Hair transplantation useful?

[Marev1993]

Good afternoon from Germany,

I (28 years old) have been suffering from hair loss for five years now and have recently become increasingly interested in hair transplantation.

I would like to hear your opinion whether you think a hair transplant in my situation makes sense or not?
Do you think my donor is okay?

What would you do in my situation?

I have not used any medication yet, I am only currently using Bioton tablets.

I would be very grateful for an assessment.

Many thanks in advance

 

Martin

[digi23]

1 hour ago, Marev1993 said:

Good afternoon from Germany,

I (28 years old) have been suffering from hair loss for five years now and have recently become increasingly interested in hair transplantation.

I would like to hear your opinion whether you think a hair transplant in my situation makes sense or not?
Do you think my donor is okay?

What would you do in my situation?

I have not used any medication yet, I am only currently using Bioton tablets.

I would be very grateful for an assessment.

Many thanks in advance

 

Martin

The most crucial step for you would be to try Finasteride and see if you feel fine on it with no side effects so you can be on it long term. When you know that you can start to think about a hair transplant or in your case probably more than one. You look to be heading towards Norwood 6, but you have alot of hair to try to keep with medication. 

A problem also if you do a hair transplant now without medication, is that you might lose alot of minatuarized hairs due to shock loss if you are not stabilised. Preferably you should be on Fin for 6-12 months before the transplant.

Your donor looks pretty good.

Without medication you are in for a tough battle, might be possible but personally I would not risk it. 

Edited November 28, 2021 by digi23

[ciaus]

Agree, if you've had noticeable loss since your early 20s its not wise to go down the hair transplant journey without first trying to stabilize the DHT onslaught against your hair with Finasteride. If you end up being one of the unlucky few that get side effects, or still keep losing anyway, look at alternatives like hair piece systems, just shaving it. Maybe revisit the idea of getting hair transplants in your 40s if your donor area is still good. And try to be conservative with realistic expectations so you don't run out of hair before you can achieve an acceptable result.

Edited November 28, 2021 by ciaus

[Z--]

Disagree with the others. Would def recommend researching Fin. If you are okay with the low risks of the side effects, I'd say go for it. Otherwise, I think you've lost enough that it makes sense to consider a transplant even without Finasteride (assuming the an ethical surgeon gives the okay), noting as others mentioned that you are likely to lose more. Find a great surgeon who can plan around that loss -- you will likely need 2+ transplants if you jump the gun now. Just keep expectations in check.

[Hair4Days]

12 hours ago, digi23 said:

The most crucial step for you would be to try Finasteride and see if you feel fine on it with no side effects so you can be on it long term. When you know that you can start to think about a hair transplant or in your case probably more than one. You look to be heading towards Norwood 6, but you have alot of hair to try to keep with medication. 

A problem also if you do a hair transplant now without medication, is that you might lose alot of minatuarized hairs due to shock loss if you are not stabilised. Preferably you should be on Fin for 6-12 months before the transplant.

Your donor looks pretty good.

Without medication you are in for a tough battle, might be possible but personally I would not risk it. 

Take a look at his second photo again. What hair is worth worrying about in regards to shock loss? There’s very few remaining hairs which are clearly on their out. A 2500-3000 session to rebuild his hairline/frontal third is clearly an option for this patient. It would make a massive difference in the hands of the right surgeon. As for the whole medication topic…It’s better to find out what’s possible with surgery alone for your particular case in case you go completely bald. Take a look at some nw5/6 restoration threads. You’ll be surprised what they’ve accomplished with just surgery & 4-5k grafts. 
 

[digi23]

18 minutes ago, James C said:

Take a look at his second photo again. What hair is worth worrying about in regards to shock loss? There’s very few remaining hairs which are clearly on their out. A 2500-3000 session to rebuild his hairline/frontal third is clearly an option for this patient. It would make a massive difference in the hands of the right surgeon. As for the whole medication topic…It’s better to find out what’s possible with surgery alone for your particular case in case you go completely bald. Take a look at some nw5/6 restoration threads. You’ll be surprised what they’ve accomplished with just surgery & 4-5k grafts. 
 

Well I agree that Norwood 5, even with thin hair calibre can do it without medication. Norwood 6 it becomes more difficult, specially if you have thin hair like under 60 microns, it would still be possible if you have a high amount of grafts per cm2, but you might need to overharvest on purpose. 

If you have thick hair calibre like 80 microns+ thats where you see all those amazing Norwood 6 to Norwood 1 cases. 

[Hair4Days]

4 minutes ago, digi23 said:

Well I agree that Norwood 5, even with thin hair calibre can do it without medication. Norwood 6 it becomes more difficult, specially if you have thin hair like under 60 microns, it would still be possible if you have a high amount of grafts per cm2, but you might need to overharvest on purpose. 

If you have thick hair calibre like 80 microns+ thats where you see all those amazing Norwood 6 to Norwood 1 cases. 

Not even back to Norwood 1 though. A nw6 back to a nw2/3 with a conservative age appropriate hairline is usually doable in the average patient with no meds using roughly 5k grafts give or take. Ideally 6k. That crown is going to be light though. But that’s better than shiny bald.  But yeah, ultimately comes down to donor characteristics 

[digi23]

3 minutes ago, James C said:

Not even back to Norwood 1 though. A nw6 back to a nw2/3 with a conservative age appropriate hairline is usually doable in the average patient with no meds using roughly 5k grafts give or take. Ideally 6k. That crown is going to be light though. But that’s better than shiny bald.  But yeah, ultimately comes down to donor characteristics 

Well you can see someone with thinner hair like @Rolandas is a good example, they used a little bit over 6500 grafts on him with a conservative hairline. He was Norwood 5A. He had 55 microns hair with 85 grafts per cm2 in the donor. If Rolandas were to be Norwood 6 instead with that hair calibre, you would probably need about 3000 more grafts because of the low crown dip. So someone with thin hair you are looking at about 9500 grafts for the whole Norwood 6 area, I would say less than 50% of patients have that available without overharvesting. 

For me I have 45 microns thickness, I doubt I can even reverse Norwood 5 without overharvesting.

[Hair4Days]

13 minutes ago, digi23 said:

Well you can see someone with thinner hair like @Rolandas is a good example, they used a little bit over 6500 grafts on him with a conservative hairline. He was Norwood 5A. He had 55 microns hair with 85 grafts per cm2 in the donor. If Rolandas were to be Norwood 6 instead with that hair calibre, you would probably need about 3000 more grafts because of the low crown dip. So someone with thin hair you are looking at about 9500 grafts for the whole Norwood 6 area, I would say less than 50% of patients have that available without overharvesting. 

For me I have 45 microns thickness, I doubt I can even reverse Norwood 5 without overharvesting.

I don’t know about another 3000 grafts for a dipping crown. I’d say another 1000 for the lower hemisphere of the crown. Depending on how wide it is.  Look at @Zoomsterhe achieved it all. With the use of beard hair as well 

Edited November 29, 2021 by James C

[Gatsby]

14 hours ago, digi23 said:

The most crucial step for you would be to try Finasteride and see if you feel fine on it with no side effects so you can be on it long term. When you know that you can start to think about a hair transplant or in your case probably more than one. You look to be heading towards Norwood 6, but you have alot of hair to try to keep with medication. 

A problem also if you do a hair transplant now without medication, is that you might lose alot of minatuarized hairs due to shock loss if you are not stabilised. Preferably you should be on Fin for 6-12 months before the transplant.

Your donor looks pretty good.

Without medication you are in for a tough battle, might be possible but personally I would not risk it. 

This ^

[digi23]

23 minutes ago, James C said:

I don’t know about another 3000 grafts for a dipping crown. I’d say another 1000 for the lower hemisphere of the crown. Depending on how wide it is.  Look at @Zoomsterhe achieved it all. With the use of beard hair as well 

Yes Zoomster had 5400 scalp grafts, 1400 beard grafts, total 7000 the first procedure. Here he did not have full coverage and pretty low density. HT 2 he had 2400 scalp grafts and 2200 beard grafts. Total of 11600 grafts. 

Zoomster have almost perfect hair characteristics, salt and pepper hair, his donor is depleted but looks good when its grown out abit. 

I think its unfair to say that anyone can have a result like his, you see Melvin was also Norwood 6 and he have not yet covered his crown, now he decided to try to mix beard grafts with scalp grafts. He have awesome beard, for someone who does not have his beard, youd need to leave the crown or try to overharvest the donor and grow it out abit longer.

Ontop of all of this, you need to consider that your hair will thin out during your whole lifespan, so each year you are losing density, thats why it is so important and why all the best Drs in the world ask you to atleast try Finasteride to slow the process and in the end get a better overall result.

Edited November 29, 2021 by digi23

[Gatsby]

Also you need to remember that zoomster's lower crown lifted (filled in) from taking Propecia! So being on finasteride, etc, is just as beneficial to being a Norwood 6 as it is for a Norwood 2.

[Hair4Days]

13 minutes ago, digi23 said:

Yes Zoomster had 5400 scalp grafts, 1400 beard grafts, total 7000 the first procedure. Here he did not have full coverage and pretty low density. HT 2 he had 2400 scalp grafts and 2200 beard grafts. Total of 11600 grafts. 

Zoomster have almost perfect hair characteristics, salt and pepper hair, his donor is depleted but looks good when its grown out abit. 

I think its unfair to say that anyone can have a result like his, you see Melvin was also Norwood 6 and he have not yet covered his crown, now he decided to try to mix beard grafts with scalp grafts. He have awesome beard, for someone who does not have his beard, youd need to leave the crown or try to overharvest the donor and grow it out abit longer.

Ontop of all of this, you need to consider that your hair will thin out during your whole lifespan, so each year you are losing density, thats why it is so important and why all the best Drs in the world ask you to atleast try Finasteride to slow the process and in the end get a better overall result.

Melvin only had 5400 grafts done i believe. I think 1500-2000 grafts would do wonders in his crown. Which would put him at that 7k mark for total grafts. But when we discuss someone without the option of beard hair, the question is can the average  patient get 7k fue grafts  from their scalp donor. I’ve heard yes from konior & bisanga As well as others. 

[Hair4Days]

2 minutes ago, Gatsby said:

Also you need to remember that zoomster's lower crown lifted (filled in) from taking Propecia! So being on finasteride, etc, is just as beneficial to being a Norwood 6 as it is for a Norwood 2.

Yes i remember him crediting fin for his lower crown which wasn’t transplanted. The topic in question is basically how many grafts does it take to restore a nw6 with no meds (on average)

[Gatsby]

9 minutes ago, James C said:

The topic in question is basically how many grafts does it take to restore a nw6 with no meds (on average)

Whoops! My bad! 😬 I should have read the entire thread sorry. In answer to this question though my answer is simply 'I don't know?' The reason being because we have know real scientific way of predicting the future of the MPB hair loss and the miniaturization of the donor supply?

[Britanium]

@Marev1993In answer to the original question you posed… I agree that you should consider taking Fin/Minox to help save and maybe (hopefully) improve your current hair. You do have hair to save. And it’s definitely won’t hurt to strengthen your donor before undertaking a hair transplant. Talk to your own Dr/Dermatologist for professional advice for the meds ! 
When I see your from Germany then obviously Hattingen spring to mind. They could be worth consulting with for advice and a possible transplant in the future.

[SLA]

11 hours ago, digi23 said:

Yes Zoomster had 5400 scalp grafts, 1400 beard grafts, total 7000 the first procedure. Here he did not have full coverage and pretty low density. HT 2 he had 2400 scalp grafts and 2200 beard grafts. Total of 11600 grafts. 

Zoomster have almost perfect hair characteristics, salt and pepper hair, his donor is depleted but looks good when its grown out abit. 

Some good points @digi23 and @James C. I think @Zoomsterhad very solid full coverage for his 1st HT. Although, true that it was not super dense in bright lights, I think he could have gotten away without a 2nd HT and thrown in a few fibers and/or supplemented with SMP if he wanted to go denser without a 2nd HT. Also, Zoomster is in his late 40s, so I think the look is age appropriate and will continue to be more so over time...and of course his 2nd HT will throw him over the top. I also think, he could have gotten away with a more mature hairline if he chose for more density in the midscalp/crown.

I do not think Zoomster has idea hair characteristics aside from his salt and pepper hair; otherwise, his hair is straight and on the finer side.

As for @Rolandas, he definitely has super results and a lot of grafts were used to achieve his results due to thin hair, although I wouldn't say he had a particularly conservative hairline. I also think he could have gotten away with excellent results with a tad fewer grafts and instead relied on shingling of hairs and/or SMP.

I think there are a lot of options for NW5/6, such as someone having a more mature hairline, having a lighter crown and supplementing with SMP as a density treatment, etc.

As for someone achieving 7k grafts with FUE...to answer your question, I just had an in person consult with Dr. Bisanga (best thing I have done so far in my journey) in which he accurately inspected and measured my donor capacity (he literally cut a few pieces of my hair to measure density). I have not surprisingly very low side of average donor density at 65 with 15k total grafts in my donor to which he could extract 6k-6.5k over a lifetime via FUE alone. My hair is fine yet curly which I was told sometimes tends to come with a slightly lower density (hopefully curl will provide some illusion). I would guess that someone with 80 density could be able to extract 7.5-8k grafts in a lifetime.

...and despite my low side of average density, he wanted to do FUE (not FUT which he also offers) of 7-8k grafts (~5-5.5k scalp grafts and 2-2.5k beard grafts)  over 2 surgeries for my bordering on a NW6 scalp would pretty much get me full coverage although crown density would be lighter at 30. The doctor thought that supplementing with SMP would be a great idea and provide a full look. I am also about to turn 48 so my idea of acceptable density might have been different if I was 28.

Hope that helps...

[Zoomster]

I think this gentleman is a perfectly  suitable candidate once he agrees to ring fence his procedure with finasteride....I have to say i take my (ugly duckling😄)hat off to Melvin who has already had 3 procedures and about to undergo a 4th ..or indeed to anyone who has had more than 1 HT in pursuit of their own personal goals ..I was really enjoying  my new rug after HT1 but alas hairgreed got the better of me and I’m now experiencing a fair bit of psychological discomfort as Ive suffered what looks like some recipient HT1 shock loss ..so almost 3 months out from HT 2 it feels like I’ve taken a step backwards and it’s pretty painful ..I’m trying to trust in the process as I’m sure everything will bounce back by month 6 or so...

I’d be interested to hear has anyone else found HT2 much tougher recovery than HT1 ..might be educational for future 2 pass clients ..

good luck @Marev1993..I think your prognosis is very good .

Edited November 29, 2021 by Zoomster

[SLA]

Hang in there @Zoomsterand trust the process. In no time, you will gain it all back.

[Marev1993]

Good evening everyone.
First of all I would like to thank you for all the answers and advice and apologize for my late feedback.

To get back to the topic at hand:

Unfortunately, I am already very uncomfortable with the current hair status. I would not be satisfied if I could only maintain the current few hairs through finasteride.
The biggest concern I have, however, is with possible side effects.

Would a possible hair transplant (frontal area) in 2022 be a mistake?

 

[Zoomster]

My sincere apologies if i somewhat derailed your thread @Marev1993..it wasn’t my intention at all .

You’re in a situation where hair loss is bothering to a sufficient degree that you feel meds won’t cut the mustard..

You’ve just answered your own question and the great news is you live in an era now where you  don’t have to accept being bald anymore if you’re in a position to do something about it ..

For some ..being bald is fine and that’s great ....it wasn’t fine for me anymore and it sounds like it isn’t for you also ..

I say go ahead and reach out to a few clinics ...

Trust your gut on whose best suited to your own particular set of circumstances..

Any questions please feel free to PM me .

Good luck 

[salsasakke]

You reminded me of this video when i saw your situation. Maybe try finasteride first for 6-12 months and then decide?