I started HT about 10 years ago and it has been a slow long road for me. I have had 5 surgeries, unfortunately when I did 3 of them they were doing 600 size sessions! My hairline only has about 1500 grafts but looks decent the crown is my concern, I have enough hair for 2 more surgeries according to my Dr.
Should I make the hairline the best it can be and continue to use concealer in the crown, or just finish the crown and have an ok hairline for life?



Here is a shot of the back.

hairuse.jpg (26 Kb, 758 downloads)

Hello Panther,

Well what you do is truly and solely up to you honestly. It's all based on your preference and what you want to accomplish. I would say, for me personally, if I were in your shoes, I would consider the following:

1. How much donor hair I have left
2. How the front of my hair looks (in various lighting including the most harsh lighting like florescent lights)
3. How much better my crown would look with another surgery

I think those are the major factors I would consider. How much donor does your doctor say you have left? Have you gotten 2nd and 3rd opinions? Your picture doesn't show your whole head so I couldn't give you great advice, but it does seem like you have extensive loss in your crown area and the area below it. The crown has been referred to as the "Black Hole" when it comes to HTs because it takes an awful lot of grafts to make a significant cosmetic difference. BUT...if you are happy with your hairline and front and have a good amount of donor hair, I'd say go for it. Just make sure you choose a top doctor to do your work.

Feel free to check out my pictures below...especially the 3rd surgery. I'm only 1 month post op...however, you'll notice my direct post op pictures...I DID decide to tackle the crown. NOw I won't have great density, but I will have some coverage.

I hope this helps

Falc

Falceros Thanks.
I guess I really have to make up my mind here.
Yes the crown is a black hole! It seems you can [place 5000 grafts there and still be thin.
I think i am going to beef up the hairline and then see whats left fopr the crown.

new2_edited.jpg (15 Kb, 241 downloads)

panther5000,

In my opinion, I think you should address the hairline first if it is not satisfactory to you. This is what people see when they look at you not to mention what you see in the mirror. You don't want to continue looking at it wishing it was better. Also, it's difficult if not impossible to make a hairline look acceptable with a concealer.

On the flip side the crown, when totally baren, can be improved with less grafts than one might think. It helps when you have something where once there was nothing but it will take a lot to get it looking even close to full. I'd go the hairline route then, if you have enough left over, look at dusting the crown. At worst, as you stated, you can continue to use concealer in the back and it should work better than using it in the hairline. Ultimately, I'd like to see you not use concealer but that of course is a personal call.

Thanks Jo.
Let me ask you I have seen some pics from H&W that shows the donor area extending way to the top of the scalp on the side.
Isnt that risky if the patient recedes on the sides??
Also do you guys always shave?

about the donor scar: it all depends how much you have and how many grafts you want to get. Dr Hasson pointed out on another thread that it's a neccesarily evil in some cases.

quote:

Originally posted by panther5000:
Thanks Jo.
Let me ask you I have seen some pics from H&W that shows the donor area extending way to the top of the scalp on the side.
Isnt that risky if the patient recedes on the sides??
Also do you guys always shave?

About the donor scar I have neever seen one so high on the sides I think it was Facelros who posted here.

panther,

Kind of a predicament, eh? I went through the same thing before starting with the first of two HT's. I'll give you my prospective.......

Before I had any HT's I was considered NW 4 with diffused thinning all over top. From the front, I looked like I had a receeding hairline, from the back it was terrible..........a huge shiner.

For me, I didn't want to have the look of no loss in the front with a very noticable bald spot in back. To each his own but I don't believe that looks natural. For this reason, my most recent HT focused on the crown. with a little touching up in the front.

From you pics, it's a little difficult to tell. Your crown looks thin and is noticable, front didn't look bad but it's tough to tell from the pic. If I were you, my goal would be to get enough in the crown to cover it with a little length and also try to refine the hairline.

You have to make your own decision. I wouldn't like the look of no hair loss from the front with a bald spot in the back.

Falc has a good point. It heavily depends on your donor supply. For this reason, I'd consult with a few quality docs and get some ideas on how many grafts you have left and what it would take to reasonably cover the crown and do the work you want in front.

Hope this helps.

Oh here is the problem. The last 2 HT we focused on the vortex and crown and had some decent coverage but I thought it would be alot more then it turned out to be. Two different Drs told me I have around 2500 grafts to work with.
I know if I toss these in the crown it would make somewhat of a difference but it will still be sparse looking but may free me from using concealer.
If I broke it up and did half in the hairline it would be an amazing result and a hairline which I would be happy with but th crown may still be sparse hence concealer usage for life.
If I do the crown only I may be able to stop the concealer and thats the benefit there and I would be left with a hairline which isn't at all that bad but just short of being very good.

Panther,

Yes my donor scar is high...and some patients may not be able to get a donor scar so high. I told Dr. Hasson it was ok to go that high, based on his professional opinion that I would not lose hair up there since there is no minaturization and my family hairloss history shows a pattern that the men in my family, even the bald ones have "high sides" and have not lost hair there. Technically, I suppose it could be looked at as a risk...and if I wasn't getting an HT done by a world class surgeon, I might have questioned it...but after much research, I went there under the what I believe to be accurate presumption that Dr. Hasson KNOWS what he is doing, so I put my trust in him to do things as he saw best.

Falc

Falceros,
That gives me hope! I have very highh sides too and no family member has receeded there at all.
Maybe I have more hair left to graft than I think?

Very possible. Do a few consults. I'd be sure to check out Hasson and Wong among them. Scalp exercises really help. You can find a video of how to do them on Hasson and Wong's website, with a video demonstration by JoTronic as well.

Hope this helps.

Falc

I have been doing scalp exercises for 1 week and in the beginning it would barely move now it is so loose! Its incredible it really is.

Well guys I decided to really beef up the front hairline and deal with the crown if any donor remains. My problem is I have had so many surgeries I have laxity issues and it seems a big yield isn't possible.
I am tired of doing the comb forward and looking like a douche!

hair_presurgery.jpg (42 Kb, 126 downloads)

Here is my hair pushed back. its obvious how thin it is. I had about 1400 fu's when my front was totally bald.
I was pushing it forward but want to get a real hairline again.
How many do you guys think it would take for a nice improvement?

hair_presurgery_002.jpg (47 Kb, 147 downloads)

hard to give you an estimate on the number of grafts from that angle. Can you take a picture from the top of your head at an angle...see some of my pictures for an example on my links below. That will probably help us give you a better idea.

Falc

Damn after taking these pics I am feeling so depressed!
I am so tired of looking like shit....

hair_presurgery_top.jpg (66 Kb, 144 downloads)

Panther5000,

Once more thing: Are you currently taking finasteride (Propecia/Proscar) and using Nizoral shampoo? These should be a part of your regimen to help combat possible future hairloss.

panther-

Tough to say how many grafts in front from the pics. My best guess would be around 2000 starting in front 1/3 and blended to midscalp. Your hair characteristics remind me a little of my own in that I have thick hair on sides and back which makes a thin front/top/crown stand out all the more. For that reason, I think you'd want a nice enough hairline to be able to comb your hair back instead of foward. It helps the front to stand up a little and soften the transition to the hair on the side of your head which is thick.

If you end up with a decent harvest, I wouldn't completely ignore the crown. It can take several grafts to "cover" it totally, but, you may be able to get a "thinning" look with far less. I'll try to post pics of my HT#2 soon for you to view............I've been talking about it forever but as it seems there have been many crownwork questions lately I need to get off my behind and do it!!

Kamin has a good point, are you doing anything to prevent further loss?

Panther,

You say that you are depressed and "hate looking like shit". You don't look bad at all. I think that you are still in a good position. Everyone gave you a lot of good advise and I would listen to them.
There are a lot of people in worse hair shape then you are. At your age you still have a decent looking coverage. If you were to thicken up the frontal region things will be super. As you age further things start to "catch up" sort of speak to a natural age of hairline, coverage, etc. And guess what, as others in your age bracket continue to loose their hair, your transplanted hair will be with you for life. Good luck with things.