There Are So Many Variables with Hair Transplant

[hanginginthewire]

I don't understand how people can make a decision.

I am 36, very slowly have been receding since I was like 21 maybe. Very slowly. Wouldn't the slow rate of loss bode well for a transplant? I am also totally willing to take fin. I currently take Finpecia from online because i couldnt Get a prescription for legit propecia. I also will pay up to 15K or more. As of right now I pretty much just have temple recession and some overall thinning up top. Is overall thinning up top what you all call "diffuse thinning?" The average person would not consider me bald (certainly not) and most laypeople wouldn't even consider me balding (yet.) My older brother by seven years who i have always resembled is starting to look straight up balding though. My donor area should be pretty good. I have thick Irish hair and barbers used to comment on how thick the back of my hair is. (I think that's one reason I never really realized the extent of my recession/thinning.. Anyway, is it true that hair transplants are always a multi operation endeavor? If I knew I could have a good result from one transplant that would last maybe fifteen years or so id book a surgery tomorrow. Like always in life though there are so many variables and you are damned if you do and damned if you don't.

[JoeTillman]

I don't understand how people can make a decision.

I am 36, very slowly have been receding since I was like 21 maybe. Very slowly. Wouldn't the slow rate of loss bode well for a transplant? I am also totally willing to take fin. I currently take Finpecia from online because i couldnt Get a prescription for legit propecia. I also will pay up to 15K or more. As of right now I pretty much just have temple recession and some overall thinning up top. Is overall thinning up top what you all call "diffuse thinning?" The average person would not consider me bald (certainly not) and most laypeople wouldn't even consider me balding (yet.) My older brother by seven years who i have always resembled is starting to look straight up balding though. My donor area should be pretty good. I have thick Irish hair and barbers used to comment on how thick the back of my hair is. (I think that's one reason I never really realized the extent of my recession/thinning.. Anyway, is it true that hair transplants are always a multi operation endeavor? If I knew I could have a good result from one transplant that would last maybe fifteen years or so id book a surgery tomorrow. Like always in life though there are so many variables and you are damned if you do and damned if you don't.

If you are not at a point where one would look at you and consider you to be a hair loss sufferer then you are in a great position. Kudos for being proactive at this point as you stand the best chance of succeeding in your fight.

However I think that you should not make assumptions about your loss and speak to a few IAHRS doctors about your situation. Send the best photos possible and shoot a video as well if you can. Skype consultations are great if you can't see doctors in person. One word of advice is to not let anyone know upfront what you are willing to spend as this keeps the budget from influencing the assessment (it happens). Just send in your information and tell the doctor that you are concerned about your loss and would like to address it but you would like their recommendation. Take the recommendations and evaluate each very closely.

The question I'd like to ask you is; if you don't look like you need a hair transplant, should you actually get one? My inclination is to say "no" because that is the whole point of surgical hair restoration, to give you the appearance of more hair but if there is no cosmetic need at this point then it is a waste of money to have one.

[hanginginthewire]

Well I meant to the average Joe on the street - they are not going to say "that guy is balding". But I have a distinct m shaped hairline, thinning behind the hairline, some thinning in the crown/overall top. I had thicky, dark, wavy Irish hair so it hid a lot of the loss. I assume I would be Norwood 2. This hair loss issue is kind of the straw that broke the camel's back for me - I feel like if I don't sort it out its going to ruin whatever was left of my life.

What really kills me is how I didn't even realize I was balding for all these years. I figured I just had shitty hair. I cannot believe I have been saddled with this though. I see guys my age and much older with non disfigured hair and I feel so disheartened. Just heartbroken and despairing. I try to buck up and think hey you can bite the bullet and get a hair transplant! Which of course would be a huge financial and emotional commitment. But it sounds like even that's no solution either, I keep reading articles where dudes get a transplant and then need another one in less than two years! What the shit is that!!?? And I can't be sure that the finpecia I take is doing anything/is legit. Hairs from this ****ED up genetically susceptible zone continue to fall out as they have for years. Its just all too much.

[HTsoon]

If you can tell that you're balding more than likely others can tell as well, especially if you're thinning.

One and done surgeries almost never happen, since hairloss is progressive you'll likely need additional surgeries to compensate for the progressive hair loss. Could you post some pictures so we can see? I suggest buzzing your head for two reasons, one to see whether you're willing to live with a shaved head. Two to really see what your level of hairloss is really like, when you have long hair you may think you're just a Norwood II but when you shave and it starts growing back you may see miniaturization throughout the scalp. Knowing where your at currently and where your headed will allow you to plan your surgeries better assuming you have surgery.

[hanginginthewire]

I did shave my head to like a #.5 in Sept. I was pretty horrified by it. I saw a dermatologist a few months back, he said I had some slight recession at the temples and that was it. Although my head was pretty much shaved when He examined me, so i dont know if he could have picked up on thinning with The hair so short. Said "even a lot of women" get that (amount of recession). Wouldn't give a fin script. Its the "not knowing" nature of this that's making it so much worse and triggering my anxiety and depression. Don't know what to do and feel consumed by it, which I know is dumb.

And btw, if multiple transplants are the norm, what's the big deal about young 20 somethings getting a transplant? Its sounding like virtually everyone can expect to undergo multiple procedures anyway. At what age does the pattern of loss becoming more definite? Cause it sounds like never....

[hanginginthewire]

Also, is it never the case that people have a "mild" pattern of male baldness and could have a decent result with just one procedure? Are all these celebrities having multiple transplants? I wouldn't think they'd even have the time for it.

[HTsoon]

I did shave my head to like a #.5 in Sept. I was pretty horrified by it. I saw a dermatologist a few months back, he said I had some slight recession at the temples and that was it. Although my head was pretty much shaved when He examined me, so i dont know if he could have picked up on thinning with The hair so short. Said "even a lot of women" get that (amount of recession). Wouldn't give a fin script. Its the "not knowing" nature of this that's making it so much worse and triggering my anxiety and depression. Don't know what to do and feel consumed by it, which I know is dumb.

And btw, if multiple transplants are the norm, what's the big deal about young 20 somethings getting a transplant? Its sounding like virtually everyone can expect to undergo multiple procedures anyway. At what age does the pattern of loss becoming more definite? Cause it sounds like never....

The problem with young 20 year olds getting transplants is not necessarily the need to have multiple surgeries its more to do with graft placement, I myself went nearly completely bald by age 30, if I would have gotten a procedure when I was 21 when I just noticed some thinning in the hairline, I could've easily focused too many grafts on the front and not had enough to make up for the rest of the scalp, remember were only born with a certain amount of donor hair, we don't have infinite number of grafts so placement and strategy is very important. Typically it's easier to know where you'll end up when you're in your 30's, it's the 20's that hair loss can be ultra aggressive for some.

From my observation there are three categories, men with very mild hair loss who end up only being a norwood II to III even at the later stages of life.

Then there are the men who begin to notice hair loss mid to late 30's, these men typically don't go very bald until their late 50's to 60's, a good example of this is Ed O'neil otherwise known as Al Bundy, if you look at his hair in Married with Children he was about a norwood III, now in his 60's he's become a norwood VI. Another example of this is Matt Lauer their hair loss was severe but slow and not aggressive.

Then you have the men who go bald by age 30, you got your Patrick Stewart, Dr. Phil etc. These are typically the guys who end up being repaired, because their hair loss is so aggressive they end up not having a good long term strategy and end up chasing their hair loss with procedures in their 20's. These are the guys who are most at risk with having a procedure.

There is no age really in which hair loss stops, I think its safe to say that most men who develop hair loss at a younger age typically reach the end of their hair loss younger also, but I don't think you can ever really say your hair loss has completely stopped. I think you reach a point in which your hair loss slows down and the changes aren't visible until years and years.

I wouldn't worry too much If I were you, you're 36 so you're not that young, if people really can't tell your bald by this age I'd say its pretty safe to say you wont be going bald for a while maybe 20-30 years (generalization), if you get on meds now then you may never reach that stage. Be happy bro, I wish I was in your shoes, instead I lost almost all my hair and im 5 years younger than you.

[hanginginthewire]

Thanks, great post. I still find the seeming necessity of multiple transplants to be really confusing though. Isn't there a way to plan for the worst case scenario? Thin hair is better than no hair. What if you have a fantastic donor supply? People always commented on how thick the hair at the back of my head was/is. Wouldn't this help? And anyway, if you continue to bald to a Norwood 7 or whatever , can't you just give in and shave the transplanted hair? Who could possibly commit to hair transplantation if it means several procedures at five figures each? I assume that your avatar is your own pic - looks great , are you destined for more transplants though?

[RU58841]

Thanks, great post. I still find the seeming necessity of multiple transplants to be really confusing though. Isn't there a way to plan for the worst case scenario?

Yes, and an honest doctor will attempt to do that. Family history is an indicator, but unfortunately nobody knows for sure how your loss is going to go. Could stop tomorrow, could double-down tomorrow. I've seen like 1 or 2 rare cases where somebody who was young and had basically no family history of hair loss (but had some minor recession) had a procedure done, confirmed there was no additional miniaturization (so it looked like his hairloss had reached the final pattern), then went back a year later and did it again to get additional density on his hairline since the doctor was confident it would never get worse. So the point is that they did it across 2 procedures instead of 1 because they were planning for the future and wanted to be SURE that it would be a safe idea to allot more grafts to that frontal area, that's why they waited a year. Some doctors get criticized for using "too many" grafts in a procedure if the patient is too young. But on the other hand, you don't want to use too few and up with a wispy, artificial-looking result -- that's the pitfall of "isn't thin hair better than no hair?" I'd say not if it looks fake or weird, which it unfortunately sometimes does to me when they don't use enough grafts to get good density.

What if you have a fantastic donor supply? People always commented on how thick the hair at the back of my head was/is. Wouldn't this help?

It would, yeah. Look up "nicnitro", he's a user on various hair loss forums who's had like 12,000 grafts transplanted across 3 surgeries with Hasson & Wong. Went from basically fully bald to a norwood 1 hairline. Of course that's pretty rare -- he had basically double the grafts that most people have. But in your case, you can send a picture of your donor area to the clinics and they can make an evaluation, although I think they need an in-person evaluation to get the most accurate idea here.

And anyway, if you continue to bald to a Norwood 7 or whatever , can't you just give in and shave the transplanted hair?

Yeah, but obviously if those transplants were by the strip method, you're gonna have a huge telltale scar on the back of your head that says, "I've had a hair transplant, AND i'm bald." So if that's part of your plan, you wanna go with the FUE method, but then you gotta realize that has some potential disadvantages of its own (higher price, not as many doctors are good at it, somewhat less predictable result, subsequent procedures may have difficulty getting the number of grafts aimed for).

But in summary yeah, if you do have one procedure at your age you're almost certainly gonna have to have another one. From my research it seems like if you're going to a good doctor from the first time -- rather than a bad one that requires a repair later -- you can expect to do 3 procedures in your lifetime.

Also, if you're 36 and Norwood 2 and have been losing hair for like 15 years, that sounds very slow, and since you're on treatments, you possibly COULD get away with a transplant that might not require a followup for 10+ years, yeah. But look to your brother's case: was his hair in the same spot at your age? Then accelerated sometime within the past 7 years? Or was it worse when he was 36? And is he treating it in any way? That's the kind of thing that might be really helpful to know when the hair transplant doctor is coming up with a plan for you.

[HTsoon]

Thanks, great post. I still find the seeming necessity of multiple transplants to be really confusing though. Isn't there a way to plan for the worst case scenario? Thin hair is better than no hair. What if you have a fantastic donor supply? People always commented on how thick the hair at the back of my head was/is. Wouldn't this help? And anyway, if you continue to bald to a Norwood 7 or whatever , can't you just give in and shave the transplanted hair? Who could possibly commit to hair transplantation if it means several procedures at five figures each? I assume that your avatar is your own pic - looks great , are you destined for more transplants though?

Thanks and yes that is my own tranformation in my avatar I've had two procedures this far, I'm planning a third in October.

The question of further surgeries really depends on several factors, one of course is level of loss, the other is progressive hairloss. If you're currently like myself a Norwood 6 there's is simply no way you will be able to move as many grafts necessary to cover the entire scalp with adequate density, so let's do it mathematically, let's assume the average bald scalp is 200cm2 we know that for descent density you need at least 45fu per cm2, in order to cover the entire scalp at that density you would need 9,000 grafts, most guys don't have that many grafts at their disposal, but even if they did there is no way to remove 9,000 grafts out of the donor area with no problems, so this would have to be done in installments.

Before I embarked on my journey I already knew I would require several surgeries given my level of hairloss and age, I also chose FUE instead of FUT because what if I become Norwood 7 I will have to shave my head I did not want to have a visible scar in the donor area.

If you have minor balding like I assume you do, you can not implant hair where hair already exists, so there's no way to transplant your whole head if you already have a full head of hair, te plant for the worst case scenario doesn't work that way. To plan for te worst scenario you would have to be very conservative with your grafts and have a good master plan for your procedure, assume that you may need touch up procedures every 10-20 years. Of course unless you stop caring at that point then you can leave your hair as is. Another reason why guys get multiple surgeries is hair greed, you want more hair, now that I've gone through my transformation I see weak areas that could use improvements so naturally I want to have surgery to have those areas fixed. Hope this makes sense.

[hanginginthewire]

Do you mind me asking how much your surgeries were? I don't understand how guys can have one after the other.

This is a pic of my hair from last month. I know it's not very close up but gives you at least an idea of where I'm at.

[hanginginthewire]

Also my brother is not on treatment and yes his hair is worse at 43 than it was at 36. I have a maternal uncle who is pretty much slick bald up top and has been for decade or more (in his sixties now) my dad had hair into late 60s but thinned a lot.

And sorry again I know that pic is not very helpful just wanted to give something to go on presently. A closer shot and now that I've cut my hair shorter again would reveal a lot more thinning and miniaturization.

[RU58841]

Also my brother is not on treatment and yes his hair is worse at 43 than it was at 36. I have a maternal uncle who is pretty much slick bald up top and has been for decade or more (in his sixties now) my dad had hair into late 60s but thinned a lot.

And sorry again I know that pic is not very helpful just wanted to give something to go on presently. A closer shot and now that I've cut my hair shorter again would reveal a lot more thinning and miniaturization.

No no, regarding your brother, what I meant was how would HIS hair (when he was 36) compare to YOUR hair at age 36? If it was about the same, but it's much worse now, then you might expect that you'd lose a lot more hair in the next 7 years than you have during the past 7.


As for prices, I think top doctors' FUE prices are $6-8/graft. It's really hard to tell in your pic, but assuming you don't have crown loss, I'd GUESS you'd be looking at somewhere between 2000-3000 grafts for FUE. So maybe plan for like $18000? For FUT it would be more like $12000.

[hanginginthewire]

Waaaat? It's that much? That sounds crazy to me. My crown has minimal thinning/ minaturizing. My brother was similar to where I am now when he was 36 yeah. My other brother has no hairloss to speak of and he's 40. I'm totally shocked at your figures. And that's just for ONE procedure? I guess that settles that then cause there's no way I can swing that. I was gonna ask what people thought of this result, looks amazing to me (started as a norwood 5a) but I'm guessing he paid 30k or something:

Https://www.baldtruthtalk.com/album.php?albumid=802

[RU58841]

Waaaat? It's that much? That sounds crazy to me. My crown has minimal thinning/ minaturizing. My brother was similar to where I am now when he was 36 yeah. My other brother has no hairloss to speak of and he's 40. I'm totally shocked at your figures. And that's just for ONE procedure? I guess that settles that then cause there's no way I can swing that. I was gonna ask what people thought of this result, looks amazing to me (started as a norwood 5a) but I'm guessing he paid 30k or something:


Https://www.baldtruthtalk.com/album.php?albumid=802

Well he had 3217 grafts, and sometimes doctors give discounts if the grafts needed exceed [however many], so probably closer to 20k. With 3200 grafts out of the supply, and assuming he's got an average number, then maybe that's about half of his total, so maybe he'd be doing only one more procedure for a lifetime max cost of like $40k-45k? Obviously you're not gonna be doing 3 procedures of 5,000 grafts each.

You should visit the websites of a few renowned places like Hasson & Wong, Rahal, etc. and just submit your pictures and see what they say. Might prove me wrong. Plus, different doctors are known for slightly different strategies (some being more aggressive in density) and sometimes one will recommend a lower number of grafts. It's worth inquiring before you give up on the idea, it's not like you have to commit to anything.