Too Old To Rock N' Roll, Too Young To Be Bald (Long Hair After Transplant Discussion)

[StillAlive]

Playful title aside, I wanted to chew the fat on the following :

When I was young, I used to wear my hair really long. As my hairloss started in my late 20's, I began cutting it shorter and feathering it, to preserve the illusion of fullness (as any of you that sported long hair will know, the weight of hair can expose the balding parts of the scalp, whereas, the shorter you cut it, the more voluminous it appears) and it worked really well. Certain lengths were out of the question as they exposed my horrendously gleaming skull but with the right cut, no one in their right minds would suspect I was balding. Around 35 I went for a regular short cut, which also looked alright, a full NW3. That used to work until I hit 40, when my magnificent NW4V pattern is impossible to conceal. 

Now I'll be getting a transplant in September and I'm keeping my expectations grounded and realistic. I wanted to ask anyone with a similar history to mine who went for it and got an HT :

Post transplant and provided that you do not experience further aggressive hair loss, it should be possible to wear hair longer again, preserving that illusion of density. I imagine there's always a cutoff point where it'd look bad, a bit like turning back time and going to the point where I was a NW2.5/3? It's a good thing those undercuts, fades and pompadours are in fashion lately  

 

[TommyLucchese]

Me: Always had long hair. receding and started minoxidil age 16. aggressive hairloss by 20. got on propecia and had a HT on frontal third age 23 which was 10 years ago next month.

I've had my long hair back for 8 years now since it all grew in. When it's slicked back it looks thick, and when it's brushed down it covers the conservative hairline and looks normal. Not as thick as my original hair but still pretty awesome. I'm going to have a touch up in the next few years and lower the hairline / thicken up what's there....but that's just me being greedy now after a decade.

So to your question - yes you can grow it long and look good and no-one will know / care!

 

 

[StillAlive]

That is fantastic to hear man, thank you for sharing, you give me strength!

[TommyLucchese]

No problem! The last 2 pics in that thread show what it's like down and long. Because of your age and level of loss, you will probably be able to be more aggressive with grafts and hairline design than I was (the younger you are, the less certain future loss is so you have to be conservative). So with the right doctor and if your donor is good you will probably be able to get a better maine than me. 

Who are you getting your HT with? Have you consulted with anyone?

[StillAlive]

Well, I'm in a bit of a tough spot, because the only forum/community recommended doctor that I can afford, is Dr. Yaman in Istanbul.

I consulted with both him and Dr. Lorenzo in Spain and Yaman eyeballed me at between 3500-4000 grafts to reconstruct the hairline-frontal area of the head (I'm either a really bad 3V or 'healthy' 4V, never entirely sure). Lorenzo also quoted me 3800-4000 grafts but the cost difference was too much for me (3.2K for Yaman vs about 16K for Lorenzo) so I'm going with Yaman.

I'm 40 now, never taken fin or minox and I do not intend to, I'm a very 'low maintenance' kind of guy if you will, and saw an opportunity to fix something that's been bothering me for the past 12 years. I'm fully aware that I may need another procedure at around 50 to cover the crown and potentially enhance whatever I've lost in the frontal area and I'm cool with that. I'm just sick and tired of looking like a chrome domed, misshapen alien in family photos and goddamn it, I want my kids to go to ball games with a father that doesn't look so much like the baseball  

PS I'm also prepared for the possibility that it all goes sideways and after September I need to roll all Statham like. I'm thinking of this more as a great, gamble of a gift to my mid-life crisis self!

[dotdashdashdash]

8 hours ago, StillAlive said:

Playful title aside, I wanted to chew the fat on the following :

When I was young, I used to wear my hair really long. As my hairloss started in my late 20's, I began cutting it shorter and feathering it, to preserve the illusion of fullness (as any of you that sported long hair will know, the weight of hair can expose the balding parts of the scalp, whereas, the shorter you cut it, the more voluminous it appears) and it worked really well. Certain lengths were out of the question as they exposed my horrendously gleaming skull but with the right cut, no one in their right minds would suspect I was balding. Around 35 I went for a regular short cut, which also looked alright, a full NW3. That used to work until I hit 40, when my magnificent NW4V pattern is impossible to conceal. 

Now I'll be getting a transplant in September and I'm keeping my expectations grounded and realistic. I wanted to ask anyone with a similar history to mine who went for it and got an HT :

Post transplant and provided that you do not experience further aggressive hair loss, it should be possible to wear hair longer again, preserving that illusion of density. I imagine there's always a cutoff point where it'd look bad, a bit like turning back time and going to the point where I was a NW2.5/3? It's a good thing those undercuts, fades and pompadours are in fashion lately  

 

I really appreciate this post, because my dream was (is?) to have long hair again.

While my fue fixed the front fairly well, I only had 1852 grafts and was not on fin at the time (now I am). That means the front grew in very nicely, but there was still progression of loss behind the ht.

I guess I could have long hair now, so long as I part it from the side. Otherwise, the part in any other spot is slightly too wide and reveals too much thinning. I can wear a pompadour sort of, but under certain lighting the hair becomes see-through. (I am strongly considering going back for a second ht this fall to try to fill in the area behind the first ht or maybe some smp.)

Which is to say...I think it is great that you are getting many more grafts than me but also I hope you consider starting finasteride. I am happy to dm about it, if you'd like. There are so many myths about this drug, it is really frustrating. As you likely know already, your donor is not limitless and you are starting off with 3500-4000 grafts. Without a dht blocker, the rest will without a doubt fall out and there will almost certainly not be enough grafts to cover the rest of your scalp. I don't mean to be harsh, I just want you to achieve your goals, too.

[NARMAK]

OP, sorry if you mentioned but i didn't see it. You said you're at a Norwood 4 or so but the most severe pattern can be a Norwood 7. Are you on any medication to help you stop or slow hair loss? 

It doesn't necessarily matter if you don't take it as long as other factors are in your favour and you plan accordingly for future hair loss by keeping a higher hairline etc. it's just best to have a plan for to specifically. 

The general recommendations imo apply to young or old. Medication to try prevent DHT induced loss as much as possible. 

[StillAlive]

@NARMAK@dotdashdashdash You both have very good points and I have taken all of these factors under consideration.

Essentially, I have experienced two aggressive periods of hair-loss, both tied to massive shocks/traumatic events :

27-29 : I went from NW0 to NW2.5 then had a very slow and gradual progression to a thick NW3 for the next 10 years (never taking any medication or special treatments apart from Nizoral shampoo and the random vitamin here and there).

38-40 : The final shock (after this, I don't believe that there is very much left to faze me in this world) taking me from a thick 3 to 4V. All of the terrible BS is over now, so I'm taking stock of the wreckage and looking to fix as much damage as possible.

I mapped out hairloss on both sides of my family (I know it's unpredictable but it helps to keep track of as many relatives as possible) and went by worst case scenario : Maternal grandfather a NW4V at 54 clocking out at NW6 at about 82. My father only got to 3V at 70, my brother is an absolute NW0 at 39 (having lived a wonderfully stress free life) and apart from those two periods that I believe have greatly accelerated my own natural progression, I've never experienced any massive sheds or periods where I was visibly losing hair.

Naturally, I'm aware that it's a progressive condition and I model myself after my grandfather, believing that I'll be a NW5 at 55 and hit NW6 in my twilight years. It's all about timing.

The main reason why I don't want to take finasteride (even though I'm by now middle aged and have had all the kids I ever plan to have) is that sex has always been my saving grace/go-to/thing. Many guys say that or assume it, but it's a whole other thing if you are a successful fiend. So if there's a 0.01% chance that a drug will compromise that, nope, I'm out, I'd rather be cueball bald, it's not even a dilemma for me. 

TL;DR I'm aware that I'm gambling here. If I'm right and progression is slow, I just need to go back in at 50 and do the rest of my donor as fillers for the crown and any mid-scalp loss. And who knows, maybe some great drug will have come along in 10 years time or some better transplant tech. If I'm wrong and Nature's chainsaw goes crazy on me, I'll take stock of my super-weird situation and probably buzz it all off and get a diamond stud and goatee. I'm going to get that first HT prepared for the worst case scenario.

If it actually pans out and I get my youthful look restored, it's a party. If not, well, I've given it a shot to the extent that I was prepared to go. I won't have that 'what if' nagging me. 

The above strictly reflects my personal approach/philosophy and is by no means a general recommendation, nor do I claim that it's a wise course of action.

I'll keep you all posted on how it goes

 

 

[Melvin- Admin]

@voxmanis our resident rocker/senior. He’s had two hair transplants and wears his hair long. 

[NARMAK]

28 minutes ago, StillAlive said:

@NARMAK@dotdashdashdash You both have very good points and I have taken all of these factors under consideration.

Essentially, I have experienced two aggressive periods of hair-loss, both tied to massive shocks/traumatic events :

27-29 : I went from NW0 to NW2.5 then had a very slow and gradual progression to a thick NW3 for the next 10 years (never taking any medication or special treatments apart from Nizoral shampoo and the random vitamin here and there).

38-40 : The final shock (after this, I don't believe that there is very much left to faze me in this world) taking me from a thick 3 to 4V. All of the terrible BS is over now, so I'm taking stock of the wreckage and looking to fix as much damage as possible.

I mapped out hairloss on both sides of my family (I know it's unpredictable but it helps to keep track of as many relatives as possible) and went by worst case scenario : Maternal grandfather a NW4V at 54 clocking out at NW6 at about 82. My father only got to 3V at 70, my brother is an absolute NW0 at 39 (having lived a wonderfully stress free life) and apart from those two periods that I believe have greatly accelerated my own natural progression, I've never experienced any massive sheds or periods where I was visibly losing hair.

Naturally, I'm aware that it's a progressive condition and I model myself after my grandfather, believing that I'll be a NW5 at 55 and hit NW6 in my twilight years. It's all about timing.

The main reason why I don't want to take finasteride (even though I'm by now middle aged and have had all the kids I ever plan to have) is that sex has always been my saving grace/go-to/thing. Many guys say that or assume it, but it's a whole other thing if you are a successful fiend. So if there's a 0.01% chance that a drug will compromise that, nope, I'm out, I'd rather be cueball bald, it's not even a dilemma for me. 

TL;DR I'm aware that I'm gambling here. If I'm right and progression is slow, I just need to go back in at 50 and do the rest of my donor as fillers for the crown and any mid-scalp loss. And who knows, maybe some great drug will have come along in 10 years time or some better transplant tech. If I'm wrong and Nature's chainsaw goes crazy on me, I'll take stock of my super-weird situation and probably buzz it all off and get a diamond stud and goatee. I'm going to get that first HT prepared for the worst case scenario.

If it actually pans out and I get my youthful look restored, it's a party. If not, well, I've given it a shot to the extent that I was prepared to go. I won't have that 'what if' nagging me. 

The above strictly reflects my personal approach/philosophy and is by no means a general recommendation, nor do I claim that it's a wise course of action.

I'll keep you all posted on how it goes

 

 

I respect anybody to do their research and come to what decision is best for them. However, i do think if i can respectfully point out using your post that any hair loss suffered due to stressful life events typically is not the same as hair loss that occurs due to Androgenic Alopecia. Hair loss due to stress etc. will typically regrow but can potentially be exacerbated by AA and make it seem like that hair loss was due to stress instead. 

I think you have a plan and i do wish you well to hopefully get the result you want. 

[StillAlive]

I agree. I suffer from AA same as everyone here. I just believe that its progression was accelerated by the events of those years.

 

Like in two years I lost the hair that I'd have lost in 10 if I was living stress free and lucky. My reference points in the family, uncle and grandfather, the two worst Norwoods, also suffered massive losses in very short time spans, when going through their own troubles.

This reinforces my belief that I may be alright for a decade before having to go back for a second procedure.

[ciaus]

Most of us mistakenly judge our hairloss based on when it first becomes noticeable in the mirror. The reality is that it starts sooner than that, years sooner, because most guys have to lose about 50% of their original hair density before it even starts to become visible to the naked eye. You've lost more than you realize, and at only 40 you've got plenty of years for additional spurts and very gradual loss you'll need a photographic record to track.

Without taking a DHT blocker you're definitely increasing the odds of running out of hair, but at least you have a good positive attitude and willingness to accept the worse case scenario. If things ever go really south look into hair concealers like hair fibers and Dermmatch if you haven't already. They have to be re-applied after washing your hair, but they can dramatically improve the appearance of thinning areas. You may want to even sample them now before your hair transplant, see if they are something you'll be able to lean on down the road if needed.

Edited June 8, 2022 by ciaus

[StillAlive]

I went through a concealers phase about 8 years ago and they do work amazingly well, but my goal is to live as hair hassle free as possible after this. I've no interest in making concealers part of my permanent routine but I tend to think of them as more of a fancy 'trick' when attending some kind of special function. Particularly if I have a great hairline and then gaps behind it, concealers would definitely do the trick for me  

[voxman]

Hey all !  Been away - retired now so travel beckons!  Yeah - go for it Still Alive!  Plan properly and you should be able to do any number of things.  I brought photos of the hairstyle I wanted so my Doc could see where to plan the best graft placements.  I vacillate now between shoulder long and 'normal' long.

[Melvin- Admin]

1 hour ago, StillAlive said:

I went through a concealers phase about 8 years ago and they do work amazingly well, but my goal is to live as hair hassle free as possible after this. I've no interest in making concealers part of my permanent routine but I tend to think of them as more of a fancy 'trick' when attending some kind of special function. Particularly if I have a great hairline and then gaps behind it, concealers would definitely do the trick for me  

Are you in it for the long haul? You know hair transplants are usually not a one and done. It’s a life long journey. 

[NOMORENORWOOD]

13 hours ago, TommyLucchese said:

Me: Always had long hair. receding and started minoxidil age 16. aggressive hairloss by 20. got on propecia and had a HT on frontal third age 23 which was 10 years ago next month.

I've had my long hair back for 8 years now since it all grew in. When it's slicked back it looks thick, and when it's brushed down it covers the conservative hairline and looks normal. Not as thick as my original hair but still pretty awesome. I'm going to have a touch up in the next few years and lower the hairline / thicken up what's there....but that's just me being greedy now after a decade.

So to your question - yes you can grow it long and look good and no-one will know / care!

 

 

Since your original HT almost ten years ago and it appears being on fin you were very wise back then have you noticed any further loss? So many people say having a HT younger than 25 can be risky due to forelock going or further recession in crown. Basically just curious if fin kept what you already had and the HT was just icing on the cake

[StillAlive]

@TommyLucchese's hair looks pretty damn amazing in those pics, if I met him on the street I would just envy the mane and not even suspect that he ever experienced hair loss. So his regime definitely works out for him

Many thanks to everybody posting on the thread, my question has been thoroughly answered. 

@Melvin- Moderator Compared to some of you, I'm an absolute lightweight/tourist when it comes to commitment and I'm quite at peace with that. At this stage in my life, hair restoration is an affordable luxury more than a priority for me. So I figured that I'll take my chances now (fully prepared that it all may go south and instead of a new mane, I might sport The Pitbull Look from '23 on) and reassess my situation and needs in about ten years time. Maybe I'll care, maybe I won't, maybe a miracle will have come along. Hell, I don't know.

One thing's for sure though. This forum (along with the regional/national boards) is an incredible resource and an absolute treasure trove of information for balding men the world over. I have been lurking in the Baldosphere since some time in 2008 and I've learned more than I ever expected to on the subject. Fingers crossed that it all goes well and I'll be posting an operation review thread in due time!

[Gabreille Nelson Mukhia]

I was a Norwood III before I got my hair transplant. I keep my hair long now. I also take finasteride for the preservation of my pre existing hair. My hair looks absolutely voluminous and there are no bald spots showing.

[TommyLucchese]

9 hours ago, NOMORENORWOOD said:

Since your original HT almost ten years ago and it appears being on fin you were very wise back then have you noticed any further loss? So many people say having a HT younger than 25 can be risky due to forelock going or further recession in crown. Basically just curious if fin kept what you already had and the HT was just icing on the cake

No, no further loss. I had crown loss beforehand and am going to have a HT with Hattingen in a couple of years to fix it. It hasn't got any worse since 2012 though. Fin has been a god send....the original HT and my next HT are both for fixing the original loss between 2005 and 2010. 

2 hours ago, StillAlive said:

@TommyLucchese's hair looks pretty damn amazing in those pics, if I met him on the street I would just envy the mane and not even suspect that he ever experienced hair loss. So his regime definitely works out for him
 

thank you! i can't predict the future but all I can say is I am very lucky to be where i am 17 years after first being 'diagnosed' with MPB by a trichologist. 

[TommyLucchese]

23 hours ago, StillAlive said:

Well, I'm in a bit of a tough spot, because the only forum/community recommended doctor that I can afford, is Dr. Yaman in Istanbul.

I consulted with both him and Dr. Lorenzo in Spain and Yaman eyeballed me at between 3500-4000 grafts to reconstruct the hairline-frontal area of the head (I'm either a really bad 3V or 'healthy' 4V, never entirely sure). Lorenzo also quoted me 3800-4000 grafts but the cost difference was too much for me (3.2K for Yaman vs about 16K for Lorenzo) so I'm going with Yaman.

I'm 40 now, never taken fin or minox and I do not intend to, I'm a very 'low maintenance' kind of guy if you will, and saw an opportunity to fix something that's been bothering me for the past 12 years. I'm fully aware that I may need another procedure at around 50 to cover the crown and potentially enhance whatever I've lost in the frontal area and I'm cool with that. I'm just sick and tired of looking like a chrome domed, misshapen alien in family photos and goddamn it, I want my kids to go to ball games with a father that doesn't look so much like the baseball  

PS I'm also prepared for the possibility that it all goes sideways and after September I need to roll all Statham like. I'm thinking of this more as a great, gamble of a gift to my mid-life crisis self!

I wouldn't advise a one or the other approach. I admit I don't know anything about Yaman, hopefully they are excellent. But don't rule out travelling.

In 2012 it was all about North America so I flew from UK to New York for Dr Feller...this time around I will fly to Switzerland and go with Hattingen. There are many great options around Europe now so you should try to consider and consult with more doctors in my opinion.

Limiting yourself to surgeons in your region is temping but not advised - especially since you have your heart set on being able to wear your hair a certain way. Trust me you won't want to go Statham after going through the physical, financial and mental ordeal of a HT. in 12 to 18 months after the op you want to be in a place where you forget you even came on this forum because you get so used to having great hair again. 

[StillAlive]

Man, I'm in Iceland, hair restoration here consists of clipping wool off of sheep and pasting it over your bald areas whilst chanting obscure Sigur Ros lyrics, so I will be travelling to Turkey.

If I had the money, I'd probably end up in Spain, with Lorenzo, Couto or De Freitas but I've seen impressive work -particularly in 'simple' cases, like mine- from Yaman and the budget fits mine. I'm also at the stage where I consider this an enjoyable luxury, a little 'you made it through hell, here's your hair back' gift to myself, not something I want to break the bank on or pin the rest of my life on. 

Either way, I'll keep you all posted on the results

PS I had completely written off the prospect of a transplant based on cost but finally, we have the tech that allows us to obtain good results without dropping the price of a good car on our heads. 

PS2 I know there is much passionate debate over 'Expensive vs. Cheap' surgeons and I don't want to get started on that. I'll just say that we've come a very long way from the days when there were like 5-10 dependable surgeons and everything else was a minefield. Sure, we've got plenty of hair mills, but that's why we have sites like this, to help us navigate the jungle. If my story ends up helping someone with a similar predicament and outlook to mine, all the better. 

If not, I thank all of you for the invaluable wisdom that you've contributed over the years!

[TommyLucchese]

Good luck! You're one of the few who is going down this road having done their research properly, most people don't find us until they made a bad choice and it went wrong. 

Based on my timeline it was around 2 years post op for chin length hair by the way