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Lost the Crown, confused about whether to move forward and who to choose


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Hey all, I've been a viewer on this forum for a while, but I'm feeling a little lost with my hair loss decision. I am a Norwood 4 or 5, and have been losing hair since I was 20 (I am 31 now). I've been told by several doctors that the crown is a lost cause, but that they would recommend a 3k to 4k FUE session to restore the frontal hairline and work back a little from there. (2 pics attached). 

I had scheduled a transplant with Hassan and Wong but it'd been delayed several times due to travel restrictions and I am guessing I'd have to wait another year before a surgery in Canada would be possible given the pandemic (I am based in Boston). I had also eliminated Bernstein and Konior due to cost. 

I've narrowed down my selection to True & Dorin, Lindsey, and Bloxham. I'm confused as to who to go with and also if I should even get a transplant given that the crown is a lost cause. Additionally, if people were to put these docs into tiers for frontal FUT sessions, would the three doctors mentioned above all be roughly the same? I have seen all of their work, but am not sure who to go with. 

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Hello have you considered or tried finasteride? You want to stabalize your loss as much as possible before you start moving hair around on your head.

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Hi

I don’t think of the crown as a lost cause. But it’s easy to use up 1000s of grafts in trying to get decent coverage. And it’s more important for a lot of us to rebuild the front hairline first. This is what you or most other people see. 
You mentioned some excellent Drs. Tough call to make. 

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Hey, I did a few times (once pills, one topical) but had side effects with both so figured it wasn't worth it for me. I have been using Rogaine foam for a long time.

 

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Finasteride will work better than minoxidil. You may wanna give Finasteride another try. Sometimes people are so afraid of the rare side effects that they don't really give it a try. Give it a month and see if sides are real. It will hopefully help stabilize the loss and you can then plan surgery accordingly after being on it for a year or so.

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I wouldn't necessarily give up completely on the crown. After you address your front/mid scalp areas, depending on how your loss progresses, there is also a topical dht blocker Clascoterone -called Breezula that could be FDA approved within the next few years that doesn't mess with your horomones like finasteride. There's a weaker dosage that was just approved for treating acne so that's a good sign that the stronger version will be approved too. If that could stabilize your loss you could potentially transplant some hairs into your crown, enough that you could also use a concealer like Dermmatch to give you the appearance of full coverage. The forum moderator has alot of loss in his crown area and he uses Dermmatch very well, posted this tutorial topic below.

 

 

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You are not currently shaving our head. It's the men who have buzzed or shaved heads that have a much tougher decision to make because if they don't get enough coverage they were OK with shaving it if they had to and they'd rather shave than only have partial coverage. If buzzing/shaving is not something you want to do then the decision becomes much easier. With the frontal half filled in with hair you will look much better than you do now even if you don't get the crown done. If you are thinking that you may shave it down if it gets worse then you should try that first before making a decision to see if you can easily deal with that. If that look is not for you then get the transplant.

 

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  • 2 weeks later...
On 10/17/2020 at 3:56 PM, Curious said:

Give up the crown, wait it out and go to Hassan and Wong.

Thanks for the advice! Do you think H&W are just kind of a tier above? Are there any other doctors in the US you'd recommend? I think it could potentially be a year before Americans can travel to Canada.

 

On 10/17/2020 at 3:20 PM, deitel130 said:

Finasteride will work better than minoxidil. You may wanna give Finasteride another try. Sometimes people are so afraid of the rare side effects that they don't really give it a try. Give it a month and see if sides are real. It will hopefully help stabilize the loss and you can then plan surgery accordingly after being on it for a year or so.

Thanks for the tip - Dr.True gave the same advice. Thinking about giving it another shot.

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On 10/18/2020 at 6:14 AM, BeHappy said:

You are not currently shaving our head. It's the men who have buzzed or shaved heads that have a much tougher decision to make because if they don't get enough coverage they were OK with shaving it if they had to and they'd rather shave than only have partial coverage. If buzzing/shaving is not something you want to do then the decision becomes much easier. With the frontal half filled in with hair you will look much better than you do now even if you don't get the crown done. If you are thinking that you may shave it down if it gets worse then you should try that first before making a decision to see if you can easily deal with that. If that look is not for you then get the transplant.

 

This makes sense to me - kind of what I was thinking, a transplant is going to make things look better if not perfect. I couldn't see myself with a shaved or buzzed look.

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1 hour ago, ES5919 said:

Thanks for the advice! Do you think H&W are just kind of a tier above? Are there any other doctors in the US you'd recommend? I think it could potentially be a year before Americans can travel to Canada.

 

Thanks for the tip - Dr.True gave the same advice. Thinking about giving it another shot.

Do give it another shot, don't throw in the towel just yet. There are other medications out there. I myself couldn't tolerate Finasteride and switched to Dutasteride, haven't look back since, probably one of the best decisions I ever made but that doesn't mean you'll have the same experience with Dutasteride as I did, it's just another option to consider before giving up. Good luck whatever you decide to do. 

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Bloxham all day..don’t even bother with meds.. he’ll get you the most coverage front to back as physically possible with surgery alone. Gonna take 2-3 though

Edited by James C
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My opinion would be Dr. Bloxham all day. I would say he'll attack the frontal zone zone first with a dense pack FUT strip procedure.  Go back 12 months later and do the vertex and crown with a second surgery and you should be all done. He's extremely knowledgeable, transparent and putting out some great consistent, natural looking results - see his youtube channel (Feller & Bloxham Medical). 

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Give up the crown. Don't take medications (and potentially deal with side effects). Expect to do 2-3 surgeries to cover full head. It'll be expensive, but worth it. Otherwise if money is an issue, just shave it off and rock the bald look.

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