Hi George,
Welcome. First of all, 200 will not make much of a difference. As a NW-5 2500-2700 will not cover much. Are you expecting to leave the crown uncovered? It's amazing how many grafts it takes to get reasonable density. A bald crown alone can easily take 2500 by itself.

Shock loss affects both transplanted hair and native natural hair. Generally the loss is temporary to healthy hair, but can cause permanent loss to hair that is destined to be lost to MPB.

Hope this helps.

Welcome to the forum George.
It would help if you could post pictures, many of us will be able to give you an opinion. Who is the surgeon you chose? It sounds like you have spent time reading on this forum.

I posted some pictures... for some reason it stared a new thread.

My Current Pictures... Click Me

Hi George,
I think you should be aware that 2500 or so will give you a thin look. Also, unless you manage to stop your hair loss with drugs like Finasteride and/or Rogaine, you will more than likely need another pass later.

I wouldn't worry about getting a thick rug that looks out of place for your age. That won't happen with a hair transplant. Look at my pictures. I got 2700 in just the front half. It still looks thin.

I could step it up to 3,000 with a phone call. I'm concerned that if some reason it doesn't take... I have that much less to work with in the future.

I've been taking Propecia for 3 months now... my rate of shedding has drastically reduced, no more hair in my comb and very little in the shower drain.

My transplant was conditional on if I could slow down the rate of loss. I didn't want to get HT every 3 years.

*Just a side note... My Doc states I would want 5,000-6,000 to get good density.

George,

You're in a very similar position as I was before HT #1. See my blog for reference. I was also a NW 5 but was a little hasty getting into the HT chair. HT #1 I only received 1200 grafts in the frontal third with some in midscalp. I was a diffused thinner on top and it did help thicken but I could use more density. Hopefully, Finasteride will help me keep what native hair I have left there.

For HT #2 I focused mainly on the crown......3886 total grafts and I'd say 3000 went into the crown with the remainder enhancing the widows peak and around the midscalp. I need to post updates but I can tell you my crown is totally covered.........a little thin but you can't see the scalp at all. Actually, I have a little bit of a dilemma in the my rear midscalp/crown is probably a little more dense than the frontal 1/3.

At any rate, you need to think long term and look at your goals. I just turned 40 a few months ago so we're pretty close to the same age. If you have the donor hair and go to a top doc, and can spare the cash, I'd try to hit a home run as far as grafts are concerned. You'll need at least 5000-6000 for any appearance of density. As I've stated, I've gotten around 5000 and while I'm a little thin, my head is totaly covered. I do have a little temple recision....I believe the front of my hairline (measured up from the eyebrows) is about 7-7.5cm if that helps.

There are Docs out there than can get you more than 5000 in one pass if you have the proper donor supply..........if I were you that's probably the direction I'd head. No reason for the HT not to "take" if you go to a quality surgeon.

If you don't mind me asking, who's your HT surgeon? If you're not commited, you may want to review the Coalition Surgeons recommended here.......they're the best of the best and consistently deliver excellent results. One other thing, don't let location determine who you choose. I did for HT #1 and would definitely do it different (as I did for HT #2) if I could do it again. For HT #2 I flew to Canada for the HT and it was a wonderful experience, they covered 2 nights hotel stay and a credit in grafts for the airfare......few in one day, HT the next, flew home the next.....no big deal.

I hope this helps.

I agree with Hairbank, if you can do it all in one shot go for it. I also think you might not happy with coverage and density with any less than 4,000 FU, you would get appropriate density and coverage between 5 and 6K FU, don't worry you'll never get the rug look with even 7k.
Who is your surgeon?

quote:

Originally posted by George8211:
I could step it up to 3,000 with a phone call. ... My Doc states I would want 5,000-6,000 to get good density.

You should step it to 4000-4500 and leave the crown almost as it is. Later you can add a 2-3000 to the crown and almost no one will notice it after a week or so.

Short of a major unfortunate event, if you go with a doctor that has proven himself, you will be fine with 4000 grafts at a time. You will cut a nice chunk of your head, feel numbness and pain for a while, and look really weird for 3-4 months. Why do it if you aren't going to look a lot better? You will not look suspicious since you can place the hairline where ever you want.

George,

I am from the Detroit area and I am wondering what doctor it is that you are considering? There is only 1 office in the area that I would even consider sending anyone to--Dr. Tessler and Aronovitz. The others I would not send my worst enemy--seriously. If you are not comfortable with puting name of doc on the forum send me a PM (private message).


Remember, just because they are respected plastic surgeon does not make them best at hair transplant. Gretzsky was a great hockey player but sucked at goalie position.

Hi George,
Why not tell us his name? We'll be gentle. Really. Well, maybe not. You know how meticulous we are.

To be honest - a respected plastic surgeon with 20 years experience means nothing. That might sound harsh, but many doctors have credentials that sound fantastic. You really have to examine each doctor individually. Dhuge67 found this out the hard way. And they'll all tell you that they use the latest ulra refined techniques.

Does this doctor have a web site? Let us investigate.

Nice of you guys to stay on topic for the thread that I started.

This is exactly why I didn't post any names... basically what it comes down too is that no doctor can do a decent HT except the one listed on this board.

quote:

Originally posted by George8211:
Nice of you guys to stay on topic for the thread that I started.

This is exactly why I didn't post any names... basically what it comes down too is that no doctor can do a decent HT except the one listed on this board.

the questions asked were answered and you're free to ignore all or part of the answers.

No, that's not true George. If a doctor is truly doing great work we will be the first to say it and recommend him. He/she does not have to be a member of this coalition. We are simply trying to help people avoid a mistake.

You are free to ignore our advice.

George,
By reading and spending more time on this forum you'll find that most of us are very open minded, recently Pat recommended a Doc from Pakistan I believe it was. We are always looking for talented surgeons we have not heard about, so for you to suggest that we are only considering the already listed Docs is a serious misconception on your part. By listing your Dr name several scenarios might happen:
No one has heard of him ...
He has had good or bad reviews in the past ...
Either way it's a win win situation for you and for us as we expand our knowledge of HT surgeons.

George please listen to these men. They are truly trying to help you or someone else from making a BIG mistake. I had scheduled with a local Philly doctor thinking because he stated he had years of experience as both a surgeon and a hair transplant specialist I would be getting a state of the art procedure. Then to my surprise I read several post of his patients complaining about his work. Then I even found out that his methods of HT were years behind compared to the work being performed by all the coalition doctors listed on this site. Now that I have finally had my first HT I am able to rest assure knowing that I made the right choice.

George,

I guess I read your original post again and see that it is this Tuesday that you are scheduled. I guess the last thing that you need at the last minute is for us to cast a doubt.

We are honestly trying to help and I am sorry that we are creating a little concern for you but it is now our natural instinct to steer people towards doctors that have proven track records.

I guess though that you sometimes have to expect to hear some things that you don't want to. In regards to your question about # of grafts, a few extra won't make much of a difference. Shockloss will effect transplanted hair and sometimes native hair. It is usually temporary but may be permanent. The skill and techniques of the surgeon is a big factor. Best of luck with your upcoming HT. Keep us posted on how it goes.

George,

As far as # of grafts go I would disagree with most that 200 grafts won't make a difference. Placed in the Temples for instance, the extra can have a real impact. The other factor in the number of hairs per graft. If you are loaded with 3-4 hair FU's vs some one loaded with 12 hair grafts that will be a real difference. Do not get to caught up with the number of grafts, the key is quality vs quanity! I know you can get both with a skilled surgeon and 3000 is nothing to sneeze at. In all likelyhood though, you may want to go another round to "touch up" some areas not addressed in HT #1 (most of us hear have or will!). Once HT #1 has grown out and matured you will be able to plan for #2, take it one step at a time, it is not a race!

Good luck on Tuesday,

Also, just because your surgeon has plastic surgery as experience does not make him a bad HT surgeon. Hopefully though, it is a main part of the practice. Dr. Paul Rose is a coalition surgeon who also practices other plastic surgery procedures. My surgeon, Dr. James Vogel is a HT and plastic surgeon with extensive experience in both and is a recommended network HT doctor. The key is to see thier results in both photos and in person if possible.

Yeah, the old "Help me decide if I am making the right decision, but if I don't like what everyone says, i'll just attack the credibility of the site/posters syndrome"

We see it everyday........
Let's see......
50/50 chance your Doc will actually be using "state of the art" equipment and techniques.

Here are all of the Docs that AT LEAST are in the ISHRS, which doesn't guarantee anything really, but I would like to know if your doc is among them?

Darius J. Karimipour, MD Ann Arbor (734) 936-4193

De-Hong Tang, MD Ann Arbor (734) 936-5895

L. Scott Grant, MD Birmingham (248) 645-1552 (Check this guys site out and look at his "procedures" LOL)

Daniel M. Stewart, DO Clinton Township (586) 286-0112

Steven L. Ringler, MD Grand Rapids (616) 451-4500

Gregory D. Shannon, MD Haslett (517) 339-3200

Marvin E. McElroy, MD Prudenville (989) 366-4800

Salvatore Cavaliere, DO Rochester (248) 651-5051

Cary S. Feldman, MD Rochester (248) 651-7099

Leonard E. Aronovitz, DO Southfield (248) 353-1117

James H. Aronovitz, DO Southfield (248) 353-1117

Daniel Didocha, DO Southfield (248) 354-0581

Martin E. Tessler, MD Southfield (248) 353-1117


Steven P. Holt, MD Troy (616) 318-2213

Ayoub Sayeg, MD Troy (248) 457-1810 Doctor Details

William D. Yates, MD Troy (616) 318-2213


Anyway, I am too tired to keep going through this list---- There are 2 Coalition Docs in Michigan--- Do some research and if you believe the guy you want to go to, then go.

Just be aware that most of the "Docs" on this list use 2 mm punches to do FUE and still believe that density's over 25-30 fu's cm/2 compromises vascularity. In laymans terms that means they like to use very little magnification making incisions and they like to use nice large incisions so the little grafts fit right in the big holes.

Thanks Again, and remember: Just because you don't want to hear what others with much more experience at this sort of thing are telling you, doesn't mean it isn't true.
Good Luck!