Bucky O Hair

The study is a small sample of only 112 people, and who knows what the skill level is of this "surgical team" that performed this surgery. Those photos included in the study show some pretty bad postop results, and it definitely looks like they performed surgery on several poor candidates who had poor donor to begin with. I wouldn't put too much into these numbers. However, it is true (as @Gatsby said above) that your donor hairs aren't DHT "proof". They are DHT "resistant". Your transplanted hairs will likely thin out over time, but not likely to thin out over a 3-4 year span (assuming they were all taken from the safe zone, and you weren't experiencing serious miniaturization across your donor area preop). I always figure that the main goal of a HT is to eliminate the PATTERN. If you're lucky, you can get density too...but it's that male pattern baldness that you can eliminate with a hair transplant. Correcting your hairline, framing your face, and trying to get rid (or reduce) that large circle on the back of your head by evenly distributing what you can across your crown and vertex.

You can wear a loose hat, but it will look kind of stupid because it cannot make contact with the recipient area. I originally planned on doing this, but then I didn't bother when the Patient Care team showed me how to put it on (I looked like some 90s hip hop wannabe, wearing the hat so lightly on top of my head). They do give you a surgical cap that you can wear, but people will obviously wonder why you are wearing a surgical cap then, ha ha. I ended up just wearing nothing (just the surgical cap when I needed to step outside, but that was only really for the travel back home). I didn't have to fly home (I drove) so I ended up just chilling at home for two weeks, and wore nothing on my head until it was safe to do so. After that, it's been just my regular proper fitting baseball caps.

Topical Fin works according to many on here who use it. Moazzam is giving you some bad advice, so I would take what he says with a grain of salt. He's not a doctor and his claim about "taking fin long term will make your sides go away" is foolish and possibly harmful to you. There are many on here who use Fin (both orally and topically), but the results of any DHT blocker will vary from person to person. It's difficult to measure the rate at which it slows down your loss, but people take it as a preventative measure and to increase your chances of slowing down the loss and keeping your hair as long as possible. It's never a guarantee to continue to slow down (or stop) your loss, and there are cases where it loses it's effectiveness over time. Re: your HT... The good news is you went with FUE (so no scar to worry about) and you look like you still have donor hair available. There are options in India (as people have stated above) and you could use that donor hair along with beard hair to fill in the area behind the hairline toward the vertex. If you don't have enough hair to get the desired density you'd like, you could supplement it with SMP (since you're open to SMP) and you could probably pull off a nice "HT with SMP blend" giving you a dense but realistic looking buzzed look. You have options.

Maybe they harvested grafts from the crown instead of the safe zone? No, just kidding. Did they shave your entire head (crown and midscalp included)? Sometimes, when you shave your head, it shows every bit of detail and thinness you may not have seen before. I just got my HT a month ago (on the front half of my head only), but my crown looks a lot worse than before my head was shaved.

A lot of you hairs that are attached to the scabs will fall out. It's unavoidable and usually happens after that first wash with massage/contact. You'll be fine.

I would avoid FUT at all costs...but I'm an "FUT hater". I just don't think it's ever worth it to put a linear scar on the back of your head. You'll never be able to cut your hair short on the sides and back, and you lose the 'opt out' where you can just clip your hair short all over (if you ever progress to a NW6 in your senior years). Even though docs will tell you that you will get more hairs out of an FUT procedure... I find that people rarely get exact numbers from these docs. It always seems to be some "to be confirmed" amount, that relies on things like 'scalp laxity' and ensuring you do some weird 'laxity exercises' and things like that. If you can get an ACTUAL estimate from these docs on how many ADDITIONAL follicles you'll receive from an FUT procedure over and above an FUE procedure (without them tapdancing around the subject) then you can make an informed decision. But if they're just going to say that it's more, and not actual tell you how much more...then just go for FUE. But even if you do get more from the FUT...it would have to be A LOT more in order to make it worth putting a linear scar on your head (IMO, getting an additional 500 to 1000 more hairs is totally not worth it). Again, I'm biased against FUT, but I'm sure if you surveyed this board the vast majority opts for FUE over FUT in almost every scenario. Re: your hair... You seem to have very good donor hair, and you have a good amount of native hairs left on top of your head. Your native hair shafts in your forelock looks pretty coarse too, and doesn't look miniaturized either (which is good). The estimates provided by your two docs are probably accurate (somewhere between 3500 and 4500 should be good) and that will give you full coverage (front to back) in conjunction with your existing native hairs. H&W are pretty world renown. I don't know too much about the other doc, but they're on the recommended list here so I'm sure they're fine too.

In which week postop does donor area shockloss typically occur?

Really? How?

In my opinion, it's simple mathematics. I paid for 3200 grafts across an 80 cm area, so I expect about 40 FU/cm2 average (with my front being 50 FU/cm2 and my vertex being closer to mid 30s). I know what 50 FU/cm2 looks like, so that's what I expect to get across my hairline. The yield that these preferred doctors is always pretty high, so I don't expect any negative results. I've been liking the results I see from people on here for the past while, and I think we've gotten to the point where bad results with top docs are generally not the same thing as what 'bad results' really were in the past (where people looked terrible). Also, I am VERY satisfied with FUE donor area healing. I can't see a single FUE scar at all. I've been flashing all kinds of different lights up close and I can't see a single mark. I've seen the same thing this with a couple of colleagues of mine who had received HTs themselves earlier in the year and wear their hair extremely short in their donor area. I think FUE extraction over the years has improved in the HT industry so much that it's been a complete game changer.

Yea, my forelock had a decent amount of hair left (probably about 25-30 FU/cm2)...but they're all mostly miniaturized. Dr. Rahal added hairs between them to replenish the area, increase the density, and obviously for it to match the fullly balded areas (like my temples and very thinning vertex, which will largely be comprised of transplanted hairs). After one month, I can tell the difference between my transplanted hairs vs my native hairs. My native hairs are growing at a normal rate (about 0.5 inch lengh per month) and my transplanted ones are growing a lot slower (probably because they are about to fall out and shed with the previous ones). You're going to a big-name HT doctor, so transecting native hairs won't be a thing. That's usually a result of going to a no-name doc who doesn't know what they're doing. I thought that my miniaturized hairs would maybe fall out from the trauma of a hair transplant, but it looks like they're all there intact and growing just fine. It's really just the newly transplanted hairs that aren't growing quickly, and all just shedding out (which is expected).

I am also a NW5 and am exactly 4 weeks postop from my first ever hair transplant (I did it with Dr. Rahal). I did enough research, and even held back from getting a hair transplant for many years. So, when I booked this I knew I wanted to do this. I am also a guy who doesn't suffer from any sort of anxiety ever, and am pretty laid back (even in the most stressful situations). But even I found that in the couple of weeks leading up to my HT appointment, I woke up a couple hours earlier than I usually do and couldn't go back to sleep (similar to that mental alarm clock people have when they have something important in the morning to wake up for, like having to go to the airport in the morning). I knew this was because of my HT appointment coming up, and even though I didn't feel nervousness or anxiety about it...It was obviously still on my mind if it was waking me up earlier than I normally wake up and had trouble getting back to sleep. In the end, I felt a lot of relief after I finished my HT and had no more issues going back to sleep after that (despite having to sleep on a stupid incline with a travel pillow). It will feel great when you're sitting there with your scabbed up head admiring your new hairline. To be honest, all I was doing in the first two weeks was admiring my new hairline. It's probably a good thing that it shed and I am in this ugly duckling phase. Finally having completed your HT is a big task, so it's a good thing to get off your plate FINALLY. Even though I have started the ugly duckling phase, I don't even care. I didn't bother shaving my head yet, and I look pretty stupid now (with hair on the sides, and thinning hairs on the top again)...but I'm wearing some nice hats wherever I got and I could care less. Couple more months, and I'll probably be able to cover up the bald spots with my native hairs, and the new hairs will begin sprouting. First month didn't feel long at all, and it's summer time, so wearing hats in casual summertime settings is totally ordinary. I've already visited tons of people, went for dinners, barbecues, etc...and I've told NOBODY, hahaha. I ain't telling anyone jack $hiiiit. But IMO so far, the preparation and lead up to the hair transplant was worse than the HT itself and the one-month postop period so far. I think having a HT in the summer turned out to be a good thing after all. I initially wanted to do it in the winter, but with events in the winter being indoors and people generally doing nothing in the winter time, I feel like being able to do all these outdoor things (with a hat on of course) really does make the time pass by.

Your AFTER photos are pretty good, but the hairs are wet and under a harsh bathroom light. Have you tried a more dry look using hair paste instead? You may not need to bother with a third HT if you wear your hair in a more flattering way.

What is the definition of 'dense packing'? (in terms of density in cm2) Native hair density is usually between 80cm2 to 100cm2, but hair transplants are generally half this amount. Correct me if I'm wrong, but I thought it wasn't best practice to go beyond 50cm2 density, as anything above this threshold affects growth yield and can also lead to necrosis of the skin (if you attempt to pack too many grafts so close to each other).

I think any sort of sweating is fine after the 2 week mark postop. Push it to 4 weeks if you wanna be safe. I actually asked my HT the same question you asked (because I want to go to the beach) and they said to just wear a hat on the beach and you're good. They just don't want your actual recipient area to get burned at all. They do want you to shower afterward to keep the area clean. To be safe, I even bought a waterproof hat that I could wear when I go swimming (I tend to swim out there for 30+ minutes). They sell baseball caps that are completely waterproof and float. The brand that I bought was called "Everyday California" and they make a floating waterproof snapback surf hat. There are a lot of other brands that make floating waterproof caps like Melin, Kore, etc. It's probably worth grabbing one if you're going into the water for an extended period of time.

Direct sunlight (for longer than 10 minutes) - 6 months Working out (cardio) - 3 weeks Working out (heavy weights) - 4 weeks This is what I got from my HT doc. Every doc provides slightly different estimates, especially with the working out thing...but I find that they are pretty consistent on avoiding the sun (to avoid sunburn) for 6 months. Just buy some nice baseball caps. It's summer time, so you can get away with it.

Ok. Sounds like you're doing all the right things. I'd push for the full hormone profile, just so you can have that full baseline to compare with. Also, I wouldn't feel guilty about talking to your GP about hair loss and any steps you want to take to remedy this. I felt the same way when I asked my GP to sign off on a doctor consent form from my HT (attesting that I am in good physical and psychological health). I rolled it all up into my GP appointment and kind of threw the request at her at the end of the appointment. I was pleasantly surprised at how positive she responded to it, and she mentioned how she gets these requests all the time. I threw all kinds of requests at her the previous year (especially during COVID when there were so many rules around visiting docs or getting prescriptions) so this was yet another thing I am requesting, but in the end it's their job and they probably get several of similar requests like these every day. It probably doesn't even register in their brains half the time.

OK. But it's probably good to maybe get a second opinion from another dermatologist on this (or ask Dr. Bisanga if it's okay to use steroid creams on a healing scalp that is trying to grown recently transplanted hairs). It's not the end of the world though. You found yourself a good HT doc and when this all heals up I'm sure you'll be able to take any next steps to make things better.

Sorry...did you say you've been on antibiotics for three months?! Did you mean antibiotic pills? or antibiotic creams? Neither one is good to take for so long. Generally you shouldn't be putting anything on your healing scalp. Using antibiotic creams excessively can irritate your skin even more, including redness. If you've been putting antibiotic cream on your scalp this whole time, then this could be why it's still red. If it's pills, then I would be surprised if a doctor prescribed you pills for this long of a period unless you have some sort of chronic health issue that never goes away. A hair transplant isn't a reason to be on antibiotics this long.

Get a blood test to check your Endocrine (hormone) levels before starting on any drugs. This is something that a lot of people don't do, but should always be done. That way, you can then get a second blood test in the future to confirm the impact it has had on your system. Judging based on 'side effects' alone is the wrong way to confirm how it has impacted your system. You should go by the numbers that your blood tests show. If you do decide to go on drugs, then going with the topical versions first is probably a bit safer. This is a lifelong commitment, so you should be cautious in your approach. Same goes for the testosterone boosting. You mention you have 'been told' to look at supplementing testosterone. Was this a doctor that told you this? If so, then why haven't they ordered a blood test first? Pretty reckless doctor if they are diagnosing you with potentially low T without even testing you for it. Boosting your testosterone will increase your DHT and may accelerate hairloss...but again, this all goes back to testing your current levels and getting a detailed understanding of your current state (so you at least have a baseline). For all you know, you may already have low DHT and taking finasteride may not have as big an impact to slowing your loss. Also, taking a DHT blocker and a testosterone booster at the same time could swing your hormones outside the normal ranges. Maybe your loss is being accelerated by a skin condition, or by your overall health profile (since you mentioned you've already had a lot of 'health stuff'). You have to also remember that you probably should always be in optimal health before undergoing any sort of surgery, and that includes hair transplants too as it can impact results. I think you should hold off on any drugs, and start with a full hormone blood test (testing your Test, DHT, Estrogen, TSH, etc.) and check out a dermatologist (since scabbing on your scalp is not normal).

Photos are deceptive. Nobody here is going to give you an accurate assessment, and any predictions may send you on the wrong path. Everyone should always get an in-person assessment of their donor hair (with the surgeon) before committing to a HT. They can measure your hair follicle shaft thickness, they can measure the size of your safe zone area, and they can analyze your graft density (per cm2) in your safe zone area. They can give you an estimate of your lifetime grafts, and you should be able to make a decision based on the numbers.

Out of curiosity... What percentage of hairs shed when the scabs come off?...versus that 4-8 week period afterward? It seems like I always had at least one hair attached to a scab that fell off (during that first two week period postop), but once you take that first shower and all those scabs just naturally fall off, you don't really know how much actually had hairs attached. I ask because I am enjoying my newly transplanted hairline (and am at my current 3 week postop mark), but curious if what I am seeing is just a thinner version of what my actual hair density will look like (since I may have already shed a lot in the shower during that first scab shedding).

I'm curious to know what proportion of shed generally happens when your scabs come off versus the amount comes off during that 4-8 week period postop.

You posted this same topic two weeks ago. Based on your post history, it seems like you have a bit too much anxiety about (what seems like) normal hair shed and you seem to be spending a lot of time stressing too much and looking for flaws in the mirror. I don't think anyone would consider this a case of your 'HT being busted'. You are in your 30s and have a good head of hair, and a HT won't ever match that original density. I think the consensus on here is to not get another HT and actually enjoy the hair that you actually have (and not try and find variances in hair density by combing your hair in the least flattering way possible and spending your time staring at it by using a harsh bathroom mirror).

Steroid cream thins your skin, and I don't think it's a good idea to do that on your scalp. I was told to not put anything on my scalp and let it heal.

Same goes for me Dunes. I am at 3 weeks postop and haven't shed anything (other than some hairs that came out with my scabs during my first showering). I've been lightly rubbing and massaging my recipient in front of the sink to see if any are falling, and it's nothing so far. I fully expect the two of us to suddenly go bald sometime during the 4-6 week mark, then clutter this forum with photos in panic asking people "Is tHis noRMaL?!!".