davidjosepha

It definitely accomplishes that! It's not at all thin, but it's also not unnaturally thick (which doesn't look great at any age, but the older you get, the more conspicuous it is). It's difficult to tell without seeing your face, but from your skin and hair, you look like you've aged very well — in a 'mature but well taken care of' way, not the sense it sounds like you're worried about.

Looks superb! I'm admiring the detail with how the hairs in different areas are placed at different angles to create a wonderful (and extremely natural) flow. How do you feel about it? Everything you were expecting?

Thanks, ALittelTeal! I'm quite happy with how it's going. It still feels a bit thin on the right side, which has become more obvious as it's grown out -- not the thinness directly, but more so that due to lower density, the hair doesn't stand as high compared to the left side. It feels a bit wiry which I think is typically a problem that resolves itself over the 9-12 month range, but we'll see. Either way, I'm extremely pleased with the result. Ten months (4/20/24) Had to try on a suit to make sure it still fit for a friend's wedding coming up and figured I'd take update pictures while I was at it. Please ignore the up-turned collar, as I apparently did until cropping the photos just now. Also need to clean up my beard, it's been getting rather disgusting lately.

Nine months (3/31/24)

Quite late updating, but I did take pictures monthly, just kept putting off posting because I've been wanting to add comparison pictures of hair at certain lengths prior to the surgery, but it's a whole lot of work finding pictures of me sober (and also show my hair at a given length) for the few years leading up to the FUE and I don't really want to put up pics with that dead look in my eyes. Still might find and post comparison pics at some point but I don't want to wait till I do to continue posting updates. Eight months (2/26/24)

Thanks Gatsby and baddecisions! Agreed that natural-looking is best. Upon looking a bit more, I think the notch in the front right isn't a problem, although I still do hope back left fills in a little more, even if it's not completely uniform density with the rest, particularly because it's the 'focal point' of how I part my hair when it's long. But whatever happens, happens! Yep, I've decided to allow the top to grow longer after the 6 month mark as suggested by Steeeve. Going to continue to cut the sides and possibly trim the top just to even up growth, but planning to allow it to get significantly longer. Good point. I've been trying to find some pictures of myself pre-transplant with hair length comparable to the updates so far (2 guard and 2 guard + one month of growth), but I'm not sure I have any that show things clearly. For several years, I was mostly trimming to 1/2 guard all around, or 1/2 on sides and 1 on top, then last year after scheduling transplant, I started growing it out just to get an idea of what I'd look like with hair, but I may have missed taking any pictures in the period where hair was at around a 2 guard. I'll keep looking, and I do have a decent number with it a bit longer that I can add to future months' updates for a more direct comparison.

Thanks guys, and apologies for the delayed update, but here it is. ~Seven months (1/31/24) Haven't trimmed my hair (or beard) since last update, meant to clean up the sides a bit before the update pics but since this isn't a beauty contest, I figure you can still see progress on top of my head regardless. Still some weakness on sides, most noticeably the larger indent in back left and the smaller indent on right near the peak which I'm hoping will fill in more, but even if progress stopped entirely today I think I'd be quite happy with the results (although I'm glad that I've still got several months of progress to look forward to!). Apologies for the inconsistency of my head angles in the front-facing shots from update to update.

I would say it's a quite good result. I understand it not being everything you hoped for and I don't blame you for being disappointed, but I think it still looks quite good, and definitely a huge improvement from before the surgery. The 'bonus photos' are interesting, they're not what I would have expected seeing the other photos, which look significantly better. However, your hair is 'combed' (by means of the hat) in a way that doesn't look as good as it could, even ignoring the hairline issues, so imo the problem there ends up being 'if I don't have my hair styled optimally, the thinness of my hairline is more noticeable'. It'd be great if you didn't have to think about that at all, but I wonder whether you can work around that just by being careful about how you style your hair, and when wearing a hat, put it on such that your hair is pulled back, rather than to the sides. You also may want to consider keeping the sides shorter so the contrast does some of the work for you. There are folks on this board who put in a whole lot of work every day to have their hair styled such that the thinness isn't noticeable, and unfortunately for many, that's just the reality of the situation (see Melvin's post on transplants being an illusion of density). You're lucky to be in a position where you could likely make the density a reality with another surgery, but I understand if that's not the route you want to go down. If it were me, I'd probably look into filling in the front a bit more (particularly the front left), but I also wouldn't feel self-conscious about where it's at now. Congrats! And I'd also be interested to see an update in 3 or 6 months to see if there's any change. I wouldn't count on it, but sometimes there are still improvements to be had past the 12 month mark.

Thanks, guys. I'm slightly worried the right side is weak in terms of number of follicles that have 'sprouted' near the hairline. I realize that each follicle will strengthen / thicken over time, but supposedly around 80% of the follicles should have broken through the skin by this point, so unless the growth is quite unevenly distributed, seems like even with potentially ~20% of the follicles left to go, it'll probably be a bit weak. But that's the side I combed over when I still had hair, so probably won't be too noticeable. Overall very happy with progress and excited to finally let the top grow out a bit!

Thanks Steve and hybonix, I cut for the 6 month update but going to let it grow on top from this point. Let's see how it goes! ~Six months (12/30/23)

Thanks for the side-by-side, that's a more dramatic difference than I'd noticed. Seems to be going very well so far! I want to be able to judge progress, which is why I've left my hair shorter, but I'm planning to grow it out a bit, just not sure when I should start that process. Maybe buzz once more for the 6 month mark, then let it grow after that point. Thoughts?

~Five months (11/30/23) Sorry for the delay, had a busy Thanksgiving. Pictures were taken 11/30. Hair cut to a 2 guard a couple days before they were taken.

Thanks for the confirmation on donor area. 'Looks completely untouched' is quite the compliment to Dr. Josephitis and his team, and a great reassurance to me. See below for more. And yes, I'm astounded at how much growth I've seen already this early. I believe I've seen a fair bit even since these last pictures, but I'll wait till ~11/20 to take and share more. My parents were visiting me last weekend and my mom commented on it seeming like my hair was really filling in, and she'd seen me just a month before that, so she had a good source of comparison. Thank you, I've been pretty happy with how it's looked as it's grown out. I've never had a beard get this long before without being a complete mess. I unfortunately took off more than I intended a week or so ago trying to even things up, but it'll grow back. Donor area (11/9/23) After the comments about my donor from jwolfe and steeeve, I decided to just go for it and trim my sides to 1/2 guard and see how it looked, as very shortly it will be prohibitively cold. Pay no attention to the top of my head, in particular the hack cut I gave myself this morning so I could take these photos. I see a couple marks that could be scarring from the surgery, but I have to look really close to see them; to me it's not at all obvious that anything was done there even at such a short cut. All in all, I don't think I'll have to think even a little about hiding anything, which is nice, as a 1/2 guard on the sides can be nice in the summer. But let me know what you think.

Thank you for the kind words, Silent and HairFunk. You got it. Four months (10/22/23) Some progress. The growth is more visible in the side shots than the front ones, I think, and more visible in a mirror than it is in the photos, but there's a decent amount of immature hairs filling in the gaps in my hairline and it looks like a few mature ones as well, although I could be imagining it. I see myself almost every day, so even referencing the older photos it's difficult to know what's in my head and what's on my head. In any case, I feel like my hair looks better than it used to at this length, and it's a nice feeling. (Nonetheless, feel free to disillusion me.) Freshly cut to a 2 guard all around, as was the previous month's update. I'm not going to include these every time, but this time I took shots of the donor area. It does look a bit patchy, but I'm not convinced that's necessarily a result of the procedure—I can find pictures of myself from prior to the procedure with similar patchiness after a trim. It may just be because my clippers aren't very sharp and it's difficult to trim the back of my head. I don't see any scarring, but at around the year mark, I'll trim down to a 1 or 1/2 guard on the sides just to see what it looks like. I believe I was told prior to the procedure that I shouldn't expect to be able to trim shorter than a 2 without the scarring being noticeable.

I am a new user but have been lurking on and off for years. I think this would be useful as a way for people considering a beard transplant to easily find progress threads that go into detail on the process and their results. I've vaguely considered getting a handful of follicles of my body hair (which is excessive) transplanted to a few small weak spots in my beard (where, for whatever reason, the hair is sparse), but it's hard to find details on the process anywhere. Even if the forum is quiet with infrequent posts, it seems useful to have it segmented off from other hair transplant threads to make it easy for those considering such transplants to find. Or, alternatively, is there a way that threads in the normal hair transplant forum could be encouraged to add a standardized tag (or mods could tag such threads) to make beard threads easier to find? Currently the tagging process is easily missed, and even users who add tags might use them inconsistently such that these threads are not easy to find. I would think that, given the relative rarity of even beard transplants, it may be best to combine all non-scalp transplants into a single forum, eg "Beard and Other Body Hair Transplants". (Can't find a way to manually add a quote while editing a post, but this is in response to JasonElva1990's comment around eyebrow transplants.)

The second set of pictures here (in the white henley) is the 3 month mark, or a week shy of it. I'll post an update in a couple weeks for 4 months.

As for number of grafts, I imagine 1000 more would be plenty to fill that out, but if you're worried about still not being happy with it even after a second procedure, and you're going to do the procedure anyway, I would consider doing a bit more on the front and getting some of the crown and maybe mid done as well. I don't know how pricing works with other clinics, but if it's similar to Shapiro (or if you go with them again, sounds like they may give a discounted rate), the price drops off a lot after a certain number of grafts (2000 with SMG). So you may want to consider filling out some of the rest while you're at it to save cost and to save yourself another procedure in the future. You do run the risk of using your finite donor supply in places that might never need it, but if you notice your crown thinning, there's a pretty standard pattern to how that happens that you can use to predict where it'll be needed.

I agree that it's not a perfect result—as has been discussed it seems like number of grafts was too low—but this seems overly pessimistic. This is where you were at before: And this is where you're at now: That is a night and day difference. Your hairline is a bit thin now, I agree, but you didn't even have a hairline before—you had a handful of miniaturized hairs where your hairline used to be. That is a massive improvement and it doesn't look half bad even in direct light when you're pulling your hair back. In dim light, it frankly looks quite good: I understand wanting a second procedure, and that's probably a good decision given you were hoping for more density, but I think you're being overly critical of your results or not entirely honest with yourself about how bad the front third of your hair was before the procedure. I seriously doubt you only had 60-70% yield—you just didn't have enough grafts to cover an essentially completely bald area. And you don't need to wear a hat; your hair looks better than half of 35 year old guys who don't shave their head.

I'm hoping so, since I've really started to like having my hair buzzed, especially in the summer. It'll just be nicer if it looks like a conscious choice rather than that I'm bald. Keeping expectations tempered, though. We'll see how it goes.

Thank you -- redness was mostly gone in a month (7/17 pics above), but the next photo I can find that clearly shows the scalp in decent lighting was about a month and a half (8/8) and I don't see any redness whatsoever. I think even at the one month mark, the redness was primarily there because I was scrubbing so vigorously in the shower to try to get the last of the hairs to fall out.

Gladly. Was going to post an update next week since that'd be 3 months, but I've got a busy week coming up so this is actually better, and I already took pics a few days ago for my own log. I also have pics from ~1 month after surgery that weren't worth posting on their own, but are good to show what things looked like after everything healed and most/all the transplanted follicles fell out, since I had significantly longer hair in my 'before' pics that make direct comparison difficult. I'll aim to keep a consistent 2 guard for pics going forward, but winter gets goddamn cold here, so it's up in the air whether I'll follow through on that for the full year. (Did I spend $15k on a hair transplant because I keep losing my $15 winter hats? I won't say one way or the other.) Both sets of pictures were taken approx. 4-5pm near an east-side window of my house (same place and more-or-less same time as my one and two week updates), but obviously sun path/angle changed in the two months between the two sets of pictures here and I have no memory of whether those days were cloudy or sunny. Based on the background and the hair on the sides of my head, though, it seems like lighting was reasonably comparable. Not sure there's any visible growth yet, although I have noticed over the past couple weeks the occasional light tingling in my scalp (like a sharp pain, but so minor it's a stretch to call it 'pain' at all) that I wonder whether might be a couple new hairs starting to break out of the pores. I'll aim for monthly updates going forward, but even if I forget to post some month, I'll still have pictures to post with the following month's update. One month (7/17/23) Can't remember whether this was 2 or 1.5 guard. ~Three months (9/14/23) Pardon the beard mess. Haven't bothered trimming it in... well, probably not since the surgery, to any significant degree, and I didn't realize I hadn't combed it before the pictures until after I'd taken them. Freshly cut to 2 guard all around. (forgot to take a shot with my head angled down midway between the above and below photos)

I know it's been a while, but this looks great to me even at the 8 month mark and I'm curious how things have been going since then, both the last few months of growth and then talks of a follow-up surgery. Do you have any photos from the 12 month mark or beyond so we can see how everything turned out?

Oh wow, I hadn't noticed that until just now. It's actually from my own name, used this username for years. I'd realized he and I share a 'David' but didn't make the connection that we share a 'Joseph' as well. Knew there was something about his name that sounded trustworthy 😅 Probably should have used a more anonymous username here but I figured if I'm posting pictures of my face, anonymity is predicated on no one recognizing me from the real world, which is probable but not a given.

Hey man, thanks for commenting on my thread about my transplant with Dr. Joe. I saw this thread yesterday while looking at Josephitis threads before I posted my own. I wanted to provide some feedback then but I was having trouble figuring out what exactly to say. After I saw your comment on my thread though, I figure I'll give it another shot. I apologize if some of this sounds harsh, but I think it's something you could benefit from hearing. Take from it what you will. I understand your disappointment and anxiety around the results, I imagine I will be feeling something similar over the next year as I wait for mine to grow in. But I really think you're jumping to conclusions and possibly have unrealistic expectations, and after reading your fin thread, you seem to have done the same with meds. You were basically bald at your hairline in your 12/21 and 1/22 updates, and by 5/22 you had a noticeable improvement, but from month 2 on you'd say you were disappointed with the lack of progress each update. You reported on May 1 no sexual side effects whatsoever, including no watery semen, then on May 15 you had a single bad orgasm and you stopped entirely, then retroactively decided you'd actually been depressed and anxious for an entire month and it must be related to fin, not the 'challenging life events' you mentioned, and reported feeling better immediately after stopping fin -- less than a week later -- which is not how hormones work. You started again two months later, mid July, at an even less regular frequency, and in August, a month later, you complained about your hairline thinning rapidly again -- which, of course it was! You were going through a shed. That's what happens when you start taking finasteride. You were on it 5 and a half months, not nearly long enough to grow healthy hairs, stopped for 2 months, and then you seemed to think you were picking back up where you left off, but you weren't; you were starting over. And a month after starting back on finasteride only twice a week, you scheduled your hair transplant, describing your results with fin as 'lackluster'. No, they weren't! You were getting great results for only 5 months on fin, you just stopped too soon, and when you scheduled the hair transplant, you were going through a shed! By October you were starting to see significant growth again, but then you stopped, and 2 months later started up again at just one pill a week, and seem to have stopped again another 2 months after that. You haven't gone on a finasteride journey, you've been going on a finasteride treadmill. Of course it didn't do anything for your hairline, you never were on it long enough to give it a chance to. Some advice on finasteride: first, buy a pill splitter. They're like $5, and you've spent literally a year and a half cycling on and off finasteride because you keep using 1 mg doses but at steadily less regular intervals, which is the worst way to do it both for results and for avoiding side effects. It's a much better idea to, for example, take 0.25 mg daily than to take 1 mg every four days. The latter is more likely to result in yo-yoing of your hormones. Second, yes, watery semen is an 'adverse' side effect, but it doesn't actually matter for anything other than getting a woman pregnant or painting her face, and it's subsided every time you've stopped, so you know it's fixable within a couple months by quitting finasteride. With that knowledge to comfort you, just stick it out for 6 months after you first notice watery semen. It will most likely resolve on its own. But if after 6 months it doesn't, and you really care that much about your semen consistency, go ahead, drop finasteride entirely. But starting and stopping repeatedly is not going to fix the watery semen issue, and it's not going to fix your hair. Back to the transplant. You say you expected better results because of your native hair: It will! Once it is done growing in! Why are you looking at your results at the halfway point and deciding they're not what you expected? Of course they're not, because they're not the full results yet. But you don't have any native hair there! Or, barely any. You've been off finasteride for months, any hairs you had there at the time of the surgery were shaved off or fell out due to shock loss, and you're back to where you started in Dec 2021, which is this: For practical purposes, that area is bald. Sure, there are a few hairs, but in terms of the density following the surgery, those hairs add approximately nothing. The reason for this is that you refused to stay on finasteride consistently because of your fixation with your sperm's texture. If you had stayed on finasteride for the full year like it was suggested you do, you might have had something there to work with. But right now, there's next to nothing, and you need to have reasonable expectations about what is possible with a single surgery when filling in completely bald areas. There is a limit to the density of follicles that can be placed in a single surgery without compromising the survivability rate of those follicles, and SMG is ethical in a way that many clinics are not; they will not waste your limited supply of follicles by packing them too tightly and having a third of them not survive. If you want to take a bald area and get a density that is completely indistinguishable from a natural, non-balding hairline, even under bright lights and while wet, you most likely need multiple surgeries. If you get on finasteride and stay on it for a year, based on how successful the 5 months you were on it was, it's likely that you will get some enough growth in that area to make a noticeable impact on the density of your hairline. But if you refuse to do that, you need to have reasonable expectations about what the results will look like, and I can pretty much guarantee you were briefed on all this, because 1) Matt Zupan made it extremely clear in his stock-presentation, which he gave me in 2022 only a few months off from when you met with him; 2) Dr. Josephitis brought it up as well prior to surgery; and 3) it was also stated explicitly in the forms I was required to sign before they could start the surgery. The goal is to have hair that looks natural under normal social conditions. Expecting a single surgery, even of just one area, that isn't at all noticeable when wet and under a bright light is just not realistic. But lastly, and most importantly, you are doing the same thing you did with finasteride -- ignoring the stated timeline and doomsaying about how the whole thing is failed and worthless. You are at month 6. As you quoted from the SMG info, you are only 50-60% of the way there. Look at this picture in insanely direct bathroom lighting: Do you see more skin or more hair there? Because when I look at it, I'd say around the hairline, 2/3s of what I see is dark brown hairs, and 1/3 is scalp peeking through. So if this is only 50% of the way to the final result, wouldn't you expect the scalp to be entirely, or almost entirely concealed by the time the whole thing is finished? Take a look at this guy who also had surgery with SMG. Left picture is month 5, right is month 11. Look how frizzy and sparse his hair is at month 5 compared to 11? Sure, you're a month later along than he was at the time, but his hair at month 6 is only a bit better than month 5 -- still nowhere near as full or solid as when he finished. And everyone's timeline will be slightly different. It's going to be all right. Your hair is going to continue to improve for another 6 months. You don't need to fret so much about what it looks like at any given moment. And it doesn't need to look perfect even when it's fully grown in. It will look great, but if you're focusing on how it's not perfect because some of your scalp is visible when someone dumps a bucket of water on your head then shines a spotlight on it, even 'great' will feel like a complete failure. If you really want your hair to be denser, there's one thing you can do besides a second surgery, and that's to get back on finasteride and stay on it. Cycling on and off finasteride doesn't result in any actual progress. If you get on it today, even 0.25 mg a day, and stay on it for the next 12 months, in 6 months your hair transplant will be fully grown in, but even after that happens, you'll have another 6 months of progress to look forward to after that as the finasteride begins to show real results with your native hairs.

Thanks everyone for the kind words. I'm going to write up a bit more about the process in the next couple days in case it helps anyone considering Dr. Josephitis / SMG. Nothing but positive things to say about the experience (pending the results). Thank you, it's a good feeling being back on this plane of existence 👽