40, NW4, Considering FUE (3500-4000 Grafts)

[StillAlive]

Greetings, my follicularly challenged brothers!

I'm celebrating my midlife crisis in style and I figured that it just might be time for some hair restoration.

I'm 40 and what I believe to be NW4. I'm attaching some pics with my hair greasy, unwashed, looking it's fair worst. The front of my scalp is absolutely see-through. Depending on the angle and shadow, someone might be fooled into thinking I was an early NW3V but no dice, it's bad.

I consulted with Dr. Lorenzo in Spain and Dr. Yaman in Turkey and the consensus of both is that I'd need between 3500-4000 grafts in order to recreate my frontal hairline. The crown, I don't care so much about. Maybe in a later procedure in ten years time or if we have any leftover grafts. I have never used minoxidil or finasteride, nor do I intend to start. I'm a 'low maintenance' kind of guy and I was considering an HT as a 'one and done' type of solution to this. I'm fully aware that hair loss is progressive and I'll keep losing my natural hair but the fact that it's been stable for many years, prompted me to consider the option. If I'm pleased with the result, I might go back in 10-12 years to get another procedure done.

I'm mostly just sick of this "has a bit of hair/is totally bald'' non-look of mine and interested in hearing about the experiences of any guys with similar hair loss to mine. Did you do it? Are you pleased some years later? Does the new hairline feel as real as it looks? In your opinion, is it worth it?

[Melvin- Admin]

I’m turning 37 this year, definitely don’t feel near midlife 😅 

What are your goals? Do you want to lower the hairline? Do the crown? 

[StillAlive]

Just recreate a 'normal' hairline at this point, get rid of the Dracula V and fill in this see-through-to-the-skull thing in the front. To take family photos and not reflect the room back when I tilt my head forward, I don't mind staying with a 'mature' and high hairline in order to achieve this. The crown can wait, as I'm not really aware of it.

Really curious if that is possible with the proposed 3500-4000 grafts. 

[Doron Harati]

The donor looks healthy with thick hair above the average, I think you can get 4000 grafts on 2 days of surgery. looks very good candidate 

[DrMunibAhmad]

3500-4000 is surely more then enough for the frontal part. 

Maybe even 3000 is better, with a conservative hairline, given the fact you're not willing to take any meds. Leaving more grafts back as a reserve would be more safe imo. 

[StillAlive]

Many thanks for the replies!

I also had another concern. I still have hair in the forelock-mid region in various stages of miniaturization. A good doctor should implant between those hairs and the grafts would have equal chances of survival to the ones transplanted in the entirely bald areas, correct? Or do I stand higher chances of permanent shock loss to my existing hairs? From what I've read, the scenario would be unlikely and should only occur if a doctor transplants on top of an 'active' hair follicle.

The above is my last fear before pulling the trigger and going ahead. Kinda like...OK we'll implant 3500 grafts and then I'll lose just as many hairs and I'll have spent money to look about the same I know it's unlikely but I'd like to hear some of your own stories, maybe you'll set my mind at ease!

[Willyd]

There is always a small chance of permanent shock loss when implanting grafts around miniaturized hairs. You minimize this risk if your hair loss is stabilized with medication like finasteride and minoxidil as well as choosing a great surgeon who takes care while implanting to not cause too much trauma to your scalp. Research some more surgeons that are recommended here before making your decision.

[DrMunibAhmad]

5 hours ago, StillAlive said:

Many thanks for the replies!

I also had another concern. I still have hair in the forelock-mid region in various stages of miniaturization. A good doctor should implant between those hairs and the grafts would have equal chances of survival to the ones transplanted in the entirely bald areas, correct? Or do I stand higher chances of permanent shock loss to my existing hairs? From what I've read, the scenario would be unlikely and should only occur if a doctor transplants on top of an 'active' hair follicle.

The above is my last fear before pulling the trigger and going ahead. Kinda like...OK we'll implant 3500 grafts and then I'll lose just as many hairs and I'll have spent money to look about the same I know it's unlikely but I'd like to hear some of your own stories, maybe you'll set my mind at ease!

I would implant in the same density on the bald places, and the places where you have your own native miniaturised hair. A good surgeon can inplant them between these hairs. Although you won't make direct damage to these grafts, there is a high chance for non-permanent shockloss of these hairs due to trauma in this region. These hairs will grow back for sure. And when they will fall out in the future, you won't be left with a lower density of the frontal part. 

[Fue3361]

You’ve got good temporal points, and a good looking donor.  I think you’d look great with 4k grafts!