CopaSurfer

Thanks a lot, @Sparky, for your encouraging pic! Also many thanks to you, @wb280, for understanding my rationale. @HTSurg: I appreciate your advice. I know about the limitations of a transplant, but actually, after a very thorough discussion with several people who know the whole HT industry very well, they told me that my goal IS achievable. So, while not expecting to get my hair back as it was, of course, I am quite optimistic to achieve a result, i. e. the best possible "illusion", that comes as close to my original looks as possible. @biscuit: I know how I look with extremely short hair - I looked terrible with that kind of hair cut when I still had my full head of hair - and that's exactly why I want to get as close to my former "style" as possible. I have discussed my case with two largely independent experts here in Germany who got transplants themselves and have seen plenty of HT patients. They considered my goals to be realistic and achievable. They also know many of the top surgeons and their procedures from personal visitations, and - while not being linked to Dr. Keser in any way - they agreed with me that Dr. Keser would be a perfect choice for the kind of hairline design and density I am looking for. There are plenty of absolutely outstanding results from Dr. Keser in hairline design and density (his manager has given me access to some more results that haven't been published), even on patients with more severe hair loss and less than 3,000 grafts.

Hi EpilepticSceptic, it's only now that I have the time to respond to your post. Thank you so much for sharing your experience - I took everything you wrote into account when I was considering different options and surgeons over the last months. Finally, I have decided to have my HT with Dr. Keser in Turkey. I made an appointment for the last week of February (as Dr. Keser only does 600-800 grafts per day, and he does all of them himself - just as I prefer it - it'll take a week to get everything done), but am at the top of a waiting list for an earlier appointment, should the opportunity arise. I did indeed draw the hairline too deep and actually deeper than it had ever been. After a thorough online evaluation the estimate is that I'll need close to 3,000 grafts (not more) to restore my hairline at its original position, with maximum density, so that I can style it upwards again without any "see through" appearance and as close as possible to my original looks, which is exactly what I want and, according to Dr. Keser and two independent experts who know Dr. Keser's (and many other surgeons') work and whom I talked to, CAN be done! I still have to send some better pics of my donor area to Dr. Keser, as I had my hair cut very short and, due to a not-so-skilled barber, uneven some time ago. He just wants to check if I have at least average donor quality. From what I'm seeing and have been told by various people who work with hair on a daily basis, my donor area is actually pretty dense. So, I'm very optimistic that we can get exactly what is needed. A final word about my personal (!) philosophy, which many people won't agree with, of course. I intend to give absolute priority to my hairline, which I want to restore and keep at its original position with maximum density. Since I'm the "Northern European" type of guy, my hairline has never been extremely low, and it'll still look good and natural when I'm older. I prefer to have a hairline that is as close to its original appearance as possible, and should my hairloss progress significantly, a (possibly considerably) thinner crown area. I know from my previous experience that Minox will help me to keep the hair I still have for a significant period of time, so that there is a realistic chance to live my 30s with the looks and style I would have liked to have during my 20s (As soon as my hairline had started receding and thinning, I combed my hair forward to hide the hair loss, and it really destroyed my looks). From my perspective, that's worth it, and I'm prepared to tackle any further loss and take the necessary steps to make the crown look as decent as possible. But what matters most to me is the appearance I have when people look directly at my face. Thank you once again for your advice - I'll be posting updates on my HT details and progress towards my desired looks regularly!

Hi again, just wanted to post some better photos. I have already sent them to the favorite surgeons on my list and am getting to close to making a fincal decision on the doctor of my choice. By the way, I have noticed with the help of some older photos, that my hairline has actually not receded more than 0.1 - 0.2 cm in the middle. So, I'm not going to put it further down there than just that, while restoring it in the temple area as well as filling in the thinning areas. The graft estimates I have received from the docs on the basis of my goal (restoration of hairline at its original position with maximum density) has been consistently at or slightly below 3,000 grafts - just as some users had estimated here, too. I'm only waiting for a final conversation with Dr. Keser's manager who has been extremely helpful, but has not yet responded to an e-mail I sent him last Thursday. As soon as I'll get his response and have the chance to clarify some final questions with him, I'll be ready to take my decision and am going to open a new thread in the patient results sections with all the details of the procedure! I intend to post regular updates there, because I'd never have come to this point without the help of so many others who shared their stories and experiences and have given me their valuable advice! Thanks to all! CS

Hi EpSc, I'd say that not everyone takes a decision based on what makes a difference to "the chicks" (whoever that may be), but they make it just for themselves. A good approach, kind of emancipatory, in my opinion. Apart from that, I'd like to mention that there are FUE surgeons who don't do megasessions, but a maximum of about 600-800 grafts per day. In one week, they can get you more than 3,000 grafts, if needed. And some of them even do practically every step of the procedure (at least extracting and implanting the grafts) themselves. It's just necessary to do some extensive research and to talk to as many people as possible about their own experiences.

Yeah, Sean, that's right. I've done very extensive research and talked to some of his former patients here in Germany, because I'm at the point of choosing the right surgeon for my HT. What I especially like about Dr. Keser is the fact that he actually does the whole procedure himself, i.e. extracting the grafts from the donor region AND implanting them in the recipient area! That's why he does only 600-800 grafts per day. He also uses the so-called "slit and place" method, which means that he doesn't punch out all the holes first (or has them punched out by techs, as most other surgeons do) and THEN implants the grafts (or has them implanted by techs, as most other surgeons do), but punches out one hole and immidiately places the graft, one at a time. In my opinion, this methodology is an important factor when it comes to minimizing trauma and achieving the best possible yield (although it may not earn the surgeon the highest possible profits, due to the limited number of grafts per day). I'm still discussing the details of my possible procedure, but Dr. Keser is definitely my top favorite right now.

Hi EpilepticSceptic, in my case, "as close to nature as possible" equals "the densest, thickest results"! By the way, I've taken some better photos and already started to send them to the top surgeons on my list. I'm going to post them here soon and tell you how the consultations go. Thank you once again for your feedback!

Hi, this sounds like a very cruel situation and context. I mean, for true friends you should be the same, if with or without HT or whatever. In the end of the day, individual levels of hair loss are also part of human diversity, and with a bit understanding and tolerance and empathy, it should make no difference for anyone who really cares about you and respects you and your decisions?! :confused: The following quote comes to mind: You laugh at me because I'm different, I laugh at you because you're all the same. Enjoy your freedom and I wish you all the best!

Hi Johnny B, I read your hair loss story - pretty impressive and reminds me of myself. How is it going with your hair? Do you have any pics of your current situation? You are about five months post-op, right? EDIT: Sorry, just saw your hair restoration site. Looks really good only 4 months after surgery! Happy growing!

Hi, that's a very good question! I'm definitely going to discuss this with the surgeons I intend to consult over the next days/weeks - from the beginning. Actually, a top transplant should give you any styling option you wish, but as I want to wear my hair upwards, I believe that maximum density AND natural design of the hairline are even more important. Probably, this kind of hairstyle is really the one where every detail becomes most visible.

Thanks @matt! My calculation of 35-40 sqcm already included the area on the left side behind the current "hairline" that has thinned out considerably. From the middle to the right temple, there is still good density behind the existing hairline, apart from a small spot of maybe 2-3 sqcm in the middle, where it is also noticeably thinner. I have to add that the frontal hairs in the middle have been cut very short in order to even out the look when I put the hair forward. So, that may be a reason why it looks thinner there than it is. I think it would be best to leave that area behind the hairline from the middle to the right temple just as it is and put the new hairline with maximum density in front of it. If a higher density than 60-70 grafts per sqcm is needed, that might lead us to a total of about 3,000 grafts. But I have no idea where I should put 5000+ grafts?

OK, Surfarosa, I'm just asking myself why I haven't seen the same photo results from some clinics (that market themselves quite aggressively) as I have seen from others? And I'm talking about results where the hairline was shown very closely and under strong light and also wet in some cases! I believe that if other clinics had such results, they would make sure that they are put out in the air. Don't get me wrong: I understand the need to meet HT patients in person. But in the end, you will at best meet a very small fraction of all people who got their HT from a certain clinic. So, you will have to rely on other means of documentation as well - especially the experiences shared by other patients, online.

Hello EpSc, I think it's better to post other pics first because it will facilitate our discussion. However, I'm still wondering where I should put 5,000 grafts into an area of 35 cm2 or 40 cm2 at the most?! I have been examining my hair very thoroughly over all those years, so I cannot imagine to be so far away from the reality I'm facing every single day. However, I really value your experience and appreciate that you are trying to raise my awareness of some very important aspects and limitations. I might be wrong with my observations, and we'll know better as soon as I have good quality photos which I'm going to present to a very experienced hair consultant whom I have met in that German forum and who has already helped lots of users there in their preparation for HT surgery. Also, I might have the chance to meet a guy who has got his HT from Dr. Keser through my barber/hair stylist. By the way, I never said that I had "coarse hair" - it's only that several people told me I had thicker hair than average. I think that it is a bit premature to draw any conclusions regarding the possible effects of that observation on the outcome of my HT. Did I get it wrong that, at first, you considered your observation of my having "medium to medium fine, blondish hair" a possible disadvantage? I would say that thicker hair than average is good for coverage and perceived density, as long as it is not extremely thick/coarse. Your first statement regarding this issue seemed to point into the same direction. "Blondish" hair doesn't seem to be any disadvantage, anyway.

I have seen some very dense HT hairlines that also looked very natural. Actually, that's exactly what I'm looking for

I have drawn some lines to give you an idea of where my hairline used to be. I assume that due to the angle of the photos the situation may look even more terrible than it is... :rolleyes:

Hi Matt, thanks for sharing your thoughts. As I stated earlier, my hairline has receded not even 0.75 cm in the middle. The right temple has receded about 2-3 cm and the left temple about 3-4cm at the outside margin. I'm the Northern European type, so my hairline was never very low, and maybe my photos are actually making it look worse than I see it when I look in the mirror (not only inside, but also outside in full daylight) and compare it to where I come from. However, though I never had a low hairline, I used to have very dense hair also in the front that stayed upwards even without the use of gel or wax. And people used to tell me that my hair looked quite good that way. So, my estimate of the area to be covered remains more or less the same that I have already stated (about 35 - 40 sqcm). But I might be totally wrong, so I definitely need to post some better pics. If it is more or less the area cited above, it would definitely be possible to have a very dense result in the front even with only 2,000-2,500 grafts, and that's all I am aiming for, because I know that I can maintain and considerably strengthen the existing hair by using Minox again. @Surfarosa: I have also seen some very dense and also natural hairlines without "see-through look" from patients whose hair status had been much worse, so I still believe that should be possible in my case, too - if it is done the right way by the right surgeon. I say it very clearly - I'm not going to aim for anything less and am willing to take the grafts needed for such a result in the front, even if it means one day having only thin hair in the crown (In the end, that's my personal "philosophy" and decision).

First of all, @Surfarosa, your hair looks great! Looking forward to your personal hair loss website where you can post all your photos. I'm going to put one up in the near future as well. I have seen many photos and photos of different quality. At least there are some photos of really good quality and under strong light, preferably daylight (without flash), where you can clearly see the hairline in detail. I've also seen some videos who match those criteria. So, if you pick the best results out of those results, it's a good starting point, I think. I still believe that the area to be covered in my case is quite limited. Mainly because I think we can put nearly everythin in front of the still existing (!) hairline, with maximum density. Even if it has thinned out a bit in the 1-2cm strip behind that hairline I have decided to leave that alone for now, as it won't be noticeable, if the hairline is dense-pacekd. I know from my previous experience that I can stabilize and even strenghten my existing hair with Minox very considerably, so my current goal is to get a perfect hairline into the area I described. If those grafts are dense-packed by a surgeon who has demonstrated that this is really one of his specialties (as well as hairline design in general) - although I am still not 100% sure who this surgeon is, but I have my strong favorites - I think it's possible to get quite close to natural densitiy and looks. What I mean by this, is that I want to put my hair upwards as I used to without that see-through appearance that I have seen on so many HT photos (!). Yeah, also photos that were not of the best quality. Then there were others of top quality where the hairline was just perfectly dense, but also natural. So, obviously the specific skills of a surgeons, his experience, methodology, number of grafts per session etc. matter a lot. Contrary to EpilepticSceptic's impression, I have also been told by various people (including some who work with hair on a daily basis) that the diameters of my hairs are actually above average. Apart from that, I have fair hair, which is also an advantage. So, I'm a bit more optimistic, but nevertheless very grateful for other people highlighting critical points and limitations!

Hi @RCWest, thanks for weighing in. I have not set any limit - 2,000 grafts were a spontaneous guess I made on the basis of a not so exact measurement of the area that needs to be covered. I might be wrong and we have to go further behind, so I'm looking forward to getting more feedback on the new and better photos I'm going to take. I have seen a good number of Dr. Keser's results, and actually I found the quality of those photos much better than most others. The same applies to the results. If I remember well, some of them also had close to 3,000 grafts, so that should not be a problem. It will just take a bit more time than with those megasessions which, in my opinion, increase the risk of low yield and poor results. If necessary, I'm prepared to stay more than a week to get the number of grafts I need. But I still don't think that it's necessary. On the right side, the hair is still dense enough behind the still existing, although receding hairline. However, it has only receded about 2-3 cm in the outer right temple. On the left side, it has receded more and we might have to go about 4-5cm behind at the outside margin. In the middle, the hairline has only receded about 0.75 cm and density behind is still ok there. My guess for the area to be covered was 35 sqcm. If we take an average density of 60 grafts per sqcm, I don't know where we would put a lot more than 2,000 grafts. Also taking into account that, from my previous experience, I have a good chance of even strengthening the existing hair when I use Minox again. We'll just have to see what Dr. Keser and other docs I'm going to consult think about my case.

OK, thanks for your advice, that's how I'm going to do it. By the way, did you see that patient (who was classified a NW 2-3, but had a far more advanced hairloss than I have) and what someone made of him with just 2,000 grafts? And I have seen a couple of other patients who were in a worse situation than me, but have got top-notch results from Dr. Keser: http://www.hairrestorationnetwork.com/eve/156605-dr-keser-2000-grafts-fue.html

Hi @EpilepticSceptic, thanks a lot for your honest feedback. I also had serious doubts about the quality of the photos. It was not an attempt to hide anything, of course. It was just at night and I couldn't take them outside, you know. And the first pic was just to illustrate how I'm trying to hide my problem in everyday life. In any case, it is very helpful that you told me to get better pics right away, because it will save me lots of time and prevent a possible back-and-forth with the doctors. I don't think that my hair loss is quite as advanced as you wrote it might be, because I have, at the most, very minimal thinning in the crown where my hair is extremely short right now (in an attempt of my barber to even it all out). Also, I am always told that my hairs are quite thick. But I'm just going to post better pics for you to evaluate. Thank you so much for your help!

I have been thinking about this over the weekend - fortunately, I have quite thick hair, as you can see in the pics I posted in that other thread ("result as close as possible to nature"). But mathematically, someone whose hair shafts (diameters) are twice as thick as those of another patient with thinner hairs will actually be able to cover 2^2 x π = 12 times the area with the same amount of hairs/grafts! Thus, the same number of grafts per sqcm would give a much (!) denser look to the patient who has thicker hair.

By the way, it would be really great to get some more feedback on my photos and my goals as well as who YOU (I mean everyone who reads this, especially the more experienced forum members) think would give me the best possible result and why. :confused:

I don't have much experience with taking this kind of pics either. Also wear my hair forward normally to hide the problem zone (see first photo). Unfortunately, I had to use flash (which is not ideal), but in this case, it didn't change the outcome. By the way, you can take normal face pics and then use Photoshop or, as I do, IrfanView to zoom into and cut out the area you want to post here.

Thanks a lot for sharing your experience, @Surfarosa. It sounds like you have had your own difficult journey and, fortunately, are here trying to help someone like me not to make certain mistakes. My guess of 2000 grafts was the result of a measurement I did of the area that has to be covered (according to my calculation about 35 sqcm) and an average densitiy of about 60 grafts per sqcm. But I'm going to consult with the top docs on my list to see what they suggest - and as you underscored: I'm going to focus on my desired result! I have been doing research for eight years now, too, and, you know, after a long process of weighing different arguments I have decided to have a FUE procedure. However, as I have seen some very poor results even from so-called top surgeons, I have now elaborated some criteria that I personally consider fundamental to the success of my procedure. I want a surgeon who does, at least for the most part, every step of the procedure himself. That is only possible - due to the mostly ignored fact of human fatigue and its effects even on the most skilled and experienced surgeon - for someone who doesn't transplant more than 600-800 grafts per day. In my opinion and the opinion of some experienced guys I've talked to, this is also crucial to minimize the trauma especially in FUE procedures (where the trauma for the follicles is per se much higher) and risk of lower yield. So, I'm narrowing down my list to the surgeons who meet these criteria and whose results in hairline density and design are in accordance with my goals. I'll keep you updated, my hair buddy! We're all hair buddies here! Thank you also for the advice regarding Minox - I only applied it once per day, too, when I used it last time, and it was definitely enough for me! And let us know how you feel about your situation! Do you have any recent photos?

Well, you know, if something works very well for you and you notice that your hair loss is advancing very slowly anyway, you may sometimes lose your discipline. :rolleyes: I'm going to re-start immediately after my HT (this fall) - they recommend to stop using it about 2 months before the procedure, so it wouldn't make sense to start right now.

Hi @surfarosa, as mentioned earlier, I'm 31 now. I have, at the most, very minimal thinning in the crown that is not noticeable. As I'm also a very good responder to Minox (though I haven't used it for some time, but will start again after getting my HT) and my hair loss has advanced only very slowly over the last years as well as with respect to my family history, I'm very optimistic I can maintain the hair I still have for a long time. Should the necessity of another HT arise, there will be plenty of hair left in my donor area which is very dense. I guess that 2000 grafts should be about right to achieve my current goals - what do you think?