Is it generally a bad idea to get a hair transplant if you’re only a Norwood 2 or so? Just been rejected by Fuecapilar

[RichieChuck]

Hey,

So as per the title, I’m 33 years old and have relatively mild hair loss (Norwood 2 hairline, slight thinning on the crown). I’ve been on topical finasteride and minoxidil for about 10 months. I’ve been considering getting a transplant just to fill in the receded temples, but apparently that’s not such a good idea?

I’ve had a couple of free consultations in the UK. Both clinics indicated that my crown would be unsuitable for surgery, but they did say that they could do my hairline and gave me a quote so I was a little surprised by Fuecapilar’s rejection. However, I suppose it shouldn’t be too much of a shock given that particular clinic’s reputation for conservative hairlines and only taking on safe cases.

Dr Turan’s comments are as follows:

[QUOTE] Following the photo analysis, Dr Turan indicated that your alopecia level seems to be a Norwood II according to the Norwood-Hamilton Scale of Male Pattern Baldness (re: the image in the next page)

Dr Turan completely agrees with the local clinic's assessment on the crown. The density of the healthy native hairs is too much for a surgery which means you do not have a hair loss in the crown that necessitates a surgery. A surgery performed in this area will damage the native hair in another way as well since the nutrients provided by the subcutaneous blood circulation has to be shared with the native hair and the implanted hair, causing graft competition. It can affect both the development of healthy hair and the survival rate of the implanted hair.

 

The doctor also has doubts that if you undergo a surgery a natural outcome will be as likely as you wish to have the natural outcome by having an implantation on the temples. You might lose the natural look you already have for two reasons if you undergo a hair transplant surgery:

     

   1) The skin elasticity would not allow reaching the native hair density by a hair transplant.

There is a limit to the density that can be reached with hair transplantation. 
And most probably this may not meet the patient's native hair density  The density on the corners will be lower since we can not achieve the density of your native hairs.

 

2) When you get older, your hairline will not look natural considering the future receding. In this case you will have a hairline which has lower density in the frontal-temporal area which creates a very unnatural look. The age appropriate hairline that you will have in the future will be affected as well.

 

Due to the factors above Dr Turan definitely does not recommend a surgery. He also indicated that you have a very good looking hairline and a surgery will be more problematic than being beneficial at this stage. [/QUOTE]

 

His comments about a new hairline looking unnatural after potential future recession do make sense, although can’t that largely be mitigated by continued use of medication post-surgery?

Pictures attached for ease of reference. Would be grateful for your opinions.

Thank you

[Gatsby]

If you're on medication then I have to agree with the doctors. A hair transplant will never look as good or natural as your own hair. Enjoy the great head of hair that others here would die for. In time of course if your hair loses ground then you could revisit this again. All the best. 👍

[Dillpickle123]

Your hairline looks awesome already sure your corners are a bit miniaturized but you have to take into account the risks of surgery vs reward I think if you were to go through with it you need no more 1000 grafts for those two corners it really isn’t that bad unless it affects you that much 

[Mountinvan]

I wouldn’t touch hairline at this point but could we see some crown pictures?

 

[A_4_Archan]

I would suggest you to just get on medication - oral minoxidil and finasteride after consulting ur surgeon and u cn evn consider prp therapy which will boost your grafts and make it fuller and thicker and will give you more coverage ....

Imo prp therapy with medications will solve your problem and you will not feel the need of a surgery for few years atleast ...

[StillAlive]

Dude you have perfect hair, don't even joke around with an HT. Meds should sustain your full head of hair all throughout your life without need for anything invasive. 

[mr_peanutbutter]

do not get ht for the front

 

would like to see the crown

[NegativeNorwood]

Consult with better doctors who do temple points regularly, like Feriduni or Mwamba (or Couto if you can wait 2 years for consultation).

Temples are the hardest to get right in a hair transplant so most doctors chicken out as they don't have the necessary skills to pull out a natural result.

Good luck with your search, temple points are very important for framing the forehead and face, so they'll be a great improvement to your already great hair. Just choose top level doctors who do temples regularly to consult with, your average "good enough, recommended" doctor won't help you as you already discovered.

Btw, point two is a huge cope, you can still get more transplants to match the density. Also, there's no such a thing as an age appropiate or juvenile hairline, you are either balding or not...people like Brad Pitt or Tom Cruise naturally have perfect hairlines at 60 years old. "Age appropiate" is euphemism for balding, and "juvenile" is euphemism for not balding.

Edited February 23, 2023 by NegativeNorwood

[ScottishGuy21]

I wouldn’t be looking for surgical improvement from those pictures (Unless your crown needs work). That’s still a really solid hairline, the risk of a procedure going wrong or not to your liking far outweighs the benefit you’d get at this point. 
 

 

Edited February 23, 2023 by ScottishGuy21

[Dr. Guncel Ozturk]

It seems that you have been experiencing mild hair loss, it has not progressed yet, and you have been using topical finasteride and minoxidil for 10 months. 

Consider the potential risks and limitations of getting a hair transplant. Have a realistic expectation of the outcome. Hair transplant may not be suitable for you at this time, but this may change as your hair loss progresses. You have a limited donor supply, so it would be the best to get your surgery, at the right moment to harvest your donor (as long as you are eligible with enough donors)

It appears that the density of the healthy native hair in your crown area is too high for surgery. If a surgery is performed in that area, it may damage your native hair and cause graft competition, which can affect the survival rate of the implanted hair and the development of healthy hair. Additionally, if you get hair transplant on the temples due to the skin elasticity not allowing for reaching native hair density you may not achieve a natural-looking result you look for, as you age, future recession may cause the transplanted hairline to look unnatural, which can be mitigated by continued use of medication post-surgery.

In the meantime, I suggest keep using topical finasteride and minoxidil to maintain your existing hair and potentially slow down hair loss progression. You don't have to rush for HT for your case, but it would be the best to keep what already you have.

[Bucky O Hair]

hard pass on the HT 

[Westview]

Agree with all posters, not time for a transplant yet.

Use drugs for now, and fibers also

[Gatsby]

Remember that it takes up yo two years to see Finasteride’s full effects. All the best. 

[Rafael Manelli]

Meds may thicken the crown, and you can definitely use Toppik for it.

you don’t need to match the native density, transplants can look good with the “illusion of density” wherein a lower density can blend in seamlessly and not be detectable to the naked eye. It needs to be high but not THAT high.

surgery is the only way to restore a Norwood 1. You look to have great donor, a strong head of hair and you’re on meds. The only issue is you may continue balding. In that case you might want to conserve your grafts to maintain your current hairline.

personally I’d go for the surgery for the front, could be 1000 or 2000 grafts depending on what hairline you want. But that’s depending on how much the recession bothers you. If it doesn’t bother you much, just keep it where it is.

[Rafael Manelli]

If you post straight on pics, and pics from the side profile, blurring your face if you wish, it would help.

[Gramatik]

On 2/23/2023 at 1:54 AM, RichieChuck said:

Hey,

So as per the title, I’m 33 years old and have relatively mild hair loss (Norwood 2 hairline, slight thinning on the crown). I’ve been on topical finasteride and minoxidil for about 10 months. I’ve been considering getting a transplant just to fill in the receded temples, but apparently that’s not such a good idea?

I’ve had a couple of free consultations in the UK. Both clinics indicated that my crown would be unsuitable for surgery, but they did say that they could do my hairline and gave me a quote so I was a little surprised by Fuecapilar’s rejection. However, I suppose it shouldn’t be too much of a shock given that particular clinic’s reputation for conservative hairlines and only taking on safe cases.

Dr Turan’s comments are as follows:

[QUOTE] Following the photo analysis, Dr Turan indicated that your alopecia level seems to be a Norwood II according to the Norwood-Hamilton Scale of Male Pattern Baldness (re: the image in the next page)

Dr Turan completely agrees with the local clinic's assessment on the crown. The density of the healthy native hairs is too much for a surgery which means you do not have a hair loss in the crown that necessitates a surgery. A surgery performed in this area will damage the native hair in another way as well since the nutrients provided by the subcutaneous blood circulation has to be shared with the native hair and the implanted hair, causing graft competition. It can affect both the development of healthy hair and the survival rate of the implanted hair.

 

The doctor also has doubts that if you undergo a surgery a natural outcome will be as likely as you wish to have the natural outcome by having an implantation on the temples. You might lose the natural look you already have for two reasons if you undergo a hair transplant surgery:

     

   1) The skin elasticity would not allow reaching the native hair density by a hair transplant.

There is a limit to the density that can be reached with hair transplantation. 
And most probably this may not meet the patient's native hair density  The density on the corners will be lower since we can not achieve the density of your native hairs.

 

2) When you get older, your hairline will not look natural considering the future receding. In this case you will have a hairline which has lower density in the frontal-temporal area which creates a very unnatural look. The age appropriate hairline that you will have in the future will be affected as well.

 

Due to the factors above Dr Turan definitely does not recommend a surgery. He also indicated that you have a very good looking hairline and a surgery will be more problematic than being beneficial at this stage. [/QUOTE]

 

His comments about a new hairline looking unnatural after potential future recession do make sense, although can’t that largely be mitigated by continued use of medication post-surgery?

Pictures attached for ease of reference. Would be grateful for your opinions.

Thank you

At this point, i would not do a hair transplant. I totally agree with Dr Turan's ethical response.