55-year-old male with NW 5/6. Am I a good candidate for hair transplant?

[DavidD777]

I am looking for some input and advice. I am a 55-year-old male. I started losing hair in my twenties. After years of getting by with Toppik fibers and thickeners, I am reaching the point where fibers are no longer effective because there's not enough real hair to bind to.

As you can see from my photos, I have a substantial receding hairline, thinning and balding in some areas. I am guessing I am on Norwood Stage 5 or 6.

I had tried Minoxidil for many years and Finasteride for about 2 years. I really couldn't tell if either of them helped. Right now I am not using either one.

Do you think I am a good candidate for HT and if yes how many grafts do you think I need? Based on my reading so far it looks like I may need around 5000-6000? Also I am concerned about whether I have enough donor hair. I don't have a lot of facial hair, and pretty much no chest hair at all. Any recommendations in terms of doctors or clinics? I am in the USA.

Thanks for reading and I appreciate any input or advice.

Edited July 13, 2023 by DavidD777

[BaldReaper]

can you post some better donor pictures? ideally with a shorter haircut

[YodaHead]

Your donor area doesn’t look great, but i think you can go with a very conservative hairline and get enough hair from back and sides to get some density on the front and mid-scalp. I don’t think you have enough to cover the crown fully since the bald area looks big, plus as you said there’s not much hope from beard or chest. You will also have to stay on minoxidil and finasteride to keep the existing hair for as long as possible. I feel this can be done if you go to the right surgeon.
 

Edited July 14, 2023 by YodaHead
Edit

[DavidD777]

Thanks @YodaHead for the input. I will start minoxidil and finasteride again. Keeping my expectations in check re HT but hopefully with some more density on the front and mid-scalp, the fibers will then have a better chance to do its thing.

@BaldV Sure I'll take and share some better donor pictures soon. Thanks.

[Matt434]

11 hours ago, YodaHead said:

Your donor area doesn’t look great, but i think you can go with a very conservative hairline and get enough hair from back and sides to get some density on the front and mid-scalp. I don’t think you have enough to cover the crown fully since the bald area looks big, plus as you said there’s not much hope from beard or chest. You will also have to stay on minoxidil and finasteride to keep the existing hair for as long as possible. I feel this can be done if you go to the right surgeon.
 

I agree with YodaHead, your best bet is to focus on the front and augment the crown just enough so that topik is a viable option again. I would add that you should think deeply about what kind of hairline you would be satisfied paying for. It's important to go conservative with the hairline given your donor, but make sure that you would be happy walking around with whatever the doctors recommend.

[Vann]

Depending on your wants you can either go for a decent hairline, midscalp (frontal thirds) and maybe go with a thinning crown with the way your donor looks. 

I cant really say much I think we would need more photos of your donor to evaluate more. But my best advice is look up some surgeons on here and reach out to them for a consultation as they would be the ones actually working on your head.

I would say you are a candidate for a HT but I would try to rule out some tests to see if there's anything that would prevent you (scalp inflammation, dermatitis, possible auto immune issue). If you see your PCP I think these are free (under most insurance) whenever you do a yearly physical. 

If money is not an issue for you... I would suggest Konior who takes a very conservative approach and has worked with what I believe difficult cases and knocked it out. 

Lastly, I would suggest looking up some people here who have a similar hair loss to yours. Given your age and level of hair loss I would say you have pretty much stabilized, so the option to do some work is possible. Just try to see any local (surgeons/doctors) that work in this field and see how they evaluate you in person.

Also... if you havent tried oral minoxidil you could probably get some coverage back try taking 2.5mg and upping your dosage to 5mg if you tolerate it well. You might be able to reduce the amount of landscape you need to fill in a HT.

[DavidD777]

Here are a few more photos from the back and side. The more photos I take and the closer I look, the worse it looks!

@Matt434 Thank you, yes considering my age and donor area, I think I would be satisfied paying for a result that brings my "hair age" back 15 years or so.  Looking at some of my photos from 2007 for example, I would be happy if I have that hair now  

@Vann Thanks, I will start researching and reaching out to some surgeons and browse/search the forum for cases similar to mine. I have not given much thought  to things like auto immune issue & scalp inflammation. Will talk to PCP about those tests and also whether my other health conditions (A1C 6.7) will be a factor. Re oral minoxidil, no I have only tried topical minoxidil like Rogaine. Will definitely look into that.

I briefly looked up Konior and I think he's out of my budget ($US 6-10K). Looks like Konior is in the 20K or more range? For my budget I probably need to work with a doctor/clinic in Turkey/India or another country with similar prices.

[Vann]

16 minutes ago, DavidD777 said:

Here are a few more photos from the back and side. The more photos I take and the closer I look, the worse it looks!

@Matt434 Thank you, yes considering my age and donor area, I think I would be satisfied paying for a result that brings my "hair age" back 15 years or so.  Looking at some of my photos from 2007 for example, I would be happy if I have that hair now  

@Vann Thanks, I will start researching and reaching out to some surgeons and browse/search the forum for cases similar to mine. I have not given much thought  to things like auto immune issue & scalp inflammation. Will talk to PCP about those tests and also whether my other health conditions (A1C 6.7) will be a factor. Re oral minoxidil, no I have only tried topical minoxidil like Rogaine. Will definitely look into that.

I briefly looked up Konior and I think he's out of my budget ($US 6-10K). Looks like Konior is in the 20K or more range? For my budget I probably need to work with a doctor/clinic in Turkey/India or another country with similar prices.

I believe your donor makes your case a very difficult one. See what the doctors say about your photos.

[BaldReaper]

I dont think you are a candidate with this donor

[DavidD777]

Thanks everyone for your valuable input/advice. I will send my photos to a doctor or two and see what they say but I have a feeling they will say the same.

[Davies]

You're a very similar case to me and I've been advised to have a large FUE procedure upto 3500 - 4000 grafts and keeping a higher hairline...

[Rahal Hair Transplant]

@DavidD777,

To be honest, your hair  loss pattern looks almost exactly like mine would be had I not undergone surgical hair restoration.  I was able to restore a pretty full looking head of hair although under harsh lighting, it does look a little thin, especially the crown area and below.  That said, I no longer have any bald spots and I was able to find a style that works well for me and most people don’t even know I ever lost any hair.

All that to say, everybody is different as are their needs and goals. Whether or not you are content it will depend on what a skilled surgeon can  take from your donor hair and implant into the balding areas strategically and whether or not you’ll be satisfied with what can be accomplished.  At the end of the day, hair transplant surgery is about supply and demand.

While you’re donor hair supply will be substantially less than your demand for hair in the recipient area to restore a full head of hair, a skilled surgeon may be able to re-create a conservative looking hairline with some illusion of density behind it and enough coverage to satisfy your needs.  That said, you will need to consult with a couple of surgeons that you are impressed with and find out what can be done in your case and circumstances.

if you are interested in a no obligation information session, feel free to send me a private message and I can set up something for you with Dr. Rahal.  If you’re not familiar with Dr. Rahal‘s reputation on this forum, feel free to do a search to see what his patients are saying. Also, he is recommended by this community and a member of the this sites highest membership (the Coalition of Independent Hair Restoration Physicians).

Best wishes,

Rahal Hair Transplant

Edited July 15, 2023 by Rahal Hair Transplant

[DavidD777]

@Davies That's good to hear. It makes sense to keep a higher hairline for cases like me. Thanks!

 

[DavidD777]

23 hours ago, Rahal Hair Transplant said:

@DavidD777,

To be honest, your hair  loss pattern looks almost exactly like mine would be had I not undergone surgical hair restoration.  I was able to restore a pretty full looking head of hair although under harsh lighting, it does look a little thin, especially the crown area and below.  That said, I no longer have any bald spots and I was able to find a style that works well for me and most people don’t even know I ever lost any hair.

All that to say, everybody is different as are their needs and goals. Whether or not you are content it will depend on what a skilled surgeon can  take from your donor hair and implant into the balding areas strategically and whether or not you’ll be satisfied with what can be accomplished.  At the end of the day, hair transplant surgery is about supply and demand.

While you’re donor hair supply will be substantially less than your demand for hair in the recipient area to restore a full head of hair, a skilled surgeon may be able to re-create a conservative looking hairline with some illusion of density behind it and enough coverage to satisfy your needs.  That said, you will need to consult with a couple of surgeons that you are impressed with and find out what can be done in your case and circumstances.

if you are interested in a no obligation information session, feel free to send me a private message and I can set up something for you with Dr. Rahal.  If you’re not familiar with Dr. Rahal‘s reputation on this forum, feel free to do a search to see what his patients are saying. Also, he is recommended by this community and a member of the this sites highest membership (the Coalition of Independent Hair Restoration Physicians).

Best wishes,

Rahal Hair Transplant

Thanks for the info. That's good to hear that I have some options and it's still worth it to consult with a doctor. Sure let me do some more research and I'll reach out.

[Bhumik Shah MD]

Your donor area appears to be sub optimal. Candidacy for surgery would depend on your expectations. Since you are open to hair loss medications, that is a good place to start whether or not you decide to pursue hair transplant.

[A_4_Archan]

@DavidD777 Seeing your donor pics it seems you are not a good candidate of HT ..all the factors related and affecting a HT outcome are against you...still if you really wanna go for it than you imo you can explore two options ...

-keep your expectations very reasonable and go for very very conservative approach and do a hairline plus mid scalp work and leave the crown as it is and wish the medication works on you

-another option which i would prefer if i were you is to fix a hairline (conservative) and spread the remaining grafts all over the scalp in some well planned manner and even use beard and chest grafts and even can do a bit of over harvesting of donor in a planned maner and than once you get full results do SMP and keep buzzed look....or if not full buzzed just keep your hairs very short(guard 2-3 )and thn can use hair fibres when required....

[Grouse]

It does seem weaker than most. That said, none of us are a doctor doing an in person consultation. 

 

I am confused how people are confidently asserting this donor is insufficient, when there are what I'd consider excellent results from even worse donors. See 2 examples below.

1. 

2.  

 

I'm still new, but I think either a) people are understimating what can be done with sub-optimal donors and beard hair or b) the results I posted above are total freaks of nature and exceptions to the rule of donor quality. 🤷

[Turkhair]

Scalp? Nah. Your donor is really bad.

Start finasteride and minoxidil and it should thicken it up.

Hows your body hair? If you’ve good body hair then you’re a good candidate for hair transplant 

[DavidD777]

@Grouse Thanks for the links. That's good to know. Yeah while my expectations are very much dampened, I am still planning to consult with a doctor for professional advice.

@Turkhair Southeast Asian here... my body is like a dolphin  hair is pretty much non-existent there. Yes already asked my doctor about renewing my finasteride RX. 

[mr_peanutbutter]

consider smp

we have expert on this topic on this forum like @hairthere

given that you have a relatively spare donor and very limited bodyhait it would be close to impossible to cover your whole head

 

you could however get a low density transplant and combine it with smp

 

here are a few example

 

 

Edited July 28, 2023 by mr_peanutbutter

[Grouse]

@DavidD777 did you hear back on your candidacy? Wishing you the best

[Melvin- Admin]

Your donor appears sparse. I think above all, you would have to keep your expectations in check.