Is my donor area really only containing 1000 grafts?! (See pictures)

[Jonas Medin]

I'm planning to do my first HT the upcoming year and I have now been doing a bit of research visiting three clinics in my home country for a consultation.

1️⃣ The first clinic told me that my hair is thin and that I can expect in total 3000 grafts harvested from the donor area. However, the doctor only wanted to do 1500 grafts per surgery, meaning that I should come back for a second HT if needed. 

2️⃣ The second clinic told me that they could easily harvest 4500 grafts from my donor area in one (!) HT-surgery.

3️⃣ The third clinic told me that my hair is thinning in the donor area and that I have only 1000-1500 grafts in total left to use for a HT. 

As you may understand, I now feel very confused about the the varying answers that I have got and wondering: 
- Which of these clinics is correct?
- What can I expect from a HT based on the attached pictures?
- Are my conditions good enough for a successful result?

I would be very grateful for any estimation based on the pictures attached. I know that the pictures are in low quality, I think the reason might be that the clinic that took them don't want me to use it in forums like these. Thanks in advance to all helpful forum members!

[mister_25]

Which clinics did you consult with?

[Jonas Medin]

Ilter Clinic, Akacia Medical and NordicHair. All based in Stockholm.

[mister_25]

I’ve never heard of these clinics, you should consult with some of the best in Europe and hear from the elite doctors opinion on the state of your donor. The forums recommended list is a good start.

[MisterBreakfast]

I'm going to be honest, that donor looks like it's thinning.  Have you been checked for DUPA? 

I have DUPA, and I've recently decided not to go through with my transplant.  My donor looks quite a bit denser than yours as well.

[MisterBreakfast]

When your donor is viewed under a microscope microscope, you want someone to check for varying diameter hairs. Here you can see on my donor, almost every follicle group has miniaturization. Some amount is normal, but in my donor almost every group has miniaturized hair. Elite doctors recommend under 10-15%.  Lesser doctors will operate < 25%.

 

 

[Rahal Hair Transplant]

@Jonas Medin,

Honestly, if you’ve never undergone hair transplant surgery before and you’re being told you only have 1000 grafts, then one of two things is likely going on. Number one, you may possess diffuse unpatterned alopecia (DUPA) which means that your donor area is thinning in addition to the thinning on the top of your scalp OR the clinic you are consulting with isn’t giving you accurate information for one reason or another.

if the former situation is true, then you likely are not a candidate for hair transplant surgery at all unless or until you’re able to get the thinning on the sides and back of your scalp to stop and thicken up.  Even then, you would likely be bound to non-surgical solutions for the rest of your life to keep that area from thinning.

The reason why this is so important is because hair transplant surgery operates on a principal known as donor dominance.  This means the transplanted hairs retain the characteristics from the area from which they came.   In other words, if the area the hairs were removed from starts to thin, the transplanted hairs will start to thin even though they were moved.  This is why those with DUPA are typically not candidates for hair transplant surgery.

in my opinion, I would consult with a few doctors that are recommended by this community for an accurate assessment. If you are interested in a no obligation information session with Dr. Rahal who is highly esteemed and recommended by this community as well as a coalition member (the highest form of recommendation by this website), feel free to send me a private message and I’ll be happy to set this up for you.

Best wishes,

Rahal Hair Transplant 

Edited January 5, 2023 by Rahal Hair Transplant

[Kraki77]

1 hour ago, MisterBreakfast said:

I'm going to be honest, that donor looks like it's thinning.  Have you been checked for DUPA? 

I have DUPA, and I've recently decided not to go through with my transplant.  My donor looks quite a bit denser than yours as well.

Can you share pictures of your hair? I'd be really interested about it because I also have some suspicious about my hair. I've seen cases where you'd never say visually that someone has DUPA and it's something that bothers me. De Freitas accepted to operate but I'm mentally prepared for potentially disastrous news on the day of intervention, if that happens.

[shiba1985]

Unlikely. 

[MisterBreakfast]

@Kraki77

 

 

Edited January 5, 2023 by MisterBreakfast

[Kraki77]

43 minutes ago, MisterBreakfast said:

@Kraki77

 

 

How old is your hair in these pictures? And has anybody told you exact percentage of miniaturization in donor? Would you say that your hair was this thin from adolescence or it started to occur later?

Thank you for the taking the time to deliver pictures. 

[MisterBreakfast]

18 minutes ago, Kraki77 said:

How old is your hair in these pictures? And has anybody told you exact percentage of miniaturization in donor? Would you say that your hair was this thin from adolescence or it started to occur later?

Thank you for the taking the time to deliver pictures. 

~37 years.  My hair was thick as **** back in the day.  Don't know exact percentage but as you can see from that photo its well over 25%. 

I also have no desire to get scarring to transplant miniaturized hair.

[Kraki77]

13 minutes ago, MisterBreakfast said:

~37 years.  My hair was thick as **** back in the day.  Don't know exact percentage but as you can see from that photo its well over 25%. 

I also have no desire to get scarring to transplant miniaturized hair.

When did it all start? When did you notice your hairloss and was it rapid?

[MisterBreakfast]

1 hour ago, Kraki77 said:

When did it all start? When did you notice your hairloss and was it rapid?

Hard to say.  The top went kind of twice, once at 22, probably lost about 1/3rd and then again sometime in my mid 20's, lost another third, shaved it short, never looked back.  

For the donor, I was planning on getting a transplant, took meds, had a good response, then once I grew my sides out only then did I notice that they too had started to thin.  It's more exaggerated / noticeable in photos.  In the mirror, or in person, you can hardly tell the donor thinned.

[MAIZE1694]

1 hour ago, MisterBreakfast said:

Hard to say.  The top went kind of twice, once at 22, probably lost about 1/3rd and then again sometime in my mid 20's, lost another third, shaved it short, never looked back.  

For the donor, I was planning on getting a transplant, took meds, had a good response, then once I grew my sides out only then did I notice that they too had started to thin.  It's more exaggerated / noticeable in photos.  In the mirror, or in person, you can hardly tell the donor thinned.

I'm in a similar situation to you. I've never seen my hair under magnification but I can tell with my trained eye it looks thin. I had a pretty bad seb derm/ scalp infection and postponed my surgery but at this point it probably won't happen any time soon. Don't want to mess up the back of my head and have it look ridiculous for some thin hair that may or not take. I have a little more on top than you so I'm just taking fin for now and riding it out.

[Dillpickle123]

It could also be telogen effium due to stress my donor had more thninng then parts of the tops of my head lol but I had been going through stress either way the doctor will be able to tell which hairs to get in your donor if they wear loupes 

[Jonas Medin]

On 1/5/2023 at 5:00 PM, MisterBreakfast said:

I'm going to be honest, that donor looks like it's thinning.  Have you been checked for DUPA? 

I have DUPA, and I've recently decided not to go through with my transplant.  My donor looks quite a bit denser than yours as well.

Very interesting @MisterBreakfast! I have never heard of DUPA before. I will definitely check it up. Do you think this is something that a "normal doctor" can check or does it need to be a professional hair doctor?

[Jonas Medin]

On 1/5/2023 at 9:32 PM, Kraki77 said:

How old is your hair in these pictures? And has anybody told you exact percentage of miniaturization in donor? Would you say that your hair was this thin from adolescence or it started to occur later?

Thank you for the taking the time to deliver pictures. 

Thank you @Kraki77 for replying to my thread. I'm 36 years old. I don't have a clue about the percentage of miniaturization in the donor area. Do you know if this is something that I can get help with from the National Health Service or do I need to contact some private hair doctor? 

I feel a bit unsure about your question if my hair has been thin from the start. I would say yes it has always been thin compared to many others, but it definitely has gone thinner by the years. Do you also think that I might have DUPA when checking the pictures?

[osmosis]

On 1/5/2023 at 4:32 PM, Rahal Hair Transplant said:

@Jonas Medin,

Honestly, if you’ve never undergone hair transplant surgery before and you’re being told you only have 1000 grafts, then one of two things is likely going on. Number one, you may possess diffuse unpatterned alopecia (DUPA) which means that your donor area is thinning in addition to the thinning on the top of your scalp OR the clinic you are consulting with isn’t giving you accurate information for one reason or another.

if the former situation is true, then you likely are not a candidate for hair transplant surgery at all unless or until you’re able to get the thinning on the sides and back of your scalp to stop and thicken up.  Even then, you would likely be bound to non-surgical solutions for the rest of your life to keep that area from thinning.

The reason why this is so important is because hair transplant surgery operates on a principal known as donor dominance.  This means the transplanted hairs retain the characteristics from the area from which they came.   In other words, if the area the hairs were removed from starts to thin, the transplanted hairs will start to thin even though they were moved.  This is why those with DUPA are typically not candidates for hair transplant surgery.

in my opinion, I would consult with a few doctors that are recommended by this community for an accurate assessment. If you are interested in a no obligation information session with Dr. Rahal who is highly esteemed and recommended by this community as well as a coalition member (the highest form of recommendation by this website), feel free to send me a private message and I’ll be happy to set this up for you.

Best wishes,

Rahal Hair Transplant 

This video questions the donor dominance theory using interviews with one of the Farjo Clinic doctors and peer reviewed papers.