Decided I want a HT but what now?

[Hair, my old friend]

Hey Everyone, I’ve been looking at all your posts on here for years and finally have decided that I really do want my hair back. I miss it, and if I can achieve results that don’t look like plugs, then I’m really all the way in. Thanks to all yall who posted and have given me the courage to do the same. 
 

I’m 38 and started balding in my 20s and by the time I was 30, it was different versions of what I have going on now. 
 

I would say this is a Norwood 6, but any clarification from anyone who knows more than me is appreciated. 
 

I want to stay in the United States, but am at least open to the idea of traveling. 
 

a few opening questions I have are:

1) what can serious balding like mine expect from a transplant? I don’t want the Lebron effect, and I have very coarse, thick curly hair. 
 

2) what are some of the leading clinics in the United States, and do any of these focus on nw6? 
 

3) am I correct in stating that I have a nw6? 
 

4) does anyone have any experiences they can share of ethnic hair success stories, or of success stories with this level of balding in the USA preferably? 
 

thanks for any of your insights. Excited to embrace the journey! As I told my wife, it’s less about being happy, and more about missing that old friend who moved away. I live fine without seeing them, I’d just prefer them living nearby! 
 

Thanks!

[Gatsby]

I would say you are at least Norwood 6. However you still have your parietal humps (your hair on the sides of your scalp are still quite high and haven't dropped). Also the fact that you have thick, curly hair is an asset as it will give the illusion of more density. What are your hair restoration goals? Are you wanting full coverage, etc? Have a look at some of the surgeons recommended on this site who operate in the States. However you really want to focus on clinics that excel at Norwood 6/7 results. The best clinics that come to mind are Eugenix, Dr Pitella, Hasson and Wong, etc. If you are going into a life altering surgical decision then travel is a negligible aspect as you will be waking up and looking at your hair in the mirror for the rest of your life. Wishing you all the best on your research and keep asking questions. All the best!

[Mike10]

In my opinion you are not a candidate for HT

[Hair, my old friend]

12 hours ago, Gatsby said:

I would say you are at least Norwood 6. However you still have your parietal humps (your hair on the sides of your scalp are still quite high and haven't dropped). Also the fact that you have thick, curly hair is an asset as it will give the illusion of more density. What are your hair restoration goals? Are you wanting full coverage, etc? Have a look at some of the surgeons recommended on this site who operate in the States. However you really want to focus on clinics that excel at Norwood 6/7 results. The best clinics that come to mind are Eugenix, Dr Pitella, Hasson and Wong, etc. If you are going into a life altering surgical decision then travel is a negligible aspect as you will be waking up and looking at your hair in the mirror for the rest of your life. Wishing you all the best on your research and keep asking questions. All the best!

Hey Gatsby, thanks for the lengthy response. Travel is not necessarily an issue, though I do feel I want to stay in the United States or Canada. I did a deep dive on the hair transplant network after this post and check out all the NW6 journal entries and the doctors who performed the best looking ones. Ive reached out to Konior, Bernstein, Hasson, and Cooley. All those guys are relatively local and seem to achieve incredible results, mostly through the use of microscopic implantation and personally conducting the surgery rather than having techs conduct them. Are there others I should be looking at that are near?
 

My goal is to have thick hair density in the front and mid, with some thinning and balding being fine in the crown. The most important thing for me is that I achieve a natural looking hairline that doesn’t have a pluggy look. My understanding is that the use of microscopes, with specific attention to the direction of the hair follicle in its placement are key to achieving realistic results - is that your understanding? I have lots of thick hair on the sides - does this mean I have a good donor area? What determines the donor area quality? 

Trying to drown out the negative at the moment. Appreciate the encouragement. 

[Hair, my old friend]

5 hours ago, Mike10 said:

In my opinion you are not a candidate for HT

How come Mike? I’ve seen plenty of people more far gone, who have achieved great results. 

[Z--]

43 minutes ago, Hair, my old friend said:

Hey Gatsby, thanks for the lengthy response. Travel is not necessarily an issue, though I do feel I want to stay in the United States or Canada. I did a deep dive on the hair transplant network after this post and check out all the NW6 journal entries and the doctors who performed the best looking ones. Ive reached out to Konior, Bernstein, Hasson, and Cooley. All those guys are relatively local and seem to achieve incredible results, mostly through the use of microscopic implantation and personally conducting the surgery rather than having techs conduct them. Are there others I should be looking at that are near?
 

My goal is to have thick hair density in the front and mid, with some thinning and balding being fine in the crown. The most important thing for me is that I achieve a natural looking hairline that doesn’t have a pluggy look. My understanding is that the use of microscopes, with specific attention to the direction of the hair follicle in its placement are key to achieving realistic results - is that your understanding? I have lots of thick hair on the sides - does this mean I have a good donor area? What determines the donor area quality? 

Trying to drown out the negative at the moment. Appreciate the encouragement. 

All of the doctor's you've checked out are phenomenal. Given the reasonable expectations, if they think you're a candidate you are probably good to go. Dr. Shapiro and Gabel are another two in the US to consider who are very good too.

[GoliGoliGoli]

I think almost anyone can achieve pretty good aesthetic improvement from a HT as long as your expectations are reasonable, which it sounds like yours are.

 

The one thing that is a bit concerning is the view of your donor in the 5th picture. It looks a bit sparse in the middle section there. But do consult with a variety of Dr's though because trying to determine donor quality from a few pictures is a fools errand.

[Hair, my old friend]

33 minutes ago, Z-- said:

All of the doctor's you've checked out are phenomenal. Given the reasonable expectations, if they think you're a candidate you are probably good to go. Dr. Shapiro and Gabel are another two in the US to consider who are very good too.

Thanks very much Z! I’ll check out those two docs and add them to the list. Appreciate the feedback. 

[Mike10]

1 hour ago, Hair, my old friend said:

How come Mike? I’ve seen plenty of people more far gone, who have achieved great results. 

because of your donor

[Ryan Daniel]

You are balding deep into the ''safe area'' of the donor area. This is very risky... especially when harvesting grafts that might be prone to die after implanting but still anything can be done for everyone.

However, if you are willing to have 2 high quality procedure for an acceptable conservative result, then yes there's a chance for you

[Hair, my old friend]

2 minutes ago, Ryan Daniel said:

You are balding deep into the ''safe area'' of the donor area. This is very risky... especially when harvesting grafts that might be prone to die after implanting but still anything can be done for everyone.

However, if you are willing to have 2 high quality procedure for an acceptable conservative result, then yes there's a chance for you

Thanks for your opinion on this, and this is very concerning to hear. I’ve take another couple of shots of my donor area. I appreciate your taking a look. 

[Hair, my old friend]

36 minutes ago, GoliGoliGoli said:

I think almost anyone can achieve pretty good aesthetic improvement from a HT as long as your expectations are reasonable, which it sounds like yours are.

 

The one thing that is a bit concerning is the view of your donor in the 5th picture. It looks a bit sparse in the middle section there. But do consult with a variety of Dr's though because trying to determine donor quality from a few pictures is a fools errand.

Thanks G - appreciate your feedback. I uploaded another couple of photos of the donor area. I am starting to appreciate that that is a bit of a concern for me. Let me know what you think of the other photos I posted. Thanks again for chiming in!

[GoliGoliGoli]

It's a bit too hard to tell from the new pictures, they aren't zoomed in enough. Trust me I know it's a challenge to get a good picture of the donor, best is to take a video and then screenshot images of the video. 

Really our opinions will only get you so far anyways though. Go get a in person consultation and see what they say. 

[BaldDude]

I would definitely get on medication to save the donor you have left, preferably dutasteride.

[Hair, my old friend]

3 minutes ago, GoliGoliGoli said:

It's a bit too hard to tell from the new pictures, they aren't zoomed in enough. Trust me I know it's a challenge to get a good picture of the donor, best is to take a video and then screenshot images of the video. 

Really our opinions will only get you so far anyways though. Go get a in person consultation and see what they say. 

Got it. 
 

I did take a vid and screenshot. Posting some stills here. 

[GoliGoliGoli]

Donor doesn't look to bad in those pictures. Also looks like you have a beard that seems to match the hair on your head suitably well which can work in your favor. Using beard hair as a donor typically costs more but it's still an option to take hairs from under your chin where you don't care about them so much.

But again an in-person consult is what you need. Overall you seem like a decent enough candidate given your reasonable expectations and what appears to be a suitable donor. 

[Hair, my old friend]

 

2 minutes ago, GoliGoliGoli said:

Donor doesn't look to bad in those pictures. Also looks like you have a beard that seems to match the hair on your head suitably well which can work in your favor. Using beard hair as a donor typically costs more but it's still an option to take hairs from under your chin where you don't care about them so much.

But again an in-person consult is what you need. Overall you seem like a decent enough candidate given your reasonable expectations and what appears to be a suitable donor. 

Thanks for taking the time Goli  It’s much appreciated. 

[Ryan Daniel]

Do you have a good beard? If yes... it will play a huge part for a full coverage restoration. 3000 grafts from under the chin + 3500 grafts from the back can give you wonders under the right doctor..

[GoliGoliGoli]

20 minutes ago, Ryan Daniel said:

Do you have a good beard? If yes... it will play a huge part for a full coverage restoration. 3000 grafts from under the chin + 3500 grafts from the back can give you wonders under the right doctor..

Is 3000 grafts a reasonable amount to expect from under the chin if someone has a thick beard? I've always wondered what amount can be reasonably harvested assuming someone has a good thick beard that matches their scalp hair reasonably well. 

[Ryan Daniel]

5 minutes ago, GoliGoliGoli said:

Is 3000 grafts a reasonable amount to expect from under the chin if someone has a thick beard? I've always wondered what amount can be reasonably harvested assuming someone has a good thick beard that matches their scalp hair reasonably well. 

Difficult to say but maybe I'm wrong.

 

All im saying is, you have options and the best thing to do is to avoid going to someone that will make you look worse. 

Just by looking at your photos, I can see that your hair loss has reached it's final destination. Meaning you can get hair transplants without worrying your hair will continue to go backwards. Take your time and find the right doctor that will take care of you

[LookMaxx]

4 hours ago, Hair, my old friend said:

Got it. 
 

I did take a vid and screenshot. Posting some stills here. 

 

Flush that toilet bro 😜

[Hair, my old friend]

1 hour ago, Ryan Daniel said:

Difficult to say but maybe I'm wrong.

 

All im saying is, you have options and the best thing to do is to avoid going to someone that will make you look worse. 

Just by looking at your photos, I can see that your hair loss has reached it's final destination. Meaning you can get hair transplants without worrying your hair will continue to go backwards. Take your time and find the right doctor that will take care of you

Thanks for your thoughts Ryan. 
 

I’ve got some consultation requests out. Initial indication is that I have a narrowed donor area, as y’all have suggested. Waiting on a response to more photos. I’ll let y’all know what I’m told✌️

[Hair, my old friend]

Would still love to know what others think, please feel free to comment. 

[pkipling]

On 8/24/2022 at 2:20 PM, Hair, my old friend said:

Would still love to know what others think, please feel free to comment. 

So glad you found the forum to help you navigate this. While I don't think a successful HT is impossible for you, your particular case will require even more careful consideration than your average person. You're still quite young, the hair loss is advanced, and as pointed out above, the hair loss does seem to be creeping into what is considered the "safe zone" for most people. These aren't necessarily reasons to be discouraged, but are reasons to be extra mindful and cautious before jumping into anything. You'll likely need a carefully formulated game plan and a conservative approach. 

At this point, I think you're gonna get the most insight from having professional one-on-one consultations with some top rated surgeons. Once you get a few of those under your belt, you'll be able to compare their suggestions and input, and have soooo much more info at your disposal to use to make your final decision. Managing expectations will be key for you, which is seems like you're already well-equipped to do. Hopefully this leads you down a path to a very positive experience and outcome! Keep us posted on how this continues to unfold. 

[Vann]

Honestly, I would have said FUT would’ve been your best bet, however it looks like you have some miniaturization below your crown and I’m not sure if it’s the way your hair grows but slightly under your parietal humps.

my best advice is to see if you might respond to medication such as minoxidil (either oral or topical) and perhaps derma rolling.

try to get a live exam with a surgeon that’s local or if you’re willing to travel try seeing a top surgeon. I know you mentioned konior and H&W. I think both are very good choices. 
 

if you’re going outside the country I think your best bet would probably be with Eugenix (dr Sethi).

if it’s in EU perhaps fretas, pinto, or Bisanga, maybe even Zarev.

however if I was in your case I’d probably want to do FUT around the sides and fue in the back to maximize everything. So I would only consider konior since I personally think he would get you the most result with the least amount while being able to do FUT. 
 

you may not have the best donor based off your scalp but it doesn’t always mean all hope is lost. 
 

hopefully any medication will help you respond well. You seem to have some miniaturized hairs so it’s not like you don’t have any potential to thicken them up. 
 

Best of luck to you man and thanks for sharing your case. I hope you keep us posted.