How many grafts would I need to restore hairline?

[jsmyth]

I started losing hair around 21 and I am 30 now. The loss has been very very slow so I am interested in pursuing an FUE. Basically everything behind this thinning frontal area is in good shape. How many grafts would I be looking at?

[TorontoMan]

I’m in a very similar situation and was quoted 2,000-2,500 by doctors when I consulted online and in person. Did you take medication to maintain your hair to that level ?

Edited June 12, 2020 by TorontoMan

[jsmyth]

1 hour ago, TorontoMan said:

I’m in a very similar situation and was quoted 2,000-2,500 by doctors when I consulted online and in person. Did you take medication to maintain your hair to that level ?

Kind of a long story but I took Finasteride for 4 years and then quit because of sides. Developed PFS after that which I've had since. It's fucked up a lot of things but one positive is that I haven't lost hair anymore.

[Taken4Granted]

Need better pictures and a proposed hair line. I haven’t had mine done yet, but I need a lot more work (full frontal) and I feel 3000 is adequate with a skilled surgeon. I can see 2500 for you if you’re going for density, but it would be foolish to assume you’re not gonna need more work in the future, so then it’s a question of donor supply.

[BDK081522]

Completely arbitrary question because we can't see your hairline and have no idea if you want to lower it or just fill in receded temple area. Take more photos with hairline exposed and a tentative hairline placement drawn. 

[jsmyth]

3 minutes ago, ruca2 said:

Completely arbitrary question because we can't see your hairline and have no idea if you want to lower it or just fill in receded temple area. Take more photos with hairline exposed and a tentative hairline placement drawn. 

Here you go - I want the hairline filled in in the corners and at the front but I don't want it lowered any further than where the middle currently reaches.

[BDK081522]

It looks like you have significant miniaturization in at least the first centimeter of your forelock. So that would need reinforced along with filling in the completely hairless temple areas. You could probably get away with 2000 grafts but it wouldn't have significant density. For a dense result with reinforced frontal you're probably looking at 2500-3000 grafts. 

[jsmyth]

9 minutes ago, ruca2 said:

It looks like you have significant miniaturization in at least the first centimeter of your forelock. So that would need reinforced along with filling in the completely hairless temple areas. You could probably get away with 2000 grafts but it wouldn't have significant density. For a dense result with reinforced frontal you're probably looking at 2500-3000 grafts. 

Thanks for getting back to me!

Do you think you could find an example/photo of what kind of density it would look like at around 2000 grafts. Would it look similar to how thin it does right now but just more straight of a hairline?

What surgeon do you think would be a good option for this kind of case?

[Taken4Granted]

@jsmyth

He’s recommending that graft count because he knows you need density. We high NWs would not use 3000 grafts to cover that. If you’re seeking a serious answer to exactly how thick, I’d recommend estimating the area you need covered in square centimeters. You can divide the graft count over that and look up results posted with stats on grafts/cm^2.

I think the surgeon should be the main thing on your mind. Once you talk to one or two, you’ll have a better idea of what to expect. I haven’t gotten my HT yet, but I’m ride-or-die for Konior.

Edited June 13, 2020 by Taken4Granted

[jsmyth]

 

14 minutes ago, Taken4Granted said:

@jsmyth

He’s recommending that graft count because he knows you need density. We high NWs would not use 3000 grafts to cover that. If you’re seeking a serious answer to exactly how thick, I’d recommend estimating the area you need covered in square centimeters. You can divide the graft count over that and look up results posted with stats on grafts/cm^2.

I think the surgeon should be the main thing on your mind. Once you talk to one or two, you’ll have a better idea of what to expect. I haven’t gotten my HT yet, but I’m ride-or-die for Konior.

Ya I'll need to look into that I guess. I mean my hairline hasn't been especially thick for most of my 20s so I don't think I'd care too much. Just want the hairs themselves to be of a better calbre and it to be more uniform. I have sort of fine hair that's naturally been a bit more wispy so I'm never going to have that stand up kind of hair anyways. I need to just get an idea of what the density in that thinning part is currently I guess then go from there.

 

Konior does some awesome work, but I just don't know if I could do the US. I think he charges like 8 USD for FUE grafts. So at 2500 that would cost me almost 30k in CAD. I don't mind paying for a quality surgeon but that is just too much.

[Taken4Granted]

@jsmyth

No kidding. I’m just looking into this again after deciding to hold off 10 years ago. It’s more expensive than I remember. I mean, I was planning for a high price tag and I’m still surprised. All the same, I would pay it. I would pay anything to fix a disastrous HT, so it seems better to choose the right doc and pay away some of the risk. My situation is worse, though. It’s gonna take FUT and several rounds.

[jsmyth]

3 hours ago, Taken4Granted said:

@jsmyth

No kidding. I’m just looking into this again after deciding to hold off 10 years ago. It’s more expensive than I remember. I mean, I was planning for a high price tag and I’m still surprised. All the same, I would pay it. I would pay anything to fix a disastrous HT, so it seems better to choose the right doc and pay away some of the risk. My situation is worse, though. It’s gonna take FUT and several rounds.

Ya it is absurd how little the price has changed for so long. Like it's still hardly accessible. Basically a downpayment on a house. I've been looking at some of the surgeons in Belgium. They're a bit cheaper than NA and seem to be pretty well regarded. Rahal was a lock for me for a while and he has $1k of mine on depost from a long time ago that I could put towards but I just here so much iffy shit about his FUE on here.

 

[BDK081522]

The reason why I mention the density issue is that your hair behind your hairline looks relatively thick. So to have a dense wall of hair behind a sparse restoration might not meet your goals. If you don't mind the thinning look then you can always go with a lower graft count but a surgical assessment by a top doctor is your only way of getting an accurate depiction of what is achievable in your case. Konior is the always the best option but many are turned off by the long waitlist or unable to afford his prices. Just FYI he doesn't necessarily charge by graft either. It's more of a generalized surgical fee based on a proposed graft count. 

[Taken4Granted]

@jsmyth

Agree. I wouldn’t risk it with Rahal. He’s done great, truly superb work, but I’ve seen unacceptable outcomes with some of his patients.

Edited June 13, 2020 by Taken4Granted

[jmghair]

On 6/12/2020 at 6:08 PM, ruca2 said:

It looks like you have significant miniaturization in at least the first centimeter of your forelock. So that would need reinforced along with filling in the completely hairless temple areas. You could probably get away with 2000 grafts but it wouldn't have significant density. For a dense result with reinforced frontal you're probably looking at 2500-3000 grafts. 

Why waste grafts in the forelock? Strategically speaking, if he already has hair in the center the wise thing to do would be to pack the sides and temples. I agree with 2,500-3000 graft estimate. Furthermore, Its a mistake to be considering FUE. You're rolling the dice with FUE when you need that many grafts. Many take it for granted they will have good yield with FUE what with all the online photos. Reality is that its more hit or miss. When you need such a large number (~3k), its not worth the risk. FUT is a much more safe bet.

[BDK081522]

14 hours ago, jmghair said:

Why waste grafts in the forelock? Strategically speaking, if he already has hair in the center the wise thing to do would be to pack the sides and temples. I agree with 2,500-3000 graft estimate. Furthermore, Its a mistake to be considering FUE. You're rolling the dice with FUE when you need that many grafts. Many take it for granted they will have good yield with FUE what with all the online photos. Reality is that its more hit or miss. When you need such a large number (~3k), its not worth the risk. FUT is a much more safe bet.

Firstly, he wouldn't be "wasting grafts in the forelock". If you look at the first cm of his hairline you would see that these are miniaturized hairs that are on their way out. Any transplant around the hairline could potentially shock these out so you have to reinforce the area or else he could end up with strong temples and a receded midline. This equates to unnatural. Meaning doesn't occur in nature and will draw attention. The goal is to recreate a hairline that is undectable or "natural" thereby not drawing attention to the restoration. Secondly, a blanket statement about FUE being hit or miss is kind of ridiculous. I'm not getting into an FUT vs FUE argument as it's an exhausted topic. The reality is if he goes to a quality surgeon he will get a quality restoration regardless of extraction technique. FUE cases of 2000-3000 grafts are routinely being done with extremely high yielding results. 

 

[jmghair]

3 hours ago, ruca2 said:

Firstly, he wouldn't be "wasting grafts in the forelock". If you look at the first cm of his hairline you would see that these are miniaturized hairs that are on their way out. Any transplant around the hairline could potentially shock these out so you have to reinforce the area or else he could end up with strong temples and a receded midline. This equates to unnatural. Meaning doesn't occur in nature and will draw attention. The goal is to recreate a hairline that is undectable or "natural" thereby not drawing attention to the restoration. Secondly, a blanket statement about FUE being hit or miss is kind of ridiculous. I'm not getting into an FUT vs FUE argument as it's an exhausted topic. The reality is if he goes to a quality surgeon he will get a quality restoration regardless of extraction technique. FUE cases of 2000-3000 grafts are routinely being done with extremely high yielding results. 

 

His forelock looks fine to me. It looked thin in the pic where he is pulling his hair back because the hair is at a weird angle pointing straight forward. How is it FUE being hit or miss ridiculous? Its a fair statement. I'm speaking from my own experience as this patient has a hairline similar to mine before I had my first FUE procedure. If so many grafts are at stake its prudent to go for the highest yield possible.

Edited June 26, 2020 by jmghair

[Taken4Granted]

There’s very little hit or miss when you pick the right surgeon, FUE or FUT.

[BDK081522]

20 hours ago, jmghair said:

His forelock looks fine to me. It looked thin in the pic where he is pulling his hair back because the hair is at a weird angle pointing straight forward. How is it FUE being hit or miss ridiculous? Its a fair statement. I'm speaking from my own experience as this patient has a hairline similar to mine before I had my first FUE procedure. If so many grafts are at stake its prudent to go for the highest yield possible.

FUE being hit or miss is an antiquated take on a very viable extraction technique. It comes down to surgeon selection. If a patient does their research and chooses an ethical, well established surgeon with years of experience then the technique doesn't matter. Both will yield similar results in the hands of of skilled surgeon. Now whether or not you think a patient needs to start with FUT to maximize donor capacity is a different argument. That usually comes down to donor characteristics and not actually dependent of extraction method. Your experience with FUE may have been negative but I don't think it's prudent to be telling prospective patients just starting their journey to disregard a surgical option based on your own bad experience. Once again if you went to a top tier clinic you would probably be happier with your result.  

[Gabreille Nelson Mukhia]

 

Hello. Hope you are well.

If the hairline is restored with lowering by 2 cm then around 1500 to 1700 grafts might required.

The mid frontal point should be:

1. Above the palpable frontal muscle mass.
2. Or around 7cm above Glabella (Glabella is midpoint between the eyebrows).

 

[BDK081522]

11 hours ago, Gabreille Nelson Mukhia said:

 

Hello. Hope you are well.

If the hairline is restored with lowering by 2 cm then around 1500 to 1700 grafts might required.

The mid frontal point should be:

1. Above the palpable frontal muscle mass.
2. Or around 7cm above Glabella (Glabella is midpoint between the eyebrows).

 

He said he didn't want it lowered under where his current hairline reaches so not sure why you would give him this hairline. Also, you thinking 1500 grafts will give adequate density dropping his hairline 2cms is just plain wrong. Please don't take this advice. 

[1978matt]

It's hard to say without some side on photos but 1500 FUE, 2000 tops seems reasonable.

Problem with FUE is there's only 5 or 6 doctors in the world I might trust, as most delegate extractions to some unknown assistant. 

[Gabreille Nelson Mukhia]

23 hours ago, ruca2 said:

He said he didn't want it lowered under where his current hairline reaches so not sure why you would give him this hairline. Also, you thinking 1500 grafts will give adequate density dropping his hairline 2cms is just plain wrong. Please don't take this advice. 

You are correct if he does not want to lower his hairline. It was just an opinion that if he does restore his hairline by lowering then the above seemed reasonable. However, if he doesn't want to lower the hairline then he would require less.

[Gabreille Nelson Mukhia]

14 hours ago, 1978matt said:

It's hard to say without some side on photos but 1500 FUE, 2000 tops seems reasonable.

Problem with FUE is there's only 5 or 6 doctors in the world I might trust, as most delegate extractions to some unknown assistant. 

Are you also planning on taking finasteride?

[Doron Harati]

Would say around 1500-2000 grafts to restore your original hairline.

If you ask me, don't lower your original hairline, it's a big waste of grafts.