I'm 43 years old with a hair density of 5/5 and a present class V l l. My estimated future class of the same V I I (Photo)

In general most men have about 6000 to 8000 donor hair grafts in their life time.  You can plan your surgery based on your donor hair and understanding of what is possible (in terms of final results).

I would recommend at least 3000 FUE grafts via Neograft or similar single follicular unit technique rather than a strip harvesting technique. In our clinic, we would focus on reconstructing your frontal hairline, and then adding density to your scalp crown. You may need more grafts in the future.

From the photograph it appears that
you have limited donor options as well as retrograde alopecia. It is important
to have a consultation with a hair restoration expert prior to a procedure, in
order to discuss your options as well as set reasonable expectations.

You have an advanced hair loss pattern. Retrograde alopecia (hair loss from the neck upward) seems to limit your hair loss even more.

You have to understand that a very limited restoration can be possible, possibly an 'isolated frontal forelock' designed. This is an isolated island of hair at the front. The first thing for you to decide is fi you would be happy with a limited coverage.

FUT would clearly give more grafts than FUE with such a narrow donor area. The logic is simple: FUT only needs about a 1,5cm which strip to give 3000 or more grafts, whereas FUE requires 1cm2 area for each 15-17 grafts extracted. I would estimate about 1500-2000 grafts via FUE. You could certainly have some more grafts in a subsequent session which ever option you choose.

You have to also consider if your hair loss advances such that most of your hair bearing area is see-through, you may end up with visible scars.

I recommend you think twice before deciding on having hair surgery.

It does appear that you have about 3000 grafts harvestable from the scalp donor region.  Depending on your beard, perhaps more.  The main question is what your expectations are and how you wish the appearance of the transplant to be.  As a general rule, if you make a fist, the area your fist covers requires roughly 1500 grafts to cover at moderate density.  What would be possible in your case is to create facial framing of a conservative nature and use the grafts available to you to restore the frontal half of your scalp leaving a bare crown.   Again, a key component of the equation will be your expectations and how you wish to wear your hair when its grown out. 

With FUT, you will lose a significant amount of hair in the back -- excising a strip of the only hair you have. FUE will make it thinner, but it won't affect the vertical height. I would recommend FUE with either a VERY experienced manual FUE surgeon or consider the ARTAS procedure.  Good luck!

Always ask your doctor to see and meet patients who had your pattern of balding to see their results. What you see is what you are going to get. We can show many patients that have had your balding pattern. The quote you received is very low and few doctors can really address problems like you have unless that combined scalp micropigmentation with hair transplantation.