Inputs on surgeons who does all the procedures themselves vs. surgeons who let their technicians do most of the work
• Setting expectations for long hair vs trimmed look with my situation
• Any other suggestions/information that I should know before taking the plunge

Many Thanks

Edited May 11, 2019 by elicochin

[hairlossPA]

• Am I a Nor-wood 5 or 6?

NW 6

• I am looking for an age appropriate hairline so What can I expect from FUE in my current state?

FUE with NW6 leaves you with limited donor. I figure you could get an age appropriate hairline (high and receded) but still frame your face nicely

• Can I get a FUE without taking any medicines? what are the pros and Cons?

Yes you can get a transplant without taking meds. In fact, finasteride and minox won’t do anything for you at this point since you essentially have no hair on top. Pros: *maybe* strengthens your donor hair

• Your thoughts on combining FUE with SMP (may be a year later)

Probably a good strategy. Looking at your donor hair and the area you have to cover... This is just my personal guess but you may be able to get 3000-4000 grafts which would give you a hairline and very light coverage moving towards the crown. SMP could lower the contrast of the skin vs hair so yes it’s a good idea

• Inputs on surgeons who does all the procedures themselves vs. surgeons who let their technicians do most of the work

Youll get mixed feedback here. Focus on the results of the clinic. If you’re adamant on the surgeon doing it himself, make sure to double check

• Setting expectations for long hair vs trimmed look with my situation

What does your donor look like grown out? You may need to wear your hair slightly longer if you get any sort of procedure done (FUE or FUT)

• Any other suggestions/information that I should know before taking the plunge

Have realistic expectations on your results. You are behind the ball as far as donor supply goes. That can only take you so far 

Edited May 12, 2019 by hairlossPA

[Melvin- Admin]

Honestly, you look like you’re headed towards NW7. There seems to be significant thinning in the lateral humps. Truthfully, I wouldn’t expect a huge change with FUE alone. SMP may be a better option for you.

[elicochin]

Thank you Melvin! Are you saying that I should do FUE along with SMP or just SMP; please clarify.

[Melvin- Admin]

I would do FUE only to the hairline and SMP the rest. I doubt you will have enough donor hair to adequately treat the midscalp. You will need to maintain this buzzcut appearance. If that's something you would be happy with go for it, but if your goal is to have longer hair than I wouldn't move forward with surgery.

[elicochin]

Melvin, my thinking is inline with your's. I am well aware of the the inadequate donor supply so I would settle with buzzcut which I have been doing for the last 10 years or so. I would do FUE to get a mature harline/temples with light converge on midscalp/crown and then SMP to improve the appearance on midscalp and crown. Based on your experience, how much hair I can expect to harvest in a conservative fashion?

[Melvin- Admin]

Maybe  3,000 grafts

[Lennney]

I think Melvin is spot-on with saying that you'll have to grow your hair out post HT if you want any procedure done other than SMP.

Look into docs who specialize in high Norwood cases. I don't want to sound biased, but Dr. Bhatti has several cases where he did transformative work. There are others too, but his stand out to me especially.

If I were in your position, I would want *"thinning" hair rather than a bald head. I think with you having 2 inches on top, half inch sides would improve your appearance. I would focus on a strong hairline that's appropriate for your age, and then put the rest on top. I think you'll look fine without super dense coverage on the crown, but I would want more coverage on the frontal third.

Just my two cents.

[mephesto]

Hi elicochin, why did you choose FUE instead of FUT? Are you trying to maintain your current buzz style?

Edited May 20, 2019 by mephesto

[elicochin]

Hi Mephesto, Thanks for your response. I would like to maintain the buzz-cut style knowing that I may not have enough donor supply for a long hairstyle.   

[elicochin]

On 5/18/2019 at 3:35 PM, Melvin-Moderator said:

Maybe  3,000 grafts

Melvin,

One more question, how much of shock-loss I should expect realistically from whatever hair is left on my mid-scalp?

[Melvin- Admin]

6 hours ago, elicochin said:

Melvin,

One more question, how much of shock-loss I should expect realistically from whatever hair is left on my mid-scalp?

Honestly, it’s not going to make a difference. You have little to no hair left. Shock loss occurs with individuals with a lot of native hair. That’s not something that you should even worry about.

[elicochin]

Thanks Melvin for the response and going straight to the point 😊

[elicochin]

Dear all,

Many thanks for your responses. As a next step I am going to reach out few surgeons recommended here. Mostly in India, Turkey and here in the US. I would like to ask you what are the top 5/10 questions I should seek answers to. I think someone else may have asked this before and I do not want to duplicate it. If anyone has come across a similar topic/question, kindly share the link. 

Thanks for your support