multiplier

You want to shave the recipient area (top), but not the back and sides? Wouldn't that more be much more obvious?

Yeah the cork-screwy effect happens in the first year and then usually evens out.

Cooley.

I have used fin for 10 years, but hairloss has been slowly progressive. Not radical, but evident. You can check my profile for more details. I never doubted there would be some loss. It's ultimately a stopgap while better options become available (better surgery techniques, etc). I have finasteride to thank for a decade of subtle hairloss.

But doesn't the follicle extend below the surface of the scalp? In which case, what does it matter if the head is shaved or not? The damage would still be the same.

That looks great and is very age-appropriate. Is there a reason he went for FUE and not strip?

Definitely sounds like NotHappy should meet with H&W again and look at the results in person and sketch out a reasonable gameplan. Another surgery to improve density (FUE?) at a reduced cost, if indeed it was some fault of the doctor? What exactly are the options?

Interesting. When you say "ketoconazole shampoo and pyrithione zinc shampoo", are there brand names? What frequency of use? Also, did you prescribe Propecia or Proscar, or does it matter?

I've got a question - what are the options now for someone like NotHappy who supposedly has below average donor and laxity. At what point does a doc know that there simply is no more donor hair to be taken? Obviously from the photos, the job only looks half-finished aesthetically. Is FUE then your only recourse?

What's going on with this thread?

The post-ops give a nice picture of what you should be seeing another 6 months from now. Really impressed at the lack of visible scar.

Considering his level of hairloss, I'm curious why the first session wasn't more like 3000-4000 grafts?

I've had black eye bags from sinus issues since I was a kid, I can't really tell if Rogaine is worsening things. I've also heard about it causing wrinkles under the eyes, but wonder if that just isn't from natural aging.

Thanks guys. I think my outlook is realistic. But the crazy part - I was sitting in a bar earlier reading your responses on my iPhone, then I got on the subway and stood next to a guy who had classic fencepost-style transplants in the front third of his scalp, sparse and sticking straight up. His hair was very short and when he turned to the side, I saw the huge U-shaped scar in the back. The skin also looked lumpy and uneven like there was excess tissue. Previous to seeing this, I had been in a good mood. It's amazing what a close-up view of transplants-gone-wrong can do I'm telling myself he probably got them done 15 years ago and has never had a second round of transplants either because he's broke or has no donor hair. And maybe he never took Propecia or Rogaine. But still. I wonder if the way he looked is an image that crosses all our minds late at night when we wonder where our hairloss will lead.

Can't thank you guys enough. It has been hard being in limbo the last 2 years, watching my hair get thinner and greyer and meanwhile caking on concealer and brushing my hair to the side every day, convincing no one I'm sure. I do have diffuse thinning and some baldness on both sides of the family, but then again none of them used Fin + Minox. I'm hoping sticking with those + surgery will put me back in a good place where I don't always feel like I'm so self-aware. One thing I hope is an advantage, and tell me if it's not - I have no desire to transplant to my temples, even though they're very receded. I think doing so is a waste of donor for certain people, no? I would like to strengthen the area around and behind the hairline all the way to the back third, but am not interested in the frontal hairline of a teenager (I'm 36 years old). I'm also expecting that if I leave the back crown mostly alone for now that I still may have to use Toppik there from time to time. That is not the end of the world. What feels like the end of the world now is that I can't even part my hair in any remotely flattering fashion without it looking extremely brittle and silly. The reason I'm saying this is to let you know I'm pretty realistic and conservative. I don't have the thickest donor, but the three topmost respected doctors have said I'm a candidate that would benefit from a procedure of 3000 (estimated) to start with. That makes me optimistic.

Thanks thehairupthere, it's good to know that places like True/Dorin and others are meticulous about planning for a patient's future. I think it's a big part of building the relationship with the patient and avoiding misunderstandings. Anyone else have insights here? Thanks!

^I'm trying to figure out why that was posted. In any case, that is some decent coverage for 2200 grafts, looking good.

Some of you know my story, but I'll give the condensed version. Ten years ago I got surgery of 800-900 grafts spread throughout my frontal 2/3, done by MHR. I have always been on Proscar and more recently minox, but the loss has continued slowly. This is the most revealing current picture - imgur: the simple image sharer I am in a weird spot where I'm not sure if I have any choice but to get another surgery otherwise the grafts in the front are going to begin to look very strange and sparse. I have spoken with 3 of the top doctors recommended on this forum. All of them have said I have about average donor density and room for a 3000-4000 graft procedure to start with. So what am I waiting for? I'm not really sure. The first time I had the surgery, it was a big emotional deal to stay hidden away from 6 months while the shockloss grew back, which not all of it did. But I guess since most of my frontal hair is FUT, it's unlikely to suffer from that this time around. Just in general it's the fear that I will be told that 4000 is really all the donor hair I've got. I get that transplanted... and then what? What happens if/when more hair falls out? I suffer form the same fear as many people on this board: I don't want to eventually look like a freak. I know transplants have come a long way since 2001. I know the HRN docs are concerned with planning for the future. I just want to know in my heart that I'm a decent candidate for this, the work will look decent, and it won't be something I'll regret. Any words of advice? I could use the encouragement.

Yeah, I actually wondered if they'd done what I did 10 years ago which is get minigrafts with a place like MHR, realize the consequences 5 years later and then swear off surgeries for good. On the positive side, I'm glad that the work being done these days by HTN's recommended docs is a bit more refined and forward-thinking. To me, it's worth spending the money to get things repaired and move your life forward.

I live in Manhattan but in 8 million people and 5 boroughs, I feel like I've never seen a transplant. Then last night I went to the Meadowlands and saw not 1 but 2 obvious transplants within 10 minutes. In both cases there was sparse coverage in the frontal third of hair that was way too thick in diameter to be there, while the back 2/3 were bald. Both men had hair cut fairly short so you could detect the outline of a scar. Both men were in their mid-30s. I have to say, this had a bit of a chilling effect on me. I couldn't help but wonder why they walked around like that instead of getting another procedure, although neither had what looked like good donor area. The overall effect was not the kind of thing you'd want to see in the mirror and I felt bad for the guys. It's this kind of thing that simultaneously makes me wish either a) I'd never gotten my first transplant, and/or b) I need to hurry and get another. A very strange feeling. What do you guys think when you spot transplants in the wild?

Alright now my curiosity is completely peaked. I've always wanted to visit Russia but not for any mysterious procedures, although I'm fascinated with how you ended up there. Post your journal! Or at least PM me a link Good luck to you man...

@Hal: I do use Toppik. Here is a thread that will give you a better idea - http://www.hairrestorationnetwork.com/eve/158939-how-many-grafts-sessions-me-pics-attached.html

If you already had 3800 and have 4000 left, that sounds like above-average density, no? Reason I asked is because both phone consultations I've had with SMG, there was a heavy emphasis on planning for the future, etc, though if you get good coverage with this one, that's awesome. Interesting. In both consultations I had, they said they definitely recommended all patients use finasteride in order to keep their hair, post-surgery. Otherwise if any native hair falls out, you're left with sparse transplant hair. But I guess since you had little native hair left, it's not a problem? Good question. I've consulted with what I think are the 3 best docs in the US. Trying to plan for a procedure for this summer or fall. The tough part for me is that I had about 800 grafts 10 years ago in the front, but my hairline has started to recede past it. So things are beginning to look funny and I've thinned out overall, despite meds. Kind of painted me into a tough corner, not to mention I haven't mentioned any of this to the wife yet My main concerns are 1) taking off work and 2) how much donor hair I actually have an whether, if exhausted, it's enough to get me decent coverage.

Very much in the same position as you Hal, looking forward to keeping up with your progress. Did they recommend future surgeries or meds, re: planning for the future?

HT scars seem to be one of those things that are only noticed by people who are familiar with the procedure themselves. Unless the head is shaved and the scar very red & obvious, I can't imagine the general public knowing what it's all about. Even people who haven't had HTs sometimes have anomalous markings or lines on their scalp. I don't think it makes most people take notice.