BDK081522

The work looks superb! The crusts are all normal so nothing to worry about there. Follow your clinics guidelines for post-op care but generally speaking you want to start gently washing the recipient area to remove the crusts around day 7. Happy healing and we're here for support during the ugly duckling stage. It definitely is not fun but it passes and it's magic once those grafts start popping!

As others have mentioned, nothing to worry about. It is merely a hair shaft that has shed not the graft. There would have been significant blood if a graft was dislodged on day 3. You're good!

While your donor pictures are slightly blurry I think it's suffice to say that your donor hair is slightly above average in terms of density. The diameter looks to be medium coarseness as well. Those two characteristics along with the natural wave make your overall donor hair very good in my opinion. In the hands of Dr. Konior you should have a very respectable result. Depending on exactly where you place the hairline I think you need closer to 3000 than 2000 to get the density you're looking for. Your hair behind looks very solid, so bear in mind that it is difficult to match density like that in one pass even from the most elite surgeons.

No reason not to mention the clinic especially since you said you would not return for a subsequent procedure. This forum is established to help guide those in need of information on potential surgeons. Showing a result that you're apparently unhappy with does nothing but stir the pot. All surgery leaves scars. FUE is not scarless and your expectations may have been unattainable if you expected to have a zero fade with no signs of extraction.

While I agree pre-op photos would certainly give a better indication of how things may turn out if in fact he has native hair in the restored area. However, it doesn't seem like there was anything there to begin with so if it's all transplanted then the density is below what top clinics would transplant at. After reviewing thousands of cases over the years you get a sense of what will be a good result based off post op placement. It's well known that Aussie clinics are simply not up to par with elite surgeons at the moment.

You needed more grafts for the area covered. Your clinic mislead you in saying survival would be low if implanting at a higher density. You will not be satisfied with the density based on your post op photos.

One year after the procedure is approximately only 7-8 months of growth. The grafts lie dormant for 4-5 months and then come in thin and wispy. It takes roughly 12-18 months to mature and mimic the surrounding hair caliber. Also, remember that your not matching the density of your native hair. Only about half the density is able to be transplanted in one procedure. So, keep that in mind as well. Transplants are the illusion of density. It takes multiple passes to achieve true density and most patient's donor can't handle that.

You do understand that the recepient hair sheds and grows from nothing correct? So it will take 3 years for the transplanted hair to catch up to your existing length. It's going to look odd for a very long time unless you somehow style it to cover up the transplant. Honestly better to shave and start growing everything from scratch. Everyone wants immediate gratification nowadays. Hair restoration is a long and emotional journey and will affect your appearance for the rest of your life. 3 years is only a drop in the bucket.

All we can do is offer suggestions from our own personal experiences. You need to put in the work. None of the senior members of this forum are going to do the legwork for you. Many of us have researched for years before making a decision. You are ultimately responsible for how much or how little effort you put into getting the result you are looking for.

If price is not an issue then you don't need a top 5 list. You need to contact Dr. Raymond Konior. You won't get a surgeon that is more genuinely interested in your long term goals then him. He is expensive but he delivers and his FUT scars are second to none from what I've seen. Chicago Hair Institute. Hasson or Gabel would be my second recommendations. Keep us posted on who you decide on.

Sorry you are having to go through this @jimcraig152. When going with a top rated surgeon and paying top price you would expect quality results. Unfortunately, this isn't always the case and some of your concerns from immediately after the procedure are coming to fruition. Of course, it's imperative to wait for full growth around 12 months but those of us who have been in the game awhile can usually see from immediate post op pictures how the result will pan out. Sometimes Dr Diep has everything line up in his favor and he knocks it out of the park. Sometimes, his decisions, for whatever the reason, lead to noticeable issues in the final results. To take some positivity from your situation you have not been botched and your result can be improved upon with relative ease. Some density and refinement with fine singles in front of the pluggy rows will camoflouge his work and give you a more natural result. Keep your head up and remember it does take most of us multiple surgeries to get where we want to be.

Not sure why you think only 4,000 grafts can be harvested by FUE until the donor looks depleted. It all has to do with each patient's individual physiology. Some donors will look thin after 3,000 and some will still look solid after 8,000. There's no magic number. It has to do with multiple factors including donor density, hair characteristics, punch size, extraction pattern, and donor area size. This is all different for each patient. Yours does look slightly thin for 1250 grafts at the moment. It's more than likely some shock loss along with the extractions not being spread far enough apart. All you can do at this point is be patient and trust the process.

I think 2000 is good for reinforcing your frontal third. However, I would be leary of lowering your hairline at all. Dr Konior definitely makes grafts go further due to his implant angles and staggered placement but you have fine hair. It would eat up another 1000 grafts to lower your hairline and have acceptable density if Ryan Gosling is your inspiration photo. You're consulting with one of the top hair restoration surgeons in the world and he'll advise what is best for your future, but be conservative with this transplant. You've already used grafts and finasteride isn't stabilizing as it did in the beginning. You will more than likely need 2-3 to get you where you desire to be.

Correct. No product would effect survival of grafts or overall hair heal.

Don't use gel. That's something we used in the 90's. It's alcohol based and hardens as it dries leaving no way to restyle through the day. Today's best options are pomades. Come in two types -water based and oil based. Experiment with both. Best on the market that I've found is Reuzel

It's not possible to make this statement without doing a thorough physical exam and knowing your family history. Family history is not always indicative of your final pattern but it can be used a general guideline to predict how you may end up.

The "little hairs" you're referring to are not baby hairs. As in, they've not been that short and thin your whole life. They are terminal hairs that have been negatively impacted by DHT. Essentially, they have begun the process of male pattern baldness. The hair follicles begin to shrink with each successive hair cycle, thereby producing a thinner and thinner hair. Eventually the hair turns translucent and the follicle stops producing hair altogether. Minoxidil and finasteride can help slow or even reverse the process for some follicles. These medications are most effective in the crown region however.

Your hairline has definitely matured. It may stop here or it may keep progressing. The detrimental sign from your photos is that you have miniaturization. This is indicative of male pattern baldness. Seek consultation with a dermatologist to confirm

Agree with @Aftermath and @1978matt that doing the temple points can turn an average result into a phenomenal one. Of course, you have to take into account future loss and make a decision based on the proposed final pattern of loss. I also agree that patients who get a dense packed hairline and have completely lost their temple points look unnatural. After all, the goal is to mimic nature to achieve the most undetectable results possible. In nature there simply aren't super dense hairlines without the temple points. I find it odd that Dr. Lindsey would suggest that this is unnecessary for a great result and should be avoided. Surgical skill is paramount and if you don't possess the skill then I agree you should not be performing temple point restorations. They are difficult due to angle of insertion and caliber of hair. If the surgeon chooses donor hair meticulously then the results can be great. Dr Konior did mine and he only used the finest of singles. Presumably from the nape or above ear area. They are indistinguishable from my native temple hair other than not being as gray as the surrounding hair.

Comparing Bosley to Dr. Konior is akin to comparing a Ford Pinto to a Ferrari. You have the best surgeon/clinic in the world in your back yard. Patients literally travel from across the globe to have restorations done by Dr. Konior. And he's worth every penny as a surgeon and human being. Please don't go to Bosley. As others have suggested, they are a hair mill and most of their surgeons practice other specialties and do hair transplants on the side. The technicians do most of the work and they are subpar with extractions, implant angles, and density. You're young and you found this forum at the perfect time, before you've had any surgical intervention. Take time, try finasteride, and make an informed decision after doing adequate research.

Recommendation is to shower and while your hair is still wet apply minoxidil. With wet hair the scalp is more accessible and Rogaine works by absorption through your skin. If you apply to blown dry hair it is much more difficult to reach the scalp. Especially because after the transplant grows in you'll have much more hair to deter the minoxidil from reaching your scalp. I usually apply when I get out of the shower to wet hair, then blow dry, add product and style. Works well for me.

In an earlier post you mentioned putting polysporin on the recipient area. Hopefully you meant on the donor area. The ointment would be very difficult to clean off the recipient area at this point without scrubbing. Only put the on the donor. As for itching, just spray saline on the recipient to alleviate. The itching is terrible but this will give some very short term relief.

Would love to see an update of this case @Dr. Jean Devroye. It's very interesting with the pubic grafts and the beard recepient sites.

While I think staying on finasteride for a year before surgery is always a good idea I'm not sure in your particular situation it would add much benefit other than strengthening your donor. With the pictures of your hair grown out it suggests you're a NW 5/6. Your crown does not drop too low so finasteride should definitely help keep that where it's at. It would be unlikely you would progress to a 7 as long as you stay on medical therapy. To answer some of your questions it's typical to have redness in the recipient area anywhere from 2-6 months. The donor area isn't usually noticeable with FUE after a few weeks of hair growth. With FUT you can grow the area above the incision longer pre-op and it can camoflouge the donor site. As far as time in between procedures it is generally recommended to wait 12 months to give your recipient area time to achieve full density.

They don't just use one punch size for all patients. Follicle characteristics determine the punch size they choose. They can even vary punch size on the same patient when going for fine 1's vs multi graft units.