Opinions on graft no required and donor quality.

[D8n]

Ive been in the background for a long time doing my research. The time has come that I feel I am ready to have a transplant in the next year. To give an idea of my situation I am 28 and have been losing my hair since I was 21,22 and would say I am probably a NW3.

Ive contacted some well regarded surgeries with the help of this forum, but I have been surprised by how varied the no of grafts I have advised would be required vary they go from 1700 to 3500. I'm not for one minute doubting the feedback I have had and its worth mentioning that I have only met with one consultant and the rest have been done via pictures so this could play a part.

I will of corse meet with the Dr I end up having a procedure with to discuss my options, but until i get the opportunity to I wanted to get peoples opinions on the graft no's required to restore my hairline and the quality of my donor area.

[thejack]

Hey D8n, I am no expert but I have looked over many transplant pics and have had one myself which was very successful.
Are you taking finasteride? Because most doctors would advise you start to stabilise your hair loss first. With that being said your donor looks above average imo... I was told mine was about average and yours looks a bit stronger from those photos.
With regards to grafts it depends what your objectives are from the surgery? I am guessing you want a norwood 1 look? In which case I would say you would need 3500 for a dense hairline. Your front hairline has receded as well as the temples so this will suck up the grafts for sure. It will probably take two procedures if you want a nice dense finish. Good luck with who you choose

[D8n]

Thank you for your response thejack, Its reassuring to hear that about my donor area.

I am currently taking propecia to maintain what I have. My objective really is to restore my hairline so I can style my hair at the front. I am willing to compromise on density in order to save some grafts for future. I was just unsure as to what I would have left should I go for a 3500 graft procedure.

[thejack]

Your welcome pal.
I don't know what type of procedure you want but to maximise your donor you want to go with a strip procedure for the first couple. When your donor is tired of that you can move onto FUE.

[D8n]

How many procedures have you had Thejack? Im still undecided as to go for FUE or FUT, manly because of the linear scar. So you would recommend having FUT first?

[JoeTillman]

D8n,

I would suggest you get some more consultations. I looked at your photos and I disagree with the idea of you being a NW3. You are a diffused NW5A with a frontal forelock as there is clear thinning throughout the top of your scalp into the high crown region. Furthermore I see retrograde alopecia on the profile image you shared which means that strip is probably not a good idea. Retrograde alopecia is an upward thinning usually seen behind the temple points and above the ears. It narrows the region from which the strip can be taken which further reduces the margin for error with strip placement and potentially reducing the amount of hair available.

How long have you been on Propecia and do you think it is working for you? In other words, do you look the same now compared to when you first started or have you been on the medication long enough to know?

[D8n]

Bloody hell Joe well now you've got me worried!

Thank you for your response, I appreciate your advice. Im really just trying to plant for the future and thinking ahead to be honest as Ive only been on propecia for near 6 months. I want to give it a year to see how I react to it before booking a procedure.

I do have to agree with you that I took the photos with wet hair for the first time and was surprised to see that my hair appeared to be thinner throughout the top. When its dry it looks to be only an issue in the front and beginning of mid. You say I am probably a NW5A does that indicate thats the pattern of baldness Im likely to follow without preventative treatment such propecia? i.e. would I naturally become a NW 6-7 or stay at NW5A?

Can you tell me a little bit more about retrograde alopecia? What makes you think that I have it form the pictures? Could it be because my hair is wet and a no 1 at the sides.

What would you say is the best corse of action form here?

Dan

[JoeTillman]

Hi Dan,

Sorry to be the bearer of bad news, mate but I've got to call it as I see it. Currently you are a 5A diffused meaning you are visibly thinned, currently, in the pattern of a 5A. Without meds this pattern will become more prominent however I think that the pattern itself will continue to progress unfortunately but I cannot say how far.

Retrograde alopecia is very common to varying degrees but it is as I stated earlier. It is a thinning of hair vertically on the sides above the ears and it can also be present with temple point recession. It can also affect the back of the donor zone with a deterioration of the nape into the permanent donor zone. Combined with the probable continued expansion of your existing pattern your sides are being hit from three sides; the top moving down, the bottom moving up and the temple point moving back. Your hair cut may have something to do with this but if you look at the image of the back donor zone compared to the side there is a big difference in density and this is common with retrograde alopecia in that it can many times only affect the sides. This is why FUE would be a better solution for you as the strip has a very narrow sweet spot in which to harvest from.

My advice is to devise a long term "wait & see" approach with Propecia, avoid processed sugars, exercise and have a healthy diet overall and see how your hair evolves. If you have any further questions let me know.

[thejack]

Just one so far, 2000 grafts FUE which was all I needed to give the look for a full head of hair. I started finasteride 6 years ago which gave me some regrowth and solidly held my hair since. Now I am looking to get a small second one to add to my temple points and that will be me done for good hopefully. Before I had a transplant I had been on finasteride for 2 years and had monitored my hair closely, therefore it was evident I was in a good position to have a procedure.
Whatever you do don't jump in, make sure you do EXTENSIVE research and fully understand your situation and what are realistic objectives.