harryforreal

I can't comment on what 4k grafts implanted "should" look like, but I will say that most will tell you it's still to early to asses the outcome. What I do find strange, however, is the extensive bald spot behind the transplanted area. What was the reasoning for this design? At least if you have the donor supply you can add to it - and maybe the doctor felt 4k was enough for one day of surgery and better to come back at a later date for more?

With regards to the vascular theory, Dr. Bloxham, is it possible that transplanted grafts can get TOO much blood supply and grow super thick?

Strange question, I know, but...

My redness has lasted over 5 years!!! Just completed my second V-Beam treatment 1 month ago, and FINALLY after lasering the area a second time it looks rather normal - though a very close inspection will reveal some lingering pinkness - but nothing like before. I don't think it would have ever gone away had it not been for these 2 laser treatments. FFS.

I think it is important to show all types of results because that is the reality of hair transplantation.

Finally, some honesty with regards to expectations after 1 procedure.

While everyone is going gaga over Aftermath's recent photos, the fact is the results Aftermath is currently posting are after 10 years, 4 surgeries, and ~$40,00 - $50,000.

Thank you for the photos, Dr. Charles

As strange as this sounds, can you get photos of your hairline even more closely?

Also, back to the hair color topic (which I am obsessed about if you have seen any of my other posts), when I look at the post-Farjo photos, in the top down shot it looks like the transplanted hairs are darker, but the crown hairs are not. But in the post-Farjo photo of the hair line that does not necessarily appear to be the case, though of course from a photo it's hard to tell theses things.

Do you feel the color and diameter of the transplanted hairs are darker and thicker?

Thanks!

Aftermath, just curious if you dyed your hair - your before pics seem to have lighter hair. The result of your last HT, of course, looks very impressive indeed.

My doctor put in multi haired grafts into my hairline and it does not look natural and it can be seen across the street.

Yeah, this bothers me greatly, too. Hopefully in another week or two I'll address some of the multi haired grafts with electrolysis. I'm hoping that helps. I already tried putting single grafts in front of and around the multi-haired grafts, and it helped SOME, but still looks weird.

Most transplants that I see on here always have multi-haired grafts in the hairline.

Very impressive work.

He'll never model on the runways of Milan, but...very well done as far as HT's go.

I especially like the clear, high resolution photographs: thank you.

The extractions from the sideburn areas - did you harvest these grafts to place in a particular location in the recipient region or were you just seeking to maximize total available grafts? I have not seen extraction from the sideburn areas before.

What is the age of the patient may I ask?

Finally, perhaps the biggest complaint I have with my HT (and I have several complaints, but the dark color is the biggest...I think) is the darker color of transplanted hairs.

In the photo, "11 months after 1st" one can see an almost linear border where the darker transplanted hairs meet the native hairs of the crown. Do transplanted hairs grow darker after being implanted? Or are the donor hairs simply darker and thicker to begin with, coming from the back and sides of the head?

I'm guessing this guy is a natural blond? But the hair on top of his head looks quite dark.

To be clear, I think Dr. Maras and his team have done a fine job; however, I am just trying to better understand how HT's work and what the limits are of HT's in recreating a natural look.

Thank you.

Hopefully, the general hair restoration population will become aware about the dangers of doing neograft or artas.

Hehe, yes - that is the ASSUMPTION many people make - but I don't buy it necessarily, and I felt that that would be the direction this conversation would be steered in without any evidence to support such a statement when the question of a machine being used came into play. But the grafts have grown fine - they are quite healthy. As I said, with the second HT most of the grafts did not shed and were growing virtually from day 1.

Also, in a conversation I had w/ Dr. Feller in one of the linked threads, Dr. Feller states that damaged grafts either 1) do not grow or 2) grow thinner; neither of which seems to be an issue here.

Yes, the amount of tissue surrounding the graft DOES affect the quality of the graft. A single hair graft devoid of virtually all surrounding tissue is a poor quality graft no matter which method is used. However, the super thin graft produced using FUE is a far inferior graft compared to the super thin graft produced using FUT.

 

A damaged graft will first and foremost simply not grow. Or, it may grow, but produce a hair with a thinner shaft. Or the hair may become kinky and thin, which means it will become incapable of picking up scalp oils giving it a dry or frizzy appearance.

Post 28: http://www.hairrestorationnetwork.com/eve/182316-pre-op-anxiety-3.html

HTsoon, You have dark hair, I do not. I am more inclined to believe it is a difference in hair color/shaft diameter that creates the real problem. Of course the hair could have been damaged, but I am not willing to make such an assumption when the hairs are growing so thick and well - TOO thick and well!!!

I would love to hear that softer hairs can be transplanted densely - but when I've asked about nape hair, for example, I've been told repeatedly that this is not a good option.

As I said, at this point having had 2 HT's, I feel most all HT's I've seen (that is via photo or video), do not look 100% natural - even though they may look very good! I've seen a few that look exceptionally good - but then again, that's in a photo on the internet.

That being said, I do think that certain hair colors and types hide a HT better than others - dark hair, for example, such as yours. Or gray hair.

But lighter hair colors where the hair is still quite dense and thick, I have more reservation, even though again I've seen some that looked good.

For my part I always appreciate the input - if I didn't I wouldn't be willing to share. Presently my plan is to zap a few hairs and see how they look. If I kill them off completely and I miss the dark, black hairs, you are correct, I have enough where I could actually go back and harvest some more! But at some point it just gets to be....eh....enough already!

The original HT was 1000 grafts - and it was a machine (neograft) but not robot. So the doc did cherry pick, especially when he went back the second time added another 300-400 grafts, targeting singles. Most of the grafts the second time never shed but continued to grow, so at the very least I'm quite confident in that the grafts the second time grew fine. Honesty, I just don't think the placement is very dense. BUT EVEN THEN....the black pubic hair look!!!

I'm definitely not a fan of the design!

The simple fact is that anyone can see a difference between the transplanted hairs and the native hairs. I'm just not convinced that going for more density - which always seems to be the mantra - will make it look natural. PLUS there is the bumpy texture - and in my case permanent redness that has only begun to disappear after two V-Beam laser treatments (which is why I had to shave the hairs in front down in the recent photos). 2500-3000 is a lot plus down time, plus potentially more bad results, when at this point I'd just like to actually slowly raise my hairline with electrolysis to get rid of these dark, coarse hairs. I mean, I've been doing a combover of these black hairs now for 5 years - if I'm going to do a combover, I'd rather it be over natural looking skin than weird black hairs!

Yes, machine, and the hairs seemed to grow fine I THINK (but who knows maybe not?) - but in those original pics on my profile from several years ago the density was quite poor, just as blahblah1982 mentions:

I see the issues you mentioned. The placement at the hairline is sparse in contrast to your native hair, which highlights the difference in density.

And I certainly agree: the difference in density between my native hairline and the transplanted hairline was quite absurd.

http://www.hairrestorationnetwork.com/eve/182288-hair-transplant-reversal-2.html

But in post 24 of this thread I provided the above link to several pics I took just a couple of weeks ago. The doc went back and increased the density AND targeted single hair grafts to soften up the hairline almost two years later for free (though it could STILL be touched up in a couple spots), but again the issue to me is the coarse, dark hairs, even with the added density in front - just looks bizarre!!!

But the 2's and 3's are what I think look most bizarre and exaggerate the dark hairs, and that is why I am going to target some of the 2's and 3's in the hairline with electrolysis and see what that does to improve it, but AGAIN, even if it softens it up a bit, I'm not sure that the color will make much sense. Look at the color difference in the link I provided again and you'll see what I mean.

I actually want to decrease the density at the very front (by changing some 2's and 3's to singles hopefully), but it won't change the fact that the color is basically black at the front.

There are two sides to the coin. Thicker donor gives more coverage but looks less natural up close. Thinner hair gives less coverage need more grafts but hairline looks softer and more natural. I am guessing you had fue and wondering does the doctor you went with do strip and fue or just fue? Just wondering where their area of expertise is supposed to be. If fue was this by machine or by hand?

Yes, but how does one get thinner donor hair???

It was FUE, and it was machine, though the doc did do strip for many years prior to machine, and now does exclusively by hand.

But again, the primary complaint I have read about machine (neograft or artas) is low survival rate of grafts; my FIRST complaint is the dark, thick hair shafts at the front. I'm not crazy about the evenness of the density, but if the thicker donor up front looks unnatural up close, it's really irrelevant if one is concerned about someone getting close enough on a date to run one's hands through the hair.

But I'm always open to hear any new thoughts!

If I were in your shoes I'd go to a top HT doctor and get that mess fixed

The doc added more to increase the density - but it doesn't change the fact that the hairs in front are so dark - basically black, and thick. So I don't see how going to a "top doc" is going to change this.

Here is a patient of Rahal complaining about the same thing (in post 35):

That was one of the options I was considering or FUE ing them out. There's not amount of time that will make this look these course black hairs in the front blend with my blonde hair.

http://www.hairrestorationnetwork.com/eve/181838-fue-rahal-1431-a-4.html

Haha, yes, nothing to be happy with I don't think ^^

Oh, well, I prefer not to say. What's done is done. Why it looks like that, I don't know - technique? Aesthetic sense? something weird with physiology?

It's not just a question of the HT itself, but the actual hairs that are growing are just too thick and dark for that part of the head. But, yeah, the HT itself was hardly a home run!

Just to get an idea of what your HT standards are, could you please point out in this video which transplants you think look unnatural:

For me, I'm mainly looking at where the hair exists the skin - not top down photos where all you see is a mass of hair. And here is where I offer the word of caution: especially if you are new to looking at such images, where there formerly was little or no hair, you now see...HAIR!!! Looks amazing!

But I must agree with Spanker, to really know the hairline you need to see it in person. He drove across country to look at a hairline if I recall correctly (from a post several years ago). This will be more telling than such a video.

Again, if you're just looking for hair coverage, then a HT might well be for you!

If you're looking to go on dates and have potential dates run their fingers through your hair....eh....better look at some HT in real life I say - and even then you might be happy with what you see! But maybe not!

Also, here is a comparison of a plucked transplanted hair versus a plucked hair from the middle of the back of my head. The shorter transplanted hair is clearly thicker and darker. Don't ask me why - I'm no scientist. I just know it doesn't look like any native hairs on my head!

http://www.hairrestorationnetwork.com/eve/182316-pre-op-anxiety-post2461262.html#post2461262

On this thread you can see some photos from a couple weeks ago:

http://www.hairrestorationnetwork.com/eve/182288-hair-transplant-reversal-2.html

...maybe your view might be a little different if you were one of the advanced cases rather than a borderline need....So I often wonder how the NW2 NW1s I see here who put 2000-3000 into their hairlines (i.e. "first world problems") would change their views if they were NW4 at age 30 and NW5 by mid 30s etc.

I do agree with your sentiment completely, and that is why I have never come out with a blanket statement against hair transplants. For some guys it is a great thing for sure, and I definitely respect that and understand it.

At the same time, however, someone like myself who is noticing the first signs of thinning hair (@ age 40 or 41 I believe at the time), if we check into a site like this and see all kinds of rave reviews about the naturalness of hair transplants and how happy guys who've had a HT are, we might get the wrong impression.

I know I certainly had the wrong impression after I walked out of my consultation!

You know, you see on TV - from Oprah to Dr. Oz - all the time about hollywood stars having plastic surgery and hair transplants and etc, etc, and you think - "Wow, all it takes is money to look like a star!" It seems so easy to look perfect.

I literally thought from seeing Bosley commercials on TV growing up that in one afternoon you just took hair from the back of the head, moved it to the front, and walked out that same afternoon with an amazing looking head of hair ready to hit the club that night! It looked so easy!!!

Yeah....I know...pretty uninformed!!!!

So my main purpose in sharing another view is that it aint' so easy, and it doesn't look so perfect. Then guys have to decide for themselves if it's right for them - and that's before any potential complications (which I also had - permanent redness for 5+ years in a band along my forehead!!!).

That being said, a NW 5 or 6 isn't going to have much in the way of softer, lighter hairs along their hairline, so a large HT might not have two distinct color zones like I feel I have.

As for who will notice, well, when I have a date reach up into my hairline and run a finger through the transplanted hairs while bending in for a closer look - that's where the real problem is (ugh, last summer!). Though I certainly feel I have had the occasional perplexed, strange stare from someone standing at a check out counter as well. If I were married and were considering a hair transplant as some guys on here, I also think that might be a different story. In this type of circumstance the person who matters most to you - your wife - already knows what you are considering doing. But trying to date with a HT is a real concern, this I tell you, especially if it looks bizarre.

With all that said, how did you get "black curly hairs" on your hairline? Did it come from other parts of your scalp? If so it seems strange that golden straight hairs elsewhere morphed into black curly hairs once they were transported - considering they are identical hair, just moved to a new place. Have you documented that here - I'd be curious to see as I have read 100s of threads the past few years and havent seen the hair change color and form like that once you get past 12 months.

I definitely think some hairs actually got thicker and darker, though others on here surmise that it's just hairs coming from areas of the scalp where the hairs are naturally thicker and darker (for clarification my hair is naturally wavy/curly, so that's where the curl comes from). However, I've plucked the transplanted hairs and compared them with native hairs from the back of my head and the transplanted hairs are definitely thicker and darker. But even this aside, the soft vellum hairs along the hairline are naturally lighter and finer than hairs from other parts of the scalp. It's a bizarre look, black hairs in front, blonde hairs (now graying) behind them. Perhaps if I had been completely gray at the time the contrast would not have been so noticeable - but I'm not sure about that. I keep hoping that eventually it will all soften up and blend, and in fact I am hoping that MAYBE the electrolysis will lighten these hairs and make them finer without getting rid of them completely, but even if they do go completely, quite frankly I think it will look better than at present. The transplant part works - it can be done; aesthetically it's the worst hair styling I've ever had - quite shocking to me. Just doesn't make sense to me aesthetically - I honest to God can't figure out what the aesthetic goal was.

And yes, actually, I have documented the darker hairs and had discussions with other guys on here who've complained about the same thing. I'll post a couple links to those photos and discussions.

So all of that said, what then are the aspects of a HT result that make it "unnatural" aside from the potential lack of density? It seems as though the "pluggy" transplants are a thing of the past given today's techniques.

There are very few photos of HT's that look natural to me - especially now that I've had a HT and know what to look for and not to simply be "awed" by hair covering an area that was formerly thin or bald.

I really dislike the look of mine, and in fact I'm not even sure if I really needed one or if some meds might have simply helped to fill it up just enough - but too late now!

For me the things I don't like are the pluggy look of 2's and 3's along the front of my hairlines - in fact, I am planning on having electrolysis done on these in another couple of weeks. Interestingly, Bloxkham and Feller just shared a repair case where a guy's hairline had been made of all singles essentially and looked too thin. When I look at the vidoe, the repair looks very good, however, I can definitely see larger grafts, especially on the patients right temple I noticed. But overall it's very good - again, the question is does it ever look totally natural, and my view is "no".

Also I HATE the dark color of the transplanted hairs at the front of my hair line - AND their thickness, even the singles. They are simply too thick and dark to be at the front of the hairline - it looks like beard stubble when shaved down. What's really annoying (depressing?) is the beautiful soft golden hairs I see behind these damn dark black stalks. I used to love the way the golden hairs whisped around my face. Now I've got black, curly pubic hairs across the front of my hairline. WTF?!!?

Yeah, I'm pretty down on HT's unlike many of the other guys on here. HOWEVER, obviously some people are happy with their results. But I feel obligated to speak and provide the other side of the coin - especially about some of the things I never imagined before I had the HT - like black, curly hairs across the front of my forehead! I mean, if I was a dickhead to people in life it might be appropriate!!!

But most people think I'm pretty nice...

Hi Upset, I was actually recommending you talk to a Hair Transplant Doctor/Surgeon/Consultant rather than a GP. I would personally think that the world of hair transplantation is beyond the scope of knowledge required for a GP.

I disagree with this statement 100%!!!

Especially if you have a good relationship with your local GP, you should talk with your GP!!! Your GP most likely does not have a financial interest in trying to "sell" you a hair transplant and may be able to offer you an independent, completely objective opinion.

That said, I also would not rely solely on my GP, but I would talk to multiple doctors. Doctors are people, too, and have different insights - some of which might surprise you.

Once I had a doctor actually tell me one, "Oh, don't go to that dermatologist - he's a butcher!!!"

That was quite the tidbit of information that no doctor would publish publicly but might be more than willing to share with you privately, especially if you had a good relationship with the doctor.

I stayed red for five f@#*$&9in' years!!! Thank the gods for the V-Beam laser, or I'd still be red!!!

When the hair is cut down to a buzz cut it's pretty easy to determine what direction the follicle is pointing under the skin and minimize accidental transection. When the hair is long it's much more risky.

Very interesting.

I also think even if there is a difference of skin pigmentation after hairs have been removed by electrolysis, that particular transplanted hair follicle could STILL be removed via FUE; so all things being equal, it still seems to me to go first with electrolysis to minimize invasive scarring, and then follow up with FUE if necessary to address any specific problems with pigmentation/color.

Definitely try finasteride/propecia first - I love it. Very rare to have any side effects, and this drug only stays in the system for a couple of days, so if you SHOULD have any problems, simply stop and it will flush out in two days or so.

I've always had kind of a strange hairline and never really had what I would call an NW1 hairline even looking back at pictures from when I was 11-12 years old.

After getting my HT along the front of my hairline, I looked at many hairlines in the photos of young guys 18-20 and realized that high hairlines are quite common in that age range; I concluded it was not the height of the hairline that signaled hair loss or aging, but rather the thinning of hair. I wouldn't be worried about the height, instead focus on stabilizing first with meds.

...for the moment makes my hair look good enough for me.

This is really the main point. If it looks good enough for you, I'm quite sure everyone would tell you not to have a HT. While some are quite happy with their results and others are not (myself being one who is not), all will tell you it never looks completely natural.