Hair loss Norwood category

[Shah007]

Hello!
I posted 2 years ago. Nothing seems to have noticeably changed. There’s a loss in hair density in the front area within the marked area. Any idea of what the existing density is in this region would be appreciated. H & W recommended not to transplant hair in between hairs in this region and to wait longer. Dr Konior was confident that it wouldn't be too risky to do so. So I’m still debating whether to risk it and go for increasing density in this area or just wait longer. 

Also wondering what Norwood hair loss category I fall in if anyone can guide. I’m 46 going on 47. No hairloss meds ever taken or any HT ever undergone. Adding some pics in bright overhead lighting with wet and dry hair. 
Thank you. 

Edited September 18, 2022 by Shah007

[Shah007]

Pictures with wet hair. 

[Shah007]

Dry hair pictures. 

[Gatsby]

I would say Norwood 3. Transplanting hairs within an area of hair risks shock loss to that area. In fact there are always risks when it comes to surgery. Are you opposed to trying medication? If not surgery should be a last resort. I’m not a doctor but I would speak with your dermatologist and look into minoxidil and Finasteride. Give the medication a year before making a judgement. You have an excellent donor going by your pics. All the best! 👌

Edited September 18, 2022 by Gatsby
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[mister_25]

Looks like a Norwood 3A.

Don't even consider a transplant unless you have stabilized your hairloss. If you get a transplant for your frontal third to match your midscalp density and you continue to thin and approach a higher norwood (4/5), you will have a hard time catching up elsewhere.

[Shah007]

So Norwood 3 it is!  Thank you for the info. Don’t really want to take any meds. It seems stable enough to attempt a HT. Only issue is possibility of perm shock loss in the frontal region. That’s my only concern. Any idea what the density would be at present in this region? Just an educated guess works. Thanks. 

[MisterBreakfast]

NW3a.  It looks like your tuft might be forming an Island, so maybe headed to NW4a. There is also a little thinning in the midscalp (hard to tell for sure since the hair is combed over it).

With the miniaturization going on in that front region, I think you are going to lose that hair without medication.  Too hard to guess what your current density is, but if I were you, and I couldn't take meds, then I wouldn't touch that region until your hair is gone.

Edited September 18, 2022 by MisterBreakfast

[A Fue Good Men]

On 9/18/2022 at 3:03 AM, Shah007 said:

Hello!
I posted 2 years ago. Nothing seems to have noticeably changed. There’s a loss in hair density in the front area within the marked area. Any idea of what the existing density is in this region would be appreciated. H & W recommended not to transplant hair in between hairs in this region and to wait longer. Dr Konior was confident that it wouldn't be too risky to do so. So I’m still debating whether to risk it and go for increasing density in this area or just wait longer. 

Also wondering what Norwood hair loss category I fall in if anyone can guide. I’m 46 going on 47. No hairloss meds ever taken or any HT ever undergone. Adding some pics in bright overhead lighting with wet and dry hair. 
Thank you. 

I would trust koniors judgement. He’s top notch. I saw him a little over two weeks ago  and I have nothing but high praises for him and his staff.

 

Keep in mind konior uses meticulous stick and place technique vs h&w’s pre made incisions. Chances are, koniors incisions will be made smaller as they don’t need to accommodate for skin elasticity m/contraction. This probably limits chances not shocking out nearby hairs as well.

 

personally, even though at your age it’s not required, I would still hop on finasteride even if it’s at a low dose. It can help with any potential shock loss.

[NARMAK]

Anybody that doesn’t want to take medication like Finasteride etc. is a completely personal choice and i understand it may very well have been something you decided on after much research and conclusion  so let's just skip to the bigger elephant in the room. 

Right now, your age seems to be generally solid and you're a Norwood 3A BUT you have got what appears to be thinning from the middle to the back and although it's not very noticeable, somewhat hidden even with the more slicked back hair but it is a longer term concern. Should you transplant in between the existing hair, it could hypothetically without the medication cause shock loss and speed up the thinning and loss in those areas. Without medication, you are also generally playing Russian Roulette with where exactly and when the hair loss might progress and how that might leave you looking when the native hair is lost and the transplanted hair remains. 

Generally the ideas to be as conservative as possible in the hairline design and really be aware of ALL the risks and how you're going to manage things if the worst happens. 

[Shah007]

Thank you all for the guidance 😊