Is my donor area too thin?

[Alex98843]

I am 41 never had HT before, I got a diffuse thinning mainly at the frontal area of my scalp but all over, I just let my hair grow out for the last 2 weeks (been shaving it for the last 6 years with SMP ) and I now notice my donor area looking pretty thin , I think it would still be possible to extract 2500 grafts (that's what the doctor I sent my photos to advised me )but  my concern is that the donor area being already thin will look very patchy after ther HT and also the future does not look too promising for more grafts for future HT in case I need them with the thinning that is going on right now.

I just started taking oral fin and planning to go minoxidil after the HT

What do you guys think?

 

 

[Melvin- Admin]

It’s hard to say with these pictures, are you on medication?

[TheGreatPretender]

Looks good howeaver you should wait at least a year or two to see if medication is able to possibly give you the results you want, if after that you're still unhappy then go for a surgery. Always remember that this is your last resort.

[Alex98843]

2 hours ago, TheGreatPretender said:

Looks good howeaver you should wait at least a year or two to see if medication is able to possibly give you the results you want, if after that you're still unhappy then go for a surgery. Always remember that this is your last resort.

The thing about medication that I was on them on the past for a couple of years (fin/min) and while it did thicken my hair at the mid scalp/crown it never brought back my temple area, I started to lose my hair at the temple many years ago so I think it's fair to say that area is not going to grow hair again. given that, having HT in the temple area seems pretty safe no?

[Alex98843]

2 hours ago, Melvin- Moderator said:

It’s hard to say with these pictures, are you on medication?

I just started taking oral fin a few weeks ago and planning to go minoxidil after the HT 

[Gatsby]

Just be careful if you are not doing an in person evaluation. SMP will give your donor a denser appearance than it probably has. It depends where they applied the SMP. I mention this only because my donor was assumed to be much denser than in reality when I had an in person consultation. You can also up your odds by taking finasteride and minoxidil for at least six months at a bare minimum. All the best.

[TheGreatPretender]

9 hours ago, Alex98843 said:

The thing about medication that I was on them on the past for a couple of years (fin/min) and while it did thicken my hair at the mid scalp/crown it never brought back my temple area, I started to lose my hair at the temple many years ago so I think it's fair to say that area is not going to grow hair again. given that, having HT in the temple area seems pretty safe no?

It's usually safe to say that, howeaver you want to make sure that you have explored the maximum capacity of the drug even in terms of stabilization before undergoing surgery just in case. 

But it's a safe bet that it won't grow back though I have seen some extremely bald hairlines coming back from the dead with just Finasteride and Minoxidil though not very common. 

[Rafael Manelli]

What’s your ethnicity and hair texture?

[Dr. Guncel Ozturk]

Your concerns about your donor area are valid. It is important to make sure that you have enough donor hair to achieve your desired result without causing significant thinning or patchiness in the donor area. Looking at photos you've shared, you have hair in parts that should be preserved and should not get damaged cause of operation, because of this my assumption would be that 4000 grafts needed with DHI technique. If your doctor has advised that 2500 grafts are feasible after face-to-face consultation, I'd advise trusting their professional judgment. However, it is also important to consider the long-term implications of hair transplant surgery, including the potential need for future procedures and the availability of donor hair.

Regarding your temple area, it is true that hair loss in this area can be more challenging to address with medication alone. Hair transplant surgery can be a safe and effective option for restoring hair in the temple area, as long as there is enough donor hair available and the procedure is performed by a qualified surgeon. Taking oral finasteride and planning to use minoxidil after the hair transplant surgery can also help to maintain the results and potentially slow down further hair loss.

[Rahal Hair Transplant]

@Alex98843,

I agree that it’s a bit difficult to evaluate your donor area based on the photos you presented alone however, I do feel that it’s possible that you have some thinning in the donor area. Now, this could be for one of several reasons. Either you have a naturally thinner donor area which is probably the best case scenario in your situation. The other concern would be that you have an actual thinning situation going on in your donor due to is referred to as diffuse unpatterned alopecia or DUPA.

Men with DUPA are typically not good candidates for surgical hair restoration because they experience thinning hair all over the scalp including the sides and back of the head. Because of this, there is no “safe zone“ that hair can be taken from and moved to the top of the scalp a.k.a. the traditional balding areas.

To be a bit more technical, hair transplant surgery works on a principle known as donor dominance. In other words, hair moved from the donor area retain its properties which means if you move hair that is resistant to DHT to an area of the scalp that’s balding, even if DHT tried to attack those hairs, they will still be DHT resistant.  Thus, the hair won’t end up thinning or falling out.

But, if hair in the donor area is not DHT resistant, moving it won’t do you any good because it will retain its properties and when attacked by DHT on top of your scalp, it will thin just like it was in the donor area.

Long story short, get evaluated by a dermatologist and find out if you have DUPA.  He or she will be able to run some tests including evaluating your scalp under magnification which includes the hair on top and on the sides and back of your head. If you do not possess DUPA, then your donor area may just be naturally on the thinner side but you would still be potentially a candidate for a surgical hair restoration assuming that your expectations are realistic.  Of you do possess DUPA, he will likely not be a good candidate for hairtransplant surgery however, you could attempt to use finasteride and minoxidil (Applied to the sides back of your scalp) to see if it thickens up. If it does thicken up enough, you may be able to undergo her transplant surgery but you need to be aware that there’s still a significant risk of losing that hair. The only way to then potentially stop it from falling out would be to continue using finasteride and minoxidil on the recipient area as long as you want to keep that hair. Even then there are no guarantees. 

I hope this helps.

Rahal Hair Transplant 

[HairFunk]

Try and get better photos from the back and sides in brighter light so we can evaluate better...