harryforreal

MrGio-WHTCClinic

Senior Member

Hard Core Real Hair Club Member

 

Thinning out the more visible grafts could improve the hairline and make it more natural-looking. Adding more hair may not achieve the desired goal of softening the front, and which may also likely further complicate your success with the repair procedure. FUE is a viable solution to remove and redistribute the multi-hair grafts.

Mr. Gio has an important view point, here. It is my intention to have electrolysis done on the darkest, thickets grafts - especially some of the 2's and 3's and such at the front of the hairline.

Dr. Cooley, actually, was the first person to suggest I might could try electrolysis on the doubles and triples when I consulted with him a couple of years ago. His other option was to add more hair (Dr. Cooley was not my original HT doctor, just for clarification, I sought him out after my original HT to get another opinion). I opted to return to my original HT doctor who offered to add more grafts for free to "soften" the hairline. It did help a bit, but honestly, overall it still just looks unsatisfactory because the grafts are just the wrong thickness and color for the front of the hairline.

When I met with Dr. Cooley a couple of years ago, he suggested that with electrolysis the technician could control the strength of the electric current with a dial and that it might be possible to partially affect the hair graft so that it might grow back a bit softer. The laser technician who did my V-beam laser last month gave me the business card of an electrolysis technician and recommended her highly - I checked out her website and the rates are quite reasonable - certainly a lot cheaper than another HT.

I intend in the next month or so to go to the electrolysis technician and target a few just to see what the result will be. At "worst" the offending hairs at the very front of the hair line will be gone completely...eh, no big deal, really. At best, they hairs will grow back softer and more natural - perhaps much more soft and natural then any new transplant hairs? Time will only tell. But here is my thought: If I target, say, 10 hairs or so with electrolysis at the front of my hair line as an experiment (for a grand total of perhaps $30?) and they don't ever come back, I don't think it will make that big a difference in terms of defining the hairline - might even look better if these most ugliest of transplanted grafts don't come back. But if they do come back softer, then that might actually contribute to a softer, natural look in front of the other transplanted hairs.

Since Mr Gio has suggested trying to thin a few hairs out, it might make sense to try this route first before another HT. After all, if you end up missing the small number of hairs that you target, you can always add them back in when you go back for your second major HT. If you were thinking of adding, say, 1500, then what difference does it make if you add 1510? None, really.

My recipient never returned to normal even approaching the 5 year mark. The V-Beam laser treatment I had almost 1 month ago definitely helped, but there is still discoloration - the laser technician suggested it might take 3 treatments, so I'm still within her original estimation. I hope to meet with her again next week to gage the result and probably schedule another session.

Yeah, I have felt the same way about my hair transplant. The problem is that the transplanted hairs are just wrong for the forehead. They are too thick and dark. It's not a question of density I don't believe - it's a question of the type of hair that is transplanted to the front of the forehead. If the hairs were finer, it would look natural.

I've plucked so many hairs from the front of my forehead in an effort to make them smaller and finer that I have sandwich bags full of them (I've marked the bags by month so I could see if the hairs got finer). Some hairs have indeed become finer - whether that's due to plucking or time I can't quite say. But there are still plenty that are quite ugly - especially the 2's and 3's and such in the hairline; but these I plan on having electrolysis on in the next couple of months.

I appreciate what Dutchie is trying to say, however, the issue is not density, it's aesthetic quality.

Greetings, Sam!

I couple of months back I had a micro-needling procedure at a dermatologist's office (not the office of the hair transplant surgeon where I had my surgery) to smooth the bumpy texture and skin "collaring" around the transplanted graphs like you've described. The micro-needling procedure really produced a noticeable positive, result - so much so that I honestly think it needs to be further investigated as a standard part of the hair transplant procedure to soften the results of a hair transplant - or maybe not everyone ends up with a bumpy texture, and your and my experiences are the exception rather than the rule. I really can't say if the bumpy texture afterwards is the norm, and if it is, it apparently doesn't bother very many people who get a transplant; really, sometimes the mantra to me seems to be "hair on the head is the only thing that matters". I hate to write that, but I consistently hear praise for things that look shocking to me!

So I know how you feel. I was very dissatisfied with my result and honestly never imagined it would look so bad. The thought that it could look so unnatural to me never even occurred to me - but I should add I really didn't do anything in the way of research prior to the procedure. I just went in for a consultation after seeing something on tv, and walked out with a brochure that seemed pretty convincing that everything would look perfectly natural. Ha! I was quite naive.

I'm still not especially happy with the result, but I can at least say that the micro-needling procedure really helped to smooth the texture of the skin. Three weeks ago I had another dermatologist's office "laser V-Beam" the area to reduce redness, and when I hit the 4 week mark next week I'll post some photos of that procedure. In other words, at least I have hope for improvement, and to that end I've had some modest success so far, though certainly not the result I had hoped to achieve when I went in for the original hair transplant.

Like you, I also think it would have been better for the doctor to have started at my original hairline and work forward, as I have some gaps between my original natural hair line and the new hairline. It really greatly annoys me and just pisses me off. I don't understand the aesthetic reasoning of this.

I have heard others speak of "framing the face." I don't understand this obsession with "framing the face" with a very defined hairline of several millimeters and then it's thinner behind it. To be bluntly honest and without meaning to offend others on this forum, I question if many people's obsession for transplanting hair impairs their ability to objectively assess the total aesthetic result; again, I don't wish to offend and I'm not trying to be accusatory, but it is a question I find myself often asking. Or perhaps it's more fair to say that different people have different aesthetic tastes.

For me I'm inclined to agree with you - a thinning head of hair that is soft and 100% completely natural is better than a wiry rug "sewn" into the scalp. I've been plucking the hairs out of my transplant for well over a year now, trying to "soften" it. I am planning on having a lady use electrolysis on some of the most ugly grafts (some thick doubles and triples/quadruples in the hairline).

One thing I've wondered about the bumpy texture and such of my transplant, is the doctor used implanter pens, and I've wondered if pens are more prone to producing such results. Just curious, do you know what your doctor used? Implanter pens or blades? Not saying that would make a difference, but it is something I've often wondered about, and others are free to chime in with their experiences.

In any event, I would check with a dermatologist regarding micro-needling the transplanted area. Newer scar tissue responds better than older scar tissues from what I understand, so might as well look into it sooner than later since there's no chance of damaging your grafts at this point.

As for waiting until the 12 month mark or more to assess the final result, that is true; however, it certainly doesn't mean you will be happy with the result when that time comes. But no point in worrying excessively about it now, and I do think you can will find some options for improvement, though no magic one step solution - I mean, we're aging, and the body is falling apart. Such is life.

Another statement I'd like to make is this - while I quite like many of the things I've read written by the gillenator over the years, I've heard this one from others as well and I don't quite understand it, "You have very black native hair that is producing a wide color contrast." If the hair was black to begin with, then the color contrast should be the same before and after the transplant. I don't really understand this statement, except that it is not a satisfactory description for why the transplanted hair looks a bit more bizarre. I have pulled a transplanted hair out by the root (well, quite a few - literally sandwich bags every month which I label so I could see if there was any change in the quality of the hair over time), and compared the root of the transplanted hair with a native hair I plucked from the back of my head. I CAN SAY WITH ABSOLUTE CONFIDENCE that the transplanted hair is thicker and darker than a native hair. Something about the transplant process has changed the hair, and despite more than a year's passing, the hair was still extra thick and dark.

In any event, here's a photo 18 months or more after my original hair transplant - many will say, "Looks great!", but if you notice the difference between the transplanted dark, thick, standing hairs across my forehead versus the much lighter, thinner, softer, flush native hairs on the side of my head, there is no way I will ever be convinced that one would be convinced this is "natural" looking. Now.....most people won't notice as they walk past you in the supermarket - but the girl at the check out line may as she's talking to you and telling you what your bill is...but honestly, these folks are not the one's you really care about....it's that one special person that you're most interested in and about whom you're most worried noticing something's off when you get close. Eh...but such is life. ^^

Dr. Konior, I was just visiting your page and reading on your techniques. By stick and place you mean a pen? And do you feel that lateral slits produce better results then stick and place? Why do you only use stick and place when trying to fill in between hair grafts?

Thank you!

Thank you, Dr. Konior, for clarifying. I see now that you did write he presented with mouse in his hair. I think it looks great and certainly is a great improvement over the previous transplant. But it would be nice to see it dry just to compare apples to apples. But otherwise it looks great and I'm sure the patient is very happy. Also glad to see an FUE example of your work.

Yes, I have fair skin.

My expectation for a hair transplant I think was uninformed at best.

My photos don't really capture the redness and certainly don't capture the bumps. I tried very hard to capture the bumps in the pictures, but it was very difficult - of course that was with an iPhone that only had a standard camera, not HD, at the time (iPhone 3).

Both the medical spa doctor and the V-Beam laser technician in the dermatologist's office said that the area is not red from irritation (which is what I assumed) but rather because the surgery broke capillaries (or something to that end) and the redness was the result of these capillaries/blood vessels. The technician said that she has V-Beamed along the scars of persons who have had face lifts, and that along the edge of the scars there appeared new little visible red blood vessels like the kind you get on your nose as you age but that the V-Beam eliminated them.

I just want the redness to go away. Then I can better evaluate the HT itself and how to improve on it.

The biggest limit to a hair transplant along the hair line, I believe now after having done it, is trying to get soft, lighter hairs in the front like are naturally there. I am greatly bothered by the dark hairs in front of my lighter hairline - just looks bizarre I think. Also several doubles and triples in the hairline that do not look natural either, but that I will target with electrolysis once I get the redness to go away. Of course that may leave a "hole" in a couple of places, but...eh...I'm sick of dealing with it all anyway. I just want it to look natural and not molested.

Consult with your doctor for sure, but I have been told as well that by the 11th day those grafts are not coming out.

I have repeatedly plucked grafts that I do not like, and they continue to grow back, so it's permanent if it's taken root. Next stop for me is electrolysis.

I generally quite like your hairlines, Dr. Konior, and this looks very nice. I do wish, however, that you could provide "after" photos with dry hair as in the "before" photos.

Had this patient had a previous hair transplant, or was just thinning?

Thanks for regular posting! Keep us update!

Ahhhh......redness and bumps.

Yes....

I know this story very well.

My redness still exists several years later - most people don't notice until I point it out; but I of course notice it every day. And if I step out of a hot shower....

Well I CAN say it has improved considerably since the initial procedure, but honestly I would not let people see my hairline for 18 months, at which point I consulted with my HT doc and said "I've waited the max time everyone suggests; now it's time for some action."

We began with some Kenalog shots which helped some. I also used scar gel for the bumpiness, and alternatively applied an OTC 1% Hydrocortisone steroid cream from CVS pharmacy. I did this off and on for months and months. Still do the Hydrocortisone occasionally and did the scar gel up until a month ago (more on that below!). I don't know how much it really helped the redness versus just time passing and it gradually improving very, very, very slowly - but yet to go away completely. And the bumpiness never really went away to my pleasing. Still, I had nothing to loose but more money, sooo.....

Even so, I still was not pleased with the redness or bumpiness. I have for years gone to a medical spa for botox/dysport and IPL treatments, and two months ago I asked the doctor (the medical spa doctor, not my HT doctor) about a solution for the bumpy, scarred texture as well as the redness.

She suggested a micro-need procedure for the bumpy, scarred texture. She also said that all the lasers she had in her office (IPL, Fraxel) would damage the hair follicles, but that maybe a V-Beam laser might not affect the follicles and that I should look into that since she knew several doctors in town who had a V-Beam laser. But first I went ahead and scheduled the micro-needle procedure.

So a month ago I had the micro-needle procedure for the bumpy, scarred texture with the medical spa doctor. I went ahead and purchased a full facial micro-needle procedure ($225 on special, otherwise $300) and the assistant just needled into my hairline no problem saying she would apply "extra needling" on the transplanted area since that was my primary concern and that the transplanted area would show more trauma as a result. It was essentially a painless procedure, except for a few key points on my eyebrow line where bone is close to skin.

Well first off - the micro-needle procedure: OH MY GOD!!!!! :D

SIGNIFICANT IMPROVEMENT IN TEXTURE IN ONLY 1 SESSION of the transplanted area!!!!!

AND since she micro-needled my whole face: DAMN AGAIN! My skin looked as fresh as it did when I was in my late 20's/early 30's - very impressive! I've scheduled a second micro-needle session for the holidays as the results are virtually instant, though there is some redness and peeling for the first couple of days. Honestly, I hardly can see any scar or bumpy texture after the first session - not enough to notice even when pointed out. But I just loved the outcome after only 1 session, and what it did for my face I have to say I am SOLD!!!!! If it looks this good after one session, I can't wait to see if there is ANY evidence of bumpy texture or scarred, punctured pores among the hair follicles after the second session, because there is very, very, little left and not anything anyone would think was unnatural - basically it looks like regular scalp texture now, though not "quite" as smooth at my hairline as before I had the transplant - but I had a COMPLETELY SMOOTH forehead, so I am measuring against perfection. Really, it essentially looks almost perfect - and I do mean almost perfect, to a degree that if I didn't have another micro-needle procedure done I think it would be very natural looking.

I should also add that the medical spa doctor said that micor-needleing works best when applied to scarred tissue sooner than later, though to be fair my scar tissue was at least several years old and I'm ELATED with the results.

The original redness, however, has not disappeared - which the medical spa doctor had said the micro-needle would not improve the redness, so that was to be expected.

So last week based upon her advice I had a consultation with a dermatologist with a V-Beam Laser for zapping the area. I had read on the internet two doctors say that a V-Beam laser does not target hair follicles and would leave the hair follicles undamaged. Anyway the technician at the dermatologist's office looked at my hairline and said the same, that the V-beam laser targets the blood vessels but does NOT target hair follicles like other laser treatments such as IPL or Fraxel. The downside is that the technician said I would have to shave the area before treatment - I have long hair, not a pleasant thought after all i've been through, but....if it gets rid of the redness finally I'm more than willing to do it. She also said it would leave the area very bruised for a week, so that I should plan accordingly, maybe even apply some makeup. She said that my redness was light enough that it might only take one treatment (@$200), but she couldn't guarantee it, but that she thought I would have significant improvement with one treatment. So now I'm just trying to figure out a good time for me to go in and get it done.

ANYWAY, the point of all this is that there IS HOPE.

ALSO, I DO NOT AGREE with all the other posters on here saying that that the redness and bumpiness will improve and that you will be happy as a bug in rug in only 6 months. Sorry, if you have anywhere near the amount of redness or bumpy texture that I have endured and you feel like me, you will not be happy.

However, I read your post a few weeks ago when I was researching V-Beam lasers online and could certainly sympathize with you. I didn't want to write anything at that time because I wanted to see how happy I was with the micro-needle as well as first go in for a consultation at the dermatologist's office over the V-Beam laser, which I did on Tuesday of this week.

I have suffered for almost 4 years now feeling mostly unhappy with my HT results - though there are times when I look at it in a certain light and think, "Well, it doesn't look bad in this light - best it's looked in a long time," and then other hand at night I walk into the bathroom and turn on the light (a fluorescent light, which I find makes the HT look its worst) and look in the mirror and think, "Jesus F-ing Christ! Looks like S-t!!!"

I have very mixed feelings.

BUT I can honestly say that the micro-needle procedure is the first fully, almost instantly, satisfying result I've experienced in 4 years.

And now my hopes are ever raised for the V-Beam, though I DO have some trepidation about damaging hair follicles, but if what everyone has said is true, it should not be an issue - so I'll let you know after I go for it.

As for "manning up"...well, we each have to deal with things our own way. I'm not sure whose luckier - those who grow old and ugly with age, or those who die young and never know the withering pain of Age setting upon us slowly, coldly, methodical in intent to enshroud us in His cloak of death.

Yeah, I find poetry brusquely manly. ^^

Though I defer to Dylan Thomas as the master poet on the subject...Well the Welsh (and the Irish) DO know a bit about suffering.

But anyway, relax, breathe. At least give it some time before freaking out. And look into micro-needling. I don't know how long you need to wait before getting a micro-needle procedure (or V-Beam Laser for that matter), but I would think it wouldn't need to be too long if the hair follicles are essentially firmly rooted after only 10 days. But best you check with several doctors on that.

But I can say that if had known micro-needle would have improved the texture so well, I would have done it as soon as it was deemed safe. Even if it will improve on its own after a year or two, why wait? And get the full facial and feel like you're in your 20's again, then hit the gym!!!

I would definitely start generic finasteride first, then, no matter what, while you look for solutions.

I also would inquire about the success rate of densities higher than 60/cm, and also how natural does body hair look?

For myself I feel I jumped into the hair transplant without adequately researching it. I honestly thought you walk in, they moved some hairs from the back to the front, you walk out with a new head of hair - that's what it looked like in the Bosley commercials. Downtime never even occurred to me - and I'm a pretty educated guy, just didn't even think about it before I went in and consulted with the hair doctor.

I consulted with one doctor - the doctor who did my hair transplant, and it seemed like it was a no brainer after talking with him (though he did say the results weren't immediate!): the results would be very natural.

I think it's very easy to get the impression from certain sources that a HT is a simple solution, but read through this forum and it becomes quite clear it's anything but a simple solution!

Clearly many men are happy with their results, so I don't want to discourage someone from getting a HT if it's the right path for that person. Just make sure you do due diligence.

In my case I didn't and was quite shocked and horrified with the results. That being said, if I had done due diligence, I might would have done it anyway, but at least I would have been a bit more prepared for the results. I can say this: I DEFINITELY would have done the finasteride FIRST. That is the biggest regret I have, simply because I would like to have seen what results I might have had with medicine alone. Might been enough for me NOT to pursue a transplant option. Or maybe I still would have.....

At any rate, I like that the doctor you spoke with was honest with you ABOUT THE RESULTS YOU SHOULD EXPECT.

What I notice mainly is that the transplanted hairs look very thick compared to the native side hairs.

As I stated, I have had the same problem. I went back for a 2nd HT with the same concerns as you: harsh hairline and "gaps". The doctor did add density with a second HT, and also specifically targeted hairs behind my ear with FUE because they were "softer".

Still, many of the hairs grew in black, and the native hairs I used to have at the front of my head were always soft and a bit blonder. After my first HT when I saw my dad for the first time in a year, he asked, "Is your hair getting darker in the front??"

I must say, I am very disappointed in the "harshness" and artificiality of my hair transplant. If someone had told me that my hairs would grow in looking like pubic hairs I definitely would have had second thoughts and might not have gone for it! Certainly I would have sought out more information. I don't think this aspect of hair transplants is emphasized enough - seems to be rarely mentioned. I'm not sure if my physiology is simply different than most HT patients resulting in darker hairs at the front, or if it's just not adequately addressed by hair surgeons and the "industry" at large.

I do feel that many of the hairs I have plucked in an effort to soften the hairline have come back thinner and softer - though often still black or very dark. I continue to pluck in hopes that they will soften even more. Whether it is the plucking or simply the passage of time causing them to soften I can't say. However, I might suggest plucking a few and seeing how they grow back? Make sure to take photos, and keep the one's you plucked in a dated ziplock sandwich bag ^^

Still, pretty crazy to have spent so much money and downtime on 2 HT's only to pluck the hairs out every day....but it is what it is!

And again, the issue may not be body hair - the issue may be density. Above 60/cm is difficult to achieve based on what I've read and been told.

Generic finasteride is incredibly cheap. I pay $5/month.

I doubt you will experience any regrowth, Scandinavian, but you never know until you try it. It does stabilize hair loss in a significant number of men, though, and that alone is a very good reason to try it first. What's the point of having a hair transplant if only 1 year later you have gaps between the transplanted hairs and where your hair continued to recede because it wasn't stabilized with medicine?

Yes, indeed - think positive, and remember: there's always more than one path to get you where you want to go.

As a side note, many women (and men) like men who have the Bruce Willis look - a friend of mine after I told her I had a HT told me she had a fetish for bald men and she wished men would not obsess over hair loss. She is seeing someone with no hair and she has told me that they get quite kinky with his bald head...and she is an attractive women with a position at a major university.

Maybe the path for you is to just get rid of the hair piece and see how people respond?

How about facial hair/beard hair?

Also definitely try propecia/finasteride - I never had any side effects, and it was a dumb doctor who took me off of it because she thought I was just imagining my hair loss, and then after I stopped taking it several years later I had real hair loss and since then two HT's. I would definitely try it - if you have side effects you can always stop taking it.

"He said he can give me some coverage but it will look like a guy who is balding. The density would be approximately 60 hairs per square centimeter. "

I like the doctor you visited in Norway - he sounds honest and ethical.

The issue may not be the amount of donor hair; the issue may well be the density that can be achieved regardless of available donor hair. 60 hairs per square centimeter is considered fairly high density *I believe*. Achieving a higher density can be quite a difficult medical achievement is my understanding - but let others chime in on this.

I always like what Mickey85 has to say about such things, even though he's no doctor.

It's a nice result. I will say, however, that I find my transplanted hairs always look much better in sunshine than inside my work environment under fluorescent lighting. Natural bright light seems to reflect back. The ultimate test I have found is the Home Depot test - go look at transplanted results in the bathroom mirror section under dim fluorescent lighting. But wait until Halloween - it can be a bit frightening! ^^

Also be prepared for the Home Depot staff to give you stares as you comb through your hair in front of each and every bathroom vanity mirror/medicine cabinet.

I like Ferrudini's hairlines, too; however, I do notice several things about his hairlines:

1) many of the guys on his website already have strong forelocks before the hair transplant. When looking at a patient from the front "straight on" the strong native forelock masks the temporal transplanted hairs.

2) many of the "superstar" patients on his website are quite young and have model looks; it's easy to imagine oneself walking out of a Feriduni transplant with model looks - but if you didn't have model looks before your hair loss, chances are you won't have model looks after a hair transplant! ^^

3) One thing I really commend Feriduni on is the high number of singles and then doubles he uses in his transplants. Many of the images on his site even state "No triple hair FU". The high density numerous singles he uses in his hair lines and no use or limited use of triples FU's when incorporated really makes a difference in the "naturalness" of his transplants I think. Of course such large numbers of singles means a lot more time is needed for the transplant, which is probably one reason his costs are higher than others.

Notice the difference between the native hair on my sides and the transplanted hairs in front. Is this what you want? Hair Restoration Social Network - Hair Loss and Transplant Photos

Of course you can have 800 grafts or whatever placed into the front of your hairline - but I seriously doubt you'll be happy with how it looks - I certainly wasn't with mine. Transplanted hairs don't really match the surrounding native hairs, and if you are concerned with the very mild recession you have presently, you're going to obsess over the difference between native hairs and transplanted hairs should you do a HT at this time.

front forelock looks great - i wouldn't risk surgery at this point.

I also have some "bare" spots like you and have wrestled with the idea of getting them "filled in". But adding more thick, black hairs that seem unnatural and highlight the scalp seems almost counterproductive, not to mention the tremendous downtime I have already experienced as the result of now 2 HT's.

I have some of the same issues - I don't like the thicker hairs at the front that don't fall softly, and the color is much darker - often black!

If the color were just lighter I don't think it would be so obvious, but it is darker. I have plucked a transplanted hair from the front and a native hair from the back and compared them side by side - the transplanted hair is significantly thicker and much darker. This tells me that it is the transplant process that actually changes the hair quality since the transplanted hair doesn't look at all like any of my native hairs still growing in their native location.

In many ways I think the dark hairs actually visibly accentuate hair loss - they create very obvious contrast between transplanted hairs and scalp skin, contributing to a "thinned" look.

I have plucked so many hairs now in an effort to get them to grow back thinner and lighter. I literally have ziplock sandwich bags of plucked hair labelled by month so I can compare the differences over time.