FUE and realistic expectations according to your expertise

[Spela]

Hi everyone,
I need your expertise here.

I'm 38, been on finasteride for about 10years, stopped it 6years ago, now on minoxidil only since about 6-8months. Got dramatically worse in the last 6months(minoxidil?).

I am at the stage where I am finally planning for a hair transplant. I contacted several doctors and got very different opinions and quotations number and $ wise.

Many of you on here can praise great knowledge and I would really love to hear your opinion in terms of a number of grafts, area to focus on more and obviously what you think the outcome would be. Will I ever be able to get good overall coverage where I would look "normal"?
I'm considering FUE only.

I posted the same question on another forum so this way I can get the best experts opinion.

Pics just out of the shower with nothing on 😞

[mrclean]

Obviously the front is the focal point that most people focus on so i think you would get the most benefit from that. It depends on the density of the donor area as to the number of graphs you will get. My donor area was too thin to do FUE even though it looks like i have most of my hair. So they may have given you a number from pictures but you won't know if you are a candidate until they see you. Hopefully you will pick a good Dr. and have done your research.

[Spela]

One of my many questions is, should I aim for an overall coverage with low density in order to preserve donor for the future or get high density on the front and mid scalp right at first surgery?

[Raphael84hair]

@spela
Looking at your photographs you have pretty extensive loss. Also, as you have explained that you have stopped finasteride and are using minoxidil but have noticed things getting dramatically worse over the last several months. Obviously that isn't the ideal scenario. Maintaining what you currently have should be priority one, but I can only imagine that you stopped finasteride for a specific reason.
Depending on your goals and what you are ultimately desiring to achieve, in my opinion, session one should address the new hairline and strengthening behind in the frontal 1/3 and top of the scalp. Then I would attempt to touch the crown in a successive surgery.

Ideally I understand everybody would prefer one and done, but that isn't the right approach nor realistic for many people and that should apply to you also.

From your photography, your donor appears to be reasonably strong with no obvious sign of miniaturisation. This is important and would potentially suggest that you have good donor.
Your question regarding further loss and a plan that would make this priority is essential. You can still lose further hair and this must be taken into account. This is why you must choose your physician carefully and select somebody who has solid ethics and a great track record of looking after their patients long term interests.

Patient Advisor for Bisanga & Cole Hair Transplant Clinic - Athens, Greece
http://www.bchairtransplant.com
bc2@bchairtransplant.com

[Spela]

Conservative vs aggressive, I would personally go for a conservative since i aspect my baldness to get worse overtime. I prefer a full coverage with lower density than high density and in a few years being with bald spots because not more donor available.
I still don't understand how is possible that I got quoted from 3000 to 7000 from different doctors...this is really confusing. Would 3000grafts give me an overall decent coverage? Do I have 7000grafts available?

[Raphael84hair]

@spela
In your particular case you need to be very conservative. I believe with the right physician you could achieve great results.

Regarding the recommended graft counts from various Doctors, it is only natural that different Doctors plan a different approach for you. But the range from 3000-7000 is extreme.

In my opinion, you would need toward the upper end of this range to achieved a more full coverage, lower density result as you mentioned. But I also believe that it is possible.

Your long term plan considering further hairloss however is HUGE. Considering that you no longer take Finasteride and are experiencing further loss, you need to be very careful. You must cover from the outside in toward the crown in order to avoid islanding, and you must be extremely realistic about your long term goals.

Research, consult, educate and make the most informed decision possible.

Patient Advisor for Bisanga & Cole Hair Transplant Clinic - Athens, Greece
http://www.bchairtransplant.com
bc2@bchairtransplant.com