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Hesitant to pull the trigger, norwood 6/7, looking for advise


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I have been researching transplants religiously for the past 6 months or so, I am a 35 year old male from the US, started balding when I was 17-18, currently my loss seems to have stabilized, I have been on fin for almost 10 months now. I have contacted some clinics in Turkey, a couple have turned me down, Cinik and Este Prime said yes, and obviously are very reasonable, However I am considering Eugenix in India instead even thouigh it will be 2.5x the cost roughly, because I want a good result.  Had a video consultation with them, they told me 4-5k first session with beard and crown later. I dont have verey thick beard hair under my chin.  I am hesitant to pull the trigger because I have been told my donor is weak, and I would need a lot of grafts. I am not looking for 100% density, so I have realistic expectations.     

 

Here are some photos, 3 taken with about 2 weeks growth, and then about 2.5 months.   short pics show the donor looking sparse, the other side looks better probably because the light wasn't super bright (right by the mirror lights). I also appear to have retrograde ive been told. It seems too grow in thick despite the possible (misleading?) pics of the donor.    I am just looking for some good honest advise.    I would hate to go through it all and not be happy. If I could go to turkey and spend 3k instead of 6 I would be thrilled also.         

I used to wear a hair piece, and I will again if a transplant is not a good idea.

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Edited by the496rocket
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Well you can rule out the hair mills, Este Prime + Cinik. Under no circumstances do you want a “Tech” driven procedure. To have any chance of a decent outcome you need someone like Eugenix, who you have already mentioned. 
It’s going to be a challenge, but if anyone could give you a satisfactory result then it’s Eugenix. With a Norwood 7 and not a particularly strong donor area or beard ? Your going to need a realistic goal. I wouldn’t be looking anywhere else to be honest. And I can see why some places would turn you down. 

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Your best course of action would be to spend time time browsing two of the forums:

Hair Restoration Results Posted by Patients

Results Posted by Leading Hair Restoration Clinics

If you do a keyword search in these by terms such as "NW6" or "Norwood 6" in the thread titles you will come up with various cases with several photos.  The more useful ones are those where the people come back down the line to show the full result.  There are some common similarities in regards to who can produce a good transplant with your level of hair loss.  I'd avoid most of Turkey.  You have to get your HT done right the first time, with so little to work with.  If you use beard grafts that expands how much more you can get done.

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Eugenix without a doubt is 1000x better than the mills you mentioned. As a high Norwood you need to get it right, two guys similar to you @Zoomster and @kirkland check out their threads. 
 

As for happiness, if you expect a full head of hair, just keep shaving. You have to be realistic. You will need multiple procedures to get coverage and density, even with Eugenix. If that’s not worth it, keep shaving.

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@the496rocketI agree with @Melvin- Moderator. You need to make a smart choice for a HT because you are a higher NW. Not much room to make a mistake so take your time on the decision. 

I was looking for the price sheet at Eugenix but their site seems down at the moment....looking at you Dr. Bhatti....just kidding.

When I checked just a couple of weeks ago, I saw that they have the same price that I went for on the Exclusive package, which was 210 INR per graft, which is just under $3 USD. That was with Dr. Bansal doing the design, incisions....I still think that's an absolute bargain for her skill set. She definitely does not get the love as much as Dr. Sethi but she is as equally, if not more, skilled. Don't want to get in trouble here - they are both excellent surgeons with a ton of experience in high NWs.

I love to pump the tires on Eugenix and Dr. Bansal because everything is coming up roses for me. I was close to your level of hairloss and the turnaround has been incredible with only 3500 grafts. To me, that is a testament to the skill of the surgical team to harvest the best grafts and get the most out of them. But whatever choice you end up making if you go for a HT, don't go bargain hunting in Turkey. 

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You need to go a doctor & have anaylise what can be acheived rather than just online.

If I was you I would go to Zarev. He does a consult where he calculates how many grafts you need & how many you have.

A buzz cut transplant might be our best option. Like a 3mm haircut where grafts are spread out in an even manner.

But if you dont want a buzz that rules it out

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If even some mills in turkey refuse to perfrom work on you this is a huge red flag. From the clinics you mentioned only Eugenix would be worth discussing with IMO. And I would contact a FUT clinic like H&W or Hattingen.

My honest opinion is nevertheless: You are not a candidate as you donor appears thinning (almost) all over. If you go down the HT route, you probably will have multiple surgeries and spend several ten-thousands of $. 

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Hello sir,

Your best hope for a successful result would be to go to someone that has excellent donor area management

You have very fine hair, i wouldn't say thin but it is on the finer side. You must also consider have a very high hairline, this will ensure a large number of grafts for maximum coverage throughout the entire scalp and deep into the crown area, aswell as some beard grafts into the ''balding donor area'' at the back since the progress was so severe. 

 

I have attached below a rough estimate of what you would be looking at to have a presentable coverage of ''illusion''

Im not a Doctor nor a hair consultant, just a stranger on a forum trying to help out. But I'd say it would do the job. 

Regarding hair transplant procedure, with a case like yours it would probably take 2 procedures. 

Untitled.png.9c4a8a185c0b26227893e801e97c9c83.png 

Im going to repeat, please find someone who is excellent with donor area management... or else you will end up with alot of hair on top and an absolutely destroyed back and side!

Since I saw you wrote about Eugenix, you are in safe hands

Good luck sir 😊

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Okay great thanks so much everyone for the replies.     Everything everyone has said makes complete 100% sense to me and I appreciate all of it. Eugenix quoted me 4-4500 front and mid scalp, with 500-1000 of that being beard, and then crown work 6 months later.    If I have this done it would be Eugenix, I wont consider a cheaper place after all the advise.  but I would choose the lowest package which is about $1 a graft, and I dont think doctors are involved much correct me if I am wrong and I have set my mind at the absolute maximum I want to spend on this entire journey. I understand its an investment into myself, but I also have a point where having my hair again isn't worth the cost to me because I am not opposed to going back to wearing a hair system, but I would rather avoid it, and I just want/need closure on whether a HT would give me a satisfactory result, before I throw in the towel, because otherwise I will spend the rest of my life wondering if it could have worked. 

I used to have extremely thick hair, and my other concerns are that my retrograde will progress, and my donor will keep thinning, to the point where the transplanted hair also will thin out in 5-10 years time, even though I am on meds. 

 

It is such a tough decision. If I have my donor maxxed out, and it doesn't end up working out, then I dont know if even wearing a system would work as there isnt thick enough hair to blend.    I absolutely do not want to be bald, I almost consider shaving my head not an option, I cannot stand shaving my head, and looking in the mirror and hating what I see every day is extremely hard on my self esteem. I wear a had literally 100% of the time when I go out. I never leave the house without one. I have tried literally probably 10 times to be comfortable with the shaved look and I cannot. I have tried so hard. 

 

 

Edited by the496rocket
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All the packages have Drs. involved. A surgery without a doctor's involvement is unacceptable. An elite clinic like Eugenix wouldn't compromise on that. You're in good hands.

Edited by Drish
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In my opinion you don’t  have the luxury of a lá carte picking of surgeons or clinics for your situation. …I think you’re on the absolute limits of viability here …you’ve a Coronet going on which you’re going to have accept it’s highly unlikely you’ll have it filled ..The good news is I can see a 3k scalp 2 K beard possibility for a very pleasing aesthetic difference ..

Put simply I’d still be shaving my head had I not had a video consult with Dr Sethi …I’d strongly recommend that  you do the same …

Wish you the very best of luck 

Karl 

 

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Congrats on identifying all the critical issues —future donor management, thinning donor vs system wearing etc. 

As a red haired person you will have less hairs per sq/CM. It’s quite possible FUE will leave your donor threadbare and I think you might have less beard donor than you think. 
 

You might be able to achieve a shaved spikey hair look with 2,000 grafts in the frontal third from the head and maybe 500 bearD FUE. But will that be enough to satisfy you ? If yes then think of it as kind of Zidane shaved look just before he fully shaved down to the scalp and this might be achievable. Combine that look with good health, attitude, and pumped up body and you could come away with a new mature look—and the good news is you you won’t seem to change much to the outside world between the ages of 35-55 while your peers age more rapidly. You’ll have framed your frontal third and maintained your options for a hairpiece and not thinned out the donor too much.
 

you could also try for the temp SMP on your shaved head and see if you like that look as stand alone option or in combo with the above FUE
 

Otherwise...you have to assume that you are going to progress in the hair loss. Medication doesn’t always work forever or you might have to get off it at some point for whatever reason.
 

You have an asset insofar as you have worn systems before and they are indeed easier with a donor that is intact. Hair systems are getting better all the time...wear one with pride and even with the ability to joke about it to others and you might find yourself loving all the new looks you can rock that non-system folks can’t understand. People love the ability of others to poke a little fun at themselves—it also puts YOU in control of the situation.
 

The point is—-you are young. You have options—rock a system, shave, SMP, or try a LIMITED initial FUE. Be very careful about the amount of grafts you use on the first cut—as others have said, donor management is key.

 

 

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It is possible, but you need to find a good surgeon who others have mentioned knows what they are doing when it comes to the donor. I'd estimate you only have a few thousand grafts to work with from your donor. 4,000 or so if I had to guess. You would have to go with beard too. Eugenix would probably be the best choice for this, but other good options who excel at donor management that i've seen are De Freitas, Demirsoy, Ferreira.

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Thanks for the replies, makes a lot of sense.   I am honestly starting to shy away from attempting a transplant altogether due to the fact that, like I was saying and everyone else is saying, my donor is real fine and looks to be thinning, (Turan said it looked like possible DUPA and the reason he turned me down)     And if my donor continues to thin out, the transplanted hair will also thin out over time and ill be back where I started, but furthermore highly likely without the option to wear a system due to the donor being so sparse from the transplant.    

Nothing more than I want than to be able to have a head of my own hair again, but it also seems to be a huge roll of the dice, as to whether it will still look acceptable in 5-10 years time. Right now a system is my 2nd best choice I feel, I do it all myself, and the cost is VERY low. and it looked great. But before I decide to do that, I am going to be absolutely sure that a HT is not an option anymore, as I dont want to keep thinking for the nest 20 years "could it have worked?" Just gotta have closure first I guess.  Ugh, such a frustrating, stressful, and difficult decision to make...

 

   My father has a full head of hair, and hes is 72 (thin yea but age) my mothers hair is very thin, and her sister and her mother both wear wigs because their hair is too thin now, and I take after her a lot.   Grandfather on my dads side was a NW7, Grandfather on my moms side died at 92 with a full head of hair.    Very odd genes on out family. 

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Yeh, bearing in mind what has been said by Turan, and looking at the very real possibility of future further thinning ? The system option sounds like the one I would be opting for. In a way you can never say it’s too late though.. @Gatsbyis a prime example of someone that wore as system for many years, and finally has got a solution. His involved a lot of Beard and erm.. even intimate sources… 

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3 hours ago, the496rocket said:

Thanks for the replies, makes a lot of sense.   I am honestly starting to shy away from attempting a transplant altogether due to the fact that, like I was saying and everyone else is saying, my donor is real fine and looks to be thinning, (Turan said it looked like possible DUPA and the reason he turned me down)     And if my donor continues to thin out, the transplanted hair will also thin out over time and ill be back where I started, but furthermore highly likely without the option to wear a system due to the donor being so sparse from the transplant.    

Nothing more than I want than to be able to have a head of my own hair again, but it also seems to be a huge roll of the dice, as to whether it will still look acceptable in 5-10 years time. Right now a system is my 2nd best choice I feel, I do it all myself, and the cost is VERY low. and it looked great. But before I decide to do that, I am going to be absolutely sure that a HT is not an option anymore, as I dont want to keep thinking for the nest 20 years "could it have worked?" Just gotta have closure first I guess.  Ugh, such a frustrating, stressful, and difficult decision to make...

 

   My father has a full head of hair, and hes is 72 (thin yea but age) my mothers hair is very thin, and her sister and her mother both wear wigs because their hair is too thin now, and I take after her a lot.   Grandfather on my dads side was a NW7, Grandfather on my moms side died at 92 with a full head of hair.    Very odd genes on out family. 

@the496rocketyou have to be comfortable with what best suits your situation. 

It's a positive that you have already had a hair system and liked it. That seems like your best option at the moment. In a few years, there will still be options for you for a HT if you change your mind. In fact, there will likely be more options for you from better meds that can strengthen your donor and more clinics that are capable of doing high NWs well.

Good luck in whatever choice you make.

 

 

 

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update, i reached out to Konior in chicago recently and sent him photos and he said that he doesnt think I would be happy with my results because of my donor density. Did not offer an in person evaluation. I think if I could get that done somewhere, it would at least give me 100% closure so I am not constantly thinking "what if it could work" and I could move on with my life and wear a system.   If I dont, I will never stop wondering. 

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3 minutes ago, the496rocket said:

update, i reached out to Konior in chicago recently and sent him photos and he said that he doesnt think I would be happy with my results because of my donor density. Did not offer an in person evaluation. I think if I could get that done somewhere, it would at least give me 100% closure so I am not constantly thinking "what if it could work" and I could move on with my life and wear a system.   If I dont, I will never stop wondering. 

Yes, that is a good plan. From your earlier post you mentiones eugenix quoted 4k grafts.  in person hair analys will definetly help. Just make sure it is very ethical doctor with proper assessment of donor area.

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The unfortunate part for you is that you don't have that thick coarse beard that would make you a good case for a clinic like Eugenix. Konior is right in the sense that if you took a few thousand or so from your donor, it would probably end up looking much thinner back there and on top of that 3,000 is not enough for full acceptable coverage. What about just using grafts for your frontal third only and considering a low density partial hairpiece for the midscalp and crown?

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On 2/19/2022 at 8:57 AM, the496rocket said:

I used to wear a hair piece, and I will again if a transplant is not a good idea.

Can you share what your goals are exactly in terms of what would leave you feeling unhappy? This is so important with everyone when it comes to a hair transplant. A patient can have incredible results but to them they are left miserable. Another patient can have a results that is then and only covers 50% of the scalp and they can be elated. It's such a subjective thing. You may be better off going back to a hair piece or keep shaving your head because once you have a hair transplant shaving your head is out and a hair piece will be your only option. Having said all that, I believe Eugenix can work wonders 'IF' you and Eugenix are both on the same page. I have probably more hair loss than you and a large head with bad scars from previous work as well (and no hair to show for it). I am five weeks post op with Eugenix and I had to use scalp, beard and body grafts for coverage. However I'm 55 and as much as I want total coverage, if it falls short in any way, I am well prepared for that 100%. All the best!

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@Gatsby The one thing I see happening often, is people that were at my level, get a transplant but only the front and mid, and the crown not done, and there is a "wall" of hair that starts where the crown meets the mid (if that makes sense)  I seen that in person and I thought it looked awful.   I would be happy with front and mid coverage, and then if the crown was thin, but looked natural, I feel I would be happy. I know @Zoomster was a NW6-7 and looks awesome now, but he had probably 3x the density of beard under his chin.   And yes @ML488, The fact that I have a lot of area to cover, and my beard is not thick (especially under my chin) is a big concern.  

 

These photos were of me at 24 years old, roughly 11 years ago. my hair was thinning out pretty bad, but I was still happy. If I was able to get that type of coverage again, I feel I would be happy, although I know that most likely the hairline would be higher. It was definitely thin, but at least it still framed my face, and didn't hardly affect my confidence. under certain lighting at this age, it looked worse.    The gentleman in this thread had a good result, and looks natural, albeit thin but natural, BUT he had FUT, which I am not interested in. 

 

 

Its depressing to look at old facebook photos, and over the years see the transition of my hair getting thinner and thinner, and seeing me wearing a hat more and more. Now i do NOT leave the house without a hat. EVER, I cannot STAND the way I look without hair and never will, I have tried probably 6 times to be ok with it and I cannot. I wish  could. I have very pale skin being a redhead, and the balding area gets a lot of freckles and not the darker area where I still have hair, and I despise how it looks.  

 

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Edited by the496rocket
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