Advice on Norwood level and graphs

[Jamos1982]

Hey everyone just after some general advice on what Norwood I would be. Had a few quotes from clinics they advice I’d need 4000-5000 for full  coverage, would I be better to go for less graphs say 3500 to do just hairline and mid for density then a second op for crown? Is that a good strategy?  I have currently been on fin and min for 5 weeks

thanks 

 

[Gatsby]

To be honest I would first give both of those drugs at the very least 6 months (preferably 12) to see what response you get from them. Five weeks won;t show anything in terms of possible regrowth or strengthening of your donor, etc. Take your time and all the best.

[NARMAK]

Try both medications for 12 months and i strongly suggest adding Microneedling with a derma pen once a week at 1 to 1.5mm to try boost your results. 

[mrmane85]

Your donor looks strong.

I would personally look to do the surgery in two sessions as your crown may get some considerable coverage from the meds, so you won't need as many grafts when it comes for the 2nd surgery.

Who are you thinking of getting surgery with?

[Jamos1982]

Thank you all for the advice I had consult with dr laorwong in Thailand he seems to think my do it has 5000 to 7000 available and suggested 4000 would be enough to cover all scalp but might need second op to add density etc. is dr laorwong a good doctor? 
thanks 

[Adam561]

1 hour ago, Jamos1982 said:

Thank you all for the advice I had consult with dr laorwong in Thailand he seems to think my do it has 5000 to 7000 available and suggested 4000 would be enough to cover all scalp but might need second op to add density etc. is dr laorwong a good doctor? 
thanks 

Honestly, your donor looks in good shape. If i were you, I wouldnt consider Thailand. Probably India and Eugenix is a better choice for your higher NW case. There are also good surgeons in Spain, Turkey, and Brazil. Have you connected with them? 
Tag some clinic on your thread to get a free evaluation, it will help you refine your research. 

[mister_25]

Looks like Norwood 4/5. I would say continue finasteride until you hit a year, 6 months at least then consider consulting with some of the best in Europe and elsewhere.

I would say somewhere between 4500-6000 for something very strong

[Doron Harati]

@Jamos1982we need more photos for better estimation, but seems you have a great donor above the average with thick hair, I think you can cover the frontal and middle scalp with 4000-5000 grafts in total with 1 big session option, additionally your corridors have full thick hair with narrow scalp structure, definitely ideal to assist the HT result, great candidate 👍🏻

[MisterBreakfast]

That's like what 100cm2?  30-40 grafts per cm, might need 2 surgeries for density.

[Jamos1982]

On 11/16/2022 at 8:00 PM, mrmane85 said:

Your donor looks strong.

I would personally look to do the surgery in two sessions as your crown may get some considerable coverage from the meds, so you won't need as many grafts when it comes for the 2nd surgery.

Who are you thinking of getting surgery with?

Thank goodness I found this forum I Had consult with smile in turkey but changed my mind after re searching here. I’d had consult with HLC , Eugenix dr laorwong they all said 4000-5000 coverage 

[Melvin- Admin]

I think you need around 7,000 to get full coverage and the illusion of density. But I agree 5,000 sounds right in one session. 
 

Take a look at our list of recommendations. Use this list as a starting point for research.

https://hairtransplantnetwork.com/best-hair-transplant-surgeons

[Jamos1982]

On 11/16/2022 at 9:48 PM, Adam561 said:

Honestly, your donor looks in good shape. If i were you, I wouldnt consider Thailand. Probably India and Eugenix is a better choice for your higher NW case. There are also good surgeons in Spain, Turkey, and Brazil. Have you connected with them? 
Tag some clinic on your thread to get a free evaluation, it will help you refine your research. 

I did look at Eugenix and for the price point it’s very expensive and heavy tech focused with minimum doctor involvement 

[Sean]

Try meds for year first.  Yes, breaking up procedures a 12-15 months apart  not a bad idea.  Less time grafts are out of body, and yes, every min counts.  You can see without wasting too many grafts on how the yield comes out.  Aside from that, if you need a repair (hopefully not), then you are really looking out for your limited grafts to make sure you have enough ammo later for any touch ups later

[Jamos1982]

41 minutes ago, Sean said:

Try meds for year first.  Yes, breaking up procedures a 12-15 months apart  not a bad idea.  Less time grafts are out of body, and yes, every min counts.  You can see without wasting too many grafts on how the yield comes out.  Aside from that, if you need a repair (hopefully not), then you are really looking out for your limited grafts to make sure you have enough ammo later for any touch ups later

I think instead of going for one HT for 4000-5000 to go for a first with less graphs say 3000-3500 to do front and hairline and go for density then continue meds to see if crown improves and then hit it on second I think that’s a good plan? What do you think?

[Adam561]

4 hours ago, Jamos1982 said:

I did look at Eugenix and for the price point it’s very expensive and heavy tech focused with minimum doctor involvement 

As per the Eugenix website, it shows the extensive packages with different benefits & you can the confirm the doctor involvement in the procedure. Do have a look on the same.

[BackFromTheBrink]

3 hours ago, Jamos1982 said:

I think instead of going for one HT for 4000-5000 to go for a first with less graphs say 3000-3500 to do front and hairline and go for density then continue meds to see if crown improves and then hit it on second I think that’s a good plan? What do you think?

I think that’s a really sensible approach. I had slightly less loss and had 3100 grafts with most in the hairline and midscalp. I’m 9 months post surgery and believe it was the right approach. Medication has helped strengthen my crown so I may not need another surgery.

[BackFromTheBrink]

50 minutes ago, BackFromTheBrink said:

I think that’s a really sensible approach. I had slightly less loss and had 3100 grafts with most in the hairline and midscalp. I’m 9 months post surgery and believe it was the right approach. Medication has helped strengthen my crown so I may not need another surgery.

Here's the before and after to give you an idea of the difference 

[Jamos1982]

Wow that looks so good what a difference ! Gives me hope then. We do have very similar starting points 

[BackFromTheBrink]

37 minutes ago, Jamos1982 said:

Wow that looks so good what a difference ! Gives me hope then. We do have very similar starting points 

Thank you - I'm really pleased with the outcome. I'm hopeful my crown will continue to respond to the medication - I'm told it's an 18 month process so plenty of time to go.

 

[Sean]

21 hours ago, Jamos1982 said:

I think instead of going for one HT for 4000-5000 to go for a first with less graphs say 3000-3500 to do front and hairline and go for density then continue meds to see if crown improves and then hit it on second I think that’s a good plan? What do you think?

This is a great approach.  Take it nice and slow and see what type if yield is achievable on your scalp.  Start with front half, but dont do the crown right away.  Let meds fill it in and in any case you should keep surgeries at least 1 year or more apart so you can fully gauge results. 

[Jamos1982]

Thanks for the advice glad I am doing things the right way then! 

[Adrenaline7]

11 hours ago, BackFromTheBrink said:

Thank you - I'm really pleased with the outcome. I'm hopeful my crown will continue to respond to the medication - I'm told it's an 18 month process so plenty of time to go.

 

Wow, your crown looks great. Definitely don’t need another hair transplant. 
 

Can I ask how long it took you on meds to see results? What did it look like after 6 months?  I’m almost 7 months on finasteride and my density hasn’t improved at all. 

Edited November 21, 2022 by Adrenaline7

[BackFromTheBrink]

1 hour ago, Adrenaline7 said:

Wow, your crown looks great. Definitely don’t need another hair transplant. 
 

Can I ask how long it took you on meds to see results? What did it look like after 6 months?  I’m almost 7 months on finasteride and my density hasn’t improved at all. 

That's a really difficult one to answer - I started taking meds just before the surgery so it's hard to pick apart the impact of each. 

 

Different people respond differently too - the amount of regrowth, speed of growth after surgery etc.

 

I'd say I was a very early grower so my timeline is probably atypical. However, my crown lagged the rest significantly.

 

The biggest change was probably months 8-9, but for others that may be a few months later. 

[messda]

On 11/20/2022 at 7:42 PM, BackFromTheBrink said:

Here's the before and after to give you an idea of the difference 

Did you have any crown work? Your next pic looks really good

[BackFromTheBrink]

2 hours ago, messda said:

Did you have any crown work? Your next pic looks really good

I did. The grafts were placed with high density in the frontal third, medium density in the mid scalp and much lower in the crown.

we were aiming for another 300 grafts in the crown but we were up against the level of anaesthetic allowed, so called it early. 
 

I’d say it’s probably 50/50 from grafts and meds, though Dr Arshad did a great job at recreating the swirl (and showed it to me specifically afterwards, so think he was pleased with how it looked).