Is there any going back once you have your first HT - A not very discussed question it seems

[GoliGoliGoli]

I'm going for 4000 grafts on my first HT. Norwood 3a (Mainly crown loss) My question is this: Assuming I will continue losing and don't want to go back for a 2nd (Or possibly 3rd HT) is it a mistake to get the 1st? I see a few people on here talking about electrolysis and methods to reverse a hair transplant and that kind of confuses me. Does it really look noticeably different to have shaved down hair follicles on your hairline and crown but with nothing around it even if you're rocking a completely razor shaved cueball look? Another consideration I'm curious about with a HT is that some guys look better with hair grown out an inch or inch and a half despite having big bald spot and receded hairline. I suppose that option completely goes away once you have your first HT? 

A bit more context for my personal situation: I'm not on finasteride and do not plan on going on it (Please don't discuss in this thread). As mentioned I'm a Norwood 3a and started balding at maybe 26 or 27. Started with a bald spot on the crown, and slowly my hairline has been moving back as well. 33.5 now. Starting to see some initial diffusing in the area between hairline and crown also. No balding history on my moms side, but my grandfather on my dads side went bald early but very slowly over time. Even in his 80's he still had some hair on top left although not much by that point. My dad has full hair along with his younger brother, but their oldest brother had hair loss that mimicked my grandfathers.  (I know family history is only somewhat relevant to what my pattern will be but I do seem to be following my grandfathers pattern). 

Thanks!! For reference I'm pretty much resigned to the fact that I'll need a 2nd HT at some point, but I'm just curious what the options and what hairstyle options go away after the 1st HT. 

Edited July 4, 2022 by GoliGoliGoli

[deeznuts]

You're not a 3A if you have crown loss. The A implies you're only losing in the front. V is for crown loss. If you have diffuse in the middle, your pattern is probably going to be 4 or 5 at least I'd imagine

I think there are a few examples of guys with failed transplants still shaving it bald. Joe Rogan has a scar on the back of his head from his failed transplants for example

[Gatsby]

Hey @GoliGoliGoli if you have any reservations at all about not following up surgery with more surgery for MPB then I highly recommend that you don't begin on this path to begin with. So many people have said (including myself) that they wished that they never had a hair transplant. You have to be committed to chasing your hair loss with surgery (or for others using meds) for the rest of your life. The only way I can see around this is to 'wait' until you are a Norwood 6/7 and have someone like Dr Pitella or Dr Zarev do a one and done surgery. But even that can only happen if you have great scalp donor (and beard and chest) hair. You can't predict the future but we can rely on science and MPB is progressive over the lifespan. Other options are to simply forget about MPB, shaving your head, SMP or wearing a hair piece. You could have the frontal hairline band grafted and wear a hair piece to give you a natural looking hairline. But then you are hand cuffed to wearing a hair piece for the rest of your life. Wishing you all the best!

[NARMAK]

I agree with Gatsby here that if you have any plan at all to "go back" to before you had a HT, you probably shouldn't start by getting anything. It's probably better to look at other things like even maybe getting a hair system or SMP if you want an appearance of hair but otherwise, there's the shaved/buzzed down option. 

Regardless of what option you choose with hair loss, you probably have to be committed to that. Even shaving requires you to keep constant maintenance. Hair systems also require upkeep. SMP fades and also you usually see people keep the head shaved. 

Hair loss is progressive and its best to assume you may need a 2nd or more procedure at some point. If you're willing to accept that, then it's also time to make sure you understand all the other aspects to set realistic expectations. 

Good luck on your journey. 

[GoliGoliGoli]

3 hours ago, GoliGoliGoli said:

I'm going for 4000 grafts on my first HT. Norwood 3a (Mainly crown loss) My question is this: Assuming I will continue losing and don't want to go back for a 2nd (Or possibly 3rd HT) is it a mistake to get the 1st? I see a few people on here talking about electrolysis and methods to reverse a hair transplant and that kind of confuses me. Does it really look noticeably different to have shaved down hair follicles on your hairline and crown but with nothing around it even if you're rocking a completely razor shaved cueball look? Another consideration I'm curious about with a HT is that some guys look better with hair grown out an inch or inch and a half despite having big bald spot and receded hairline. I suppose that option completely goes away once you have your first HT? 

A bit more context for my personal situation: I'm not on finasteride and do not plan on going on it (Please don't discuss in this thread). As mentioned I'm a Norwood 3a and started balding at maybe 26 or 27. Started with a bald spot on the crown, and slowly my hairline has been moving back as well. 33.5 now. Starting to see some initial diffusing in the area between hairline and crown also. No balding history on my moms side, but my grandfather on my dads side went bald early but very slowly over time. Even in his 80's he still had some hair on top left although not much by that point. My dad has full hair along with his younger brother, but their oldest brother had hair loss that mimicked my grandfathers.  (I know family history is only somewhat relevant to what my pattern will be but I do seem to be following my grandfathers pattern). 

Thanks!! For reference I'm pretty much resigned to the fact that I'll need a 2nd HT at some point, but I'm just curious what the options and what hairstyle options go away after the 1st HT. 

D

[GoliGoliGoli]

1 hour ago, Gatsby said:

Hey @GoliGoliGoli if you have any reservations at all about not following up surgery with more surgery for MPB then I highly recommend that you don't begin on this path to begin with. So many people have said (including myself) that they wished that they never had a hair transplant. You have to be committed to chasing your hair loss with surgery (or for others using meds) for the rest of your life. The only way I can see around this is to 'wait' until you are a Norwood 6/7 and have someone like Dr Pitella or Dr Zarev do a one and done surgery. But even that can only happen if you have great scalp donor (and beard and chest) hair. You can't predict the future but we can rely on science and MPB is progressive over the lifespan. Other options are to simply forget about MPB, shaving your head, SMP or wearing a hair piece. You could have the frontal hairline band grafted and wear a hair piece to give you a natural looking hairline. But then you are hand cuffed to wearing a hair piece for the rest of your life. Wishing you all the best!

I'm sure you've written about this before so apologies for asking but why did you regret your first HT? Was it just a poorly done job or was it just the fact that you hadn't considered the financial commitment of having to do multiple? I'm pretty sure I've chosen a good surgeon so I'm not too worried about the results. It's also Dr Nader is Mexico so financially it isn't as huge a commitment as some other places. 

[GaryStruthers]

It’s a great question you’ve asked though. I have - and may still - think along the same lines. Can you picture yourself shaving your head and getting used to it? Wouldn’t that be amazing if you could own that? Your choice of no meds obviously means multiple surgeries so I think you’d be happier not going down this road. Have you studied the top SMP results coming out lately? Phenomenal in my opinion. But as the lads mentioned above - there’s upkeep in every choice other than the clean shave/no meds approach. 

[GoliGoliGoli]

33 minutes ago, NARMAK said:

I agree with Gatsby here that if you have any plan at all to "go back" to before you had a HT, you probably shouldn't start by getting anything.

 

 

Well, I obviously have no plan to "go back to before" a HT, I guess I just want to know if it would look noticeably funky to go clean shaven after and if the hair follicles on hairline would look funky even though shaven down. I don't think it would, but curious because people often ask about electrolysis. I guess maybe they ask because they'd like to grow hair out to an inch and just rock the receded hairline/bald spot look but still have something there? A lot of actors still look fine even with receded hairline and ball spots. 

Or are you just saying not to go with the first one because of the financial commitment? 

TBH, I'm ok with eventually shaving down to completely clean shaven. Would just like another 5-10 years of hair. Right now I'm cool with the idea of a 2nd HT, but I want to know that it wouldn't look too funky if I eventually wanted to shave it completely down to the skin. 

 

Edited July 5, 2022 by GoliGoliGoli

[Gatsby]

13 minutes ago, GoliGoliGoli said:

I'm sure you've written about this before so apologies for asking but why did you regret your first HT? Was it just a poorly done job or was it just the fact that you hadn't considered the financial commitment of having to do multiple? I'm pretty sure I've chosen a good surgeon so I'm not too worried about the results. It's also Dr Nader is Mexico so financially it isn't as huge a commitment as some other places. 

Because it was performed on me when I was only 18 and should never have been carried out at all. It was back in the day of 'punch grafts' (Google punch grafts for pics) and I was too young to know any better and the doctor just saw $$$. I took six or seven operations over a six year period with a plastic surgeon to have them removed leaving me with permanent scars. This is still happening today in hair mills only to a different looking disfigurement. I wore a hair piece for 25 years to hide the scars and progressive MPB until six years ago when I had SMP. In January of this year I went to Eugenix and had the whole mess repaired over six days of back to back surgery. End of the day often doing nothing is the wisest decision.

[GoliGoliGoli]

30 minutes ago, GaryStruthers said:

It’s a great question you’ve asked though. I have - and may still - think along the same lines. Can you picture yourself shaving your head and getting used to it? Wouldn’t that be amazing if you could own that? Your choice of no meds obviously means multiple surgeries so I think you’d be happier not going down this road. Have you studied the top SMP results coming out lately? Phenomenal in my opinion. But as the lads mentioned above - there’s upkeep in every choice other than the clean shave/no meds approach. 

Eh, I'm fairly confident I would be alright with no meds and 2 HT's. My loss has been pretty darn slow so I don't think I would need a 3rd, and at a certain age I feel like I will be happier with going clean bald than I am now. I'll never "love it" obviously and will always prefer hair, but at 40 or 50 it's much more normal to be bald. And because I'm going with Dr Nader in Mexico my cost will be fairly low. And if I don't want a 3rd or even 2nd HT I can always just go totally clean shaven, and it doesn't sound like it would look to funky.

Edited July 5, 2022 by GoliGoliGoli

[GoliGoliGoli]

20 minutes ago, Gatsby said:

Because it was performed on me when I was only 18 and should never have been carried out at all. It was back in the day of 'punch grafts' (Google punch grafts for pics) and I was too young to know any better and the doctor just saw $$$. I took six or seven operations over a six year period with a plastic surgeon to have them removed leaving me with permanent scars. This is still happening today in hair mills only to a different looking disfigurement. I wore a hair piece for 25 years to hide the scars and progressive MPB until six years ago when I had SMP. In January of this year I went to Eugenix and had the whole mess repaired over six days of back to back surgery. End of the day often doing nothing is the wisest decision.

Damn what a bummer. I feel very fortunate to be dealing with this issue in 2022 when I have the internet and great forums like this to do research and talk with you all so I understand what I'm getting in to. 

Also from your profile picture the SMP looks great so glad you've gotten some closure from the sound of it

Edited July 5, 2022 by GoliGoliGoli

[GaryStruthers]

6 minutes ago, GoliGoliGoli said:

Eh, I'm fairly confident I would be alright with no meds and 2 HT's. My loss has been pretty darn slow so I don't think I would need a 3rd. And because I'm going with Dr Nader in Mexico my cost will be fairly low. And if I don't want a 3rd or even 2nd HT I can always just go totally clean shaven, and it doesn't sound like it would look to funky. 

Got ya! Well it sounds like you’d like to go ahead with it, best of luck. Just to be clear, when you say “I can always just go totally clean shaven“, you mean with a razor to the skin, and not a buzz cut right?

[GoliGoliGoli]

2 minutes ago, GaryStruthers said:

Got ya! Well it sounds like you’d like to go ahead with it, best of luck. Just to be clear, when you say “I can always just go totally clean shaven“, you mean with a razor to the skin, and not a buzz cut right?

Correct, just going razor to the skin. Because I suppose by getting a 1st HT you are losing the option of growing it out a small bit right? 

Also, if it's a chore to look up don't worry, but if you know some top notch SMP places with before and after pics I'd appreciate if you'd share their names or sites. But no biggie if it's a chore to find. 

Edited July 5, 2022 by GoliGoliGoli

[GoliGoliGoli]

You know, I guess if you got a 1st HT and then decided not to want a 2nd but still wanted to grow it out a half inch or so you could always just razor to the skin the transplant areas to keep it from looking funky? Hmm.... Interesting. 

[GaryStruthers]

I checked out a few places at this link SMP There are definitely more top clinics that aren’t on this link, and a few members here will be able to speak to those. 

[mafpe]

imo you might need SMP. or shave very very regularly in short period of time.

the skin of transplanted hair is different from a balding one, you can see normal balding people have slick smooth and... shiny head.

for transplanted hair, there is some irregularities, it might not be as much as pitting or cobblestoning, but it won't be fully smooth. there might be slight indentation or slight bumps. if you're fine with the front being... somewhat lush while having a barren scalp... then i guess it's fine, but yes it won't be "natural", because normally people won't have their balding on the scalp only and a head full of hair in front. it'll look weird (which is why people end up shaving/electrolysing)

[THE TRUTH]

Excellent question. 

Well the problem is for example if your transplant turns out to be a failure (unatural, very low density etc...) and you are not happy then you will want to shave your head. 

But the problem is even with you go with a razor the white dots from FUE like Mister Rolandas for instance or a wide FUT scar like Joe Rogan will be visible.

So not only your balding pattern that many headshavers refer to as "the shadow" will be visible but also the scars....

Now of course some people scar worse than other. 

If FUE then it'll depend on how well the extractions were spread out,  punch size, hair to skin contrast, your own body healing capacity.

I've seen cases of guys shaving their head after FUE wherr the donor was looking very bad because of white dots. And others where it's barely noticeable. 

But you have to plan for the worse. 

Now from what you described your hairloss is already significant.

The crown is a black hole for grafts and it takes at least 2  sucessful surgeries to get decent coverage. 

I would think about it twice.

If you are already ready to shave your head then getting SMP (although it's also a minefield industry too and it also has lots of limitations) might be a safer bet since it will preserve your donor and conceal your balding pattern in case you decide to shave you head. 

Like Gatsby and other experienced guys told you, sometimes it's better not to get a hair tranplant... 

It's not what you wanna hear as a young man losing hair. Hairloss is devastating.  I know. It s*****....But it's what you need to hear. 

And if you do decide to get one then you gotta do your research like crazy and go with an excellent doctor. And even then you might not be satisfied. 

And of course commit to at least Finasteride long term. 

Finasteride is a bit overhyped too. Not just in terms of sides effects but also and more importantly in terms of efficacy. 

It's certainly not a cure for hairloss at all. It absolulety does not regrow any hair at all. At very best it might thicken up existing miniaturized hairs. 

But it is the most effective treatment to slow down hairloss significantly and minimize the needs for future for transplants, donor supply being limited as you know. 

There is Dutasteride too of course and some other hardcore anti androgens and estrogens of course but these are not really viable. 

 

[Gatsby]

8 hours ago, GoliGoliGoli said:

but at 40 or 50 it's much more normal to be bald.

Not true. It's 'normal' to be bald anywhere from your late teens to early 20's but baldness will still worry you at any age. The only difference is that the older you are the better you are at decision making.

[Gatsby]

8 hours ago, GoliGoliGoli said:

Eh, I'm fairly confident I would be alright with no meds and 2 HT's.

What if one or both hair transplants fail and you have tapped out your scalp donor? What if you agree to augmenting beard grafts and begin to experience anagen desynchronization? What happens when senile alopecia kicks into your scalp donor? There is no such thing as a 'true' scalp safe donor zone that is entirely safe from DHT. As I said before MPB is always progressive over the life span.

[Rahal Hair Transplant]

@GoliGoliGoli,

To be completely honest with you, if you are having second thoughts, hold off until you feel confident that you’re making the right decision. While there are ways to reverse a hair transplant, none of them are perfect.  Reversing hair transplant surgery can leave you with scarring, inflammation, a reduction of natural hair in addition to transplanted hair, etc.  Besides, if you ever decide to move forward again and undergo hair transplant surgery, you will have already lost some of your limited donor hair.

Now here’s a good news.

While you may require more than one hair transplant to meet your long-term hair restoration goals, a skilled and experience surgeon will always perform a standalone hair transplant procedure. When I say “standalone“ I don’t mean that it will necessarily provide you with all of the coverage and density you need depending on your degree of hair loss.  But, every hair transplant procedure should look natural and gradually fade into the next area of thinning/baldness as if you lost hair naturally that way.

Be sure to speak to whichever surgeon you’ve selected about this and make sure that he will be performing each procedure as a standalone procedure.  Be wary of any surgeons who either don’t implement this philosophy or aren’t familiar with it.

But even with proper planning and selecting a skilled and experienced surgeon, there are some patients who simply just aren’t ready to make the commitment and take the plunge.  Some people have expectations that are too high or for one reason or another scrutinize every little thing that to everyone else looks natural but is a problem for them.   Frankly, if you are one of these individuals, I recommend holding off and not moving forward with hair transplant surgery.

That said, as long as you select a skilled and experienced surgeon who has a proven track record of producing outstanding results consistently, the probability that you’ll end up with a spectacular result is quite high.  I worded it this way because there are always risks with every surgical procedure and even though they are rare, it’s important that you understand them. That’s why every clinic will go over these potential risks with you prior to you undergoing hair restoration surgery. You will likely have to sign something that states that you agree that there are risks even though that they are rare.

I don’t say any of this to scare you or convince you not to undergo surgery. But since you are asking about backing out and reversing the procedure, I think it’s important that you are completely aware of everything because all patients should provide “informed consent”.  This essentially means that you are making an informed decision based on knowing all the facts both good and bad and not a decision based strictly on emotions.

All that to say, there are hundreds if not thousands of happy patients who have shared their experiences and results on this forum and elsewhere because they’ve selected a skilled and experience surgeon that impressed them based on their own advanced research. I encourage you to do the same. If you need help on how to properly research and select the right surgeon for you, let me know and I can provide you with more information.

Best wishes,

Rahal Hair Transplant 

Edited July 5, 2022 by Rahal Hair Transplant

[davidn]

I think the truth lies somewhere in the middle. Statistically, yes it is far more common to be bald in your 40s/50s/60s than early 20s, this is just the reality and implicitly implied each time someone says "hair loss is progressive". I think it is a valid thing to say that many young men feel like being bald is a significant disadvantage for them in the romantic market or even in the job market if you consider things like the halo effect etc. Chances are being bald makes you less attractive. This doesnt mean that every bald man is unattractive obviously. But there are studies in which >20% of men admit feeling depressed by losing their hair. This is in self-reports which are usually skewed as men are embarassed by admitting depression over vanity. I am all for bald positivity and think for many men it is the most sustainable option, but I think we are not entirely honest with ourselves telling people that there is an easy solution which is shaving their head and embracing it, as we wouldn't need coping mechanisms and support communities if it wasn't a big deal for many men. The hair transplant market wouldn't be projected to grow so much in the next years if it was true. However, it is a valid thing to say for people in their 40s/50s/60s as well that they absolutely care how they look and want to look good and feel good about themselves even when older. This is what young men often neglect when they don't do smart planning with hair transplants. Of course you don't wanna look ridiculous at 50 when you have children and a wife and be constantly made fun of by colleagues and such having big ass scars all over your head.

Edited July 5, 2022 by davidn

[GoliGoliGoli]

11 hours ago, davidn said:

I think the truth lies somewhere in the middle. Statistically, yes it is far more common to be bald in your 40s/50s/60s than early 20s, this is just the reality and implicitly implied each time someone says "hair loss is progressive". I think it is a valid thing to say that many young men feel like being bald is a significant disadvantage for them in the romantic market or even in the job market if you consider things like the halo effect etc. Chances are being bald makes you less attractive. This doesnt mean that every bald man is unattractive obviously. But there are studies in which >20% of men admit feeling depressed by losing their hair. This is in self-reports which are usually skewed as men are embarassed by admitting depression over vanity. I am all for bald positivity and think for many men it is the most sustainable option, but I think we are not entirely honest with ourselves telling people that there is an easy solution which is shaving their head and embracing it, as we wouldn't need coping mechanisms and support communities if it wasn't a big deal for many men. The hair transplant market wouldn't be projected to grow so much in the next years if it was true. However, it is a valid thing to say for people in their 40s/50s/60s as well that they absolutely care how they look and want to look good and feel good about themselves even when older. This is what young men often neglect when they don't do smart planning with hair transplants. Of course you don't wanna look ridiculous at 50 when you have children and a wife and be constantly made fun of by colleagues and such having big ass scars all over your head.

Yep, well said. Maybe this is complete nonsense, but I feel like I would be a lot more open to going bald if I wasn't already a pretty attractive guy. Like I've spent my whole life benefiting from the halo effect as you call it, and the thought of losing it as time goes on is a concern. Hair fibers have allowed me to continue to enjoy the halo effect for now but at a certain point it will be less effective as the balding progresses both on the crown and hairline. (Luckily they do seem to stay in pretty well during sex even when a girl is grabbing your hair pretty aggressively :O) 

Edited July 6, 2022 by GoliGoliGoli

[johnto]

Can you show us pics of your hair? this might put things into perspective for everyone

[Gatsby]

Personally I believe a great looking guy who's bald or has shaved his head will always trump an average or below looking guy with hair.

 

[GoliGoliGoli]

1 hour ago, johnto said:

Can you show us pics of your hair? this might put things into perspective for everyone

Two pics for ya. One is obviously hair pulled back to show full extent of loss. Second is styled to look (almost) as good as possible.