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Hello all,

I recently posted some pictures of my current state of hairloss. My hair at the time of the photo was probably a number 5 guard at the back and sides.  It was that photo that I used for an online consultation with Dr Bisanga who said I had a good looking donor zone and was likely a great candidate for fue.  Yesterday however I returned from the barbers after having a 1.5 grade back and sides and noticed the back of my head looked thin quite far down.

So far, the plan based on the photo originally submitted was to take 4000 grafts and put 3000 into the hair line and mid scalp and put a 1000 into the crown.

What is your opinion? Do you think I’m going to go thin further down the back? And if so would that change the current plan?

Im 37 and use rogaine foam once or twice daily and nizoral shampoo once every 2 weeks.  Propecia scares me too much to take orally but have been recommended topical finasteride which I’ve heard can be effective.

Ultimately, I’d like a strong but age appropriate hair line and mid scalp, but I wouldn’t mind the look of a thinning crown if I were not to have enough grafts.  I guess I would like to be able to buzz it off one day if it doesn’t fully work out but it to look natural.  Hope that makes sense!

Im looking to get this booked for October and stop worrying and obsessing! 12 years is long enough!

Thanks in advance for your opinions, tips and advice 👍🏼

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I wouldn't worry too much to be honest. At a 1.5 grade, most donor area's can look somewhat on the thin side. Think I'd only be concerned if it looks  thin/patchy when you grow it out. How does it look when grown out?

The donor area will be examined for miniaturisation etc during your in person consultation and if there is an issue, a reputable surgeon will bring it up. With Dr Bisanga you are in good hands. Has a conservative, ethical approach and if he has seen your pictures and said your donor looks suitable, I'd go with that. 

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2 hours ago, Fozzie said:

I wouldn't worry too much to be honest. At a 1.5 grade, most donor area's can look somewhat on the thin side. Think I'd only be concerned if it looks  thin/patchy when you grow it out. How does it look when grown out?

The donor area will be examined for miniaturisation etc during your in person consultation and if there is an issue, a reputable surgeon will bring it up. With Dr Bisanga you are in good hands. Has a conservative, ethical approach and if he has seen your pictures and said your donor looks suitable, I'd go with that. 

Thanks Fozzie that’s  reassuring to hear. I have chosen Dr Bisanga as I had read that he has a very ethical approach and is keen to plan realistically for the future.  Please see the below photos of my donor area grown out to I think a grade 5 ish?

What do you think?

cheers

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Going by your pictures with the hair grown out, your donor looks fine in all honesty. 

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your donor looks fine. your donor looks thin when cut shorter because it allows light to shine through your hair standing completely straight up, making it look thinner when it’s really not

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^pretty much this

Hair when longer blocks light from reflecting off of the scalp. This is why the scalp is visible when short or wet. Shorter hair allows light in, as well as wet hair because it clumps together. You look fine and you appear to be a good candidate for hair restoration. Please consider creating a thread of your experience and a patient website. This is what keeps our community vibrant and alive. 

https://www.hairtransplantnetwork.com/blog/


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

My Hair Transplant Journey

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 @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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34 minutes ago, Melvin-Moderator said:

^pretty much this

Hair when longer blocks light from reflecting off of the scalp. This is why the scalp is visible when short or wet. Shorter hair allows light in, as well as wet hair because it clumps together. You look fine and you appear to be a good candidate for hair restoration. Please consider creating a thread of your experience and a patient website. This is what keeps our community vibrant and alive. 

https://www.hairtransplantnetwork.com/blog/

Thanks for the reassurance Melvin, I hope you’re right!  I will certainly be documenting my restoration journey from start to finish. I’m getting excited now about the possibility of having a hairline again. Ironically I’m nervous too because I feel like I’m admitting to others that I’m insecure and unhappy with my appearance, and perhaps not the confident Witty guy people say/think I am.  Seems so unfair! Not sure how I’m going to tell a crew of firefighters who just love an excuse to make jokes! 

Fingers crossed anyway

 

cheers 

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I think you are crazy to consider grafts in the crown. First, you are just doing Rogaine.  For how long have you done it?  Do you feel you are retaining?  From the angle of the photos you have posted it seems you are not losing vertically on the donor.  Good sign.  But, 1000 grafts is going to do absolutely nothing to that area.  

Consider a circle, similar to yours, (the back), that drops slightly vertically in the back.  You fill the circle. But, because you've shown the propensity to lose-you will continue losing.  You drop down vertically some more.  Now you've created a smile in the back of the head.  Now you need to waste more donor just to fix it.  This is called chasing the pattern and it never stops.

A smarter way to approach the back, (and that same 1000 grafts will make a big difference), is to work horizontally on the pattern as far back as you can so at to minimize the size of the crown.  The doctor would work in a sphere shape so that, even if the pattern expands vertically in the back, you will still look round and natural and have no "smile" back there.

More importantly is the use of medical therapy.  Propecia, Rogaine, Laser and PRP.  And while I understand you are using Rogaine, consider adding another modality as you are playing with fire.  You are going to use a HIGH percentage of your donor and have no clue what your pattern will do down the road.

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14 hours ago, LaserCap said:

I think you are crazy to consider grafts in the crown. First, you are just doing Rogaine.  For how long have you done it?  Do you feel you are retaining?  From the angle of the photos you have posted it seems you are not losing vertically on the donor.  Good sign.  But, 1000 grafts is going to do absolutely nothing to that area.  

Consider a circle, similar to yours, (the back), that drops slightly vertically in the back.  You fill the circle. But, because you've shown the propensity to lose-you will continue losing.  You drop down vertically some more.  Now you've created a smile in the back of the head.  Now you need to waste more donor just to fix it.  This is called chasing the pattern and it never stops.

A smarter way to approach the back, (and that same 1000 grafts will make a big difference), is to work horizontally on the pattern as far back as you can so at to minimize the size of the crown.  The doctor would work in a sphere shape so that, even if the pattern expands vertically in the back, you will still look round and natural and have no "smile" back there.

More importantly is the use of medical therapy.  Propecia, Rogaine, Laser and PRP.  And while I understand you are using Rogaine, consider adding another modality as you are playing with fire.  You are going to use a HIGH percentage of your donor and have no clue what your pattern will do down the road.

Thanks for the response Lazercap.  I agree with the crown work being left alone for now. I see what you mean about the smile shape being left if my hairloss progresses further down.  Do you think Dr Bisanga would suggest this at an in person consultation? So far it has only been online.  

In answer to your question about Rogaine, I have been using it since 2011. It seemed to slow the process but the thinning has certainly progressed in that time.  I fully intend to have PRP therapy as another measure but I am scared of finasteride to be honest. I hear bad things all the time and I don’t want to risk ruining a good sex life with the wife.  Have you got on well using finasteride? Would you advise I try it?  What are your thoughts on the topical version?

I want to be realistic when it comes to my procedure and be fairly conservative. Like I’ve said before, I would like a good hairline and top and wouldn’t mind the look of a thinning crown/ vertex ( as far back as possible) for my individual case.

Fingers crossed its a positive outcome for me!

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I am sure you will be fine, just go in there with your eyes wide open.  Ask the doctor to show you photos of patients similar to your own and this should boost your confidence.

I have been on Propecia/Finasteride for 30+ years.  There is more testosterone under the medication than without, so you should perform better, not worse.  That's the way I think about it and it has worked for me.  Many believe that the increase in testosterone is only temporary as the body kind of figures out what's going on and eventually regulates accordingly.  

Every year, it seems, I hear more and more negatives about Propecia only to find, a few months later, that additional tests show that what was reported no longer applies.  I will continue using the med even when I am 6 feet under.  

I will tell you, if you do experience a side effect, it will be within the 1st week.  If you don't, you never will.  This is not a medication that you take for years and, all of the sudden, you experience something. Either you will or you won't.  And, if you do, there are ways to offset the side effect.  Take it every other day, etc.  I would ask the doctor his opinion and go from there.  I never tried the topical version.

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