Asian: Should I get a HT?

[azn_guy]

Hey Everyone,

 

I've been an avid reader on the site and wanted to get everyone's opinion.

 

Just to give you all a little background. I'm asian, I started to lose my hair little by little starting at 24. You all will notice I still have hair, but the hair (the non horseshoe portion) doesnt grow long anymore while the horseshoe portion (the donor hair area) grows like crazy.

 

Obviously I'm asian so my density is better than most caucasians. I also know Asians have "less" hair in general, maybe around 80,000? But looks can be deceiving, because while some photos looks like I am not balding, there are other photos where you can easily tell I am.

 

I went to Dr. Koher in Raleigh Durham Area, and I also went to Dr. Cooley since many of you recommended him.

 

I am thinking of getting roughly 2500, or 3000 grafts. Both recommended roughly 1500-2500.

 

Any thoughts? I've attached several photos and you all can gauge. I'll try to put them in chronological order so you can see the progression.

 

I finally decided to post and help represent some of the asian race, you all seem very supportive and passionate about this, which is great

 

I'm going to start on Propecia (finasteride), and I'm starting to use Revita Shampoo for 8 months, then maybe beginning of 2010, I may get a HT, but I'm wondering if I should wait a tad longer to see if my hair progression increases in speed....

 

Please note the photos from age 23-29.

Also note the random photos from May 2008

 

I figured I would do all sorts of angles and shots to really show off the whole picture. It always helps

 

<link removed>

 

I know its a lot of photos, so I can be pretty obsessed...

[azn_guy]

I decided to add some photos from December 2006 also just for reference, the same URL will reflect the updated photos

[El Nino]

Hi AG,

 

I would recommend taking some more pics now in natural light with dry hair and no flash.

 

From the pics you look to be a NW 3 vertex. Is your hair loss stable now? What is your family history of hair loss?

 

Dr. Rahal has many patients who go to him from Korea, so many in fact he has a Tech from there who translates for him.

 

You should check him out along with the other top doctors.

[azn_guy]

Hey King Crown,

 

Yeah, I'll take some photos and post them later this week.

 

My Dad has one brother that is bald, and his sons are completely bald, but they have progressed really fast, so by the time they were 25, they were a norwood 5/6

 

My Mom's oldest brother is a norwood 6, he started in his late 20's and he's now in his 70's. She has 5 other brothers that are about a norwood 2-3 but they are all in their 60's. in their 30's they all had a full head of hair.

 

What is different from my uncles and me is while they may be in norwood 2-3, their hair grows long, they can do the whole "comb back" look like Al Pachino does. I cant do that (notice in my photos, the "front" just doesnt grow long)

 

King, When you ask about my hair being stable, I think the photos from December 2006 and March 2008 are practically the same... and that's a 2 year difference. So my answer would be 'yes', but then again, in a year my answer could be "no" because what if my hair loss dramatically speeds up (this is one of my concerns)

 

I feel at age 28, I am still "too young" to get a HT, but both doctors have said that I am not too young, anyone under 25 they must really "consider", but at 28, they have a good idea how my hairloss will progress.

[Abedogg]

Asian,

 

I think you would be a fine candidate to thicken up your hairline. But I would suspect you may see future loss, based on some of the diffused thinning seen in the photos. If you wanted to you could probably do a big session at H&W or Rahal and get it taken care of in one session.

 

If you aren't already, get on propecia and stay on it forever.

 

Abe

[azn_guy]

Hey Guys,

 

Thanks for the feedback. You'll notice that the photos I'm showing off here on the site is me with long hair.

 

Obviously with a buzz cut, you would classify me a Norwood 3 only

 

I actually got a buzz cut (clipper #2) about 3 weeks ago, my hair has grown back pretty quick.

 

Click on the URL again, and you'll see updated "May 2009" Photos

 

<link removed>

 

Abedogg, so you would think going with H&W and doing a megasession would be a good for me?

 

I was thinking of doing 3000 grafts to be initially aggressive, and maybe 15 years from now, do an additional 2000-2500 (if necessary)

[azn_guy]

Hey Guys,

 

Most HT surgeons usually do the "frontal 1/3 of the scalp" correct?

 

Well the distance from my hairline to my crown is pretty short, take a look at this link

 

measuring hairline to crown

 

If you notice, this patient from his crown to the hairline is about 20cm (8in), when I measure my head it's about 15cm (6in)

 

and if I take my hand and put it on my head, it almost covers the whole head (zone 1,2,3,4 if you reference the link above). The caucasian in the link, looks like he would only cover zone 1,2 & 3

 

it's like I have an extra zone for the HT surgeon to transplant hair, since I have a short head

 

I might be over-analyzing this =)

 

I mean, if 3000 grafts covers zones 1,2,3,4 for me, then I should be pretty well off

 

Both Dr. Koher and Dr Cooley did not have any hesitation when they looked at my scalp/hair, to them, it didnt seem like there would be any challenges.

[the B spot]

Hi AznGuy---I want to commend you on your excellent photos from all angles and different lengths.

 

With that said, I believe you should strongly consider either #1. Not doing a HT, or #2. Using FUE to target the areas behind your existing hairline and mid-scalp regions to provide density and coverage.

 

There is ALWAYS a chance for you to advance to a higher NW--In your case, given your age and level of thinning-- you look like you might go to a NW4-5...possible a 6 ---you would need to monitor your lateral humps (your sides) to see if they fall, etc... as you go forward.

 

With the amount of native hair you currently have, I would be against your doing a strip surgery at this time.

 

Your situation brings to the fore the battle between when to decide to go with strip or FUE.

 

Let me preface my following comments with this: Fue has been over-hyped, over-sold, and in many cases, under-delivered.

 

However, when approached and performed correctly, FUE represents an opportunity for some to forgo the necessity of a strip scar and still retain the ability to buzz down to a lower cut or if the level of baldness continues, either do more FUE or switch to strip.

 

Looking at your situation: 28, still retaining a nice hairline, thinning throughout the middle of the pattern, some concerns with temple recession and losing the laterals---doing 2000-2500 grafts will likely only "hold the fort down" for the immediate future.

 

There is no forecasting science, only a well-educated approximation of where you might end up.

 

In your case, getting on Propecia, waiting 6 months to see where your hairloss goes, doing research on methods, making an informed decision is your best bet.

 

My personal opinion is that you look great now, get on Propecia, rock that buzz cut, and add some concealer like Dermatch or Nanogen (just a little!) to make your hair look thicker--forget about the HT for now.

 

Please ask as many questions as you like.

 

Take Care,

Jason

[azn_guy]

what do you mean by

 

"you would need to monitor your lateral humps (your sides) to see if they fall, etc... as you go forward. "

 

I think you may be referring to the

May 2009: Side Shot

and

May 2009: Right Side Shot

 

correct? Just to let you guys know, the "hair" which is pretty fine, is starting to fade, while the left side is fine.

 

<link removed>

 

<link removed>

 

the "hair" between the temples and my side burns. sorry I dont know the terminology... =)

[Bill - Seemiller]

Azn_guy,

 

Welcome to our forum community.

 

In my opinion, you should hold off on considering hair transplant surgery altogether and consider getting on Propecia as soon as possible. I'd also suggest considering using Rogaine in addition to Propecia.

 

Given your minimal degree of hair loss, you should definitely consider using these medications for a year to see if you are a good responder.

 

Later, you can consider a hair transplant. I'll save the strip verses FUE debate for another time. :-)

 

Best wishes,

 

Bill

[azn_guy]

Hey Guys,

 

Just to give you some information.

 

I tried Minoxidil Foam (aka Rogaine) back in 2006 and it irritated my scalp, so I stopped using it.

 

I was on Propecia (finasteride) from September 2006 to September 2007 and I decided to stop. To be honest I was expecting hairloss to happen after I got off Finasteride, but to be honest my hair shed was minimal...

 

Just FYI

 

I might get back onto Propecia/Proscar soon and see what happens...

 

So I see most of you recommend me to not get a HT , I obviously know I'm going to lose more but from "conceptual" perspective, why not get one now, then in 15 years, I'll be back to where I am "now", at least I can enjoy having a head of hair from age 28 until 43?

 

Now if I wait until I'm 43 and get one, pretty much I've gone through my whole 30's thinking about my hair rather than going off and having "the time of my life"

 

Any thoughts?

[why oh why]

try the foam this time... maybe it won't irritate, unless that's what you were doing the first time around (rogaine)... then, if that, carry on...

[Bill - Seemiller]

Azn_Guy,

 

I encourage you to re-read my post which should answer why I advise you to wait to get a hair transplant.

 

If you are indeed a good responder to Propecia, your hair loss may stop and your hair may thicken. Thus, you may not feel that you need a hair transplant anymore.

 

In my opinion, since you're getting on Propecia anyway, give it a year to see how it works for you.

 

Best wishes,

 

Bill

[El Nino]

Hi azn_guy,

 

After looking at your recent pics I agree with Bill and you should use the Meds for a year.

[greenmud]

Hey azn_guy,

 

Why did you stop propecia? Did you experience any sides from it?

[azn_guy]

Bill/KingCrown, I'll take your suggestions and try propecia one more time for a year and see how it works.

 

Greenmud, I stopped because I wanted to test the "getting off" the meds. I did a lot of research on finasteride and many folks mentioned that waiting a year is where you should see "results" meaning either stop of hairloss or a little bit of regrowth. A lot of folks also said when they stopped, they ended up returning back to their original hair situation prior to taking finasteride.

 

I wanted to see how my hair would fair after getting off the drug. At first I was worried that I would shed like crazy, but I realized I didnt shed at all.

 

I did a little experiment and it worked out to my favor, in a sense that my hair was stronger than I thought (if that makes any sense)

 

I'm going get back on finasteride for a second time for a year and lets see how I fair.

 

I'll probably continue to add photos each month and we'll see how good Finasteride is and I'll get your opinions in a year

 

One thing I want to ask and it may have already been answered.

 

Who on this site has had a Hair Transplant and is NOT taking Finasteride and everything seems to be completely fine? The reason I ask is lets say by "chance" my hairloss stops at NW4 (I'm obviously being optimistic, hehe), and I get roughly 3000 grafts in the frontal 1/3

 

All I needed was a HT and if I stop at NW4, I may never have to take Finasteride for the rest of my life.

 

Haha, I'm being very optimistic. But of course it could be the complete opposite and I end up being a NW7....you never know...

[azn_guy]

oh, and one more thing, no side effects with the drug.

[hdude46]

asian's typically have LESS density than caucasians....thats why strip surgery is hard for patients like these. there is a blurb about that in the visits to other clinics session where they observed an asian gett a ht.

[hdude46]

from rahal's clinic visit:

 

"On the day of my visit the patient of the day was from Korea. He had lower than average density and the vast majority of his follicular units were one and two hairs, as is typical with many Asian patients. Thus despite taking a fairly wide and long strip he only yielded just under 3,000 grafts."

[azn_guy]

hdude, I agree with you and always noticed that in terms of FU's, there are usually 1 or 2, and possibly 3

 

But I was also told that asian hair tends to be "thicker" than most caucasians

 

so while a caucasian may need 3-4 hairs to make something appear, asians only need 1-2, correct me if I'm wrong...

 

One thing that has always been on my mind is the strip scar itself, have you all noticed that when an asian buzzes his hair the angle of the hair is straight up? it's not flat like most caucasians, you know this because if an asian buzzes his hair, it's much easier to see the scalp.

 

I've been a big fan of latinlotus because I know he's asian and he's shown me a few photos and his scar is pretty minimal and hidden.

 

Also, this brings up the question, obviously there are some folks on here that have tremendously a lot of donor hair. eg: Bill =)

 

But how many grafts on average does an asian have? The HT doctors I went to gave me different estimates, one said 5000, the other said close to 9000-10000

[azn_guy]

I found this article from Dr. Cole's site about caucasian hair versus korean hair

 

Hair Mapping

 

it's really gibberish to me. Anyone care to summarize? =)