Regular Member austx Posted November 13, 2023 Regular Member Share Posted November 13, 2023 Hi, thank you for the help this community is providing. Im from Texas, US. Im looking to get hair transplant. Never used any medicines before. My front hairline is receding but Im mostly concerned about crown are. Not sure what norwood stage I'll fall into. Heard crown transplants are not as successful as other areas. Please suggest a good surgeon. TIA. Link to comment Share on other sites More sharing options...
Senior Member GoliGoliGoli Posted November 13, 2023 Senior Member Share Posted November 13, 2023 Your hair loss pattern is very similar to mine. I think it's reasonable to expect you will end up somewhere between norwood 4 and norwood 6. How old are you? You should at the very least jump on topical minoxidil. This is the bare minimum of medication you should be on before considering a HT. As for Dr's, I would look at Dr Nader since he is very close to Texas and has great results for a reasonable price point. Link to comment Share on other sites More sharing options...
Senior Member LaserCaps Posted November 13, 2023 Senior Member Share Posted November 13, 2023 Review the Norwood chart and notice the progression. As patterns advance a number of things happen. The hairline recedes. The corners become deeply recessed. The crown begins to expand. When you get to a class 5, the only thing left is a bridge. When that's gone you're a 6. The donor then dips and you've arrived at a 7. What's your family history like? Are there males with very advanced patterns? Donor limitation often drives this industry, particularly when dealing with an advanced pattern. There's typically not enough to allow for density in the front, top and crown. It's for this reason most doctors will suggest working the frontal area first. It's the area you see when you look at yourself. It's also the area others see when they interact with you. Now the crown and the reason for your post. In the most basic of concepts, I'd like you to think of the crown as a circular area. You fill it. Because you've shown the propensity to lose, you'll continue losing. You go on to lose all the native hair around the island of permanent hair and now you've created a target area and an unnatural pattern. Retention of the native hair is imperative. Also consider the whirl. The crown is the weakest point we all share due to the whirl. It's the point from which the hair stems. That is, no hair is coming into the area to provide any sort of shingling. The hair grows away from the point exposing the area. It would take many, many procedures and many grafts to achieve density. We refer to this area as the black hole of hair restoration. The crown can eat all your donor. If you ever lose the front, you'll have nothing to work with and still look bald. I can almost hear you ask "why did you put all my donor in the crown when I now have nothing left for the front and still look bald?" Remember, it's the front people see when they converse with you. Propecia and Rogaine are considered to be the best meds for retention in the crown. The problem, is a year later when people see no visual change. Most do not understand, the meds are not intended for you to grow anything. They're to keep you from losing more. If you look the same a year later, the meds did what they were intended to do. (A small percentage do get to enhance the native hair. A very small percentage similarly, do not respond to the treatment). Research PRP and Laser. When done correctly, these can help reverse miniaturization. If the crown is the main priority, I'd be one to do all modalities and give them a year. You still have a lot of miniaturized hairs that have not left the building. These could possible enhance which, in the end, would add density to whatever you end up doing. And, if they're successful, it's critical you continue the regimen. If you stop, not only will you go on to lose what you would have lost had you not been on the meds, you'll resume losing hair. Patient Consultant for Dr. Arocha at Arocha Hair Restoration. I am not a medical professional and my comments should not be taken as medical advice. All opinions and views shared are my own. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 13, 2023 Author Regular Member Share Posted November 13, 2023 1 hour ago, GoliGoliGoli said: Your hair loss pattern is very similar to mine. I think it's reasonable to expect you will end up somewhere between norwood 4 and norwood 6. How old are you? You should at the very least jump on topical minoxidil. This is the bare minimum of medication you should be on before considering a HT. As for Dr's, I would look at Dr Nader since he is very close to Texas and has great results for a reasonable price point. Thank you. Im 45 yrs old. How many grafts do you expect to implant for HT. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 13, 2023 Author Regular Member Share Posted November 13, 2023 53 minutes ago, LaserCaps said: Review the Norwood chart and notice the progression. As patterns advance a number of things happen. The hairline recedes. The corners become deeply recessed. The crown begins to expand. When you get to a class 5, the only thing left is a bridge. When that's gone you're a 6. The donor then dips and you've arrived at a 7. What's your family history like? Are there males with very advanced patterns? Donor limitation often drives this industry, particularly when dealing with an advanced pattern. There's typically not enough to allow for density in the front, top and crown. It's for this reason most doctors will suggest working the frontal area first. It's the area you see when you look at yourself. It's also the area others see when they interact with you. Now the crown and the reason for your post. In the most basic of concepts, I'd like you to think of the crown as a circular area. You fill it. Because you've shown the propensity to lose, you'll continue losing. You go on to lose all the native hair around the island of permanent hair and now you've created a target area and an unnatural pattern. Retention of the native hair is imperative. Also consider the whirl. The crown is the weakest point we all share due to the whirl. It's the point from which the hair stems. That is, no hair is coming into the area to provide any sort of shingling. The hair grows away from the point exposing the area. It would take many, many procedures and many grafts to achieve density. We refer to this area as the black hole of hair restoration. The crown can eat all your donor. If you ever lose the front, you'll have nothing to work with and still look bald. I can almost hear you ask "why did you put all my donor in the crown when I now have nothing left for the front and still look bald?" Remember, it's the front people see when they converse with you. Propecia and Rogaine are considered to be the best meds for retention in the crown. The problem, is a year later when people see no visual change. Most do not understand, the meds are not intended for you to grow anything. They're to keep you from losing more. If you look the same a year later, the meds did what they were intended to do. (A small percentage do get to enhance the native hair. A very small percentage similarly, do not respond to the treatment). Research PRP and Laser. When done correctly, these can help reverse miniaturization. If the crown is the main priority, I'd be one to do all modalities and give them a year. You still have a lot of miniaturized hairs that have not left the building. These could possible enhance which, in the end, would add density to whatever you end up doing. And, if they're successful, it's critical you continue the regimen. If you stop, not only will you go on to lose what you would have lost had you not been on the meds, you'll resume losing hair. My dad is bald but he turned bald around his late 50s. I was thinking if I fix my crown and went on medications my front recession may stop due to the medications. But what you said makes sense. Link to comment Share on other sites More sharing options...
Senior Member Shadman Posted November 13, 2023 Senior Member Share Posted November 13, 2023 (edited) 3 hours ago, austx said: Hi, thank you for the help this community is providing. Im from Texas, US. Im looking to get hair transplant. Never used any medicines before. My front hairline is receding but Im mostly concerned about crown are. Not sure what norwood stage I'll fall into. Heard crown transplants are not as successful as other areas. Please suggest a good surgeon. TIA. Crown transplants are definitely successful only if you proceed with a good surgeon. In my opinion, you can consider Eugenix. I've seen some of their good crown work. Edited November 13, 2023 by Shadman 1 𝐄𝐮𝐠𝐞𝐧𝐢𝐱 / 𝐃𝐫. 𝐒𝐨𝐦𝐞𝐬𝐡 / 𝟏𝟖𝟎𝟑𝐆𝐫𝐚𝐟𝐭𝐬 / 𝐉𝐮𝐧𝐞 𝟐𝟎𝟐𝟑 / 𝐁𝐚𝐝 𝐇𝐚𝐢𝐫 𝐓𝐫𝐚𝐧𝐬𝐩𝐥𝐚𝐧𝐭 𝐑𝐞𝐩𝐚𝐢𝐫𝐞𝐝 Link to comment Share on other sites More sharing options...
Regular Member jjalay Posted November 14, 2023 Regular Member Share Posted November 14, 2023 In your case before jumping into surgery i would consider medication first. Oral finasteride or topical finasteride or topical minoxidil for the crown area may help. After that adding some concealer to the crown may do the job, in such level were you wont need a hairtransplant at ths point. Your case is difficult because if you get a ht now your hairloss at the crown after a couple of years may proceed and in that case you will need more hts to cover the lost ground. Link to comment Share on other sites More sharing options...
Regular Member hairsave2021 Posted November 14, 2023 Regular Member Share Posted November 14, 2023 (edited) 1 hour ago, jjalay said: In your case before jumping into surgery i would consider medication first. Oral finasteride or topical finasteride or topical minoxidil for the crown area may help. After that adding some concealer to the crown may do the job, in such level were you wont need a hairtransplant at ths point. Your case is difficult because if you get a ht now your hairloss at the crown after a couple of years may proceed and in that case you will need more hts to cover the lost ground. He is 45. His case is not difficult and if he can't do a hair transplant then no one can. Edited November 14, 2023 by hairsave2021 Link to comment Share on other sites More sharing options...
Regular Member jjalay Posted November 14, 2023 Regular Member Share Posted November 14, 2023 2 minutes ago, hairsave2021 said: He is 45. His case is not difficult and if he can't do a hair transplant then no one can. The concern that i have is he is only bald in the crown. If it progresses more after ht he will be left with an inseln of hair in centre and balding all around it. Otherwise yeah a ht with is hair is not a problem. Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted November 14, 2023 Valued Contributor Share Posted November 14, 2023 I would definitely recommend medication for a year to see how it stabilizes your crown. After then only would I consider surgery. All the best! GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Regular Member hairsave2021 Posted November 14, 2023 Regular Member Share Posted November 14, 2023 (edited) 14 minutes ago, jjalay said: The concern that i have is he is only bald in the crown. If it progresses more after ht he will be left with an inseln of hair in centre and balding all around it. Otherwise yeah a ht with is hair is not a problem. If it progresses more without a HT he still will need a HT. My point is that there are people who are NW 3-5 and are above 40, and they would probably be better of if they do a HT than experiment with medications. Unless of course you want to get a George Clooney type of hair into your grave then sure wait until 65. Edited November 14, 2023 by hairsave2021 Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 14, 2023 Author Regular Member Share Posted November 14, 2023 6 hours ago, jjalay said: The concern that i have is he is only bald in the crown. If it progresses more after ht he will be left with an inseln of hair in centre and balding all around it. Otherwise yeah a ht with is hair is not a problem. I see what you are saying but this problem occurs to anyone who had HT, right? Just trying to understand how is HT a concern in my case. I can try medications for a year(not sure how many are successful). If this did not work I'll be in much worst case from now. Thats why I was thinking of HT now. Please weigh in. Link to comment Share on other sites More sharing options...
Rahal Hair Transplant Posted November 14, 2023 Share Posted November 14, 2023 @austx, Based on your current hair loss pattern and your age, you seem like a good candidate for surgical hair restoration. And while using finasteride will likely help you maintain your existing hair, or at the very least slow down the progression of male pattern, baldness, given the specifics, you’ve shared, I personally don’t feel that you would need to wait a year to proceed with surgery. Here’s why. Ultimately, while there are some miniaturizing hairs left in the crown, realistically using finasteride or minoxidil isn’t going to regrow all your hair in the crown. At best, some of the miniaturizing hairs may thicken up a bit and while I’m certainly an advocate of using medication in conjunction with surgical hair restoration to maximize results, whether or not you wait a full year or not before surgery won’t likely produce a night and day difference. Besides, most reputable surgeons possess a 6 month plus waiting list which would be plenty of time for any medication you decide to start taking to begin doing its job. At 45 years old and your current hair loss pattern, it’s unlikely you will develop an advanced Norwood class level of hair loss, especially if you start finasteride and you are a good responder. Just be sure to consult a physician before taking any medication. If you are interested in a no obligation, information session with Dr. Rahal, feel free to send me a private message, and I’ll be happy to set this up for you. This will give you much more precise idea of what can be accomplished in terms of results, number of grafts, etc. Best wishes, Patient Advocate - Rahal Hair Transplant Rahal Hair Transplant Institute - Answers to questions, posts or any comments from this account should not be taken or construed as medical advice. All comments are the personal opinions of the poster. Dr. Rahal is a member of the Coalition of Independent of Hair Restoration Physicians. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 14, 2023 Author Regular Member Share Posted November 14, 2023 18 hours ago, Shadman said: Crown transplants are definitely successful only if you proceed with a good surgeon. In my opinion, you can consider Eugenix. I've seen some of their good crown work. Thank you for the recommendation. Couldnt find any reviews though. Can you point me to any links? Link to comment Share on other sites More sharing options...
Regular Member BackFromTheBrink Posted November 14, 2023 Regular Member Share Posted November 14, 2023 The search functional on this site should provide lots of patient results for Eugenix. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 14, 2023 Author Regular Member Share Posted November 14, 2023 10 minutes ago, BackFromTheBrink said: The search functional on this site should provide lots of patient results for Eugenix. Im looking for crown specific. I'll keep searching. Thank you. Link to comment Share on other sites More sharing options...
Regular Member BackFromTheBrink Posted November 14, 2023 Regular Member Share Posted November 14, 2023 9 minutes ago, austx said: Im looking for crown specific. I'll keep searching. Thank you. @Gatsby have a crown procedure with them recently Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 14, 2023 Author Regular Member Share Posted November 14, 2023 3 hours ago, BackFromTheBrink said: @Gatsby have a crown procedure with them recently Thank you. Going through very informative and inspiring posts by @Gatsby 1 Link to comment Share on other sites More sharing options...
Regular Member jjalay Posted November 14, 2023 Regular Member Share Posted November 14, 2023 5 hours ago, austx said: I see what you are saying but this problem occurs to anyone who had HT, right? Just trying to understand how is HT a concern in my case. I can try medications for a year(not sure how many are successful). If this did not work I'll be in much worst case from now. Thats why I was thinking of HT now. Please weigh in. I am not saying that you are not a candidate for a hairtransplant, its just that your case is relatively rare. You only have to cover the crown, and this wont make any big aesthetic difference like with someone who is bald on the front and needs to cover the hairline to frame his face. Many many people dont care so much about the crown but in your case this is where your hairloss started and thats why you need to treat this. At your age you definitely can have a hairtransplant and this wont be any wrong move from your site. You just needs to know that down the road you may need another hairtransplant if your hairloss progresses further. For crown work i would definitely recommend doctors like couto, dr. wong in canada, jerry cooley, luis nader in mexico. These are all great choices. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 20, 2023 Author Regular Member Share Posted November 20, 2023 On 11/14/2023 at 4:38 PM, jjalay said: I am not saying that you are not a candidate for a hairtransplant, its just that your case is relatively rare. You only have to cover the crown, and this wont make any big aesthetic difference like with someone who is bald on the front and needs to cover the hairline to frame his face. Many many people dont care so much about the crown but in your case this is where your hairloss started and thats why you need to treat this. At your age you definitely can have a hairtransplant and this wont be any wrong move from your site. You just needs to know that down the road you may need another hairtransplant if your hairloss progresses further. For crown work i would definitely recommend doctors like couto, dr. wong in canada, jerry cooley, luis nader in mexico. These are all great choices. Thank you. I tried reaching out to Nadar but no response. Meanwhile, I got to quotes from Eugenix and Laorwong. Both are similar price. Any recommendations please? Link to comment Share on other sites More sharing options...
Senior Member Rawkerboi Posted November 20, 2023 Senior Member Share Posted November 20, 2023 2 hours ago, austx said: Thank you. I tried reaching out to Nadar but no response. Meanwhile, I got to quotes from Eugenix and Laorwong. Both are similar price. Any recommendations please? Both the clinic are very ethical and produce good results. There are lot of reviews in our forum for both these clinics. You also need to take in consideration the factors like traveling and the availability of dates Link to comment Share on other sites More sharing options...
Regular Member jjalay Posted November 20, 2023 Regular Member Share Posted November 20, 2023 3 hours ago, austx said: Thank you. I tried reaching out to Nadar but no response. Meanwhile, I got to quotes from Eugenix and Laorwong. Both are similar price. Any recommendations please? Between those two i would go with Laorwong, he is more consistent with his results. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 23, 2023 Author Regular Member Share Posted November 23, 2023 On 11/20/2023 at 12:59 AM, jjalay said: Between those two i would go with Laorwong, he is more consistent with his results. Thank you. Yes, I see good results from Laorwong. Looking forward for a phone call with Laorwong. Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 24, 2023 Author Regular Member Share Posted November 24, 2023 (edited) Also heard back from Dr. Turan and Dr. Gur with quotes. Now cant decide between my options now. my options are: Dr. Das (1800-Crown 1400-Front) 10k Dr. Laorwong (2000-Crown 1200-Front) 7.5k Dr. Turan (1500-Crown 2-2.5k-Front) - 5.8k Dr. Gur ( 1-1.2k-Crown 2-2.3k-Front) - 6.3- 7.3k Turan and Gur are well in my budget. Tried to PM some of the members but I think I do not have the permission to do so. Please help filtering these options to my hair situation. Appreciate your help!! Edited November 25, 2023 by austx Link to comment Share on other sites More sharing options...
Regular Member austx Posted November 24, 2023 Author Regular Member Share Posted November 24, 2023 @Melvin- Admin Please let me know if including the prices in the post is against forum rules. I'll remove the prices. Link to comment Share on other sites More sharing options...
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