Is hair transplant an option for me? Using a hair system at the moment...

[Ccd99]

Hi all,

I have been a long time lurker of this forum and it's inspiring to see so many positive hair transplant results.

I am 32 years of age and I started losing hair when I was 21/22, unfortunately I have one of those faces that just does not suit a bald look.

So, I went into a phase where I started using hair fibres/concealer and I then transitioned to wearing a hair system since age of 26. As you can see in my photos, I am a diffuse thinner. I've always said to myself that after I hit 30 I would probably get a hair transplant.

My plan is to start reaching out for consultations with doctors, my budget is around 13000/14000 USD but in the meanwhile I thought I'll post up my photos to see what the community thinks of my hair loss?

I would say I am a Norwood 6, and probably need a minimum of 5000/6000 grafts to cover the front and top, crown will probably need to be a separate session. What do you guys think?

I am not sure how my donor hair is either, I've always had strong back and side hair when I was younger and it usually grows in really fast. These days I go for a short fade so I haven't really grown it out in a long time but I hope it will be adequate!

Lastly, I decided to start on meds too to help thicken my existing hair, I will be taking 2.5mg oral min and 0.5mg oral dutasteride starting tomorrow (I tried 1mg finasteride for around 2/3 years in the past, with luckily no side effects but I don't think it did too much for me so I stopped when I started wearing a hair system).

PS: Some of the photos below are a mixture of where the top of my head is trimmed down to a zero, and some where my hair has been growing for about 3 weeks just prior to being trimmed at the hair system salon. The redness you can see is just the outline of the hair system. Also I probably have a bit more hair around the crown and edges but they have been trimmed for the hair system.

I look forward to hearing your input!

Edited July 26, 2023 by Ccd99

[A_4_Archan]

@Ccd99 It seems from the pics that You have a big head and you will require more than 7k grafts but your donor looks decent and not that bad and even from one of your pics your beard looks great and when someone has high grade of baldness and planning to go for a HT beard plays an important role and can give lots of grafts....good that you have started medication which can help to recover your crown and some of those miniaturized hairs on midscalp and will also make your donor strong...

In that budget i would advise you to consult eugenix clinic which is consistently producing good results in high norwood cases....i hope this helps you ...best of luck...

[Z--]

I have the same pattern of loss as you - though you're more diffused. I'd do this over two or three surgeries of 3k grafts each. Start with your hairline/midscalp and move backward. You may never get full coverage, but if you opt for a conservative hairline, I think you can get a pretty good look. Def consult with elite doctors; you can't afford to waste precious grafts from a botch job.

At the budget you've got, check out some European doctors like Pinto or Hattingen. Alternatively Laorwong is quite good and reasonably priced.

[Ccd99]

Thank you both, your input is much appreciated!

I agree I do have a large head lol @A_4_Archan, my beard hair has always been strong so hopefully I can use that in my favour. I am optimistic about starting meds and hope to see some improvement on my existing hair which would then hopefully mean I require less grafts.

7k is a lot and I agree 2 sessions of 3k/3.5k make more sense rather than a "giga session" of 6/7k.

I have heard good things about Eugenix so will check them out as well as the European doctors you mentioned @Z--

I will document my journey on this forum, I am hoping to have a surgery done in the next 9-12 months (want to give it sometime for research and the meds to take some effect).

Edited July 26, 2023 by Ccd99

[Ccd99]

I have enquired with a few clinics, just waiting to hear back, in the meanwhile ASSUMING I can get some of the miniaturized hair on mid-scalp to re-thicken using meds over the next 9-12 months, what do you guys think of following?

For crown area I am thinking I could augment it with beard hair to reduce the hit on my back/side donor area. I think I have enough donor hair for 4000/5000 grafts but I'll let a doctor confirm that.

[Ccd99]

Okay I think my graft numbers are definitely wrong there, crown will require more as its not easy to fill it due to different directions of the hair, and maybe 3500 for front is a bit excessive? Anyhow I am just thinking out loud here! Look forward to hearing back from the doctors.

[Al - Moderator]

You have a lot of thin hair all over the top of your head that has been covered under the hair piece for a long time, so I think with meds you may get a good bit of growth all over. That would really help with having the hair transplant. Your donor area doesn't look too bad and it looks like you have a lot of beard hair that can be used.

 

Edited July 28, 2023 by BeHappy

[LaserCaps]

I agree with your assessment. One thing to keep in mind, grafts can never compete with the density of a system.  That being said, let me give you my 5 cents, hopefully it helps you with your approach.  

Glad to hear you're on a regimen to help you with retention of the native hair.  It's likely the reason why you've kept as much as you have.  You may want to incorporate PRP and Laser.  When done correctly, these can help reverse miniaturization.  (The mechanism of action of each modality is totally different and there's synergism when combined). 

Donor limitation often guides us.  There's typically not enough to allow for density throughout the entire pattern.  It's for this reason most ethical doctors will concentrate their efforts, at least initially, to the front and the area right behind the front as these are the most prominent.  Allow the meds to do their thing towards the back, where they tend to be the most effective.  Have the doctor work horizontally on the pattern in U fashion.  The farther back he can go, the smaller the size of the crown.  

The crown is the weakest point we all share due to the whirl.  It's the point from which the hair stems.  There's no shingling of any kind as no hair is coming into the area. Rather, the hair grows away from the point.  It would take many procedures and many grafts to fill the area.  But let's also address this in a much simplistic way. 

Think of the crown as a circle.  You fill it.  Because you've shown the propensity to lose, you'll continue losing.  You go on to lose all the hair around the island worth of hair.  You've now created a target area and an unnatural pattern.  Retention of the native hair is imperative. So, when is the right time to do a crown?  When you're content with the front and you confirm the meds are working.  Having hair in the front will always serve you well.  It'll help frame your face and give you styling options.  If you're going to be thin, be thin in the crown. 

Lastly be pattern appropriate.  An advance pattern would never have a hairline in the middle of the forehead. 

 

[Silent123]

Hey man, your donor hair looks very strong. You could look into a FUT and FUE combination surgery. It might be possible with just a few FUE surgeries. 

[Ccd99]

On 7/28/2023 at 12:55 PM, BeHappy said:

You have a lot of thin hair all over the top of your head that has been covered under the hair piece for a long time, so I think with meds you may get a good bit of growth all over. That would really help with having the hair transplant. Your donor area doesn't look too bad and it looks like you have a lot of beard hair that can be used.

 

Thank you, I appreciate the positive words! I hope you are right, I am really banking on the meds doing its thing over the next 6 months and then I will re-assess. In the meanwhile I am shortlisting clinics and obtaining consultations. I am pretty happy with my beard hair, it's always been quite dense so I am more than happy to sacrifice some of that for the HT.

 

On 7/28/2023 at 2:36 PM, LaserCaps said:

I agree with your assessment. One thing to keep in mind, grafts can never compete with the density of a system.  That being said, let me give you my 5 cents, hopefully it helps you with your approach.  

Glad to hear you're on a regimen to help you with retention of the native hair.  It's likely the reason why you've kept as much as you have.  You may want to incorporate PRP and Laser.  When done correctly, these can help reverse miniaturization.  (The mechanism of action of each modality is totally different and there's synergism when combined). 

Donor limitation often guides us.  There's typically not enough to allow for density throughout the entire pattern.  It's for this reason most ethical doctors will concentrate their efforts, at least initially, to the front and the area right behind the front as these are the most prominent.  Allow the meds to do their thing towards the back, where they tend to be the most effective.  Have the doctor work horizontally on the pattern in U fashion.  The farther back he can go, the smaller the size of the crown.  

The crown is the weakest point we all share due to the whirl.  It's the point from which the hair stems.  There's no shingling of any kind as no hair is coming into the area. Rather, the hair grows away from the point.  It would take many procedures and many grafts to fill the area.  But let's also address this in a much simplistic way. 

Think of the crown as a circle.  You fill it.  Because you've shown the propensity to lose, you'll continue losing.  You go on to lose all the hair around the island worth of hair.  You've now created a target area and an unnatural pattern.  Retention of the native hair is imperative. So, when is the right time to do a crown?  When you're content with the front and you confirm the meds are working.  Having hair in the front will always serve you well.  It'll help frame your face and give you styling options.  If you're going to be thin, be thin in the crown. 

Lastly be pattern appropriate.  An advance pattern would never have a hairline in the middle of the forehead. 

 

Thank you for your professional input. I am completely aware that a HT will never match the density of a hair system. In all fairness I tend to go for a very light density hair system as it looks unnatural otherwise. In fact I would be more than happy to have some bald/see through patches on my scalp as that is more natural.

Good to know regarding synergy with PRP, Laser and meds. I've only just started meds (day 3 at the moment) so I hope I can yield some positive results over the next few months. I know most clinics will include a PRP session part of the package so I will make use of that.

 

On 7/28/2023 at 10:18 PM, Silent123 said:

Hey man, your donor hair looks very strong. You could look into a FUT and FUE combination surgery. It might be possible with just a few FUE surgeries. 

Thank you! I do feel positive about my donor hair too.

I am a bit scared of FUT, seen some photos of scars that never quite healed up. I like to wear my back and sides hair quite short as I go for a fade usually, so my preference is FUE or DHI. DHI will probably require 3/4 surgeries, but I hope I can get the job done with 2 FUE (front - mid scalp 1st session, and mid scalp - crown 2nd session) - I am realistic and not expecting 100% full coverage. After 2 surgeries I can then re-assess and see if I need more depending on donor hair etc.

Edited July 30, 2023 by Ccd99

[Ccd99]

I found some old photos from about 1 or 2 years before I started wearing a hair system - these photos are from 2015 (I started wearing in 2017). This was when I was actively taking Fin for about 1 year. 

Looking back I wish I went for a HT instead, my crown/back of scalp are still in a great state IMO, and I would have just needed to address the front to mid-scalp area. When I did start wearing I went for a front partial piece only, but it was hard to blend that in well so over time I just transitioned to a full top piece instead even though I had natural hair available at the crown still.

In these pictures my hair is wet and before I have applied any hair fibres/concealer

 

Edited July 30, 2023 by Ccd99

[Ccd99]

Been doing some maths, and tried to measure the surface area of the top of my scalp:

#

Using area of an oval as an equation to approximate the surface area, this works out to be 224 cm^2. Now obviously I have still some hair at top and if the meds can do the job then I am going to assume the area that need to be covered is 80% of 224 cm^2 (being conservative and assuming I have about 20% coverage there once meds kick in) which is exactly 180cm^2

From what I read online FUE density will vary somewhere between 35 to 55 grafts per 1 cm^2 (typically more at hair line, and less as you go back). So let's say on average I get a HT with 40 grafts per square cm. This means I would need 180 * 40 grafts = 7200 grafts for full coverage.

That honestly does not sound so bad? Split over 2 surgeries of 3600 grafts each seems doable? Provided donor hair/beard hair can support of course.

Any thoughts from the community?

Edited July 30, 2023 by Ccd99

[Ccd99]

After spending the last week going through reviews on the forum and also consulting with various hair transplant clinics, I've got back the following consultations so far:

• Dr Gur (2 surgeries, 1st surgery consisting of 3500 grafts but would be a conservative NW3 hairline)
• Dr Turan (mentioned I have great donor hair (from photos easily 6000+, and strong beard hair) but wanted me to wait 9 months to re-assess after meds take effect - very ethical of him!)
• Dr Yaman Rasul (6000 grafts over 2 days)
• Dr Bicer (2 surgeries, 1st surgery consisting of 4000 grafts to reconstruct hairline up to mid-scalp, 2nd surgery 8 months later to address mid-scalp to crown, as many grafts as donor allows)
• Dr Koray Erdogan, ASMED (5000 grafts over 2 days)
• Dr. Bruno Ferreira (on the waitlist for consultation, all consultations booked for 2023)
• Dr. Rafael De Freitas (awaiting consultation report)

What do you guys think? Dr Ferreira, Dr Bicer, and Dr Turan are my top choices

I am looking to book something for March/April next year, I want to give it 6-9 months so that the meds (dut, minoxidil, biotin) can take effect. I also plan on scheduling some PRP sessions to promote re-growth.

@Melvin- Moderator is there any way to move this thread to the Hair Restoration Questions and Answers forum? I think I posted this in the wrong place and there is not much activity in here

Edited August 6, 2023 by Ccd99

[Ccd99]

I've gone ahead and booked myself in with Dr. Bicer for March next year! I like how she just does 1 patient per day, and I seen some good success stories from her. Of course not everyone achieves 100% success but such is life - hopefully I can get a reasonable result.

The plan is to harvest approx. 4000 grafts and cover the frontal region + half of the mid-scalp. I am low-key hoping she will do more grafts on the day according to my donor situation (I seen that in some cases she has done 4500 in one day).

The second surgery will be (hopefully) late 2024 and will cover the remaining mid-scalp to crown area.

PS: Her price has just gone up to 3 EUR / graft as of 1st August. I was able to get the old price of 2.5 EUR / graft as I enquired prior to 1st of August.

Edited August 7, 2023 by Ccd99

[MildSeven]

You Had Good hair While on Finasteride in 201

i guess you are regret now to stop finasteride...

 

get back on meds bro

[Ccd99]

On 8/17/2023 at 7:12 PM, MildSeven said:

You Had Good hair While on Finasteride in 201

i guess you are regret now to stop finasteride...

 

get back on meds bro

Yes of course. I intentionally stopped because I started wearing a hair system. Of course hindsight I wish I kept on the meds but back then I was not as educated about hair loss as I am today.

Anyway I started meds again as of 3 weeks ago. I plan on sticking to meds from now on.

By the way, my pictures above look far worse than they really are due to the fact my head is fully shaven every 3 weeks when I clean and re-attach my hair system.

But I've now completely stopped shaving it, I plan on growing it out to see what it looks like. My hair is definitely miniaturised but it's not completely gone, I still have coverage everywhere midscalp to crown, it's just getting thinner... Hopefully the meds can re-thicken and revive the miniaturised hair and provide me with some coverage.

Here's a picture with about 4 weeks of growth, if you look closely you can see hair growing still:

There is some diffuse thinning though. Therefore I know I need at least 2 HT sessions. First 4000 grafts in March will be for hairline/front/mid-scalp and then a 2nd session to do the mid-scalp/crown.

I estimate I need about 7500 grafts. I have a consultation next week with a local hair transplant surgeon who will assess my scalp and donor hair using trichoscopy.

Edited August 19, 2023 by Ccd99

[MildSeven]

in 2015 - 2017 your hairline was still intact only some thinning around

and you didnt need any for your crown

 

if you were keep taking finasteride... i guess you only need around 2000 - 2500 graft maximum for your frontal area

 

good luck brother

keep update your medical progress, hopes it could improve your hair, and you need less graft later surgery

[Ccd99]

11 hours ago, MildSeven said:

in 2015 - 2017 your hairline was still intact only some thinning around

and you didnt need any for your crown

 

if you were keep taking finasteride... i guess you only need around 2000 - 2500 graft maximum for your frontal area

 

good luck brother

keep update your medical progress, hopes it could improve your hair, and you need less graft later surgery

Yep it's true, It would've definitely secured my mid - crown area and stabilised hair loss at front/hair line and probably only 2500 grafts like you said.

Hoping the meds make a difference, I'll keep updating this thread with progress, and once my 1st hair transplant takes place next year, I will document that too.

[Dillpickle123]

I think the meds will thicken the middle I think you should wait until the meds do their magic because you risk permanent shock loss if you do a transplant now plus that allows you to wait for doctors who have long waiting list since your gonna be on meds anyways no need to rush in 

[Ccd99]

5 hours ago, Dillpickle123 said:

I think the meds will thicken the middle I think you should wait until the meds do their magic because you risk permanent shock loss if you do a transplant now plus that allows you to wait for doctors who have long waiting list since your gonna be on meds anyways no need to rush in 

Thank you, I appreciate the input - yep the plan is to wait for meds to do their thing! I have booked in for surgery with Dr Bicer in March 2024 - that gives 6/7 months for the meds to start taking effect.

Do you think I should wait longer or is that a reasonable time frame?

[Dillpickle123]

15 hours ago, Ccd99 said:

Thank you, I appreciate the input - yep the plan is to wait for meds to do their thing! I have booked in for surgery with Dr Bicer in March 2024 - that gives 6/7 months for the meds to start taking effect.

Do you think I should wait longer or is that a reasonable time frame?

Honestly they said give it a year maybe add some propecia to it to make it faster 

[Gatsby]

On 8/20/2023 at 9:55 AM, Ccd99 said:

Here's a picture with about 4 weeks of growth, if you look closely you can see hair growing still:

I would give take the meds religiously and wait 'at least' one year and grow your hair out. You could also consider taking oral minoxidil. Then I would consider surgery.

[Ccd99]

8 hours ago, Dillpickle123 said:

Honestly they said give it a year maybe add some propecia to it to make it faster 

 

7 hours ago, Gatsby said:

I would give take the meds religiously and wait 'at least' one year and grow your hair out. You could also consider taking oral minoxidil. Then I would consider surgery.

Thank you both. I am currently on 0.5mg dutasteride + 2.5mg oral minoxidil - I was hoping I won't need to do a mixture of fin/dut but I will see how progress goes. In terms of oral minoxidil, I am already taking it but I may up the dose to 5mg later down the line.

Anyway I'll keep monitoring my progress and see how things go over the next 6 months and then decide based on progress if I should extend meds for another 6 months before surgery.

I'm also seeing a local hair transplant surgeon next week who can better advice on my current scalp condition and hair calibre.

Edited August 23, 2023 by Ccd99

[Ccd99]

Consultation went well. I was told I have about 5500/6000 safe grafts in my donor area. Hair calibre is average. The doctor recommends I stay on the medication for next 12 months and then come back in for a re-assessment. He also suggested increasing my minoxidil dose to 3.75 mg (2.5mg in the morning and 1.25mg at night).

He commented that my mid scalp area is actually very decent in terms of density (around 60 fu/cm^2) but it's just thin/miniaturized. But that is good because if I respond well to meds, then that could drastically reduce the amount of grafts I require.

His plan is to do a 2-day op around 4000 grafts, 2500 at front and 1500 at back and leave the rest for future. This is assuming my mid-scalp area will thicken up. If it does not, he will go for a slightly conservative hairline and reduce density on the crown and keep the remaining 1500 grafts for future use.

A bit torn on what I should do as I have already booked in with Dr. Bicer. I will be going ahead with Dr. Bicer but not sure if I should I wait the complete 12 months, or go ahead with surgery in March (around 9 months mark)... I think I will keep monitoring my progress over the next 3 months and then make a decision at year end depending on how things are looking.

Edited September 1, 2023 by Ccd99

[Ccd99]

Exactly 2 months on Dut & Oral Min and also letting my scalp hair grow for exactly 2 months, see photo below on what that looks like.

Mid-scalp has some density so will need less grafts there, curious to see how much the crown will recover from the meds.

My surgical plan is:

• 1st HT: 4000 grafts for frontal area & some of that for mid scalp too (booked with Dr Bicer for March 2024)
• 2nd HT: (depending on donor) around 2500 grafts to crown (utilise some beard grafts if necessary)

Do you guys think I can get an acceptable result? 

Edited September 25, 2023 by Ccd99