Is it standard/advisable to get a HT to add density to an area which has thinning hair

[4Godot]

Hi. I'm currently researching Drs and possibilities fir a HT next year, my objective is to restore my hairline to mature from receding and add density to the front third and ideally mid scalp. The crown has just started thinning but I just started oral minoxidil and topical finasteride and im optimistic i can improve that to a level I can live with, and thus ideally save grafts for other areas.

I recently had a consultation with a reputable Dr in NYC (recommended by this site) however, who said while I had a good donor area, they wouldn't add any grafts to areas with existing hair to add density, as this risked shock loss. They basically just do the frontal hairline where the hair was totally or almost totally gone. My hair is now pretty thin in the frontal 3rd so this'd be kindof a game changer for me in terms of whether not surgery/ surgeries are worth it. 

 

I have consultations with Dr Cuoto and Dr Ahmad later this year and early next. Both indicated from remote consultations that my plan/ objectives made sense and unless there was some major issue with donor hair detected at in person consult, adding density would make sense and/or even be necessary to achieve a natural result.

 

Was curious if others have encountered this resistance to adding grafts to existing thin and thinning areas? I was under the impression it was fairly standard practice.

 

Thanks for your thoughts!

 

 

[A_4_Archan]

9 minutes ago, 4Godot said:

Hi. I'm currently researching Drs and possibilities fir a HT next year, my objective is to restore my hairline to mature from receding and add density to the front third and ideally mid scalp. The crown has just started thinning but I just started oral minoxidil and topical finasteride and im optimistic i can improve that to a level I can live with, and thus ideally save grafts for other areas.

I recently had a consultation with a reputable Dr in NYC (recommended by this site) however, who said while I had a good donor area, they wouldn't add any grafts to areas with existing hair to add density, as this risked shock loss. They basically just do the frontal hairline where the hair was totally or almost totally gone. My hair is now pretty thin in the frontal 3rd so this'd be kindof a game changer for me in terms of whether not surgery/ surgeries are worth it. 

 

I have consultations with Dr Cuoto and Dr Ahmad later this year and early next. Both indicated from remote consultations that my plan/ objectives made sense and unless there was some major issue with donor hair detected at in person consult, adding density would make sense and/or even be necessary to achieve a natural result.

 

Was curious if others have encountered this resistance to adding grafts to existing thin and thinning areas? I was under the impression it was fairly standard practice.

 

Thanks for your thoughts!

 

 

Plz post ur scalp pics so people can see ur condition ....and thn cn understand the situation well...

Where as jst understanding ur prospective through ur post i feel you wanna create a gud hairline and u want to put grafts on mind scalp or crown whr thr is thinning and u want density by putting grafts thr in between ur existing hairs...

Bdw u chosen 2 of the best in business ...so u cn go with any of thm...seeing extremely good and natural results frm dr ahmad 

[Rafael Manelli]

Who is the NYC surgeon?

[sunsurfhair]

Please share who the NYC surgeon is. Lots of people get added density to existing areas and or second pass of a previous HT to enhance density, so that’s very odd to hear that. Was this Dorin or Bloxham?

[HappyMan2021]

When adding new grafts near thinning/miniaturized hair, even in the best of hands there is a risk of permanent shockloss. 

I dont think anyone would really be happy say, for example, you add 1k grafts to a very thinning crown and get 500 existing hairs shock lossed out. That is a bad deal. 

It seems like in your personal case the nyc surgeon thought the risk was too great. If that is the case he may advice PRP or Rogaine.

Shockloss can be unpredictable and when deciding to implant in thinning hair or not, at the end of the day it cones down to both the doctor and the patients' risk threshold. 

Edited February 7, 2023 by HappyMan2021

[BaldEagle]

I had a similar experience too, I had a few thinning areas near mid-scalp and the crown which I wanted to address. Both surgeons I consulted recommended it would make sense to rely on Fin and Minox at this stage than risk potential shock loss. However, I regularly see cases such as mine getting grafts placed on thinning areas alongside already existing hair.

Does this just come down to specific surgeons and their preferences?  Or, are some patients more prone to shock loss than others? I am interested to learn more on this topic too

[4Godot]

Hey thanks so much for all your thought and responses. I saw Dr Shaver, who is the second Dr at Dr Bernstein's practice. She was great to deal with, very helpful and honest, definitely not pushy about pointing me towards a HT at all. Just the issue of adding density/ shock loss gave me pause.

Also I'm 38 years old. She said my hair was on the fine side but there was an above average donor area. She recommended FUT over FUE as fine hairs are harder to harvest using FUE and so I might lose/waste my donor supply if I went with FUE. Again I'm not questioning her expertise but neither of the other two Drs said FUE would be a problem. 

 

Again all thoughts/insights appreciated. Sorry for the not great pics, all I have available at the minute.

[sunsurfhair]

36 minutes ago, 4Godot said:

Hey thanks so much for all your thought and responses. I saw Dr Shaver, who is the second Dr at Dr Bernstein's practice. She was great to deal with, very helpful and honest, definitely not pushy about pointing me towards a HT at all. Just the issue of adding density/ shock loss gave me pause.

Also I'm 38 years old. She said my hair was on the fine side but there was an above average donor area. She recommended FUT over FUE as fine hairs are harder to harvest using FUE and so I might lose/waste my donor supply if I went with FUE. Again I'm not questioning her expertise but neither of the other two Drs said FUE would be a problem. 

 

Again all thoughts/insights appreciated. Sorry for the not great pics, all I have available at the minute.

That’s your problem right there. Bernstein is one of the worst HT docs out there. He’s a joke. Great on his research but terrible w surgery. Shaver may be nice but I wouldn’t her consider in the elite category at all. 
 

If you’re set on staying in NYC, go get consults with Dorin, Bloxham or Wesley. Much better options. If you’re set on FUT, go with Bloxham but prepare yourself that you may end up w a nasty scar. Out of the 3, I would go with Dorin, Wesley, then Bloxham again if I was to stay in NYC. If not, you have many other elite options. 

Edited February 8, 2023 by sunsurfhair

[A_4_Archan]

8 hours ago, 4Godot said:

Hey thanks so much for all your thought and responses. I saw Dr Shaver, who is the second Dr at Dr Bernstein's practice. She was great to deal with, very helpful and honest, definitely not pushy about pointing me towards a HT at all. Just the issue of adding density/ shock loss gave me pause.

Also I'm 38 years old. She said my hair was on the fine side but there was an above average donor area. She recommended FUT over FUE as fine hairs are harder to harvest using FUE and so I might lose/waste my donor supply if I went with FUE. Again I'm not questioning her expertise but neither of the other two Drs said FUE would be a problem. 

 

Again all thoughts/insights appreciated. Sorry for the not great pics, all I have available at the minute.

If u wanna go for fut thn u cn consider dr wong..dr konior..dr bloxham...and for fue thr are many other options u cn consider from....i dnt have any knowledge abt the surgeon u mentioned so i cant comment on him/her...here thr is a recommended doctors list..u shud go through that thn shortlist 4-5 doctors from thm after seeing their results and thn consult all of them and talk to their patients and thn take ur decision ....

Should not do it in a hurry ..should take ur time cause more time will lead u with more knowledge and understanding and more clarity ...

If u want to do something in hurry thn i wud say u can start medication asap...😊

[4Godot]

Hey thanks for replies. Yeah I really hadn't intended going to Bernstein for procedure, just to get oral minoxidil prescription and , I'd hoped, a more scientific, precise measure of whether my hair loss had stabilized or not. Obviously somewhere local would be better to monitor this as I'd wanna drop in once a year say. As it was they just took a picture and told me what I already knew.

My plan is still to proceed with Dr Cuoto or Dr Ahmad, both of which I'll have in person consultations with this year and early next. Honestly I was pretty surprised at how low the quality of work seemed to be in NYC of all places. Even the websites look dated, and their "before and afters" would not make anyone wanna go for a HT. Not to mention being about twice as expensive as European options with current exchange rate (in some cases).

 

Maybe they just really need to update their websites and they've progressed with the times

[Xanadu]

On 2/7/2023 at 4:15 AM, HappyMan2021 said:

When adding new grafts near thinning/miniaturized hair, even in the best of hands there is a risk of permanent shockloss. 

I dont think anyone would really be happy say, for example, you add 1k grafts to a very thinning crown and get 500 existing hairs shock lossed out. That is a bad deal. 

It seems like in your personal case the nyc surgeon thought the risk was too great. If that is the case he may advice PRP or Rogaine.

Shockloss can be unpredictable and when deciding to implant in thinning hair or not, at the end of the day it cones down to both the doctor and the patients' risk threshold. 

The way I see it shock loss is completely irrelevant because it comes back after a few months.

[Adrenaline7]

4 hours ago, Xanadu said:

The way I see it shock loss is completely irrelevant because it comes back after a few months.

This is what I always thought, but I hear ”permanent shock loss” thrown around quite a bit on these forums. 

[sunsurfhair]

3 hours ago, Adrenaline7 said:

This is what I always thought, but I hear ”permanent shock loss” thrown around quite a bit on these forums. 

I really think it comes down to the quality of the surgeon if hair is permanently shocked out. There are variables of course, but with an excellent surgeon, your risk goes significantly down. 

[mr_peanutbutter]

„Sherecommended FUT over FUE as fine hairs are harder to harvest using FUE “

 

is this true?

[Xanadu]

4 hours ago, mr_peanutbutter said:

„Sherecommended FUT over FUE as fine hairs are harder to harvest using FUE “

 

is this true?

Not for a good clinic. The nape and around the ears etc are full of them.

[A_4_Archan]

9 hours ago, mr_peanutbutter said:

„Sherecommended FUT over FUE as fine hairs are harder to harvest using FUE “

 

is this true?

How come fut be able to take out fine grafts...Fine hair are on nape and lower end of the sides and i guess no one wud take out a strip from there to get fine hair...

Fine hairs are used only for temple work...for hairline singles are used...and fue wud b better to cherry pick singles and taken out as required ...and evn suitable for finer hairs..

From my understanding its easy to construct a softer hairline through fue cause they can cherry pick the singles..whereas in fut the number of singles cannot be cherry picked...so i doubt tht doctor's statement ...its just my opinion and my understanding and i may be wrong..

[sunsurfhair]

On 2/9/2023 at 1:54 AM, mr_peanutbutter said:

„Sherecommended FUT over FUE as fine hairs are harder to harvest using FUE “

 

is this true?

Not at all. In fact, it's the polar opposite. FUE enables a surgeon to cherry-pick the grafts, whereas FUT only allows the surgeon to harvest grafts that come from the extracted strip. This is one of the "pros" of FUE v FUT. 

[mr_peanutbutter]

1 hour ago, sunsurfhair said:

Not at all. In fact, it's the polar opposite. FUE enables a surgeon to cherry-pick the grafts, whereas FUT only allows the surgeon to harvest grafts that come from the extracted strip. This is one of the "pros" of FUE v FUT. 

i think the quote is more related to graft survival?

[sunsurfhair]

5 hours ago, mr_peanutbutter said:

i think the quote is more related to graft survival?

That was disproved and that would have no bearing on "fine hairs".

The one advantage of FUT is a potential greater yield and donor preservation - meaning you could potentially get more donor grafts out of your reserve vs FUE. I still believe the cons significantly outweigh the pros in the FUE v FUT debate, especially with how far FUE has come in terms of efficacy. 

[mr_peanutbutter]

9 hours ago, sunsurfhair said:

That was disproved and that would have no bearing on "fine hairs".

The one advantage of FUT is a potential greater yield and donor preservation - meaning you could potentially get more donor grafts out of your reserve vs FUE. I still believe the cons significantly outweigh the pros in the FUE v FUT debate, especially with how far FUE has come in terms of efficacy. 

what are the cons except that you cannot cut your hair that short? is there a higher risk for complication?

 

thank you so much

[Gatsby]

Dr Arika just did a live stream with an answer to this exact question and her response was as long as the distance between hairs is 2.5mm then it is safe to implant grafts in there.