Is 2000 or so grafts worthwhile for my crown? (pic)

[Joe HT]

I am very wary as to just when I'm going in for my next HT. I've been on rogaine and what I hope is finasteride (overseas, you know) after a single HT and I am happy with the gain. If my loss is stabilized well enough, I would like to add density to my crown area.

My gf says that's the biggest contributor to the 'bald' look of mine, and I agree and would like to add some density.

 

Is it worthwhile, with the possibility of shockloss and considering what a big area it is, to invest 1500-2500 follicles into this spot?

Should I go with less? More?

I'm only looking for 'improvement' there. I would rather keep my hair relatively short, as opposed to growing it out 3 inches.

 

If necessary, I'll take more pics, but for now, this:

 

 

Yeah, and I'd like to fill in the temples/hairline area, but the crown's more of a priority at the moment if I ultimately have to choose.

 

[Joe HT]

I am very wary as to just when I'm going in for my next HT. I've been on rogaine and what I hope is finasteride (overseas, you know) after a single HT and I am happy with the gain. If my loss is stabilized well enough, I would like to add density to my crown area.

My gf says that's the biggest contributor to the 'bald' look of mine, and I agree and would like to add some density.

 

Is it worthwhile, with the possibility of shockloss and considering what a big area it is, to invest 1500-2500 follicles into this spot?

Should I go with less? More?

I'm only looking for 'improvement' there. I would rather keep my hair relatively short, as opposed to growing it out 3 inches.

 

If necessary, I'll take more pics, but for now, this:

 

 

Yeah, and I'd like to fill in the temples/hairline area, but the crown's more of a priority at the moment if I ultimately have to choose.

 

[Joe HT]

If 1000 grafts makes for a good difference I'd be VERY pleased. Btw this would be my last strip procedure if I do it. And I have no plans on rushing the last 1-2 HT's at all, I consider it a long-term plan, so I am factoring in further hair loss.

[Big1]

I would not get another transplant if I were you. You don't look bald; you have a thin look (which is all most of us want). You look great. ALmost all men have a thinning crown. More surgery is a waste of money imo (unless your filling in the hairline). You will also lose hair from shock. A losing proposition if you ask me.

[Old Baldy]

Ditto what Big1 said. You don't need an HT IMHO.

[Joe HT]

Thanks for the replies. The issue for me is the number of grafts vs possible shock loss warranting a crown HT.

 

Also, I know I won't be able to spend too many follicles there, need future reserves.

[Big1]

It is possoble that you will experience shock loss. I don't know how much you will experience. Could be worth it or could not be.

[Ams99]

perhaps you should consider body hair for the crown at a later time. that is, if you have a hairy body like me.

[EastCoast]

Dr. Charles once said a crown can easily eat up 5k of grafts.

[Joe HT]

Dr. Charles once said a crown can easily eat up 5k of grafts.

 

Indeed that's easily believable, looking at the size of the area. My hope is that the propecia and rogaine come through. And I don't take them expecting regrowth, I take them expecting a near-halting or very effective slowdown of loss, so that the grafts I do get added in would be to contribute to density as opposed to being my only coverage in the next 10 or so years.

 

Sorta hoping the next decade brings advances in multiplying hairs, otherwise I'll be yankin' follicles outta everything from my chest to toes later on in life.

[Jeffrey Epstein MD, FACS]

Dear Joe- There are a number of reasons why I would seriously advise you against having any hair grafting to the crown region. Given the size of your crown region (which will only increase in size with age, unless you maintain an impressive response to Propecia) it would take a minimum of 1200 to 1500 grafts to achieve even a modest increase in the density to the area- assuming you have all 1 to 3 hair follicular unit grafts placed to the area- and these are grafts that you should "conserve" for work in the future along the more anterior regions of your scalp. The results of crown work are never as impressive as they are with further forwards work, likely due to both the actual large size of the crown area which is usually underestimated, as well as the fact that, if restored properly, a swirl pattern will result in the hairs growing away from each other, thus resulting in a thinner look for the amount of grafts expended.

 

This is the advice I give to all of my relatively young patients such as yourself. I use the anecdote- You know why camels smile all the time? It's because they cannot see their humps.

 

Enjoy what you have up front, and don't make a mistake that you will likely regret years in the future. Get real finasteride, to provide you with the best chance of maintaining your crown region hair.

 

Best ofluck.

 

Sincerely,

Jeffrey Epstein, MD, FACS

Miami, FL

www.foundhair.com

[carl kolchak]

Excellent post Dr.Epstein.I think it is only

natural for people to underestimate how much

hair they will lose in the crown.its rather

depressing to contemplate.

So most people have no idea how much hair

they will lose in the crown until they do.

 

What about Body Hair transplanted into the

crown??? this way you can keep the donor area

banked for the front

[Joe HT]

Well I only want 'improvement', with a bit left for overall frontal coverage (almost happy with my front already, I've shifted prioities to filling in the crown a bit).

 

Just enough to make the pattern a bit less obvious.

 

As for the comment about body hair, I *expect* to be migrating some of nature's little testosterone joke in just that manner, as I need. The thing is, I will only use head hair for the immediate hairline, and since bodyhair FUE would cost consideraly more, I'd rather make a larger job of the crown from a strip.

 

Call me odd, but the thought of more surgery interests and excites me silly. Especially going with body hair.

 

How big a problem is shock loss really, on the average? That's my main concern in all this, as it's not as easy to plan for as available hairs from the head and body.

[Kurly]

Hi Joe , Your pictures are VERY similar to my situation . I have curly/wavy hair with a good donor area but a sparce crown . I'm 43 and had about 1,000 HT's to fill in the crown about 10 years ago . Worked out ok until I lost the majority of my real original hair and now it looked thin again . My front hairline area is still pretty good with a little recesion at the temples which doesn't bother me . I generally pull my hair back when combing and the curly hair hid the crown pretty good but I agree completely that it's easy to under estimate how really thin it is until you get a good view of the area under light and move the combed over hair away . So I decided to go for an agressive session and got an additional 2,600 to fill in the entire crown area, roughly a 5" round circumference. I figure If I ever need any in the front in the future I may be able to squeeze out 1 more strip , if not I can go with FUE and take from the sides , if that's no good I have plenty of chest hair . If that's no good I figure maybe some new methods will crop up to save me 5-10 years from now IF i even need another one . I figured it's best to get the max quantity out of the strip as you can , after all it's not like you can get an unlimited amount of strips. So I decided my crown will be permantly fixed and I'm gambling that I made it to 43 with the front hanging in there so for me I think it was a good choice . Also being that I allready had a strip scar and a fine one at that , it was a no brainer to go with a strip for the 2nd one . I used Dr. Feller and it's only been 2 weeks so the results obviously will take some time but I have no regrets whatsoever on my choice . Let me know if the link works if not I can send you pics if you want, good luck whatever you decide .

 

http://www.imagestation.com/album/?id=2430485093

[Reverse the Curse]

Kurley,

i tried to look at your pics but it says i need a password. i am looking at dr feller & would like some feedback.

thanks

[Kurly]

RTC I tried to take the password out , hopefully it works now .

[Reverse the Curse]

thanks got to site with no problem. am i correct that you will have a total of 3600 grafts in 5 inch circle at crown? i will need 3000 grafts in first session & only have between 6000 & 7500 available. what did it cost for your 2600 grafts. someone on this site said close to $4750 for 2100 grafts (second surgery with dr feller)

[Reverse the Curse]

balloonman,

what happened to your post on dr feller. please resend again as i never had anyone saying bad things about dr feller

[Kurly]

thanks got to site with no problem. am i correct that you will have a total of 3600 grafts in 5 inch circle at crown? i will need 3000 grafts in first session & only have between 6000 & 7500 available. what did it cost for your 2600 grafts. someone on this site said close to $4750 for 2100 grafts (second surgery with dr feller)

 

Glad the link works now . Yes the pictures you saw are my 2nd transplant I just had done Nov 29th with Dr Feller . I had about 1,000 done in the crown area about 10 years ago so all together I have about 3,600 in that circular crown area . I think it's safe to say I won't be doing any more HT's in that area again !

[Reverse the Curse]

kurley,

no one seems to want to talk cost, could you let me know past & present cost of surgery?

thanks

[Kurly]

kurley,

no one seems to want to talk cost, could you let me know past & present cost of surgery?

thanks

 

I paid $8,350 for 2,500 grafts.The fees are listed on his website http://fellermedical.com/Fees_Financing.htm

 

I'll let you know in the summer if I think it was money well spent! I'll be taking pictures as things progress. I don't remember how much I paid for the 1st one.

[Bill - Seemiller]

Joe,

 

I think your hair looks fine the way it is. The crown is a little thin, but not noticable at all. In fact, if I were you, I would just grow your hair out a bit, and one wouldn't even be able to tell you are thinning there. Just an opinion, but if you are going to keep your hair that short, why worry about having hair at all or going through HTs? If I wanted my hair that short, I would go bald happily and naturally and save my money! But you have a good head of hair on you since your surgery. Grow it out just a little bit and wear it proud!!!

 

Bill

[paris_caine]

Dr. Epstein, you mentioned you dissuade your younger patients from getting crown work done. i am curious, how young is young? what other factors determine your decision?

i think that crown work is as important as the front. essentially, if you have a bald crown, you still look at yourself as "bald", which sorta defeats the purpose of HT. Just my opinion. would appreciate your views further elaborated, if you can.

 

thanks

 

paris.

[HairSeeker2]

I had 3 surgeries with dr Charles and none of them were front work.He was able to make the bald crown appear thin. I had 2 great surgeries with Dr Nusbaum many years ago and am pleased with front.

Dr Charles was realistic with his opinion on the result where he never promised full density but more like a cover up.

[Smoothy]

2000 fu is a lot for crown considering your youth-- if you were in your 40's it might be fine but using that many fu that you might need later, might not be a good idea. Your pics, looks like you dont need that many anyway. I would guess 1000 would give good coverage with what you currently have, then you still preserve some donor in the future if you need it.