Suggestions required for crown HT

[livinla]

Hi Guys,

First of all , thanks to all the forum users and moderators for the wealth of information here. Really helps all of us guys in here.

Coming to myself - I'm 29 years now from India and I have had thinning since early 20s. I had transplant to the front of about 1800 grafts FUE for the hairline and the result is mildly satisfying. It's neither great nor worse. I am a diffuse thinner with fine hair. Now I look back after an year of transplant - I see my crown has had thinned a lot and there's a considerable bald spot which has been bothering me quite a bit and has taken a hit on my confidence.

I will post the pics of my crown currently in various lightings. Could you guys please see and suggest if FUE on crown is the way to go for me and also suggest how many grafts would be great for a decent coverage. With toppik fibres currently , none gets to know that my crown is thinning but using it daily and with rains/ wind - there is always this fear of losing the mask.

I come a culture where traditionally hair is seen as something very important and is probably an aspect when I plan to marry. So really appreciate what you guys would think and would be the best way to go .

Here are the options I am exploring currently :

1. Get HT to the crown with no-shave FUE from Dr Bhatti
2. Get SMP done with long hair done from A's clinic to conceal the thinning and plan an HT in future

The end goal is to not worry about hair for atleast 2-3 years down the lane again.


What do you guys think. How many grafts would be sufficient for a decent coverage? Any input is appreciated. I am really confused and looking for answers

[JoeTillman]

I didn't see any mention of this but are you taking hair loss prevention medications such as finpecia? If you aren't, you should consider it because you're only going to continue losing more hair, especially being only 29 years old and having such an obvious pattern of future aggressive loss. Assuming you are doing something to slow or halt your existing loss, I would highly recommend against having any kind of "no shave" FUE. Having FUE in this manner completely negates the reasoning for having FUE to begin with. When this procedure is done they still shave but it is in a narrow strip of the donor area from one side to the next, with the idea that your longer hair will cover the area shaved, so that it is easily hidden. The problem is that when your donor area heals you have a strip of lower density hair that draws attention by others if your hair is cut too short. If you're going to do that you may as well have a strip surgery. The proper way to have FUE is to allow the doctor to shave your donor zone. It will heal in a few days and no one will know anyway.

SMP will help but keep in mind it is only going to replicate the exit points of hair. In my opinion, the density in your crown is not strong enough to for a cosmetically pleasing result. Your density has to be higher for a good "thickening" procedure and you're better off with fibres at this point.

I hope this helps.

[livinla]

I didn't see any mention of this but are you taking hair loss prevention medications such as finpecia? If you aren't, you should consider it because you're only going to continue losing more hair, especially being only 29 years old and having such an obvious pattern of future aggressive loss. Assuming you are doing something to slow or halt your existing loss, I would highly recommend against having any kind of "no shave" FUE. Having FUE in this manner completely negates the reasoning for having FUE to begin with. When this procedure is done they still shave but it is in a narrow strip of the donor area from one side to the next, with the idea that your longer hair will cover the area shaved, so that it is easily hidden. The problem is that when your donor area heals you have a strip of lower density hair that draws attention by others if your hair is cut too short. If you're going to do that you may as well have a strip surgery. The proper way to have FUE is to allow the doctor to shave your donor zone. It will heal in a few days and no one will know anyway.

SMP will help but keep in mind it is only going to replicate the exit points of hair. In my opinion, the density in your crown is not strong enough to for a cosmetically pleasing result. Your density has to be higher for a good "thickening" procedure and you're better off with fibres at this point.

I hope this helps.

Thanks for the insights Joe. Very helpful indeed. I am on finasteride at the moment for the past few months and it did lower the hairfall considerably. Yea , I also feel SMP would not give the desired result with the current low density.
How many grafts do you think would be required for crown at this juncture? The main reason for no shave FUE is to get back to office with the same look after ~ 15 days or so. Also for the transplant , do they shave the recepient area in the crown as well?

[JoeTillman]

My guess would be that you need 1500 minimum, maybe 2000, to get a result that will make a tangible difference. Keep in mind the top of your scalp is still thin so if you want to at least match what you have in the mid-scalp then those numbers should do the trick. Unless your doctor has a lot of experience working within unshaven native hair I'd suggest you allow them to shave. Keep in mind that after 15 days your FUE extraction points should be fully healed and the shaved hair will have grown a few millimetres. Have your entire head buzzed down for the procedure and by the time you return to work you only look like you've had a very short haircut. With your skin tone the redness will be all but gone in a week to ten days.

[Hairhope4ever]

Hi Livininla,

I agree with Joe. Judging by your photos, I think 2000 would give you great coverage, and very good density in the crown area.

Best of luck going forward.

[kaushik]

Hey .. did you end up doing your HT with Dr. Bhatti. Thanks