I received mixed hair transplant advice from multiple surgeons. I am unsure what to do. (Photo)

So the story starts that I am 27 years old with diffused hair thinning with a Norwood V hair loss emerging. I have been on monxoidil but reluctant to take finisteride because of the side effects I have now spoken and seen roughly about 8 surgeons. Some regarded as the best in the world with mixed fredback. 6 say I need about 1800-2000 grafts and 2 say roughly 5000 grafts. I said to the 6 surgeon about other feedback and they said there would be no place to put that amount of grafts. I feel lost

Doctor Answers 10

If you have post surgical issues, please contact your doctor. Your doctor knows the details of you surgery and can best answer y

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If you have post surgical issues, please contact your doctor. Your doctor knows the details of you surgery and can best answer your questions.

Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 106 reviews

I received mixed hair transplant advice from multiple surgeons. I am unsure what to do.

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1800-2000 grafts would be the best estimate for you, judging by your age and the amount of thinning hair on your photos. More than 2000, in my opinion would be a gross misuse of your limited number of "safe" donor grafts. Be conservative. You'll be happier I bet. 

William Woessner, MD
New Orleans Hair Restoration Surgeon
5.0 out of 5 stars 5 reviews

Variable graft ranges

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Doctors differ in their approach.  The likely answer is that they are both right - because although 1800-2000 grafts will make a significant difference, you are going to be losing more hair over time just on minoxidil, so eventually you will need more grafts, hence the estimate for 5000.

In general, more grafts=happier patient, so some docs like to get as much as they can the first time, and some docs just don't feel that that would be their approach.  GO with the doc you feel most comfortable with.

Good Luck!

Sara Wasserbauer, MD
Walnut Creek Hair Restoration Surgeon
5.0 out of 5 stars 10 reviews

Different opinions from different surgeons

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Welcome to the world of surgery, where there are sometimes as many opinions (whether it's your kidney stones or your follicles) as there are surgeons! But I agree with most of the other doctors who have submitted responses to your question: at your age, it makes sense to be conservative with your donor area and get started on finasteride to maintain your native hair and minimize the need for repeated surgeries. I'm not sure what to make of the photos you've posted (they look like they're from two different people), but I would think 2000-2500 grafts would make a considerable difference. 5000 grafts seems excessive, in terms of your recipient area, your donor area, and your wallet. 

Understand that it is in your interest to maintain your existing hair no matter how large or small a transplant you have. Finasteride is by far the most effective way to do that. It is successful in halting or even reversing the progression of male pattern baldness in 90% of men. There is no drug that has no possible side effects, but the much feared side effects of finasteride are waaayyy overblown in Internet chat rooms, with no scientific studies to support the claims. On the other hand, a large, randomized, controlled, prospective, double-blind study found that there was only about a 0.5% greater risk of decreased libido/erectile dysfunction compared to a placebo. It's important to remember that up to 40% of men have ED by the age of 40, and that ED has myriad known causes: relationship stress, family stress, financial stress, job stress, depression, and hypertension/diabetes/alcohol/other drugs, to name the more common reasons. Finasteride has become a convenient scapegoat for many cases of sexual dysfunction, and more often than not the "side effects" are simply a self-fulfilling prophecy. And don't forget, the side effect of NOT taking finasteride is baldness.

What you could do, if you're afraid that you'd be in the 0.5% and not the 99.5%, would be to start with a very small dose (0.5 mg) 2--3 times a week and gradually increase to 1 mg a day over the course of several weeks. My money is on YOU.

  Thanks for your question--I hope this was helpful.

  Dr. Ballon

Jonathan Ballon, MD (in memoriam)
Atlanta Hair Restoration Surgeon

Mixed hair transplant advice

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I think that you will loss all the hair at the middle part of head in time .İt is hard to say something about vertex and back ..I advice you to have 2000 grfats for frontal area +for anew frontal hair line and 1500 or more  grafts for the middle .İt supports your young appearence and self confidence at least 4-5 years without any problem .But after you lost more because of AGA you will need a second intention to support middle and the back .dont feel lost , you just need a good plan 

Ilhan Serdaroglu, MD
Turkey Plastic Surgeon

Mixed opinion on graft number

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At age 27, you need to use your donor hair very judiciously. Your non transplanted hair is still in a state of loss (and no one knows the rate of that loss) It would be wise to stay on the lower more conservative side of graft numbers if you decide on a transplant.

Dow Stough, MD
Hot Springs National Park Dermatologic Surgeon

What to do

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5000 grafts i taking your money and depleting your donor area significantly for future needs. Don't do that!

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 29 reviews

The more the better

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Realistically, you'd look great with 2000 grafts.  If you don't take the finesteride and continue to lose your hair, you'll need 5000! I would really ask you to consider the finesteride.  The side effects occur in only 1% of cases and are completely reversible if side effects do occur. Medical therapy is most important in young patients because this is a progressive disease -- you are still losing hair.  Combining medical therapy with a transplant will prolong your results and save money in the long run! Long story short, take the Finesteride and do 2000 grafts, then add more in 10-15yrs!  Good luck.

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

I received mixed hair transplant advice from multiple surgeons. I am unsure what to do.

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Thank you for your question and photo, 

Loss of hair is a natural process when it is between the limits that the body can restore them. When the capacity of the body to restore the hair loss is beaten by the excessive hair loss then we can name this situation something that should be treated. Women started to experience balding even more in the last 2 decades. It is getting more and more common also in women population. However it is also good to know that this problem is also treatable when it is present in women.

To obtain alive hair follicles implanted in higher rates, the latest technique being used is not the only manner, it is also affected by compliance of implantation area that we found a better way to improve as a result of our researches, The Organic Hair Transplantation. By this new and unique Organic Hair Transplantation Technique, before the extraction and implantation processes; we regenerate the implantation area with injection of stem cell enriched fat tissue. Regeneration of cells in target area before FUE transplantation with the support of stromal stem cells results in higher rate of alive thicker hair follicles.

Organic Hair Transplantation is a surgical technique that moves individual hair follicles from a part of the body called “donor site” to bald or balding part of the body known as the “recipient site”. Grafts containing hair follicles that are obtained from genetically resistant to balding area transplanted to the bald scalp by latest minimally invasive technique. One of the most important reasons of the hair loss is the decreased quality of the scalp. Therefore to make the only transplantation would provide only a limited benefit without improving the quality of the scalp. In the “Organic Hair Transplantation”

Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.8 out of 5 stars 102 reviews

It does not hurt to start

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small and ad more later if needed.  You should choose the doctor you are most comfortable with as no doctor is perfect.

Rashid M. Rashid, PhD, MD
Houston Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.