Senior Member asterix0 Posted October 5, 2020 Senior Member Share Posted October 5, 2020 Hi guys, I had sent Dr. Lorenzo some pictures for a consultation and getting back my pictures, I'm wondering for myself that I may not be a candidate for surgery. He agreed to do the in-person consultation for a microscopic evaluation, but still, judging from the pictures, I'm not so optimistic. Here are my pictures, I've also been on finasteride and minoxidil for years and am 28 right now.. I buzzed my hair with a 1 and a 2 in the first pics, and the mixture of brown and blonde hair kind of creates a thinner appearance, but I'm not sure. I know I will never get full coverage and I'm ok with that, I was just hoping to strengthen the crown and hairline a bit so I can use concealer better, and while still keep more donor in the bank for future loss of the midscalp if finasteride and minoxidil fail me. @Melvin-Moderator any advice would be appreciated! Link to comment Share on other sites More sharing options...
Senior Member 1978matt Posted October 5, 2020 Senior Member Share Posted October 5, 2020 (edited) Donor hair looks normal to me, maybe on the lower density end of the scale. I think you have DPA not DUPA on the top of your head. Diffused Patterned, i.e. crown loss. Finasteride and fibres is your best bet until the area gets really thin, after which a transplant may be worthwhile. The front still looks quite solid apart from perhaps an uneven hairline. Edited October 5, 2020 by 1978matt 1 4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013 1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018 763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020 Proscar 1.25mg every 3rd day Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted October 5, 2020 Author Senior Member Share Posted October 5, 2020 (edited) Fibers work great but I was hoping to fortify the crown to make them easier to use. Same with the forelock area of the hairline and maybe slightly on the edges if possible, like above the right temple in the first picture. Edited October 5, 2020 by asterix0 Link to comment Share on other sites More sharing options...
Senior Member 1978matt Posted October 5, 2020 Senior Member Share Posted October 5, 2020 Maybe. 1500 grafts maximum in that area, but I wouldnt expect miracles. The existing hair may just get shocked out and replaced by the new hair and you're back to square one. Also, if the doctor is a clown he may overharvest your donor, leaving insuffcient hair to cover the front. 4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013 1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018 763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020 Proscar 1.25mg every 3rd day Link to comment Share on other sites More sharing options...
Senior Member giegnosiganoe Posted October 5, 2020 Senior Member Share Posted October 5, 2020 I'd say your donor looks pretty decent given you buzzed with a 1 or 2 guard - that is very short. I'd be mainly worried about shock loss. How does your hair look if you grow out the top longer? Link to comment Share on other sites More sharing options...
Senior Member Curious25 Posted October 5, 2020 Senior Member Share Posted October 5, 2020 Donor looks ok to me aswell, what were his reasons for saying you weren't a candidate , was it specifically because of how your donor appeared, or because you still have too much hair (albeit miniaturised) - as these two reasons mean completely different things in terms of your candidacy. How long have you been on medication? Have things slowed down/improved since then? Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted October 5, 2020 Author Senior Member Share Posted October 5, 2020 (edited) 22 minutes ago, Curious25 said: Donor looks ok to me aswell, what were his reasons for saying you weren't a candidate , was it specifically because of how your donor appeared, or because you still have too much hair (albeit miniaturised) - as these two reasons mean completely different things in terms of your candidacy. How long have you been on medication? Have things slowed down/improved since then? He didn't say I wasn't a candidate, just that I need to be mindful of DUPA/retrograde alopecia, and with a microscopic evaluation he'll be able to better assess the donor region. I think it's because on the sides, there is retrograde alopecia which appears to look like DUPA (like the area above my ears), but also because I buzzed my hair super short, that may play a part in it looking like that. Yes finasteride and minoxidil have pretty much slowed things down to a crawl in the last 4 years, but I am still losing, just at a lower much rate. Edited October 5, 2020 by asterix0 Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted October 5, 2020 Author Senior Member Share Posted October 5, 2020 43 minutes ago, giegnosiganoe said: I'd say your donor looks pretty decent given you buzzed with a 1 or 2 guard - that is very short. I'd be mainly worried about shock loss. How does your hair look if you grow out the top longer? Looks better but still thin obviously in the crown area, which is the main region I'd want to address, with a maybe a little strengthening in the front. Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted October 5, 2020 Administrators Share Posted October 5, 2020 It doesn’t look like DUPA, maybe some slight retrograde alopecia around the ears, but not DUPA. I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing 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: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Senior Member Curious25 Posted October 5, 2020 Senior Member Share Posted October 5, 2020 5 hours ago, asterix0 said: He didn't say I wasn't a candidate, just that I need to be mindful of DUPA/retrograde alopecia, and with a microscopic evaluation he'll be able to better assess the donor region. 8 hours ago, asterix0 said: Hi guys, I had sent Dr. Lorenzo some pictures for a consultation and getting back my pictures, I'm considered that I won't be a candidate for surgery ? Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted October 5, 2020 Author Senior Member Share Posted October 5, 2020 5 minutes ago, Curious25 said: ? Sorry, meant to say I was wondering for myself that I may not be a candidate. Link to comment Share on other sites More sharing options...
Senior Member giegnosiganoe Posted October 6, 2020 Senior Member Share Posted October 6, 2020 It's interesting because when Lorenzo replied to my online consultation a few months ago, he told me I didn't have DUPA. Yet I'm pretty certain my donor is a lot worse than yours. And I also have obvious signs of retrograde. I tried following up multiple times, even sending him microscopic images of my donor where I have a larger than average number of miniaturizing hairs, but he hasn't sent me a second reply. I even tried sending a new consultation form. Complete silence.. it's discouraging because I considered him as one of the few surgeons who took difficult cases quite seriously. 1 Link to comment Share on other sites More sharing options...
Senior Member asterix0 Posted October 6, 2020 Author Senior Member Share Posted October 6, 2020 35 minutes ago, giegnosiganoe said: It's interesting because when Lorenzo replied to my online consultation a few months ago, he told me I didn't have DUPA. Yet I'm pretty certain my donor is a lot worse than yours. And I also have obvious signs of retrograde. I tried following up multiple times, even sending him microscopic images of my donor where I have a larger than average number of miniaturizing hairs, but he hasn't sent me a second reply. I even tried sending a new consultation form. Complete silence.. it's discouraging because I considered him as one of the few surgeons who took difficult cases quite seriously. Would you mind sharing your pictures? If you prefer you can also PM me, maybe my opinion might be helpful. Link to comment Share on other sites More sharing options...
Senior Member aaron1234 Posted October 6, 2020 Senior Member Share Posted October 6, 2020 11 hours ago, 1978matt said: The existing hair may just get shocked out and replaced by the new hair and you're back to square one. This. If you think all of the miniaturized hairs in your crown will survive surgery you got another thing coming. Dr. G: 1,000 grafts (FUT) 2008 Dr. Paul Shapiro: 2,348 grafts (FUT) 2009 ~ 1,999 grafts (FUT) 2011 ~ 300 grafts (Scar Reduction) 2013 Dr. Konior: 771 grafts (FUT) 2015 ~ 558 grafts (FUT) 2017 ~ 1,124 grafts (FUE) 2020 My Hair Transplant Journey with Shapiro Medical Group Link to comment Share on other sites More sharing options...
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