Mycroft

Everyone's physiology is different so it's hard to say for certain, but I'd guess that any contrast you're seeing will lessen with time. If nothing else those hairs will be seeing more exposure to sun and other light than they would on the back or sides of your head and that should make them lighter over time. I wouldn't necessarily expect them to be as light as your original hairline hairs because 1. They're obviously not miniaturized and 2. The hairs in the donor area tend to be thicker and darker than hairline hairs in general, although hairs towards the temples or nape tend to mimic the hairline hairs a bit more closely. The thicker hairs also work in your favor though, because they provide better coverage so a lower than natural density is still able to have that thick look. I don't think the contrast is very evident in the photos, so it may very well sort itself out. As a general tip in the meantime hair obviously looks darker with a spritz of product or wet, as you've demonstrated. A very light application blended into all of your hair will probably make color appear more uniform.

Dr. Cooley did right by you. This already looks good at six months but I think by 12-18 as everything matures it's all going to blend even better. Good choice of doctor.

A situation like this is tricky. The patient has a lot of existing native hair although it has definitely thinned. The hairline looks pretty densely packed despite this. Did the doctor elect to go through this area to maximize aesthetic benefit or did he attempt to work between the existing hairs?

It may just be the low photo quality disguising your concerns, but this looks like a pretty solid result unless you've got some multis in the hairline that I can't see because of the blur.

Looks great already. I'm sure by the time the hair finishes maturing this is going to be incredible.

I'm sorry to hear this, but if the grafts grew initially I'm not sure how your case is the fault of the clinic. There isn't a surgeon in the world who can guarantee transplanted hair won't be subject to miniaturization, especially if you're not taking medication. A case with subpar growth could be attributed to errors made by the clinic, but if you had the desire growth and began losing hair years later, that isn't something they have any control over. The OP's case is a completely different scenario in that he had poor growth as well as some kind of dermatologic reaction which may or may not be related to the clinic's surgical approach. In his case it is worth discussing that possibility with the doctor.

I wouldn't look twice at the donor area if you weren't explicitly asking me to find the scars, which is pretty good for 4,000 grafts removed. Congratulations.

Just popping in to say the result looks great even in the harsh lighting. I honestly don't think the result could have been much better.

The work is still holding strong. I hope things are all right after that freeze. We managed to get by without too much issue but I know some folks like you got hit harder. The confidence you've gained really comes off in your posts. There's a certain air about your writing that is different from when you first started the thread. Very happy for you.

At this point Derek is probably one of the best go-to sources for a condensed lesson on how/why hair loss happens and what medication is available to treat it. He's not very familiar with transplants but he is very upfront about that and doesn't pretend to be. Great resource for training and nutrition knowledge as well.

I agree with the other posters. If you adjust the fade point a bit I think this will work fine. There's only a very small area at the bottom that looks off.

You're only about two months in. I've seen cases where redness lasted much longer before dissipating. Don't stress this too much right now, especially because you had the folliculitis. As far as your hairline design goes I think that is mainly in your head. It looks fine as far as the pictures you've posted here. I'm not dismissing your concerns, but you're very early in the process and most of this is common so you shouldn't worry yourself over it just yet.

How's this progressing @LondonRamen?

Those are some really strong part lines. Great work.

Thanks for coming back and updating us. I agree that the level of aftercare described and shown here on the forum is top notch. I think if you're still seeing some additional improvement since the last photos, you're likely going to be in a position to reach your goals even if it does require another operation. I know it would be ideal to have that home run result on the first go, but since both you and the doctor are committed to getting you to a result you can both be satisfied with you are going to be just fine. It may simply take a bit longer than initially expected. I applaud you for taking a step back to evaluate your situation as calmly as possible. I'm sure it's a bit distressing but that big picture mindset is really important for this sort of thing since it's a lifelong struggle. I'm looking forward to your next update and hoping that you'll keep us in the loop all the way to your expected result.

This guy had to have grafts removed from the recipient in the first round in addition to having new ones placed. That severely limits what the surgeon can do with new graft placement in the same surgery.

I am actually unclear whether any of the photos thus far represent the peak strength of your transplant results. The way I've read it all photos here reflect your hair after the additional thinning you described in the original post. Is that correct? It's hard to comment on the original result without being sure of what I'm looking at, but I agree with others that it doesn't look terrible, but I also see why you're frustrated with it. You said you're 11 months on Finasteride, but in the original post you referenced a previous thickening with meds. Was that Minoxidil or did you have a previous stint with Finasteride?

Looks appropriate for the area covered, in my opinion. I think there should be enough density to blend nicely into the native hair behind.

I agree with other posters that a transplant is probably not for you. I think a hair system is a possibility if you decide to go that route, but I'd definitely start on some medication to preserve what you've got left if you want to have that option. It's a marginal investment to get one or two to experiment with and try it out. You may like it, you may not, but you can always go back to the shaved head look. I'm sorry I don't have better news for you, but I can't imagine any ethical doctor being willing to operate with your particular circumstances.

On the subject of eyebrow hair, I'm not sure if I have MORE but I do think the individual hairs are growing a bit longer on average and just a little bit thicker as a result. This is also true of any non scalp body hair in my case. No visible hair where there wasn't before though. Also 5mg daily, for those wondering. Just an anecdote.

If you're interested you may want to look further into how microneedling is used on the face to treat acne scarring. I'm sure the same principles would apply to donor scars, though you of course have the extra complication of hair all over that area. I've seen some indication that a good PRP protocol might also have benefits as far as improving marbling of scar tissue, and that may be an option as well. It was used for treatment of injuries long before anything to do with hair rejuvenation. The thing I've been wondering is specifically how much went into the crown vs the midscalp. Before the second surgery you were thinking you would likely need less in the crown than the midscalp thanks to medication. Did you find this to be true, or did the doctor comment on it?

I think you could get a fairly good improvement for 1,000 grafts or less as far as the crown goes, but it's always kind of tough to ballpark the crown in diffuse situations. Still, the area doesn't look that large and it's also not slick bald either. The biggest thing to consider is whether you want to risk the shock loss given that your donor isn't the best to begin with. Might be worth asking a doctor directly how many grafts they'd recommend and then asking how it might impact the result if you had permanent shock loss of the natives in that area.

If you suffer shock loss of terminal hairs those will likely come back as long as there has been no transection. Hairs that were thinning/miniaturizing may not come back if they are subject to shock loss. Temporary shock loss isn't ideal, but not the end of the world.

I'm glad to see you had such a successful result, and blending through the frontal area ensures you'll likely be in a good spot even if there's a bit of future progression. Donor looks untouched at this length as well. How was travelling with the extra red tape due to Covid-19?

Okay, I would definitely say the miniaturized hair in the front has grown out more in the after pictures. Look how short it used to be vs how long it is growing now.