Al - Moderator

Thought I'd link to a recent case of a 65 year old who had a hair transplant by Dr Damkerng Pathomvanich. This shows what a nice improvement an older gentleman can have without trying to get with a head of hair like a 20 year old.

Nothing unusual looking so far which is good news. Yes you should be rubbing the grafts when you wash your hair at this point, but don't try too hard to get them all off at once. You may get a few that want to hang on a few days after the others are gone. That's OK.

Adding to my previous post... over the past few years I've become a big fan of using body hair because it lasts much longer than scalp hair. For men who become NW 7s or even men who just start thinning all over their head as they get older, over the long run the body hair transplanted to your head is going to far outlast the scalp hair that was transplanted. I've been losing scalp hair for the past 40+ years yet I'm still gaining hair everywhere else.

The old transplants may have worked at the time (at least as far as getting growth), but his hair has thinned out so badly which means the transplanted hair would have thinned out just as much. You can see he has a few wisps of hair still growing over the top of his head when the Dr combs over it. The back is very thin, but the top will be even thinner because those grafts would have been spread out over a larger area than the small area where it came from. I'm in the same situation. It isn't as noticeable on me because I started repair work 10 years ago before it got so bad that I didn't have any transplanted hair left, but if I hadn't had any body hair added over the past 10 years I'd have almost nothing left throughout my entire original transplanted area right now. Here is a picture I posted of myself some time ago. It's a bit blurry, but you can see the many rows of scars with almost no hair around them because the retrograde balding went up so far. This area was once full of thick hair which is why hair was taken from that area.

This: and this Yeah if you can do it as a fashion statement or part of your outfit and coordinate different hats with what you are wearing then you can pull it off. If you are going to wear a hat then this is the way you need to go. I think most guys don't think this way about it, though. They just throw on a baseball cap and that's it. I do think most people who see you regularly will get the idea that you are bald under those hats, but if you are trying to date I think women won't care as much if you seem stylish rather than just wearing baseball caps all the time.

Right. Exactly. It actually holds you back from doing things and living your life. I used to panic on windy days worrying if my hat would fly off. I was not attending events such as weddings and funerals because I had to wear a suit. I am so glad I stopped wearing hats and hiding under them. I did a complete turn around and since then I've had a job where I wear a suit and tie every day. The hair loss still bothers me of course, but I no longer have that afraid feeling of someone seeing me... at least not as much. I still hate people seeing my ugly bald head 😔 but it's not as bad.

Yes. That is part of the reason I'd rather not get started on using concealers. I'd just end up in the same place I was with hats where I'd be afraid of going out without it... and what happens when people you know just happen to come over to your house while you are there relaxing without anything in your hair. Nope. I don't want to be panicking all the time hoping nobody finds out.

Hi @hairchr, Welcome to the forums. Take a look at our recommended Drs on this list: https://hairtransplantnetwork.com/best-hair-transplant-surgeons Some clinics don't like to do small sessions, so even if you only need a small amount of work behind the hairline, they may try to talk you into recreating a new, lower hairline, or worse yet, not even discuss it with you and create it anyway. I'm not saying the clinic you mentioned in particular will do that (I don't know), but be careful where you go especially if you are already questioning going there due to bad reviews.

Did Pittella say how many grafts he did on this patient?

It's a crown whorl. All the hair grows away from each other in a circular direction at that spot, so you are able to see your scalp in the center of the circle.

Thank you for getting back to me on that. I personally prefer subtle temple peaks as was done in this case which is why I was curious as to how many grafts it took.

I had a pretty good amount of 2 haired grafts taken from my chest and abdomen. Not nearly as many as if it was scalp grafts, but it's still a lot better than if they were all single hair grafts, so the number of hairs, at least in my case, would be a good bit higher than the number of grafts.

Well... if it's a tech driven clinic where the Dr just shows his face once in a while during the procedure then I'd say the techs are the most important because they are doing all the work. But if the Dr is designing the hairline, extracting the grafts, and making the incisions, then the Dr skill is extremely important. Of course the techs would still need to be great too because they are handling the grafts and usually they are the ones implanting them, so really in most cases it takes a great team that works well together.

I like the subtle temple points as well. I never had thick, far forward temple points, so I wouldn't want them, but I do need to add just a little so it isn't recessed so much now. I was looking at this case and thought this is the idea I am going for. Just a small amount

This was a great discussion. Take a look at our next discussion about wearing hats and tell us your thoughts.

This weeks topic: Hats. Should you wear them or not Last weeks topic about shaving your head led me to think about hats. It was mentioned that some people try to hide their baldness under a bad combover and I thought about hats. A lot of guys wear hats to hide their thinning and balding. So... what about it? Should we stop wearing hats or should we wear them with style and try to match them to our outfits. My own experience was that I never wore a hat to hide my balding head before I got a hair system, but that changed after I got rid of the hair system to get a hair transplant. Once I took off the hair system I was almost a NW 6, so I went from having full, thick hair with the hair system to NW 5 / NW 6 instantly. At 22 years old that was just too much for me, so I started wearing a hat all the time while going through the HTs. After the HTs I was left with donor scars all over and very little hair actually growing from the HTs, so I kept wearing hats trying to find some solution. Then one day I was heading out with friends and it happened to be a place where an old girlfriend was working and I said to myself I'm not going to wear a hat around her, so I didn't wear one that night. That was the first time I went out without a hat in years. Shortly after that I set up a date with a girl through an online dating site and again I said to myself, There's no point in hiding under a hat. If the date goes well then she'll have to see me without a hat eventually....then what? So I didn't wear a hat that day and we ended up dating for 7 months. I've never worn a hat to cover my scars and balding head ever since except when I go for a repair hair transplant because it's just a mess. But once the scabs start coming off in a week the hat is gone again. I think most guys are better off not hiding under their hat because it just holds you back. You are always worried about what someone will think if you take off your hat. It's better to let them see what you really look like right up front. What do you guys think? ---- To see the previous discussion about shaving your head, go here:

This turned out really well, especially since your donor wasn't great to begin with after the first surgery.

If I was just starting out on my repairs then I would absolutely be interested in Dr Pittella. However I've already used near 6500 beard and chest grafts which have grown in pretty well without ever having to shave my head and being able to go back to work each time within 7 to 10 days after the HT. That strategy, although taking a long time to get where I want, has worked for me in terms of not disrupting my life at all without anyone knowing I have had any surgeries unless I tell them. I've had no issues with Dr Dorin and his staff, so far. I think I can still get 2 more sessions done and if I can get as many grafts as I'm hoping, then I think I'll be very close to where I was hoping to get, so at this point in time I think I'm better off staying with what I've been doing. However if I get turned down for any further surgeries and feel like I'm still not where I need to be, then I will definitely look at Pittella and possibly a few others. It's good to know there are still possible options.

It's a little bit low, but to be fair, it's not fully 2000 in the hairline as they did scatter some grafts throughout the midscalp, so you may be fine. You'll need more grafts there eventually as you're thinning there, but you didn't really use up a whole lot in the hairline.

I'm seriously considering of using some arm hairs to recreate my temple points and will probably try that if the Dr agrees to do it.

I will definitely follow this one. I never had an instagram account and never cared to have one, but I just signed up so I could follow this case. This guy is almost identical to myself if I didn't have any beard and chest grafts done... extremely huge area to cover, very thin donor area with multiple scars from previous HTs, very little hair still growing on top from the previous HTs due to the greatly expanded area over the years as well as the extreme thinning, and using only body hair to fully repair as much as possible. This case is probably as near as I've ever seen to my own. I really want to see how this turns out.

I think it looks good.

I think there was a short video on this a long time ago. I think it was from Hasson and Wong. I wonder if I can find it. EDIT: OK. Here is the one I was thinking of. The video on this page shows you how to improve scalp laxity. https://hassonandwong.com/scalp-laxity-exercises/

Some Drs like the untrimmed "beefier" grafts. They are less prone to damage when handling them and implanting them. Thinly trimmed grafts are very fragile and can damage more easily. However, trimmed grafts can be more easily dense packed. I personally think larger graft sizes generally have a better long term survival rate, but that's my personal opinion. I don't know of any actual statistics or studies on it. In any case, what matters most is the Drs end results.

How old are you? I think you should probably stay on meds for a while and see what happens. You have minimal hair loss right now. I personally would not go for a hair transplant if I were you. However, if you were going to do it I don't think you'd need more than 1000 grafts. I don't have an issue with FUT, but I would probably go with FUE for such a small procedure. If you're doing minimal work then there's no reason to create a linear scar.