Am I a good candidate for a crown transplant?

[fitwhynot]

I'm 34 years old.

I've been on oral finasteride since 7 months.

I've been on topical minoxidil since 11 months.

I derma-roll 1x every two weeks with 1.5 an automatic derma-stamper (hence the redness in some of the photos). I've seen a stabilization in my hair-loss, improvement in hair quality, but not necessarily very much re-growth.

(Somehow my hair looks better in these photos than it does in person)

Am a I good candidate for a crown transplant? I consulted with Dr. Rahal and he informed me that it's too early, due to potential shock-loss, I may not see much benefit. I'm partial to disagree though.

Edited July 27, 2022 by fitwhynot

[BaldReaper]

Your crown doesnt need a hair transplant

[AlexMeister21]

My crown looks somewhat similar to yours and I've been told from several docs that they wouldn't transplant on my crown at the moment due to potential shock loss. Wish something could be done, but may just have to use Toppiks for the time being.

[fitwhynot]

9 minutes ago, AlexMeister21 said:

My crown looks somewhat similar to yours and I've been told from several docs that they wouldn't transplant on my crown at the moment due to potential shock loss. Wish something could be done, but may just have to use Toppiks for the time being.

Can I see what yours looks like?

[AlexMeister21]

2 minutes ago, fitwhynot said:

Can I see what yours looks like?

[fitwhynot]

3 minutes ago, AlexMeister21 said:

Yours is in way better shape than mine lol, nice!

[AlexMeister21]

7 minutes ago, fitwhynot said:

Yours is in way better shape than mine lol, nice!

I think my hair is just longer in the photo. I stopped wearing hats with adjustable straps because my bald spot starts to show in the back there now.

[GoliGoliGoli]

1 hour ago, fitwhynot said:

I'm 34 years old.

I've been on oral finasteride since 7 months.

I've been on topical minoxidil since 11 months.

I derma-roll 1x every two weeks with 1.5 an automatic derma-stamper (hence the redness in some of the photos). I've seen a stabilization in my hair-loss, improvement in hair quality, but not necessarily very much re-growth.

(Somehow my hair looks better in these photos than it does in person)

Am a I good candidate for a crown transplant? I consulted with Dr. Rahal and he informed me that it's too early, due to potential shock-loss, I may not see much benefit. I'm partial to disagree though.

Curious if the crown has improved since you started on fin/min? Or has it stayed the same/gotten worse? Same question for @AlexMeister21

[fitwhynot]

5 minutes ago, GoliGoliGoli said:

Curious if the crown has improved since you started on fin/min? Or has it stayed the same/gotten worse? Same question for @AlexMeister21

I've seen a stabilization in my hair-loss, improvement in hair quality, but not necessarily very much re-growth. (This applies to the crown as well)

[hairman22]

37 minutes ago, AlexMeister21 said:

My crown looks somewhat similar to yours and I've been told from several docs that they wouldn't transplant on my crown at the moment due to potential shock loss. Wish something could be done, but may just have to use Toppiks for the time being.

Think the shock loss argument is an excuse by doctors who just are not confident to transplant in the crown

 

I had shockloss was not on finesteride. It will grow back & they can plan for some shockloss transplanting

It can be done so long the surgeon is confident yo have the donor supply for the future

[Melvin- Admin]

37 minutes ago, AlexMeister21 said:

Actually you have a lot more hair. 

[Melvin- Admin]

1 hour ago, fitwhynot said:

I'm 34 years old.

I've been on oral finasteride since 7 months.

I've been on topical minoxidil since 11 months.

I derma-roll 1x every two weeks with 1.5 an automatic derma-stamper (hence the redness in some of the photos). I've seen a stabilization in my hair-loss, improvement in hair quality, but not necessarily very much re-growth.

(Somehow my hair looks better in these photos than it does in person)

Am a I good candidate for a crown transplant? I consulted with Dr. Rahal and he informed me that it's too early, due to potential shock-loss, I may not see much benefit. I'm partial to disagree though.

You’re a good candidate for medication and fibers. I think the cons outweigh the pros here. This is easily concealed with some fibers and a hairstyle. 

[fitwhynot]

52 minutes ago, Melvin- Moderator said:

You’re a good candidate for medication and fibers. I think the cons outweigh the pros here. This is easily concealed with some fibers and a hairstyle. 

I tried fibers a long time ago and didn’t quite like them. Don‘t they wash away if they get super wet or look unnatural in the sunlight? Additionally I would find it hard to find fibers to match my true hair color I think. Do you recommend a specific brand?

Edited July 27, 2022 by fitwhynot

[GoliGoliGoli]

Just now, fitwhynot said:

I tried fibers a long time ago, don’t they wash away if they get super wet or look unnatural in the sunlight? Additionally I would find it hard to find fibers to match my true hair color I think.

I mean if they get super wet they will wash out but generally they're fairly rain resistant. The less you have to use to more natural it looks, you could get away with using very little. I don't think you would have trouble finding one that will match your color and again since you don't have to use a lot it wont look unnatural anyways. 

Try Caboki. IIRC Toppik has some chemical in it that is thought to be toxic, whereas Caboki does not. 

[Melvin- Admin]

4 minutes ago, fitwhynot said:

I tried fibers a long time ago and didn’t quite like them. Don‘t they wash away if they get super wet or look unnatural in the sunlight? Additionally I would find it hard to find fibers to match my true hair color I think. Do you recommend a specific brand?

You would be medium brown, very easy to match. I have system that allows you to go swimming and it doesn’t come out. 
 

 

[Gatsby]

I think you really need to give your meds at least a year for a fair trial before judging them. If safe with your physician you may even be able to tweak them. The danger about addressing your crown now is that you may fill in an area which will take a lot of grafts. Then if your baldness accelerates then you will be left with an island of grafts that you will be continually chasing. If you add in the other potential risks such as shock loss, etc, then this really could be a recipe for disaster. If you feel that you have stabilized then I really feel then that you have won. Save all of those grafts if needed for the frontal area 'IF' you ever need them. You are in a better position than you realize and with hair fibres, etc, I wish you all the best!

Edited July 28, 2022 by Gatsby

[AlexMeister21]

3 hours ago, GoliGoliGoli said:

Curious if the crown has improved since you started on fin/min? Or has it stayed the same/gotten worse? Same question for @AlexMeister21

I think Fin has stopped shedding to a degree. Before Fin, I used to notice a lot of hairs in my hand when shampooing in the shower, but after fin I don't notice too many strands or none at all. I still think my crown has gotten a bit worse though. My crown was absolutely fine until four years ago when I tried going vegan for a couple weeks and my crown started to itch like crazy all of a sudden. Then I looked in the mirror and noticed thinning. Not sure if going vegan would have exacerbated things, but I tried vegan again two years ago and same thing happened where my crown itched until I stopped the diet. 

[mafpe]

I think the shock loss risk is real. True the shock loss might be temporary, but take me for example, usually the ops won't include my crown area. Currently due to the HT, the recipient area is lagging behind severely due to the trauma. It's possible it's just temporary, and after the phase pass, it will all grow well again, but if by chance it killed some hair due to the trauma... you'll end up worse than when you started.

It might just be fear talking, but thats my current state 1.5 mo post op. It'd take at least half a year to see if everything is alright or if it's not.

If i'm to rewind time, i'm not sure whether i'd still have my crown transplanted.

[fitwhynot]

2 hours ago, mafpe said:

I think the shock loss risk is real. True the shock loss might be temporary, but take me for example, usually the ops won't include my crown area. Currently due to the HT, the recipient area is lagging behind severely due to the trauma. It's possible it's just temporary, and after the phase pass, it will all grow well again, but if by chance it killed some hair due to the trauma... you'll end up worse than when you started.

It might just be fear talking, but thats my current state 1.5 mo post op. It'd take at least half a year to see if everything is alright or if it's not.

If i'm to rewind time, i'm not sure whether i'd still have my crown transplanted.

Can you post pics of your HT?

[mafpe]

18 minutes ago, fitwhynot said:

Can you post pics of your HT?

https://www.hairrestorationnetwork.com/topic/64288-dr-demirsoy-armamed-3270-grafts-june-2022/

 

[TommyLucchese]

9 hours ago, fitwhynot said:

I tried fibers a long time ago and didn’t quite like them. Don‘t they wash away if they get super wet or look unnatural in the sunlight? Additionally I would find it hard to find fibers to match my true hair color I think. Do you recommend a specific brand?

Try Mane thickening spray / root concealer. I've used it for over 10 years and they offer a travel sized option so you can trial it for less money....it works great for me. Don't go for their expensive 'lock in spray' just get some strong hold hairspray from the supermarket and spray it on afterwards. It survives rain and wind until I wash it out. 

[Rahal Hair Transplant]

Fitwhynot,

The crown is one of the most controversial and difficult areas of the scalp to transplant with any real degree of density.  In fact, the crown is often referred to as the “black hole“ for grafts because of this.   Well I can’t speak for Dr. Rahal personally, I agree that you may not see much benefit from transplanting the crown at the stage. Allow me to explain.

The crown is a very strange area of a scalp. those who are completely bald in the crown, a little can go along way. But for those who already have a covering in the crown, it will take a significantly large number of follicular units to achieve any real density.  

And then you have the risk of temporary and permanent shock loss. While most shock loss is temporary, any hair that’s on its way out anyway due to male pattern bonus may be permanently shocked and may not grow back.

At this stage, you are only 7 months into using finasteride and thus, it’s too early to tell just how beneficial this medication will be for you.  It’s recommended to take finasteride for at least a year to determine whether or not it’s affective. But in order to reverse the miniaturization process completely, assuming it’s even going to do that, but take more time. Many of the hairs on your scalp and in the crown are currently fragile and transplanting in the area may result in permanent loss of some of the natural hair.

Long story short, I concur with Dr. Rahal that it is likely a bit too early for you and in my opinion, you should give finasteride more time to see just how effective it will be prior to undergoing her transplant surgery.

I also want to say this. I know I’ll tempting it is to blow off a doctors advice because it goes against what you want to do. I’m sure you’re not happy with the thinning you’re experiencing and you want to do anything you can do reverse it. Just keep in mind that top doctors like Dr. Rahal have your best interest in mind and ultimately his advice is for your long-term benefit.

Sure it would be easy for him or any clinic to take your money and perform surgery on you.  But you have to truly respect the doctors that tell you to wait   They are the ones looking out for you and making sure that you obtain a net gain in hair over the long term rather than simply giving you what you ask for which may result in an overall net loss of viable hair   

In my opinion, stay on the medication for another year or two and then reevaluate. By then, if the medication is working, it’ll be working to its max capacity and any miniaturized hairs that exist today will likely be terminal.  As a result, you will experience much less permanent shock loss and then result will be a net gain of viable, terminal hairs instead of a potential net loss.

Best wishes,

Rahal Hair Transplant 

[fitwhynot]

7 hours ago, mafpe said:

https://www.hairrestorationnetwork.com/topic/64288-dr-demirsoy-armamed-3270-grafts-june-2022/

 

Looks really good, but you also had a lot more hair than I have. I hope you have a great result, even if it takes longer (as the crown sometimes does, if I’m not mistaken?). Good luck!

[Rahal Hair Transplant]

@hairman22

You said, “Think the shock loss argument is an excuse by doctors who just are not confident to transplant in the crown”

Maybe that’s true for some but this is definitely the furthest thing from the truth regarding Dr. Rahal.  Dr. Rahal evaluates each patient individually and will make recommendations for them based on their individual circumstances. In the above case, I’ve already explained why I personally agree that it might be too early.  But make no mistake. Dr. Rahal has done some amazing crown transplants and will certainly do them when it is appropriate for the patient.

in the above case, I do feel that the op should give it more time to see just how effective the medication is before undergoing surgery.  Hair loss medication like finasteride doesn’t typically regrow hair in completely bald areas but it is quite good at reversing the miniaturization process four hairs that are in the middle of it.  If a transplant is done too soon before these miniaturizing Harris become terminal, they could be permanently lost during surgery.

Dr. Rahal is trying to make sure that when this patient undergoes hair transplant surgery, that he’s able to retain as much of his natural hair as possible along with the transplant and hair as opposed to simply replacing miniaturizing hairs with transplanted hair.

So while I understand that some inexperienced or a neophyte surgeons might make excuses so to speak, Dr. Rahal is not one of them and his assessment is based on what he genuinely believes in the best interest of the patient. In the above case I happen to fully agree with him  based on the recent song explains.

Note also that he did not say no, he just said that he feels it’s too soon. Based on what I explained above, do you really disagree with that? And if so why?

Rahal Hair Transplant 

Edited July 28, 2022 by Rahal Hair Transplant

[hairman22]

I disagree that the crown shouldnt be transplanted on this stage.

its more so about whether the patient as the donor supply to meet there possible highest norwood level.

I