M 27 - Advanced stage hair loss. Am I a good candidate for FUE HT?

[SSD17]

Hello everyone,

I feel my hair loss is now at an advanced enough stage and am planning on a hair transplant very soon. I would love your input on if you think I am a good candidate for FUE and if you could provide some pointers in terms of number of grafts I would need and what expectations I should have in terms of hair line and density. 

Having gone through the list of recommended surgeons on the website I've been especially impressed by Dr. Bicer's reviews but am open to other suggestions. I've not yet reached out for a consultation but am planning to contact 5-8 surgeons after I have your opinions. Also, what are some important things to discuss with the surgeon during the consultation in addition to number of grafts, hairline and density expectations, incision by doctor or technician?

I'm not on finasteride since I experienced strong side effects when I tried it for a few months. My hair loss is also relatively stable now and there hasn't been any significant change in the last 18 months or so. 

Please see attached pictures

 

Edited September 21, 2021 by SSD17

[Z--]

Hi! You and I have similar (if not the exact same) hair loss pattern and we are near a similar age. Understand that without Finasteride, which I cannot take either, we will continue to lose our hair. 

That said, given your age and pattern (you can see a slight dip in the crown), I think you are probably heading to a Norwood 6. With that, it’s imperative that you preserve grafts and use them wisely. 

The surgeon I will be using for my own transplant stated that this type of pattern requires precise donor management and typically recommended less grafts to prevent shock loss (which you should absolutely ask about along with how they plan to manage your donor for future hair loss). The truth is if you do a hair transplant now, you will need two or three in the future. Fortunately you have beard grafts as well, which can be used. Please have them check your donor region to get a sense of how many grafts you have available. If you want a one and done transplant, I suggest you wait until you lose more hair (and even then I think you’ll need a minimum of two transplants). 

In my case, which I think you ought to consider given our similarities, the doctor has suggested an initial surgery of 2,000ish grafts next year just for the frontal third (and not to lower the hairline!). You should focus this area first as it frames the face. I anticipate that for my second transplant, likely using a mix of beard hairs, to cover a portion of the crown. From my own rough estimates, I’ll need to budget my donor to have enough donor left to cover any future loss that comes later (possibly 2k grafts to be safe is my guess) and to strengthen those areas.  In other words, you and I are probably in this for the long haul. Do keep me updated and best of luck on your journey!

Edited September 21, 2021 by Z--

[Britanium]

Maybe you can consider Eugenix @Eugenix Hair SciencesDr Bisanga @sl@Raphael84, HDC @Doron Harati, Vertex @DrTBarghouthias just some suggestions of clinics doing really good work with the higher Norwood levels. 
All are forum recommended. Dr Bicer as you have already discovered is a excellent choice also. Good luck 🤞 

Edited September 21, 2021 by JohnAC71

[RandoBrando517]

Your donor looks good why wouldn’t you be a candidate? 27 aint that young

[gillenator]

I agree that 27 is still young and because MPB is a lifelong journey and also because you are not on effective hair loss meds, continued progressive loss is inevitable.

Having said that, right now you are a true NW6 and what we do not know is if there are any NW7's in your family history...if yes, then I caution you in doing anything in your crown for now...why?, because if you do progress into class 7, the coronet area of your crown will dip down with more loss...and you do not want to be left with an open gap that you would be committed to filling in when the management of your donor reserves is critical.

I concur to start with the frontal zone for now, nothing more, and yes a conservative placed hairline will help to save as much future donor reserves since you are at a young age.

Lastly, possibly try a topical finasteride/minoxidil application...you may be able to avoid side-effects with a topical approach. 

[DrTBarghouthi]

Thank you for tagging me. I do believe that things are quite getting clear in your situation. This means that we can focus on front, mid scalp and part of the crown for a reasonable number (beard and scalp) and leave a good number behind for any future work that may be needed. I would consider you a NW 6 at this stage from a planning point of view. I would also recommend utilising the beard and scalp from the first session so as not preserve scalp donor too if needed. 

[blackislback]

On 9/22/2021 at 10:33 AM, DrTBarghouthi said:

Thank you for tagging me. I do believe that things are quite getting clear in your situation. This means that we can focus on front, mid scalp and part of the crown for a reasonable number (beard and scalp) and leave a good number behind for any future work that may be needed. I would consider you a NW 6 at this stage from a planning point of view. I would also recommend utilising the beard and scalp from the first session so as not preserve scalp donor too if needed. 

Doctor, can you tell us about connection related to family history, that genetic side and future loosing  hair, as some doctors who perform HT say that it's connected to mother's side line in family, as i explained my father had loosing hair, and my grandfather (father of my father)  , then was information that not important if grandfather by father's line important history, but grandfather on mother's side line?

Not sure about this line, as most of clinics-doctors ask like  was someone in family like father, grandfather with loosing hair, but no one mentione grandfather as father of our mother or father?