Am I a bad hair transplant candidate?

[BeadHead]

Do you think I'm a bad transplant candidate based on my donor area? I have very fine thin straight hair. I was on Finasteride and Rogaine for the last 20 years. Over that time the hair loss slowly got worse. 1.5 years ago I started shaving the top of my head and wearing a hair piece and stopped taking Finasteride and Rogaine. I shave the sides and back of my head with a 2 guard faded up to a 6 guard. Now I would like to get a hair transplant since I don't like wearing a hair piece. Shaving my head isn't an option since I have tons of moles. I have uploaded a bunch of pictures. The last picture is the top of my head 1.5 years ago when my native hair was long.

I also have a very thick beard. Tons of thick stomach hair with double grafs. Tons of chest hair. 

 

 

Edited January 22, 2021 by BeadHead

[Britanium]

It’s difficult for me to really tell what your donor area is like in those pics. Seems reasonable from what I can see. Yes a mix of scalp and BHT would be needed.

Have you considered consulting with Eugenix ?! Some other names would be HDC @Doron Harati,Dr Bisanga @sl& @Raphael84 and Vertex @DrTBarghouthi 

 

[Al - Moderator]

Your donor hair doesn't seem too bad from the pictures, but it's always best to get an in person evaluation of donor area on higher NW cases. Pictures don't always show everything the way it actually is due to lighting.

 

 

[Blower]

you got a nice beard to use also for high norwood like me.

[DrTBarghouthi]

Hi

Your donor seems good but I can’t comment on the texture itself. You would require a good number of grafts to get decent coverage of the area though. This can possibly be done via FUT/FUE/BHT combinations of all or two.

[Melvin- Admin]

Donor quality is only one part of the equation. Another factor is your expectations. You are a complete Norwood 6 bordering 7. You will always have some thinning, it’s possible you won’t be able to restore the crown. A hair transplant is never gonna be close to a hair piece for someone like yourself, regardless of your donor. I just want you to know that before you look into getting an HT.

Again, we don’t sell hair transplants here, we educate. We link educated patients to our list of recommendations who’ve been tried and tested by the members of this forum. We also have a pay it forward system that keeps this community flourishing. I suggest you take some time and look up reviews like @Zoomster @zaxter to name a few. See what a hair transplant looks like on a nearly slick bald head. Feel free to look at my journey as well. 
 

some examples of bad candidates

 

[Doron Harati]

Your donor looks good, but you have a lot to cover, you need to have expectations with a clinic and you'll need at least 2 procedures to cover 70-80% of your scalp.

[BeadHead]

Thanks everyone for your replys!

@Melvin-Moderator - I would 100% be ecstatic if I got anywhere near your coverage. I think your hair looks great! I've watched zoomers video and I would love that result too!  My ideal hair style would be a slick back like yours or a slick back to the side style. What style's are best to wear after a transplant? The side part maybe like Mr Rolandas?  I know some people here complain about being able to see their scalp after a transplant, especially when its wet. Maybe it's just my hair but even as a kid when my hair was wet I'm pretty sure you could see my scalp. I always thought that was normal. 

@Blower - Thanks, I love having a beard! As a high norwood like myself do you have any pictures of your procedure?

I'm looking to stay in America to get this done so I've been in contact with Dr. Konior and Dr Bloxham. Both have told me that it will take 2 FUT procedures and even then I may not have complete coverage. They still need to see my donor area in person. Both said for the 1st FUT to focus on the hairline and the front half of the scalp. If I don't have enough for my crown in the 2nd procedure then I'd just use fibers. My crown has hair their now for the fibers to grab onto, its just that they are thin. For my 2nd procedure I also have the option to use some BHT.  If my crown gets really bad then I also have the option to wear a hair piece to cover that. The main problem I currently have with my hair piece is the hairline. I workout alot so when I sweat the front hairline tends to comeup. So I only feel comfortable wearing my hair in a way that covers the hairline. Having the hairpiece just in the back would eliminate that problem and I could probably wear it 4 weeks instead of the 2 weeks I'm doing now. A hairpiece is alot of maintenance and I'm also constantly worried people will find out about it. 

I've been off finasteride for 1.5 years now but I was taking it for 20 years before that. Is it recommended to go back on it at age 41? I never liked it because I did get sexual side effects from it. Does the topical version have the same side effects? Are there websites to buy oral or topical finasteride? Are they cheaper with a prescription?

Does anyone recommend either Dr's Konior or Dr. Bloxham for a FUT procedure over each other in my case? 

Edited January 22, 2021 by BeadHead

[Melvin- Admin]

Dr. Konior is largely referred to as one of the best surgeons in the world. That said, for your case, you’d be better served with a clinic that specializes in megasession FUTs. I would also consult with Dr. Hasson and Wong. Take a look at Dr. Shapiro as well. My advice is submit several consultations with as many as possible. Feel free to submit your pictures via the link below

https://www.hairtransplantnetwork.com/Consult-a-Physician/hair-transplant-surgeons.asp?sr=HRN-MOB

[Curious25]

Interesting backstory. Great beard Aswell by the way. 
 

2x FUT’s seem pretty reasonable . . I would be interested to see whether an initial FUT, then a second and then a 3rd FUE would sit you in a better position. I’m pretty confident you’d get full coverage if you throw your beard into the equation later down the line. 
 

You have such a large area to cover it is vital you get as high a graft survival rate as possible, which is why choosing an elite surgeon is more important than ever - it simply mitigates the likelihood of things going wrong. 
 

If you want to stay in North America, then H&W are the GOAT’s of FUT mega sessions over your neck of the woods, Dr Konior who is arguably one of the greatest surgeons in the world will also be a great choice - however I’m unsure of whether he has worked on as many high level NW’s as H&W . x maybe he has, idk. 
 

RE. Finasteride - let’s be frank you don’t have much hair to save, and your final pattern seems to be pretty much established. People argue it will help strengthen your donor, which depending on your in person consultations may be something you’d need . . But as you refer to yourself as a patient who has unfortunately suffered from unwanted side effects, I guess it ultimately boils down to whether you want to live with them or not.  

[BeadHead]

4 hours ago, Curious25 said:

Interesting backstory. Great beard Aswell by the way. 
 

2x FUT’s seem pretty reasonable . . I would be interested to see whether an initial FUT, then a second and then a 3rd FUE would sit you in a better position. I’m pretty confident you’d get full coverage if you throw your beard into the equation later down the line. 
 

You have such a large area to cover it is vital you get as high a graft survival rate as possible, which is why choosing an elite surgeon is more important than ever - it simply mitigates the likelihood of things going wrong. 
 

If you want to stay in North America, then H&W are the GOAT’s of FUT mega sessions over your neck of the woods, Dr Konior who is arguably one of the greatest surgeons in the world will also be a great choice - however I’m unsure of whether he has worked on as many high level NW’s as H&W . x maybe he has, idk. 
 

RE. Finasteride - let’s be frank you don’t have much hair to save, and your final pattern seems to be pretty much established. People argue it will help strengthen your donor, which depending on your in person consultations may be something you’d need . . But as you refer to yourself as a patient who has unfortunately suffered from unwanted side effects, I guess it ultimately boils down to whether you want to live with them or not.  

Unfortunately H&W turned me down and said I'm a bad candidate. I sent them photos of my hair while it was damp. I sent them new photos but I haven't heard back yet. Fingers crossed!

I don't want to go back on oral finasteride but would be willing to if my hair transplant would benefit from it. Does topical have less side effects? I know from the pictures it seems like I've lost most of my hair on top but there's still ton there in the back half. Since I'm a diffuse thinner its hard to see it but I can feel tons of hairs. Even when I touch my crown I don't feel scalp, I feel hair. The hair on top of my head is about a milimeter long as I shaved it 2 weeks ago. Also can't my transplanted hairs and sides get thinner over time if I'm not a finasteride?

Edited January 23, 2021 by BeadHead

[Curious25]

3 hours ago, BeadHead said:

Unfortunately H&W turned me down and said I'm a bad candidate. I sent them photos of my hair while it was damp. I sent them new photos but I haven't heard back yet. Fingers crossed!

I don't want to go back on oral finasteride but would be willing to if my hair transplant would benefit from it. Does topical have less side effects? I know from the pictures it seems like I've lost most of my hair on top but there's still ton there in the back half. Since I'm a diffuse thinner its hard to see it but I can feel tons of hairs. Even when I touch my crown I don't feel scalp, I feel hair. The hair on top of my head is about a milimeter long as I shaved it 2 weeks ago. Also can't my transplanted hairs and sides get thinner over time if I'm not a finasteride?

I would recommend in person consultations from now on, it is the only accurate way to be assessed, and it will ultimately save you time and energy wondering or worrying about whether you are a candidate or not. I understand, easier said than done at the moment with restrictions in place. 

Theoretically topical finasteride doesn't produce side effects, however theres a question over whether it does indeed go systemic or not. One theory it may not cause side effects, is that it is just an ineffective form of administration, and patients receive little to any side effects from it - wanted or unwanted. 

Transplanted hairs thinning over time is inevitable due to the biological ageing of the body's cells - theres a difference between this form of thinning compared to DHT induced thinning. 

You previously mentioned you spent 20 years on finasteride - Did you experience these sides during the course of the 20 years?  

[deitel130]

Just read through your story. I personally don't think you should stay on Finasteride with the amount lost and seems your final pattern established. The other reason is that you got sides. 

Have you tried consulting with Eugenix they are also great at working on high Norwood cases. You may also need some beard or chest grafts and they are great with BHT.

Perhaps another option is shave it and get some SMP. The SMP may help camaoflouge the moles. You may wanna have a SMP consult to have that confirmed. This would give you another option. 

[aaron1234]

Just a thought... removing your scalp moles would be much easier than covering your NW6/7 bald area with hair.  Have you thought about going to a plastic surgeon to get them shaved off? That way a shaved head with a kick ass beard look would still be an option for you.

[kramer79]

8 hours ago, BeadHead said:

Unfortunately H&W turned me down and said I'm a bad candidate. I sent them photos of my hair while it was damp. I sent them new photos but I haven't heard back yet. Fingers crossed!

I don't want to go back on oral finasteride but would be willing to if my hair transplant would benefit from it. Does topical have less side effects? I know from the pictures it seems like I've lost most of my hair on top but there's still ton there in the back half. Since I'm a diffuse thinner its hard to see it but I can feel tons of hairs. Even when I touch my crown I don't feel scalp, I feel hair. The hair on top of my head is about a milimeter long as I shaved it 2 weeks ago. Also can't my transplanted hairs and sides get thinner over time if I'm not a finasteride?

Was there a mention of which doctor turned you down? or was it the consultant?

[Melvin- Admin]

To be perfectly honest, you need to see a doctor in person. What state do you live in? I can refer one to you, you need to be examined. 

[BeadHead]

3 hours ago, kramer79 said:

Was there a mention of which doctor turned you down? or was it the consultant?

I sent it to Wong but it was their consultant who emailed me back.

[BeadHead]

3 hours ago, Melvin-Moderator said:

To be perfectly honest, you need to see a doctor in person. What state do you live in? I can refer one to you, you need to be examined. 

I live in Colorado. I have a in person consultation with Dr.Harris next week, he's local. Do you recommend someone else?

[BeadHead]

7 hours ago, aaron1234 said:

Just a thought... removing your scalp moles would be much easier than covering your NW6/7 bald area with hair.  Have you thought about going to a plastic surgeon to get them shaved off? That way a shaved head with a kick ass beard look would still be an option for you.

Thanks for the advice! I would wear the hair piece before I shave my head. I've had a dermatologist shave off some of the moles and they still sometimes leave darkened spots. Maybe a plastic surgeon could get rid of those. I probably have 20 or so throughout my scalp. I used to tan alot in my 20s so probably got them from those days.

[BeadHead]

9 hours ago, Curious25 said:

I would recommend in person consultations from now on, it is the only accurate way to be assessed, and it will ultimately save you time and energy wondering or worrying about whether you are a candidate or not. I understand, easier said than done at the moment with restrictions in place. 

Theoretically topical finasteride doesn't produce side effects, however theres a question over whether it does indeed go systemic or not. One theory it may not cause side effects, is that it is just an ineffective form of administration, and patients receive little to any side effects from it - wanted or unwanted. 

Transplanted hairs thinning over time is inevitable due to the biological ageing of the body's cells - theres a difference between this form of thinning compared to DHT induced thinning. 

You previously mentioned you spent 20 years on finasteride - Did you experience these sides during the course of the 20 years?  

Yes I had the sides the majority of the time I was on fin. I've been off fin for 1 .5 years and the sides finally went away after a year. So I can pretty much determine they were from fin. So fin only slows down dht? It doesn't do anything for a hair shaft decreasing due to age?

[BeadHead]

9 hours ago, deitel130 said:

Just read through your story. I personally don't think you should stay on Finasteride with the amount lost and seems your final pattern established. The other reason is that you got sides. 

Have you tried consulting with Eugenix they are also great at working on high Norwood cases. You may also need some beard or chest grafts and they are great with BHT.

Perhaps another option is shave it and get some SMP. The SMP may help camaoflouge the moles. You may wanna have a SMP consult to have that confirmed. This would give you another option. 

I will contact eugenix. Do you know if traveling to India from the U.S. is an option right now with covid restrictions?

I find smp doesn't look good with someone with my pale completion. It's better for those lucky enough to have tan completions

[Curious25]

On 1/23/2021 at 10:23 PM, BeadHead said:

Yes I had the sides the majority of the time I was on fin. I've been off fin for 1 .5 years and the sides finally went away after a year. So I can pretty much determine they were from fin. So fin only slows down dht? It doesn't do anything for a hair shaft decreasing due to age?

What side effects did you experience, if you don't mind me asking? Putting up with whatever they were for almost 20 years makes me assume that hair loss was more of a concern for you, than what was being affected. 

And in answer to your final question - Correct. They are two different mechanisms - DHT miniaturises the scalp hair follicles that are genetically susceptible to androgenic alopecia  - otherwise 'healthy' hair follicles are like any other organ in the body - due to cell and tissue changes as we age, they slowly lose function - so your remaining hair will naturally weaken over time as a result of the ageing process. 

[BeadHead]

7 hours ago, Curious25 said:

What side effects did you experience, if you don't mind me asking? Putting up with whatever they were for almost 20 years makes me assume that hair loss was more of a concern for you, than what was being affected. 

And in answer to your final question - Correct. They are two different mechanisms - DHT miniaturises the scalp hair follicles that are genetically susceptible to androgenic alopecia  - otherwise 'healthy' hair follicles are like any other organ in the body - due to cell and tissue changes as we age, they slowly lose function - so your remaining hair will naturally weaken over time as a result of the ageing process. 

I'll pm you

[Hair4Days]

Did you make a decision yet on a procedure? What are clinics advising you to do ?

[Melvin- Admin]

Interested to know how it turned out as well.