NW 6/7 Worth going for HT?

[avisaxena33]

For some background, I’m a 24M who has been losing hair since 16. Between 15-16 is when the hair loss was extremely significant, after that it’s was a slow recession and thinning for a few years.

 

I kinda lost hope for getting a HT until reading about Eugenix and their work with severe hair loss cases. After a consultation with them, they assessed me as a NW7 and would want to start out with 3500 grafts (including beard grafts) to cover the front and mid area in one HT due to a weak donor area. They would then reassess the donor after a few months for a 2nd HT for the crown.

 

I wanted to get some opinions from this forum to see if yall think its worth going for HT(s) at this point. I’ve had SMP done last summer on my head and shave my head every other day. I have tried a hair system in the past (not for me and it gave me constant anxiety).

note: attached pictures are after roughly 3-4 weeks of hair growth

Edited January 9 by avisaxena33
Update background info

[Gatsby]

@avisaxena33 you run very parallel to my case. Except I also had a very wide FUT like scar running along my hairline and I had previous work that left scars in my Norwood 7 donor depleting it even further. My biggest concern is that you are a Norwood 7 at 24. What are your goals and expectations? Would you be happy if they could not give you full coverage? I also had SMP and it gave a false illusion of a stronger donor and despite sending video's of my donor and beard my beard was weaker than expected. My advice first off would be that if you are not on finasteride then I would speak with your doctor and commence it (I'm not a doctor) and give it twelve months to see how your hair donor responds to it. You also have a good beard which is in your favour. Wishing you all the best.

[jjalay]

Judging from your donor area you are not a good candidate for hairtransplant. I dont know where they are going to find these 3500 grafts to operate on you in first place. You can try finasteride for 12 months and then reconsider. Shaving your head with a blase and letting your beard grow is always a better alternative.

[avisaxena33]

10 minutes ago, jjalay said:

Judging from your donor area you are not a good candidate for hairtransplant. I dont know where they are going to find these 3500 grafts to operate on you in first place. You can try finasteride for 12 months and then reconsider. Shaving your head with a blase and letting your beard grow is always a better alternative.

They wanted to do 2500 from the head and 1000 from the beard apparently

[avisaxena33]

24 minutes ago, Gatsby said:

@avisaxena33 you run very parallel to my case. Except I also had a very wide FUT like scar running along my hairline and I had previous work that left scars in my Norwood 7 donor depleting it even further. My biggest concern is that you are a Norwood 7 at 24. What are your goals and expectations? Would you be happy if they could not give you full coverage? I also had SMP and it gave a false illusion of a stronger donor and despite sending video's of my donor and beard my beard was weaker than expected. My advice first off would be that if you are not on finasteride then I would speak with your doctor and commence it (I'm not a doctor) and give it twelve months to see how your hair donor responds to it. You also have a good beard which is in your favour. Wishing you all the best.

TBH I don’t really know what to expect. I’d be thrilled to have a decent head of hair. I understand it will never be the same as before, but to at least be able to look my age you know?

i’ve been on oral fin and oral min for about 4 months now.

[Gatsby]

1 minute ago, avisaxena33 said:

TBH I don’t really know what to expect. I’d be thrilled to have a decent head of hair. I understand it will never be the same as before, but to at least be able to look my age you know?

i’ve been on oral fin and oral min for about 4 months now.

Ok I would give the medication more time to see if your donor improves. At least another six months. All the best. 

[avisaxena33]

FYI, below is what my hair looked like at 15 and then at 18

[Maorizio]

39 minutes ago, avisaxena33 said:

FYI, below is what my hair looked like at 15 and then at 18

That’s an extremely aggressive AGA, I honestly think it’s best to shave it and grow a beard in your case.

Since you try medications maybe give a chance after a year of treatment as said above, the donor might improve.

[Fox243]

Have you seen much help with the medications or nothing much?

[baddecisions]

Accept your baldness and (that's my opinion) remove that smp. It's better to be a regular bald person thant someone with ink in the head.

Moreover, the results you will get with a hair transplant won't be enough to justify the effort: years of procedures and waiting in order to have, in the best case scenario considering you current state, a poor coverage.

All the best!

[mr_peanutbutter]

id consult with pittella (brasil) for a second opinion

[Gatsby]

The real problem for me with this case is the age for this level of loss. This was me at 24 and I went on to become a strong Norwood 7. 
 

[Gatsby]

This was me at 18. I’m concerned that by 30 you may have a thin band of hair for your donor. How will surgery hold up by then? I was probably around 40 when I reach Norwood 7. But at 18 you could not predict this going by my hair at the time. Balding sure. 
 

[Slickster76]

True, but as severe as your case was - your hair now looks solid…and I think it gives so many of us hope that perhaps anyone can be helped.

[Rahal Hair Transplant]

@avisaxena33,

I haven’t read any of the responses so I apologize if this is repeat. While I Norwood class five or six could undergo a hair transplant surgery and be satisfied depending on expectations, the primary problem is that your donor area is exceptionally thin which really doesn’t make you a good candidate for surgery at all. Also, you’re only 24 years old and it’s possible that hair loss Will progress even further.

while I know it’s not the same, if you are used to or enjoy wearing your hair cropped short like a buzz cut, you could consider scalp micropigmentation or SMP.  This is a micro tattooing procedure where tiny, that like tattoos are placed all over the fitting areas of the scalp to make it look almost identical to buzzed or cropped hair.  To those who have never heard of research the procedure, this may sound ridiculous. But many men, especially young men with advanced hair loss or those who purposely choose to wear their hair cropped like a buzz cut as their long-term hair style have gotten SMP and are very happy with the results.

there are other non-surgical options as well like hair systems, etc. At the end of the day, none of them are perfect but they do offer options for men with advanced hair loss and nominal donor.

I hope this helps.

Patient Advocate - Rahal Hair Transplant

[Berba11]

Agree with @Gatsby100%.

You have very advanced hair loss at a young age, which in all probability means you're likely to lose more hair still in the future (I recognise you're on fin & min now, but this isn't guaranteed to completely stop your hair loss).

Your donor also appears to have some challenges - what looks like retrograde alopecia quite high up above the ears. A bit of retrograde alopecia isn't uncommon and isn't usually a barrier to a HT, but if the RA is quite advanced and you have a lot of scalp to cover up top, it becomes a problem. Lastly, based on the picture of your crown I think you have a slightly disadvantageous head shape. This matters because different head shapes and sizes will often determine how many grafts you need for decent coverage. Two different people with exactly the same amount of hair loss and balding pattern could need quite different amounts of grafts depending on their head size/shape as well as hair calibre.

None of which is to say that you definitely aren't a candidate. No of us here can say that for sure. What you really need to do is get in-person consultations with high NW specialists, especially as your SMP may enhance the appearance of your donor & recipient areas via photographic consultation alone. Doing a full round of in-persons will take time (and money). Personally I'd view that as an opportunity to take two or three holidays over the next year or two. Just don't rush into anything - remember that in your situation, a HT will not only be expensive, but may actually leave you in a worse position aesthetically than where you began. A buzzcut or clean shaven head is a million times better than a sub-par HT.

[Melvin- Admin]

In my opinion, your case is extremely difficult. You require over 10,000 grafts, it will take multiple surgeries and a lot of money. On top of that, your donor looks a little thin. If you can accept balding that’s probably your best solution.

[mr_peanutbutter]

maybe this would be a good approach for op

 

 

[Sunset Dune]

Your donor is weak and you have very aggressive balding. Unfortunately hair transplant is not an option for you and there is really no purpose in taking medication with your situation at this point you will need to embrace the bald look.
You were already bald as a teenager this will be your lifetime look. 

[avisaxena33]

Appreciate all the responses. This is a really difficult decision for me as on one hand, I could stick with my SMP and shaved head but regret not at least trying for a HT at all down the line or on the other hand, at worst I’d waste time + a decent chunk of cash for a result that could or could not be satisfactory.

Eugenix is guaranteeing full coverage within 2 HT (2nd one for crown), but they are saying crown area will be lower density due to using more beard grafts (1000 of which are already being used for the first surgery)

i’m looking through their NW7 results here (https://eugenixhairsciences.com/norwood-class-7/) and im very conflicted as some of these are crazy good / satisfactory while others seem like a waste of time and money. Is my case fundamentally worse than all of these? If I could get something significantly better than my picture above at 18 it would be a success.

[mr_peanutbutter]

here are some people who decided to shave after they ht for whatever reason, so your worst case scenario

 

personally i dont think it looks worse compared to just being bald

 

however you really need to go a good clinic to avoid cobblestoning etc becaise that would look really not good

 

and you need to decide if its worth to spend like 20k and more even though there is a not so little chance you wont look better or even slightly worse after

 

personally id wait if verteporfin works out. in the meantime you could save money and get a second opinion from dr pittella

Edited January 10 by mr_peanutbutter

[zach07]

I respectfully disagree that you can't get decent number of grafts (3,000 - 4,000) in the hands of the right surgeon. Hair transplant science has evolved exponentially in the last 5 years. With scalp and beard hair alone, you could get a pretty decent coverage. As long as you are realistic about your expectations, I would say don't lose hope. Talk to surgeons like Wong and Pittella. 

[general-etwan]

Unfortunately your donor hair (and remaining DHT-resistant hair) is very thin and sparse, do that does not bode well for a high-graft scalp only transplant. Only a few thousand grafts could be taken from your rear scalp donor area, and that's not nearly enough to produce an overall uniform look of any solid density. I'm afraid if you insist on trying a transplant you'd have to agree to use beard hair and even body hair, and that's a whole other beast and challenge. The math honestly isn't good for your situation of hair quality. Medication (finasteride) for at least 10 months is a must first if you really want to see if it can be done

[DH97]

I would consult with dr.pittella, Im a nw6 with a bit more donor and I'm considered a candidate. I'd look into medication and also you will definitely need body hair in order to get a decent look.

[avisaxena33]

Welp, I decided to yolo it. 3500 grafts for a first surgery with dr das at eugenix — roughly 800 from beard