mattj

You're definitely in good hands. Having gone through the experience before, like you say, you know what to expect - but this time it'll be easier as it's FUE. Will be great to see how your result progresses!

It would be easier to assess if you showed photos without the white outlines. They kind of get in the way. Temporal points can add a lot in terms of aesthetic value, but they aren't necessary and you might find that concentrating on your hairline will have the most impact. With that said, your hairline doesn't look bad now; but I say that on the basis of only one photo angle.

Your hairloss looks like nothing more than typical male pattern baldness. I don't see anything to suggest a female hairloss type. Are these the same photos that you sent to the clinic?

Impossible to know what this particular doctor is thinking, but it could be that he sees your hairloss as being very minimal and wants to recommends the less invasive surgery.

I replied to your other thread that didn't have photos. Now I see your photos I really don't think you need a transplant at this time. Your hairloss is very minimal (perhaps a bit more pronounced at your left temple than your right). You say that you never had a NW1 hairline, in which case you must not have lost much hair at all as you aren't that far off a NW1 now. I'm guessing from what you said that you first noticed your hairline was changing a year ago. The best advice is to wait and see how it progresses over the next year. Personally I wouldn't even suggest using meds at this early stage.

The pics aren't showing. Do you want to try again? One of the benefits of having an HT is getting back styling options you lost, and often HT patients want to style their hair upwards in such a way that the newly transplanted hairline is visible. But not always. If your preferred style is more brushed to the side then I think, in general, that is a style that doesn't require quite as high density. The bottom line is, when you consult with HT surgeons, make your style preference known so they can factor this into their graft estimation.

The strip scars you see tend to be longer because of the number of grafts that were required. It has been mentioned already how donor density and laxity play a part. 750 grafts is a very small procedure for FUT and I would expect the scar to be shorter in length for a procedure of that size.

Looks fantastic! Did you purposely avoid treating the scar on the back?

I remember your photos and thinking (and saying) that you had a very successful result. It's not clear what your actual worry is. Is the problem a lack of density in one specific area? If a touch up (as in, more grafts) is being offered and is what is needed, then I would accept this offer from the doctor. Like I said before, your procedure looks to have been a great success -so with that in mind, it seems like a good idea to return to them.

It's a very good sign that your father and grandfather have only very limited hairloss in the same pattern as you. That family history plus the slow rate of loss that you have experienced are both strong indications that your hairloss probably won't progress very far. But this isn't certain. On the subject of HT surgery: I don't think you've lost enough hair to justify a procedure. I think that most reputable doctors would advise against surgical intervention at this time. The main thing to take away from this is very positive. Hairloss too minor for surgery and a family history which suggests that your hairloss won't progress very far. This is a good reason to feel happy.

Hi MayiraP0chu, I actually replied before I saw your email. I'm glad you liked my response. Dr Lindsey: that's interesting. Do you know how smoking would be the cause of post-operative infections? Is the constriction of blood vessels the cause?

You're one of those people I've always envied. Those who can smoke here and there without ever getting a full habit! Everything everyone has said above is true. The vasoconstrictive effects of smoking are what can be detrimental to a result, but the real effects of this have not (and probably cannot) be measured. Ernie is an example of someone whose smoking didn't prevent him from getting what must be one of the nicest results I've seen in all my years on this scene. But also remember that some people smoke through most of their lives with no ill effects while others might get cancer. Point being that it varies from person to person. That individual susceptibility could also matter when it comes to the effects of smoking on an HT result, and if you're someone who doesn't have an actual addiction to smoking then there's no excuse for not stopping completely, in the interests of your HT investment. With that said, I do think the most damage would occur in the very early post-op stages, when the transplanted follicles are re-establishing their blood supply. At two months I doubt if your transplanted follicles are at any more risk than any other follicle on your scalp.

Some men never have strong temporal points, even before MPB. I'm one of those men. It looks like you could benefit from work in that area and it would definitely have an aesthetic impact.

I must admit that comment puzzled me too. We've been posting FUE results for many years. Try this link below: Forum By and for Hair Loss Patients - Search Results

I agree with those who have said that it's best to avoid strong sunlight at such an early stage, especially for prolonged periods. I know that it's impossible for any of us to know the inner workings of your job, what is expected of you and how much power you have to influence the event, but it would be a shame to have to avoid it. It seems that, as the host, you have some control over things and could organize the event in such a way that your head is protected. Like pkipling said, there are types of hat that aren't as sloppy as a typical cap. Your transplant is important, the event sounds important too, and I think you'd be amazed at what people can accept.

The common use of the term diffuse is to describe hairloss within the usual male pattern balding area, which is to differentiate it from the patterns where recession occurs (as well as defined loss from the crown). Of course there is some overlap between the two. You are definitely what would be considered a diffuse thinner. When you say that Finasteride hasn't helped a bit, does that mean that you've continued to thin or is it that you haven't experienced the increase in density that you hoped for? Obviously your goal when starting the drug was to make some gains (and that's what we all pray for) but it doesn't always work out that way. Sometimes the only result is maintenance of existing hair and this should be counted as a success.

Having had a procedure before shouldn't rule out having another one, whether it be FUT or FUE. That isn't an acceptable reason to say no to surgery. However, your donor density doesn't look great and you do have a large area to cover. It's possible that a second FUT procedure would be the best way forward, allowing you to wear your hair longer to cover the scar.

Have you not had a transplant before? I would say that a procedure in the region of 2000-2500 grafts would give you a massive transformation.

This patient is age 35. He came to Dr Rahal in 2015 with extensive hairloss requiring a high number of grafts. He underwent a larger FUE procedure of 3040 grafts and then a second surgery a year later for 2714 grafts, also via FUE. Surgery #1 Type: FUE Recipient Area Treated - 75cm Total Grafts - 3040 Total Hairs - 6708 Recipient Graft Density - 40.5 grafts/cm Recipient Hair Density - 90 hairs/cm Graft Breakdown: Single Hairs - 523 grafts Two Hairs - 1475 grafts Three Hairs - 933 grafts Four Hairs - 109 grafts Average Hairs Per Graft - 2.21 ------------------------------------------------------ Surgery #2 Type: FUE Recipient Area Treated - 78cm Total Grafts - 2714 Total Hairs - 5869 Recipient Graft Density - 35 grafts/cm Recipient Hair Density - 73 hairs/cm Graft Breakdown: Single Hairs - 479 grafts Two Hairs - 1385 grafts Three Hairs - 780 grafts Four Hairs - 70 grafts Average Hairs Per Graft - 2.16 ------------------------------------------------------

My first thought was skin darkening due to sun exposure making the SMP appear less obvious. Very hard to be certain what's going on.

Gaps could be giving the appearance of hypopigmentation. We're basically 'blind' when judging your situation, so it will be good to see the pics.

I can see some contrast, but it's mostly (I think) due to your real hair being a bit longer. I don't see a total disaster my any means.

Both of the shedding timelines that you've seen for the two surgeries are normal. Your experience is not uncommon and is a good example of how there can be variety even for one HT patient. I see absolutely no reason to worry - you've had one good result already and I'm sure that you'll be happy with this one.

It's very difficult to say without seeing some photos. This is obviously causing you distress, so I would say get someone to take some photos and upload them here and then we can give you better advice as to what is going on.

On the basis of your photos alone, you appear to be a good candidate for a procedure. It's important to also know your age as well as the age when your hairloss began. Whether you're using any treatments or not is also important. The area to focus on depends on what area matters most to you. For most patients that will be the hairline and frontal zones as it is this area that you see most often and that others see when they look at you. Basically, you'd be looking at restoring your hairline and working backwards towards the crown and the more grafts that are used, the further back the transplant can go. This would require a number in the region of 4000-4500 grafts. It all depends on your donor area and how dense it is as well as the laxity. The more your scalp can stretch, the more grafts the doctor can get. 4500 is a figure that most patients have available, but that number can be higher if density and laxity are optimal. Where are you located?