Pics: Two Hair Surgeons Recommend 1800 Vs. 3500 Grafts Respectively For This

[matin1991]

Hi all,

I am 24 years old, have quit Propecia for 4 days ago due to sides and now want a hair surgery instead of thinking of my thinning hair all the time. To begin with, I thought it was called the temples where I am thinning (see attached pictures), but one of the hair surgeon's assistants corrected me and said that it was actually the hairline that was thinning.... :wave:

The thing is, I have contacted two hair surgeons independently (two of the good ones from Turkey whom people recommend in here). The one recommends 1800 grafts to cover my thinning area which onecan see on the pictures, and the other one recommends 3500 grafts. It is to be said that this is of course estimates.

However, if some of you guys have any experience in hair transplants, what would you say sounds more realistic - 1800 or 3500? And by looking at my hair, do you think I'd get a good result from a hair transplant? I only think I will lose the hair at my hairline (formerly called temples by myself) as this is the only place my paternal grandfather lost his hair, and my father has almost not lost any hair whatsoever even though he is 55. My brother though have the same hairline as me, except he doesn't have any hair where mine is thinning.

I have also attached a back picture of my hair to show that the rest of my hair actually is pretty nice, and I am super happy with it - I guess my back hair should also work as great donor hair? At least it looks like it from my point of view


Well - what do you think guys; 1800 or 3500 grafts, what should I go for?

BR,
Matin

 

[Pequod]

Most of us in here would die to have that much hair. I wouldn't do anything but go back on finasteride lower dose to keep it.

 

[matin1991]

Greetings my long haired brother! Nice to see more guys with long hair around here, thought I was the only one.

Well it seems that your corners thinning and are minituarizing and it's a bit tricky because all the hair there will probably eventually minitiuarize, I'm guessing this part but you should look up from whom you got MBP and try to guess your Norwood pattern. It's a bit tricky IMHO because if the surgeon transplants some donor hair between your native hair and then the original hair minituarizes over time he would need to fill it even more. On the other hand if he transplants over the original hair that is thinning he might damage and destroy the native hair. But I would say anywhere between 1800 and 3000 is about right. 3500 is an overkill in my opinion.

Just wondering if it's not a secret, which doctor gave you the 3500 graft count?

I love the color and the texture of the hair btw, always wanted to dye my hair blonde.

Thank you so much, Vincent

I am absolutely sure that the hair some day (perhaps very soon) will die, as a lot of it came when I started using Propecia and Rogaine in combination. And now I am only using Rogaine.
When you are talking about the native hair, I suppose you're talking aout the very thin hair. And yes, I have had the same concerns? For me it would be fine just to transplant over the thin hair, as it is already broken as of now, if you get what I mean. So rather a full hair transplant where it is thinning than a 'half work'.

However, I don't know if it's even possible to hair transplant over native hair, even though it's fine?? Any experiences?

Of course, that is not at secret. Dr Koray Erdogan offered me the 3,500 grafts. This what the exact sentence:

"Dr Koray proposes for 55-60 cm2 a 3500 grafts FUE surgery, according to your donor capacity, in one operation day, for your frontal area. He plans per 1 cm2 a implantation with over 50 Grafts. We need for the implantation in the first row on the frontline your original single Grafts. We create your density with your multiple Grafts after the first single Graft row. This allows a very natural look. With this Graft number you will have a very high density and a good transition to you own hair."

BR,
Matin

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Most of us in here would die to have that much hair. I wouldn't do anything but go back on finasteride lower dose to keep it.

Thanks, Pequod! However, it looks a bit strange having so much hair except in the very thinning area to be honest. As of now, I need to cover the thinning areas with the long hair.

I already was down on .125mg a day. Do you really think I would benefit at all from Propecia if I went down to .0625mg a day? That's 1/16 of a 1mg pill.....

 

[petersterling]

so you have tried 1/4 of a propecia (finesteride) pill and had sides? Not talking about proscar.

Your other option would be to shave and get a clearer picture of where your norwood is heading. Plus, it will look good shaved at a No.2 clipper for now, and give you some time to decide. Sometimes we get fixated on things more than we should.

 

[matin1991]

so you have tried 1/4 of a propecia (finesteride) pill and had sides? Not talking about proscar.

Your other option would be to shave and get a clearer picture of where your norwood is heading. Plus, it will look good shaved at a No.2 clipper for now, and give you some time to decide. Sometimes we get fixated on things more than we should.

I have tried both .5mg (half a Propecia), .25mg (1/4 of a Propecia), and recently .125mg (1/8 of a Propecia) - sides every time.

What do you mean by it will good shaved at a No. 2 clipper? Do you mean 2mm? I had it shaved before I got long hair, and I actually went for long hair exactly because I could see too much that I was starting to thin in those two areas. At least now I have some long hair to cover it.

Thanks for your inputs everyone. Nice to talk with someone about it

 

[teeth_of_lions]

3500 is way too much. There´s a clear pattern at your temples that is about to thin; once that is gone I'd say about 2000 grafts should do the trick. Maybe a little bit more though. If you are sure to not recede much further (as you say in your opening post) then it should be safe to go for a bit more. However if your loss would continue a lot more then be careful with wasted grafts.

 

[Pequod]

Here is the problem for you, as I said I would die to have your head of hair as many others in here would also do. You are barely showing any thinning at this point compared to real thinning like many of us others have had. Yours is barely started at 24, and if you are doing a hair transplant at 24 you will be out of options by the time you are 30 as your male pattern baldness will continue without medication.

When you have a hair transplant it destroys the area you get the transplant kind of like a farmer plowing a field. You think your hair looks bad now, wait two months after a hair transplant to see what it does.

finasteride has the ability to reverse that loss you have already had. If finasteride isn't doing it then try dutasteride. I had side effects too on finasteride but they went away after about 35 days and I actually improved the other way. I am much older than you though so my effects probably wouldn't happen the same as they have for you. Maybe try small doses of dutasteride as finasteride doesn't stop conversion as well.

But my advice to keep what you is have try all options with meds first and resort to a hair transplant last. A hair transplant is like taking money out of a bank account, you only have so much of it. For the cheap price of meds you can get a reversal equivalent to 1500 to 3000 grafts. If have had 3000 grafts done myself and it is a lot of hair, about to size of your entire hand area. Try to picture that going into that little loss you have and see if it makes sense.

BTW your donor area looks amazing, not sure what that Dr is seeing. Still I would not mess with it until it is needed for some real help. Without meds you may go all bald on top, this is what we all fight. Anyway I wish I had your problem, lol. A lot of others do as well.

 

[matin1991]

3500 is way too much. There´s a clear pattern at your temples that is about to thin; once that is gone I'd say about 2000 grafts should do the trick. Maybe a little bit more though. If you are sure to not recede much further (as you say in your opening post) then it should be safe to go for a bit more. However if your loss would continue a lot more then be careful with wasted grafts.

Thank you very much for your reply, teeth_of_lions - really appreciate it. I also think 2000 sounds reasonable from what I'ver heard from people with similar conditions on this forum. But do you think thatmy thinning hair has to be gone before I can get new hair transplanted, or wouldn't they be able to transplant hair on the current thin hair?

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Ha! I knew that was Dr. Erdogan. Yeah I have the same issue as you, only problem is that my hair thinned out in the front part of the hairline. I visited Dr. Erdogan for the consultation in June and he told me that my hair there, although thinner, is too close together so it would be a risk to damage it when he would transplant new hair. And since it looks like I'm thinning from the hairline till the vertex he said he wanted to wait and see how my male pattern baldness progresses before we take any action on the hairline. He expressed concern that I would not have enough hair for the rest of the head since my donor area is thinning as well although he said I have an 8000 grafts capacity in the donor area. He recommended that I should try Propecia.

Thanks for your input, Vincent777! So how old are you? FYI I don't think your hair look bad at all, but obviously it's mostly one self who thinks that in most cases

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Here is the problem for you, as I said I would die to have your head of hair as many others in here would also do. You are barely showing any thinning at this point compared to real thinning like many of us others have had. Yours is barely started at 24, and if you are doing a hair transplant at 24 you will be out of options by the time you are 30 as your male pattern baldness will continue without medication.

When you have a hair transplant it destroys the area you get the transplant kind of like a farmer plowing a field. You think your hair looks bad now, wait two months after a hair transplant to see what it does.

finasteride has the ability to reverse that loss you have already had. If finasteride isn't doing it then try dutasteride. I had side effects too on finasteride but they went away after about 35 days and I actually improved the other way. I am much older than you though so my effects probably wouldn't happen the same as they have for you. Maybe try small doses of dutasteride as finasteride doesn't stop conversion as well.

But my advice to keep what you is have try all options with meds first and resort to a hair transplant last. A hair transplant is like taking money out of a bank account, you only have so much of it. For the cheap price of meds you can get a reversal equivalent to 1500 to 3000 grafts. If have had 3000 grafts done myself and it is a lot of hair, about to size of your entire hand area. Try to picture that going into that little loss you have and see if it makes sense.

BTW your donor area looks amazing, not sure what that Dr is seeing. Still I would not mess with it until it is needed for some real help. Without meds you may go all bald on top, this is what we all fight. Anyway I wish I had your problem, lol. A lot of others do as well.

Thanks for your very detailed reply, Pequod. I'm suprised when people tell me that my hair loss will continue though, and that I eventually will go bald on top - how are you so sure? My maternal grandfather had the exact same high temples as me in the age of some 35 (just without any hair compared to my thinning hair). That is, he did not have any hair loss elsewhere.

I was on Propecia for over a year, so I guess the sides would have disappered earier if that was the case.

If you can tell me a product that works like Propecia and dutasteride but doesn't give the same sides, I'd be happy to know about them

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He said that he had sides, depending on how bad they were he can either try to ride it out or try some other solutions. I personally wouldn't risk ****ing up my hormones and my sexual life for hair.

matin1991 I suggest you track down the baldness in your family, try to see from whom you've got the MBP. If it's thinning all over your head then you're in trouble, if it's just the front you're quite safe and you don't need propecia in that case anyway.

Thanks again very much, Vincent. However, it's very difficult to determine.. As I've mentioned earlier, my maternal grandfather had the exact same issue as me in the age of some 35. My father doesn't have any hair loss whatsoever. My brother has the exact same issue as me, the difference is just that I have taken meds, hence I have some thin hair at my high temples where he hasn't. My paternal uncle is pretty bald on the top. How do I determine whom to look at?

 

[Pequod]

finasteride doesn't work for everyone, so yes a small hair transplant would work. They could add to your hairline with 2000 and fill those areas in, 1000 on each side. With all that hair you have you may get shock hair loss though. hair transplant can have side effects as well.

You didn't say if you would do FUT or FUE, I did FUT to save money. It also keeps the same hair density on the back of the scalp, you only have a little less.

 

[matin1991]

finasteride doesn't work for everyone, so yes a small hair transplant would work. They could add to your hairline with 2000 and fill those areas in, 1000 on each side. With all that hair you have you may get shock hair loss though. hair transplant can have side effects as well.

You didn't say if you would do FUT or FUE, I did FUT to save money. It also keeps the same hair density on the back of the scalp, you only have a little less.

As far as I have understood 'shock hair loss', it's permanent loss of existing hair - right? It's that really something that someone in here has tried? Sounds crazy, and the doctors aren't telling about it?

I have only been offered FUE - I actually thought it was the way to go... I guess you also keep the same hair density with FUE when it grows out again?

BR

 

[teeth_of_lions]

Thank you very much for your reply, teeth_of_lions - really appreciate it. I also think 2000 sounds reasonable from what I'ver heard from people with similar conditions on this forum. But do you think thatmy thinning hair has to be gone before I can get new hair transplanted, or wouldn't they be able to transplant hair on the current thin hair?

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You're very welcome. I am in a comparable situation as yours; pretty much every male in my familiy got NW3 at around 26/27 and stayed like that for the rest of their lives. I am definitely lucky with this genetic background in the hair loss world. Currently 23 years old and NW2. I am patiently waiting until the time is right to go for a transplant.

I am not sure if doctors will plant grafts on your current thin hair, could be though but I don't know. My advice would be to be patient until the hair is gone though, it's never wise to rush a (cosmetic) surgery.

 

[Pequod]

How can you keep the same hair density at the extraction site with FUE when they are extracting follicles in that area? They are just moving around grafts, so one area gets more and one area ends up with less. The strip method they take that piece of scalp out entirely so the hair density stays the same there and goes up in the graft area, but you end up with a scar. FUE can also give scarring too. I doubt you plan to shave your head so this may not matter.

With FUT you can keep your hair long for the procedure, with FUE I don't think that is an option.

I'm surprised they did not give you FUT as a possibility, I find that very odd myself. It is not like FUT is the stone ages of hair transplant, it is less expensive though, maybe they want your money. I had an FUT a couple of months ago myself, and it went very well.

Also, don't forget that the follicles they extract have between 1 to 3 hair per follicle, so if you do say 2000 grafts you may get about 4000 hair follicles out of that. Since you are doing such a small area I assume they put the one follicle graft in the front and the 2 to 3's farther back. Most are 2's so this may not matter much anyway.

 

[Cue Bald]

I agree with Pequods early posts. Stick with finasteride and hold off on a hair transplant.
Having an aggressive hairline hair transplant will only look stupid if you end up being a NW6 - and if you are not on finasteride, there's every chance you could become NW6 - what if the gene is on your mother side? my dad/grandfather are both slightly thin NW2 - yet all my uncles are NW5.
Plus there's the shockloss issue. If you are desperate for a NW1 then get the hair transplant but make sure you stay on finasteride.

 

[arfy]

How can you keep the same hair density at the extraction site with FUE when they are extracting follicles in that area? They are just moving around grafts, so one area gets more and one area ends up with less. The strip method they take that piece of scalp out entirely so the hair density stays the same there and goes up in the graft area, but you end up with a scar. FUE can also give scarring too. I doubt you plan to shave your head so this may not matter.

Strip surgery also causes thinning (less density) in the donor area. I seem to recall reading that strip and FUE both achieve similar total graft numbers when harvesting from the "traditional" donor area, with FUE having the advantage of no strip scar, and the ability to harvest from other areas too. But neither method gets a better yield from the back of the head. And some people claim that strip can get better yield (whether that's true probably depends on the clinic).

Not trying to nit-pick on a tangental issue, but strip does reduce hair density in the donor area.

 

[Pequod]

Strip surgery also causes thinning (less density) in the donor area. I seem to recall reading that strip and FUE both achieve similar total graft numbers when harvesting from the "traditional" donor area, with FUE having the advantage of no strip scar, and the ability to harvest from other areas too. But neither method gets a better yield from the back of the head. And some people claim that strip can get better yield (whether that's true probably depends on the clinic).

Not trying to nit-pick on a tangental issue, but strip does reduce hair density in the donor area.

It reduces the size of the hair area but not the hair density because the rest of the scalp in that area is not touched. So hair density is not touched in the donor area other than a strip of scalp is removed. If you use an excellent surgeon he can leave a very tiny scar compared to some of the horror photos you see online. If you have a second FUT procedure done he can take the next scalp area from the original incision and so you still only have one scar but less scalp again.

BTW a person if they later decide to go buzzed can have an FUE procedure done to place grafts in the FUT scar to make it invisible again if it bothers them.

I agree with you on crown density, if a person wants to look like a bear rug they have to double or triple the numbers I posted. However if someone only has so much hair then to waste it all on a crown makes no sense. A lot of posts seem to be early 20 year olds with already thick hair expecting to stay that way forever. They will face father time like the rest of us regardless.

 

[arfy]

It reduces the size of the hair area but not the hair density because the rest of the scalp in that area is not touched.

If I understand correctly, hair density in the donor area is reduced after strip surgery, because the scalp is stretched in order to close the gap where the strip used to be. This stretching results in more distance between follicular units. By the time you've harvested a comparable number of total grafts (with FUT) that you could achieve via FUE, the resulting donor area densities will be similar. That's my understanding, I might not have this entirely correct.

 

[Pequod]

If I understand correctly, hair density in the donor area is reduced after strip surgery, because the scalp is stretched in order to close the gap where the strip used to be. This stretching results in more distance between follicular units. By the time you've harvested a comparable number of total grafts (with FUT) that you could achieve via FUE, the resulting donor area densities will be similar. That's my understanding, I might not have this entirely correct.

You have to take a lot of skin out of the scalp to stretch it in that area. The way people talk FUT is now taboo or something. FUT has a higher chance of graft survival over FUE. What good is FUE if 50% of grafts die? Anyway this guy is doing FUE so I won't comment on FUT here anymore.

Would you use a doctor that recommends you dump 3500 grafts into those small areas? That is a lot of donor area to give up for this. Anyway good luck with this, I still say I wish I had his hair, lol.

 

[matin1991]

You're very welcome. I am in a comparable situation as yours; pretty much every male in my familiy got NW3 at around 26/27 and stayed like that for the rest of their lives. I am definitely lucky with this genetic background in the hair loss world. Currently 23 years old and NW2. I am patiently waiting until the time is right to go for a transplant.

I am not sure if doctors will plant grafts on your current thin hair, could be though but I don't know. My advice would be to be patient until the hair is gone though, it's never wise to rush a (cosmetic) surgery.

No, I've got some hair transplants offered now from various surgeons, and I asked one of them whom said that they wanted to implant the hair in between my current small fine hair - which, for me, doesn't make sense as I know the current small thin hairs eventually will fall out soon anyway.

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How can you keep the same hair density at the extraction site with FUE when they are extracting follicles in that area? They are just moving around grafts, so one area gets more and one area ends up with less. The strip method they take that piece of scalp out entirely so the hair density stays the same there and goes up in the graft area, but you end up with a scar. FUE can also give scarring too. I doubt you plan to shave your head so this may not matter.

With FUT you can keep your hair long for the procedure, with FUE I don't think that is an option.

I'm surprised they did not give you FUT as a possibility, I find that very odd myself. It is not like FUT is the stone ages of hair transplant, it is less expensive though, maybe they want your money. I had an FUT a couple of months ago myself, and it went very well.

Also, don't forget that the follicles they extract have between 1 to 3 hair per follicle, so if you do say 2000 grafts you may get about 4000 hair follicles out of that. Since you are doing such a small area I assume they put the one follicle graft in the front and the 2 to 3's farther back. Most are 2's so this may not matter much anyway.

Sorry, I just don't think I really get what you mean. In my understanding, all one's hair will eventually grow out again in the extraction area? But I guess I need to read up on that soon...
Thanks so much for your detailed reply though, really appreciate it!

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I agree with Pequods early posts. Stick with finasteride and hold off on a hair transplant.
Having an aggressive hairline hair transplant will only look stupid if you end up being a NW6 - and if you are not on finasteride, there's every chance you could become NW6 - what if the gene is on your mother side? my dad/grandfather are both slightly thin NW2 - yet all my uncles are NW5.
Plus there's the shockloss issue. If you are desperate for a NW1 then get the hair transplant but make sure you stay on finasteride.

Hi Cue Bald. Won't stay on finasteride since I get bad sides - even though I have now been off it for one week, I am still experiencing the sides (can't get hard with a woman and low libido). Really hope it will disappear soon :/

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You have to take a lot of skin out of the scalp to stretch it in that area. The way people talk FUT is now taboo or something. FUT has a higher chance of graft survival over FUE. What good is FUE if 50% of grafts die? Anyway this guy is doing FUE so I won't comment on FUT here anymore.

Would you use a doctor that recommends you dump 3500 grafts into those small areas? That is a lot of donor area to give up for this. Anyway good luck with this, I still say I wish I had his hair, lol.

Thank you again, Pequod. I've actually now got quite af few different recommenditions from doctors:

1. 3500 grafts
2. 1800 for hairline and 700 for temples - I don't get this on though, he means it's called my hairline where I am thinning, but as I see it, it is my temples... I am still yet to find out what he means with 700 for temples then.
3. 600-800 grafts

Any suggestions on what sounds more reasonable?

 

[Pequod]

1. 3500 grafts
2. 1800 for hairline and 700 for temples - I don't get this on though, he means it's called my hairline where I am thinning, but as I see it, it is my temples... I am still yet to find out what he means with 700 for temples then.
3. 600-800 grafts

Any suggestions on what sounds more reasonable?

I can only go by the photos you show here but to me 3500 is too much and 600 is too few. I don't think you will notice 600 to 800 enough, which I assume means 300 to 400 per temple. Yes your hairline is receding at just above the temples. They can call it what they want but I do see the thinning.

To make sure that you get coverage i would think 2000 is needed, but this is only my opinion. But it's hard to tell you what to do as i said you have amazing hair many in here would like to have. These procedures do have risks and you can end up worse than you started off.

Also depending on where they place the grafts if you have thinning later they can leave two bushy areas on each temple that look bad. You have to think long-term but you probably don't want to hear that.

 

[matin1991]

I can only go by the photos you show here but to me 3500 is too much and 600 is too few. I don't think you will notice 600 to 800 enough, which I assume means 300 to 400 per temple. Yes your hairline is receding at just above the temples. They can call it what they want but I do see the thinning.

To make sure that you get coverage i would think 2000 is needed, but this is only my opinion. But it's hard to tell you what to do as i said you have amazing hair many in here would like to have. These procedures do have risks and you can end up worse than you started off.

Also depending on where they place the grafts if you have thinning later they can leave two bushy areas on each temple that look bad. You have to think long-term but you probably don't want to hear that.

Thank you, Pequod - appreciate all the answers you provide!