TheEmperor

reywd30, Panama Jimmy's advice is spot on. Personally, I think you have the physical characteristics to eventually get a good result. It usually takes more time and money than you at first might imagine. If you dont have the financial and emotional stability, getting a HT can be a bad idea. Doctors screen for more than just physical characteristics. They will probe your financial and emotional states. This is probably for the best. THat said, I guarantee you could find a doctor to work on you tomorrow. But you should only be talking to the best of the best. There are less than ten docs to consider, IMO. I'm pretty sure you can set up a good restoration plan with one of them, but it may cost up to 30K total and take a few surgeries. There are things you CAN do to improve your confidence right now. Take up marathon running or get into weightlifting. It sounds stupid, but if you feel that you have physical limitations right now, you can make drastic improvement by being in shape. Your face will look differnt, you will feel better. Then when your confidence has improved from that, you can look into HT. Or you could focus on intellectual pursuits / hobbies and put physicality behind you. Its a longer road for some people but you can get there.

This probably depends on the maturity of the people you work with. Yes, people will gossip and project their insecurities onto you. The more they can "punish" you, the better they will feel. So you are not crazy, this does happen. Yes your hair looks great. Other than telling them to F___ themselves, there is not alot you can do other than outing yourself and making the HT a topic of discussion. But that puts it into the realm of public discourse which has its own problems. The thing that keeps me sane is that if anyone were ever openly critical about the HT, I would simply ask them how they would feel about being bald? And then express good fortune about being able to do something about it.

I left staples in for over 3 weeks.

Yes, they work in shifts of two, working from front to back.

That looks normal. The red line will turn white over time. Looks about 2-3mm. The hair that was shocked or shaved around the incision will regrow and help to hide the scar. The area will be ultimately be thinner than before the surgery, but will thicken up over the next 6 months.

Its hard to predict results. You should go for as large a first session as possible, and plan for an additional 1,2 procedures. Cost will be around 25-35K. You look like you have coarse hair, so you should get a good result. If you have the cash and realistic expectations, then it can be a positive experience. Its a numbers game.

Boondock, While what you propose makes sense, I think the reality will not work as well as you think. Lets look at what can be accomplished with HT. 2500 Grafts "in the front" really doesnt accomplish much unless you have strong sides and temple points to support it. A typical NW7 not only loses on top, but also looses down the sides. So that 2500 grafts will be enough to provide a thin "ring" of hair on top. When the hair is lost on the sides, it will no longer be connected. Well then, get more grafts, right? Maybe not. I hink it is deceptive just how far grafts go. Almost ALL good hair transplants have supporting hair from behind or on the sides supplementing the look. I think to get a good "hairline" by itself with connecting side hair on a NW7 would require 7K grafts. Also, NW7s usually have miniturization on the side. Figure that half of the hairs you transplant will be subject to disappearing over the years. And then there is the scar and potential for permanent shock loss, making hiding the scar difficult. If you go FUE, the liklihood of this is less, but then you may not get near the 7K grafts you need. I think the end result (should you hit NW7 at age 40), will be a wispy thin hairline with wispy side hair that struggles to connect the side hair to the front. Your sides and donor will be either moth eaten and see through, or stretched and see through,depending on if you went strip or FUE. The resulting hairpiece that you get might as well be called a wig, because it will be covering 70% of your scalp and will be styled forward into your "native" transplanted hairline. The differences in density will be quite stark and difficult to conceal. Better options: A) Wait until the loss pattern has stabilized (age 35), then you know how much HT hair you have to work with. You may be able to get a "frontal forelock" or thin coverage of hair that leaves you "not bald". B) Just get a hair piece and call it a day. It will look much MUCH better than the 20-30K you spend on the HT. Maybe at the age of 35 you migh look into ditching the piece for a HT. C) Wait for other medical advances.

Standing behind a patient is good, but if there was no growth, the physician really should give a refund.

Slick, Im not trying to be insensitive, but your post made me chuckle as it brought back memories of when I was your age, going out drinking with friends (while trying to hide the hair situ), and my adventures with Couvre. The 20s are the worst for hair loss suffering. You will be ridiculed for losing hair, and will be ridiculed for doing something about it. Regarding my adventure with couvre, I was in my late 20s and ordered two tubes of the stuff. "Light Brown" and "Medium Brown". I started with the light brown and wore it for a few weeks without comment. It made a subtle difference. I got greedy and tried the medium brown. I was quite proud of myself looking in the mirror that morning, I had apparently doubled the look of my hair. When I got to work, a girl I worked with was chatting with another 20 something and she complimented me "I really like your hair coloring, it makes your hair look much better". (The guy snickered.) Of course, in retrospect, the comment was not meant to be a compliment, but in that context a jab. What I learned from that was that I'm a "light brown" kinda guy, but the experience left me deflated and not wanting to put makeup on my scalp. Look at the big picture and be thankful they do not seem to know about your transplants. With social media like Facebook, I imagine it could spiral into an uncontrolled PR nightmare. Sorry no real advice. Maybe get some light brown and try it instead.

hrvoje, I think you will always have problems with those gaps. The gaps are because the hair behind the gaps is not as thick. The hair layers forward to cover the area in front of it. Perhaps Rahal could have planted back a bit further, or perhaps you receded some more. There will be some improvements in coming months, and you will learn to style around the issues, but I feel you will always be wanting in that area, especially as you recede more. What you have is a big improvement.

Looks great.

Julius, By the "less is more" look I am talking about planting the top at (say) 1/3rd density via FUE. You buzz the sides really short and keep the top at 3/4" (and can spike with some gel or toppik.) You see this look on alot of guys in their 40s. It looks like a buzz cut, but there is no hiding the fact that there is some MPB going on. Maybe when you lose more hair and get older you will realize there is a difference between being bald and having thin hair. Having thin hair that still defines a hairline is 1000% better than being stark bald. I agree, there is no perfect solution. Your end result depends on your NW level, your hair characteristics, and your choice of physician. I would not be happy with the hair I have now when I was 27, but at my current age, it is a significant improvement.

This is my feeling at the moment, but I still want to buzz to a #2 or #1. I know this is not really possible with strip, so I would need fue into the scar anyway which is no guarantee of achieving this, though I do know of two guys who are able to shave to a #1 now because of it. Now due to such a large amount of loss, the doctors on this forum will probably not do fue for me as I do not have enough grafts available via this method. I would be taking a risk with a doctor who is not recommended here using a technique where there is little documentation of successful on cases over 2500 grafts. I want fue to be the holy grail of hair loss, but I am not seeing the results. I have even though of trying a radical fue ht procedure were I would have a whole area balded by fue and a tattoo placed there but neither Feller or Shapiro's reps even deemed it worthy of a reply. It seems with what I want and the amount of loss I have I am stuck between a rock and a hard place with fut and fue. Any suggestions? Sorry to hear about your experience Scar5. I was recently sort of warned off fue by a guy on this very forum who has had 7 fue sessions so far from dr jones, he who cannot be named from Australia, cole and Feller, and has to angle his hair down so it does not look so pluggy, he also said the results always look better in pictures than in person. Julius, It sounds like you have a realistic understanding of what can be accomplished with both FUE and FUT. You are searching for a favorable compromise. Regarding the use of tatoos or FUEing into the scar, they are both poor ideas. FUE growth in the scar is questionable, but the reality is that the donor thinning around the scar is the real problem. If your hair is coarse and thick, then you can buzz to a #3/4 with a reasonable chance of not seeing the scar, assuming no stretching anywhere. In the case that your hair is coarse/dense, you dont need FUE into the scar. OTH, if your hair is normal or fine, the donor area will start to thin out as hair is removed by either strip or FUE. FUEing into the scar really wont hide it because of the depleted surrounding hair. The only solution is to grow to an inch or longer. The hair length is determined by how much density you have remaining, and how big the scar is. Even if the scar is perfect, if your donor is fine and depleted, it wont be hidden unless hair is grown over 1". Tatoos wont adress the issue either. You may find that Couvre (masking product) will help to hide the scar. I find that this works for me. So I think your options are two-fold. You can go for a high-yield strip surgery, with understanding that you have to style around the strip scar. I buzz the sides over the ear (and under the scar) to give a more stylish look. Dont know why more people dont do this. Other option is a "less is more" look with FUE. You could have a doc plant a receded and somewhat thin hair (maybe 25-30 g/cm2), with the understanding that you are going to go with a buzzed look. If your hair is fine-to-average, a good doc should be able to create a natural hairline. It will be a receded hairline, but no one will notice it as unnatural. (More coarse hair seems to demand higher density to hide individual hair shafts) You could buzz the sides really short, and keep the top at 1/2"-3/4". Both the top and sides would be somewhat seethrough, but there would be a harmony. You can use toppik and other product to bulk up this style and make it look like there is more hair. If I did not have a strip scar, I would be able to do this, but I have to keep the side/back hair too long, so I am not able to achieve balance. However, I would never have been able to afford moving 4-6.5K FUE grafts and if the yield was even less than I got, then the "less is more" look would have just been LESS. So it is a catch 22. I think the solution is to either accept your baldness, or wait another couple years until you realize not being able to buzz is not the end of the world. Then strip will be the better option. The other option (which is a gamble) is to go for a "less is more" FUE look, with the understanding that if it doesnt work, you can just shave and move on. Most of the FUE docs are doing dense hairlines, but there might be someone who understands and specializes in "less is more". I hope this helps. I know its a big issue and a big decision. A high-yield strip clinic is still the gold standard for high NW guys.

There really isnt that much donor. What I have found from my strip surgeries is that the hair has to come from somewhere. This means one of two things. A) The skin is stretched locally to the incision, thinning out the area around the scar. B) The scalp is moved and stretched over its entire surface, making the bald area larger. I believe it is a combination. Neither possibility is appealing. The point is that while it may *seem* that there is alot of donor hair, when you start taking it from the back, things start to thin out, or you may find your bald areas expanding. That said, the estimate of 6-8K grafts MAX for your average patient is realistic, and I dont care what Norwood you are. The area around the scar will thin out until is will look bad. Only guys with really dense donor and coarse hair will be able to pull off shaving to (say) a #4. If what Feller says about donor scarring with FUE is true, then a patient has even less grafts availble with FUE. An 7K grafts is not quite enough to give NW4+ guys a full head of hair. They will always be wanting. They may get to a place where they have coverage with recession, and can make it look good with products and styling. That said, MAXIMIZING grafts and yield is the primary consideration. Strip should be the first option, although once stripped out, FUE should be considered as an adjunct. A patient who is stripped out may be able to build density with FUE (either scalp or body hair). For those guys who will never progress beyond a NW3, FUE may be the ticket. But then it may not be. Given the hit-or-miss nature of FUE, I would not want to be the guy who got a 3K FUE procedure with sparse growth, knowing that had he gone to H&W, he would have a good result and be finished. I dont think the FUE yield concerns are propaganda.

Rahal is your best bet.

TDS, I would say 95% of my grafts had surfaced by month 6. The cosmetic advantage did not become apparent until month 9-10. Look at the timeline and understand that the improvements seen post month 6 are virtually all due to lengthening hair and layering. I presume that everyone is similar. You need to give 3-6 months for the hair to grow to have an effect. Consider that 6 months of growth is only 2.5" in length. So it takes at least 6 months AFTER hair has sprouted to provide its optimal cosmetic advantage. Since most guys results are "complete" at month 12, this means 95% of hairs have sprouted by month 6. The majority of sprouting occurs in the 3-4 month time frame, and as early as 2 months. Look at my result with knowledge that virtually no new hairs sprouted after month 6. The improvements were all related to the hair growing longer. I have yet to see a "slow grower" who has a late, excellent result. If the moderators or anyone can provide a link to a patient blog showing this, it would be appreciated and I will reevaluate what I am saying. Slow growth is a euphemism for low density or low yield.

There is absolutely a correlation between what are considered impressive results and "rapid growth". When half as many hairs are transplanetd, the hair needs to be twice as long to provide as much "coverage". If the hair transplant is lower density, or there is lower yield, it will take longer for the results to materialize and look "good". As far as delayed growth up to 12 months, that just doesnt make sense. Why would a living follicle hang out for 12 months and then start growing? Maybe there will be a small % that do this, but not a majority of grafts. I think all the improvements we see after 6 months are largely the effect of lengthening hair that layers and provides increasingly more coverage.

I think you are correct. It is not that they take longer to grow, only that less of them grow. Many time what people attribute to "delayed growth" is lower yield. When yield is lower, it takes longer for the growing hair to make a cosmetic difference. I believe hair starts to sprout around month 2, the majority of them have sprouted by months 4-5 (it is at this point that it looks like something is really happening) and then by month 12 they are largely mature. I dont buy into the "delayed growth" rhetoric, and believe it exists to ease patients anxiety and get them closer to the 12 month mark where they are ready for a second procedure. I believe that while 95%+ yield is possible, there is a range of yields from 0-100%. Anything above 75% will look like good yield and be difficult to differentiate from 100% yield. (Unless of course you do a graft site accounting with close up photography.)

Megatron, It appears that the majority of existing hair that you had before the transplant is not regrowing. My experience is that when grafts are dense packed into an area of respectable density, than much of the native hair is transected and does not regrow. If that hair were going to regrow, it would be 3/4" in length by now. If I were you, I would shave the top to 1/2" and the sides as short as you can go. Tell anyone that asks that you had an allergic reaction or folliculitis and had to shave down for treatment. Hopefully the acne will clear up, but trying to conceal things is not going to help with the acne.

Drew, you might try experimenting with a "less is more" hairstyle with Toppik. If you can still cut your side hair short (say 1/2-3/4"), you might also cut the top hair to 3/4". Put some toppik in there and finish off with some hair spray to hold the toppik and add texture. This is not something I tried while waiting for #1 to grow out, but while waiting for #2 to grow, the hair from #1 is growing and is still less than an inch. Wouldnt have considered this styling option, but it is better than a combover in many ways. Without toppik, it would be too see through, but putting toppik in takes less time than blow drying with gel, and it looks reasonably good. The only problem I have now is the shock loss on the sides which makes short hair on the sides difficult. Hopefully shocked hair will grow back. Just another styling option to consider.

It can look natural on a man who is in his 50s. But Tom Hanks hairline makes him look older than he is. If he lowered his hairline, he would look alot better. That is the point I was making. Its possible to make an advanced NW "not bald", but unless the hairline is (say) within .5cm of where the original one was, the original face framing, the face proportions will still be out of whack. And this is why baldness looks bad on some men, because it draws their features out of proportion. Not having hair is secondary.

Its possible for a hairline to be too high to provide cosmetic advantage. Hair tranplant can take a bald guy and make him "not bald", but that is not the same thing as reframing his face. My new hairline is higher than any hairline I had, even when receeding and it doesnt frame my face in the way that I would have hoped. So while I am not "bald", I did not achieve any facial balance. Lots of things plan into whether or not a lower hairline can be achieved or whether it is appropriate, however I agree with the OPs argument. An artifically "mature" hairline is not necessarily more appropriate than a NW1 hairline. The question is whether it can be pulled off or not. When hairline matures in most men (not MPB), I think there is some temple recession and overall thinning which makes the hairline more see through. This makes the hairline _look_ higher, but it is actually not so. When HT docs plant a hairline 1-2cm higher than the original hairline, it is only because there would not be enough grafts to cover more area. But make no mistake. This is not desirable.

As my HT1 hair grows out after HT2, it might almost be possible to create a good buzzed look from afar. If you are planted at 1/3rd original density, then the hair on top would need to be 3x as long as native (side) hair to provide the same coverage. So if the side hair is buzzed to 1/4", you could grow the top hair to 3/4". With hair growing forward, it doesnt spike up like a porcupine, so it would look somewhat homogenous. 100% No, but under most conditions, no one would notice. This assumes there is no scar. My hair is fine and somewhat light, and I find that a "less is more" look would have been possible with FUE. I cant go nearly that short on the sides because of the scar. If my hair were more coarse or dark, I think this would become less possible as the individual hair details would be obvious. If I did not have a scar, I would seriously consider keeping the hair on top at 3/4" and buzz the sides/back.

Yes, concealers work to hide shock loss, but the side hair will need to be longer. Probably an inch or longer.

Lots of variables. These are some of the most important questions that will determine you quality of life and post-op satisfaction. My advice is that a couple weeks prior to the operation, trim all your top hair to 1/2". Maybe keep the sides at 3/4" to help concealing the scar. This will get everyone used to your "bald" look. (Tell them you wanted to see what you look like shaved down.) The goal is to not have any drastic changes in your appearance post op. Your ability to look normal post-op depends on many things. If you dont have much native hair, and your skin is fair, the recipient may be red for many months. It will be 6-8 months before your new hair grows in and looks "normal". However, if you have significant native hair, it will help to camoflage the redness. Regarding concealing the donor, it comes down to your donor density and hair quality. (And healing characteristics.) If your side hair is fine and you have shock loss around the scar, it will be a few months before it looks "normal". Some guys with thick donor look normal with hair cut to a #4,only 2 weeks post. Those are the lucky ones. I would say the biggest factor in looking "normal" is the density and quality of donor. If you are able to buzz down to a #4, you will look quite normal while your new hair is growing in. If your donor hair is fine and you have shock loss, you will need to keep the side hair longer, and it will be much more time before the top hair catches up to the sides. (You will be bald and red on top with long hair on sides... not a good look, trust me.) The tldr version: If your donor is coarse and dense, are not fair skinned, and you plan your preop shave down well, you can be back in action in 2 weeks with no one knowing. If your hair is fine, your skin is fair, and you have shock loss in donor region, it may be 6+ months before you look normal.