Balding Blog

I’ve been on Fin for 2 years, Rogaine for 6 years, and dermarolling for the past 4 months. Also been using Nizoral shampoo for like 3 years. Talked with 3 different reputable hair transplant doctors and they all said I am too young (24 yrs old) for transplant and that my hairloss seems pretty aggressive. I have diffuse hairloss and was told that my donor reserves are somewhat limited. With the current pattern I will probably end up as NW6/7. I feel like Fin/Rogaine had slowed it down a bit but it seems to be less effective then it use to be and my hairloss is starting to accelerate again. I’ve been thinking about doing PRP now. Any other things worth trying assuming money is not an issue? One of the hair transplant doctors recommended I switch from Rogaine foam to liquid since it absorbs slightly better. I’ve been on it for a couple weeks now and have had major dandruff. Hoping it will clear in a couple weeks otherwise I will switch back to foam.

P.S. I’m not looking for a surgeon to say yes. I talked with some of the best surgeons in the game, and they all said no, so i’m going to take their word for it. I will not go to some shady place to have a hair transplant.

I wrote a paper a bit over a year ago suggesting that when combining FUE (of FUT) with Scalp Micropigmentation, almost anyone can have a hair transplant (https://newhair.com/wp-content/uploads/2018/11/Combining_Follicular_Unit_Extraction_and_Scalp.98621.pdf). A try to teach here that everyone needs a Personalized Master Plan for their hair loss and that includes a hair transplant when appropriate. Although I tend to delay hair transplants on 24 year old men, to at least 25 or 26, if the balding pattern is clearly evident, I have often transplanted someone of your age provided that the man is (1) mature, (2) realistic, (3) has realistic expectations which I help set and (4) they have the financial means to complete what they started.

this is my grandfathers brother. I don’t have a picture of his crown but from this picture could tell me please if he’s a Norwood 6 or 7? I’m praying you will say 6.

Without seeing the back of his head I can’t be sure but from the sides, it looks like a Class 7 pattern. You need a Personalized Master Plan with a good hair restoration doctor. White hair generally does very well with transplants, especially if it has a medium or coarse hair texture

Your donor area may be over-harvested reflecting that either the FUEs were taken too close to each other for the density of the area, the punch was too large or your donor area could not support the number of FUE grafts you received. It is possible that the donor area is undergoing vascular shock loss. If this is the case, it might grow back in 6 months or so. If the area that is shown reflects the height and extent of your FUE harvest, then your surgeon took it too high and too low. You might want to get a second opinion.

I would have expected more frontal density, as well, based upon your Class 3 pattern with a strong front forelock and 3,500 grafts. Actually I think that 3500 grafts were actually an excessive number of grafts for that area. You and your doctor established expectations when the surgery was done, so go back and review these expectations with your doctor. I would have expected more density but some of the grafts may not have grown causing the reduced density you are seeing.

The donor area has been significantly impacted by FUE, suggesting that your original donor density was significantly less than what the number of FUE grafts could have supported. Your doctor should have measured your donor area density prior to doing FUE. The limits on FUE is related to your donor density, otherwise it produces significant scarring as this photo shows. If the donor area remains see-through, you should get Scalp Micropigmentation to fill in the missing spaces.

You were very fortunate to have a good strong forelock prior to your surgery which will give you a strong frontal hairline. These forelocks are great and if they last until the age of 35, they usually last your lifetime. Some of these forelocks have a different genetic code than the hair around them.

It is difficult to tell if you have shock hair loss or over-harvesting of the donor area. Over-harvesting would be unlikely if your original donor density was normal as shown here (see: https://newhair.com/donor-area/). However, if your donor density was low, then 3000 grafts could have exceeded your maximum number of grafts that can be harvested. There is little you can do now but wait and see what you look like in 5 months or so.

To find out how many grafts you need for the crown, there are a few things you need to know first:

(1) Thickness of the hair – fine, medium, or coarse (the thicker the hair, the less the number of grafts you will need)

(2) Character of the hair (wavy is better than straight)

(3) Color contrast between your hair and skin (brown hair on light skin often means more grafts, while gray hair requires less hair)

(4) The crown is the place where the direction of the hair changes.

If you want the swirl, you need to discuss this with your doctor. Your balding area is similar to mine, and I had 2,700 grafts placed into it over the past 25 years. So, if I were to estimate a range of grafts for you, it would be between 2,000-3,000 grafts, modified by the above.

This is the result of a single hair transplant. His smile shows his satisfaction

 

The loss of 120 lbs can cause any genes for hair loss you have to express more quickly. Don’t mess around with it and see a good doctor who specializes in hair. You need to get it addressed properly as hair loss in men is genetic and progressive. The earlier you treat it, the better.

Advice for a new balding guy! from tressless