Mycroft

Taking a quick glance at her results it seems like a higher graft count and a more aggressive approach is somewhat common. That's not intended to be a knock, as other highly regarded surgeons like Dr. Hasson are also known to do so if donor allows, just an observation. The results seem to have good volume and density, so it's not like the grafts are going to waste, but I understand wanting to be more conservative. @JamesNYC any idea what the graft distribution was? Looks generally like an emphasis on the frontal third with a smaller amount for improved crown coverage.

Yeah, it all depends on what you have to work with. There are really only a handful of options the way I see it. 1. You have a higher pattern and need to choose how to appropriately distribute your grafts to achieve something that will look aesthetic to you but also mimic a natural pattern of thinning. 2. You have a lower pattern and ample donor supply so you can achieve a true full restoration. 3. You can go for the hairline/hair system combo like a case that was posted recently and get the appearance of a full restoration as a compromise. All of this also assumes some other things like you not having weird physiological complications that make you have poor growth despite good work by surgeons, or excessive scarring well beyond what the average person should have, etc.

I totally understand why you're nervous, but it's probably not great for the crusts to stay stuck in your hair for that long either. At this point you should not be losing any grafts. I've never heard any surgeon suggest that they're anything but totally secure in your head this late in the game. If they weren't they wouldn't be getting the necessary blood supply and would be dead anyway.

It can go either way. I've seen some good work that holds up even in person, and then there are others I look at and know right away that some work was done. Hairlines that are too straight, low, or pluggy are things that often come to mind for us, as well as density being too low. I would also say density being too HIGH in some areas disproportionate to the rest of the scalp is also a big sign. I often think of one guy who was Norwood 6/7 and worked on by a reputable doctors who does good work, but for some reason after a good first pass the guy had a second pass to add a bunch of hair into the frontal third or so with lighter coverage elsewhere. The difference in volume was crazy and looked very artificial, like he was wearing a high density hair piece that only covered his frontal-temporal area. That's no shade directed at the doctor either. Just a case of a patient who probably wouldn't listen to what was good for him.

Donor looks great. Out of curiosity, did the doctor mention how many grafts extra the less conservative hairline would have required? Looking at your side profile shots I definitely think you made the right call following your existing hairline. It's a good height and placement for your head shape from what I can see of it. With 8k grafts to work with and around average hair thickness, I feel like you will have plenty of supply to fit your needs as long as your growth is good and you don't get greedy.

Very nice to see the work holding up so well. Was the operation split into smaller sessions to try to reduce trauma to the native hairs?

There are plenty of doctors who COULD do what you're asking, because it's not all that difficult, but it's a question of who WILL. It's NOT more aesthetically complex than being conservative. Any competent surgeon would be capable of doing this work, but that isn't the point. You're not on medication and unwilling to try, you want a juvenile hairline at a relatively young age, and you have a bleeding issue. There's a list of recommended surgeons on the site. Look at their results and pick a few whose work you like. Get consults with ALL of them, and at least one in person consultation with someone who will give you a graft count and a miniaturization examination. An ethical surgeon isn't going to commit to a hairline that aggressive without looking for signs of future progression in other areas. You've repeatedly brought up family history, but that's no guarantee that you will follow that trend. That's the equivalent of hoping for the best, and it's a poor long-term strategy. You need a professional to literally examine your head with a microscope. If you don't do your due diligence the odds that you'll get fucked up long term increase substantially. If you want a generic recommendation, fly to Hasson and Wong and pay to see one of their doctors in person (not a rep). They've been doing this a long time and have innovated a number of industry techniques. Be sure to disclose the factor nine issue and listen to what they say even if it isn't what you want to hear.

Sure, but how many grafts do you have in the tank compared to how many grafts you would need to cover your scalp? Reputable doctors likely won't want to touch this kind of hairline goal at your age it you're not stable on medication. If you're going to pursue surgery at all you should start by getting an in-person consultation from a surgeon who can examine your scalp for areas of miniaturization and provide an estimate on your total donor grafts available. All that said, that hairline would still be a massive gamble. Family history is a guess at best.

I believe by day 13 they should be totally secure but feel free to check with the clinic.

It's up to you whether you want to ask the clinic to touch up the work, but based on photos I wouldn't bother if it were me. Unless those sparse areas are much more obvious in different lighting or you desperately want to comb your hair that particular way, why mess with it? If it looks good you win.

Looks about right so far. It's obviously harder to tell with unshaven transplants but you look like you're doing a fine job of cleaning in these photos. Have you mentioned how old you are? Didn't see that in the original post.

No matter how much you liked a first consultation with a surgeon (any surgeon) it's always best to get multiple opinions. In theory everybody should be recommending a similar graft count and strategy for your goals. If one doctor says something wildly different than the others I would generally consider that a red flag. There are loads of cheap clinics in Turkey and just as many horror stories to go with them. There are good budget clinics, but be careful.

Yeah. That's not how that works.

Nobody is going to have shock loss from PRP. They're not making incisions in your head like they do with surgery, just injections. Any hair that sheds after a PRP treatment will either come back (likely thicker) or was already walking "dead" anyway.

This is a very thoughtful and detailed response. I think we don't often touch on scalp issues in this forum because honestly most of us are simply dealing with androgenetic alopecia, and this is good information. With that said, I agree 100% that the first thing to look at is simply the fact that the graft count was likely insufficient to meet patient goals and expectations so there were bound to be issues from the start.

Yeah, don't neglect the washing. One if the doctors here had a video about a patient who neglected washing for the first couple of weeks and then when he finally did wash he tore out a huge number of grafts because the scabbing had gotten out of controk.

Yeah, this looks plenty familiar. My frontal thinning is very similar. Thanks for including the additional photos. Without these kinds of images earlier stage diffuse thinning can be tougher to see.

From what I understand he has a relatively low daily graft count per day. If I remember your thread correctly @Rolandasyou had around 3,500 but spread over two days. If a small punch size is being used and total punches per day is kept low, possibly this leads to a faster healing time because the total scalp trauma at one time is kept to a minimum.

Yeah, a six year update is usually unheard of, but this result still holds up even though medication wasn't taken.

There are plenty of cases on here where grafts were placed into thinning areas successfully, but it is a risk because shock loss does happen and there are a few stories on here about that as well. One factor is your unique physiology and unfortunately that's something that's hard for you or the doctor to gauge. No way to know how your body will respond, although being on Finasteride helps reduce this risk. The other is skill of the surgeon. If a surgeon transects an existing follicle trying to transplant a new one, that transected follicle won't grow any more hair. If you're referring to transection of previously grafted hairs that shouldn't be an issue as long as the surgeon doesn't mess up because those hairs weren't miniaturizing.

I'll be interested to see how this goes. You've got a decent amount of native hair so as long as there are no issues with shock loss I think you have potential for a very nice result. I appreciate your breakdown of how the plan was mapped on the scalp. Donor looks good. Any notable pain or discomfort so far? Edit: I personally wouldn't drop the Minoxidil at this point. It's probably keeping your native hair thicker and healthier in appearance, and even those weaker hairs partially rejuvenated by Minoxidil can contribute to the fullness and density in your result if the doctor was implanting around them. If you drop it you run the risk of shedding and possible exacerbating your progression. I personally wouldn't want to risk it.

I continue to be impressed with the documentation when this clinic posts results. You don't generally see progression of growth depicted outside of patient results and it's very refreshing.

I don't know what it is about Dr. Arocha's clinic but the post ops I've seen from his clinic never have the black dots (unless the patient has black hair in which case you're seeing the hair). It may be that the recipient is cleaned more frequently throughout the surgery because it's unshaven and you don't want blood caking the native hairs and getting in the way? @Steeeve might have an idea about the cleaning. You've also got lighter colored hair, so the implanted hairs themselves shouldn't be super visible if they aren't covered in dried blood or something. I think it looks good so far. I like the hairline design that was chosen and I think 1,500 grafts should improve your situation nicely. I hope you keep updating so we can see your progress.

@Steeeve is probably the best documented journey with this doctor, at least that I have seen. Hair is still looking good with that extra length, especially au natural in the sun.

I will be as honest as possible based on my experiences and what I'm seeing from your photos @MagnificentAl. As a disclaimer, let me say that your pattern of loss/recession is one of the more aesthetic options (if there is such a thing), at least in my opinion. While your temporal recession is deep, your frontal tuft is still intact and your hairline is at a reasonable height with only minor diffuse thinning. Moreover, your donor area already looks really good and I doubt any women would give it a second glance.I think as you hit the ugly duckling phase where your recipient starts to get that patchy growth you'll have to decide whether you want to do anything to disguise that like you are talking about in your video. I'd probably avoid doing a full shave just so the scars in the donor aren't exposed. That is a conversation that may not go over well with some women because they will think you lack confidence and/or are vain. There's a strange double standard of judgment with this when it comes to guys. Definitely don't do the hat move on a date because women are wise to that and it will actually draw more attention to your hair. I think your best move at this point is to just grit your teeth and power through with confidence. As cliche as that sounds you're now at an age where a lot of guys will have started showing signs of hair loss, and guys with more aggressive patterns may have lost all their hair already. Women are going to start seeing some level of hair loss as more "normal" just like your parents. What you need to do is focus on playing up your other merits. If you're financially stable, tall, in shape, dress well, etc play to those strengths. You can't be deficient in everything and still be successful, but you can afford to have some weak points. I don't want to hijack your thread with this too much, but feel free to DM if you're still stressed and want to talk about it more. I honestly think you are more concerned about it than most of your potential dates will be though.