How many grafts do you think? And what strategy would you use?

[Leafs1967]

Hi guys, have read and learnt a lot on here! Thank you all & appreciate it

I've done a couple local consultations here in Toronto as well as phone/skype consultations overseas (Eugenix, Turkey, Mexico). 

Generally, feedback is that I need 5000 grafts (with different opinions on how much needs to go in the front... usually around 2500-2700 though). However, I get a bit confused as I've seen people on here do around 2200 grafts in the front with the feedback being that it was not enough. So I'm a bit concerned about the amount to rebuild the hairline...

Am I better off starting with a session locally at 2500 grafts & addressing the mid & crown afterwards? Or should I get myself to Eugenix for something closer to 4500 grafts to start?

Turkey facilities seem hit and miss... as there is always someone complaining about the job done. Eugenix has good results but is far... and still says I may need a second session.

 

Anyone have general thoughts as to what might be a good strategy?

[Leafs1967]

Thanks in advance to anyone helping out here

[ThePerseverantWarrior]

Have you tried medication? If yes, for how long and how did you respond?

[duckling]

1)talking about your donor : your donor is tough to assess with long hair but they sure look dense in these pics.

2)meds has to be your first line of treatment. They are necessary as they can get you back some hair(which are miniaturized). The follicles you have lost from long time are mostly gone. meds will also thicken your existing hair which will help in providing density along with future transplanted hair. Only transplanted hair will not get you desired density.

3)If possible please get your donor area examined from any good local HT surgeon who can provide you an estimate of your donor graft count that can be used. (Unless you trust your HT surgeons overseas with the graft count they provide you during online consultation)

4)For choosing clinics: check that clinic's results for your grade of baldness (use norwood scale). 

5)Ask the clinic which areas they want to focus on in first surgery with how many grafts. And what will be ratio of scalp grafts to beard grafts. And how many days the surgery will last as in single day no clinic should go more than 2500 grafts to avoid transection. Single surgeon clinics will go more less grafts in a day.

6)If you use beard grafts then scalp grafts used will be slightly less. So less stress on donor area being over harvested at scalp.

Now coming to choosing clinic: 

1)you have hasson and wong i think near you. (I would have gone with that if i could afford them)

2)if you go to turkey then pekiner, bicer, hlc are the expensive options . turan, gur, yaman are the budget options. 

3)if you go to india then i would suggest eugenix but with higher packages ( founding surgeons designing and making slits atleast). With other senior surgeons it has been slightly hit and miss. 

4)in thailand you pick kongkiat laorwong.

5)in south ameica: thiago bianco, luis nader

6)If you want more options from europe then prices will be 5 euros or more for popular options. (zarev, couto, lorenzo, de freitas, feriduni, bisanga, pinto , ferreira, mwamba)

[duckling]

You need multiple sessions. Cover just frontal area with slight mid-scalp improvement in first surgery. (3000-3500 scalp grafts at max in first seating) . If you use beard then 500 from beard will be used.

In second seating increase density in mid-scalp and in case needed add more to frontal again. (if in first surgery density isnt looking good at front)

crown has to be ignored by you until other two areas are dense enough. Crown will be treated at last. ( as meds should help you at crown area) and it is area which wont be visible easily. Beard grafts along with remaining scalp grafts will be used for crown whirl creation.

[Rafael Manelli]

You’re about a Norwood class 5 - high sides and a bridge. Medication should be priority 1. If you can hold on to that hair in the middle and on the lateral humps, preventing yourself from becoming a class 6 or 7, you will save the equivalent of perhaps 3000 grafts. Maybe even more. Finasteride or dutasteride might actually thicken up your native hairs somewhat.

After that, I think 5000 grafts sounds about right for respectable density and a conservative hairline placement. You could go to Hasson and Wong. You could go to Hattingen in Switzerland. They do large sessions. Or you can break it up into two surgeries.

[TheGreatPretender]

You have similar pattern of baldness as myself, I am a little better though in terms of native hairs and have a slightly stronger crown. 

I think 5000 make sense in your case knowing you are NW5A with both sides alongside the bridge thinning with some hairs spread around the frontal third.

Medication should be the first thing to try so you can avoid falling under NW6 and once you stabilize it you should be able to have around aprox 3000 on the front with some 1000 to 2000 over to the crown. 

[mr_peanutbutter]

if you are cool with fut you could really consider hattingen in switzerland, they do that in one session

 

they charge like 3.50 swiss franc (=5.sth canadian dollar) per graft

[Bucky O Hair]

I wouldn't go with any surgeon based in Toronto, unless it is Dr. Rahal (who is based in Ottawa but does the occasional HT in Toronto).

I'd reach out to him so you could at least get a hair analysis and graft count done in Toronto by one of his staff.

They will tell you your expected lifetime graft count in your donor and hair shaft thickness.  With these numbers, you will be able to make an informed decision.

[duckling]

3 minutes ago, Bucky O Hair said:

I wouldn't go with any surgeon based in Toronto, unless it is Dr. Rahal

Did Hasson and wong retire ? 😄 

[Bucky O Hair]

1 hour ago, duckling said:

Did Hasson and wong retire ? 😄 

No, but aren't they based in Vancouver?  They are a great option.  I didn't know they do procedures in Toronto (if that's what you're implying).

[duckling]

5 hours ago, Bucky O Hair said:

No, but aren't they based in Vancouver?  They are a great option.  I didn't know they do procedures in Toronto (if that's what you're implying).

they do live consultations in toronto. So he can get that part done there and if he likes surely can visit them in vancouver for surgery. 

[Leafs1967]

Had the procedure done End of May 2023. So just over a year through. Will provide some update photos & progress through the way.

[Leafs1967]

[Al - Moderator]

It looks pretty good.  Where did you end up having it done at?