How many grafts would be sufficient?

[M.G]

I'm 26 years old. Started balding aggressively when I was very young. Been on finasteride for almost 6 years which have halted the hair loss for the most part. Hardly any regrowth though.

I want a hair transplant. How many grafts would be enough to lower my hairline and fill in a little bit of the crown?

If I say 3500 grafts:
- 2500 around the hairline
- 1000 around the crown

Does that sound reasonable? I don't think I can cover all of my crown with those grafts, but it's better than nothing I feel. Keep in mind that the hair I got on the hairline is also pretty thin, poor density.

I'm asking because I want to feel prepared for upcoming consultations. Also, what Norwood would you say I am?

 

[Isneezedsohard]

I'm 26 years old. Started balding aggressively when I was very young. Been on finasteride for almost 6 years which have halted the hair loss for the most part. Hardly any regrowth though.

I want a hair transplant. How many grafts would be enough to lower my hairline and fill in a little bit of the crown?

If I say 3500 grafts:
- 2500 around the hairline
- 1000 around the crown

Does that sound reasonable? I don't think I can cover all of my crown with those grafts, but it's better than nothing I feel. Keep in mind that the hair I got on the hairline is also pretty thin, poor density.

I'm asking because I want to feel prepared for upcoming consultations. Also, what Norwood would you say I am?

View attachment 157347View attachment 157348View attachment 157349View attachment 157350View attachment 157351

you r diffuse like me-- which makes it tricky.

 

[kharmacoma]

Your calculations as correct I would says 3500-4000. However you are a difficult case due to already having hair in the region you want to add. Have you considered finasteride? Would probably make you forget about hair transplant for some time. I would say you will end up NW5 or NW6.

 

[M.G]

Your calculations as correct I would says 3500-4000. However you are a difficult case due to already having hair in the region you want to add. Have you considered finasteride? Would probably make you forget about hair transplant for some time. I would say you will end up NW5 or NW6.

I've been on finasteride for almost 6 years. Why is it more difficult if I already have hair in a region I want to add density to?

 

[justinbieberscombover]

Would be wiser to get the hairline fixed, wait a year then fix the crown.

 

[M.G]

Would be wiser to get the hairline fixed, wait a year then fix the crown.

I'm definitely considering that. However, if I can avoid shaving my head, I would be willing to pay more for that option.

I've seen operations where they did not shave the head at all, but they implanted the grafts only at the hairless areas of the hairline. In my case I would have to get grafts also were there is already hair if I want more density, is that something that is possible with todays techniques?

 

[whatintheworld]

I would say 3000-4000 grafts is a good estimate. I have similar diffuse thinning to you, been on finasteride and minoxidil for almost 5 years and have sort of stabilized and am looking for a transplant this year.

In my opinion, I would not lower your hairline too much. Maybe only like two centimeters. The rest of the grafts I would just reinforce density to the top. Because I think, aesthetically, having that density would be more useful than having a very straight and low hairline, and since you have advanced baldness, every graft is extra precious.

What doctors are you considering?

 

[M.G]

I would say 3000-4000 grafts is a good estimate. I have similar diffuse thinning to you, been on finasteride and minoxidil for almost 5 years and have sort of stabilized and am looking for a transplant this year.

In my opinion, I would not lower your hairline too much. Maybe only like two centimeters. The rest of the grafts I would just reinforce density to the top. Because I think, aesthetically, having that density would be more useful than having a very straight and low hairline, and since you have advanced baldness, every graft is extra precious.

What doctors are you considering?

It depends on this whole Covid-thing and whether my boss approves my chosen vacation weeks. I need to be gone for atleast 3-4 weeks, if I don't get that approved I may have to wait atleast til winter or later. If things subsides by summer I will probably consider Turkey, and probably one of the main players such as Demirsoy. Don't really matter who for the most part as long as reputation is good online.

If I don't go to Turkey I will do it here in Sweden. We don't really have any stand out surgeons here, but prices aren't that excruciating either compared to say US/UK and there is one clinic I have my eye on, Nordic Hair Clinic, which seems okay.

 

[whatintheworld]

It depends on this whole Covid-thing and whether my boss approves my chosen vacation weeks. I need to be gone for atleast 3-4 weeks, if I don't get that approved I may have to wait atleast til winter or later. If things subsides by summer I will probably consider Turkey, and probably one of the main players such as Demirsoy. Don't really matter who for the most part as long as reputation is good online.

If I don't go to Turkey I will do it here in Sweden. We don't really have any stand out surgeons here, but prices aren't that excruciating either compared to say US/UK and there is one clinic I have my eye on, Nordic Hair Clinic, which seems okay.

For advanced Norwoods, look to doctors such as Lorenzo, Feirrera, and Zarev if you can afford them. I don't know of any good surgeons in Sweden, so I would recommend you reconsider there and maybe look to Belgium/Cyrpus (Dr. Maras?) if you want a more affordable alternative.

I am traveling from North America to see Dr. Zarev and I'm taking time off from work just for the in-person consultation. The surgery is another story. Remember, don't rush this procedure, a failed transplant with bad scarring is much worse than being bald.

 

[kharmacoma]

I've been on finasteride for almost 6 years. Why is it more difficult if I already have hair in a region I want to add density to?

You need a good doctor to work within your current hair and avoid damaging follicles of your current hair. You also need to make sure you keep taking finasteride and maybe minoxidil (for a year) after hair transplant to make sure enough blood goes to current and new hair.

 

[Wolf Pack]

Interesting case and very challenging. Not only as you have a lot of diffuse thinning but your hairline centre point is juvenile and very low...so it presents a challenge on designing a hairline especially with highly receded corners. Many doctors will approach this differently. In the end, I think you'll have a higher centre hairline and around the corners, while shaving off that centre. Because you need way too many grafts already all over and their survival will be tricky too. Be careful who you go too, in advanced cases like this it's not just a case of seeing who is on the "approved list" on various forums, rather you need to see who is good for advanced balding. I would only think of likes of Zarev, Couto, Rahal and a couple in Turkey who regularly get the best out of such patients and give them a presentable head of hair. That's why you sometimes see 6k grafts on one guy look pretty poor/baldy/pluggy and way more natural and fuller on a similar other guy. There's no real turning back once the grafts are used and recovery (if even possible in such cases) can be messy and long, money too.

 

[M.G]

Interesting case and very challenging. Not only as you have a lot of diffuse thinning but your hairline centre point is juvenile and very low...so it presents a challenge on designing a hairline especially with highly receded corners. Many doctors will approach this differently. In the end, I think you'll have a higher centre hairline and around the corners, while shaving off that centre. Because you need way too many grafts already all over and their survival will be tricky too. Be careful who you go too, in advanced cases like this it's not just a case of seeing who is on the "approved list" on various forums, rather you need to see who is good for advanced balding. I would only think of likes of Zarev, Couto, Rahal and a couple in Turkey who regularly get the best out of such patients and give them a presentable head of hair. That's why you sometimes see 6k grafts on one guy look pretty poor/baldy/pluggy and way more natural and fuller on a similar other guy. There's no real turning back once the grafts are used and recovery (if even possible in such cases) can be messy and long, money too.

Thanks for the information. Regarding my hairlines centerpoint/widows peak, I've been thinking of shaving it for a long time so that won't be a problem. It have always been a bit protruding, even before the hairloss.

I've previously, like 5 years ago when I was 21, done a consultation with dr. Erdogan from ASMED here in Stockholm while he was visiting. He told me I was a difficult case. He refused any operation on me until I've been on finasteride for a considerable time to see if it could stabilize my donor, since he straight up told me it was also experiencing some miniaturizing. So basically I got DUPA (since I also got retrograde alopecia on the sides).

All this just make things more complicated. What if I go out of country just to be denied a transplant on-site because of a miniaturizing donor? It would sting a lot.

But what do you think of dr. Erdogan for a case like me? He made a pretty good impression on me back when I met him.

 

[Wolf Pack]

I would avoid Erdogan, he's good for low Norwood cases as he dense packs like hell but I saw a few cases recently where there were some issues. And with your hair, you can't afford to make a mistake, a low Norwood can even if it gets messy. I would just get 4k grafts all over if I was you and then add density later, if you have some donor left over. You may need an FUT to get maximum benefit or you're going to be left with a thin balding donor area too most likely. What you need is this ideally but with your pattern of loss you may not exactly get that.