hair transplant Strategy

[Def]

All

I have a thinning crown, but absolutely no hairline recession (yet). The hair all over the top of my head *feels* a bit thinner than the hair on the back and sides, but other than the crown, there is no noticeable thinning. I lose many hairs each day when styling my hair and showering. Here is a picture of me front on earlier this year. I have only ever had one person (that I haven't told) notice my hairloss to date:

http://img299.imageshack.us/img299/5412/meed2.png

What have I done about my thinning crown? Well - I've been on finasteride and minoxidil for coming up to 6 years now. While (quite unluckily I feel) I've never had any regrowth whatsoever on my crown, my hair has essentially maintained during this time. I haven't taken any pictures lately, but my 1.5 and 3 year pictures are in the following link:

http://www.hairlosstalk.com/interact/viewtopic.php?f=11&t=23275&hilit=+the+3+year+mark+

My situation is essentially the same as it is in these pictures - slightly worse now perhaps. My crown has continued to thin, but only very slowly, over the past 6 years - thanks predominantly to finasteride I think. This may ruffle a few feathers on here, but I would much rather recede than end up looking like Friar Tuck. I think older men look great with a bit of recession - even as far as Kevin Spacey who can pull off a decent look with only very little hair.

Now to the point of this post(!) - I am 32 this year and am thinking that maybe I should get an hair transplant into my crown. I could easily afford a procedure or two with Feller, Hasson & Wong, ******** or the like. It's now just matter of when I do it and how I should approach this. Obviously, I want to maximise both my cosmetic benefit and donor availability if I need / want future work.

I have done quite a bit of reading on here and on the net generally about hair transplant's and I just wanted to get some opinions on hair transplant strategy. I have read that one may have both FUE and strip procedures over time. I would imagine that the best way to do this would be to have an FUE procedure first and then a strip procedure later on if required (thereby maximising the amount of grafts that may be obtained from one's scalp)?

Anyway, all thoughts appreciated. In particular, I'd appreciate suggestions as to whether you think FUE or strip would be better for me, when I should take the plunge, how many grafts you think I'd need etc.

At this sage, I'm thinking I'll maybe get an FUE procedure of about 1000-2000 grafts towards the end of 2009 or start 2010.

Cheers

Def

 

[metalheaddude]

From my understanding its dangerous to transplant a lot of grafts to the crown because it uses up ALOT of donor for very little cosmetic difference.This excessive donor could of otherwise be used on the hairline which is more cosmetically noticable. But as you said you don't appear to be receading on the hairline. And given you're now early 30's and you have had success with minoxidil etc, I think you're a good candidate to go forward and get your crown filled in. I would not use anymore than half your donor on your crown though. Go for maybe 3000-3500 FUE? And other remaining half for the donor 1500 for fill in's on the crown for the future. And the other 1500 up your sleeve just in case your hairline goes.

Thats what I think anyway (just from my own research).

 

[s.a.f]

Personally I would'nt worry about such a minor degree of hairloss but if it did bother me I'd just use a bit of toppic. I definatly would'nt consider that worthy of surgery. But anyway it would probably require less than 1000 FUE.

 

[Guest]

You hairloss is minimal at your age which is a good thing. What is the most advanced class of hairloss on both sides of your family history? Do the men lose in the crown like yourself and then begin losing their hairline in their 40's-50's?

I think you could fill in that area enough with about 700-800 grafts. The goal is not to attain high density but to fill in the thinned areas. There's enough exisitng hair there now whereby some could get shocked, but if you stay with the lower numbers, it will decreses the level of tramua.

If male pattern baldness is minimal in your family. then you may want to consider FUE to start with.

 

[Def]

Thanks for the responses.

To be fair, I agree my hairloss is fairly minor by this stage. It is, however, probably a little worse now than in the pictures I've posted of my crown taken a couple of years back. I will get another pic up shortly. Toppik etc isn't really viable for me - I go to the gym at lunch times, surf - am constantly wetting and drying my hair.

My maternal grandfather was a NW7 (ie complete chrome dome) by age 25. He went bald from the crown first and ended up slick. I think the only thing that is holding my hairline in is my dad who is a NW1 at age 62 - that and the finasteride! As I said in my first post, my hair does feel thinner all over the top than the back and sides and I lose quite a lot each day so I'm worried I will eventually end up and NW5 or greater...

Anyway, I don't plan to do anything immediately - this was more to determine how best I should move forward with my limited supply of donor hair if I need to.

I guess my ultimate question would be: "Will getting 500-1000 FUE now in any way hamper my ability to get a larger strip procedure down the track if required?".

Def

 

[s.a.f]

What you take now in FUE will be the possible amount you'll lose from any future strip surgeries.

 

[Guest]

Def,

My biggest concern for you is that you are still losing in spite of the meds. If I were you, I'd wait it out for awhile longer. I also had the premonition that you had advanced male pattern baldness somewhere in your family history. It somewhat reminds me of mine. My maternal grandfather had advanced male pattern baldness and my pattern took to his identically. He did not however have any of the successful hairloss meds that I have used since 1996. I was between a class 4 & 5 when I started them. If you do continue to lose more "everyday" as you stated, you could end up like your maternal grandfather and you may not want to even get started on surgery.

All I am saying is that from years of observation, guys who do not respond to hairloss meds "and" have advanced classes of hairloss in their family history, do not make good candidates if a candidate at all for hair transplant surgery. Something to think about.

 

[dd11856]

That loss is pretty small. I think you should stay on the meds. Have you tried the minoxidil foam?

 

[Def]

Thanks for the responses:

dd11856 - yep, I've tried the foam. I've tried normal Rogaine liquid, the foam, Spectral DNC, MIN Agent, and currently Nanominox FMS. I have never had any regrowth results from minoxidil, but I am somewhat scared to stop using it!

Gillenator - you may well be right. Obviously, I can't predict whether I am going to end up like my maternal grandfather but I think he did start balding at the crown also. I think the only solace I take from this is that if I do get FUE / hair transplant into my crown and then ultimately end up having to shave my head, although I will have wasted a few $$$, at least it won't look as strange as having a hairline grafted in with slick bald recession behind it. If I am to go completely bald, I would imagine an implanted crown could be well built upon to offer at least a result like that of Kevin Spacey (which I think looks good on him):

http://www.splotchy.com/images/blog/hero/kevinspacey.jpg

 

[dd11856]

Def,

I've never really had any success with any type of minoxidil either. I'll get the cornsilk type regrowth, but thats it. Like you I am afraid to stop using, as I feel it does halt some hairloss. I do like the ease of application of the foam, though.