mahhong

That's a good point. It's part of the reason why I'm still not 100% sold on the place of meds in hairloss. Obviously they're fantastic at keeping hair and sometimes for a long period of time, but that doesn't (or at least shouldn't) give you the opportunity to transplant at higher densities in already bald areas on the assumption you won't lost any more hair. I think if you have a 5000+ transplant you need to be pretty sure where the rim of donor resistant hair is - in other words, you need to have pretty much realised the extent of your balding. The best results I've seen in NW VIs, in the sense of long term quality, are usually from men with clearly defined rims of DHT resistant hair. You can then afford to transplant maybe 60-75% of your donor hair then, and leave the rest for backup or touch-ups further down the line. I still see more NW VIs with great hair than you could have even 5-10 years coming from most major surgeon's clinics. But I agree the most important thing is to transplant at a rate that is sustainable with your eventual balding pattern. That's why I'm sceptical of meds; they're great at holding on to the hair you have, but that doesn't mean you can then transplant 5000 grafts into your frontal third. It should mean you can transplant maybe 2000-3000 into your frontal third and keep the rest on the probably correct assumption the meds will one day lose their effectiveness and you'll need a further transplant to correct that.

I know this is a bit of a glib question but have you checked the list of recommended coalition surgeons? Pretty much anybody on that list is doing world class work and would be worth talking to. Also, I think a lot of doctors offer free consultations via their websites so it might be good to send your pics over to a few doctors in the first instance and get advice and opinions from maybe 5-10 different doctors. You might find in the e-mails you get a good feeling about one or two of the clinics and build a rapport with them before travelling for a procedure. I know you've already contacted a few doctors but it seriously might be worth contacting a whole range and seeing who sticks out to you as friendly, honest and caring. Having not had an HT I couldn't make any personal recommendations myself but I've seen great work coming from pretty much any recommended coalition doctor. I always feel a bit biased naming specific doctors from the coalition because they're all great and I wouldn't like to discriminate. There are the obvious names like Hasson and Wong (although they're obvious names for good reason) but I'd encourage you to make personal contact with doctors rather than just get a running list of popular names. You're right in saying FUT is probably the most sensible option for you, given that you need a relatively large procedure to put your hair back. Most of the doctors charge by the graft and their prices are often on their websites, so you can get a good sense of the cost. Most of the doctors charge relatively similar prices per graft (though of course there are some cheap/expensive exceptions), so you should be able to figure out an acceptable price for your procedure. For 3000 grafts I would expect something in the region of maybe $12 - 15,000 without travel expenses. That sort of money should be able to buy you a procedure with a top doctor in Europe or America. There are cheaper but equally effective solutions in Asia, though, but I'd recommend sticking to a coalition doctor (or someone highly and constantly recommended on these boards). As you rightly say, price is always something of an issue but you should be able to pay the right money for the right procedure and that sort of money is what I'd expect to pay. Apart from that there's not really much more recommendation I can give, I'm afraid. If you go on other the hairloss blogs you'll find a list of hairloss doctors and can search through a range of their results. I recommend you do that and see which results are looking most impressive to you then contact those doctors. Also, not sure if you know, but most good doctors will offer some kind of travel discount if you go travel from far away. That can help when planning your procedure and means you should be able to travel anywhere on earth for the right doctor. Best of luck!

Dr. Mohmand posts on here relatively frequently, I think. I don't think this is some suspicious posting. A new poster put his pics up and another guy asked for his opinion, I don't really see any foul play here.

Trooper, Have you managed to speak to Dr. Feller yet, as Spex suggested? Your results do unfortunately look sub-par but the truth is very likely that no one is to "blame", so don't be so hard on yourself. Feller is a good guy and he will want to look after you. If you explain the situation to him I'm sure there's something that can be done and the first step is really to go back to him, as your doctor, and get a frank assessment and range of options forward. As others have said, you should almost definitely have donor left for a further transplant if that seems the best way forward, so there are options on the table. Regarding medication, which you say you are not on, my honest assessment would be that medication would be unlikely to make much of a difference looking at the severity of your loss. It couldn't hurt I guess, but I don't think propecia would have much to work on if you did start it. Anyway, an appointment with Dr. Feller is the only real step to take next. It's clear the results are not particularly good for 4,000 grafts, but you do have options left and you don't need to feel too down about things. Speak to Feller and hopefully you can arrange a plan to go forward quickly.

Just be careful, you younger men. Imagine the scenario; you get on meds aged 20 and have a HT aged 21/22 and some doctor restores your hair to the way it was 5/6 years ago. Then, by the time you're 28 you start noticing the hair behind your hairline going. You decide to have another HT but there's a problem; the doctor already spent 2500 of your precious donor grafts filling in all of 40cm2 in your hairline/frontal third. Now you only have 3-6000 grafts left to fill another 60cm2 of balding head. The doctor has transplanted at super dense levels in your first HT and can't afford to do that again, so now you have another 2000 grafts, but this time over 60cm2 of balding head, giving you a density of 33g/cm2. Then, aged 32, you notice the crown going. Now you have another 100-120cm2 of balding head and only 1000-4000 grafts left. If you're lucky enough to have 4000, you get the rest of your head transplanted at somewhere around 40g/cm2. The net result you'd be early thirties with no donor left and super patchy, multiple HTs with no overall master plan linking them together. The alternative is to have a much more moderate first HT: maybe only say 500-1500 grafts. But the density you get from that won't be close to your native density and won't give you that "teenage" hair back. You may be lucky and not bald significantly, and I hope that's true. But don't do rash things in your 20s assuming you won't care by the time you're in your 30s or 40s. You will. And if you've used too much donor hair fixing bits and pieces here and there and don't have enough for the bigger picture, you won't have much choice but to stay that way indefinitely. I'm not trying to put the fear into you, just hoping you see a HT is not designed to replace on a hair-for-hair basis. You guys could unfortunately be heading for severe balding and the drugs are not guaranteed to work for the rest of your life and probably won't, in the very long term. Good doctors design a HT to look good and standalone even if you lost the rest of your hair, as part of an overall plan. That plan can't include patching up lost hairlines at super high densities unless you're lucky enough to not recede past a NW2/3 - which nobody can guarantee for you. Best thing is to see one of the doctors for a free consultation. A good doctor will put things in perspective and help come up with a realistic plan. It's unlikely a doctor will justify doing a HT on you until you are older and/or your hairloss has seemed stable for some time. Don't end up with some island of grafted hair on your head and bald or thing patches for centimetres around it, which is the risk you run if you get a HT too young for too ambitious reasons. You're not just going to magically stop caring about your hair come 40-50. Yes, overall appearance may be a little less important, but you're not going to want to look bad - a risk you run if you're over-ambitious and want to temporarily put your hair back to how it was a few years ago.

Good question! My feeling is that's probably true for Norwood III through to some Vs. There are also some men getting a good, solid result at Norwood VI, though I generally see less of those I think. I think Norwood VII is still, by and large, not treatable at densities most men would consider acceptable. I have seen some cosmetically beneficial procedures for NW7,but these tend to be on older men who simply want to frame their face and not be totally bald. I think the problem is consistency still, at the higher end of the balding scale. Some men are lucky enough to have fantastic donor amounts and characteristics and can transplant at 35+ g/cm2 (sometimes a lot more) and get a solid looking head of hair. Those with more progressive balding or less optimal donor characteristics are generally still getting results that I would honestly call "fair". But I think most men, certainly in their 20's, 30's and 40's, would want better than fair results. Overall though I'd definitely agree the results we can get already are pretty solid and sometimes (increasingly so) pretty spectacular. I'm seeing more and more NW V and VI patients basically having their hair restored to a density that makes it appear to all intents and purposes they have no hair loss. I think it's a case of evolving the already fantastic options out there so that those on the higher end of the balding scale can start getting the sorts of results normally reserved for an NW III or IV. When everybody starts becoming capable of seeing a solid head of hair on their shoulders again, we'll really be in exciting territory.

Unfortunately science is evolution and not revolution. If someone announces something today, it's probably still anywhere from 3-10 years away from ordinary, regular use. As HT_Doc says, the "magic bullet" is probably unrealistic. There isn't going to be a pill or an injection that will give you all your hair back permanently, cheaply and safely. The fight against hairloss is likely to continue on many fronts at once; surgical, pharmaceutical etc. I reckon within 5-10 years anybody with enough money and dedication will be able to get a large amount of their hair back. That combined with the current ability to hold on to hair will probably see many men in good stead to have strong, healthy hair indefinitely. But it still won't be a single-shot "cure" and ongoing hairloss and the limitations of surgery and drugs will still mean its a difficult battle and one that takes much dedication. That cheap and easy, single-shot cure is probably not going to be in our generation, I don't think. But I think the multi-disciplinary approach to maintaining or creating a strong head of hair and solid density really is in our grasp within the next 5-15 years, and many men are already having impressive results from drugs and the current surgical techniques available, even at Norwood V/VI. Advancements in the next decade will hopefully mean most hairloss will be treatable to a degree that produces cosmetically impressive results at densities currently better than what we're safely able to achieve. It's unfortunately a long, slow waiting game - but be patient!

It's not nice losing your hair, but an HT at this stage would harm more than help. If you get a small procedure done now you may, worst case, continue losing lots of hair and end up with patchy results and the need for more surgery. Lets hope it doesn't come to that! The truth is right now you have great hair. I'd bet you $100 that 99.9% of people would never in a million years notice you were receding. I know it's a worrying thing to see your hair going but you may just have a maturing hairline - your recession really is pretty mild at the moment. I'd take a deep breath and try and relax about it; you have lots of hair and the recession is something very, very few people would spot or care about. You still look great and have a youthful head of hair. As hard as it is, hairloss is a long term thing. What you do now will have an impact on your hair at 30, 40, 50 and beyond. Don't be tempted to patch up the problems now because you'll be in a whole heap of mess in the future, if your hairloss continues.

I don't think you need to be worried. The top and bottom of it is that H+W perform a huge number of surgeries and are incredibly popular, and many of those patients now blog about their procedures and post on forums such as these. But that increase in blogging and discussion means you probably hear more of the less good stories as well as more good stories. It's unfortunately giving people the impression H+W were once infallible and now all of a sudden are 'losing their magic', which is just not true. Nobody on this planet will get it 100% right, but H+W get particularly hurt by even mildly disappointed patients because of the reputation they have. They still perform world class surgery and have some of the highest and most impressive success rates, but the transparency you find on forums such as this means that every broadly 'negative' procedure hits 100x harder than a positive one. You still won't find better out there, I don't think. There are lots of other fantastic doctors doing comparable work, so of course do your own research and make your own decisions, but I think if H+W don't get you a "wow" result, nobody was ever going to anyway.

I see what you mean and guess it's down to difference of how to view the forums. As I say, I have no problem with honesty and if people want to say the work doesn't look up to scratch that's their right. I just feel Aman is clearly very concerned about his HT and has been long before he could have even expected good growth. I know he's come on here looking for honest and perhaps even brutally frank opinions, but I don't really see what good they are. Essentially it's all just mildly informed speculation from layman (myself included in that category). As I say; great results we can all spot, but results still deep in transition are harder to make an informed opinion on. My suspicion is if Aman hears too many negative opinions from people on here it could be damaging to him emotionally and have an overall negative impact on his growth, which is still not yet determined. I know what you mean about the deeper meaning of these forums and do share your belief it should be about information as much as support and optimism, but I think everybody should be viewed differently. I think Aman's need for support is far greater than his need for people's opinions at the moment. What good are the opinions, essentially? Yes, people have a right and perhaps even an obligation to say what they see with regards to photos and cases, but people's opinions cannot help Aman at all at the moment. None of us know the case history, have seen the hair in person, or understand the details of the patient and his procedure. If, at 12 months, the results are sub par, negative opinions can then be turned into positive action. Until that point they're just millstones around the neck of a man who is already having a hard time seeing much light at the end of the tunnel. I don't think saying to Aman "wait it out" constitutes any sort of condescending or disrespectful mollycoddling. Anybody can see the procedure is not where Aman would like it to be and I don't think those trying to be positive are lying to Aman. The truth is none of us know and none of our uninformed projections about what might happen are of much use. It's still the waiting game; if the results look great already, then you know the results will be as good. But if the results don't look great, you still don't know anything. In the meantime, I don't think Aman needs any extra pressure and as a community I would still hold the job is to be supportive until such time Aman can make a proactive decision to go forward. That time isn't at 7 months.

Whilst I certainly agree with you that honesty, openness and the freedom to state opinions is important and necessary on this site, I think the point Lorenzo is making is fair. Aman is clearly very worried about his HT and has been since long before the optimal growth. There are such a thing as slow growers that do get good results and even though that may not be the norm it's perfectly possible Aman will get a good result. Furthermore, a HT is really a work in progress until around the 12 month mark and in many ways opinions and conclusions up until that point are somewhat moot. If Aman's results are not up to scratch then his next step is to discuss that with his doctor - a process none of us are involved in. I don't think anybody here on these boards would be condescending enough to tell Aman things are great when they're not, but similarly the flurry of "not good enough" opinions cannot be relevant for at least another 2-3 months. Only time is going to reveal the success of the procedure and there's quite simply nothing that can be done until Aman is a couple more months down the line. I only say this because it's clear Aman is worried and whilst I know honesty is important on these boards, the only honesty any of us can really give is that there are at least a couple more months to go before any real suggestions on a way forward can be usable. Up until that point I think it's more important Aman is encouraged and reminded that his transplant is a work in progress and that we as a community try to relax him and make him feel positive about what could still turn out to be a good procedure. I'm totally with you that it shouldn't be only platitudes or praise on this board, but there is an important caveat here. If someone has precocious and impressive growth at only a few months and you tell them so, that's a mentally positive and stimulating comment on a procedure that is already demonstrably successful. At 6 months in, telling people their growth is sub-par or not good enough or that they should be worried is really undermining their confidence at a time they should be relaxed and feeling well, and long before the procedure can be deemed even remotely finished. In other words, within the first 6-8 months, only unusually good results are proof of any sort of result - sub-par results are not proof of a bad result, only sub-par growth at that stage. That's why I think you find more platitudes than criticism on pre-12 month progress threads. It's not about only giving out praise, but it's the fact that "wow" procedures already demonstrate huge progress, where as procedures that seem disappointing at 6 months could still turn out to surprise. Aman - I think the truth is our opinions are just speculation until the 12 month mark and when the doctor comments on your results then. You should concentrate on staying positive, staying healthy and feeling well - attributes that can only help your HT. Stressing, whilst understandable, is not helpful and also not necessary just yet - the next 6 months could be huge for you, so stay positive and we'lll all be in a position to give usable, constructive advice at that point, and not before.

I'm not trying to be disingenuous to amaninindia. My point is that his progress has been steady if not spectacular and HTs have to mature before they can be fully assessed. Yes this patient has not seen the sort of growth he would like or perhaps expect from others around him, but each HT is an individual procedure for an individual person and as long as there is progress of some sort there remains every chance this HT will be a success. Nothing can really be assessed until at least the 8-9 month mark, when the HT should be truly coming in to its own and be approaching the point at which it starts resembling the full article. If amaninindia is still unhappy then and the results have not improved then, yes, of course it's time to talk to the doctor and see what can be done. Assumptions that this HT hasn't worked are just unfair and unfounded at this point. It's really FROM this point forward we should start looking forward to how things develop. Yes, many patients see better results prior to the 6 months mark - some successful patients don't. The doctor in question can't really make any future plans (if he even needs to) until the hair has had time to mature and the results become defined - and that is not for at least another 2-3 months. So the best thing we can do is give amaninindia our support and hope the progress picks up and he's just a late bloomer. It does happen, perhaps not as rarely as you imagine either.

I would strongly recommend you don't get an HT for NW2 at your age. At your age you have no idea how your hairloss will progress (if it progresses at all). You could be an NW6 by the time you're 30, or you could still be an NW2 at 50. But the last thing you want to do is give yourself an HT to get a nice NW1 hairline and then find you start balding much more severely. Family history will tell you a bit about what you might expect, but that alone can't say for certain how bald or not bald you'll get. The hairloss medications available also don't seem to work that well in the hairline unfortunately, though it is worth talking to a doctor to get a proper opinion and see if the medications might be suitable for you at this stage. The problem with HTs is that we don't have enough available donor hair (the hair that will remain with you for life) to cover the entire top of your head at full density. A HT works by giving someone enough hair to look convincingly like they have a good head of hair, but it cannot replace an indefinite amount of lost hair. If you could guarantee you would remain an NW2 for the rest of your life you could afford to transplant enough hair to give yourself a juvenile hairline, but you cannot guarantee that and have to assume you'll lose some more. If you were to get an HT now a good doctor would want to be very conservative with how much hair they transplanted and so the results wouldn't be dramatic and probably wouldn't blend into your native thicker hair well. If you have a good head of hair my advice to talk to a doctor about starting medication for hairloss, which will probably help you keep what you have for a good while longer. Also look at your family history; if there is hairloss in your father or grandfathers that's an indication of what you might be headed for. But even if there isn't, hairloss could still be in your genes from generations back. You've definitely been wise to seek out opinions before you make any decisions, but at 26 you could (worst case) have another 40 or 50 years of hairloss ahead of you. I of course hope you don't, but it's best to think in those terms to be safe. You don't want to transplant a bunch of hair into your hairline then find your crown and vertex start balding - you want to make sure you always have enough donor supply to have options, and that means planning conservatively in the first instance. I know it's not always nice to hear these sorts of things; hairloss is not fun and there is still no surefire way to get a full head of hair again. My advice is to keep it up with the stylish Zac-style hair, talk to a doctor about your hairloss concerns, look into medication and think about an HT hopefully much further down the line, if the balding persists. Let's hope you keep your hair for a long time to come!

I think procedure looks fine so far! 6 months is way too early to really speculate on anything. I can understand the OP's anxiety because it's a huge financial and emotional investment to get an HT and even the remotest doubt it's not going to live up to your expectations is a massive worry. So far it looks fine though; it was a large session and at only 6 months, whilst some people may have experienced more growth than you at this stage, there's still all to look forward to. The hair could suddenly blossom in the next 2-3 months now, which is more than likely. The improvements are clear to see and although I understand they're not massive improvements yet, they have all the groundwork to end up impressive! Regarding this 'safe zone' debate, whilst I understand where people are coming from I think it's a bit irresponsible to make offhand remarks about it being too high. These doctors will quite literally see and work with more heads of hair than any of us would get close to. They know the patients age, medical history, probably some knowledge about the family history. In short, these doctors have more knowledge of this than any of us and if Dr. Hasson chose to take out a strip that high then he must have a very good and very plausible reason for doing so. For my money whilst the strip is high it's still a good few centimetres away from even the nearest sign of thinning and it seems clear to me the doctor feels the rim of DHT-resistant follicles has been firmly established and has chosen to take the strip close to that rim whilst still leaving a healthy margin in case there is further thinning. Not everybody just continues to thin indefinitely - the permanent, stable donor zone is going to be different for everybody and if the doctor feels confident he has established the limits of that zone then that's his decision, and I think it's pretty reckless for us to go suggesting he's wrong.

Finasteride gave me moderate and persistent side effects the both times I tried it, so I'm in that unfortunate but fairly rare percentage of men who had side effects strong enough to render the medication unusable. I think the drugs can be fantastic for stabilising hair loss and some men are keeping their crowns and vertex intact with drugs alone for 5, 10, 15+ years. But I've always had some lingering issues about the drugs and their overall place in hair restoration. There's no doubt they work and play a major role in having a good head of hair for millions of men. They're relatively cheap and seem in most men to be able to keep hair over a long period of time. But we have to remember neither finasteride nor minoxidil have been studied rigorously for long term efficacy. Looking at finasteride, broadly speaking it lowers your DHT levels, slowing down or stopping the "choking" effect this hormone has on genetically susceptible follicles. It does not remove DHT though (which would not be advisable), so there is still somewhere between 30-40% DHT in your body (if my memory serves me correctly). To me, that indicates that, over time (whether that be a decade, three decades, whatever) finasteride will lose ground on your genes and you will continue to lose hair. In short, whilst I have no specific knowledge or resources to back my theory up, I believe that many men taking finasteride in their twenties will probably still end up losing the hair they're genetically programmed to lose by the time they're in their fifties or sixties. They might have kept onto it for a lot longer (itself, a mini-miracle), but I don't think many men will end up winning the war. Therefore (and I'm just speculating here), any good and ethical hair restoration doctor will not be willing to use up your donor supply under the assumption finasteride will continue to work forever. If you have, say, 7000 grafts, no good doctor would allow you to put all of them in the frontal third and hope for the best with the drugs. A good Master Plan should probably always be based around the idea that your genes will win, you'll eventually lose all their hair you're determined to lose, and your donor supply should be considered in light of these facts. So it would seem to me that if you don't use drugs you just have to be prepared for multiple procedures, and most likely a lot earlier than if you did use drugs. However, I don't think this should have any bearing on your overall success or the density or coverage of your hair in the long term. If propecia works for 20 years but then you lose the hair in your crown and want it back, you'll need to have a further procedure. You might have stalled it by a few decades but I don't think you can totally avoid (unless you come to terms with your hairloss and accept it later down the line). This is all just my speculation of course, but I think you should always plan and proceed as if you're going to be a Norwood V or VI. You should assume the worst and base your goals for each procedure as if the worst has already happened. That way if you can't or won't take drugs, you shouldn't find yourself caught short long term. I'd rather have 35g/cm2 in my frontal 3rd and 15g/cm2 in my crown than 65g/cm2 in the frontal third and 6g/cm2 in the crown! So I think it's clear the drugs have a use but I don't honestly think they allow you greater density in the hairline/frontal third in the long term, because you'll always need to plan as if hair you're maintaining with finasteride will one day be gone. It's just too much of a risk to believe finasteride will keep you looking the way you do now forever and I don't think you can be sensible and plan like that. I think, without drugs, you need to accept a much more erratic and patchier battle in the fight against hairloss. You'll likely find you have one procedure and, by the time it's filled in, more hair has gone making that procedure look less successful. Someone who has a procedure and takes fin is likely to see definite results from one procedure alone; someone who doesn't take fin might have to be thinking about the results after their second or third procedure and understanding the longer term result is what's at stake (2-4 years, say) and not the result after the first 12 months. If you're happy to think like this though, and are willing to have the procedures done when they're needed and think about goals and results in the mid and long term, my belief is that, over the long term, the people on drugs and the people off them will always end up near enough in the same place, and a HT is still the only permanent way to deal with that problem.

Interestingly, looking at both photos, I think the 'thicker' dots in his hairline are actually what remains of his native hair. I think it looks good, though obviously it's not for everyone. But the fact it can be used to conceal scars and also in tandem with a HT just to give a reduction in contrast between the scalp and hair is also interesting! Yet another weapon for the arsenal I suppose!

If Armani did say that about re-distributing grafts, that's pretty irresponsible. I'm no doctor but though I imagine it's feasible, I would also imagine it's high risk, very expensive, a gigantic mismanagement of resources and generally not a good idea. The idea of popping in to continually re-distribute grafts is terrifying I think, not to mention financially impossible for the vast majority of people. corvettester - In response to your posts, my feeling is that most doctors feel that the illusion of density is more important and more realistic than the actual density of an HT. You probably don't see that many because most people are, for one reason or another, ultimately not going to be suitable. Either their balding is advanced or in serious danger of advancing, or their goals unrealistic or overly-ambitious. I don't think any doctor wants an unhappy patient who has 80g/cm2 in a small portion of their scalp, because it reflects badly on the doctor. It's the doctors job to balance all variables and dense-packing will only work if you really are on the money about every factor. In response to your question about multiple sessions, my understanding is that it won't necessarily negate the risk of poor yield, but it can diminish that risk somewhat. in terms of the characteristics I'm not sure 100% what they would be or if you have them, but I would imagine the main factor is a minimal, stabilised bald(ing) area and ample donor hair to cover that at the density required. I think, ultimately though, dense-packing is only an option if you and your doctor are absolutely sure your hairloss has stabilised, your pattern pretty of loss pretty clearly established (and relatively moderate) and the amount of donor more than enough to cover the are at the desired density (probably with reserve in the tank to be safe). But look at it from your doctor's point of view; these factors are usually not very well known and no doctor is going to risk transplanting your hairline and/or frontal third at 60/70/80g/cm2 and then see you progress to a Norwood V/VI and transplant the crown at 8g/cm2 or something silly! A doctor needs to feel comfortable all eventualities are catered for, and first and foremost will nearly always be having enough hair to work with and never over-egging the pudding. I think for most people something around 30-60g/cm2 is always going to be more realistic. You can never tell where your hairloss will end up and super dense-packing is usually just too risky. It gets to a point where the cosmetic benefits are outweighed by the risks and future disadvantages. I think caution and moderation are, unfortunately, always the best strategies - with the tiny hope that you'll be able to overachieve at some point down the line!

I honestly think it looks fine. I think 95% of the world wouldn't notice and the few who did would probably be wearing concealer themselves! Hopefully your HT will give you all the hair you need but, in my opinion, the toppik looks just fine on you too. Most people don't really take a second glance at hair I don't think; if it looks like you got hair, their brain will accept that and they won't look much further. I think Joe's hairspray suggestion is a good one but, honestly, I think you could go out like that and nobody would notice. As you say though, photos don't always tell the full story, but it certainly looks good to me on the photos! Perhaps another idea is to buy a shade lighter and use a very light dusting along with the current shade? Just pure speculation, but you might find it gives you a bit of shine and texture that one colour alone doesn't? Either way hope the HT grows out brilliantly for you!

ACell is relatively old news but it is being trialled by several leading surgeons at the moment. I don't think we'll have any concrete idea on how well it works for at least a year or two but some surgeons seem cautiously optimistic. I don't think it'll end up a being a magic bullet or any sort by a long shot, but even if it has moderate benefits to scalp laxity post-surgery that's still something that might be of use. Reading between the lines it seems like Acell is having a good effect on some patients but not much of an effect on others. If it ends up being only 20-30% successful then it probably won't catch on as a de facto tool in the fight against hair loss, but who knows? Anyway, jury is still out but it'll probably be at least 12 months, more like 24-36 months, before we get any sense of whether it's really going to be a great tool in the hair restoration arsenal.

The results look impressive, especially considering the number of grafts use. Great work!

The only way to know for sure is to get a consultation and get examined, unfortunately. As mentioned, somewhere around 6000 is probably a decent "average", but the doc could turn around and say you have 3000 or could turn around and say you have 10,000! The other thing when it comes to HTs (amongst many variables) is also going to be the quality of your donor hair. Some people are lucky enough to have thick hair that can make 2,500 grafts look like somebody else's 5,500 graft procedure. I don't think you'll be able to make any accurate guess as to how much donor hair you have by yourself, unfortunately. The only way to get any certainty is to see a doctor and get a proper examination. The odds are you'll have something around the 5,000-7,000 mark but everybody is an individual and you're really in the dark until you have a qualified doctor examine your specific hair. In regards to your question on how much strip, Janna makes a good point. It all depends on your goals and your doctor's method. You could theoretically have 5 or 6,000 grafts taken out in one session in some circumstances. Other doctors might only want to go to 3 or 4,000 in one session, some even less. Have a firm idea of what your goals are, make sure they're realistic (i.e you're not a NW 6 hoping for 75 grafts/cm2!) and then find a doctor whose approach you feel most comfortable with.

Any hair that is miniaturized is "weak", but some of the less weak hairs may survive shock loss (or not be affected by it). You may find you'll keep some of that thinner (but still fairly strong) hair, but you should be prepared that you might lose some or all of it as well. With a good surgeon the chances of shock loss will be minimized and a good surgeon will also have a solid plan in mind that will hopefully see you in good stead. I guess you have to be prepared that you may need one or more further transplants somewhere down the line, but that might not be necessary depending on how things go! Hopefully you'll be happy with this HT and your remaining hair will stay long, but I guess it's always better to hope for the best and plan for the worst. Dermmatch/Toppik/Nanogen could possibly help cover your HT and any shock loss over the next 12 months, but you need to have hair for these products to work (at least a minimal amount of hair). I don't know anything about your current hair state, but if you do have a fair bit of coverage from your native hair these products can help give your hair a fuller look and mask the scalp pretty well, giving you a good illusion of having much more hair than you have! Don't try using these products if you have very little hair though; you'll just look like you have dirt or powder on your scalp! If you have some native hair though, results can be very impressive and practically undetectable!

I have to side with the physicians and particularly Dr. Feller on this one just a bit. corvettester - I think your posts have become a bit too vitriolic if I'm perfectly honest. You disagree with Dr. Feller and raise some interesting and potentially valid points, but you've let your argument descend into borderline personal insults now. Trying to insinuate Dr. Feller is some kind of sub-par, heavily criticised professional is unfair and downright wrong. Yes, there may have been some dissatisfied patients, but it's unfair to suggest the list is getting long. The list of very satisfied patients is infinitely longer. I think the point Dr. Feller was trying to make is a perfectly valid and acceptable one. Like it or not, it is very easy for somebody to be dissatisfied with their results and to cause a problem for any doctor they so wish. The vast majority of patients will be perfectly right to be unhappy with their results because most people do their research, know what to expect, and are sensible enough to know honestly whether their results are acceptable or not. Some people, however, could just as easily kick up a fuss unless their results were anything less than stellar. I'm not making a commentary on any specific patients in this thread (I have not read beginning to end in enough detail), I'm simply making an observation. The long story short - the contract and agreement between patient and doctor needs to be FAIR and EVEN. Dr. Feller's point was that doctors need as much respect as patients do regarding the investment they put into each procedure. In the same way I do agree it's unfair to put every bad result down to poor physiology, it's equally unfair to assume every bad result must mean endless sacrifice from the doctor to put right. I think if any patient is dissatisfied with their results they should have the right to talk about it openly with their doctor (or with any other doctor if they feel so inclined). If there is even a modicum of legitimacy in the patient's disappointment I would also agree the doctor has the obligation to offer a free consult, discussion and evaluation with the patient and come up with a plan on what could be done and a fair system on how things should move forward. Here is where the tables turn, however. Doctors run a business and they offer a service that comes with some degree of risk. If a patient falls victim to that risk through no fault of the doctor or his team, it is unfair to assume the burden of responsibility must continue to reside with the doctor. What Dr. Feller is trying to say is simple - this forum and the mindset of some of its members is in danger of making the Dr consistently accountable for fixing everything, all the time, whatever the circumstances. That's not possible, end of story. If doctors start feeling pressured to fix problems they essentially had no ability to know about or stop, the floodgates are in danger of being opened. Where does that particular buck stop? Patients could start becoming increasingly expectant of the quality of the results. "You said I'd possibly look like that guy and I don't, fix it!" would start becoming the mentality of many patients. Before long, exceptional results would be unfairly expected and not hoped for. And disappointing results would be massacred along with the reputation of the doctor. That is unfair for law abiding, upstanding doctors, none of whom will ever get it right all of the time. In short, this forum is not the place to decide results or the reputation of doctors. corvettester - you are now a prime example of the problem, if I'm honest. You've named Dr. Feller, who is clearly a successful and considerate professional, a bad doctor with a growing list of unhappy patients. That's not true. But if these posts are allowed to continue willy-nilly, Dr. Feller's reputation and business could become tarnished unnecessarily. He came on this thread to defend his colleagues but is now in danger of being made out as some sort of enemy to the casual browser who might be considering their next procedure. It is very cheap for patients and members to come on here and throw all sorts of names and accusations at doctors. I agree 100% freedom of speech is essential here, but that cuts both ways. Dr. Feller is concerned the bar is being set too high, too often, and I'm liable to agree with him. Some people are beginning to believe that anything less than the "wow" factor is a bad result the doctor should answer for. But if the bad result is down to bad luck the doctor was unable to foresee then it's unfair to tarnish that doctor because of it. And this forum is not the place to make absolute judgement on any individual's results or reasons for them. That belongs in the private consultations between doctors and their patients. In my opinion we all need to be careful how cheaply we throw about accusations and hearsay on these forums. That throwaway insult or half-baked commentary could well be viewed as the cold hard truth to the next casual browser who comes here. Dr. Feller has posted consistently good results here and in my opinion has been by and large excellent in his relationship with patients. That well earned reputation is more easily undermined by us than it is earned by the doctors - it is worth thinking about what we all say next time we say it. Everybody is entitled to their opinions and input on here and doctors should be and are liable for their results. But they cannot turn everything into magic and there will always be someone who has dismal results despite no wrong being done. At that point, these sorts of threads become pointless. The only thing that matters is the patient expressing their dissatisfaction and the doctor's express concerns and desire to re-evaluate the patient at their convenience. The speculation and antagonising that comes afterwards is all cheap talk. Dr. Feller has quite admirably come on here to defend his colleagues and by page 14 there are deep insinuations about his entire career - insinuations that could have an impact on his work unfairly. I feel deeply for patients that have poor results, but I also feel deeply for doctors who spend years training, learning and developing their craft. They should be fully accountable for their work, good and bad, and should always put the patient first. But the line between putting the patient first and feeling the obligation to bend over backwards for every patient less than satisfied is a thin one. Hair transplantation is a risky business. Results are more consistent these days but can never be expected. It is dangerous for the entire industry if we begin to believe they should be expected or that, if they're not delivered, doctors should be doling out refunds and freebies all the time even when they're convinced they're not at fault. Too much of that and the best doctors will be disillusioned with how hard it is to keep their reputations and pack off from the industry all together - much to our collective disadvantage. It is not a patient vs. doctor world we live in. But as much as we need to hold our doctors to account, we also need to respect them and be thankful for them. Talk is cheap and easy but consistent, professional results take many years and much sacrifice to earn. Let us all be careful how quick we are to undermine them when arguments break out here.

That's cool, I'm sticking to what I said too! Nah, but seriously, of course everybody is entitled to their own opinions and it's not for me or anybody else to try and change how people think, so if that's how you really feel then c'est la vie!

Well, in honesty I think I am being fairly neutral. I thought the work looked really good and thought your opinion that the patient should be "mortified" and demanding their money back seemed a bit extreme and wanted to post some balance to that. Yes, I am definitely in agreement the photos should be of uniform type and style and that's something that should be addressed, but I think the insinuation by some that the doctor has done terrible work and is now trying to hide it isn't very productive and is also a bit unfair, not knowing what the circumstances are precisely. This is obviously a place for constructive criticism and debate but I think you've jumped to a lot of conclusions that this patients hair must look terrible outdoors or in person simply because the photos have changed slightly. As I say, I do agree photos should be uniform, but I think under any circumstances you can see this patient has made a significant transformation for the better. I think it's also unfair you assume the patient is probably unhappy or come back for future procedures because there's no evidence or suggestion of that as far as I can see. Just because I disagree with your opinion on the work it doesn't mean I'm not objective or must secretly work for the clinic. I've seen many results on these forums ranging from not particularly impressive to very impressive, and for the number of grafts/hairs used I think this result is pretty easily moving towards the better end of the results spectrum. At very least I certainly don't think the results are dire or disappointing and whilst I would like to see more uniform and bigger pictures to judge properly, the work looks good.