Considering A Hair Transplant So Would Like Advice

[Balding Boulder]

This forum seems to mostly be full of teenagers who effectively have a full head of hair complaining about the fact they have the minutest amount of recession or thinning, and many of these cases are not conclusive. Unfortunately I do not have that luxury.

I am 30 and have been using finasteride and minoxidil regularly since May 2016. Before then, I had dabbled with minoxidil as early as 20, and did seem to get positive results, but it wasn't doing anything for my hairline — and that was the obsession back then. Between ages 24 and 26 I wasn't using anything, so my hair got worse in that period.

I've attached a number of photos to show you what my hair looked like as far back as 2011, when I was 22. Compared to the September 2011, you will see how my hair looks thicker in the December 2011 picture, and I'm assuming this is the result of several months of minoxidil usage.

Jump to 2016 and there's a few that were taken in May showing how bad my hair was. The 2nd and 19th May ones shocked me a bit, as I never quite realised how bad my hair had become. I certainly couldn't tell by looking at myself in the mirror. This is when I decided I needed to take action again, so on 25th May 2016 I started a long-term hair loss regime.

The 2019 and 2020 ones show how my hair is today. I've taken them in different lighting just to show the variation in how much scalp exposure there is.

Have I responded to finasteride and minoxidil? It may well have prevented further hair loss, but in terms of regrowth, there is nothing more than a negligible difference.

The only option left now is a hair transplant. I'm interested in hearing people's opinions about things like how many grafts I would need, and the kind of results I should realistically expect.

 

[brill007]

I think finasteride and mino has made a difference if comparing 2020 photos to may 2016. You look like you have straight hairs (like me) which is kind of a disadvantage, but a transplant is definitely possible if you are comfortable with using finasteride/mino for the rest of your life.

Have you tried shaving your head ? You may like it.

 

[Balding Boulder]

I think finasteride and mino has made a difference if comparing 2020 photos to may 2016. You look like you have straight hairs (like me) which is kind of a disadvantage, but a transplant is definitely possible if you are comfortable with using finasteride/mino for the rest of your life.

Have you tried shaving your head ? You may like it.

I think you’re right, it has made a difference to some degree. The hairs that do exist look courser and there is a darker overall appearance. I still wish I had started taking finasteride several years earlier, but it is what it is.

How much hair can I get implanted in one session? I know surgeons like to work front to back.

 

[brill007]

I would say that you will need 2 surgeries. They will rebuild the front /hairline first (3000-3500 grafts) and then work on the crown later (1000-1500 grafts). I would suggest having as many free online consultations as possible

 

[Balding Boulder]

I would say that you will need 2 surgeries. They will rebuild the front /hairline first (3000-3500 grafts) and then work on the crown later (1000-1500 grafts). I would suggest having as many free online consultations as possible

I am still weighing up my options as to where I will go. I am from UK and it is expensive here, but that doesn’t stop me from going to three or four consultations to get a range of perspectives. I know a lot of people go to Turkey, but I have to be careful with making a choice.

 

[brill007]

UK has horrible surgeons, there is 1 doctor who is actually good but very expensive. I got mine done in Turkey.

 

[Balding Boulder]

UK has horrible surgeons, there is 1 doctor who is actually good but very expensive. I got mine done in Turkey.

I've noticed a trend whereby surgeons in Turkey are much more likely to do larger graft sessions compared to UK ones. I guess the more cautious approach does have its advantages, such as avoiding shock loss, but it is also a good way of getting you to keep coming back.

 

[brill007]

Some surgeons do mega sessions, but most good surgeons will split the surgery into 2 if you require a lot of grafts. They determine this by the quality of your donor (density etc). Honestly most good surgeons don't care if you come back or not because they know that they are good and their work is always in high demand. The surgeon that I had my procedure with has 1 surgery per weekday so 5 per week, booked solid. If a surgeon or representative shows signs of being needy of your business I would stay away. During my surgery I had an anxiety attack while getting anesthetics injected, the doctor told me you don't have to do the surgery if you don't feel comfortable.

 

[whatintheworld]

I don't see where your pictures are, but I would advise you this: try not to count dollars when considering this procedure. You can always make more money, but once your grafts are gone, they're gone.

 

[Balding Boulder]

I don't see where your pictures are, but I would advise you this: try not to count dollars when considering this procedure. You can always make more money, but once your grafts are gone, they're gone.

Not sure what happened there, but I've reattached them.

 

[whatintheworld]

Not sure what happened there, but I've reattached them.

Ok thanks for the pictures. Your situation is tricky, as it is for many others who have diffuse thinning, like me. The problem is, a transplant may incur shock loss to your native hair, leaving you kind of back to where you were pre-transplant. If you transplant just around your hairline, the temple area, then that could work but you are looking at a lot of grafts for that.

I would recommend you look only into the crown for now, as the hairline will be trickier to deal with. Since it seems you have less hair on your crown, the chance of shock loss is also reduced.

Of course, stay on finasteride and minoxidil as well.

I would also trying buzzing your head for a bit and seeing how you like it, and maybe looking into temporary smp. It may sound silly but for diffuse thinners like you it could be quite a good solution, and of course down the line if you don't like it, you can get a transplant as well.

 

[fran1239]

I am very interested in getting a hair transplant, i got some info www realchem4all com and don't know how to use the guide

 

[Balding Boulder]

Ok thanks for the pictures. Your situation is tricky, as it is for many others who have diffuse thinning, like me. The problem is, a transplant may incur shock loss to your native hair, leaving you kind of back to where you were pre-transplant. If you transplant just around your hairline, the temple area, then that could work but you are looking at a lot of grafts for that.

I would recommend you look only into the crown for now, as the hairline will be trickier to deal with. Since it seems you have less hair on your crown, the chance of shock loss is also reduced.

Of course, stay on finasteride and minoxidil as well.

I would also trying buzzing your head for a bit and seeing how you like it, and maybe looking into temporary smp. It may sound silly but for diffuse thinners like you it could be quite a good solution, and of course down the line if you don't like it, you can get a transplant as well.

The thing is, you say that I should get the crown done first, but I know that surgeons tend to work from front to back. The hairline is also cosmetically the most important part of the hair, so I would rather prioritise the hairline in the first session and then look at improving the overall density of my hair in the second. Perhaps if there aren't enough grafts I can opt for a body hair transplant. A bit of beard hair could be used on the crown I reckon.

 

[whatintheworld]

The thing is, you say that I should get the crown done first, but I know that surgeons tend to work from front to back. The hairline is also cosmetically the most important part of the hair, so I would rather prioritise the hairline in the first session and then look at improving the overall density of my hair in the second. Perhaps if there aren't enough grafts I can opt for a body hair transplant. A bit of beard hair could be used on the crown I reckon.

I understand. The thing is, reconstructing your temples will take a lot of grafts. Also, since your hair characteristics are pretty firm and straight, I don't think you would be able to do the standard "comb-over" style that most hair transplant patients do in order to present the illusion of more density.

Transplanting into your forelock is too risky due to shock loss, perhaps the area right before it maybe.

Since you are headed toward a high Norwood, graft use needs to really be conservative in my opinion, as you will need them down the road.

 

[Balding Boulder]

I understand. The thing is, reconstructing your temples will take a lot of grafts. Also, since your hair characteristics are pretty firm and straight, I don't think you would be able to do the standard "comb-over" style that most hair transplant patients do in order to present the illusion of more density.

Transplanting into your forelock is too risky due to shock loss, perhaps the area right before it maybe.

Since you are headed toward a high Norwood, graft use needs to really be conservative in my opinion, as you will need them down the road.

I’ve always had a large forehead and high hairline, so the amount I’ve receded probably looks worse than it actually is. I wouldn’t expect to get back a perfectly straight hairline, but I would certainly aim for straighter.

I know you say that I should save the grafts for the future, but I would like to ‘max out’ my hair over the next few years. Go as far as I can with my donor zone, carry on taking finasteride and applying minoxidil, and if I become desensitised to them to the point where I start losing hair quicker, I’d probably just shave my head then and perhaps look at SMP. I just want to have hair for my 30s at least. I will probably stop giving a sh*t when I reach 40-something.

I know from what I’ve heard that hair transplant doctors say different things to you. I am aiming to go to three or four of them just to get different perspectives and see if they all say something consistent.

 

[whatintheworld]

I understand. However, be careful for trying to get a short term solution, I guarantee you will still care when you are 40, life doesn't stop there.

I would recommend "maxing out" to a certain limit. First you need to accept that your hair won't be perfect, considering your level of loss. You just want it to be good enough, which is a vague term, but I think if you focus on the crown and midscalp, you can get very age appropriate hair.

I speak as someone with a similar pattern of loss to you, headed to Norwood 5/6, and Im only 27.

 

[Balding Boulder]

I understand. However, be careful for trying to get a short term solution, I guarantee you will still care when you are 40, life doesn't stop there.

I would recommend "maxing out" to a certain limit. First you need to accept that your hair won't be perfect, considering your level of loss. You just want it to be good enough, which is a vague term, but I think if you focus on the crown and midscalp, you can get very age appropriate hair.

I speak as someone with a similar pattern of loss to you, headed to Norwood 5/6, and Im only 27.

To avoid the potential for shock loss when adding density to the scalp, isn't it a case of having less grafts but more sessions?

 

[whatintheworld]

To avoid the potential for shock loss when adding density to the scalp, isn't it a case of having less grafts but more sessions?

Yes that is a part of it. But you also need to look at your surrounding native hair and examine how weak it is, if it is thinning as well, and will the trauma affect it.

This is why transplants are generally best for areas that are already mostly bald.