How bad is it and what can be done?

[HTsoon]

And what doctor do you think would be capable of doing something good in my case? And what would amount to hairloss prevention?? Nothing really works out there.

The only procedure that could be useful for you in one procedure is strip, joe had a strip surgery he didn't do FUE, like I said FUE is limited with how many grafts could be moved in one session, if you want to get the max amount of grafts for one surgery you'll have to do strip and have the scar for life this is reality, trust me, I've had two FUE procedures and my hairloss was even less than yours and my donor looked better.

If you're set on surgery and you only want to do one it'll have to be strip, I recommend Hasson and Wong as they are good at doing mega sessions.

Hairloss prevention works, it helps maintain your hair, it's possible your hairloss would continue without any form of prevention like finasteride, minoxidil and nizoral. If you have surgery and don't take any hairloss prevention meds you may wind up like this


I don't think you're really thinking this through properly, you need to really research and think about it before you have surgery without any form of prevention. Especially if you're set on only having one surgery. I don't think it's a wise decision.

[blohan]

The only procedure that could be useful for you in one procedure is strip, joe had a strip surgery he didn't do FUE, like I said FUE is limited with how many grafts could be moved in one session, if you want to get the max amount of grafts for one surgery you'll have to do strip and have the scar for life this is reality, trust me, I've had two FUE procedures and my hairloss was even less than yours and my donor looked better.

If you're set on surgery and you only want to do one it'll have to be strip, I recommend Hasson and Wong as they are good at doing mega sessions.

Hairloss prevention works, it helps maintain your hair, it's possible your hairloss would continue without any form of prevention like finasteride, minoxidil and nizoral. If you have surgery and don't take any hairloss prevention meds you may wind up like this


I don't think you're really thinking this through properly, you need to really research and think about it before you have surgery without any form of prevention. Especially if you're set on only having one surgery. I don't think it's a wise decision.

And what was your hair prevention method and what do you take now?

[JoeTillman]

Hi Blohan,

You almost hit the jackpot by living in Panama as the next ISHRS world hair conference was supposed to be in Panama City this year but it has been moved to Las Vegas. You would have had roughly 1000 hair transplant doctors in your back yard

I'll break this down by the talking points that I remember.

You asked for help in finding doctors in Panama. I think you'll probably have to hop on a plane for your needs as Panama isn't known for being a hair transplant destination. I'm not saying you won't find satisfaction locally but I do think the odds are low, at least based on the standards you'll find here. Your odds will be significantly better by flying to see a destination clinic.

Which procedure? FUE or FUSS? This is always a question to ask but to get the answer you have to ask yourself more questions. Do you have advanced hair loss? Do you want to ONLY have longer hair styles (half inch and longer) and will never ever consider having buzz or crew cuts? Do you want as much hair as possible in one procedure? If you answered yes to all of these questions then FUSS is the procedure for you.

Why would you consider FUE over FUSS? Because you may want to have the option of a buzz cut all over your scalp without fear of a linear scar being visible. You may want the easier healing time or the potential reduction of possible post-op complications.

You referenced my first procedure (with Dr. Wong) which was my third overall. Yes, I had two previous strip procedures, not plug procedures, and they turned out horribly. I had two wide donor scars, one above the other, and the hairline was very pluggy. I lost all my hair AFTER these two procedures so I had your hair loss pattern by the time I was about 29 but I had a pluggy hairline that I grew long to comb back over my bald scalp. It was pathetic, really. But the first procedure I had with Dr. Wong put me back into a state of "normalcy" in that I did not have an appearance that attracted unwanted stares or rude and embarrassing comments.

This is what I looked like after 2406 grafts in one surgery...



Now, one thing you have to understand is that the coverage I achieved was due to good planning but also due to the grafts being "chubby". They were not ultra refined or divided into sub-follicular units. They were full on follicular units with many doubles, triples and even some quad hair grafts so they really worked together well to cover the front of my scalp. Of course the frontal hairline grafts were singles and looked very natural but the result overall was still very thin but I had enough hair to style and I didn't look different from most people because my old work was 95% camouflaged to the point that one would REALLY have to look hard to notice them.

One thing you can't forget however is that while my old work was very bad the old work did wind up helping the overall final product. How? For two reasons, actually.

1. Because they were vertical and were not laying down forward as they should have been they help to "lift" the new work so it has more overall body. Even today, with about 10,000 grafts, the front of my hair is a bit more volumous than it should be and the old work still helps. The idea was that the new work would overwhelm the old and force it to lay flatter, which is what it does, but not 100% so the old work does benefit me in this regard.

2. Frontal density and coverage. The old grafts were thick and many of them contained six to twelve hairs each so they help the front of my scalp, just behind the hairline, appear to have high density but what the front really has is about 2000 hairs (not grafts) that are not factored into the final result. My 2406 grafts is equal, visually, to about 3000 or 3400 grafts because of my pre-existing work.

So if you are not concerned about the back, the crown, then maybe you can reach satisfaction with a moderate result for the front. I say "moderate" because the density will be moderate and the coverage will be moderate and no one will confuse you for having a full head of hair. Some guys are very happy with just enough to comb and the crown is relegated to "out of sight, out of mind". There is nothing wrong with this at all and represents what is found in nature all the time. In face, one of my good friends has a natural hairline pattern where he's a NW2 up front, has strong but somewhat thin coverage on the top, and a crown that would rival any NW6 out there with very little hair remaining. But's it's natural.

Ultimately, if you are not depsperate for hair and can accept your current appearance I think you should move on in life and count your time here as a learning experience. No one NEEDS to have hair transplant surgery but many people absolutely NEED repair surgery. Don't be the latter.

[blohan]

Hi Blohan,

You almost hit the jackpot by living in Panama as the next ISHRS world hair conference was supposed to be in Panama City this year but it has been moved to Las Vegas. You would have had roughly 1000 hair transplant doctors in your back yard

I'll break this down by the talking points that I remember.

You asked for help in finding doctors in Panama. I think you'll probably have to hop on a plane for your needs as Panama isn't known for being a hair transplant destination. I'm not saying you won't find satisfaction locally but I do think the odds are low, at least based on the standards you'll find here. Your odds will be significantly better by flying to see a destination clinic.

Which procedure? FUE or FUSS? This is always a question to ask but to get the answer you have to ask yourself more questions. Do you have advanced hair loss? Do you want to ONLY have longer hair styles (half inch and longer) and will never ever consider having buzz or crew cuts? Do you want as much hair as possible in one procedure? If you answered yes to all of these questions then FUSS is the procedure for you.

Why would you consider FUE over FUSS? Because you may want to have the option of a buzz cut all over your scalp without fear of a linear scar being visible. You may want the easier healing time or the potential reduction of possible post-op complications.

You referenced my first procedure (with Dr. Wong) which was my third overall. Yes, I had two previous strip procedures, not plug procedures, and they turned out horribly. I had two wide donor scars, one above the other, and the hairline was very pluggy. I lost all my hair AFTER these two procedures so I had your hair loss pattern by the time I was about 29 but I had a pluggy hairline that I grew long to comb back over my bald scalp. It was pathetic, really. But the first procedure I had with Dr. Wong put me back into a state of "normalcy" in that I did not have an appearance that attracted unwanted stares or rude and embarrassing comments.

This is what I looked like after 2406 grafts in one surgery...



Now, one thing you have to understand is that the coverage I achieved was due to good planning but also due to the grafts being "chubby". They were not ultra refined or divided into sub-follicular units. They were full on follicular units with many doubles, triples and even some quad hair grafts so they really worked together well to cover the front of my scalp. Of course the frontal hairline grafts were singles and looked very natural but the result overall was still very thin but I had enough hair to style and I didn't look different from most people because my old work was 95% camouflaged to the point that one would REALLY have to look hard to notice them.

One thing you can't forget however is that while my old work was very bad the old work did wind up helping the overall final product. How? For two reasons, actually.

1. Because they were vertical and were not laying down forward as they should have been they help to "lift" the new work so it has more overall body. Even today, with about 10,000 grafts, the front of my hair is a bit more volumous than it should be and the old work still helps. The idea was that the new work would overwhelm the old and force it to lay flatter, which is what it does, but not 100% so the old work does benefit me in this regard.

2. Frontal density and coverage. The old grafts were thick and many of them contained six to twelve hairs each so they help the front of my scalp, just behind the hairline, appear to have high density but what the front really has is about 2000 hairs (not grafts) that are not factored into the final result. My 2406 grafts is equal, visually, to about 3000 or 3400 grafts because of my pre-existing work.

So if you are not concerned about the back, the crown, then maybe you can reach satisfaction with a moderate result for the front. I say "moderate" because the density will be moderate and the coverage will be moderate and no one will confuse you for having a full head of hair. Some guys are very happy with just enough to comb and the crown is relegated to "out of sight, out of mind". There is nothing wrong with this at all and represents what is found in nature all the time. In face, one of my good friends has a natural hairline pattern where he's a NW2 up front, has strong but somewhat thin coverage on the top, and a crown that would rival any NW6 out there with very little hair remaining. But's it's natural.

Ultimately, if you are not depsperate for hair and can accept your current appearance I think you should move on in life and count your time here as a learning experience. No one NEEDS to have hair transplant surgery but many people absolutely NEED repair surgery. Don't be the latter.

Thank you for taking the time to answer Mr. Tillman, as I said before I saw your work and was impressed, I would be perfectly happy with your first repair surgery, but I don't know if I would get the same results, also I may be losing hair in my donor area, it's not something I had noticed before this thread, although I don't feel it. Is there an age where this stops? Will I have to take medicine for life after a transplant? Do you take any medicines currently?

I really wish I could just move on but it's hitting me hard to be honest, I don't know why, it's not like I ever had great hair, I didn't, but this is very upsetting to me.

I preferred FUE because I always have buzz cuts, and I guess I will continue to do so, it's the only style that works to minimize the appearance of hair loss, but if you have any advice on this regard, I also can't afford many surgeries, specially if I would have to travel, I can totally settle with enough hair to style on the front and an actual hairline, I really do not care how the back looks.

This is a video for a procedure done in my country: https://www.youtube.com/watch?v=mjuOu_x7H5w it's by doctor Joseph Setton, I have seen this patient on the tv, he looks fine and natural but mostly he just wears a hat. I know of another transplant case but I do not know the doctor who did it or if it was in my country, but he has zero hair.

How would having it done in another country work?