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Advice needed on the number of grafts needed


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Hello, I'm early 40s, and I've been losing my hair since 1999 when I was 20.

In 2004 I started taking finasteride, and I continue to do so today without side effects.

I also put minox on my hairline, and have been doing so since 2010.

I got my hair reviewed by 2 doctors who I really like.

My goal is to restore my hairline, and I'd love to keep wearing my hair 'up' and spiky.

Apologies for the greying hair :)

Dr Panine said I need 1000 grafts, and this would cost around $6000.    Dr Nadimi recommended 1500 grafts "dense packed" which would be $12500.

My confusion is the difference in grafts, and obviously the price is quite different too. I understand that Panine is a hugely talented surgeon who can make grafts go a long way.

 

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With hair like that I wouldn't get a HT.

As for the number of grafts.  temple to temple is probably about 20cm.

Depending on hairline position, you might need to graft 1.5cm back into the old hairline.

In terms of required density, say 45-50 per sq cm.

20 x 1.5 x 50 = 1,500

1,000 could also be valid if you just reinforce the existing hairline rather than drop it down.

20 x 1 x 50 = 1,000

Edited by 1978matt
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4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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You have excellent hair for 43. I would also agree that you don’t actually need a hair transplant.  Either 1000 or 1500 grafts it wouldn’t make a huge difference and obviously the density implanted will in no way match your native hair. 
But at least the clinics your consulting with are both very good. 

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Did you ever get diagnosed with hair loss and prescribed Finansteride by a Dr? Because many guys who panick by a little receding and revert to Finansteride based on self diagnosis. While I could be wrong, that is another odd thing that strikes me with you.

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15 minutes ago, Mike10 said:

Did you ever get diagnosed with hair loss and prescribed Finansteride by a Dr? Because many guys who panick by a little receding and revert to Finansteride based on self diagnosis. While I could be wrong, that is another odd thing that strikes me with you.

Thanks for the response. Yes, I have been diagnosed by a few different doctors, such as Panine, Bosley, my PCP etc. They do all say I am in a good position though

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2 hours ago, 1978matt said:

With hair like that I wouldn't get a HT.

As for the number of grafts.  temple to temple is probably about 20cm.

Depending on hairline position, you might need to graft 1.5cm back into the old hairline.

In terms of required density, say 45-50 per sq cm.

20 x 1.5 x 50 = 1,500

1,000 could also be valid if you just reinforce the existing hairline rather than drop it down.

20 x 1 x 50 = 1,000

Thanks for the response. My hairline has really bothered me for a long time, especially when my hair is a bit longer. I feel like the receding temples are a but more obvious and I cannot quite style my hair how I would like. I understand that I'm in a good position compared to a lot of people my age though. It still affects my confidence though.

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A couple of points come to mind.  Based on the photo it seems you have tons of hair.  This will eventually be confirmed with an in-person evaluation.  I think it is important to understand that hair in the front and mid scalp grow forward.  Yes, when you slick your hair back, (with the hand), it shows you could reinforce the hairline area.  But by just leaving the hair be, as shown on the 4th photo, the bangs you have make it seem as if you have a lower hairline.  It is evident by your age and loss pattern the loss has been very gradual.  I'd bet most people would say you have a full set of hair and would question adding any grafts at this time.  You, however, look at this daily and are aware.  If it bothers you...OK. Otherwise-leave it alone.

I congratulate you for using medical therapies to help you with retention.  Please continue.

Patient Consultant for Dr. Arocha at Arocha Hair Restoration. 

I am not a medical professional and my comments should not be taken as medical advice. All opinions and views shared are my own. 

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3 hours ago, 97133620 said:

Hello, I'm early 40s, and I've been losing my hair since 1999 when I was 20.

In 2004 I started taking finasteride, and I continue to do so today without side effects.

I also put minox on my hairline, and have been doing so since 2010.

I got my hair reviewed by 2 doctors who I really like.

My goal is to restore my hairline, and I'd love to keep wearing my hair 'up' and spiky.

Apologies for the greying hair :)

Dr Panine said I need 1000 grafts, and this would cost around $6000.    Dr Nadimi recommended 1500 grafts "dense packed" which would be $12500.

My confusion is the difference in grafts, and obviously the price is quite different too. I understand that Panine is a hugely talented surgeon who can make grafts go a long way.

 

Screen Shot 2022-01-07 at 6.45.12 AM.png

Screen Shot 2022-01-07 at 6.44.52 AM.png

Screen Shot 2022-01-07 at 6.44.03 AM.png

Screen Shot 2022-01-07 at 6.42.43 AM.png

Screen Shot 2022-01-07 at 6.51.52 AM.png

at your age you could look into hairline lowering surgery i think they do it if your past a certain age with no hairloss.

as for transplants, realistically you would need 2 HT for a density that matches the rest of your scalp probably around 1400 grafts combined

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IMO your natural hair looks amazing and, while it is fair and understandable that even minor hairloss would legitimately bother anyone, I believe you getting a hair transplant - even from an elite doc - the risk of surgery far outweights any benefit. 

I'm actually a bit surprised these 2 elite docs would encourage you having surgery - but what do I know. 

Edited by SadMan2021
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