John1991

Here's an example - my hair has been almost exactly as shown in this picture for 8 years (this picture is from last month just before turning 31). I had some definite concern when - at 23 - I noticed that seemingly all of a sudden my hairline wasn't quite what it was at 18. Given that you're posting on here, you're clearly more in worry mode than I was. I would advise you that, for your mental well-being, don't go down the road of obsession that I have. You have two choices... One is to see if you remain stable and then in 5-7 years perhaps be aggressive and go from NW 2 to a stronger NW 2 with surgery. The other is to be (IMO) reckless and try to go from a NW 2 now to a stronger NW 2 now. If you do and you stay stable, you end up with years worth of being a better NW 2 under your belt (though that's arguably not going to really impact your life much). If you do and you have considerable loss, you're in disaster territory because you lowered an already solid hairline at age 24 and then are chasing to keep up with your loss. I think the other posters (I'd imagine all of whom have more experience looking at hair loss than I do) are correct to write you words of caution.

OK then. In the pictures you posted here, you don't appear to be losing hair. It's not uncommon for small amounts of recession to occur in your early 20s - that's not necessarily a sign that you're going to suffer bad hair loss, much less bad hair loss soon. I experienced that at 23-24 (probably slightly more than you have), and didn't even get on finasteride until years after that. I'm 31 now and my hair has hardly changed since then.

If OP's native hairline density was very high (as it clearly was), then this transplant likely matched or exceeded it in density. A study conducted on 14 men who were all free of any signs of hair loss showed the FU/cm squared in the frontal hairline ranged from 38-78. The average was 52 FU/cm squared. This pretty well explains why dense packing of 50+ FU/cm squared in the hairline tends to look very good - it is roughly the average hairline density of adult males without hair loss. The notion that you can only transplant 50% of the native density (and that that will achieve good results) may hold true, but to get more than just an illusion (but a result that restores an individual to non-hair loss levels of density) it seems more than 50% is needed. Obviously donor area and extensiveness of hair loss come into play and this is why many people never achieve non-hair loss levels of density in their hairlines (or anywhere else). If you look at the best hairline results, they're all 50-60 FU/cm squared. And this one was apparently even denser and is actually at the very extreme of density that even hairlines in nature produce.

I agree with your assessment that he should wait before pursuing surgery. Especially until after he knows if finasteride can stabilize him. It doesn't actually appear to me that he needs to be "stabilized," though. He doesn't appear to be someone who is on the verge of minor hair loss, much less precipitous loss. This guy looks like a normal 23 year old, with a strong hairline. It may or may not recede, but nothing in these pictures really indicates that it will and I would hesitate to call this a "mature" hairline.

Looks like the difference could easily be chalked up to the angle, closeness of your hair to the camera, and the fact that the second picture has less favorable lighting if you ask me.

Dr. Bloxham seems to be pretty damn good with his "frontal band" hairline reconstructions. Basically, he lowers the hairline a bit and beefs up the existing area appropriately. He'd likely recommend it as an FUT. His and Dr. Feller's YouTube channel is pretty damn convincing. They show results as transparently as possible and they look excellent.

Looks very good!

My thoughts exactly. If someone can get this guy to a decent NW2ish state, then more power to them. I just think he's in the somewhat rare circumstance where he actually looks good bald, so if he can't get to the aforementioned state, he's sort of choosing for a balding look over just shaving and looking good bald. I'm not trying to knock him by any means, just my two cents.

I look terrifying with a shaved head too.

If the whole point of this is to look good, I honestly think this guys best bet is to shave his head, build some muscle and either rock the beard fully or try the handsome stubbly look. I’m just not sure the amount of hair he’s going to be able to get from surgeries will look better than shaving his head. Especially since he’s actually able to pull off the bald look well - especially for a white dude.

It's hard to tell from the after surgery pictures exactly where the newly grafted area stops. If the rest were shaved and the grafted area were more easily definable, it would be easier to make an assessment on whether that will be dense enough. Just curious, but why not go with FUT to ensure greater graft survival and to keep as much donor area available for later? How old are you? As far as the final result, you're almost certainly 3-4 months away from something that could look final (and even that would probably only be 70-80% final), so there's much time for improvement still.

Great looking result!