Donor area too weak?

[HairGone29]

Three pics, one with flash,  one without, at a length of about an inch. The third pic is when it was WAY overgrown, not how I'd ever normally have it, about 2-3 inches.

I planned to have a consultation in the UK (Farjo) before taking the dive and flying to Turkey, but the consultation was cancelled due to Corona Virus.

Some surgeons have said from the photos my donor looks too weak, others have said no point giving me an opinion without being seen in person first.

My biggest fear is getting the go ahead for a 3500-4000 graft transplant only to have a bald/patchy donor area forever.

[baldforalongtime]

Are you looking at FUE or FUT? Also, have you only been consulted from the pictures? No microscope to detect miniaturization?

I'm dealing with this same question but on the after-HT surgery side. Honestly, I'd kill to have your donor area, but am interested in what the community recommends.

[Melvin- Admin]

Have you seen any surgeons in person?

[LonelyGraft]

Really tough to say as pictures can be deceiving depending on picture quality, lighting, etc. I highly recommend you visit a reputable surgeon in person and get evaluated and have your donor viewed microscopically. In the UK the only guy I would trust would be Dr. Reddy. Lots of good doctors in neighboring countries to you in spain, belgium, etc. 

[gillenator]

Almost all donors look good when the hair length is grown out...the best view is when the length is one inch or less.

I do agree that the donor shows thinning overall and I wonder if some of that area is DHT receptive...and trust me, YOU WANT TO KNOW "BEFORE" ANY SURGERY IS SCHEDULED.

And as was already mentioned, it is absolutely critical to have your entire donor zone examined microscopically before any surgery is performed.

If you have a DHT receptive donor, you will eventually lose that hair after it is transplanted...hard to say how long it will take but as we all know, DHT receptive hair is not terminal hair and not suitable for transplantation.

[Silent1234]

Definitely go and get assessed properly by a hair transplant surgeon before singing up anywhere. 

[HairGone29]

Taken some wet pics for a better idea,

 

[Melvin- Admin]

Looks like the entire scalp is thinning. Again, I can’t stress enough the importance of being evaluated in person. Looks like DUPA to me, but I’m no doctor.

[HairGone29]

On 5/29/2020 at 5:03 PM, Melvin-Moderator said:

Looks like the entire scalp is thinning. Again, I can’t stress enough the importance of being evaluated in person. Looks like DUPA to me, but I’m no doctor.

I've only ever had one in person consult with the Maitland clinic (Dr Ball) who assessed the donor, he never said I had DUPA but he struggled to distinguish where the DHT resistant hair started and wherev the DHT affected, but maintained hair ended.

I have fired off a bunch of emails to several surgeons.

Dr Demirsoy - Donor area looks weak and unhealthy, asked if I have a vitamin or iron deficiency. Advises against surgery.

ASMED - NOTE: Due to the fact that your hair is a fine and light colour. The shedding is active we believe that Finasteride does not have a high impact on your hair. The reason for this is because it is obvious that you have miniaturization. It is expected that the final result will not provide intensive coverage. There would be a homogeneous natural look with coverage that is not very high.

Dr Bhatti - 

Thank you for the mail with pictures and 2 videos which I have gone through.

You shall need around 2800 scalp grafts for the hairline and temple points.

However since the scalp donor on first inspection does not look too dense, I think we should settle on 2500 scalp grafts for the purpose which should also be fine.

 

Here is a final video where I comb the donor hair against the grain

 

 

I guess I have no option but to accept that I can only maintain what little I have for a few more years then shave it. I started Dutasteride a couple months ago once per week to go a long with the daily Finasteride i've been taking for the past 8 or so years. 

Sad times

[gillenator]

I don't want to discourage you but IMHO many doctors would highly discourage you from taking "both" low dose finasteride and dutasteride concurrently as this can have an adverse affect on the prostrate.

[Melvin- Admin]

In my opinion, get an evaluation in person, with a doctor that uses high magnification cameras or lenses. It appears that you have diffuse loss all over your scalp, but perhaps that’s because your hair was wet. We really can’t say for sure, and the only way to really rule out surgery is to be seen in person.

[gillenator]

A microscopic examination of your entire scalp is what is needed, especially the donor area.

[giegnosiganoe]

Finasteride for 8 years? How old are you and what did your hair look like back then?

If you don't have a doctor you can see in person, you may want to order a USB microscope off Amazon for about $30.

And I would personally take dutasteride daily instead of finasteride in your situation. I wouldn't expect any miracles but I think it would give you a bit more time.

Edited June 10, 2020 by giegnosiganoe

[Rolandas]

Like many already said, check yourself with hair specialist. Maybe you even got some deficiency in something, but like Melvin said, it does indeed look like DUPA (Diffuse Unpatterned Alopecia) which like you described "he never said I had DUPA but he struggled to distinguish where the DHT resistant hair started and wherev the DHT affected, but maintained hair ended".
That's pretty much definition of DUPA.