26, NW5a (maybe eventually 6?) pattern. Starting on my journey.

[akbar264]

Hi all,

 

New to the forum and also new to this journey. I have been losing hair since my early 20s and just kind of denied it until recently. I am kicking myself because I had a pretty decent head of hair just 3 years ago but let advance quite severely to the point where I am clearly balding.  I think I'm a NW5a, but could potentially progress to 6 since my crown is starting to dip. I have started fin and been on it for almost 2 months,  have had some sides which has forced me to titrate my dose, but thankfully it's nothing unbearable and I can pivot to topical if I absolutely have to. I have been on Minoxidil for 1.5 years. It helped a bit but it was a mistake not to get on fin sooner. I have a few questions about HTs as I'm considering getting one in a few years if I can stabilize my loss.

 

Questions

1. Can NW5a's theoretically get full coverage with average donor/density?

2. Will someone who is destined for NW7 avoid getting there entirely on meds?

3. What is more important to a hair transplant, coarseness or density?

 

 

 

Edited August 10, 2022 by akbar264
I removed my pictures because I realized I am not comfortable having my head on a public forum)

[akbar264]

Apologies if this is the wrong topic. I can repost  

Edited August 10, 2022 by akbar264

[GoliGoliGoli]

Hey, it might help if you could list out any specific questions/concerns you have like below to help us in answering them:

1. 

2.

3.

 

From the 2nd picture it does look like your crown is starting to dip a good bit which may compromise your donor. Since you're on meds, it's advised to wait at least a year while being on them before getting a HT to see how much you can regrow naturally. Some people regrow a lot, some people don't regrow at all and the meds just preserve what they have. Some people continue losing on meds but its expected to be at a slower pace. You're also going to need a lot of grafts to cover your area, so probably 2 different sessions required if your donor can even handle that. But I'm no expert so the first step is to  to consult with 3-5 REPUTABLE doctors to get their opinion. There are many non-reputable Dr's out there you will need to avoid. Top right of the page has this forums recommendations, but their are also many other good doctors not on the list too so doing some research is important. But the recommended list is a great place to start. 

 

Overall, if you fully understand the risk that come with the meds and are nevertheless determined to stay on them, my advice would be to give it at least a year on the meds before getting a transplant. This gives you time to consult with Dr's and do your research, and you can also possibly get on the waiting list with some of them while you wait to see the full results of the med's. 

Edited August 10, 2022 by GoliGoliGoli

[akbar264]

11 minutes ago, GoliGoliGoli said:

Hey, it might help if you could list out any specific questions/concerns you have like below to help us in answering them:

1. 

2.

3.

 

From the 2nd picture it does look like your crown is starting to dip a good bit which may compromise your donor. Since you're on meds, it's advised to wait at least a year while being on them before getting a HT to see how much you can regrow naturally. Some people regrow a lot, some people don't regrow at all and the meds just preserve what they have. Some people continue losing on meds but its expected to be at a slower pace. You're also going to need a lot of grafts to cover your area, so probably 2 different sessions required if your donor can even handle that. But I'm no expert so the first step is to  to consult with 3-5 REPUTABLE doctors to get their opinion. There are many non-reputable Dr's out there you will need to avoid. Top right of the page has this forums recommendations, but their are also many other good doctors not on the list too so doing some research is important. But the recommended list is a great place to start. 

 

Overall, if you fully understand the risk that come with the meds and are nevertheless determined to stay on them, my advice would be to give it at least a year on the meds before getting a transplant. This gives you time to consult with Dr's and do your research, and you can also possibly get on the waiting list with some of them while you wait to see the full results of the med's. 

hey, thanks for your feedback. I know I will need two sessions, and am willing to stay on meds for a year. I added a few questions in the OG post. I also removed the pics because I feel like it's probably best to save those for a surgeon.

[mister_25]

1. Norwood 5as can get something relatively strong and dense looking. But it will take pretty a large amount of grafts, usually around 6500-9000. Captain calico and Rolandes are really good examples of Norwood 5 recoveries with 6500 grafts and 7000 respectively. don’t expect native density but you can get something that will hold up decently even in the worst conditions. Obviously there will be scalp showing in those cases but it should still look rather good if you got it done by a elite doctor with a successful result. I’m basing this without seeing your pictures.
2. It’s not a guarantee, but it’s possible.  I think there is someone on this forum who got on medication at NW3 and avoided getting NW7 like the rest of their family. I usually like to give examples but I’m unsure who it was. In my case, I went from a Norwood 5, to a Norwood 4 or even debatably a Norwood 3 vertex. I've stabilized for over a year without any regression in my regrowth. I shed quite a lot and it will look worse temporarily but it always grows back in. The reason for my shedding is that I get slightly sloppy with my minoxidil application.

3. If you have fine hair, you will need more hairs/cm2 than someone with coarse hair. I would say density is more important in your donor, but coarse hair goes a long way in advanced Norwood’s. Additionally, if you are a advanced case. You can have your donor intentionally homogenously overharvested in extreme cases. But you would probably resort to beard hair. Their is a lot of hype around beard hair usage recently and I will say some of the results are incredibly impressive. But beard hair if done poorly can look super unnatural and actually look worse than being bald.

 

First step, get on medication. You will need to stabilize your hair loss. You might be able to get regrowth. Take a look at my post on Finasteride. I went from. Norwood 5 to Norwood 4. You can get USB microscopes to examine your crown for miniaturization or it would be better if you got a excellent trichologist for that. After being on medication for a year and if you presumably stabilize, you should consult with a elite doctor for your case. Someone experienced in Norwood 5a but also has excellent donor management for upcoming Norwood 7s.

Zarev is very skilled in high Norwood donor planning, Sethi as well. Bisanga/Mwamba/Ferreira/Hasson all have track records and skills for Norwood 5a. Other doctors that I think you should put on a research list is Pinto, Konior and Freitas

Edited August 10, 2022 by mister_25
more reasoning

[akbar264]

18 minutes ago, mister_25 said:

1. Norwood 5as can get something relatively strong and dense looking. But it will take pretty a large amount of grafts, usually around 6500-9000. Captain calico and Rolandes are really good examples of Norwood 5 recoveries with 6500 grafts and 7000 respectively. don’t expect native density but you can get something that will hold up decently even in the worst conditions. Obviously there will be scalp showing in those cases but it should still look rather good if you got it done by a elite doctor with a successful result. I’m basing this without seeing your pictures.
2. It’s not a guarantee, but it’s possible.  I think there is someone on this forum who got on medication at NW3 and avoided getting NW7 like the rest of their family. I usually like to give examples but I’m unsure who it was

3. If you have fine hair, you will need more hairs/cm2 than someone with coarse hair. I would say density is more important in your donor, but coarse hair goes a long way in advanced Norwood’s.

 

First step, get on medication. You will need to stabilise your hair loss. You might be able to get regrowth. Take a look at my post on Finasteride. I went from. Norwood 5 to Norwood 4. You can get USB microscopes to examine your crown for miniaturisation or it would be better if you got a excellent trichologist for that. After being on medication for a year and if you presumably stabilise, you should consult with a elite doctor for your case. Someone experienced in Norwood 5a but also has excellent donor management for upcoming Norwood 7s.

Zarev is very skilled in high Norwood donor planning, Sethi as well. Bisanga/Mwamba/Ferreira/Hasson all have track records and skills for Norwood 5a. Other doctors that I think you should put on a research list is Pinto, Konior and Freitas

Thanks man. I will absolutely put those doctors on my list, although I doubt I can do anyone in Eugenix because I am of Pakistani origin and will probably not be able to get a visa to India.