Transplanted hairline with a hair system behind it.

[arnie]

Hey I am a 25 yr old NW6. I had a word with a renowned hair transplant surgeon who told me that he could cover my scalp using scalp , beard and body hairs but it would cost a bomb. Besides having seen results of transplants on his patients with higher norwoods, I wasnt very satisfied with the density.

So I am thinking of going for a dense FUE transplanted hairline with a hair system behind it to have a density appropriate for my age. I'll probably wear the hair system for another 5-7 yrs or more if I am comfortable. Whenever (if at all) I decide to get rid of the hair system, I'll probably get a very short haircut or may as well go for further transplants. I have worn a hair system for a week with temporary clip attachments and felt that I will be able to carry it. Besides, with a transplanted hairline and a decent lace system, I guess it would look very natural and the constant need for reattaching the front of hair system at the hairline (which I have heard is problem with hair system wearers) wont be there.

I am considering an inch to inch and half coverage at the hairline. This would take around 2500 grafts.

I have a few doubts though:

How sound is the plan? Has anyone gone down this route? Do the transplanted hair and system hair match in their density , colour and texture?

Should I go for lower or higher no of grafts for a more natural result? (I am thinking of 2500 only so that it is still reversible in case i give up the hair system and can have a lower density transplant behind this high density hairline. Should I go for even less?)

Any other possible issues which I am not taking into consideration?

PS: I have limited scalp donor grafts being a NW6. The doc said that he could harvest somewhere around 3000 grafts from my scalp in one sitting and then another 2500 grafts after a couple of months. I have a dense beard from which around 2000-2500 grafts can be extracted. Body hair can added as filler (This is if I went for a transplant only solution. For now I'll just use 2500 scalp grafts and use the rest later in case I need it)

[Hubris]

I wore a hair system a little under two years ago. To be honest I found it to be a complete nightmare. Very expensive in the long-run too. I'd rather be bald and everyone know it than wear a piece. However, clearly many other people get a long with them just fine.

I suggest you try wearing a hair system for a few months before committing.

[arnie]

Could you put some photos so we can have a look and maybe give you some advice?

2500 grafts would cover somewhere between 2nd and 3rd lines as per the doc.

[arnie]

Donor

[JoeTillman]

I agree with Dr. Karadeniz but I'll expound based on my own experience dealing with patients.

What you ask for is possible, and I've seen it done with excellent aesthetic results. In my opinion however if one is going to attempt such a plan they should already have been a veteran of wearing hair systems for a number of years. It should already be an integrated part of your daily life. The maintenance they require is never ending. Your lifestyle choices will be limited as you'll always be cognizant of it's presence and you'll be constantly modifying your existence to accommodate it's use. In short, wearing a hair system will dominate and rule your life. To add a new hairline to the mix means that you are effectively locked in to be a slave to the hair system. You will never be able to go out without it and you will most likely not be in a position to be completely open with your partner as the removal of the system but having a defined, narrow, dense hairline only will look unusual and may be off-putting. Considering the above points you are, in my opinion, in no position to consider such a move because you have no idea what the long term requirements are.

Before you consider anything you should be working on prevention. Being 25 you're going to lose more hair and while it may not seem like you can lose much more, you can in fact lose enough that would alter any plan you have today. Medical prevention is the first step and with a bit of luck, you can actually see enough benefit that your outlook may change. Consequently, you can also choose to go the opposite direction and shave your head, hit the gym, and "own" your hair loss by embracing it. It sounds tough but I've seen many guys do it with success especially when they've been working on their physique as well as their mental game.

If you are determined to have "more" hair as opposed to embracing your loss then I think the surgical route would be best compared to a system and you could add Dermatch or Toppik as a daily filler to give you the appearance of density you desire. They work quite well and while you'd still be a slave to their use you would not look unusual if you decided to just stop as opposed to giving up on a hair system after you've had a new hairline built using surgery.

Whatever you do, don't rush into anything and please PLEASE research and carefully consider the information available to you.

[Candide]

Hi Arnie - I have done this, and i am really happy with the result. Originally I was wearing a small hairpiece behind a patch of natural hair which hid the front of the piece. Then the natural hair thinned to the point where it looked weedy and was no longer hiding the front. I tried just shaving it and exposing the lace front of the hairpiece, but I always felt a bit exposed without the bit of natural cover, in case the base of the piece might show and give it away. So I did a transplant to replace the front band. It works really well and I feel I now have a long term solution to my problem. Some of the comments above seem unduly negative.

I have a few photos that I don't mind sharing with you, but I don't want to put them on the Web. You can email me on systemwearer at yahoo dot co dot UK if you are interested.

[Dr. Lindsey]

So far we are ZERO for Three in getting good results in patients who wear hair systems postop. While they all assured me they'd make sure not to let the system get near the grafts, in 2 of the 3....there was clear evidence of scalp irritation in my recipient area at all postop visits. The third, assured me he would not wear the system and complete his 2 cases....and I saw him on TV about 3 weeks out from his procedure with the piece on. Never heard from him again, still see him on TV with the piece.

So my 2 cents is throw away the system if you want a good result. My associate Dr. Feller says he's had better results with these types of issues, but we're pretty consistent in getting good results...except in system wearers.

Dr. Lindsey McLean VA

[arnie]

Thanks Dr lindsey, Dr Ali and Joe for the word of caution on the low hairline and being stuck with the hairpiece forever.
Thanks Candide for sharing your experience.

I have always been apprehensive of taking finasteride because of the sides, so I never took it. Used mintop for a year but didnt get any cosmetically useful results. I was kinda assuming that I am done with my hair loss now as there hasnt been an active shedding for around a year now. I may be wrong here.

I still dont think a transplant would satisfy me , theres too much area to be covered. I'll probably commit to a hair system for a couple of months for now and decide what I want next. I guess a few months of system usage wouldn't make my scalp unsuitable for a transplant.

[dutchguyhanging]

Thanks Dr lindsey, Dr Ali and Joe for the word of caution on the low hairline and being stuck with the hairpiece forever.
Thanks Candide for sharing your experience.

I have always been apprehensive of taking finasteride because of the sides, so I never took it. Used mintop for a year but didnt get any cosmetically useful results. I was kinda assuming that I am done with my hair loss now as there hasnt been an active shedding for around a year now. I may be wrong here.

I still dont think a transplant would satisfy me , theres too much area to be covered. I'll probably commit to a hair system for a couple of months for now and decide what I want next. I guess a few months of system usage wouldn't make my scalp unsuitable for a transplant.

arnie, as NW5 candidate i duly understand ur frustration. And I agree with your comments. I also dont think hair transplant will satisfy your expectations. what they will do is a bit of magic and put few hairs at front. then you still have a shiny crown at the back. you are 25 and u want NW0 expectations.. 100% agree with you.... I also rather be NW6 shaved then having few hairs on top of my head.
unfortunately their hands are tied. if we have unlimited supply I am sure they are top niche doctors out there could make u look NW0.
you are asking me what i did? yes i shaved it and moved on with my life. I am here to give people my advise and if there is any cure comes out I wanna see it here...

unfortunately the future doesnt look so bright either. SM results are horrible, I dont expect much from replicel... so we are probably stuck with this mess for another 10years at least. Better not worrying and know that u r not alone...

and never forget, hair is like money.. no matter how successful surgery u have ever had, you will always seek for more...

[monty3001]

What you are desirous of can be achieved. I wore 1 cm hair piece across the front of my head for a while. The texture and colour match was superb and I have awkward mousey hair. Very difficult to match that colour but they did it right, first time.

I gave up on it though as applying such a small and delicate piece was EXTREMELY difficult and de bonding and cleaning the piece was hard too as it was so delicate. Once de bonded and re bonded over 10 times to get it right when I first started.

Also, the edge of the hair line is prone to raising. Absolutely needs glue which is a PITA to use and clean up. What you are suggesting removes the worry of being caught out by a dirty or loose hair line and also removes the need for glue. Tape is fine for the mid section of a piece and whilst your transplant is growing you could wear a piece BEHIND the HT with tape perhaps.

Def wear a piece for a while first though. You need to adopt wearing as a lifestyle choice that you are committed to. They are high maintenance. Don't spend thousands on one either. You can get really good affordable custom pieces. Plan ahead. Buy one and when it matches and you've tested it to be of the standard you want buy 2 more immediately. Can take a few months to produce.

[arnie]

@monty - yes I have decided to get used to a system before going in for a transplant. thnks for all the info

@dutchguy - i am glad you could accept it and move on. I wish i am able to do it someday

[Stevedawg18]

A lot of work

Sounds like a huge amount psychological, physical, and financial drain to spend on your hair. Easy to say but hard to do, may want to try and just live with a shaved head. You'll still have girlfriends and have plenty of fulfilling experiences in life. I know because I lost most of my hair throughout my twenties and still did. That being said I still got a transplant at 33 but wasn't a clean Norwood 6. So I wasn't successful in accepting it but glad I didn't do this any younger.