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txtransplant last won the day on February 24 2019

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  1. Strip procedure for 1500 grafts would be plain dumb. A huge scar for a tiny transplant makes no sense. 50 grafts per cm2 is only 30 cm2 coverage. That's almost nothing! We need to see pics. This sounds kind of like a mess waiting to happen and maybe a not so good surgeon. But we won't know what you are trying to explain without pictures.
  2. Last three shots. First is in a very well lit hallway full of sun. And of course to have this perspective in real life, you would have to be over a head taller than me. Next is outdoors on a sunny day, but not bright sun directly over head. Last is the same spot outside on a sunny day from an angle most people would view me. Actually that is not even true. You would have to be very tall to have this view. But you get the idea. The illusion is better when you look sideways as me rather than down through my hair from above. So far, my review of the transplant is everything is healing well. Some tiny "pores" in the transplanted scalp that seems to be common, but not talked about. I am not even sure it would be noticeable if buzzed my hair off. Probably would be slightly if I shaved it. All feeling has returned and happy with that. We are at just under 6m and rationally they almost always get better, even if just a bit from this point. I don't see any new growth, so not terribly optimistic much will change, but time will tell. It seems like almost 1/3 of the grafts just have not sprouted yet. Will have to wait and year and see, since it is to early to know for sure. Surgery aside though. The reality is under MOST lighting conditions and viewed from the normal angles people interact with you there is a big difference. Therefore this has had a nice impact on my life and is a good example of what the realities are for a man with average to thick caliber hair implanted at around 30 cm2 can be. While I am not thrilled with the growth rate so far. For guys who have a lot of area to cover...this is what you can expect with around 30 grafts per cm2. Far from great hair, but good enough to frame your face and make a nice presentable look where your hair loss isn't the defining feature of your look. In other words, if someone was given instructions to look for you in a crowd, bald, or balding isn't one of the adjectives they would use.
  3. Next four demonstrate how it really is. Direct bright light is a bad look. Shows the worst flaws. Good to send to your doctor for evaluation, not so good for your ego. Second is with less intense light. Better, but my days of spiked hair are over and dead. 3rd is the classic pulled back centerfold shot. last one here is in the same light, but hair down and obviously letting less light in. You can see that even with low density, it can look like I some passable version of hair.
  4. Thanks for the prod to post an update. A few days shy of 6 months. Going to be an update, but also a addendum to the ongoing debate on density and illusion of density going on in other topics here. Good read if you guys have not already. So far I am thrilled with the change in my appearance. But not so much with the density v what I had implanted. Clearly there has been some thickening up and let's hope it continues. But implanted density was in the low to mid 40's and I don't think we are there yet. Closer to 30 at best from what I can make out. I am truly at the point in the right situations it can look great or a mess. Pics taken today, no gel or product or any kind. First two shots, fairly typical indoor daytime lighting from a normal viewing distance. Sunny day, windows partly closed and overhead light. Typical office lighting I would say. Next shot in a shaded corner. Much more typical of night indoors if no direct overhead light.
  5. listen guys. Here is a dose of reality. Nobody looks at Brad Pitt and thinks he is loosing his hair. But look! On moments you can see scalp through his hair! My point is the idiots here who think you should have a light proof helmet of hair are crazy. We don't dissect people's hair we meet on the street. We get a snapshot impression, hair, no hair, scraggly hair and that's pretty much it. There is some really sad soul who posted his HT he got to lower an already respectable hairline. He then had it lowered maybe 3cm and it looks terrible. It's because he didn't know the reality and now forever will look like a guy with a funky weird hairline when it was fine before. Hopefully these pics make the point that even when we see some scalp...it's natural and we don't notice it. I am not saying my 35cm2 HT with pretty average hair is like Mr. Pitts admirable locks. But think of it line wearing a suit. Almost nobody looks past your suit. Sure, if it fits awful or made out of spandex they would. But most people see a suit and move on to something else. Only a few nitpickers are going to look at minor tailoring flaws or if it's a superb wool or lesser one. Same thing with your hair. A lot more coverage then scalp...they see hair.
  6. Sadly, the pic is nowhere near clear enough to make a good guess. I mean not even close to being able to tell. But it if we are playing the guessing game and that area was pretty much bald, it should be between 2-3k depending on head size, hair characteristics and such. But absolutely I can not tell by looking at that if you got 1,500 or 4,500 grafts. It's a blurry mess.
  7. Yes, this does not look like a great result is going to happen. There is some improvement for sure though. We may never know what happened here. You for sure are a prime candidate for permanent shock loss. Hairs that are thin and on the way out often get killed for good in a HT. Thin, end stage hairs are prone to this on their last growth cycle. It could be that you had some failure in the procedure, aftercare, or just one of the unlucky patients who just aren't great respondents. Then again you could be one of those late bloomers and it all works out. My guess is a combination of things, with shock loss maybe being the main one coupled with what looks like maybe you have thin hairs naturally. We know hair diameter has a huge impact on how dense it looks. A guy with thin hairs might have 1/2 the coverage of someone with thicker than average hairs. So keep fingers crossed. Way to early to say for sure. Truth is it might not even be a bad hair transplant. It could easily be shock loss, natural progression of baldness and then naturally thin hair characteristics all making this HT not one that has made the impact you hoped for. It is an improvement though and let's see at month 12.
  8. I think your hairline is pretty good and on point for a 40y old man too. I actually wouldn't mess with it right now. Why have surgery again when there is not problem? That starts to be using surgery as a styling too....and that is not such a great idea. As for the crown...sure, it can use maybe 100 grafts and be much improved. Though the really depends how much it bothers you. If this were me, I would just wait till things got to the point where it was more necessary. You could easily cover the crown with styling or even a bit of concealer and the hairline will probably degrade a bit over the next few years. Then do something. But of course, with so many grafts available, I could also see spending a day getting the crown restored seeing as it will be a few hours in a chair and not impact your life much. You know what, as I am writing this....if it's not much hassle and affordable, why not get the crown fixed up? But I would tend to say leave the hairline alone unless I am missing something in the pics. But the font looks good, appropriate and healthy. So I just would not mess with it at this point. Though if you did 1000 up there you would have near perfecting if everything went right. But it might not, or if your hair recedes some, then you are back in the chair in hurry. I would just let nature take it's course there and when it gets to the point surgery justifies the hassle, expense, risk and impact...go for it then. This especially because your hairline is unique and may be a bit tricky or unpredictable. Just leave good alone instead of risking sacrificing it for some unknown perfection that might not exist.
  9. One more thing about how mos HT's look thin in direct overhead light. Little science here. My HT is only 6m old and low 40's was implanted over mostly bald areas. Hair is a little thicker than average according to my Dr and average hairs per grafts slightly lower. So I think that makes me pretty average! On my head at this moment not all hairs have grown, but most have and none are thin. So, as an average characteristic guy probably with low 30's per cm2 I can create the illusion of a full head of hair you really don't notice in thinning at casual glance. It requires styling and length that is ideal to create that. And here is the science. Even in direct bright sun, if the sun isn't overhead it doesn't look thin really. Indoors in a retail store it doesn't really show it's flaws either. But even if you go into a bathroom with relatively, but focused overhead light it looks bad without concealer. And with direct overhead sunshine, It looks really thin! It is all about light getting to the scalp! If the light is coming from the sides or defused it creates lots of little shadows and also a lot reflects back off the hairs. It's almost like the old xrays. Hold the film up in a room and it's dark and you cant really see. Have a bright light reflecting behind it and it changes everything! Part of the illusion of thickness is filtering the light out before it gets to the scalp. I am not thrilled with my results yet and honestly followed all the "rules" and did my research. What I learned is that even if I get 100% growth and what should be 1/2 of my original density....it's an illusion and not full, thick hair. It is enough to fake it and look passable in most situations. BUT even though it's not ever going to be flawless even if I reach 100% regrowth and I am a little disappointed...there is no denying the huge impact it has had on my appearance and life. My face is nicely framed, I can dry my hair and go out without worrying about my hair and it looks quite natural on a early 40's guy. A pretty full head of hair that is thinning isn't a bad look on a mature man. We have to remember that! It is a completely different look than bald or mostly bald! It is truly at a point where to the general public, hair isn't impacting my attractiveness and it looks fine most of the time. And if I use a bit of concealer it looks perfect in an office or on a date. So I have the ability to fake completely solid hair when i feel like putting in 5min of effort. Truly the only time it is really a mess is if I use that brown makeup on my scalp and go out in direct overhead sunshine. Then you can see the concealer, or at least something looks funky. If I were really tall, might not be an issue. But being a short guy, lot's of very tall people might notice looking a t my head from a few inches above me. So, even though I realize even a pretty run of the mill HT getting 50% density isn't going to be anything like my hair of yesteryear, it is silly to obsess over the weakness of it. Because it has been an absolute game changer and made balding (at least in the front and top) for me a fairly small inconvenience as opposed to a daily hassle and limiting reality. Lesson learned here is if you are not happy with the illusion of density you have to go big! You need to go to H%W or to one of the guys who seem to specialize in cramming 4000 grafts into the frontal 1/3 and start getting into the high 50's to mid 60's per cm2. Those results are truly undetectable and are not trying to create in illusion. But for most people they are not wise, or realistic. So for most of us, we cover as much as we can and try to find the sweet spot where we buy the best look that our limited grafts can provide. It takes truly ideal characteristics to have a HT done in one pass that looks close to original density in all situations. Higher than average numbers of multi hair grafts, thicker than average hair diameter and implantation pushing the limits of what most surgeons and patients should be doing. That would be 45-50 grafts per CM2. In a patient with all those things going for him/her. Then a one pass HT will be an absolute homerun. And even in the front it would be pretty solid looking, but not flawless. But reality is most guys are average. Most guys getting a typical HT are not going to get those amazing results. I see a lot of guys going to your typical HT doc and getting pasible results on a first pass. For some, that's good enough and they move on not obsessed with their hair. For others, they obsess over every flaw. And some go get a second procedure and usually those 2nd porcedure guys end up with nearly perfect hairlines if they want to take it that far. All of my advice excludes people who had well below standard growth, super thin hair or the biggest single problem.....unrealistic expectations. The ones who go for a far too teenager like hairline that looks silly, Then they blow through way too many grafts to create it. Those fools are screwed! They usually have to either live with a funky unnaturally thin kiddie hairline that never naturally thins in that way....or go for a second pas and blow through every last available graft and then are in a really bad situation for the future. We see it every few days here. They think they can go to Turkey or wherever and get their 14y old hairline back in one mega surgery and fill the midscalp too. Realize after a time that their expectations were too high. Sometimes they don't man up and blame the Dr. Occasionally the Dr is at fault. Either way, they are screwed when it didn't have to be like that. I wish their was an industry standard where doctors refused to restore anyone past an early NW2. That would solve so many problems. So many 3000 graft frontal 1/3 jobs that would have looked amazing more dense over a smaller area where he patient is just ruined. Or will be in the next decade. The only patients who should be getting low, flat really youthful hairlines are young guys who have a proven family history of only frontal balding and show ZERO signs of thinning anywhere else. This is a rare subset of patients and I don't even think it is wise there. But lot's of patients want what they want and want it today. The average guy getting a single procedure who is getting the front 1/3 done just needs to know that he will get something workable in all likelyhood. But not perfect. The guys who want perfection there need to cover a smaller area and probably get a 2nd procedure.
  10. Can't see even 1/2 way clear enough to see graft angles with certainty. But they look okay to me from what I can tell. Without before pics it's meaningless because many guys don't even know what NW they are. He is a 2 now! But judging by the abrupt hairline I am guessing what we are seeing there is transplanted hair. And that transplanted hair in the pics (not great pics) looks pretty dense. Guessing mid 40's for grafts per cm2. Not too many places pack more dense than that in one operation. So I get the impression this is a decent HT all in all. Payam..His results are sub-par for where he is. Time will tell on that one. But not eveyone is a home run even though they all want to be. For every above average result, there is going to be below average ones too. But HT1046's. This looks to me like a solidly average and decent HT. It's not a $30,000 job, but that's not what he signed up for either. This thread is great though! It shows the range of mindsets, due diligence, emotional stability and vastly different expectations people build up in their minds. It goes to show you the same results to one patient might love it in spite of the weaknesses and want to show it off in a positive way. Another with the same results might just continue to obsess over the places it came up short and miss the forest between the trees. Like most plastic surgery, there is a percent. I am guessing 10-20 who are never satisfied and will always see the next flaw. We see them in real life looking like freaks. Too big lips, too much filler, too small nose. It really is a disorder where people obsess over precived flaws and tie their self worth or well being to it. Cold hard facts here people! Most guys don't care enough to get a HT. So what we have here isn't even a average sample of men. Of course we are going to have a decent amount of guys with an irrational obsession with their hair. Just like body building sites have a fair percentage who are way off in neverland taking horrible drugs and looking like freaks, or talking about guys who don't work out like they are untouchable to women. We all went to school with some girls who stated starving themselves too. Well, guess where all the man with hair dysphoric disorders end up?? Yep, right here! And just like the already starving girl. They won't see reality. Just the one spot that could be thinner on her body or thicker on his head.
  11. This,,,it woud be awesome and be barely more than a few hundred grafts, Changes the entire look. You got lucky. You didn't really get a flat hairline..you got one too high...completely something great to work with,
  12. And here we have the essence of this thread and the realities. I don't see any before pics. But I will assume this was a frontal hairline rebuild job. And being completely blunt....it is a pretty good result. Yes, it could be more "refined" maybe more subtle transition and and I agree with another poster, I would have had higher temples. But this is very much part of being an adult and taking ownership of what you want. Not just letting someone you have never met decide your hairline. So for sure any perspective patients need to know what they want going in. It is much better than letting a stranger decide the morning of. You should design your hairline. However, perhaps more often I see patients going for too aggressive hairlines and feel doctors need to be ore reserved in giving those. I think the Dr. who did this patient actually over does hairlines. I think maybe in parts of the world where many of his patients come from that is appreciated. Back to this. I see a pretty dense hairline for a HT. I have no idea what you stated with,,,but this is solidly middle of the road looking. With 7-800 grafts it could be really maxed and be a better than average result. That the patient doesn't like the design is irrelevant. That was a communication problem and has nothing to do with the skill set. Here is the rub. Plenty of guys would love results like yours. You instead hate them. From the pics (and I doubt you sent the most flattering ones) it seems like you really have nothing to hide. In fact the forward comb down looks to me much worse than what is under it. I would say this is a better result coverage wise than Melvin. But completely a case where expectations were well beyond what they should have been. I get the feeling this patient would not be happy unless he had the same hair he had when he was 13. HT is and should be a tool to make a bald guy not a bald guy any longer. Not take the hair equivalent of a quadriplegic and turn him into a Olympic athlete. This looks like good density in these pics for a single procedure and if someone is disappointed in it....then the simple reality is this is a case where the expectation is too high. We read 50% of original density good. Some people infer that means looks good as it did with no thinning. They are WRONG. It means they appear to have hair and not obviously thinned at casual glance. A HT will never hold up to close inspection. Now I will say some doctors...sometimes recklessly and sometimes brilliantly super dense pack a frontal area with massive amounts of grafts and get a look in all lights and views full kid density. But those are extreme cases. If you think you can go to the McDonalds of HT and get that in one pass. You were living in a dream world. I say this patient appears to have gotten a good HT and certainly to the casual person they meet, looks far from a bald guy now. He did get kind of a unrefined hairline and partly that is what the doc he picked does. But he also had the opportunity to go with a more natural design. And even if the artistry here is not the best. A few hours in the chair could make it terrific. I think a lot of guys with a result would be bragging here how it was life changing. You are saying it is detrimental. For sure a good example of glass 1/2 empty or full and how different humans have different expectations, perspectives a whats of handling them. Listen, I learned the hard way too...but I am not complaining. I bought into the argument and illusion that 50% of original density would give me almost perfect hair. You know what, it doesn't! It took a train wreck of a head of hair and made it presentable and where it wasn't really impacting my looks in a meaningful way and people notice me and my hair is good enough that nobody looks at it. Think of it like another body part most of us ignore...ARMS. If someone has unusually muscular arms...people notice. If they are so weak and maybe slightly disabled giving off sings of bad health or weakness....we notice that too. But on a guy, his arms can be in the bottom 20% or top 20% and damnit, nobody is going to even notice his arms one way or another. We just notice really obvious things on other people! Have a head that is closer to full than bald and people's eyes go elsewhere. That is what HT is really about. When I go out on a date now, I am under no illusion my hair is helping me or hurting me. Now if a 20y old dude with crazy great hair sat down in my lap, then the girl I am out with might notice my hair is a little lackluster. I think some people want perfect hair of a teenager. They will be disappointed even with a decent result by real world standards of HT. The guy who just want's to look presentable and hair not be a major impact on his overall look....then yes, he will be happy with typically good results. Melvin's hair looks like crap in the wrong light and with nothing done compared to someone with zero hair loss. But with a bit of effort and in the game of life, he is a guy with hair that is good enough not to take away from his looks. Compare him side by side with mode hair....it might hilght his weakness. HT didn't restore him to perfect. It restored him to where his hair isn't impacting his appearance in a bad way. It is easy to see how many HT pics are done in ideal lighting. It is pretty much the norm in fact to see before and after pics with slightly more harsh lighting before....and results ideally styled and presented. That is not unethical much of the time. It is just patients looking at the bright side and of course doctors putting their work in the best light. It is up to us, as informed patients to look through the 1000's or results here and learn for ourselves what is really happening and not think we are getting a unicorn when what we are getting is more like a donkey. That is the value of this site to patients. The info is here if you aren't lazy and have a good eye for realty. But the overall world of HT is misleading and the next is loaded with results that are presented in the most ideal conditions by patients and doctors. Yes, a few can get intense density and amazing good as teenager results. But for most patients that is not reality, or even a goal. That usually takes 2 surgeries and doctors with a good eye for natural hairlines. But like this patent, most get rehabilitated good enough to frame their faces and no longer be guys you look at and give the impression of bald. If you think your new superpower is going to be hair....you are wrong. To HTO416. Seriously...loose the comb forward. I am telling you, your hair is pretty good now and a lot if it is in your head. And if you had a bit of a wodow's peak added and maybe a few hundred singles scattered along the outer edge of the hairline you would have some truly great results! I mean that. I can be harsh and don't sugar coat things. If this were not true....I wouldn't say it. You really are okay as it is. And would be a great look with a bit of refinement.
  13. What am I looking at here? It looks like the donor hair mostly all came from the sides and pretty high up and not the typical back safe zone? I must be missing something here.
  14. Everything respectable that I have read states that hairs taken from the "safe zone" on the back of the head are physiologically different from hairs on the top of your head in that they are very resistant to the process that causes balding. The same goes for hairs in your beard. So it is not that the top of your head is toxic to hair. It is the fact that the hair that naturally grows there is susceptible to DHT attacking it. Plug some beard hairs on top of your noggen and they will grow forever and never wither and die. What you have been hearing, it sounds like the thought is you gather some fresh soldiers from the back....throw them into battle on top and they fight a good fight for a couple of years before they fall to the inevitable? I think the reality is closer to what I wrote than what you have been hearing. HOWEVER. As we age, lots of our parts don't function as well. My father, who was pretty much a NW 6 by 30 has had a horseshoe of hair now for 40 years. But now in his mid 70's even the hair in his safe zone is fairy thin. Our hair, just like our nails tends to thin as we get older. By thin I mean not be as strong or thick. It is pretty natural. But in my father's case, I am pretty sure even the safe zone hairs have been partly picked off by male pattern baldness. So I think the truth is everyone is different and those really sensitive to male pattern baldess probably won't keep every transplanted hair for their entire lives. But I think it is realistically expected that they will keep the majority of it. So let's say you have a receding hairline. You get hairs transplanted from from the safe zone to the front of your head to create a new hairline. If the hair loss continues badly...you will be left with a horseshoe in back and a patch of the transplanted hair still there in front. We have sen this where HT patients have had an area done...then the balding continues behind it. The new hair stays, but the original hairs behind it vanish as the hairline moves back. They are left with an "island" of hair where the transplanted ones survived. Simply put. IF the grafts are taken from the true safe zone in the back. Then you will keep "most" of the transplanted hairs for the rest if your life. That is why it can be risky to use a lot of grafts on a front part of a hairline. If you go mostly bald afterwards,,,,you will look like you're wearing a hairy headband on your forehead and bald top. Not a good look!