HT -- without full coverage

[Approach]

I am a very high NW. (My question is not about cost.) Do any of you believe the following approach is a good idea with a reputable surgeon like Dr. Pittella: 

The primary goal would be to add density to the frontal portion of my head and frame it age appropriate.  And, another goal would be to add a modest amount of density to the crown-- similar to pic below.  Do most of you think this is a viable option, or would you aim to have a full head of hair -- esp since it might be Dr. Pittella. (I'm 52 y/o male).

Edited May 5 by Approach

[Fox243]

53 minutes ago, Approach said:

I like that Dr. Pittella works miracles for high NW guys.  And, he did tell me he could create almost a full head of hair for me consisting of 5,000 scalp hairs from donor area and a ton of beard hair.  

However, I'm now wondering:  based on my age (52), and degree of baldness: Do I even want a full head of hair??  (My question is not about cost.) Assuming Dr. Pitella is the surgeon, do any of you believe the following approach is a good idea: 

Use all 5,000 donor scalp hairs; and use a modest amount of beard hair, instead of a ton).  The primary goal would be to add density to the frontal portion of my head.  And, another goal would be to add a small amount of density to the crown. 

So, in summary, although my crown would only have minimal improvement, the rest of my head would have the type of density I believe I'd be happy with.  I'm just wondering what the rest of you think?  Here are 2 pics of what I had in mind.

Another advantage of this approach is:  I would be using less beard hair.  I'm a bit self-conscious that using too much beard hair (texture) sometimes look unnatural.  Any thoughts?  Im asking also b/c:   "If" I'm going to be operated on, should I just go all-out and aim for a full head of hair instead?   Any thoughts guys? Thank you. 

I personally think a strong hairline with enough crown to just look slightly balding on the crown is better than full bald. I would make sure you can get a good hairline though as frontal framing is what people look at.

[Approach]

On 5/4/2024 at 11:36 AM, Fox243 said:

I personally think a strong hairline with enough crown to just look slightly balding on the crown is better than full bald. I would make sure you can get a good hairline though as frontal framing is what people look at.

Thank you for your feedback Fox.  Each tid-bit of feedback from guys on this forum is really helping.

[Al - Moderator]

This is really something that I think needs to be discussed with Dr Pitella probably just before and during the surgery because being a NW 7 with only a small amount of scalp donor and using lots of beard donor, you really don't know how dense you're going to be able to get even if you used up as much grafts as possible. You may have to decide at the time you're going through the process because some of this is going to depend on whether he will be able to get either more or less grafts than he estimated and if you need either more or less than he estimated. I'd let him be aware that you'd rather be more full in the frontal half and are willing to leave the crown low density if he can't get enough to give full coverage everywhere or if he reaches a certain amount of grafts due to your budget or because you want to save some for later or don't want to be depleted.

With that said, at 52 and a NW 7 I'm guessing you'd be thrilled to have a rather full front half even if you're still very thin in the crown. Be aware though that hair greed hits a lot of us and you'll probably eventually be wanting to go back for another session to try to get enough grafts to fill in the crown anyway, so keep that in mind.

 

[Approach]

16 hours ago, Al - Moderator said:

This is really something that I think needs to be discussed with Dr Pitella probably just before and during the surgery because being a NW 7 with only a small amount of scalp donor and using lots of beard donor, you really don't know how dense you're going to be able to get even if you used up as much grafts as possible. You may have to decide at the time you're going through the process because some of this is going to depend on whether he will be able to get either more or less grafts than he estimated and if you need either more or less than he estimated. I'd let him be aware that you'd rather be more full in the frontal half and are willing to leave the crown low density if he can't get enough to give full coverage everywhere or if he reaches a certain amount of grafts due to your budget or because you want to save some for later or don't want to be depleted.

With that said, at 52 and a NW 7 I'm guessing you'd be thrilled to have a rather full front half even if you're still very thin in the crown. Be aware though that hair greed hits a lot of us and you'll probably eventually be wanting to go back for another session to try to get enough grafts to fill in the crown anyway, so keep that in mind.

 

Al -- thank you for your feedback.  A few points that you said stand out to me.  That is:   "You may have to decide at the time you're going through the process because some of this is going to depend on whether he will be able to get either more or less grafts than he estimated..."  And, your other point about "hair greed" helps.  Thanks for the heads up.  Apparently hair greed is a bigger point than I realized.  I will keep this tid-bit of info in mind.  Thanks again.  

[Gatsby]

Hair greed is real!!!! . Trust me as a Norwood 7 with a diminished donor and scars before my first procedure. 

[Gatsby]

@Approach just looking at the pics you have posted and looking at previous patient results I believe Dr Pittella will be able to give you good coverage all over. Obviously speaking with him will answer this definitively. All the best! 👍

[Approach]

17 hours ago, Gatsby said:

Hair greed is real!!!! . Trust me as a Norwood 7 with a diminished donor and scars before my first procedure. 

This is a really dumb question, but:  What does hair greed really mean?  I may be mixing up the term.  Is it simply:  The desire to continue HTs one after another until all bald spots are covered?  Or, does it refer more to "density" of everything.  Thank you.

[Approach]

Dr. Pittella said he thinks he can get about 5,000 grafts from scalp donor.  I am NW 7.  Let's assume:  I decide to transplant just a minimal amount of hair to the crown.)

 

I will ask Dr. Pitella, but generally speaking: In your opinion--   Do you think 5,000 grafts to "frontal hairline and midscalp" would be enough to frame my face and provide adequate density to hairline and midscalp?  Or, would it be way too sparse?  I'm just trying to get a general idea of how far 5,000 scalp grafts will cover for me. Thank you.

Edited May 26 by Approach

[TakeAction]

I'm not sure it would be necessary to limit yourself to 5000 grafts if cost is not an issue since Dr. Pittella can do over 10k grafts in 2 days. 5000 grafts could cover the front and midscalp pretty well but you probably won't get much crown coverage. If you could reach the state that you showed in the pictures with the thinning crown, hair fibers would easily cover that area if you were willing to use them.

[Al - Moderator]

On 5/8/2024 at 8:13 PM, Approach said:

This is a really dumb question, but:  What does hair greed really mean?  I may be mixing up the term.  Is it simply:  The desire to continue HTs one after another until all bald spots are covered?  Or, does it refer more to "density" of everything.  Thank you.

 

There are various forms of hair greed, but it generally goes something like this:

 

If I can just fill in the front I'd be fine. I'm not worried about the crown. The crown doesn't bother me.

Hair transplant #1

(1 year later) It looks great, but now the crown really stands out. I really do need to get the crown filled in.... oh and maybe thicken the front a bit too.

Hair transplant #2

(1 year later) I'm liking it, but.... the crown is still a bit thin.. and actually there's a few weak spots still in the front too.

Hair transplant #3

(1 year later) I think I'm finally done... but I wish I had better temple points and it would look better if I just had the hair line lowered or tweaked just a bit.

Hair transplant #4

 

 

[Approach]

Al, thank you so much for explaining.  It was really helpful.  I now understand better.  Admittedly, I will fall right into this trap!

[Fox243]

On 5/26/2024 at 11:26 PM, Approach said:

Dr. Pittella said he thinks he can get about 5,000 grafts from scalp donor.  I am NW 7.  Let's assume:  I decide to transplant just a minimal amount of hair to the crown.)

 

I will ask Dr. Pitella, but generally speaking: In your opinion--   Do you think 5,000 grafts to "frontal hairline and midscalp" would be enough to frame my face and provide adequate density to hairline and midscalp?  Or, would it be way too sparse?  I'm just trying to get a general idea of how far 5,000 scalp grafts will cover for me. Thank you.

5000 should be enough for hairline and midscalp. Honestly though, I would really consider looking into using beard. YodaHead. had 5.5k taken from beard and at 4 months, his results are looking absolutely insane.

[Approach]

1 hour ago, Fox243 said:

5000 should be enough for hairline and midscalp. Honestly though, I would really consider looking into using beard. YodaHead. had 5.5k taken from beard and at 4 months, his results are looking absolutely insane.

Fox, I was just curious.  Thank you so much for your feedback.  I was hesitant about beard hair at first. But, you are right.  The more research I do, the more I realize my expectations were not realistic.   

 

As you see,  I have a salt and pepper beard & also salt and pepper scalp hair.  Question:  Does this characteristic of mine help the surgeon?  Ie, Does this make it easier for the surgeon as to where he "places" the gray-color beard grafts?  (Vs someone with a gray beard but solid brown scalp hairs.  I assume so, but I also heard the opposite.  Any thoughts?

[Fox243]

4 minutes ago, Approach said:

Fox, I was just curious.  Thank you so much for your feedback.  I was hesitant about beard hair at first. But, you are right.  The more research I do, the more I realize my expectations were not realistic.   

 

As you see,  I have a salt and pepper beard & also salt and pepper scalp hair.  Question:  Does this characteristic of mine help the surgeon?  Ie, Does this make it easier for the surgeon as to where he "places" the gray-color beard grafts?  (Vs someone with a gray beard but solid brown scalp hairs.  I assume so, but I also heard the opposite.  Any thoughts?

I don't know sorry. If I were to assume, I believe I've heard uniform salt and pepper everywhere looks like the most coverage. I would schedule another consult with Dr. Pittella to get your answers.