Transplanting safely between existing hair

[Shah007]

Hi

I wanted to share my picture and wanted opinion on whether it’s safe to safely transplant hair between existing healthy hair in the frontal area that has lost density (but is not balding) compared to the rest of the hair on the scalp. The area that has lost density in encircled by the red line. Some clinics have said it’s safe while others have said it’s not. Wondering if lateral slit method or Stick and place technique would be better in this area if it’s safe to undergo transplantation. Thanks. 

[LaserCaps]

Interesting case...particularly since you seem to be thinning throughout the entire pattern.  Also notice well developed corners. So I venture to say there family history of hair loss. The next obvious "thing" is the stark color of your hair which is not helping you.  The contrast makes the loss even worse than what it is.  Fact wise, if you've lost, you will continue losing.  And, while it may be gradual, it will happen if you do nothing about it.  So the first thing to consider is medical therapy.  Hopefully you are doing something to protect the native stuff.  Can you transplant? Sure! Keep in mind doctors will typically work under magnification and can see/work easily through the native hair.  There are some very talented doctors out there that can actually achieve density in a single procedure.  Have you had any consultations yet?

[Future Hair Doc]

I would suggest not doing this. It's too risky and you risk shock loss with the existing hairs. You've provided photos with the worst conditions (wet and direct light). I would protect what you have now with finasteride/minoxidil and see how it progresses. 

[Melvin- Admin]

There is a case very similar to you by a forum member @duchaine now is it safe? That depends on the surgeon, their staff, how many grafts you're receiving, and whether you're on medication like finasteride.

[Shah007]

Thanks for the valuable insight guys.

im 45 and have never taken hair loss medication. The frontal zone (within the red lined boundary) hair thinning has been very gradual. It’s still ok I guess with no balding spots. It’s still a bit of bother for me. I’d get a transplant if there is no shock loss issue. The temporal points have been stable for decades now with no miniaturization happening on the sides. The center of the hairline hasn’t receded.

So for the temporal point bald spots lateral slit transplant would be best and for the thinning front zone stick and place would be used? Do doctors even use 2 methods in the same surgery?

There is no maj hair hoss history in my family. My hair loss pattern is very similar to my dad’s. He has the same temporal point recessions and no bald spots anywhere else. His hair isn’t even pure white but quite grey for his age as he’s approaches 80. 
 

Ill only go for a transplant if it’s safe and doesn’t damage existing hair. Filling in the temporal points shouldn’t be an issue. The thinning in this frontal region is homogenous throughout so either transplantation can be done in all this region or none at all. The consultations I done gave mixed reviews. Some say it can be done while others say it’s not recommended. Very confusing.
 

I’ll add more pictures to help understand the hair loss situation better. Thanks. 

 

[Curious25]

7 hours ago, Shah007 said:

Thanks for the valuable insight guys.

im 45 and have never taken hair loss medication. The frontal zone (within the red lined boundary) hair thinning has been very gradual. It’s still ok I guess with no balding spots. It’s still a bit of bother for me. I’d get a transplant if there is no shock loss issue. The temporal points have been stable for decades now with no miniaturization happening on the sides. The center of the hairline hasn’t receded.

So for the temporal point bald spots lateral slit transplant would be best and for the thinning front zone stick and place would be used? Do doctors even use 2 methods in the same surgery?

There is no maj hair hoss history in my family. My hair loss pattern is very similar to my dad’s. He has the same temporal point recessions and no bald spots anywhere else. His hair isn’t even pure white but quite grey for his age as he’s approaches 80. 
 

Ill only go for a transplant if it’s safe and doesn’t damage existing hair. Filling in the temporal points shouldn’t be an issue. The thinning in this frontal region is homogenous throughout so either transplantation can be done in all this region or none at all. The consultations I done gave mixed reviews. Some say it can be done while others say it’s not recommended. Very confusing.
 

I’ll add more pictures to help understand the hair loss situation better. Thanks. 

 

You are literally a surgeons dream candidate for surgery. 
 

Your age, your hair loss pattern, your hair calibre - any surgeon worth his salt would be able to recreate your hairline and temple points for you, and leave you looking like an A lister! 
 

Medication won’t regrow your already bald temple areas, however may thicken your forelock, and stabilise the rest of your hair from any potential further loss. 
 

That being said, considering you have never taken medication, and looking at where you are at today factoring in your age and your family history that you briefly touched on, my non medical opinion would be that you are very unlikely to reach, let alone pass a NW5. 

The photo you have provided of the back of your head wet, presents some of the thickest hair characteristics amongst male patients. 

There is always a risk associated with any surgery, however after studying thousands upon thousands of cases over the years, I am confident that any top tier clinic would happily take you on and provide you with one of the best results this forum would see.  

Edited April 6, 2021 by Curious25

[Future Hair Doc]

Have you consulted with any surgeons? Where are you located?

[Shah007]

3 hours ago, qui bono said:

Would you consider trying medication for a year? If you go and check out Rassman's baldingblog he posts many cases of guys who have tried medications first and actually improved their hair loss situation. This thread by @Shifty shows how someone avoided a HT entirely by doing this (although he's clearly an outlier). Take some time to scroll through his thread which hes been updating for the last 2 years now 

Lateral slit and stick and place aren't mutually exclusive techniques, so yes they can both be used in the same surgery. Lateral slit has to do with the type of incision, whereas stick and place has to do with how the grafts are placed inside the incisions. 

For your specific amount of hair loss it can be a tough choice. The risks vs rewards might not be worth it, and you should be aware that you might end up in a worse state than when you started. The reason youre getting mixed responses from clinics is likely because of this, while also different clinics excel at different things and so might not be capable of pulling it off (and then some that are unethical and will tell you whatever you want to hear).

Consider medications (its a personal choice and might not be something you want to pursue), and try and take some time to find similar cases to your own on the forum. Message the guys privately and ask about their experiences/would they consider meeting you. I can see why your situation would bother you but nobody can promise you surgery is safe. The only thing we can help you do is make an informed choice about your own body and how to potentially mitigate any risks. 

I don’t want to go on medication. Not comfortable with taking meds. It will not help my temporal points baldness anyways. 

So the insertion in the scalp can be done using the lateral slit method for a stick and place transplant as well? For my thinning area transplant would it be correct to assume that the best bet for avoiding damage to existing hair would be by going for a stick and place transplant?

Thanks!

[Shah007]

2 hours ago, Dr. Suhail Khokhar said:

Have you consulted with any surgeons? Where are you located?

Online consultations so far and like this discussion here, there have been mixed replies. I’m looking at a potential surgery a year or so from now as I build up my finances and the corona pandemic hopefully becomes manageable. I can travel anywhere for the right surgeon. Location is not a big issue. 

[Shah007]

3 hours ago, Curious25 said:

You are literally a surgeons dream candidate for surgery. 
 

Your age, your hair loss pattern, your hair calibre - any surgeon worth his salt would be able to recreate your hairline and temple points for you, and leave you looking like an A lister! 
 

Medication won’t regrow your already bald temple areas, however may thicken your forelock, and stabilise the rest of your hair from any potential further loss. 
 

That being said, considering you have never taken medication, and looking at where you are at today factoring in your age and your family history that you briefly touched on, my non medical opinion would be that you are very unlikely to reach, let alone pass a NW5. 

The photo you have provided of the back of your head wet, presents some of the thickest hair characteristics amongst male patients. 

There is always a risk associated with any surgery, however after studying thousands upon thousands of cases over the years, I am confident that any top tier clinic would happily take you on and provide you with one of the best results this forum would see.  

Thank you for the complements 😀

This is my dilemma. A successful transplant would be an amazing home run but if there’s damage to existing hair then I’ll be left worse off. 
One things for sure, I’ll have to go for the top surgeons to maximize the chance of a successful transplant for my tricky situation. So far in my limited research Dr Hasson and Dr konior’s results have really stood out. 

[Curious25]

1 hour ago, Shah007 said:

Thank you for the complements 😀

This is my dilemma. A successful transplant would be an amazing home run but if there’s damage to existing hair then I’ll be left worse off. 
One things for sure, I’ll have to go for the top surgeons to maximize the chance of a successful transplant for my tricky situation. So far in my limited research Dr Hasson and Dr konior’s results have really stood out. 

2 of the best names in the industry, so you are on the right lines. 

You can't guarantee a successful surgery, however you can mitigate the risks associated by choosing an elite surgeon or clinic - and I am very confident the two names you have already mentioned would happily take you on as a patient, and give you an amazing result.

I am going to link you a nice case that was posted on this forum that is partially similar to your own situation, and want you to consider;

-He was 15 years younger
-He had more advanced hair loss
-He didn't take meds
-He didn't go to what most on here would consider 'a world class clinic'
-He had a strong donor, however doesn't seem to be as strong as your own going off the pics
-The native hair mid scalp shock loss he may or may not have had, regrew, 

Enjoy 
 

 

Edited April 6, 2021 by Curious25

[Britanium]

4 minutes ago, Curious25 said:

2 of the best names in the industry, so you are on the right lines. 

You can't guarantee a successful surgery, however you can mitigate the risks associated by choosing an elite surgeon or clinic - and I am very confident the two names you have already mentioned would happily take you on as a patient, and give you an amazing result.

I am going to link you a nice case that was posted on this forum that is partially similar to your own situation, and want you to consider;

-He was 15 years younger
-He had more advanced hair loss
-He didn't take meds
-He didn't go to what most on here would consider 'a world class clinic'
-He had a strong donor, however doesn't seem to be as strong as your own going off the pics
-The native hair mid scalp shock loss he may or may not have had, regrew, 

Enjoy 
 

 

Yes 👏 and he even came back and provided us with a 3 year update ! And was still good. 

[Shah007]

Ok so I have done some online consultation for finding out the no of grafts I’ll need. The doc wanted me to draw the desired hair line which I’m showing in the pictures I’m attaching. I’ve been given a no of 1600-1800 grafts required. I also drew the boundary between the mid and front scalp. The encircled area between this boundary and hair line has been thinning and the doc is confident that it’s safe to transplant hair between existing hair. It’s a relief to hear that! 
Regarding density, I’ve been told    40-50 sq cm would be the target density. I’m not sure how much this density looks like. Hope thats dense enough. 

[Melvin- Admin]

On 4/5/2021 at 11:42 PM, Shah007 said:

Thanks for the valuable insight guys.

im 45 and have never taken hair loss medication. The frontal zone (within the red lined boundary) hair thinning has been very gradual. It’s still ok I guess with no balding spots. It’s still a bit of bother for me. I’d get a transplant if there is no shock loss issue. The temporal points have been stable for decades now with no miniaturization happening on the sides. The center of the hairline hasn’t receded.

So for the temporal point bald spots lateral slit transplant would be best and for the thinning front zone stick and place would be used? Do doctors even use 2 methods in the same surgery?

There is no maj hair hoss history in my family. My hair loss pattern is very similar to my dad’s. He has the same temporal point recessions and no bald spots anywhere else. His hair isn’t even pure white but quite grey for his age as he’s approaches 80. 
 

Ill only go for a transplant if it’s safe and doesn’t damage existing hair. Filling in the temporal points shouldn’t be an issue. The thinning in this frontal region is homogenous throughout so either transplantation can be done in all this region or none at all. The consultations I done gave mixed reviews. Some say it can be done while others say it’s not recommended. Very confusing.
 

I’ll add more pictures to help understand the hair loss situation better. Thanks. 

 

Your donor quality and density is exceptional. If you go to one of the names you mentioned, I don’t see how you wouldn’t get a stunning result. 

[Shah007]

15 minutes ago, Melvin-Moderator said:

Your donor quality and density is exceptional. If you go to one of the names you mentioned, I don’t see how you wouldn’t get a stunning result. 

That’s the plan if I go ahead with a transplant. Idk if H&W use the stick and play method like Dr K does. Tending more towards Dr K for this reason. His immediate post op pics are unreal. You can tell just by looking at them that his methods are the best bet against possible shock loss (which is basically my primary concern). Time to save up

[Melvin- Admin]

1 minute ago, Shah007 said:

That’s the plan if I go ahead with a transplant. Idk if H&W use the stick and play method like Dr K does. Tending more towards Dr K for this reason. His immediate post op pics are unreal. You can tell just by looking at them that his methods are the best bet against possible shock loss (which is basically my primary concern). Time to save up

H&W created the lateral slit technique which is equally good. They both have amazing post-op photos.

[Curious25]

7 minutes ago, Shah007 said:

That’s the plan if I go ahead with a transplant. Idk if H&W use the stick and play method like Dr K does. Tending more towards Dr K for this reason. His immediate post op pics are unreal. You can tell just by looking at them that his methods are the best bet against possible shock loss (which is basically my primary concern). Time to save up

I’d be tempted to hedge a bet this could be one of the greatest HT results of all time in Dr K’s hands. What was his waiting time ? 

[Shah007]

20 minutes ago, Curious25 said:

I’d be tempted to hedge a bet this could be one of the greatest HT results of all time in Dr K’s hands. What was his waiting time ? 

Just doing online consultation with them atm plus due to this corona pandemic I cannot travel anytime soon. Looking forward to HT in approx 12 months time. Saving up in the meanwhile. Quality never comes cheap after all but is well worth it in the end. 

[Melvin- Admin]

35 minutes ago, Shah007 said:

Just doing online consultation with them atm plus due to this corona pandemic I cannot travel anytime soon. Looking forward to HT in approx 12 months time. Saving up in the meanwhile. Quality never comes cheap after all but is well worth it in the end. 

Absolutely spot on.

[Curious25]

1 hour ago, qui bono said:

I understand youre tying to be supportive, but I dont think its helpful to raise expectations too much. The best we can do as patients is help educate one another through our own experiences and try to minimise any unnecessary risks. 

I went to highly regarded doctor and didnt get the best results. 

Yea that’s fair enough - perhaps I am coming across a bit OTT in this instance, however I think it’s likely to stem from my initial confusion whilst first reading through this thread and seeing the uncertainty of responses regarding OP as a candidate, with even a doctor suggesting he was a bad candidate. For me, candidates don’t get better than this, for reasons I have outlined in my previous posts on this thread. 

[O Hare 57]

I was in the exact situation you were 10 years ago.  I would get 2500-3000 grafts in the same area at least.    I got shock loss and had to have 2nd procedure.  Spend 400 dollars and get a biopsy to measure your ratio of vellus hairs to anagen/telogen.  If hairs are miniaturizing their dead already.  Take propecia for a year B4 surgery or youll regret it.  I would plan on two surgeries spread out over 3-7 years.     It will cost you more up front but youll spend less time in hair transplant limbo.  2000 grafts is 10k.  3000 grafts is 13k.  YOull spend less time and money in the long run getting done right on your first procedure.  I had no hair loss in my crown at all until I reached 48 years old.  The hair loss demon never sleeps.  Talk to your doctor about your long term goals and likely progression of hair loss so your efforts to account for future loss are strategic and your not playing wack a mole.     Dont learn a costly lesson the hard way.  Good luck.  Its not just your hair.  Its your life.

[Shah007]

43 minutes ago, O Hare 57 said:

I was in the exact situation you were 10 years ago.  I would get 2500-3000 grafts in the same area at least.    I got shock loss and had to have 2nd procedure.  Spend 400 dollars and get a biopsy to measure your ratio of vellus hairs to anagen/telogen.  If hairs are miniaturizing their dead already.  Take propecia for a year B4 surgery or youll regret it.  I would plan on two surgeries spread out over 3-7 years.     It will cost you more up front but youll spend less time in hair transplant limbo.  2000 grafts is 10k.  3000 grafts is 13k.  YOull spend less time and money in the long run getting done right on your first procedure.  I had no hair loss in my crown at all until I reached 48 years old.  The hair loss demon never sleeps.  Talk to your doctor about your long term goals and likely progression of hair loss so your efforts to account for future loss are strategic and your not playing wack a mole.     Dont learn a costly lesson the hard way.  Good luck.  Its not just your hair.  Its your life.

Thanks for the advice. So basically what I gather from you is that I need to get a thorough consultation done with an ethical and reputable Doctor who will strategically plan my HT from a long term perspective. 
What method was employed in transplanting hair between existing hair? Was the shock loss significant. I’m assuming it was permanent since u needed a second HT to rectify it.
Thank you again for your comments. 

[aaron1234]

There is always a risk with shock loss, but if the doc works carefully then it minimizes this risk.  Also, I'd recommend shaving your whole head for the procedure, regardless if it's FUE or FUT.

[Shah007]

5 minutes ago, aaron1234 said:

There is always a risk with shock loss, but if the doc works carefully then it minimizes this risk.  Also, I'd recommend shaving your whole head for the procedure, regardless if it's FUE or FUT.

Why shave whole head if it’s FUT? Shaving doner and recipient areas is important but why areas that are neither (for FUT)?

[aaron1234]

4 hours ago, Shah007 said:

Why shave whole head if it’s FUT? Shaving doner and recipient areas is important but why areas that are neither (for FUT)?

Well, maybe not the whole donor region for FUT - just the area the strip is excised.  But shaving the recipient area if you have a lot of native hair will help the doctor minimize shock loss.