31M NW6/7, need help with planning two surgeries.

[TakeAction]

31 M, have been losing hair since 22. I got SMP a few years ago but would like to get a transplant. I'm diffusing in a NW6/7 pattern.

I've contacted a few surgeons and they've said I may not be able to get full coverage and density which I can understand. But they did say I could still do surgery. They also recommended FUE over FUT because my sides are weak.

I started dutasteride and minoxidil six months ago. haven't seen much regrowth but it seems to have stabilized.

How does my donor look and how should I go about this? I'm thinking do the frontal third first, ~2500 grafts, and then try to get 20-30 FU/cm in the remaining area.

I also have some beard hair that I could use.

 

Edited December 25, 2023 by TakeAction
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[HappyMan2021]

is your hairloss stable on meds? 

can you accept that no matter the # of transplants, the end-result will never bring you back to NW1 level?

you already have very extensive loss at a very young age. I'm just trying to gauge if hair transplants are a worthwhile investment for you. 

[TakeAction]

1 hour ago, HappyMan2021 said:

is your hairloss stable on meds? 

can you accept that no matter the # of transplants, the end-result will never bring you back to NW1 level?

you already have very extensive loss at a very young age. I'm just trying to gauge if hair transplants are a worthwhile investment for you. 

Hair loss is stable. Haven't seen much regrowth yet though.

Yeah, I don't plan on getting to NW1 at all. I'd be happy with a NW2.5 hairline and a slightly thinning crown that I can use fibers on.

Hair loss has affected my life very negatively and after shaving my head for three years and being very depressed I need to do something about it.

[HappyMan2021]

1 hour ago, TakeAction said:

I'd be happy with a NW2.5 hairline and a slightly thinning crown that I can use fibers on.

I would realistically say the 'best' would be a NW3 and a small but noticeable crown (so a step worse/more significant than slightly thinning). your crown loss is significant and the crown is known as a "black hole" for grafts as it easily needs more grafts than the frontal scalp. 

Keep in mind too that this is assuming multiple surgeries and they all must go well too (easier said than done)

perhaps this all is doable to you and the time and money will be worth it. just keep in mind you are looking at a multi-year journey. 

 

[Gatsby]

I would still give the meds another six months. For Norwood 6/7 you are really looking at surgeons who specialize in this. I would be looking at Dr Sethi, Dr Pittella, Dr Zarev, etc. But you still have quite a bit of hair on top though it is diffuse. All the best.

[TakeAction]

5 minutes ago, Gatsby said:

I would still give the meds another six months. For Norwood 6/7 you are really looking at surgeons who specialize in this. I would be looking at Dr Sethi, Dr Pittella, Dr Zarev, etc. But you still have quite a bit of hair on top though it is diffuse. All the best.

Just contacted Eugenix recently, they seem like a good fit for the case

[Gatsby]

Just now, TakeAction said:

Just contacted Eugenix recently, they seem like a good fit for the case

If you are going to use beard hair then they would be a good choice.

[TakeAction]

1 minute ago, Gatsby said:

If you are going to use beard hair then they would be a good choice.

Yeah because I'll need a lot of grafts for full coverage, I think beard hair is a must.

[Grouse]

You still have a lot of coverage up top. If you’re on dut and don’t get sides you may be able to regrow quite a bit. 
 

Your back donor looks strong. I think if you go to a top surgeon and use beard hair you can get incredible coverage tbh. Go ask a doc directly before making up your mind. Pittella or Sethi should be perf. 
 

Did SMP help with the whole hairloss thing? I’m considering doing the same but concerned it won’t really make me feel better about being bald lol

[TakeAction]

1 hour ago, Grouse said:

You still have a lot of coverage up top. If you’re on dut and don’t get sides you may be able to regrow quite a bit. 
 

Your back donor looks strong. I think if you go to a top surgeon and use beard hair you can get incredible coverage tbh. Go ask a doc directly before making up your mind. Pittella or Sethi should be perf. 
 

Did SMP help with the whole hairloss thing? I’m considering doing the same but concerned it won’t really make me feel better about being bald lol

Yeah SMP honestly did help but it wasn't the "solution". With my diffuse thinning and SMP I can pull off a one guard which is way better than a zero or a wet shave. And I mean every time I have a conversation about hair loss people genuinely are surprised and think I have a normal head of hair that I choose to shave. So it's definitely much better than being bald. I can also grow out my hair and look good with a healthy amount of hair fibers but it's a PITA.

SMP wasn't the solution though because I still think about my hair loss constantly and nothing compares to real hair. I still get depressed when I see old photos of me and wish I could go back.

Thanks for the advice, yeah haven't had any issues with dut. I'm on 1.5 mg, might even go up to 2.5. Haven't seen a on of regrowth yet but hoping for more in the next 6+ months.

Was thinking of doing Dr. Bansal, is Dr. Sethi significantly better and worth the extra cost/wait time?

Edited December 26, 2023 by TakeAction

[Grouse]

Hmm not sure. I’d get a consult and if you’re super advanced balding and won’t be on meds def do Sethi. If you’re on meds and stable seems you could go for the lower end package. 

[A_4_Archan]

Before proceeding with a hair transplant surgery, it might be beneficial to give the medications a bit more time to fully demonstrate their effectiveness. Meanwhile, take the opportunity to research the doctors you're considering and conduct consultations with them.

Considering your age and the evident hair loss pattern in your pictures, which could potentially progress to a NW6/7 stage plus your side donor looks weak ,it's wise to schedule an in-person consultation with a reputable hair transplant surgeon nearby. Although your pictures shows your back donor in a good condition, a physical assessment would be wiser as pictures may not reveal the complete picture.

When opting for surgery, adopt a conservative approach. Focus on enhancing the frontal hairline which will frame your face well. Minimize density work on the mid and crown areas to preserve more grafts for potential future loss.

Post-surgery, explore SMP for the mid and crown regions to create the illusion of density. Plus you can use hair fibres when required to those less dense areas.

I hope this helps you. Best of luck.

[TakeAction]

11 hours ago, A_4_Archan said:

Before proceeding with a hair transplant surgery, it might be beneficial to give the medications a bit more time to fully demonstrate their effectiveness. Meanwhile, take the opportunity to research the doctors you're considering and conduct consultations with them.

Considering your age and the evident hair loss pattern in your pictures, which could potentially progress to a NW6/7 stage plus your side donor looks weak ,it's wise to schedule an in-person consultation with a reputable hair transplant surgeon nearby. Although your pictures shows your back donor in a good condition, a physical assessment would be wiser as pictures may not reveal the complete picture.

When opting for surgery, adopt a conservative approach. Focus on enhancing the frontal hairline which will frame your face well. Minimize density work on the mid and crown areas to preserve more grafts for potential future loss.

Post-surgery, explore SMP for the mid and crown regions to create the illusion of density. Plus you can use hair fibres when required to those less dense areas.

I hope this helps you. Best of luck.

Thanks for the advice. I'm just frustrated that I haven't seen much improvement from the meds. It's been over six months on 1.5 mg dutasteride which suppresses more scalp DHT than 0.5 mg. And I'm on oral and topical minoxidil for good measure. 

Part of me wants to just schedule for 6 months in advance and hope I see some improvement by then.

[Melvin- Admin]

You should give the meds at least a full year. Also, have you gone in for a in-person consultation to examine your donor?

[TakeAction]

3 minutes ago, Melvin- Admin said:

You should give the meds at least a full year. Also, have you gone in for a in-person consultation to examine your donor?

Haven't done an in person yet, but I definitely should. Would I be able to get a precise estimate of lifetime grafts from that?