giving up the fight and taking the next step

[techprof]

I have decided that topicals/drugs are not going to give me any more good results.
I have scheduled for a 3500 grafts with Dr. Arvind Poswal in Delhi on June 24 th.((strip/FUHT, http://www.fusehair.com)
If I don't have enough donor hairs, I will get 3000 grafts.
I plan to use minoxidil once a day, prox-N once a day, dutasteride one pill a day for life after the hair transplant.
In my opinion, if I had started on dutasteride/min/prox before going past NW3, I wouldn't have needed a hair transplant.
My main objective is to get the crown covered which is my weakest area.
I will have 2000 grafts for the crown and 1500 for the top and the front.
I can live with a NW3 hairline.

 

[Guest]

techprof,

My guess is that you have not yet been physically examined by Dr. Poswal which is obviously understandable especially if you do not live in New Dehli. Maybe you have already met with him in person so feel free to set me straight if I am wrong.

Unless you have extremely low donor density levels, you should have no problems with the 3500 strip grafts AS LONG as you have accomodating scalp laxity and no other issues from prior procedures. Is this your first hair transplant?

How large of a surface area as measured in square centimeters will be the recipient area or did Dr. Poswal indicate to you at all the density level that would be achieved post-op? I mean are the two of you shooting for 30 FUcm2 in the crown?

The reasons I am posing these questions to you is the vertex/crown area can take up to 50% or so of the patient's available scalp donor which does not leave enough donor for the other recipient areas. I did read your goals for your frontal zone so it was reassuring to see that your are thinking of the whole picture and going for a higher hairline. Those are your personal goals so if you achieve them successfully not only now but in also planning for the future, that's great.

You definitely want to consider your ultimate potential class for male pattern baldness based on your family history. In other words if there are histories of class seven, the crown area can open up to further loss beyond the Norwood class you're in at present. Obviously that will demand much more of future donor because you would never want to be left with an island of hair and loss all around it. The one thing that we do have today that our preceding family members with male pattern baldness did not have was the hairloss meds. The big question is "will they work over the long run?"

With Dr. Poswal you probably are very much aware of his BHT procedures and if you are open to that technology then you may want to add a little BH in the crown to preserve more scalp donor for other areas. I see him as predominantly more of a FUE surgeon but are you choosing Dr. Poswal because of his low strip prices? I do not believe he does very much in FUHT.

It is very apparent that you have done a fair amount of research, you know what is medicinally working for you and what is not. So now you have come to a decision which is so refreshing to see because you are making one based on intelligence. I wish you the best man! :hairy:

 

[Aplunk1]

Why did you opt for this surgeon?

Why not go to a world-reknowned surgeon, like Dr. Hasson, Dr. Armani, Dr. Feller, Dr. Cole, etc.?


I can see that you've got good expectations, Techprof. It's good that you're staying on the proven meds-- minoxidil, dutasteride, Proxi, etc. and I'm sure that you're going to have a nice head of head very soon.

I wish you the best with your surgery, and hope that you post tons of pics here.

Andy

 

[Guest]

There are many good choices out there that's for sure!

 

[techprof]

Gillenator and aplunk thanks for your support.
Gillenator,
I have learned a lot from your posts regarding hair transplants.
This is my first hair transplant in life. If I can get 4500 grafts, I will go for it.
am planning to strip only.
I realize that i cannot do buzz cut. this is fine with me. I don't mind keeping my hair longer if it gives me a non-bald look.
I am happily married and have a beautiful kid.
At this stage in my life I can afford for a fue or other few number of good doctors, but I follow Gandhi's principle (living the life simpler as much as possible) and I would like to keep the cosmetic expenses minimum if possible.

I was a NW6 and went to NW5 using topicals and finasteride in 18 months or so. I am optmisitic of dutasteride, minoxidil and proxiphen-N to atleast keep the transplanted hairs alive.
Dr. Poswal is rated very good in hairsite.com. He is probably the best doctor in the world today for Body hair transplant.

To some extent, I can live my life as a NW5 also. But recently I feel like I look too old. If I can look my age (31) or at least 35 after the hair transplant I will be a happy man. I am not tall and muscular, so buzz cut is not really necessary.

None of my family members went past Nw4 in their entire life (even at 80 or more) for the last 2 or 3 generations. I am hoping that dutasteride/minoxidil will keep the crown from expanding.

I will be happy with even a NW3 hairline if I can not see my shiny crown on the mirror everyday. I am not very good in density Gillenator, do you think 30 is enough for my head if I keep my hairs 2 inches longer.

If I have to, I don't mind growing my hairs 2 inches or 4 inches long and using a gel to direct them to give a non-balded look. The situation has become desparate and I hope I don't regret this decision.

 

[Aplunk1]

4000-4500 will cover a lot of ground.

To my understanding, it takes a lot more hair from you donor supply to cover the crown, but 4000-4500 will probably restore your crown and give you some density up top.

Would you ever consider a second transplant-- somewhere down the line, to create more density?

 

[hairhaircomeagain]

techprof...You are a tech prof. I read somewhere you have Phds and Postdocs working under you. You have a wife and a kid. Looks like your life is going great.

I dont think I ll be too worried about hair if I were you but then again I just think.

Anyways, good luck with your hair transplant and I am sure you now will be a hairy tech prof soon

 

[techprof]

hairhair,
yes I am happy as the way life as it is. One of the reasons I am doing hair transplant is to keep the regimen simple. Now I walk to the bathroom close to 10 times a day to apply some topical (minoxidil, sod, folligen, prox-N etc). This leads to a lot of frustration (both for me and my wife) and time waste in the long run. I hope to restrict my visit to 2 or 3 times a day.

I feel that looking good won't hurt me so I am going for this. This has been a tough decision (spending money on cosmetics).

aplunk,
If I get to look like NW2 or NW3 I won't go for a second hair transplant.

 

[Guest]

techprof,

You're very welcome and glad it was of some help. You see it all really comes down to the patient's goals and defining them within one's own limitations. That's exactly what you are doing. In the early days I had developed a tendency to impose what I thought was best for that individual. Ultimately I learned that everyone is unique in their own special way and what I think may be best was not always what that individual wanted. I endeavored to become a much better listener.

If your virgin donor density levels in the scalp are low, anything above 3,000 may be getting closer to risk and not worth pushing the envelope. But Dr. Poswal is the doctor not me and he will give you his summation after his full examination. You can always be financially prepared to do more if he feels it is safe to do so.

I find it interesting that you had progressed to a Norwood 6 when no one else in your family history had reached beyond class 4. That proves a point that male pattern baldness can progress even beyond what our foregoing family members realized as rare as it is.

Do I think that 30 cm2 will be enough? Based on your stated goals, sure I do. But remember, coarse caliper compared to thin caliper grade covers much more efficiently. And your hair-to-scalp color contrast plays a big role in the visuals as well. Those of us with black or dark shades of hair color have more ultra-violet light reflecting off our scalp especially outside in the sunlight. So the darker hair against a lighter complexion will work against us.

And you're right, wearing your hair extremely short (number 2 guide and lower) will not be feasible for most hair transplant patients. But possibly you have read my posts elsewhere that in over two decades I hardly know of any satisfied patients cutting off all of their transplanted hair once it grows out. :hairy:

And yes the decision process can be challenging indeed but thank goodness you are making informed intelligent ones!

 

[Guest]

tech,

I forgot something. BE SURE to ask Dr. Poswal about his "Hyper-Acute Angulating" methods he employs for patients likened to your own situation, specifically your same hair characteristcs you stated.

Bringing down the angle of the recipient site closer to the scalp surface can at times produce an added illusion of coverage. He'll explain it all to you unless he already has. Best wishes to you.

 

[techprof]

Gillenator, thanks again.
Though I am going to choose a style that suits me, based on your experience what do you think I should do?
If you are not comfortable answering this question, that is fine too.

I will ask Dr. A about acute.. for maximum coverage. I believe he does this by default to everyone.

 

[Guest]

You're welcome tech and it would be helpful if I had some pics of you so feel free to e-mail them to me if your comfortable with that. I never share patient pics with anyone else either.

But just based on what you have provided, if I was in your situation I would first get an estimation of the total amount of potential grafts you have. You want to ask Dr. Poswal how many he feels he can get once he has a chance to physically examine all of your donor areas including the body. Then you have some idea of what your resources are and you will be better able to make more definitive goals.

But you and only you can decide how much coverage you want, where you want your hairline realistically situated, really all of the things you afore-mentioned. :wink: