Advice wanted - Contemplated an HT for a while but have hesitated to go for it

[TeeJay]

Hey all, long time lurker, first time poster. 

About Me:

34M, never been on any meds.

Backstory:

I started to thin in my early 20s and have slowly lost hair in my temple region and my crown. 

I've thought about FUE for probably 6 or 7 years now. Initially I thought the technology was new and never really followed through on it. I started to shave my head in 2016/2017 after getting fed-up with highly receded combovers. I feel like shaving my head exacerbated my thinning but I could be wrong.

Current:

I've battled with depression and lack confidence as a result of loss of hair. It's a big factor even moreso because I'm a shorter individual. I've tried to just suck it up for years but I think I've gotten to a point where I feel its time I need to do something about it.

I had reached out to a few doctors last year (Pekiner and Erdogan) but never really got feedback and didn't follow through. I've currently reached out to De Frietas and Bisanga. I also plan to reach out to Euginex and Ferrera.

I'm trying to answer a few questions and if you guys could help me out, that would be great.

1. I would guess I'm a norward  5 or 6 at this point? I've seen some success stories but would I require more than 1 surgery at this point?
2. How many graphs would I require? I think I'd be in the 3K to 4K range, just based on looking some of the success stories on this page
3. I've always laid of the medication, only because of the side effects that I've heard about it - Is it a mandatory requirement to start prior to surgery?
4. Are there any other doctors I should consider who have had success with a similar case to me? 

I've attached a few pictures for reference. 3 of the pictures are from today. 4 of the pictures that I have longer hair growth are from October 2021.

Edited June 13, 2022 by TeeJay

[mafpe]

You'd require way more than 3 4k graft depending on how much you want to restore your hairline. Although i suppose you can look like nw 2 with that much graft. Will still have a really big forehead that way though.

Unless you and the doctor is ok with low density which won't really look good. Of course, you can combat this by regularly using concealer (fobers etc) though. If you're okay with that i think you might be able to cover enough.

[TeeJay]

32 minutes ago, mafpe said:

You'd require way more than 3 4k graft depending on how much you want to restore your hairline. Although i suppose you can look like nw 2 with that much graft. Will still have a really big forehead that way though.

Unless you and the doctor is ok with low density which won't really look good. Of course, you can combat this by regularly using concealer (fobers etc) though. If you're okay with that i think you might be able to cover enough.

Hey, thanks for the quick feedback. I didn't think I would require more than 3-4k but that really is an eye opener for me. Thank you. Im guessing I've experienced more thinning than initially thought and my hairline has gone back significantly.

I agree that low density wouldn't really be an option. Combating it with concealer and fibers is an option, but don't think it'd be the ideal solution. 

[mafpe]

Thing is that you want your existing area to not be see through as well right? Which means you require grafts not only on empty area, but also weakening area. Most case i see here require their front area around 2k grafts since they need to be quite dense.

I can't really tell your condition without side picture, but im guessing you will need or want at least nw 2 stage recovered to feel happy with it. When i send my head with nw 3 estimate, most doctors says 2.5-3.5k graft, and i suppose they are mostly used in front. Your hair isnt all gone but it's halfway there. 

I think it's still definitely possible for you to have a full head though, many here have less hair and "gained" it back.

[Z--]

You'll need multiple transplants I think. Probably one for frontal density and another to deal with the crown. Depends on the doctor, but I'd check out H&W and Eugenix as they handle higher Norwood cases. 

Good luck!

Edited June 13, 2022 by Z--

[THE TRUTH]

Don't get a hair transplant unless you are willing to go with the best of the best for advanced hairloss. 

Hair transplant is a huge deal especially when you are a Norwood 5. 

Stay away from Turkey. They are crap when it comes to vertex work specifically. They'll just botch up and waste your best grafts...

Erdogan is a hairmill whereas Pekiner is decent in terms of results but just like any other turkish clinic, he struggles with crown work. 

I recommend you like into Dr. Zarev or Dr. Pitella for FUE. 

Hattingen or Hasson & Wong for FUT. 

Bruno Pinto and Rafael de Freitas  are also solid options for your pattern. 

 

[Eugenix Hair Sciences]

8 hours ago, TeeJay said:

Hey all, long time lurker, first time poster. 

About Me:

34M, never been on any meds.

Backstory:

I started to thin in my early 20s and have slowly lost hair in my temple region and my crown. 

I've thought about FUE for probably 6 or 7 years now. Initially I thought the technology was new and never really followed through on it. I started to shave my head in 2016/2017 after getting fed-up with highly receded combovers. I feel like shaving my head exacerbated my thinning but I could be wrong.

Current:

I've battled with depression and lack confidence as a result of loss of hair. It's a big factor even moreso because I'm a shorter individual. I've tried to just suck it up for years but I think I've gotten to a point where I feel its time I need to do something about it.

I had reached out to a few doctors last year (Pekiner and Erdogan) but never really got feedback and didn't follow through. I've currently reached out to De Frietas and Bisanga. I also plan to reach out to Euginex and Ferrera.

I'm trying to answer a few questions and if you guys could help me out, that would be great.

1. I would guess I'm a norward  5 or 6 at this point? I've seen some success stories but would I require more than 1 surgery at this point?
2. How many graphs would I require? I think I'd be in the 3K to 4K range, just based on looking some of the success stories on this page
3. I've always laid of the medication, only because of the side effects that I've heard about it - Is it a mandatory requirement to start prior to surgery?
4. Are there any other doctors I should consider who have had success with a similar case to me? 

I've attached a few pictures for reference. 3 of the pictures are from today. 4 of the pictures that I have longer hair growth are from October 2021.

According to your pictures, you are Grade 5V on the Norwood Hamilton Scale of baldness. You will require 2500 to 3000 grafts in your frontal zone and around 1000 grafts in your crown area. You will also require finasteride for the preservation of the pre existing hair. You can start the medication after your transplantation procedure.

We have many cases like yours. We would be happy to share their results and references with you. You can inbox us your contact details and we will get back to you.

[Melvin- Admin]

What are your goals and expectations? Hair transplants are a lifelong commitment. It’s not a one and done type of thing, especially since you will continue to bald and require additional surgeries to keep up with your hair loss. 

I would reconsider medication, as it is definitely worth trying before getting surgery. 

[NARMAK]

Melvin raises some good points. Hair transplants can be life changing, but only if your expectations are realistic and you will imo achieve a better result being on a DHT blocking medication whether oral or topical and combined with Minoxidil & Microneedling once a week at 1mm to 1.5mm. 

You literally have everything to gain at this point by trying to curb any future hair loss, recover whatever ground you can over 12-24 months and find the right hair transplant surgeon for your case. 

Life can seem unfair and i can sympathise feeling like you got dealt a bad hand with things, but it's also about taking what you feel is a weakness and either you can minimise its impact or eliminate it. Being overweight for example by exercising, not dwelling on your height by concentrating on areas in your life to improve your personality with humour etc. which is a great social skill and charismatic. 

Hair loss again, it's not great but there's many ways to deal with it. That includes shaving it all off but by coming to this forum, it's likely you don't want to go down that route but try to keep hair. I can respect that but this is a journey you begin and need to maintain for life regardless of what you choose. 

[Vann]

38 minutes ago, NARMAK said:

Melvin raises some good points. Hair transplants can be life changing, but only if your expectations are realistic and you will imo achieve a better result being on a DHT blocking medication whether oral or topical and combined with Minoxidil & Microneedling once a week at 1mm to 1.5mm. 

You literally have everything to gain at this point by trying to curb any future hair loss, recover whatever ground you can over 12-24 months and find the right hair transplant surgeon for your case. 

Life can seem unfair and i can sympathise feeling like you got dealt a bad hand with things, but it's also about taking what you feel is a weakness and either you can minimise its impact or eliminate it. Being overweight for example by exercising, not dwelling on your height by concentrating on areas in your life to improve your personality with humour etc. which is a great social skill and charismatic. 

Hair loss again, it's not great but there's many ways to deal with it. That includes shaving it all off but by coming to this forum, it's likely you don't want to go down that route but try to keep hair. I can respect that but this is a journey you begin and need to maintain for life regardless of what you choose. 

Exactly this. This was beautifully said. If not better than what I would’ve said.
 

Only thing I would add is you can also seek out as many consultations and you’ll probably hear a bunch of stuff you want to hear.
 

But remember nothing is guaranteed. So be ready to commit to whatever you do and make sure you do everything you possibly can to make sure you get the best result so you don’t look back and say “I wish I tried this first” 

[Axel]

With the amount of hair loss you have and your age, I wouldn't do a transplant personally. I also see ZERO benefit of starting finasteride when you've already lost so much hair. It won't bring it back and the risk of side effects makes absolutely no sense in your situation.

If you decide against the transplant, work on other physical characteristics that can help you feel good about yourself. Gain some muscle, start a workout routine etc. Hair isn't everything, but I would recommend growing a nice beard if possible. It can either be well trimmed or longer, but they truly do add a lot of asthetic value when you don't have hair on top.

If you do go for a transplant, be careful. Find a doctor that specializes in larger transplants and expect 2-3 procedures to be necessary. I'm not sure if the result would be what you want, but you should first find other patient stories that show similar hair loss to your own and review them.

[TeeJay]

Thank you everyone for their feedback. I will do a little bit more research and see if this is a path that I would like to take. 

For the last few years I have been shaving and going with the bald plus beard look. It may be something I may have to stick with considering where my hair journey has taken me thus far

[Axel]

3 hours ago, TeeJay said:

Thank you everyone for their feedback. I will do a little bit more research and see if this is a path that I would like to take. 

For the last few years I have been shaving and going with the bald plus beard look. It may be something I may have to stick with considering where my hair journey has taken me thus far

Oh you already have a nice beard haha, there you go man. It's a good look and you honestly have the head shape/facial structure to pull it off well. I wouldn't worry about it at all, but good luck with whatever you decide 👍🏻

Edited June 14, 2022 by Axel

[TeeJay]

On 6/13/2022 at 1:22 AM, mafpe said:

Thing is that you want your existing area to not be see through as well right? Which means you require grafts not only on empty area, but also weakening area. Most case i see here require their front area around 2k grafts since they need to be quite dense.

I can't really tell your condition without side picture, but im guessing you will need or want at least nw 2 stage recovered to feel happy with it. When i send my head with nw 3 estimate, most doctors says 2.5-3.5k graft, and i suppose they are mostly used in front. Your hair isnt all gone but it's halfway there. 

I think it's still definitely possible for you to have a full head though, many here have less hair and "gained" it back.

Thanks for the feedback mafpe. I had not considered that. I was probably really underestimating it. I'm fairly confident I won't be as dense as I would like if I were to go through with. I've seen some promising cases on here, and I know every one is different, but it's peaked my curiosity in at least getting my research in.

On 6/13/2022 at 4:57 AM, Z-- said:

You'll need multiple transplants I think. Probably one for frontal density and another to deal with the crown. Depends on the doctor, but I'd check out H&W and Eugenix as they handle higher Norwood cases. 

Good luck!

Thanks for the tips. I'll include the two of them in my research

On 6/13/2022 at 8:30 AM, Hair transplant is a huge said:

Don't get a hair transplant unless you are willing to go with the best of the best for advanced hairloss. 

Hair transplant is a huge deal especially when you are a Norwood 5. 

Stay away from Turkey. They are crap when it comes to vertex work specifically. They'll just botch up and waste your best grafts...

Erdogan is a hairmill whereas Pekiner is decent in terms of results but just like any other turkish clinic, he struggles with crown work. 

I recommend you like into Dr. Zarev or Dr. Pitella for FUE. 

Hattingen or Hasson & Wong for FUT. 

Bruno Pinto and Rafael de Freitas  are also solid options for your pattern. 

 

I agree. If i'm doing this, i'm going with someone really good. I'm not expecting a miracle of course so I'm fairly reasonable with expectations. I've heard mix stories about  Turkey. Thank for the tips on Pekiner and crows, thats good to know. Zarev and Pitella are new to me so will take a look into them.

On 6/13/2022 at 8:49 AM, Eugenix Hair Sciences said:

According to your pictures, you are Grade 5V on the Norwood Hamilton Scale of baldness. You will require 2500 to 3000 grafts in your frontal zone and around 1000 grafts in your crown area. You will also require finasteride for the preservation of the pre existing hair. You can start the medication after your transplantation procedure.

We have many cases like yours. We would be happy to share their results and references with you. You can inbox us your contact details and we will get back to you.

Thank you Euginex. I will be reaching out to you shortly for a discussion. 

On 6/13/2022 at 12:44 PM, Melvin- Moderator said:

What are your goals and expectations? Hair transplants are a lifelong commitment. It’s not a one and done type of thing, especially since you will continue to bald and require additional surgeries to keep up with your hair loss. 

I would reconsider medication, as it is definitely worth trying before getting surgery. 

I understand that this would be a journey if I were to pursue it. I do agree that I will need to jump on medication to see if it helps.

On 6/13/2022 at 3:57 PM, NARMAK said:

Melvin raises some good points. Hair transplants can be life changing, but only if your expectations are realistic and you will imo achieve a better result being on a DHT blocking medication whether oral or topical and combined with Minoxidil & Microneedling once a week at 1mm to 1.5mm. 

You literally have everything to gain at this point by trying to curb any future hair loss, recover whatever ground you can over 12-24 months and find the right hair transplant surgeon for your case. 

Life can seem unfair and i can sympathise feeling like you got dealt a bad hand with things, but it's also about taking what you feel is a weakness and either you can minimise its impact or eliminate it. Being overweight for example by exercising, not dwelling on your height by concentrating on areas in your life to improve your personality with humour etc. which is a great social skill and charismatic. 

Hair loss again, it's not great but there's many ways to deal with it. That includes shaving it all off but by coming to this forum, it's likely you don't want to go down that route but try to keep hair. I can respect that but this is a journey you begin and need to maintain for life regardless of what you choose. 

I'm pretty cognizant that I won't ever get back to the thickness of hair that I had before. I do agree that meds would be a must if I choose to follow through on this. Getting on meds now and seeing where it gets me in 12-24 months could be the ideal starting point. 

I'm grown out the phase where it really downed me. I've started to minimize the impact of it on me, but there are phases where it really challenging to deal with. I've started to become active - running, biking, exercise, sports; which has been a great way to help my fitness level. 

I've been shaving for about 3-4 years now and have slowly started to get more comfortable with it, but there are times I wish i did have hair and want to explore what that journey would be and if its a realistic possibility but with tempered expectations.

On 6/13/2022 at 4:38 PM, Vann said:

Exactly this. This was beautifully said. If not better than what I would’ve said.
 

Only thing I would add is you can also seek out as many consultations and you’ll probably hear a bunch of stuff you want to hear.
 

But remember nothing is guaranteed. So be ready to commit to whatever you do and make sure you do everything you possibly can to make sure you get the best result so you don’t look back and say “I wish I tried this first” 

I feel like I lived a lot of my life researching things but never pulling the trigger on it, and thats on many things. I agree on getting as much feedback from consults as I can to get a full view from multiple industry experts. If I'm going through this, I know I will go through this to the end and see it through.

7 hours ago, Axel said:

With the amount of hair loss you have and your age, I wouldn't do a transplant personally. I also see ZERO benefit of starting finasteride when you've already lost so much hair. It won't bring it back and the risk of side effects makes absolutely no sense in your situation.

If you decide against the transplant, work on other physical characteristics that can help you feel good about yourself. Gain some muscle, start a workout routine etc. Hair isn't everything, but I would recommend growing a nice beard if possible. It can either be well trimmed or longer, but they truly do add a lot of asthetic value when you don't have hair on top.

If you do go for a transplant, be careful. Find a doctor that specializes in larger transplants and expect 2-3 procedures to be necessary. I'm not sure if the result would be what you want, but you should first find other patient stories that show similar hair loss to your own and review them.

Thanks for the honest feedback. I know I have to start actively hitting the gym and putting on some muscle, to tack on with my sports. I know hair isn't everything, but would just prefer to have it that not it. Lol, I guess that's most guys though. If I am to go with it, it would be with someone extremely reputable. I'm googling and researching here for similar cases.

1 hour ago, Axel said:

Oh you already have a nice beard haha, there you go man. It's a good look and you honestly have the head shape/facial structure to pull it off well. I wouldn't worry about it at all, but good luck with whatever you decide 👍🏻

Thanks bud!

[deeznuts]

On 6/13/2022 at 12:18 AM, TeeJay said:

About Me:

34M, never been on any meds.

  You probably want to get on meds since you have a lot of miniaturized hair that can be saved

On 6/13/2022 at 12:18 AM, TeeJay said:

Backstory:

I started to thin in my early 20s and have slowly lost hair in my temple region and my crown. 

I've thought about FUE for probably 6 or 7 years now. Initially I thought the technology was new and never really followed through on it. I started to shave my head in 2016/2017 after getting fed-up with highly receded combovers. I feel like shaving my head exacerbated my thinning but I could be wrong.

Nah, hair is just keratin. Like nails. Cutting your nails doesn't stop your nails from growing anymore than cutting your hair stops your hair from growing. If only that were the case, my girlfriend wouldn't complain that I have toenails like a cassowary

  

On 6/13/2022 at 12:18 AM, TeeJay said:

Current:

I've battled with depression and lack confidence as a result of loss of hair. It's a big factor even moreso because I'm a shorter individual. I've tried to just suck it up for years but I think I've gotten to a point where I feel its time I need to do something about it.

 

Balding/receding sucks for everyone man. I consider myself boyishly handsome so in a way it's like being rich and then having it taken away from you. 

On 6/13/2022 at 12:18 AM, TeeJay said:

1. I would guess I'm a norward  5 or 6 at this point? I've seen some success stories but would I require more than 1 surgery at this point?
2. How many graphs would I require? I think I'd be in the 3K to 4K range, just based on looking some of the success stories on this page
3. I've always laid of the medication, only because of the side effects that I've heard about it - Is it a mandatory requirement to start prior to surgery?
4. Are there any other doctors I should consider who have had success with a similar case to me? 

I've attached a few pictures for reference. 3 of the pictures are from today. 4 of the pictures that I have longer hair growth are from October 2021.

 

1. NW scale is kinda weird in that people talk about diffuse loss differently. I've seen someone with diffuse loss through the entire scalp consider themselves NW2/NW3 which makes no sense to me. But yeah, I'd say NW5 but diffuse norwood 5 - you're in a good situation in the sense that you're not slick bald and still have a lot of hair to save.

2. Depends how much progress you make on drugs. I think there's a lot of potential for you to reverse some loss and thicken your existing hairs. If I had to guess, 4-5k? It really depends on the approach the doctor takes as well since some will break it up into multiple stages

3. Not really mandatory. Some will operate on you without drugs but you really have a ton of hair to save.

4. Probably anyone on the recommended list. I like Hasson & Wong for bigger cases but there are a lot of great ones.

[RTC]

11 hours ago, TeeJay said:

Thank you everyone for their feedback. I will do a little bit more research and see if this is a path that I would like to take. 

For the last few years I have been shaving and going with the bald plus beard look. It may be something I may have to stick with considering where my hair journey has taken me thus far

Lengthen the beard on your chin, will give you a longer more masculine face.

[Eugenix Hair Sciences]

9 hours ago, TeeJay said:

Thank you Euginex. I will be reaching out to you shortly for a discussion. 

Thank you. We shall inbox you our contact details.

[Adier]

I honestly would suggest you to try medications. Finasteride and minoxidil for a year because you might as well recover some hair which will lessen your graft requirement and donor will also be preserved for future HT if you ever need one.