Al - Moderator

This turned out really well.

I don't see any grays. It looks pretty dark to me. Your hair looks great.

Crowns take a lot more grafts to fill in than most people think, but you don't want to put too many grafts into your crown if you haven't touched the front half yet. You may not need any in the front now, but if your crown is bald it's a good bet that your front will follow soon. You need to save those grafts for the front.

I don't think it was that at all. Exactly.

Those beefy grafts and hairline look like a Dr Lindsey FUT procedure. I'm curious to know who you went with.

Just to clarify: I was talking about your case in general. It certainly could have been the Dr pushing you towards this and I wasn't trying to suggest it was your fault. Also as others have mentioned, you will still get some improvement over the next few months.

This is a very good FUT procedure. That scar is almost impossible to find. FUT can work great on guys who don't shave their sides and back all the way down. FUT takes grafts from the best, safest area as opposed to FUE which spreads out past the safe zone and is more prone to loss in a few years.

It only worked for me for a few years. After that my hair started falling out again. Was it actually still working by slowing down my loss more than it would have been? Maybe, but when your hair is still falling out even when taking finasteride, it's no longer doing what you need it to do, which is increase your hair or at the very least maintain it, so if it's not doing that, then I think that can be considered not working. I stopped taking it because I felt there was no point to it. My opinion is the more aggressive your natural hair loss is then the more likely it is that finasteride is going to lose effectiveness over time. Some people upgrade to dutasteride after a few years on finasteride.

I think this is a case where you tried to cover too much area in one transplant. I know it's hard to go through wth the surgery, spend all that money, take months to heal, etc, etc and then still have a huge shiny bald crown, but sometimes that's the best way to go as long as you plan for another transplant in the future. You are between a NW6 and NW7, so you'd need 10,000 + grafts to get a good result. Even with the 2500 grafts you had years ago, you're at 6720 grafts. That sounds like a lot, and it is for a lot of cases, but NW6 and up need more than that. Look at the picture below. If all of the grafts in the green circle were used in the front half instead, you would have a lot more density in the front half. You'd have a completely bald crown, but at least you would look like you had a lot of improvement because the front would have a lot more density. You would then have to go back for another transplant to try to get whatever grafts you have left to fill in the crown. I'm not trying to put you down or say you did anything wrong. I'm saying the transplant is working, but you were spreading the grafts out over too large an area to get significant improve anywhere. What you need to do next is wait another 6 months until you get to the 1 year mark and see how many grafts you can still get. I'd put those in the frontal half to thicken that up. Another 2000 to 3000 in the front half will put you close to the 10,000 number of grafts that your level of baldness generally requires.

Sleeping in a recliner chair with a neck pillow worked best for me. It kept me at a proper angle needed after the transplant and without putting a lot of weight from my neck onto the pillow.

Your donor does not look that great to me and you have a lot of area to cover. You need to go with a high hairline and see how many grafts you can get, how much coverage you get with those grafts, and how your donor looks afterwards. At that point you can then decide if you are able to go a little lower or not on the hairline on the next transplant.

Pimples happen in some people especially in the 3 to 4 month range, but can happen earlier or later too. Usually it's not a concern and should resolve on its own as the hair starts to grow in.

Here are a couple additional hairline FUE removals.

The one case I always think of when it comes to removing grafts from a bad hairline is Davy (link below).

Instead of lasering off the low hairline, you may be better off FUEing the grafts out so that you can transplant them further back. This will get you a few more useable grafts. There has been several cases posted on these forums of this being done and the scarring seems so minimal that it's not even noticeable.

I felt like this could use a comment. I'm wondering if it was actually poor growth or was it just that it wasn't transplanted dense enough. You only had 1050 grafts and that included temple point work which looks like it turned out very nicely, so it doesn't sound like very many grafts were put into the hair line on the first transplant.

You have really good temple points already. Why touch them and chance messing them up? There isn't any improvement that you can expect there. I can see wanting to thicken up the front, center a bit, but I would only be looking to add a few hundred grafts there. That's all I think you should do if you really feel like you need to improve it. Leave the widows peak alone. If you thicken up the frontal center area a bit then you won't notice the temple peak as much. You don't want to have a perfectly shaped straight (rounded) hair line. That is what will make it look like a hair transplant.

Even if your recipient will be in a different area you still have to think about the donor area. It takes a while for any shock loss to grow back in fully, so you're not going to be able to get a good, proper assessment of your donor until probably at least 9 or 10 months. If you know you want to do 2 surgeries within a few months of each other, you may be able to have the Dr work on one side of your head for the first one and then work on the other side of your head for the 2nd one. This way you won't have to wait very long before doing the 2nd one. I've seen that done in the past, but I think it's very rare now that Drs are able to get a lot more FUE grafts per session than they used to be able to. You don't want to take too many grafts from one area in one surgery, so whether that's an option really depends on how many grafts you are trying to get.

On myself it takes about 2 to 3 years for it to get to where it's very close to acting like scalp hair where you wouldn't be able to tell the difference except for a few stubborn hairs that don't want to fully give up their beard and chest characteristics yet, but they are slowly coming around. I've found that using a conditioner helps a lot in making it softer and straighter. I shampoo, rinse, then put conditioner in and leave that for a few minutes while I continue showering and then rinse the conditioner out at the end of my shower. That seems to work best for me.

Does the wife's family know you are getting a hair transplant? If they do then it makes it much easier. If you are only staying for the day you can probably just wear a Santa hat all day and get away with it without anyone thinking anything.

I agree with Gatsby and with your surgery scheduled for about 5 to 6 months from now, that should give you just enough time to really see how well the meds are doing. I said earlier I think you could get very good growth because of the hair piece covering it for so long. You say your first surgery is for the front, so you can just keep letting the meds work on the crown for a lot longer after that and see where you end up after another year.

Looks like it’s improving. Update us in another month or two.

Yes. Using more anesthesia can cause it to be worse. Melvin made a video about shock loss. Maybe him or someone else can post it.

Ok then you need to just wait a few months and let everything heal. You could have a lot of temporary shock loss which is normal. What happens is the surrounding hair falls out due to the trauma of surgery. It takes a few months to start growing in again.

If you’re looking at FUT then another option is Dr Blake Bloxham. I don’t think he does mega sessions as I think he sort of maxes out at around 3500 grafts, but you’d have to ask him to be sure. The idea is you go and get 3500 and then go back in a year for another 2500 to finish it off. The good thing about Dr Bloxham is he usually leaves patients with extremely thin scars. I think one reason is because he doesn’t try to get too wide of a strip that would be needed for a 4000 and up procedure. Wider strips have more tension when stapled back together which can result in the scar stretching im not saying Dr Wong is a bad choice. They do some awesome mega sessions there. I’m just giving you another option to think about.