Hair Transplant... or giving up?

[Falling]

About me:

I've been slowly losing hair since my early teenage years, so that's more than 20 years already.  And It's always been difficult to accept it. I've tried almost everything.

At first I used to style my hair with gel, and then let it dry so that it looked thicker.  The wind was my biggest enemy and I even blacklisted some streets in my hometown as they were always windy.

Then I used hair fibers for years.  At first they did the trick, but my hair kept falling out and I had to look for other alternatives

Next step was a hair system and I kinda liked it, but was into sports so I decided to ditch it

SMP was the next step. I had it in 2020 for a couple of years and I didn't hate it, but I wanted to have hair again so I went back to a hair system temporarily

And now I've decided that in 2025 I will make a final decision:  SMP again or Hair Transplant

I've been reading about hair transplants for months and to be fair, I'm not sure I'd be a suitable candidate.  But I still wanted to seek for advice before throwing in the towel

 

My HT plan would be this:

- 4500-5000 grafts FUE (with beard grafts if required)

- Dr Laorwong or Dr Panchaprateep

- Take 1 month off work so that my scalp can recover, and then shave my head while I continue wearing a hair system during the ugly duckling phase and up until the 6-7th month. Then let it grow

- I don't expect a full head of thick hair, but at least average density all over.  My grey scalp (SMP) could probably help to achieve this

- I've never taken any medication and I don't think I will due to the side effects and the fact that there's not much more hair to preserve.

- The area to be covered is around 12cm x 21cm which would require around 10.000 grafts.  But I still have some hair left, and my head is not a rectangle. 

- My donor area is average in my opinion, which doesn't help

- My budget would be around $14000

 

2020 is just before SMP

 

2024 is how it looks right now with a 4 year SMP.  I usually shave the top part (hair system) but I let it grow for a couple of weeks.

The SMP is barely noticeable due to the lighting, but even after 4 years it makes a huge difference when I shave my head

 

So the question is, should I give up and stick to a shaved head + SMP ... or is there a chance to have decent hair again via Hair Transplant?

 

Thank you.

 

[Paul_]

Difficult question - I suggest you ask it on both forums (shaved head vs HT crowds can be different in their viewpoint)

I only considered mine because my hairloss was not too brutal (and it still blew up in my face due to poor research)

In your situation, as you seem to be athletic with a good skull shape, I'd just buzz the whole thing off and never look back

[Al - Moderator]

2 hours ago, Falling said:

- Take 1 month off work so that my scalp can recover, and then shave my head while I continue wearing a hair system during the ugly duckling phase and up until the 6-7th month. Then let it grow

 

I advise against wearing a hair system after your hair transplant. It can have a bad effect on growth of transplanted hair. If you really feel the need to do it then make sure it's a hair piece that you can (and do) remove every night or whenever you are home. You want to let the scalp breathe as much as possible. Definitely don't use it the first month.

 

[Falling]

That's actually what I do now.

I only wear the hair system when I go out, and I use the weakest and thinnest adhesive tape I could find, so that it doesn't leave any residue.  And the hair system is always clean and lasts for years.

My first one only lasted a few months

Edited August 27 by Falling

[Falling]

So I´ve decided to have a HT with Laorwong/Ratchathorn in 2025. Just need to confirm the dates.

I'd prefer to have 4000-5000 grafts spread uniformly even if that means a little bit less density. I wouldn't want to leave the crown visible for a 2nd intervention.  But we'll discuss that in person

They also offer 2 complementary treatments that I've never heard of, and I would like to know if you think they're worth it or if they´re not needed at all:

 

Rigenera Activa cell therapy together with surgery 

(approximately 1040 USD)

 

Hyperbaric Oxygen Therapy (HBOT) (improved survival rate, speed up wound healing and less post op hair shedding)

-The protocol is 100% Oxygen at 1.5 atmosphere, it takes 1 hour.

-1 treatment/day= 120 USD

-3 consecutive treatments = 300 USD

 

I forgot to mention that I do a lot exercise, I don't drink alcohol and I don't smoke either. So hopefully that could slighly improve the chances of a successful HT.  if I get butchered, I can always go back to SMP

 

Edited September 2 by Falling
Typo

[Gatsby]

On 8/25/2024 at 10:18 PM, Falling said:

About me:

I've been slowly losing hair since my early teenage years, so that's more than 20 years already.  And It's always been difficult to accept it. I've tried almost everything.

At first I used to style my hair with gel, and then let it dry so that it looked thicker.  The wind was my biggest enemy and I even blacklisted some streets in my hometown as they were always windy.

Then I used hair fibers for years.  At first they did the trick, but my hair kept falling out and I had to look for other alternatives

Next step was a hair system and I kinda liked it, but was into sports so I decided to ditch it

SMP was the next step. I had it in 2020 for a couple of years and I didn't hate it, but I wanted to have hair again so I went back to a hair system temporarily

And now I've decided that in 2025 I will make a final decision:  SMP again or Hair Transplant

I've been reading about hair transplants for months and to be fair, I'm not sure I'd be a suitable candidate.  But I still wanted to seek for advice before throwing in the towel

 

My HT plan would be this:

- 4500-5000 grafts FUE (with beard grafts if required)

- Dr Laorwong or Dr Panchaprateep

- Take 1 month off work so that my scalp can recover, and then shave my head while I continue wearing a hair system during the ugly duckling phase and up until the 6-7th month. Then let it grow

- I don't expect a full head of thick hair, but at least average density all over.  My grey scalp (SMP) could probably help to achieve this

- I've never taken any medication and I don't think I will due to the side effects and the fact that there's not much more hair to preserve.

- The area to be covered is around 12cm x 21cm which would require around 10.000 grafts.  But I still have some hair left, and my head is not a rectangle. 

- My donor area is average in my opinion, which doesn't help

- My budget would be around $14000

 

2020 is just before SMP

 

2024 is how it looks right now with a 4 year SMP.  I usually shave the top part (hair system) but I let it grow for a couple of weeks.

The SMP is barely noticeable due to the lighting, but even after 4 years it makes a huge difference when I shave my head

 

So the question is, should I give up and stick to a shaved head + SMP ... or is there a chance to have decent hair again via Hair Transplant?

 

Thank you.

 

I would opt to shave. Without medication you will continue to lose more hair. The donor area also is not DHT proof but DHT resistant. You will need more than one surgery over time (trust me on this). The costs of surgery are expensive and there are long term costs compared to buzzing. 

[Tansub]

I was in a similar situation, Norwood 3 hairline and thinning in a Norwood 5 pattern. Maternal grandfather and uncle are Norwood 7 so that's probably where I'm heading. I got a HT and honestly I wish I had just stayed on meds on kept buzzing. It was cheap (only needed to buy clippers), stress free. My HT looks terrible but even if I had got a great HT I would still have to deal with the  stress of my native hair continuing to fall and needing further HTs. On top of that now I have scars in both my recipient and donor area.  

 

2 hours ago, Falling said:

I forgot to mention that I do a lot exercise, I don't drink alcohol and I don't smoke either. So hopefully that could slighly improve the chances of a successful HT.  if I get butchered, I can always go back to SMP

 

 

SMP isn't a silver bullet. I have read on multiple occasions that ink doesn't hold well on scar tissue, plus your scars can have some indentation, and SMP won't fix that. There is also the risk of the ink turning blue/green. SMP is also not a one and done, you might need multiple sessions and touch up very few years. 

 

My heartfelt recommendation would be not to get a hair transplant. 

Edited September 2 by Tansub

[Falling]

In the end I decided to go against everyone's advice. I know I might regret it, but after trying everything for more than 15 years (fibers, smp and system) I didn't want to give up yet.

I´ve done extensive research in different forums and on reddit as well and this is my final plan:

 

Booked with Dr Ratchathorn in March 2025.  It was either her or Dr. Laorwong. 

Her initial plan is around 4500 grafts (FUE). I know I will need another HT to get a good result, but first I want to see what can I achieve with 4500 grafts

Most people recommend focusing on one area first, but I don't want full coverage at the front and a bald patch at the back.  I'd rather go with less density but grafts spread evenly.  My hairline is pretty much drawn already with the SMP

I will take 4-5 weeks off while my scalp recovers and will spend some time in Thailand.  After that I will continue wearing a hair system for the next 5-6 months

If my donor looks terrible or I experience shock loss, I will use dermmatch/fibers to cover it up

Once I grow my hair a little bit after the 6th month mark I will reassess whether if I want to book another HT to add some density or I'm good for the time being

If I end up regretting my decision, I will opt for SMP again with a reputable clinic e.g Men's Ink in Italy

 

I will keep you updated

 

 

 

 

 

 

 

 

[Gatsby]

Oxygen therapy, cell therapy, etc is just a total waste of money. Honestly currently you are not cut. You have no scars on your scalp whatsoever. You are hitting Norwood 6 and you are looking at requiring 7k-8k grafts. I don’t think you will be happy spreading grafts over the scalp in a lighter manner. I’m only saying this because once you start the process of surgery there is no going back. Viewing SMP as a safety net, etc in case your results are poor is not a good strategy. Please consider what I am saying in the spirit that it is meant. 

[Sunshine09]

Spreading grafts out across the scalp just isn't going to look right. It's going to be very see through and it might look worse than where you are now..

You also have the possibility of losing more hair. You are not a norwood 7 at the end of your balding cycle. Your native hair could also go without medication. 

Just my opinion but I think you are going about it all the wrong way...

Good luck though.

[Al - Moderator]

As Gatsby and Sunshine have said, spreading 4500 grafts over your entire head is not going to give you much density. Since you are someone who has worn a hair system and has also shaved, my opinion is that I don't think a light covering all over will be enough to keep you from still wanting to either shave or wear a hair system. I suggest you at least think of the following alternative.

Get the 4500 grafts for the front half. Once that starts growing in you can wear a hair piece for the crown. This way you'll have "full" coverage with real hair in the front half and the hair piece in the crown. With that, you won't feel you need to rush to get the next hair transplant done. Having real hair in the front solves most of the issues with a hair piece. I know because I wore one in the past. Anyway, that's just a suggestion I think you should consider since you have worn a hair piece in the past.

 

[Falling]

Thanks for the answers

I still have plenty of time to decide whether if I go ahead or not, and I appreciate your honesty.

Right now I'm fully convinced that I want to do it and I've already paid the deposit; but my final decision will be made in January

And I will discuss it with Dr. Ratchathorn when I see her in person, but you guys are right. Better to use 3000-4000 grafts at the front and leave the crown for a future 2nd intervention. That was in fact Dr. Laorwong's suggestion

 

 

[Sunset Dune]

On 8/25/2024 at 9:48 AM, Al - Moderator said:

 

I advise against wearing a hair system after your hair transplant. It can have a bad effect on growth of transplanted hair. If you really feel the need to do it then make sure it's a hair piece that you can (and do) remove every night or whenever you are home. You want to let the scalp breathe as much as possible. Definitely don't use it the first month.

 

Does your statement apply for hats as well?

[Al - Moderator]

53 minutes ago, Sunset Dune said:

Does your statement apply for hats as well?

No. A hair system can be on your head for weeks at a time and directly on your scalp. Even a regular hair piece will be on your head all day until you sleep. A hat isn’t usually matted down on your head and won’t be in your head 24 hours a day. If you do wear a hat try to take it off as much as you can while at home when nobody is around. 
 

[Falling]

In my case I wear a hair system only when I'm out, and I remove as soon as I get home. 

But if you use a strong adhesive and keep it on for days or even weeks, then I agree it's definitely not good.

[Lpw]

Hi, i’m in the same position as you. Currently wear a system, have done for 5 years and looking at an exit strategy. I’m NW6 also, getting a HT in Jan, circa 4500 grafts from donor and beard combined, beard into crown and mid areas, then i’m going to do PRF and laser for 6 months after, then keep those going regularly. I’m going for a sensible widows peak type hairline which isn’t low down, and get as much density as I can, whilst wearing my system with clips sporadically for the first 6 months. If I get an OK density which I can pad out with hair fibers and maybe a second transplant then I’ll be happy. I’m growing my remaining hair on top and will ask that they retain it during surgery so that i can clip the system about a month or so after surgery. Inbox me 👍