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indymusician

If you transplant now, what will the next 20+ years look like?

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I'm 44 and had a HT 5 years ago for the vertex only, 1500 grafts via FUT. Today, my vertex looks about the same as it did 5 years ago, as apparently most of the native hairs that were there back then are gone now.

But..where I had no frontal problems, I know have noticeable recession and thinning.

I spend a LOT of time looking at pictures, specifically pictures of men in their '60s/'70s to identify patterns in hair loss.

I think I've hit upon one of the key things that makes me apprehensive of doing a transplant to the front part of my scalp (whereas I was not so when I did the vertex a few years ago).

I am a big fan of the 1960s group, The Monkees. Attached, you will see pictures of two of the members, Micky Dolenz and Mike Nesmith, across each of the past three decades. Around '94, they were in their early 50s. The second pics are from around 10 years ago (early 60s). And the final pics are from recent years.

What concerns me is that while they had receding/thinning hairlines, they had hair until their 60s....and then, seemingly in a matter of years, all of the front and top hairs just vanished. Had they had transplants in their 40s to strengthen their hairlines, what would they look like today? I realize these are just two cases, but I've read often that hairloss can start being more predictable by your 40s. Mike and Micky seem to be counter to that thought. Even if these guys had transplanted, say, 5000 grafts back in their 40s or 50s, would it look worse today in their 70s versus if they had not done anything?

So, effectively, my concern is that having already used 1,500 grafts for my vertex, if I do a 1,500 hair transplant today in the front and find myself 30 years later seeing all of the native front/top hairs fly away, I will not have enough grafts left to make myself look natural.

Your thoughts? Does a well placed transplant of even 1,500 grafts (and possibly another 2,000 down the road) allow for things not to look "bad" should I lose ALL my native hairs on the front/top?

Dolenz - 1995 (50 years old)

dolenz1995-jpg.93575

 

Dolenz - 2004 (59 years old)

attachment.php?attachmentid=58249&d=1531

 

Dolenz - 2018 (73 years old)

attachment.php?attachmentid=58250&d=1531

 

Nesmith - 1997 (55 years old)

378356_orig.png

 

Nesmith - 2004 (61 years old)

attachment.php?attachmentid=58252&d=1531

 

Nesmith - 2017 (74 years old)

Michael_Nesmith_at_the_Chiller_Theatre_E.

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Yup hairloss can be unpredictable. But ones who start losing hair later tend to keep more hair but not in all cases. Yea they seemed to have hair in their 50s even though it was thinning. Idk how the back of his head looked though. 

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You've accidentally hit on something we rarely discuss.  During the initial consultation there is an intrinsic responsibility ....the doctor should not only be discussing, designing....etc.  He must also look out for the best interest of the patient.  Thus, future planning is huge for the same reason you've posted the question.  If a hairline is designed too low, everyone will know something is up when he is in a happy home and he looks 15 years younger than everybody else. 

You seem to have just about the same hairline you had when you were younger, just a bit sparse.  Why not strengthen it?  No need to lower it, etc.  It is also important to recognize hair grows forward at an angle, (I do realize you style your hair towards the back), so whatever is added to that area, you can imagine a hairline about 1/4 inch lower than that.

Were you ever on any medical therapy to help you with retention of the native hair?

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Great examples, there area also those that don't lose much hair at all, take a look at Jack Nicholson, he was a young man with a receded hairline in "one flew over the cuckoos nest." Having said that, hope for the best and plan for the worst. Creating hairline that looks good today, and will look good in 40-50 years should be at the forefront of the goals.

1975

image.png

 

Jack Nicholson 2018 at 81 years old, his hair is pretty much the same, except slightly thinner.

image.png


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

My Hair Transplant Journey

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

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Posted (edited)

When your in your 70's who cares at that point , just buzz it down short and it won't look out of the ordinary.  You aint chasing no ass at that point so you can look back at the years you did with some decent hair lol..  Of course transplantation should always be age appropriate on the hairlines and never over aggressive ..   However who knows what variables are at work above , their loss patterns won't not look to be the norm.  Medication, health conditions could have hastened loss in those cases.  In a lot of case the loss pattern is well established by the 40's and you could kind of decipher the future loss. Of course there will be exceptions but id rather look my best in the prime years that's for sure..

Edited by BaldingBogger

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On 3/7/2020 at 12:35 PM, BaldingBogger said:

When your in your 70's who cares at that point , just buzz it down short and it won't look out of the ordinary.  You aint chasing no ass at that point so you can look back at the years you did with some decent hair lol..  Of course transplantation should always be age appropriate on the hairlines and never over aggressive ..   However who knows what variables are at work above , their loss patterns won't not look to be the norm.  Medication, health conditions could have hastened loss in those cases.  In a lot of case the loss pattern is well established by the 40's and you could kind of decipher the future loss. Of course there will be exceptions but id rather look my best in the prime years that's for sure..

72 here, and you will still want to chase ass, but it becomes damn hard to catch, especially in my Hoverround or walker.  The best way is to trip them with your cane.  If you care now you will care when you are 70

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"Imagination frames events unknown in wild fantastic shapes of hideous ruin, and what it fears, creates." Hannah More

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One doctor I had spoken to said this:

 

"A man who starts his teen years with 10,000 hairs in the frontal region goes on the lose 80% of his hair because of male pattern baldness.  At that point nature has left him with a thinning look that has 20% of his original density.  If that man went on to bald completely ten years later and then visited me to have 2000 hairs planted to recreate the thinning look he had ten years earlier, would he look weird or unnatural, assuming I recreated exactly what nature had left him with at the 20% residual density level?  Natural thinning looks natural.  A restoration to a natural level of thinning will also look natural.  This is true unless you think all thinning men look strange or unnatural with their normal balding process."

 

However, I disagree with his assessment.  There is an erosion process that happens, similar to sand on the beach getting washed away - except in the rare diffuse situations, hair recedes slowly from the start of the front, not evenly throughout the front. So, transplanted hairs that occur evenly throughout the front wouldn't look natural in your later years if all the native hairs fell out, right?  In the case of Micky Dolenz (who now looks like Kelsey Grammer), to have a few thousand hairs throughout the front wouldn't look right - same for Nesmith.

Am I not thinking correctly about this?

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 Not sure what the question is, the examples you posted, occur, just look at Billy Joel. That said, these are men who had slow hair loss that eventually reached a tipping point. It’s not like they went bald all of the sudden. I guarantee they had a lot of miniaturization even when they had hair.

Cases exist both ways, I’ve seen men with hair loss early in age, and they don’t progress in their later years. That said, senile alopecia will eventually affect all hair. 
 

Example

Jeffrey Jones in his late 30’s norwood 3 level

image.jpeg

Jeffrey jones late 60s

image.jpeg

 


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

My Hair Transplant Journey

Melvin- Associate Publisher and Forum 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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Melvin - appreciate the good counters to my pictures. Of course, my problem is "the unknown" in that I have no idea what I'll see years ahead of me.  My dad (and his brother and their dad) was Norwood 6 by the time he was 30, and all the women on my mom's side have lost tremendous amounts of hair by age 60. However, my mom's brothers had overabundant hair at age 60, and their dad wasn't more than a Norwood 4 in his 60s.

I just worry that if I progress to Norwood 6 or 7 that I'll just ridiculous with only 2000-3000 grafts in the front. Perhaps that's an unreasonable fear - and perhaps, as some say, I won't care quite as much at that point of my life. 

I'm not the type to shave my head, I think it would look ridiculous, and I always feel that bald white guys are just that - it is their defining characteristic, regardless great eyes, lips, etc. Further, I now have a strip scar, so it really wouldn't be an option....adding FUE scars will only further that. 

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Well, that's why you should prepare for the worst and hope for the best. Try and maintain a mature hairline that will allow you preserve donor for the future, no one can tell the future. However, doing a miniaturization test will help you know if you are susceptible to future thinning. I highly suggest seeing a surgeon to examine your entire scalp, as I guarantee the examples you provided, had clear signs of miniaturization, even at a young age.


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

My Hair Transplant Journey

Melvin- Associate Publisher and Forum 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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Posted (edited)
On 3/9/2020 at 1:06 PM, indymusician said:

except in the rare diffuse situations, hair recedes slowly from the start of the front, not evenly throughout the front. So, transplanted hairs that occur evenly throughout the front wouldn't look natural in your later years if all the native hairs fell out, right?

 

The solution to this is to transplant the hairline a bit high to give yourself a mature hairline. Then if it starts to thin later in life or you lose a lot of native hair behind it then it doesn't look strange. Some younger guys are getting hairlines that are too low and too thick that will look the way you are talking about over time, but if you don't go crazy with the front in both density and placement then you will avoid the issue.

As for having thin hair all throughout a NW 6 area when you get older I can tell you I had that when I was 18 and 19 years old. I had a low hairline with a diffuse thinning all over the front and top with a bald crown. If I could choose whether to have that pattern starting at age 18 or starting at age 70 I'd choose age 70. Who wouldn't?

 

Edited by BeHappy
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@BeHappy

I totally agree, donor management is vital. Blowing your donor supply in your 20s to get a low and straight hairline isn’t the smartest thing to do. 


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

My Hair Transplant Journey

Melvin- Associate Publisher and Forum 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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My hair loss comes from the maternal side...my father never had MPB...he passed away just last October at the age of 89 and although he did experience significant overall generalized thinning throughout his scalp, he never lost his hairline.

So as Laser pointed out, you would not want to lower the hairline but having grafts added in a transitionary design should still leave a more natural look even though the entire area may thin.


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. Robert True & Dr. Robert Dorin, New York, NY

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3 hours ago, gillenator said:

My hair loss comes from the maternal side...my father never had MPB...he passed away just last October at the age of 89 and although he did experience significant overall generalized thinning throughout his scalp, he never lost his hairline.

So as Laser pointed out, you would not want to lower the hairline but having grafts added in a transitionary design should still leave a more natural look even though the entire area may thin.

You mean he had thinning all over the scalp even back and sides or just the top was thinner?

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10 hours ago, Phillyman1996 said:

You mean he had thinning all over the scalp even back and sides or just the top was thinner?

 

My dad is also 89 now and probably still has more hair than I do even after I had multiple hair transplants. He still has a hairline and no bald spot, but his hair is much thinner everywhere compared to how much he had years ago. It is an all over thinning including the sides and back.

 

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7 hours ago, BeHappy said:

 

My dad is also 89 now and probably still has more hair than I do even after I had multiple hair transplants. He still has a hairline and no bald spot, but his hair is much thinner everywhere compared to how much he had years ago. It is an all over thinning including the sides and back.

 

My grandad is the same, he's not even grey at 90. My parents told me i have his personality, shame i didn't get his hair genes.

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I’ve posted pictures of my brother and father, 43 and 63 respectively, and both have more hair than me currently, even after I’ve had three hair transplants. 


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

My Hair Transplant Journey

Melvin- Associate Publisher and Forum 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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1 hour ago, Melvin-Moderator said:

I’ve posted pictures of my brother and father, 43 and 63 respectively, and both have more hair than me currently, even after I’ve had three hair transplants. 

How was your grandparents hair?

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Maternal grandfather had a fullhead of hair until he died, my paternal grandpa was a norwood 4. 


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

My Hair Transplant Journey

Melvin- Associate Publisher and Forum 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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On 3/10/2020 at 7:53 PM, Phillyman1996 said:

You mean he had thinning all over the scalp even back and sides or just the top was thinner?

Yes my father had thinning everywhere...most of it was on the top of his head but yes the back and sides had it but to a lesser extent.


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. Robert True & Dr. Robert Dorin, New York, NY

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Posted (edited)

It is an uncomfortable truth that the majority of people that receive transplants, if they live long enough, ends up with retained transplanted hairs in front/at the crown while their native hair balds around it. This is unfortunately true even if on fin/dut. Androgen sensitive follicles become far more sensitive to even the tiniest amounts of DHT with aging -- ie. studies in which older guys receiving anabolic steroids with abrupt sheds vs younger guys who don't usually lose it as abruptly.

Unlike breast implants, not a "reversible" procedure in that sense. I guess you gotta ask yourself -- are you willing to burn your boats to win the battle? Or are fears about some future war holding you back? 

Also are you on fin/dut?

You'll never know if you made the right decision, even in retrospect. Kind of the shitty thing about life. Great post.

Edited by bismarck

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37 minutes ago, bismarck said:

It is an uncomfortable truth that the majority of people that receive transplants, if they live long enough, ends up with retained transplanted hairs in front/at the crown while their native hair balds around it. .-- ie.

Unlike breast implants, not a "reversible" procedure in that sense. I guess you gotta ask yourself -- are you willing to burn your boats to win the battle? Or are fears about some future war holding you back? 

Also are you on fin/dut?

You'll never know if you made the right decision, even in retrospect. Kind of the shitty thing about life. Great post.

What are you talking about?

If you do find cases of older gentlemen with hair in the front and crown only, (and had transplants), we can assume a couple of things.  1, poor planning - perhaps by both the doctor and the patient.  2nd, little to no use of medical therapy.

"This is unfortunately true even if on fin/dut." How do you know this?

" Androgen sensitive follicles become far more sensitive to even the tiniest amounts of DHT with aging." How do you know this? How do you determine which follicles are more sensitive?" Are you a scientist?

"studies in which older guys receiving anabolic steroids with abrupt sheds vs younger guys who don't usually lose it as abruptly." What does this have to do with anything? 

My understanding, there is less DHT as we age.  You seem to insinuate it is the other way around!

There are many reasons why a patient moves forward with a procedure.  For the younger guys, they want to enjoy their youthfulness.  For older gentlemen, they want to improve their looks.  It is a fact hair does make a difference.  I've known of many ladies with CCCA that would kill to have just a bit more hair to be able to achieve some type of style.  Whatever the reason, if you can accomplish a goal - yes it is worth it.  Keep in mind - gratification is experienced almost immediately.

Choosing the right doctor is HUGE! Poor planning and just doing what the patient wants is not truly looking out for the best interest of the patient.  Education, a proper consultation, are and should always be part of the process.  

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Posted (edited)
8 minutes ago, LaserCap said:

What are you talking about?

If you do find cases of older gentlemen with hair in the front and crown only, (and had transplants), we can assume a couple of things.  1, poor planning - perhaps by both the doctor and the patient.  2nd, little to no use of medical therapy.

"This is unfortunately true even if on fin/dut." How do you know this?

" Androgen sensitive follicles become far more sensitive to even the tiniest amounts of DHT with aging." How do you know this? How do you determine which follicles are more sensitive?" Are you a scientist?

"studies in which older guys receiving anabolic steroids with abrupt sheds vs younger guys who don't usually lose it as abruptly." What does this have to do with anything? 

My understanding, there is less DHT as we age.  You seem to insinuate it is the other way around!

There are many reasons why a patient moves forward with a procedure.  For the younger guys, they want to enjoy their youthfulness.  For older gentlemen, they want to improve their looks.  It is a fact hair does make a difference.  I've known of many ladies with CCCA that would kill to have just a bit more hair to be able to achieve some type of style.  Whatever the reason, if you can accomplish a goal - yes it is worth it.  Keep in mind - gratification is experienced almost immediately.

Choosing the right doctor is HUGE! Poor planning and just doing what the patient wants is not truly looking out for the best interest of the patient.  Education, a proper consultation, are and should always be part of the process.  

Lasercap, the data has been published. The effects of androgens/steroids on older hair follicles is very different than on the young because of the mutations that accumulate with aging. Do the research yourself, I'm not going to waste my time on stuff that has already been extensively discussed. Seriously, your name is LaserCap and you're questioning established studies?

Tired of how confrontational this forum has become, understand why so many have left.

Follicles become more sensitive to DHT with aging. It does not matter that there is less DHT. Otherwise there would be less balding with aging. If you don't want to google studies just use common sense.

Edited by bismarck
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Posted (edited)
2 hours ago, bismarck said:

Lasercap, the data has been published. The effects of androgens/steroids on older hair follicles is very different than on the young because of the mutations that accumulate with aging. Do the research yourself, I'm not going to waste my time on stuff that has already been extensively discussed. Seriously, your name is LaserCap and you're questioning established studies?

Tired of how confrontational this forum has become, understand why so many have left.

Follicles become more sensitive to DHT with aging. It does not matter that there is less DHT. Otherwise there would be less balding with aging. If you don't want to google studies just use common sense.

Do you have the name of the publication? Perhaps you can direct me to the correct website.  It will be interesting to read the studies.

It's a shame you feel educating us all on this site is a waste of time.  While I understand it gets repetitive, there are a number of people that do visit, leave, return and call combinations in between.  If we are able to help one, it makes this communal effort worthwhile.  It is about helping people after all.

It is the belief of many testosterone drops considerably as we age. Last commercial I heard on the radio indicated we lose about 10% per year after age 50.  If less testosterone, less DHT.  To me that makes sense. For the follicle to be more sensitive....makes no sense. This is the first I hear of this.

It is evident - the older I get the less I know.  Must be...my wife keeps telling me the same.

Oh, don't mean to be confrontational at all....I just tend to question dilettantes.

 

Edited by LaserCap
mispelled word

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1 hour ago, LaserCap said:

Do you have the name of the publication? Perhaps you can direct me to the correct website.  It will be interesting to read the studies.

It's a shame you feel educating us all on this site is a waste of time.  While I understand it gets repetitive, there are a number of people that do visit, leave, return and call combinations in between.  If we are able to help one, it makes this communal effort worthwhile.  It is about helping people after all.

It is the belief of many testosterone drops considerably as we age. Last commercial I heard on the radio indicated we lose about 10% per year after age 50.  If less testosterone, less DHT.  To me that makes sense. For the follicle to be more sensitive....makes no sense. This is the first I hear of this.

It is evident - the older I get the less I know.  Must be...my wife keeps telling me the same.

Oh, don't mean to be confrontational at all....I just tend to question dilettantes.

 

If what you’re saying is true then why do Prostates enlarge in older men? And fin/dut is used to reduce its size? It’s exactly what the other poster is claiming...our genes make us more sensitive to dht. It’s not entirely about the levels of dht 

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