Is my donor area too damaged for a hair transplant?

[primo]

Hello, I was wondering if my donor area is good enough to have a successful transplant? Ive had these random balding patches above the ear on the right side of my head ever since I was a kid, not sure what kind of alopecia it is (retrograde? dupa? areata?) but it doesnt follow normal MPB pattern. The other side/back seems to be normal though and it hasnt progressed further.

I have also just hopped on finasteride a month ago and hope it can help increase some density in a year or so before the transplant.

If you think it is possible, what surgeon would you recommend that has experience with NW 4-5 cases like mine? Assuming I have a high budget and willing to travel worldwide.

[salsazio]

if u go to a Top Doc not yet

Edited May 19 by salsazio

[Shadman]

@primo no,with medications it'll improve

[Berba11]

8 hours ago, primo said:

Ive had these random balding patches above the ear on the right side of my head ever since I was a kid, not sure what kind of alopecia it is (retrograde? dupa? areata?)

I think you need to first go about finding out the answer to this question more definitively before proceeding with any thing else. That you've had it since you were a kid probably represents good news as it suggests it's not likely to be progressive, but you never know...

Finasteride is a good starting point, and maybe consider adding oral minoxidil a little later down the line (give yourself some time on finasteride first to see if you can tolerate it/monitor if it's working before introducing a new variable into the mix). Obviously consult with your GP or a HT surgeon when it comes to medical interventions!

In terms of getting a HT, let's assume the finasteride does its job and stabilises your hair loss... Your pattern of loss is that of a higher Norwood patient (NW5/6/7), but your donor area is pretty much no-go on one side of your head. That's going to limit you long term, so you'll need to think conservatively about your hairline and likely willing to compromise on coverage towards the crown in the long run. You'll also need to consider more carefully who and how your donor is managed: FUE vs FUT will be a factor and also thinking about surgeons who have a track record of dealing with higher NW's and compromised donor areas.

[Al - Moderator]

10 hours ago, primo said:

Hello, I was wondering if my donor area is good enough to have a successful transplant? Ive had these random balding patches above the ear on the right side of my head ever since I was a kid, not sure what kind of alopecia it is (retrograde? dupa? areata?) but it doesnt follow normal MPB pattern. The other side/back seems to be normal though and it hasnt progressed further.

 

Do those bald patches grow back in and then fall out again later? Do the bald patches show up in different places? If the answer to those are "No" and they aren't expanding then it may be something that happened when you were born or when you were young and you may be fine for a hair transplant, but I'm not a Dr. You should get it checked out. The donor in the back looks pretty good, though.

[primo]

5 hours ago, Berba11 said:

I think you need to first go about finding out the answer to this question more definitively before proceeding with any thing else. That you've had it since you were a kid probably represents good news as it suggests it's not likely to be progressive, but you never know...

Finasteride is a good starting point, and maybe consider adding oral minoxidil a little later down the line (give yourself some time on finasteride first to see if you can tolerate it/monitor if it's working before introducing a new variable into the mix). Obviously consult with your GP or a HT surgeon when it comes to medical interventions!

In terms of getting a HT, let's assume the finasteride does its job and stabilises your hair loss... Your pattern of loss is that of a higher Norwood patient (NW5/6/7), but your donor area is pretty much no-go on one side of your head. That's going to limit you long term, so you'll need to think conservatively about your hairline and likely willing to compromise on coverage towards the crown in the long run. You'll also need to consider more carefully who and how your donor is managed: FUE vs FUT will be a factor and also thinking about surgeons who have a track record of dealing with higher NW's and compromised donor areas.

The few dermatologists I went to couldnt really give me an accurate answer, I guess I'll have to find an specialized trichologist for this. It doesnt seem to be progressive though.

I'm hoping the fin will prevent me from reaching those high norwood stages and maybe fill in the crown a bit, since I probably wont have enough grafts to cover that area. I will look into oral min, the potential side effects to the heart are a bit scary but maybe I can start with lower doses.

I guess its gonna be tricky finding the right surgeon for this and it probably wont be cheap, currently looking into Nader, Feriduni, Couto, Freitas, Leal, Pitella. If you know any that would be a better fit please let me know.

4 hours ago, Al - Moderator said:

 

Do those bald patches grow back in and then fall out again later? Do the bald patches show up in different places? If the answer to those are "No" and they aren't expanding then it may be something that happened when you were born or when you were young and you may be fine for a hair transplant, but I'm not a Dr. You should get it checked out. The donor in the back looks pretty good, though.

Nope they have pretty much remained the same since childhood and are only localized to that side of the head. I hope the donor area in the back can make up for it, since my hair is pretty thick (spaniard/italian hair).

 

Thanks for the feedback!

[Berba11]

3 hours ago, primo said:

I guess its gonna be tricky finding the right surgeon for this and it probably wont be cheap, currently looking into Nader, Feriduni, Couto, Freitas, Leal, Pitella. If you know any that would be a better fit please let me know.

There’s some top names there: Feriduni and Pittella are personal favourites and I’d mention Hattingen as well. 
 

But obviously do your research and take as many consultations as you can - the key is not to rush. Slow and steady wins the race with HT’s!

[primo]

On 5/19/2024 at 6:23 PM, Berba11 said:

There’s some top names there: Feriduni and Pittella are personal favourites and I’d mention Hattingen as well. 
 

But obviously do your research and take as many consultations as you can - the key is not to rush. Slow and steady wins the race with HT’s!

After doing some research, I think Zarev would be the best fit with his insane donor management skills and work on NW 5+ patients, which is exactly what I need. Or would that be overkill? I know hes the most expensive one and has a 3+ years waiting times, but most top surgeons Ive seen have 2+ years waiting lists anyways. I still need at least a year for the finasteride to stabilize my hairloss as well.

The only other one that comes close for higher NWs is Pittella but he does seem to rely a bit on body/beard hair and tends to implant in rows which may look unnatural. He's still a beast tho and might be the other best option.

[mr_peanutbutter]

3 hours ago, primo said:

After doing some research, I think Zarev would be the best fit with his insane donor management skills and work on NW 5+ patients, which is exactly what I need. Or would that be overkill? I know hes the most expensive one and has a 3+ years waiting times, but most top surgeons Ive seen have 2+ years waiting lists anyways. I still need at least a year for the finasteride to stabilize my hairloss as well.

The only other one that comes close for higher NWs is Pittella but he does seem to rely a bit on body/beard hair and tends to implant in rows which may look unnatural. He's still a beast tho and might be the other best option.

if you have the time and money, go for zarev