John1991

Excellent!

Life doesn't end at 29, and if you proceed as if everything has to be fixed immediately, you're going to find yourself in a position (especially with your aggressive loss) where you have a transplanted hairline and tons of thinning behind it by age 27. The advice you've been given is that you should - at bare minimum - wait until your loss is stabilized for a few years and then perhaps go forward with a transplant. If you're not "motivated" enough to get on preventative medication, then you're likely to be left with little to no hair on top within the next five years. Imagine spending the time (and money) and going through the lengthy aesthetic/physical recovery that a transplant entails only to then end up with nothing behind it because you're not "motivated" enough to take step 1 in the process and try to keep all the hair you have. You'll then be forced to continue to chase your hairline with further transplants and your entire 20s will be spent hellishly. Don't do that to yourself.

Am I the only person who thinks his pictures tell a confusing story? We haven't seen one with crown growth and the last one appears to show a solid hairline even before this most recent hairline area procedure.

I think your design will use more grafts than would be wise in its attempt at restoring the temple areas. I drew on different lines. Perhaps something in-between those two designs would be even better. My guess is my design would require somewhere in the 2500-2700 graft range. Your design is pushing the 3300-3600 graft range. However much you lower, the existing hairline is going to have to be reinforced - just something to keep in mind. The last thing you want is a lowered hairline that's just as lacking in density/quality as the one you're trying to improve (not that yours is awful, but obviously you want it improved). It'll take a lot of grafts packed tightly to both lower and improve the quality/density of your hairline - and you look to have a good sized head too, so the number of grafts it might take to achieve a small lowering on your head might be equivalent to a more significant lowering on someone with a smaller or less rectangular head shape.

It would be helpful if you would post a picture from before the first (3,000 graft) surgery then after. And then before this most recent surgery and after. Also, just because some people grow fast doesn't mean everyone will. In this picture it appears there is an area in the farther back portion of the mid-scalp that was completely untouched as far as grafts go. That area seems to correspond with the area that is thinner, which would make sense. Am I missing something?

And I thought the hair part of this site was obsessive and unhealthy. This takes it a few more big steps in that direction.

He's amazing, but very expensive even compared to other top docs. I think what's most annoying about results like this is that the explanation often seems to be that planting grafts too densely will result in poor blood supply and therefore poor growth. While it is obviously possible to pack too densely, we can all see with our own eyes that good doctors can pack hairlines densely enough to the point that they look excellent. This transplant was almost entirely in his existing hairline too - there was no lowering - and the doctor still wasn't able to make his hairline dense enough to be satisfactory.

This guy doesn't look like a diffuse thinner to me. Call me crazy. Just looks like a standard NW 2.

This dude looks like Brian Scalabrine if Scalabrine had blonde hair.

According to that study, the rest of the scalp isn't as dense as is generally assumed either. This actually makes sense to me. For instance, I look at your hairline and there's absolutely no way that the average guy (loss or none) has a denser hairline than you do. Yours is clearly well above average density wise.

Very well done.

I can definitely see how that area is annoying. I think two takeaways people should have from this forum in general is a) don't skimp on the price and b) don't hesitate to do some traveling.

Illusion of density is a very fair term in the sense that someone with significant loss will not be able to restore their scalp to its original density and coverage. It's also a cop-out used by Dr's who create hairlines that are insufficiently dense to make it seem like its not their lack of skill that prevented the patient from having genuinely good results. The truth is the average male without pattern loss has a frontal hairline density of roughly 50 grafts/cm2. That's achievable by the top doctors, which is why their hairlines look like the hairlines of people unaffected by MPB - especially in their patients who started off with more limited loss to begin with. For a NW4 or 5 getting coverage and a frontal hairline density of 35-40 grafts/cm2 is probably a great result, but for OP or people lower on the NW scale that just doesn't do. Everything here varies person to person.

That's pretty much exactly what I did for my transplant minus the temporal point (and I was a NW 2 also - age 31). I don't know exactly how my results will end up, but I feel I gave myself just about the best possible chance for success. That's all anyone can do. That video is - IMO - one of there better results. They're awful. As for OP, he's 35 and a NW 1.5, so he's on the absolute cusp of doing this at all IMO. If he does do it, it best be with someone who will make it dense because he has great hair.

Fair assessment. You just have to go to the right place. This is a perfect example of a place that would be entirely wrong (for anyone, really), but in particular you. They may give guys with significant loss more hair, but they make hairlines insanely lacking in density and you'd have a wispy nothing in front of your currently solid hairline.

Well the issue you presented could be avoided simply by recreating a new, slightly lower hairline rather than sprinkling grafts into the existing one. Then any loss behind it is at least not in the front as was shown in your earlier picture. You're right to caution people against being too aggressive, but if he's 35 with hair like that and thinking about a transplant to the point of posting on here, I feel it's worthwhile to let him know it's possible for him to get the results he desires, but only in the hands of the right doctor.

Based on that, I'm guessing that the transplant was more or less grafts sprinkled in with your native hairline to add density, but not really lower? Then with the non transplanted area disappeared you were left with this? It seems this (but not other potential pitfalls) could be avoided by having an entire part of purely transplanted grafts in the anterior most point in the transplant - then any loss would simply be behind it.

Right. Then apparently it wasn't taken from the safe zone because it's evaporating. Not sure of any other explanation.

That picture is the opposite of the nightmare everyone worries about. Most are worried that if you lower the hairline you'll end up with a hairline and loss behind it. Yours is the opposite - you have hair behind a disappeared hairline.

For people with significant hair loss who are looking to get coverage over much of or their entire scalp, density will never be restored to what it was prior to their loss - hence the "illusion of density" phrase you hear. For someone like yourself with minimal loss who really just wants a denser hairline that's minimally lower, you can achieve comparable density to what you have, but you do have a very good head of hair as is. If you don't go somewhere where the hairline is packed very densely, you'll likely end up looking worse. If you get it packed densely at like 55-60 grafts/cm2, you'll probably end up with a hairline that's slightly denser or as dense as it currently is - except slightly crisper/lower. My guess would be roughly 2000 grafts could get the job done. Your crown is fine.

Old thread, but it’s been shown that even in men without visible male pattern loss frontal hairline density ranges from the high 30s to the high 70s as far as grafts/cm2. The 100 grafts/cm2 figure just isn’t accurate - or close to it, even in the donor region density is lower than that. The average density in the frontal hairline for a grown man without hair loss is roughly 50 grafts/cm2, which is why when you see results where the hairline is packed in the 50-60 grafts/cm2 range they look very good. It’s not an illusion, it’s just a great result. It may be the case that to achieve some reasonably good coverage half the density is required, but the crux of this thread was that hair transplants are - almost definitionally - an illusion. That’s not the case.

I would agree with Melvin that it's difficult to guess how many grafts that is given the length of the hair in your forelock. That said, I'm two weeks out from getting 2660 grafts implanted, and the amount you got implanted doesn't really look close to the amount on my dome. I also have a large (wide and long) head - 2500 grafts can cover a pretty considerable area. The area covered in your case would potentially be 2500 grafts worth (if the forelock area was close to bare to begin with and was packed in tightly), but only if they were packed more densely. Here's a picture for comparison. You are correct that starting with strip gives you the most available grafts over your lifetime, so that's good. Worse case scenario here looks like it'll just be mediocre - you absolutely didn't get butchered.

One wouldn't think this is that tough of a concept to grasp. If you live in the US, why on Earth you'd think it was wise to skimp on a procedure that will literally affect the way you look at all times forever by getting a second rate nobody from a second world country to perform it is beyond me. The recovery time (both from a physical discomfort perspective and aesthetically) even if you don't need a repair procedure is very annoying. If things don't go well, then you have to wait an entire extra year just to then get another procedure to then wait another half a year to see the results. All you can do is put yourself in the best position to have a good (or at least not bad) situation the first time around. It seems many don't do that, which is unfortunate.

2000 grafts.

At his level of loss, I wouldn't even advise meds. I think he should try Nizoral 2% for a while to thicken. If after that it doesn't improve or he has loss, then jump on Fin. Then minoxidil later if he wants to thicken. Starting with the kitchen sink, as it were, is annoying because then you're using this stuff forever. Start with as little as possible, then add things if you feel it's necessary is my take on the situation. If these pictures aren't a major optical illusion, he's not destined for short term serious loss, so he should try to get away with as little as possible before committing himself to a lifetime of Fin and min