Need advice - Considering First HT at age 43

[JS]

Hello All -

 

Been perusing this forum for a few days. I am considering getting my first HT. I am 43, live in AZ, and had my first consult with Dr Alexander yesterday. Nice to have one of the top guys in the country right down the road. I have been using Propecia for about 10 years and I think that is the reason I still have hair. In fact I don't think much has fallen out since I started using it, maybe a little along the way, and maybe a little receding hairline since 10 years back. I just feel I'm at the point where I should shave it all off (thank you Michael Jordan for putting the shaved head in vogue, although I still think black guys look way better than white guys with shaved heads) or do a HT. I'm at a good point in my life to do it - in between relationships, unemployed accept for a small side business.

 

Dr Alexander wants to do 2700 graphs on front and top, and then if I want he said he could do another round for the crown (which was a nice surprise as I didn't think that was an option). I haven't been using the foam rogaine all this time but he suggested getting on that to help the crown (I tried spray on minox years ago but it itched like a bitch and gave me danderuff so I stopped). I felt really comfortable talking w Dr A, and he said it would look really good when it was done because I already have a lot of hair that will blend in with it.

 

My concerns are that first few months of looking like a dork with a "sunburned" head and frankenstein gash and staple marks (Dr A shaves the head). I'm really having a hard time getting past that, like I'll just have to wear a hat the whole time I go anywhere, and basically shutdown my social life (meeting girls). I guess this is no biggie, just wait for the new and improved me in 6 months. I'm trying to view it as an investment but I have to think it is very hard emotionally during this period.

 

But I am just wondering how all you guys handled this period - the first 3-4 months when you had all that pinkness on your head top. Those of you w supportive wives I think may have had an easier time with this period.

 

I just signed up here and don't know how to post a lot of pics on one post. This post appears to only allow me to post one at a time, so I'll reply with a couple more pics

 

thanks JS

[JS]

Top

[JS]

Back/Crown

[JS]

Side shot

[hair_care]

First of all congratulations on deciding to have a HT. Dr Alexander has posted some very impressive results. Might I also suggest consulting with some other doc's before making your decision. Dr Sharon Keene is also in Arizona and does impressive work. The first few months after a HT are really hard. I am about one month post op and have to go around everywhere wearing a cap. This serves two purposes, one you really don't want people to look at you in a funny way and two , the first few months after a Ht, the scalp can be quite tender and you don't want to expose your head and the grafts to direct sunlight, especially the hot Arizona sun!!. But look at it this way , about 6 months or so after the surgery , when the hair begins to grow , you will look much better than you did before and have way more confidence with the ladies. So in my opinion 6 months or so of wearing a hat is a small price to pay for a great head of hair.

[Hair of the dog]

Hi JS

 

Did you ask Doctor Alexander specifically about shaving?

He did my HT for me without shaving and I was back at work after 2 weeks and no one suspected a thing. Also he used sutures on me, not staples and these came out after a week.

 

Cheers

[JS]

Dog - He didn't really leave it as an option. If I recall correctly he just said that he can do a much better job of laying the hair in place if its shaved. He wants me to leave a little height to the existing hairs (1/4 inch) as he goes a long to see how they lay, and then he'll shave it off in sections as the transplant proceeds.

[JS]

Maybe he will use sutures, I just assumed staples was the par in the industry since that is all I see in everyone's pics.

[HK500]

I think you chose a proven MD recommended here so your results should be good, you're stabilized on Finasteride and you seem to know all the basics.

2700 FU is not that much for you and agree with Spex, IMO you'll be happier with at least 3500 FU so you won't want a second pass for a while but maybe there are other factors you and the Dr have discussed such as donor supply or cost, etc...

To address your concern about privacy I am in favor of keeping the HT as undetected as possible and I achieved just that every time, my sessions were smaller as well, in my case I left my hair as long as I practically could before the HT and I chose a surgeon who agreed to take the extra time and effort to work around my existing hair without shaving. All the best and keep us posted.

[hairloser1]

The top and back view really show that your pretty close to nw6 territory now - or that's the obvious pattern anyway.

 

Just wondering if you thought about checking with those docs that seem to do 4000+ on a regular basis. If your a candidate as far as scalp and hair characteristics that would certainly seem to be an option - to shave it and then cover as much as possible from front to back. I'm sure you've seen some of those results on here.

 

I guess one advantage to smaller sessions would be the ability to refine the previous work in certain areas where needed.

 

I'm certainly not an expert. I'm the same age as you and probably an nw3 with no crown loss (also been on fin for 12 yrs) and I will be asking for at least 2000 in the front but not sure I would do it with less than 2500. That's why 2700 just doesn't like very many graphs for you. I've seen several nw3's get 3000 graphs or more.

[thanatopsis_awry]

You've begun your research, so the hardest part is actually over with!

 

IMHO, shooting for 2700 isn't nearly enough. I'm actually a bit confused by the statement that you have all this native hair that will really "embolden" the transplant (no offense, obviously )

 

You know what you want and will be most happy with better than anyone; so, I'd just say that you research all your options and pick the doctor and graft# that you think will make you most happy. Personally, I'd shoot for a max session; at the very least shoot for a fully rebuild hairline that is balanced by a reinforced top (if not vertex and crown, graft count willing).

[mgem]

Go for it. I am about 3 months postop it's not as bad as i thought, after 3 weeks or so i was back into my usual routine, work etc, i couldn't wear a hat to work so i started using concealers, nobody has spotted or said anything, they're not perfect but they do help. A few more months and i will hopefully be rid of my bald patch that i have tried to hide for 30 odd years. Good luck. mgem

[JS]

awry - i'm just saying that since i'm not a cue ball on top, the ht should look good because it will mix in w the existing hair. The best pics i've seen of HTs are where the guy had some hair still existing and the graphs were worked in between those existing hairs.

 

The doc said he would do 2700, I didn't feel I was in a position to tell him his job. Said it would take from 730 to 5pm to do that. A referral patient of his I spoke w this afternoon had the same deal - was supposed to do around 2700 and they had a bunch more graphs so it was closer to 3000.

[mgem]

Maybe speak to a few docs see what they say

[HK500]

JS

Dr Alexander is great but I would definitely consult, at least online with another recommended Dr and more specifically discuss your goals in terms of your anticipated level of results/fullness after only 2700 FU and the shaving issue.

[John Malloy]

Hey JS,

I don't want to sway you away from a HT, but be very careful. If you read most of the posts from the top docs, 6 months for a HT to look natural is very rare. I'm 4 months from my second HT, and would not dare go outside without a hat yet.

I was a N3. I basically had the mohawk look going on, but a very thick mohawk. I actually think the fact that my natural hair is thick makes the HT stand out a little more. My Ht does not look bad at all in pictures, but in person it is evident that something is going on up there. Anyway, if you are able to socialize as your hair is now, in my honest opinion, I don't think I would go through with it. As any reputable doc will tell you, "there are no guarantees" Trust me, you don't want a bad Ht, or for that matter a HT with poor growth---it is a living nightmare. And while I'm hopeing that my second HT has me looking natural again, I sincerely don't know if I'll ever go to another social event again with my hair if it does not show some wonderful growth in the next couple of months.

 

I hope I did not get off topic, but my point is 6 months is extremely early for any kind of signigicant result. Check out some of the other forum topics. I just feel as though the majority of responses to your post are leading you to think in 6 mos you will look completely natural. Just be extremely careful. Why not wait a couple more months? This way I can be your scapegoat. I went to Dr. Feller to correct my first Ht. He is a very respected doc on this forum. If my HT looks decent in a couple of months, I would love to give him a referral. But if a respected doc like Feller has me sporting a hat at 7 mos, I would never with a clear conscience suggest a Ht to anyone.

[thanatopsis_awry]

JS, I hear ya; just want your expectations to be met, whatever that even translates into (if it's 2700 w/ Alexander all the better, as I honestly couldn't care less what doc you go for all intents and purposes). You def aren't a cue ball, but, again, IMHO, I don't feel you have so much native hair and of such quality that it's going to make the 2700 go "that" far, even if you don't even attempt to fix up the vertex/crown.

 

Dr. Alexander disagrees. HTs aren't an exact science. It's a matter of plugging your own expectations into the equation, ultimately; I'm simply expressing my opinion, which may or may not be correct, in the end, but which should help you regardless.

[thanatopsis_awry]

Btw, here is a case to look at as a comparison: http://hair-restoration-info.c...66060861/m/862106743

 

I'm pretty sure KMan had 5300 grafts. Notably, he has more terminal, native hair in the front, and his laterals on the top are a lot more narrow. His crown is relatively tiny, too.

 

Everyone says research, and it's true; I personally like to define "research" as finding cases that resemble your own, and noting the similarities and differences over the backdrop of how many grafts were utilized. Def ask all of the docs you consult with to ship you examples in this vein, and then on your own find cases like the one I mentioned. This site has a ton of legit, unadulterated info on it.

[JS]

John - I think the comment that Dr A made was something akin to 'if you get the transplant done in the beginning of August it will start growing in by the holidays.' He didn't say it would be all in. Sorry if I conveyed that.

 

Well you certainly cast a pal over any excitement of getting a HT. I just came back from meeting with a former Dr A patient who had the front half done about 3 years back and it looked fantastic. I never woulda picked his hairline out as a transplant person. He was pretty elated and happy he had done it. But he also said he wore a hat for the first 2-3 months. But he also said the only people who ever found out were one brother and his fiance at the time. But if mine could look like his i'd be real happy.

[JS]

Thanks for you opinion awry, that's why I am on here, to get the full gammit of thoughts.

 

And maybe I heard what I wanted to hear at my consult. Maybe I said something like I thought it would look good since I still have this much original hair, and he just agreed, or hem-hawed and nodded?? I don't remember now. In any case, thanks...

[Forrest Gump]

As others have pointed out, I personally doubt if 2700 might do the job. I am guessing at least 4000 would be needed. However, perhaps you and the doctor might want to do with through multiple procedures instead of having 4000+ in one go.

 

Good luck!

[Raphael84]

JS, you seem like a sensible and realistic guy. Your research will prove priceless. I dont mean to jump on the band wagon here, but your pic labelled "top", tells the story for me. Like the other guys here, Dr A is ridiculously more experienced and better educated than myself, but 2700 seems to an inferior estimate. Just check out a few other patients blogs with similar patterns, and cross referance their graft counts and final results. Maybe express this to Dr. A and give him the opportunity to answer and explain this estimation.

 

For me, a potential patient needs to consult with as many Docs as possible. Or at least the ones that he feels confidence in. This is fortunately now, very easy with the tool of the internet. Use it to you advantage and get other feedback.

 

The 3-4 month cap issue, whilst not ideal, should really be pretty irrelevant. Think of the years of positive feelings regarding your hair when your result has fully grown in.

[hairloser1]

Hey JS, was the caliber of your hair discussed at your consult? This seems to make more of a difference in the final result than the number of graphs. Caliber meaning the average thickness of your terminal hairs in the donor area. I would want the Dr to tell me where I fall on the scale. As much hair as they look at they should be able to tell you where your hair falls in terms of thickness compared to the average.

 

I'm just curious about this because I really think that information should be stated right along every graft estimate that a Dr gives in ordert better set expectations. It's just so important when comparing yourself to other HT results.

[TC17]

I agree with hairloser1. The number of grafts is merely one of many factors that influence the success or failure of a transplant.

 

I believe that you shouldn't concern yourself too much with the number of grafts Dr. Alexander has recommended if you are comfortable with his results. If Dr. Alexander believes that he can achieve your goals with only 2,700 grafts, then great. Just because some doctors may recommended 3,000, 3,500, 4,000 or even more does not mean that you cannot achieve the same results with less grafts.

 

My point is that the important thing for you is to look at the results of the physician, and not get caught up in graft count. If you like the results of Dr. Alexander more than any other doctor, you should visit him and trust that he will do right by you. Putting your faith in a doctor who you have thoroughly researched and subsequently trust to give great results is not the same as blindly trusting any quack doctor who practices hair restoration.

 

If I love the results of both Dr. A and Dr. B, but Dr. A recommends 2,500 grafts and Dr. B recommends 3,500 grafts, I personally would choose Dr. A every single time. Results are what matter, not graft count.

[JS]

hl1 - He did mention that the hair on top was a little more fine than the hair on the side. This surprised me as I just assumed if it was there at all then it was still strong.

 

With all the comments on 2700 being a low number I will call on Monday and ask him about why he doesn't want to do a higher number. Right now, though, at $4/graph, 2700 probably is in my price range. But still, you are all saying the same thing so I wonder what Dr A's comment would be if I asked to do, say 3500.