Looking for Advice (New Potential HT)

[wingthor]

Hey guys, 

First post here. I'm 30 years old (almost 31) and have suffered from hair loss since my early 20s. I haven't been to diligent with keeping it bay, though I have used Rogaine in the past. I'm currently working on getting on Fin and Rogaine again, but I believe I am a Norwood 4 or 5?

Anyways, I was looking into doing a HT - I was wary at first, but reading the reviews and seeing the results, this definitely seems like a real option. For me, money is not a concern, so I want the best of the best. Particularly looking at Hasson and Wong, I reached out to them (and a couple others) for a consult.

My primary areas I would like to address are the following:
1) Restore a more natural hairline (it doesn't have to be teenager levels, I'm fine with a bit of recession for a more natural look, but maybe a 50-75% reduction).

2) Improve the density along top + hairline

3) Crown area

The crown is lower on my priority list, I may look to break up the HTs if the first one goes well and do the crown later down the road. I just have a few questions for you guys, since you're the experts:

1) Does my donor area look ok? I feel like it's pretty good, though maybe the crown recession is a bit low, but the hair in the back always comes in way thicker than everywhere else when I let it grow out. Don't really have much facial / body hair that could be used unfortunately.

2) How many grafts do you guys estimate to address all my above concerns? And how much excluding the crowns? Looking at results pics, I'm guessing around 5-6K, but maybe I'm overestimating.

3) How long are the wait times at places like Hasson and Wong? I went in hoping to get this done in the next couple months, but it sounds like the waitlists at all the reputable places are a year out at least. Which is fine, that will give me time to establish a better baseline with Fin + Minoxidil, but was just curious if that was normal or are these affected by post-pandemic numbers.

Here are some pics:

Edited September 5, 2022 by wingthor

[Melvin- Admin]

I’m sorry to say but your are not a Norwood 4 or 5. Your pattern is a 6. You will need multiple surgeries to achieve density. Hasson and wong is a fantastic clinic. So you’re good there.

Now, how many grafts? I would say a minimum of 6,000 and that’s not using much in the crown. Addressing the crown would require 7-8000 grafts. 

Before you do anything. I would suggest getting on oral minoxidil and finasteride. You could consider Dr. Hasson’s topical finasteride formula, based on my research its the best formula.

https://www.xyonhealth.com
 

Take medication for at least 6 months before deciding. Hopefully you’re a hyper responder to medication. If you are, you’ll significantly reduce the number of grafts you require. 

[wingthor]

33 minutes ago, Melvin- Moderator said:

I’m sorry to say but your are not a Norwood 4 or 5. Your pattern is a 6. You will need multiple surgeries to achieve density. Hasson and wong is a fantastic clinic. So you’re good there.

Now, how many grafts? I would say a minimum of 6,000 and that’s not using much in the crown. Addressing the crown would require 7-8000 grafts. 

Before you do anything. I would suggest getting on oral minoxidil and finasteride. You could consider Dr. Hasson’s topical finasteride formula, based on my research its the best formula.

https://www.xyonhealth.com
 

Take medication for at least 6 months before deciding. Hopefully you’re a hyper responder to medication. If you are, you’ll significantly reduce the number of grafts you require. 

Thanks for the response! I will definitely be taking the meds, just started Fin today and have Min coming in Wednesday. Also adding biotin and thickening shampoo to my routine. I am curious as to why you think I am a 6 - I may be trending there, but I don't think I am one currently at least. When I look at pictures of the scale, 6's seem to be missing hair on the top of their head and I definitely have a decent amount there (right now). 

In looking at the results on H&W's website, I thought this one (Which is NW4) seemed pretty close to my situation (albeit with the crown not being as bad), and they were able to achieve the results (Which are similar to what I am looking for) with less than 5K:

https://hassonandwong.com/hair-transplant-results/fue-hair-transplant-surgery-4855-graft-count/

Then again, there's also this one, which is almost twice as much for a NW6 and also somewhat similar, but my top is a lot better than this one as well:

https://hassonandwong.com/hair-transplant-results/fut-hair-transplant-surgery-7382-grafts/

I guess I'll wait to see what they say from the consultation. 

Do you think my donor area looks ok?

[Rahal Hair Transplant]

Wingthor,

Welcome to the forums. It’s a shame that you didn’t start using finasteride sooner when you had a lot more hair on the top of your scalp. I don’t know that finasteride will really do too much for you at this point although if you are heading towards a Norwood class 7, finasteride may help the sides from receding further but you’ve essentially already lost almost all of the hair on top of your scalp so finasteride really won’t do anything to make any of that come back.  

Finasteride might help save the little bit of hair you have the frontal zone which could aid the appearance of density if you do undergo hair transplant surgery.

From the photos alone that I can see you seem to have an average looking donor area which means if you do undergo surgical hair restoration you’re going to have to establish very realistic expectations as to what can be accomplished. You’re not going to obtain a full head of hair and if you are going for coverage, density will be lacking just about everywhere.

What I suggest would be to re-create a conservative looking hairline with as much density as humanly possible in the frontal zone given your donor area.  The density of the hair should then gradually fade into the midsection of the scalp providing coverage and then fade off into the crown which should essentially be on touch at least for your first procedure.

If you have the donor for it, and you are satisfied with the way the frontal and mid scalp region looks like after your first session, you can always attack the crown with a light sprinkling of hair which believe it or not will do wonders in eliminating the bald spot.

Restoring the crown is a strange phenomenon.  Because when the crown is bald, a little goes a long way but a lot doesn’t go much further.  In other words, using just a sprinkling of hair to cover the area will do wonders in eliminating the bald spot and those looking at your scalp will just assume you’ve thinned out a little up there.  On the other hand, it will take a great deal of grafts (that you just don’t have given your circumstances) to make the crown look thick with essentially no signs of hair loss. This strange phenomenon is due to the natural whorl pattern of the crown.

So like I said, if you establish realistic expectations, surgical hair restoration may just be for you and you could be very satisfied with what it can accomplish.

if you are interested in a one on one information session with coalition member Dr. Rahal, feel free to send me a private message and I’ll be happy to set this up for you. Dr. Rahal has a stellar reputation amongst his patients and peers and he will definitely work with you too establish and meet your short and long-term hair restoration goals for it

Best wishes,

Rahal Hair Transplant 

[wingthor]

10 minutes ago, Rahal Hair Transplant said:

Wingthor,

Welcome to the forums. It’s a shame that you didn’t start using finasteride sooner when you had a lot more hair on the top of your scalp. I don’t know that finasteride will really do too much for you at this point although if you are heading towards a Norwood class 7, finasteride may help the sides from receding further but you’ve essentially already lost almost all of the hair on top of your scalp so finasteride really won’t do anything to make any of that come back.  

Finasteride might help save the little bit of hair you have the frontal zone which could aid the appearance of density if you do undergo hair transplant surgery.

From the photos alone that I can see you seem to have an average looking donor area which means if you do undergo surgical hair restoration you’re going to have to establish very realistic expectations as to what can be accomplished. You’re not going to obtain a full head of hair and if you are going for coverage, density will be lacking just about everywhere.

What I suggest would be to re-create a conservative looking hairline with as much density as humanly possible in the frontal zone given your donor area.  The density of the hair should then gradually fade into the midsection of the scalp providing coverage and then fade off into the crown which should essentially be on touch at least for your first procedure.

If you have the donor for it, and you are satisfied with the way the frontal and mid scalp region looks like after your first session, you can always attack the crown with a light sprinkling of hair which believe it or not will do wonders in eliminating the bald spot.

Restoring the crown is a strange phenomenon.  Because when the crown is bald, a little goes a long way but a lot doesn’t go much further.  In other words, using just a sprinkling of hair to cover the area will do wonders in eliminating the bald spot and those looking at your scalp will just assume you’ve thinned out a little up there.  On the other hand, it will take a great deal of grafts (that you just don’t have given your circumstances) to make the crown look thick with essentially no signs of hair loss. This strange phenomenon is due to the natural whorl pattern of the crown.

So like I said, if you establish realistic expectations, surgical hair restoration may just be for you and you could be very satisfied with what it can accomplish.

if you are interested in a one on one information session with coalition member Dr. Rahal, feel free to send me a private message and I’ll be happy to set this up for you. Dr. Rahal has a stellar reputation amongst his patients and peers and he will definitely work with you too establish and meet your short and long-term hair restoration goals for it

Best wishes,

Rahal Hair Transplant 

Thanks for the info! Rahal was one of the places I've already reached out to so I appreciate the honest feedback - I'll send you a PM shortly about a full consultation. A full head of hair is definitely not what I am going for, I know that is probably unrealistic. And I do like the notion that the crown benefits from minimal work the most, which makes sense to me. As I stated, the crown is definitely lower on my priority list and addressing the hairline and top thickness (within reason) is what I am hoping to achieve first. 

Edited September 5, 2022 by wingthor

[Rahal Hair Transplant]

@wingthor

You said that you already reached out to Dr. Rahal. How did you reach out? I just wanna make sure that I get you to the right person so that we can go ahead and set up that one on one information session.  When you are ready feel free to send me a private message and I can expedite setting things up for you.

Rahal Hair Transplant

[wingthor]

2 hours ago, Rahal Hair Transplant said:

@wingthor

You said that you already reached out to Dr. Rahal. How did you reach out? I just wanna make sure that I get you to the right person so that we can go ahead and set up that one on one information session.  When you are ready feel free to send me a private message and I can expedite setting things up for you.

Rahal Hair Transplant

I reached out via the form on the website, as well as the history form. I only just completed it yesterday, but I did get an automatic response saying it was being processed and looked into by a James Villahermosa.