mattj

There are no certainties in this field, but based on the usual timeline you will see further thickening in the months to come. 5 months is considered to be early days.

Oh, I agree with you. They do look better. I'm just saying that they can exaggerate recession. The further forward they are, the further back the recessed temples will appear to go. It's probably only an issue in mild MPB cases really, and may not be of much importance to most men.

I'm pretty sure everyone would agree that you are seeing good early growth for the 5 month mark. Definitely above average.

Not being extremely young (see how I worded that?) works in your favour, but men in their 40s can still progress up the Norwood scale just as younger men do. How long have you been losing hair? I would definitely do as others have suggested and wait and see what the propecia can do for the crown. That could really save you some money. The hairline is unlikely to improve much if at all, and for that I don't see any reason why you wouldn't be a candidate for a transplant.

You're probably right, happy. I wonder how many doctors actually do cheat when it comes to actual grafts harvested. I doubt if any docs on the sweet list ever do that.

All I was really saying is that the collective response from the industry would probably be to groan and dismiss the idea. I don't know this for sure, of course. It's just a hunch. If more and more surgeons do take it up though, then it will become impossible for the rest to avoid. I'm talking mainly about the post-transplant report, which would be the most time-consuming and for many doctors would provide a very undesirable documentation of sub-par results. If a patient is pleased with their transplant, they don't need a record of graft survival. If they are unsure of whether their result was successful, or are flat-out disappointed, and the doctor makes available a document telling them that only 50% of those grafts survived (that they paid X amount of dollars for each), it could cause... trouble. Again, devil's advocate. Swing softly. This one of the most interesting subjects to come up in a while.

From what I've heard from other FUE surgeons, it's not always possible to tell if a graft has been damaged during extraction. When you consider that there have been numerous FUE cases where very poor yield was achieved, it seems unlikely that in those cases almost every graft that passed under the technician's microscope had visible damage.

This is an important observation. The temporal points project forward, and this can give the effect of making temple recession appear deeper. Like more hair has been 'scooped away'. But it is possible to give more definition to the temporal points without making them project forward too much.

A post-transplant report detailing growth rates would be much more difficult than the one-off study based on a small hair patch in Talizi's post (which was excellent, no doubt about it). I can't say this for sure (and I certainly cannot say that this is Dr Rahal's opinion), but my gut feeling is that the majority of doctors would consider it too much hassle, and, in comparison to a patient's own assessment of their result, largely redundant. Of course it would be nice if we could have all of this data, but it would be very time consuming to compile. As for the pre-transplant report, that also seems time consuming and I think that basically doctors already do consider the most important parts of it, such as density, miniaturization and total graft potential, before they do surgery. They just don't write a thorough report about it. Hair conditions are changeable too. I'm just being honest as well as playing devil's advocate really. I'm not against these ideas.

Interesting stuff, Talizi, especially the density research.

You would be in good hands with either surgeon. I have to say that really, but it also happens to be completely true. You can send photos to both for evaluation. I understand that crown work is harder to find. Here's an example of quite a wide area of crown loss Dr Rahal covered with 2803 grafts. Hair Restoration Site for El Nino

Temple points are an important area which isn't discussed very often. Mine were never strong, even before I had any hairloss, and I remember it bothered me. They help with framing the face and the forehead looks bigger without them. They may play some part in helping to give a natural appearance as part of a transplant, but I think that above that, they're simply aesthetically pleasing. They work with the temples to give a nice angle which is very masculine. So it's worth having temple points built as part of a transplant, especially as they often require just a couple of hundred grafts per side. They may require more though. Just like the hair up top, it'll depend on how much you're missing. More grafts will be needed if the whole side going up to the hairline needs to be created, which is sometimes the case.

Wow, that's an impressive transformation. 4000 grafts is a lot, but not for the area covered. I can see why you might have the urge to be greedy (based on the flash pictures which surely make it look thinner than it is) but you must be very happy with the change.

Korec, I just checked your website and the transplant seems to have made a massive difference. I wonder what that friend of yours says now. The one who went on about your hairloss before. I was surprised that going bald didn't bother you at 17. Can I ask how old you are now?

CopaSurfer, if the area is 35-40cm2 (and I am hopeless at judging area so I'll take your word for it) then 2500 should give 60-70grafts per cm2. We're in dense territory here, but I suspect that the best HTs you've seen (best as far as density goes) have been cases planted at a somewhat higher density which have had good yield. When you calculated the area, how did you do it and what region did you cover? Looking at your photos it seems that the entire frontal area is in the process of thinning. I'm not trying to be antagonistic here - I can see lots of scalp showing through going back quite far. I can't imagine dropping the hairline so low and making it so dense without adding density here.

CopaSurfer, your hairloss does look more advanced than I was expecting based on your earlier comments. I don't know how low you wish to drop the hairline, but you obviously have very high expectations for how far you want to wind back the hairloss clock. You'll need a lot of grafts to come close to achieving what you want, and even then you might not be satisfied. Don't get me wrong, a transplant could give you a fantastic result, but it would be a good idea if you were ready to expect a more modest outcome. You're in your thirties, you don't need a NW1 wall to fit with your peers. You don't even need that to look genuinely great.

I think starting it was a good call. You do have early signs of hairloss. Are you pre-cutting all of the pills and then storing them? That's the only reason I can think of for why you'd be worried about them lasting. I think most users just cut them when needed. That's what I do. That said, I don't think that they'll degrade at all.

Dr Rahal has been performing smaller FUE surgeries for a while now, taking his time to get proficient with the technique. Now he feels ready to make it a part of his regular practice. For costs, it's best to contact Adrian by email. There is an introductory rate for a limited time.

I'm not sure I understand your markings, but that temple definitely looks to be filling in and the hair appears stronger. You're one of the lucky ones.

I know Clooney has had his hairline artificially receded for a recent role. I'm not sure if it was the one you're talking about.

This sounds like a distressing situation to say the least. However, if you were a NW2, then unless you were also losing hair in a diffuse pattern and this was addressed during the surgery, then the transplant would not have been spread out far enough to effect 50% of your hair. Am I missing something here? Which areas of the scalp received grafts and from where have you lost all of this hair since your surgery?

Good question. Whichever comes first would probably be the answer. Whatever point a surgeon says, "That's it, I can no longer take any grafts via strip".

Here's a result that I think represents the maximum density that hairlines are being planted at. Before: http://i37.tinypic.com/5f23xz.jpg After: http://i34.tinypic.com/24pxugk.jpg There are other Dr Rahal results around. He's not as forward as some doctors in seeking permission to use patient photos. The thing is, you see, is that some of the examples you've seen in the past might not be as dense as you think they are. I've seen photos of transplants (and I'm talking about from all doctors) that in one photo might look incredibly dense and then in another shot might look quite thin. Also, some of the poor results that have emerged could be at least partially a result of packing grafts too close together. It is thought that this can affect yield. If you talk to a doctor or doctors, you can ask them what they can do for you regarding density. My own personal view is that high density is great, and with minor hairloss it can be something to aim for, but fundamentally a transplant is about filling empty space and creating a hairline which is more aesthetically pleasing than one ravaged by male pattern baldness.

What are the graft totals on these cases? Are they truly cases where the donor has been 'maxed out' by strip and then FUE?