How many grafts for full coverage- Crown Only

[GoliGoliGoli]

Hi all, very simple question: How many grafts do you think I need to get full coverage in this area. I'm not interested in a "light coating" of hairs that still basically looks like I have a bald spot. I'd like enough hairs to provide a good illusion of density and basically when it's styled not look bald. 

Please refrain from discussing the pros and cons of crown HT's and the fact that it's better to save grafts for more important areas and the fact that the crown will continue expanding. I'm aware of both those things. I simply want opinions on how many grafts are needed to make this area not look bald without using hair fibers.  

 

Edit: As mentioned below, diamter of the bald area is about 3.3 inches. Slighlty bigger than the bottom of a standard sized coffee mug. 

Edited November 1, 2022 by GoliGoliGoli

[davidn]

2000

[GoliGoliGoli]

Thanks for the reply David!

 

For reference, the bald area is approximately 3.3 inches diamter. So just a little bit bigger than the diameter of the bottom of a standard sized coffee mug, 

[davidn]

I have seen a post by @aaron1234where I think his spot was treated by Konior with something like 900 grafts, maybe you can find it. I think his spot was smaller though.

[GoliGoliGoli]

Just now, davidn said:

I have seen a post by @aaron1234where I think his spot was treated by Konior with something like 900 grafts, maybe you can find it. I think his spot was smaller though.

Thanks will take a look. Unfortunealty I don't have the funds to go with Konior, but what he's able to do with minimal grafts is pretty amazing. 

[davidn]

Just now, GoliGoliGoli said:

Thanks will take a look. Unfortunealty I don't have the funds to go with Konior, but what he's able to do with minimal grafts is pretty amazing. 

I hope its allowed to post this here. So see, 700 grafts and looks great. But guess the spot was smaller than yours

 

 

[DrMunibAhmad]

Would do this with 1400 grafts

[GoliGoliGoli]

1 minute ago, DrMunibAhmad said:

Would do this with 1400 grafts

Thanks, although that seems pretty low (To my uneducated eye). Wouldn't 1400 be fairly sparse coverage and basically mean I have to use hair fibers to not look balding? 

[DrMunibAhmad]

3 minutes ago, GoliGoliGoli said:

Thanks, although that seems pretty low (To my uneducated eye). Wouldn't 1400 be fairly sparse coverage and basically mean I have to use hair fibers to not look balding? 

Definitely no need for fibers. Have a look at the crown results posted by my patients. 

[davidn]

9 minutes ago, DrMunibAhmad said:

Would do this with 1400 grafts

Hey Dr,

Admire your crown work a lot.

Wanted to ask if you do crowns not before certain age (some doctor say 40) and/or without patient being on Finasteride due to progressive balding making it look unnatural. What is your guiding principle with crowns? 

Edited November 1, 2022 by davidn

[DrMunibAhmad]

Just now, davidn said:

Hey Dr,

Admire your crown work a lot.

Wanted to ask if you do crowns not before certain age and/or without patient being on Finasteride.

Thanks. Patient education is more important then looking only to the age as a number. Some patients wil loose hairs faster even though there age can be higher. Also sometimes a balding crown effects someones life so much that using a economy of grafts and get someone life back on track, even though he wil need a second transplant in the future, is better then leaving him with nothing. It all depends on donor management and leaving enough grafts in the bank for the rest of the scalp. If that mismatches, then it’s definitely a no go. 

[davidn]

2 minutes ago, DrMunibAhmad said:

Thanks. Patient education is more important then looking only to the age as a number. Some patients wil loose hairs faster even though there age can be higher. Also sometimes a balding crown effects someones life so much that using a economy of grafts and get someone life back on track, even though he wil need a second transplant in the future, is better then leaving him with nothing. It all depends on donor management and leaving enough grafts in the bank for the rest of the scalp. If that mismatches, then it’s definitely a no go. 

I see.

Thanks doc

[GoliGoliGoli]

10 minutes ago, DrMunibAhmad said:

Definitely no need for fibers. Have a look at the crown results posted by my patients. 

Just looked through your work... You are an absolute assassin. Some of the best work I've seen on this site 10/10

[shiba1985]

1500 +/- 100 . 

you have good hair and this should be more than adequate. Can you plant more? Yes but it’s not needed and you want to achieve the best cosmetic improvement without being redundant. 

[hairthere]

It's all about creating the illusion of density. So proper positioning and layering of the grafts is very important and that's why you need to go with a top surgeon. Also, with the crown you can get away with using larger grafts unlike the hairline that requires single FUs to be natural. 

[Rahal Hair Transplant]

@GoliGoliGoli,

If you’re looking for the kind of density in your crown that essentially shows no signs of thinning under even the harshest lighting, you’re looking at a much greater number than the estimates you’re getting.  This is why these types of questions typically lead to a discussion about the pros and cons of transplanting one’s crown and one’s specific circumstances.

Essentially, the natural pattern in the crown is different than the rest of your scalp.  Moreover, you run the risk of the halo effect if you simply transplant the bald area in the crown and don’t do anything to account for future risks of hair loss.

For example, I don’t know how old you are but it would be quite uncommon that your hair loss would stop there.  What’s more likely is that the area of your crown baldness will get bigger and your hair loss will begin to progress towards the midsection and the front.

Perhaps if you give us a better idea of your situation such as your age, family history of hair loss, current hair loss treatment regimen, etc. we could give you a better idea of not just what you need now but what you might need in the future.  Because frankly, it would be irresponsible of me to simply shoot out a graft estimate without knowing what you’re possibly up against moving forward.

Again to be blunt, I feel like the kind of estimate you’re looking for is not the kind of procedure that would be responsible to proceed with without knowing more about your situation.  In other words, it would take a large number of follicular units to transplant your existing crown (the way it is now) with the kind of density I think you’re looking for and wouldn’t leave you with enough grafts for the kind of future work you might need.

So whether you want this discussion to turn into a debate about whether or not a crown transplant is best for you or not, I think it’s important that you are realistic in what hair transplantation can and can’t achieve for you.   It’s equally important that you know that because hair loss is progressive that hair restoration is also a process and not just a single procedure.

Best wishes,

Rahal Hair Transplant 

Edited November 2, 2022 by Rahal Hair Transplant

[GoliGoliGoli]

13 minutes ago, Rahal Hair Transplant said:

@GoliGoliGoli,

If you’re looking for the kind of density in your crown that essentially shows no signs of thinning under even the harshest lighting, you’re looking at a much greater number than the estimates you’re getting.  This is why these types of questions typically lead to a discussion about the pros and cons of transplanting one’s crown and one’s specific circumstances.

Essentially, the natural pattern in the crown is different than the rest of your scalp.  Moreover, you run the risk of the halo effect if you simply transplant the bald area in the crown and don’t do anything to account for future risks of hair loss.

For example, I don’t know how old you are but it would be quite uncommon that your hair loss would stop there.  What’s more likely is that the area of your crown baldness will get bigger and your hair loss will begin to progress towards the midsection and the front.

Perhaps if you give us a better idea of your situation such as your age, family history of hair loss, current hair loss treatment regimen, etc. we could give you a better idea of not just what you need now but what you might need in the future.  Because frankly, it would be irresponsible of me to simply shoot out a graft estimate without knowing what you’re possibly up against moving forward.

again to be blunt, I feel like the kind of estimate you’re looking for is not the kind of procedure that would be responsible to proceed with.  In other words, it would take a large number of follicular units to transplant your existing crown (the way it is now) with “true density“ and wouldn’t leave you with enough grafts for the kind of future work you might need.

So whether you want this discussion to turn into a debate about whether or not a crown transplant is best for you or not, I think it’s important that you are realistic in what hair transplantation can and can’t achieve for you.   It’s equally important that you know that because hair loss is progressive that hair restoration is also a process and not just a single procedure.

Best wishes,

Rahal Hair Transplant 

Yes, point well taken. I understand the risks of the crown continuing to grow, and I am planning to do a 2nd HT at some point in the future. During the 2nd HT I plan to also address the hairline at that time too.

I am 34 years old and I have a very strong donor and a beard that is both super thick and a good match to my scalp hair, so I'm not especially concerned with running out of grafts. I have no history of baldness on my mothers side, but my paternal grandfather and 1 of my 2 paternal uncles went bald slowly. My father has full head of hair at 63. Basically my grandfather was NW2 at 28, and NW3 Vertex at 55. I seem to be following the roughly the same pattern as my grandfather but obviously it's impossible to truly say. I would be lucky if my baldness progressed as my grandfathers did - mine seems slightly more aggressive than his but similar. Currently using topical Minox (Which I've responded very well too) along with Nizoral and biotin. 

To be clear, I'm not looking for density that returns me to 100% density. I don't mind if there is some thinning in certain lights etc. I just an estimate for what a good number would be to return that to as normal as possible without going under or over in grafts. 

Edited November 2, 2022 by GoliGoliGoli

[GoliGoliGoli]

Maybe a good way of phrasing this question is: If you were in my position (Based on the pictures and information above), what would be a wise amount of grafts to put in this area to provide adequate coverage that wouldn't leave me feeling that that area is still pretty bare?