What’s my NW? 2 surgeries?

[Hysteria]

First off, 30 years old. I’m sure this is MPB due to my mother’s side of the family being bald in 30s. 

finasteride .5mg every other day for one year.

minoxidil topical 5% morning and night for 10 years. Only in last few months have I started applying to temple receding hairline to experiment. Not sure about any result yet. 
not sure if oral minoxidil is safe or worth it?

how many grafts do I need? Keep in mind my forehead has gotten much larger with the receding so I’d like to shrink my forehead a bit

is my donor area strong? Would I get more density with two separate surgeries?

which doctor would be suitable for me? I’m Canadian and considering Bicer, FUECapilar, de Freitas. Is Bicer just as good at hairlines as bisanga or Freitas? FUECapilar seems much cheaper yet the reviews are still decent?

 

any answers would be appreciated. 
 

[HappyMan2021]

I'd say the hairline is a NW4 or so while the crown is a NW5. 

I wager you need 3-4 really good surgeries to completely fill in anything. 

2 surgeries is unrealistic if you are looking to fix everything, sorry. You would need both of these surgeries to basically be like back-to-back flawless, homerun 10/10, which is a very rare accomplishment. 

 

[Hysteria]

Understood. 3 to 4...  This is going to be a long road ahead.

[ScottishGuy21]

2 surgeries should get you full-ish coverage with a good Dr. Breaking it up into 2 parts also helps limit the chances of damage to your donor. It can certainly be done in less than 3 or 4 surgeries if you choose wisely 

Edited July 7, 2023 by ScottishGuy21

[mavigo]

In total? Probably 3,000 for the front, 4,000 on the crown. 

[GoliGoliGoli]

I think you're not a great candidate tbh unless you're super committed to getting this done and are ok with fairly sparse coverage. Your hair loss is quite advanced for your age - especially the retrograde alopecia in the back of the head that compromises your long term donor availability. I'm just not sure you have enough grafts available. Even though you're on fin I think it's safe to assume that you will continue to lose hair so even if you had 2-3 surgeries you might still end up needing to chase it and the concern is that you run out of donor. 

That said if you understand the financial and other costs of this and have reasonable density expectations, you could go forward with it and get an aesthetic improvement. 

[HappyMan2021]

5 hours ago, Hysteria said:

finasteride .5mg every other day for one year.

 

why are you taking Fin every other day? I am not a Fin wizard but does that mean you are only getting 50% of the benefit?

Your hairloss is pretty significant and 30 is quite young in this game. You have plenty of years left to lose even more hair. 

Not to add to any pessism, just an FYI that you already have significant hairloss and given your age it is realistic that you may losesignificantly more. So if at all possible you really shouldn't cut any corners with preventative meds. 

[Viney]

I think oral minoxidil is worth trying if you feel up to it. Personally I'm willing to take it and think it's given me some improvement. You could also try switching from fin to dut if you wanted to really have a decent go at saving your existing hair and trying to get a little bit of improvement.

[mrmane85]

Personally I'd get on oral Minoxidil (2.5mg) compounded with oral fin (0.25mg) daily and then reach out to Dr Pittella or Dr Zarev. They both have a tonne of experience in helping those with high degrees of hairloss achieve full density with 1 (max 2) surgeries.

[Hysteria]

So .25mg to .5mg daily finasteride? Alright I’ll try that. I originally had dutasteride and fin at the same time and had some side effects. So I had been doing every other day for that reason. 

In my local area oral minoxidil has been a supply issue but that is the goal.

For my case, would it be too challenging for doctors like Bicer, de freitas, bisanga etc and that I should be considering the aforementioned Pitella, Zarev in addition those like eugenix and so on?

[kiwik]

Your future NW seems to be 6 (although you should have a doctor confirm you're not headed towards 7). This means you'll need at least 6k grafts in total, possibly even 8k depending on your hair characteristics. I believe good short term results can be achieved with two surgeries (that's the strategy my surgeon suggested in my case, which is quite similar to yours), and you might have to go back for a third HT in 10 years or so when you have lost more native hair.

 

You can ask Bisanga or de Freitas for advice, I don't think anything would be "too challenging" for them, although I've never seen reports on such big cases treated in their clinics. Anyway, if they say you're a good candidate, you'll be in safe hands with them.

[A_4_Archan]

If your hairloss is stabilised than you can consider HT but don't keep high hopes ..keep your expectations in check and plan accordingly....if you wanna go for a very large session thn you can consider dr zarev,dr pittela and eugenix....and if you wanna follow two or may be three phased approach than you can look at those 3 i mentioned earlier plus dr de freitas ,pinto ,couto ,Ferreira, pekiner ...whatever approach you choose or whoever the doctor is imo you should take very conservative approach regarding hairline and save grafts for midscalp and crown....

[Doron Harati]

Currently you're NW4-5, will be for sure NW6 in couple of years.

Roughly I think you can have 3500-4000+ grafts on 1st session (before checking more photos and measurements) to cover frontal area with some middle scalp.

Crown will need 3000+ grafts for both NW5-6 areas.

Be aware that you're blond, most (not everyone) blonde Caucasian candidates have thin hair, therefore it's important to do detailed consultation with good references before booking a procedure.

[Hysteria]

Here are some angles with natural lighting in front of the sunshine on my deck. 

 

 

Edited July 8, 2023 by Hysteria