Mycroft

I think you've given a pretty fair and honest analysis of your transplant. I totally understand what you mean about wanting the appearance of more uniformity in the hairline because my natural hair has the same issue, but props for recognizing that this can often require a second pass. I'm confident that you're going to be able to hit that goal in the second pass. You'll probably only need a 700 or so additional grafts in the hairline to get there. Give or take. Until then I think it looks great. On a health note, I'm very sorry to hear of your loss. Things are still on severe lockdown here in Dallas and it seems like social distancing mandates are getting more stringent even as the office is starting to talk about re-opening. Seems crazy.

Very nice change for a minimal amount of loss. I enjoy seeing these smaller procedures because they can obviously make an impact for the patient but not every doctor would be willing to consider such a small case. I do notice Dr. Wong limited the extraction pattern to the lower part of the donor zone. Was there a strategic reason for this?

Very nice job on the front. His crown is actually looking a bit stronger as well. Is it just lighting or did the patient recently start medical treatment as well?

The "safe zone" is really only a theory, but the key here is that those hairs are DHT resistant and not DHT immune. Even with transplanted hair preventative medication and non-surgical treatment still has a place.

True mark of success right here.

I really love the design and shape for this one. Youthful, but not a straight line or a simple "U" shape. Nice subtle asymmetry and irregularities that work with the head shape and existing hair shape.

Unquestionably a great result. I know exactly what you mean about some hair appearing non-existent in certain light. My hair is Auburn, so some hairs end up being more reddish and others are such a deep, dark color that they look almost black. The reddish ones tend to "wash out" a bit more in harsh light. Congratulations.

I will give you three pieces of advice on this. 1. Make sure Acell is included in the PRP or don't even bother. 2. Ask any doctor you're considering to show you results from his or her PRP treatments just like you would with a transplant. If they have a good number of patients with results you like, their method probably has some merit. 3. Assuming a good doctor and protocol, PRP tends to work best in areas of diffuse thinning. Generally speaking you're not going to see much change at all injecting PRP into a slick bald area. I can vouch for Dr. Arocha's PRP from personal experience but a couple of other doctors on this forum have some nice results as well. Do a bit of research and decide for yourself whether it's right for you.

Great response to the therapy. He may yet see some cumulative improvement if he keeps up with treatments. I know I have seen some additional gains since round 2 with Dr. Arocha. They're not quite as dramatic but my starting point also isn't as severe, so that makes sense. My temporal thinning was far worse than this guy's and I still managed to rebound to a point of pretty good coverage. What I particularly appreciate here is how much stronger is hair looks towards the mid scalp and crown. You have to look pretty hard to see the thin spots at all. I'm cautiously optimistic that exosomes could also represent a further avenue of improvement as well, but there are so few published results at the moment that I'm still on the fence about whether or not to give them a shot or wait a bit for more information.

I was referring to the dime-sized patch of thinness he mentioned. Mis-angled grafts could only be fixed by having them removed or attempting to conceal them with more grafts

I doubt any doctor would offer a refund for a case like this as your hair largely looks okay. I do see what you mean about the temple though, and I do think that a number of doctors would be willing to do a small touch-up job in that area for no additional charge. Whether Dr. Diep is willing to do so would be a question only he can answer.

I've seen numerous accounts of transplanted hair differing in color from native hair on top of the scalp, but to my knowledge nobody has been able to explain why this happens.

https://youtu.be/2QHDiVtGvB0

There was another video uploaded to YouTube earlier today highlighting some more of Dr. McGrath's results. One guy is a full blown Norwood 7 who even has a thinned out donor area. Some concentrated exosome injections into the forelock area managed to grow a tuft some pretty strong looking hair. It's not a massive amount of hair, but it's pretty impressive considering that there was practically nothing there before. Supposedly he got another treatment for the whole scalp and looks even better now, complete with a donor area that could now be viable for surgery where he was not a candidate before. I suspect the result is probably most impressive on lower Norwood levels or diffused thinning. Considering trying it for myself.

Originally started with 1.5 mm once a week based on the studies since I, like you, found lower gauges to be worthless. Good results. I do 6 reps horizontal, vertical, and diagonal. One rep is back and forth. Wash my hair with caffeinated and menthol-infused products afterwards to clean the scalp and then apply my minox. No sides for me. Eventually I went up to 2 mm once a week just because I felt like I wanted to make sure I was getting appropriate depth in areas where my hair was thicker. I'm now back to 1.5 because with my new Dr Pen the 2mm depth tends to have issues "sticking" on my forehead just below my hairline where there's no terminal hair visible. I have since started to do 1.5 mm twice a week with 1-2 days of rest in between. Sometimes I get lazy and just do once a week but I always leave at least a day between sessions. The wounds aren't deep but if you don't give your skin time to heal you're not going to be getting the benefit of the rolling which is a side result of the healing process M-W-F could potentially be viable in my experience but I'd honestly start with M and F or something. I'm also doing PRP as you know, and I believe the microneedling specifically works to activate those growth factors for as long as they're present. In fact, many doctors who administer PRP will microneedle the scalp along with it because, again, PRP is generally used to heal injuries and such. Microneedling promotes your body's natural healing response, so it should also be promoting work from that external supplementation as well.

The major studies I've seen all reference 1.5 mm once a week. However, I've seen anecdotal accounts of people using this gauge or slightly higher more along the lines of 2-3 times a week. I've done twice a week at 1.5 with no I'll effects to my progress but I'm honestly too lazy to maintain that right now. I suppose this would be most analogous to going to the gym, and the idea that it's actually the time recovering from the gym where you're truly growing that muscle mass. Microneedling is essentially stimulating an inflammatory healing response which seems to also promote hair growth. However, we also know that inflammation of the scalp can be one of the big causes of hair loss, so it's important not to overdo it. My slightly unpopular opinion on this is it tends to vary between individuals depending on your response to the wounding. How's your skin looking between sessions with this frequency? Perpetual redness? Any lingering feelings of irritation? That's more what I'd be looking at rather than blanket statements, especially considering the whole process is purely based on minimal scientific data and anecdotal accounts.

That's an incredible donor capacity for FUE. The patient is extremely fortunate to have so much in reserve on top of having an existing result like this.

My father had a fairly significant bald spot in his crown much worse than yours, but with his wavy hair and the right length it ended up looking pretty good most of the time without a single transplant. Yours is a smaller spot and with an appropriate number of grafts I think it's going to work out pretty well for you, especially if you keep your hair at the right length.

I think in this case that added wave is making your hair volume look substantially better; it looks very full in these photos. And...no concealer in this set? Honestly, your crown should be addressed without too much issue because the area needing coverage isn't nearly as large as some of the guys we see here.

I feel like we don't usually see cases from Dr. Hasson highlighting crown work over hairline work, so this is a pleasant surprise. Were all grafts done in one sitting? What is the patient's future FUE donor capacity given that Dr. Hasson estimated a high level of possible hair loss in the future?

Looks to still be a net improvement even with additional loss of native hair. Very nice.

From my understanding these are molecules that stimulate stem cell activity, but they are not stem cells themselves.

Amazing non-surgical improvement. I'm sure she's thrilled. People tend to dismiss the non-surgical options and I think that's a mistake, especially for anyone with more diffuse thinning.

I have something similar although it's less severe, and it's probably the thing about my hair that bothers me the most. I can style around it for the most part but it's not the best.

That hairline looks fantastic in the wet, slicked back photos. The entire frontal zone, really, but I've specifically been watching that gap in the frontal hairline as kind of a reference point and that has filled in VERY nicely. Honestly, looking at you straight on in that first wet picture I wouldn't say you'd had any major hair loss to speak of. Glad you posted this update. I was just talking to the doc the other day and you came up, so I had been wondering how you were doing with your progress.