Weak Donor Hair or not

[Jaxl]

Hello all,

 Brief background, I've had  two previous  FUT hair transplants   by  two different HT surgeons both of whom are  recommended on this site.

 

I am 39 years of age and  my last HT was in 2011.

Not on any medications at present.

 

Would like your opinions on whether I am a suitable candidate for a third HT preferably FUE from the video of my donor area provided in the link below.

 

 

 

 

Thank you

 

Edited July 27, 2020 by Jaxl

[Melvin- Admin]

The donor looks okay, I would say another FUT would be better, since you already have the scar. The donor doesn’t look very robust if I’m being honest. FUE may thin out the area and make it harder to conceal the scar.

[Jaxl]

Thanks Melvin shall keep this in mind. I had a feeling as well  that my donor isn't very good. Btw do you think I may become a  NW 7  by the time I get to  60 or 70 years of age considering that I am not on any medication? And can you please guesstimate the number of grafts I maybe able to extract for one final FUT? 

Of course I do understand that I would need to meet with. a doctor to get a correct assessment  but its always good to get  peoples opinions on this forum.

[Melvin- Admin]

I would say you’re a norwood 6, your sides look relatively high and healthy. The amount of grafts depends on the laxity. I would say maybe 1,500-2,000, if you got good laxity.

[Gabreille Nelson Mukhia]

How is your beard density? If you can give donor hair from the scalp and beard then you can cover your crown with 3000 grafts approximately.

[Jaxl]

Thanks Nelson. My beard is about medium in density and yes can always use hair from there to get those extra number of grafts.

Edited July 27, 2020 by Jaxl

[gillenator]

Jaxl,

A couple of things...only by buzzing down your donor area (occipital zone) would it be possible to evaluate your donor density for FUE...if the donor density is on the lower side, then might it be possible for your strip scar to show as Melvin pointed out...based on the video you provided, it looks ok but only an in person evaluation will provide accuracy.

Since your last FUHT procedure was in 2011, you should have enough laxity for another strip but that also must be tested before surgery....and I agree, since you already have the scar, why not do another FUHT and get as many grafts as possible?

How many grafts are you hoping the surgeon will harvest?

Lastly, do you any NW 7s in your family history?

 

[Jaxl]

Thanks for your comment Gill.

My fathers cousin is a NW7  going by his photos as I've never met him  but my father  isn't bald nor was his father. I think I got it from my mothers side and  their level of baldness  looks around NW 6s. Shall look into FUHT since  I can get more grafts. The only reason why I wanted to avoid FUHT was that I see so many videos on youtube especially with the Spanish doctors where they post  all these impressive FUE results with so little grafts that I thought FUE was the way to go. 

 

I did get my hair assessed in person by a HT doctor recommended on this forum  in January 2019 and I was told that they could extract 3500 grafts which I think is wishful thinking Though still odd that someone qualified would have come up with that figure. 

 

 

Edited July 29, 2020 by Jaxl

[gillenator]

Well as long as you have the accommodating scalp laxity, you will get more grafts harvested via FUHT in a strip than FUE.

You can always do FUE when you are crossing the finish line...your final procedure.

[Curious25]

On 7/30/2020 at 12:43 AM, Jaxl said:

Thanks for your comment Gill.

My fathers cousin is a NW7  going by his photos as I've never met him  but my father  isn't bald nor was his father. I think I got it from my mothers side and  their level of baldness  looks around NW 6s. Shall look into FUHT since  I can get more grafts. The only reason why I wanted to avoid FUHT was that I see so many videos on youtube especially with the Spanish doctors where they post  all these impressive FUE results with so little grafts that I thought FUE was the way to go. 

 

I did get my hair assessed in person by a HT doctor recommended on this forum  in January 2019 and I was told that they could extract 3500 grafts which I think is wishful thinking Though still odd that someone qualified would have come up with that figure. 

 

 

If it was a reputable surgeon recommended on here, then I wouldn't worry and think it as odd - as an in person consultation is the most accurate way of assessing you, so I have full faith that this is likely a good estimate - and a positive one at that, 3500 grafts plus a further 750-1000 beard grafts should be more than enough for a skilled surgeon to re-vamp your balding area, and give you a full head illusion. 

Have you any pics of the front? 

RE. your NW status, your donor seems to be in good shape, especially post two HT's, so I agree with Melvin and would guess your final pattern to be  where you are at now, however allowing room for some loss in hair shaft thickness. 

NW 7's are usually dramatically bald by their 30's, and you don't fit this category IMO. 

[Jaxl]

Thanks for your comment curious25. Will get my hair reassessed in person with a doctor to get a second opinion once things get back to some normalcy. I’d be over the moon tbh if I could actually get 3500 hair  grafts plus another 1000 beard grafts which as you correctly mention would be sufficient  to cover my bald spots.Though I am aware that only medication will be able to stop future hairloss.  Have taken some photos of my hairline as well as sides.  My right temple  including  the area   just above my right sideburn has faded quite a lot over the years. I could be wrong but from my observation most   bald people usually never lose hair directly above their sideburns which was what prompted me to think I could get to a nw7. Or I could have retrograde alopecia? My left temple region   is faring better for now.

[Melvin- Admin]

Do you have Norwood 7s in your family?

[gillenator]

Jaxl,

Got your PM and thought it might be better to post in this thread rather than privately and glad you are ok with that...chance are there are others who may be in a similar situation who are following this thread.

Now the real critical aspect to your case IMHO, is the fact that you are not on any medications for treating your loss...we understand that and although it comes down to a personal decision as to why anyone chooses to not use hair loss meds, the risk for future loss is high and certain.

Having said that, I do think you are headed for class 7 based on the photos you provided.  If you decide to continue to not use any meds, your restoration goals and plans would need to be evaluated in a very conservative and realistic way...in other words, something has to give because you will eventually lose the hair on top of your head and only the grafts from your previous procedures will remain....the thinning and progressive loss is also impeding your lateral humps, sideburns, etc.

So although you do currently have hair on top, your restoration plan must account for the fact that you will lose it....although you are 39, I am basing this on your photos.

Again, only an in person evaluation will provide you with how much available donor to use, I still think FUHT and not FUE is going to provide the most harvestable grafts for the future and I also would not do anything in the crown until your frontal zone is satisfactory with a higher placed hairline.

[Jaxl]

Thanks so much  for that informative reply Gill. It would have been helpful had the HT doctor that  I met in January  2019 explained things the way you have done  instead of telling me that I have 3500 grafts and  was ready to book me in if I was interested. I also remember showing him my  hairloss above my sideburns  but he didn't seem too concerned inspite knowing that I wasn't on any meds.

 

Just for everyones information  the doctor is recommended  here and was the  doctor  that I went to for my first HT. So the key takeaway message for anyone following this thread is that if you have any doubts  then please ask around. It could help you in the long run. 

 

Edited August 8, 2020 by Jaxl

[Curious25]

5 minutes ago, Jaxl said:

Thanks so much  for that informative reply Gill. It would have been helpful had the HT doctor that  I met in January  2019 explained things the way you have done  instead of telling me that I have 3500 grafts and  was ready to book me in if I was interested. I also remember showing him my  hairloss above my sideburns  but he didn't seem too concerned inspite knowing that I wasn't on any meds.

 

Just for everyones information  the doctor is recommended  here and was the  doctor  that I went to for my first HT. So the takeaway message for anyone following this thread is that f you have any doubts  then please ask around. It could help  in the long run. 

 

With the upmost respect for @gillenator -

I would be inclined to suggest an in person consultation with a recommended surgeon from here to be a more accurate measure of your current state of play, as opposed to that of a forum poster with no medical background, looking at some photos you've stuck up. 

Second opinions are important, I agree - however a second opinion from another medically trained hair restoration professional, in person! 

[Jaxl]

On 8/8/2020 at 11:56 AM, Curious25 said:

With the upmost respect for @gillenator -

I would be inclined to suggest an in person consultation with a recommended surgeon from here to be a more accurate measure of your current state of play, as opposed to that of a forum poster with no medical background, looking at some photos you've stuck up. 

Second opinions are important, I agree - however a second opinion from another medically trained hair restoration professional, in person! 

 

While I  agree that getting an opinion from a qualified hair transplant is the way to go  but its always good to get different peoples opinions from this forum even though they may not be medically qualified.  

There was a thread where this patient had his donor hair butchered from a  non  Hair Restoration Network doctor and guys like Melvin and Gill came to his defence as they could clearly see that something was wrong with the way the doctor had handled that patients case.  Similarly  I am just looking for some opinions whether  good or bad.

Thanks though  to  everyone who took the time to comment as I found the feedback helpful.

Edited August 14, 2020 by Jaxl

[gillenator]

It's true that I do not have any medical license, and that my opinions are simply my views and clearly not medical advice...this is why I include a disclaimer at my forum signature on every post...and also why I routinely recommend that individuals seeking help should see a licensed physician (ideally in person) who is experienced and skilled in treating their hair loss...someone with a proven track record.

Having said that, I do have credible experience (through past employment) working in this field in the clinical setting...I started researching this field in 1980 and have spent 4 decades now interacting with many individuals experiencing hair loss and subsequently having the benefit of seeing a countless number of cases.

It has always been my passion to help other individuals who suffer from hair loss as I have myself...not for money, not for notoriety, but solely to improve quality of life.

I sincerely feel that if I am not fulfilling this passion to help my brother, then I have failed.

So while Curious25 makes a legitimate point, hopefully there are some of us that can offer some credible unbiased help free of charge with no conflict of interest.

[Curious25]

On 8/8/2020 at 2:45 AM, Jaxl said:

Thanks so much  for that informative reply Gill. It would have been helpful had the HT doctor that  I met in January  2019 explained things the way you have done  instead of telling me that I have 3500 grafts and  was ready to book me in if I was interested. I also remember showing him my  hairloss above my sideburns  but he didn't seem too concerned inspite knowing that I wasn't on any meds.

 

Just for everyones information  the doctor is recommended  here and was the  doctor  that I went to for my first HT. So the key takeaway message for anyone following this thread is that if you have any doubts  then please ask around. It could help you in the long run. 

 

I once again refer you to what you previously wrote, in which my response was aimed at. I am not discrediting @gillenator as such, as there is no question he has been around the industry for a lengthy amount of time, and adds valuable input to the forum on a regular basis.  

However:

1) Your summarising point was in essence advising the community for it to be important to seek second opinions from non medically trained strangers on a forum, via photos, to that of an in person consultation with a HRN recommended surgeon,

2) The points that @gillenator made, in reference to your NW7 progression (in his opinion based from the photos), and thinning lateral humps and sideburns (again his opinion based from the photos), if true, should have and would have, been picked up during the consultation by any skilled, reputable and ethical surgeon - three attributes the HRN prides all of its recommended surgeons on being,

3) This therefore insinuates you are dubious of the credibility of the surgeon, in which should you have a dispute for whatever reason with any of the HRN recommended doctors, this should be raised as a separate issue altogether, and be bought up with the community and @Melvin-Moderator , alongside the provision of evidence as to why in the form of a case study,

4) My advice to you would remain the same even had it been one of the medically trained professionals on the boards commenting on this thread as, simply put, you cannot compare an in person examination to that of viewing some photos online, (something that @gillenator himself highlighted). 

An ethical, skilled, and reputable surgeon would not have recommended you had a further 3500 available donor grafts for surgery, unless you did have an available 3500 donor grafts for surgery. 



 

[Jaxl]

I  did mention that I will be meeting with another hair transplant doctor in person once things get back to normal and travel restrictions are lifted. Not sure why you missed that part? And the reason why I chose to get advice from forum members in spite them not being medically qualified was to get ideas and opinions  which could help me  better prepare  in asking the right questions when I meet with a doctor in person. If you look at other  threads on this forum such as. "Can I get FUT done after damage due to FUE" you'll see that @Melvin-Moderator and @gillenator  have provided their feedback which I thought was extremely helpful to the OP. This  in spite them the not being medically qualified which is why I sent @gillenator  a PM requesting him to give me his feedback  on my donor hair which he graciously did. 

 

[Jaxl]

On 8/13/2020 at 8:23 AM, Curious25 said:

An ethical, skilled, and reputable surgeon would not have recommended you had a further 3500 available donor grafts for surgery, unless you did have an available 3500 donor grafts for surgery. 

Not 100% sure on that which is why I'll  have to get a second opinion in person. 

[Curious25]

Worthwhile doing! Hope it goes well for you! 

[gillenator]

I also wish you well Jaxl and glad to see that you are getting another "in person" exam and evaluation...and try to make sure that the next doctor uses a scope to examine your scalp as a microscopic examination is invaluable for evaluating miniaturization and useable FUs.

[Jaxl]

On 8/15/2020 at 10:01 AM, gillenator said:

I also wish you well Jaxl and glad to see that you are getting another "in person" exam and evaluation...and try to make sure that the next doctor uses a scope to examine your scalp as a microscopic examination is invaluable for evaluating miniaturization and useable FUs.

Thank you again @gillenator for your good wishes.  Now I would have never thought of  "try to make sure that the next doctor uses a scope to examine your scalp as a microscopic examination is invaluable for evaluating miniaturization and useable FUs." its advice like that that can make a huge difference in the end.  Something that I am grateful for that a forum like this exists  but most importantly there are kind and helpful people like yourself who are willing to share  whatever they know.