Hot Take Discussion: Hair Transplants are the cure for almost anyone in today's age

[Fox243]

Hi everyone, I wanted to bring up a hot take to see what the forum's thoughts are. In the past, hair transplants were never the cure -- we had FUT, but FUT isn't able to extract all the grafts in the scalp donor area (in hard to reach places, for example) or in the beard. But now that we have FUE getting lifetime grafts almost as much as FUT, I think that FUT + FUE + BHT + SMP is essentially a cure for all virgin scalps, even if they were to reach NW7. You don't even need meds. 

I've attached some examples. Take care to notice that some of these people either had extremely poor donors, past (failed) procedures, or had procedures several years ago without the use of BHT. I'd dare to venture that almost anyone without a scarring alopecia or DUPA, even a NW7, in today's day and age can get to a NW2.5-NW3.

Now, there are exceptions, notably those who have had failed procedures, but I think we should be more aggressive with recommending HTs to those virgin candidates who want one but may be considered "poor" candidates in the older days. 

Edited September 10, 2022 by Fox243

[davidn]

Goddamn the h&w Case.. ridiculously good 

[NARMAK]

I think to call it a "cure" would be incorrect but current top doctors and the techniques of today refined over decades are at a point, where a large majority of people can be helped in an effective way. The problem however is that the clinics and doctors capable of it are in high demand and expensive. 

For example, if 100 people were Norwood 7 and all vying for the same doctor, it's inevitable a fair amount of them could be priced out given the typical cost. 

Even myself for example, if i wasn't a Norwood 2, and i needed as many grafts as a Norwood 2, i do not think i'd ever be able to afford the cost of a modern hair transplant with a quality clinic. That's why medication is SO important in my eyes as a prevention because nothing, and i truly do mean nothing a hair transplant can achieve especially as a Norwood 7 will ever be as good as if you kept your native hairs and have a HT as a lower Norwood in terms of overall density. 

[Fox243]

Oh, I completely agree. A transplant can never match medication if someone starts at a NW2. Point is that I’ve seen a lot of people on this forum that are NW6 or 7 that are unwilling to take medication and have reasonable expectations to get to a NW2.5-3, but because they’re unwilling to take medication, the majority of feedback is to shave. 
 

I think medication was necessary in the older days to have a good result but not anymore. Meds will be less expensive and have better results but transplants are enough too.

[ciaus]

1 hour ago, NARMAK said:

I think to call it a "cure" would be incorrect but current top doctors and the techniques of today refined over decades are at a point, where a large majority of people can be helped in an effective way. The problem however is that the clinics and doctors capable of it are in high demand and expensive. 

For example, if 100 people were Norwood 7 and all vying for the same doctor, it's inevitable a fair amount of them could be priced out given the typical cost. 

Even myself for example, if i wasn't a Norwood 2, and i needed as many grafts as a Norwood 2, i do not think i'd ever be able to afford the cost of a modern hair transplant with a quality clinic. That's why medication is SO important in my eyes as a prevention because nothing, and i truly do mean nothing a hair transplant can achieve especially as a Norwood 7 will ever be as good as if you kept your native hairs and have a HT as a lower Norwood in terms of overall density. 

 

As the old saying goes, an ounce of prevention is worth a pound of cure!

[ciaus]

1 hour ago, Fox243 said:

I think medication was necessary in the older days to have a good result but not anymore. Meds will be less expensive and have better results but transplants are enough too.

 

While I agree there's never been a better time to address hair loss, a good result is always a moving target at best, unless you wait to deal with it when you're at death's door. All those guys in your pictures still have decades of life ahead of them, assuming no sudden catastrophic accidents or illnesses.

[mr_peanutbutter]

i have to disagree. 

 

to get a good noticable result as a norwood 6 (leave alone norwood 7) you need

1. coarse hair

2. good donor/beard

3. realistic expectation (very high hairline, not so good density and/or a crown that will only look somehow dense with hair fibers

4. small head..its hard to describe but for example i think zinedine zidane would need way more hair folicles to cover his crown compares to guardiola simply bc their headshape and size differ

5. luck? dr. zarev examples are not the norm. posting these examples and assuming it will look like that for everyone is the equivalent of assuming finasteride will keep the hair for everyone (20 years plus) without any sideeffects. in fact i think the chances of getting a non satisfacting hairtransplant result as a norwood 7 guy are way higher then getting finasteride side effects. at least as long as your expectations are above zero.

Edited September 10, 2022 by mr_peanutbutter

[mr_peanutbutter]

double post

Edited September 10, 2022 by mr_peanutbutter

[Fox243]

10 minutes ago, mr_peanutbutter said:

i have to disagree. 

 

to get a good noticable result as a norwood 6 (leave alone norwood 7) you need

1. coarse hair

2. good donor/beard

3. realistic expectation (very high hairline, not so good density and/or a crown that will only look somehow dense with hair fibers

4. small head..its hard to describe but for example i think zinedine zidane would need way more hair folicles to cover his crown compares to guardiola simply bc their headshape and size differ

5. luck? dr. zarev examples are not the norm. posting these examples and assuming it will look like that for everyone is the equivalent of assuming finasteride will keep the hair for everyone (20 years plus) without any sideeffects. in fact i think the chances of getting a non satisfacting hairtransplant result as a norwood 7 guy are way higher then getting finasteride side effects. at least as long as your expectations are above zero.

That’s the traditional mentality. But that’s why I pasted these examples above, of people who don’t fit any of your characteristics basically.

[NARMAK]

12 minutes ago, mr_peanutbutter said:

i have to disagree. 

 

to get a good noticable result as a norwood 6 (leave alone norwood 7) you need

1. coarse hair

2. good donor/beard

3. realistic expectation (very high hairline, not so good density and/or a crown that will only look somehow dense with hair fibers

4. small head..its hard to describe but for example i think zinedine zidane would need way more hair folicles to cover his crown compares to guardiola simply bc their headshape and size differ

5. luck? dr. zarev examples are not the norm. posting these examples and assuming it will look like that for everyone is the equivalent of assuming finasteride will keep the hair for everyone (20 years plus) without any sideeffects. in fact i think the chances of getting a non satisfacting hairtransplant result as a norwood 7 guy are way higher then getting finasteride side effects. at least as long as your expectations are above zero.

I think the headsize is generally a good point but when you consider the fact that people who usually have a larger head, they will also tend to have more hair to compensate. Not always, but generally. 

The head shape though imo plays a big part of the hairline design too. Some people even with a higher hairline can appear more aesthetic than somebody with a lower hairline. 

[mr_peanutbutter]

17 minutes ago, Fox243 said:

That’s the traditional mentality. But that’s why I pasted these examples above, of people who don’t fit any of your characteristics basically.

yea..and those example and their results are the norm as a guy who can maintain his hair with finasteride for 30 year without any sideeffects

Edited September 10, 2022 by mr_peanutbutter

[HappyMan2021]

IMO a "hair transplant cure" means pretty much anyone - even a NW 7 - can be restored to a NW1, and additionally they could achieve this in just one procedure and never need another hair transplant again. 

Even in your own examples, these guys are not "cured". Sure, there is tremendous improvement. But taking someone from a NW 7 to a NW3 is not a cure. 

In your examples, I'm also curious how many procedures each person needed for their end result. I would be surprised if any of them were one and done. 

 

[Fox243]

Yeah, what I mean to say is with enough money, transplants, and time, almost anyone should get a good result. I honestly think most people can get to a NW2 and at the absolute worst a NW3, which is why I’m confused a lot of NW6s or NW7s with otherwise fine characteristics are told that they’re not good candidates. I’d be curious to hear some counters though. 

Edited September 10, 2022 by Fox243

[mr_peanutbutter]

isnt that guy still bald on the crown? i think i remember his case somewhere

 

[Z--]

There's a lot of trade-offs that aren't considered. "cure" is probably too strong a word. Transplanted hairs are never going to look as full as native hairs. Even the best transplants, like Antonio Conte's, when placed in an unflattering light/style will show its limitations. If you're a high Norwood, you just need to consider what is worth the risk.

The linear FUT scar, meds, SMP, BHT: all of them have drawbacks, which individually need to assessed. BHT (if no beard) /FUT (if no elasticity or you wear your hair short) may not be feasible for all patients either...That said, if you're able to do all four of them, you'll def maximize your transplant's illusion, but that's what it is. It isn't native hair. At a certain point, hair loss is so severe that you can't have full coverage; you may need to accept a higher hairline or thinner crown/midscalp. That's totally fine.

I do agree though the fear-mongering about transplants failing without meds is just plain silly. I've seen at least 3 NW6+ successful transplants from the last year without medication. They are still clearly transplants, but hair restoration surgery has come a LONG way in the last decade or so.

 

[Fox243]

1 hour ago, Z-- said:

There's a lot of trade-offs that aren't considered. "cure" is probably too strong a word. Transplanted hairs are never going to look as full as native hairs. Even the best transplants, like Antonio Conte's, when placed in an unflattering light/style will show its limitations. If you're a high Norwood, you just need to consider what is worth the risk.

The linear FUT scar, meds, SMP, BHT: all of them have drawbacks, which individually need to assessed. BHT (if no beard) /FUT (if no elasticity or you wear your hair short) may not be feasible for all patients either...That said, if you're able to do all four of them, you'll def maximize your transplant's illusion, but that's what it is. It isn't native hair. At a certain point, hair loss is so severe that you can't have full coverage; you may need to accept a higher hairline or thinner crown/midscalp. That's totally fine.

I do agree though the fear-mongering about transplants failing without meds is just plain silly. I've seen at least 3 NW6+ successful transplants from the last year without medication. They are still clearly transplants, but hair restoration surgery has come a LONG way in the last decade or so.

 

Yeah, but I think 90% of men would look better at NW2.5 than shaved bald, even if NW2.5 is a "higher" hairline or doesn't have the thickest hair.

[Fox243]

2 hours ago, mr_peanutbutter said:

isnt that guy still bald on the crown? i think i remember his case somewhere

 

I don't think so

[Al - Moderator]

It is extremely difficult for a true NW 7 to get any worthwhile improvement no matter how much hair transplanting is done. Here are a few pictures of Steve Ballmer. How in the world would he ever get enough hair on his head to be worth it? If I never had any hair transplants I would have even less hair than this person. I've spent almost 35 years going through an unbelievable number of hair transplants and my hair is still very thin everywhere.

 

[Fox243]

3 minutes ago, BeHappy said:

It is extremely difficult for a true NW 7 to get any worthwhile improvement no matter how much hair transplanting is done. Here are a few pictures of Steve Ballmer. How in the world would he ever get enough hair on his head to be worth it? If I never had any hair transplants I would have even less hair than this person. I've spent almost 35 years going through an unbelievable number of hair transplants and my hair is still very thin everywhere.

 

Correct me if I'm wrong, but you had many suboptimal hair transplants. Do you not think you'd get a NW2.5 level result say you had gotten all your surgeries on a virgin scalp today? I'd also say the H&W guy was a true NW7 and he didn't even use FUE on hard to reach areas or BHT.

Edited September 10, 2022 by Fox243

[Al - Moderator]

Even if we all agreed that if NW6 and NW 7 men get high hairlines and are willing to accept a somewhat thinning look then they can get a decent result, there is still a problem of what happens to all these younger guys who are NW3 and only have receding hairlines who get low, aggressive, thick hairlines using up more than half of their donor grafts? What is going to happen to some of them when they turn into NW 6 and NW 7 over the years. You can say not all of them will lose that much hair, but certainly some will.

 

[Fox243]

1 minute ago, BeHappy said:

Even if we all agreed that if NW6 and NW 7 men get high hairlines and are willing to accept a somewhat thinning look then they can get a decent result, there is still a problem of what happens to all these younger guys who are NW3 and only have receding hairlines who get low, aggressive, thick hairlines using up more than half of their donor grafts? What is going to happen to some of them when they turn into NW 6 and NW 7 over the years. You can say not all of them will lose that much hair, but certainly some will.

 

That is definitely an issue. That’s why I think doctors should plan for all patients reaching NW7. I think in todays day and age, we can get coverage for anyone that looks age appropriate Ie a mature hairline and slightly thinner crown. 

[Al - Moderator]

I think this is the Hasson and Wong result you were referring to in your reply to me above. The bigger issue as I mentioned is that the end result shown here is what most men are having hair transplants to fix. It looks OK as an end result if you are starting off completely bald, but most men under 30 are freaking out and going for hair transplants when they have more hair than this guys end result. I understand that as I was bald when I was still in my teens which is why I went for a HT, but as I said, what happens when those people end up as what would be a NW 7? This is the biggest reason it will become a major problem if we start calling it a cure.

 

 

[Z--]

45 minutes ago, Fox243 said:

Yeah, but I think 90% of men would look better at NW2.5 than shaved bald, even if NW2.5 is a "higher" hairline or doesn't have the thickest hair.

I suppose it's true. I personally opted for a higher hairline because I know I'll lose more in the future. Diffuse thinners really shouldn't try lowing the hairline.

That said, I don't think it's like a true NW 2.5. You'll probably have a higher hairline, but the problem is that everything behind the midscalp will be near impossible to replicate at native hair level, so you'll have that sort of norwood vertx scale-type thinning (maybe like a 2-3V). I agree that it may look better than shaved.

But think about it -- just for that you're looking at a minimum of probably 20k spend commitment, at least 2+ years of ugly hair as you wait for it grow out post-surgery (because it'll take a minimum of 2 surgeries...), months of healing (where avoiding sun/sunburn is prudent), plus a possible FUT scar, and plus possible lifetime medication. Is all that worth it...? Some may reasonably argue no, especially if near native density isn't feasible. I think it's important people know that it's a big commitment and understand that even if the technology is available, it's no walk in the park. 

Edited September 10, 2022 by Z--

[Fox243]

5 minutes ago, BeHappy said:

I think this is the Hasson and Wong result you were referring to in your reply to me above. The bigger issue as I mentioned is that the end result shown here is what most men are having hair transplants to fix. It looks OK as an end result if you are starting off completely bald, but most men under 30 are freaking out and going for hair transplants when they have more hair than this guys end result. I understand that as I was bald when I was still in my teens which is why I went for a HT, but as I said, what happens when those people end up as what would be a NW 7? This is the biggest reason it will become a major problem if we start calling it a cure.

 

 

Yeah, I agree. Honestly, I probably wouldn't be happy with a receded hairline by this much -- I'd probably say this is a NW3. But I think with FUE + BHT + SMP on top of FUT, we can lower the hairline slightly to get to a NW2 - NW2.5. I guess the ulterior motive of my thread is personal -- most of the doctors I've talked to said I'm a candidate (Hasson, Bloxham, Eugenix, etc). But when asking the forum for advice, they ask me to shave my head. I personally just want to understand the difference in expectations between the forum and doctors -- the former have no financial incentive, which is why I'm leaning on y'all. I really do think anyone can get a result like the one I'm attaching in today's day and age with the optimal techniques. I'm just hoping to learn though.

[Berba11]

22 minutes ago, BeHappy said:

I think this is the Hasson and Wong result you were referring to in your reply to me above. The bigger issue as I mentioned is that the end result shown here is what most men are having hair transplants to fix. It looks OK as an end result if you are starting off completely bald, but most men under 30 are freaking out and going for hair transplants when they have more hair than this guys end result. I understand that as I was bald when I was still in my teens which is why I went for a HT, but as I said, what happens when those people end up as what would be a NW 7? This is the biggest reason it will become a major problem if we start calling it a cure.

 

 

Obviously the caveat to the idea being floated by the OP is that you need your first surgery to be both a success, and realistic/strategic in its execution. A botched first pass with a sub-par clinic isn't going to stand anyone in good stead going forward.

As for going aggressive early and using up resources... I agree this is a problem, however it's not critical. There's many surgeons capable of taking a hairline back up the other way leaving virtually undetectable scarring in the hairline. I seen fantastic results in this area from Dr Feriduni in Belgium and Dr Ball in the UK. So even an overly aggressive approach initially can be overcome. In fact it's probably not even a terrible idea (daft enough though)... Youthful hairline for a while and then take it back up if/when needed years down the line. I'm not advocating anyone does that by any means, but it's certainly doable these days - overly aggression hairline restorations can be undone and the grafts repurposed. Again though, these things will only work if the surgeries are in genuinely expert hands, including (indeed, especially!) the repair work.