Am I a good candidate for surgery? Any approximation on how many grafts I need?

[zet]

Hi All,

I hope you're well.  I am looking into a HT, I have reached out to Pekiner, Feriduni and Bisanga.  A little background: 35, hair loss probably since teens and continued thinning into late 20s.  I've started Dut and Min (5%) as of 4 weeks ago.

I guess the obvious question is, am I a good candidate for a HT?  Also, how many grafts am I look at realistically? I'm based in the UK but can travel - I will take a look at the recommended surgeons list (but feel free to suggest anyone).

[O Hare 57]

Your young with many potential years of hair loss ahead.  You may also be a diffuse thinner over time.  You get surgery.  It looks good for a while then pre-existing hairs die off and you have to do another surgery around them to back fill the areas that thinned out.l  I would wait for some time so see if meds works.  Dont open pandoras box.  I did and it cost me a lot.  Ask doc what your potential norwood point is at the end.  I would bet money you will need more than one surgery. Plan for it B4 you jump in.

Good luck.

[O Hare 57]

Just remember.  Life is long and the hair loss demon is patient.  He waits in the shadows and may strike when you don't expect it.  The only person who has to look you in the eye each morning in the mirror is you.  You are your own worst judge and your best own best advocate.  The final verdict is yours.  I hope one day they find a cure for this superficial yet insidious disease. 

[Melvin- Admin]

Unfortunately your donor looks very thin. I would not get an HT. The donor doesn’t look suitable. Keep shaving, you have a good shape head.

[SoSoz]

Your donor looks depleted like you just had surgery

[Gatsby]

4 hours ago, zet said:

I've started Dut and Min (5%) as of 4 weeks ago.

You need to be religious with the use of these medications. Give them a good 6-12 months at least and then review your situation. All the best!

[Rafael Manelli]

I’m really sorry to say this but your donor looks very thin. You might have something going on other than regular androgenic alopecia. A specialist doctor could check it out and diagnose.

Give the meds a year to do their thing, then reassess.

Body hair and beard may be suitable donor zones.

[O Hare 57]

On second look, I agree, your donor is thin.  Its better to embrace baldness than to start cutting up your head, get half way through then have a half completed mess that you cant finish with visible scars that will make it hard to cut your hair short.  Take the meds, wait a year then re assess.  Also, pray they perfect hair cloning in your lifetime.  I believe Elon Musk will be opening a Burger King on Mars B4 they find a cure for hair loss.  

[zet]

Hi All,

 

Thank you for the advice.  I will continue with dut+min.  I have also ordered a blood test from medichecks to confirm my: SHBG
CRP HS
Ferritin
TSH
Free Thyroxine
Testosterone
Free Androgen Index

 

Is it possible my donor area looks the way it does because I buzz down to 3mm?

[Melvin- Admin]

2 hours ago, zet said:

Hi All,

 

Thank you for the advice.  I will continue with dut+min.  I have also ordered a blood test from medichecks to confirm my: SHBG
CRP HS
Ferritin
TSH
Free Thyroxine
Testosterone
Free Androgen Index

 

Is it possible my donor area looks the way it does because I buzz down to 3mm?

Its possible the lighting and angle makes it looks worse than it is, but in that picture, it looks like you've already depleted your donor. I would have assumed you've already had a few FUE procedures.

[zet]

Oh, nope never had a HT.  I'll get the blood test first and see if there's something else going on.

[Rahal Hair Transplant]

@zet,

To be honest, I would like to see some additional photos of your donor area a.k.a. the sides and back of your scalp before giving you my opinion. As of right now in seeing those photos, I’m concerned that your donor area is a bit on the thinner side. Now, if this is because your hair just isn’t that dense naturally, then yes you would likely be a candidate and I’m sure I could give you my opinion of how many grafts you would need.  But keep in mind even with a naturally thin donor area with no other issues, you’re going to have to have realistic expectations so what can be accomplished. It’s a matter of supply and demand.

However, if the hair on the sides the back of your scalp are on the thinner side because you have something like DUPA (diffuse unpatterned alopecia), then you would not be a good candidate because that means that the hair on the aides the back of your scalp is not stable.  In other words, this means you would be losing hair on the sides and back of your scalp just like on the top. Therefore, transplanting hair from the sides and back to the top wouldn’t make sense because you will likely lose it anyway. Does that make sense?

So honestly, I would like to see some better photos of your donor area in particular and also like to know what your goals are in terms of where your primary concerns are. I know everybody wants a full thick lustrous head of hair, and that might be possible for you if your donor area can handle it. But, everybody has priorities and goals in terms of what areas are the most important.

The photos you presented really aren’t that great in general so it’s kind of hard to determine exactly how much hair loss you’re experiencing on top. But based on those photos alone, I would say to restore a conservative yet dense and natural looking hairline and restore some density in the front and midsection, maybe 3000 to 3500 grafts.  Some of this really depends on how much the surgeon lowers your hairline. Because it looks like you’ve had a lot of recession in the front.  If you have any photos showing your hairline before you started losing your hair, that would be helpful as a guide. 

The crown is another animal. Just to tackle the crown alone, you would likely need another 2500 to 3000 grafts.

Now I know this sounds like a lot, but this is making the assumption that you want to restore as much as possible with as little appearance of thinning as possible all over your scalp with a nice natural and thick looking hairline. If you want to forgo the crown, then you would clearly need a lot less.

I encourage you to stay tuned because within a week I’m going to post a case that Dr. Rahal just did that will knock your socks off. The patient had similar hair loss as you and with 6000 grafts transplanted over his entire scalp from the front to the crown with significant thinning, he literally looks like he has a full head of hair with no signs of thinning. It is honestly probably the best result I’ve ever seen.  And that’s really saying a lot.

Now keep in mind, he also had exceptionally good hair characteristics that of course aids in its appearance. Everybody is different and everybody’s results will vary. But, it will show you what’s possible under the right conditions even on an exceptionally balding head.  Dr. Rahal really knocked this one out of the ballpark.  

So stay tuned for that because I believe this guy’s hair loss was probably similar to yours.

Best wishes,

Rahal Hair Transplant 

 

[zet]

@Rahal Hair Transplant - I am happy to post up more pictures.  I tend to buzz my hair down to a grade 1.  How can I accurately depict my donor area in a picture? What length shall I grow it too? 

Side note: i have found some blood results from 2019, my vit-d was extremely low, iron and ferritin in range but a little bit low.

[Mo1brag]

On 3/10/2023 at 9:30 PM, zet said:

@Rahal Hair Transplant - I am happy to post up more pictures.  I tend to buzz my hair down to a grade 1.  How can I accurately depict my donor area in a picture? What length shall I grow it too? 

Side note: i have found some blood results from 2019, my vit-d was extremely low, iron and ferritin in range but a little bit low.

Some people Are sensitive to dht Even in the back and sides of the head. However seeing that you Are using dutasteride which is extremely potent, you could reverse it. Give the medication some months and chances Are you could build up a good donor. If not you could always Get a body hair transplant

[zet]

On 3/15/2023 at 11:27 AM, Utkarsh said:

You need to consult your hair transplant specialist before considering the surgery. The surgeon will follow the below process

Pre-operative following steps are carried out

i) Proper clinical evaluation of the scalp conditions, donor area, quality of grafts, and underlying medical conditions.

ii) Pre-operative routine blood investigations If all the above are normal then the patient is ready for surgery.

 

 

 

Agreed.  I am based in the UK and Feriduni is booked until 2024.  They agreed with me to find a reputable surgeon who can confirm if I am a suitable candidate or not.  Any suggestions how I can obtain the following information:

 

Hair density in FU/cm² (occipital, parietal, temporal)

Hair structure/quality

Hair diameter (in microns)

Recipient area (measured in cm²)

Available – SAFE - donor area (measured in cm²)

DUPA/BUPA signs

[zet]

On 3/15/2023 at 2:14 AM, Mo1brag said:

Some people Are sensitive to dht Even in the back and sides of the head. However seeing that you Are using dutasteride which is extremely potent, you could reverse it. Give the medication some months and chances Are you could build up a good donor. If not you could always Get a body hair transplant

Indeed.  If I can preserve just this hair and restore the crown and top then thats okay.  Ideally, I would like the front hairline fixed which will require surgery.  

[zet]

I had a consultation with Dr Greg Williams from the Farjo Clinic.  He didnt seem to think there was an issue with my Donor area.  His suggestion was to continue with Dutasteride for 6-12 months to stabilise my hair loss (scalp / crown area).  His suggestion was to then come see him in person.

[zet]

Should note: consultation via zoom

[zet]

So, slight update.  I reviewed my blood test results and it turns out I have high blood sugar HB1AC (49) and I've since begun tracking it and reduced from 9 to 6.1-6.8 but this is with Metformin.  

 

Pics: 2.5 months progress.  Will the crown fill in?

Edited April 13, 2023 by zet

[mr_peanutbutter]

On 4/13/2023 at 11:05 AM, zet said:

So, slight update.  I reviewed my blood test results and it turns out I have high blood sugar HB1AC (49) and I've since begun tracking it and reduced from 9 to 6.1-6.8 but this is with Metformin.  

 

Pics: 2.5 months progress.  Will the crown fill in?

hello, dutasteride has a negative impact on blood sugar. id consider switching to finasteride or quit entirely