Have donor area less dense. Should I go for FUE as 4000 grafts needed? Follow-up. (Photo)

My Doc says 1000 from chest hair and rest 3000 from back head. Attached are top view and back view ( which doc claims are not much dense though would do). Please advise!
This is a follow-up to an earlier question. Click here to read it.

Doctor Answers 7

Not Everyone is a Good Candidate for Hair Transplant Surgery

Thank you for your inquiry. Seeing your pictures with only limited history, only limited advice can be given. If you are age 25 or 45, the advice would certainly be different. The average person has approximately 100,000 hairs on their head. It looks like you have lost in excess of 60,000 hairs. Having lost that much hair can be very frustrating. A transplant of 4,000 follicular units would give you about 9,200 hairs certainly a small amount compared to what you have lost. 3,000 FUE grafts would not be a treatment recommendation for 2 reasons: 1. 3,000 grafts could not be safely harvested in one session as harvesting would extend outside the safe donor area. 2. Survival rate is approximately 90% with FUE in experienced hands and much less with inexperience and Neograft. With your amount of hair loss you want as amny hairs surviving the procedure as possible.
First, you need to establish whether or not you area candidate for hair transplantation. See a number of full time hair restoration surgeons who are very experienced, they will be able to tell you if you are a good candidate and what results you can expect.

Seattle Hair Restoration Surgeon
4.9 out of 5 stars 33 reviews

Using chest hair

As you think about chest and scalp hair FUE, keep in mind that only about 50 % of chest hairs survive. (the survival is much lower than scalp FUE where the number is well above 80%). In order to cover your scalp with nice density, you'll need about 9000 follicular units. Given that you don't have this many, you'll achieve a thinner coverage with anything less than this number.  Many patients choose to focus on the front half and build nice density in that area and either not transplant or sparsely transplant the back (crown). 

Without seeing your scalp up close, I can't comment on an appropriate amount to move. Certainly your donor is thin but it really depends on your current age and how much thinner it could get. 

It's critically important to be aware that building nice results with limited donor hair is a real art. 500 surviving chest hairs (out of 1000) doesn't add a whole lot. 

Jeff Donovan, MD, PhD
Vancouver Dermatologist

Thin dono

Your donor does look a little bit thin however the ultimate results available donor hairs is indeterminate. But the principle is to take as many from scalp first before going to the chest.

John E. Frank, MD
New York Hair Restoration Surgeon
4.9 out of 5 stars 54 reviews

4000 FUE grafts

4000 FUE grafts would give you sparse coverage over this large of an area if what I see in the photos is accurate.  You risk a moth-eaten or sparse appearance of the hair at the back as well and the other risk is that body FUE hair (and FUE hair in general) can sometimes not grow as well as other grafts (like from the traditional method) since they are so delicate.  However, if diffuse coverage is your goal, this could be successful for you.  You have class 6-7 male pattern hair loss so you might need 5-8 thousand grafts to really get you covered.  Possibly two surgeries?  Bear in mind this would be quite a long process for you. 

Good luck!

Sara Wasserbauer, MD
Walnut Creek Hair Restoration Surgeon
5.0 out of 5 stars 9 reviews

You are bald

You are bald or balding to a Norwood 6 ot 7 based on photos.
Before embarking on such a large number of grafts, you need to have a realistic expectation of what 4000 grafts will produce.  It will never give you the hair you once had.  You need a master plan.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 100 reviews

Very bald, wants a reasonable approach to hair transplants

Class 6-7: If you have high quality hair (average or better weight) some salt and pepper color and enough donor density, numbers in the 5000-7000 grafts will be needed. Even with these numbers, the fullness throughout the scalp will not be 'full looking'. We are now combining less grafts (like 4000-5000 grafts) with Scalp micropigmentation which will give you a full look. See the website below. In addition, go to my website and see over 1500 patients, many with patterns similar to you listing the number of grafts to achieve the results you see there at newhair website under galleries.

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

Limited donor hair

If you have selected an experienced hair specialist, the doctor can tell you all the pros and cons for each harvesting technique. They should also be able to recommend the technique based on your individual case. Since each case is different, all the possibilities have to be discussed and examined before making a decision.  In your case since it is a large recipient area with limited donor hair to get the maximum result from the donor hair available, I recommend doing FUT technique. It is more efficient and less collateral damage. 

Michael Meshkin, MD
Newport Beach Hair Restoration Surgeon
4.8 out of 5 stars 27 reviews

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.