Al - Moderator

I have my next hair transplant scheduled for March. I wanted to go much earlier, like in December, but life got in the way and I was working 6 days per week all Summer and wasn't sure when we'd get (and keep) new hires to lighten my work load, so because of it all, I wasn't able to get a chance to have a follow up consultation and decide what to do next until just a few weeks ago. I did let my beard grow a few days last month when I had a few days off to see how much hair I still had left there. I don't have time right now, but I'll come back in a day or two and post some pics.

I don't think I've seen this thread before, but now that Melvin pointed me to it I read through all of it and I'll add a few questions and comments. @Tony711 you said you had about 2300 (I think that's what I read) grafts done years ago. Did they grow at all? Did they fall out within the first few years? Did they fall out slowly over the years as your donor area thinned? Either way I think there should have been a much smaller HT done on you to see how it would turn out. I'm thinking it should have been half of what you got, about 1500 grafts. The area covered could have been the same as you have, but the grafts should have been spaced out more. Why am I saying this? Because since you had 2300 grafts done prior and no real hair to show for it, you needed to (1) Find out if there is any other cause of the hair falling out and (2) since you now have a lot of scars from old grafts, you need to allow some extra room between grafts to allow for better blood flow and nerve reconnection which may both not be optimal from previous transplanting. That was my thinking when I started my own repair, but I had a lot more scarring than you as I had multiple scalp reductions, hundreds of spaces between grafts punched out and sewn closed to try to eliminate space between grafts, and many many punch grafts. I was very reluctant to use up half of my beard and chest hair just to find out it didn't grow in and then what would I do next. I know this doesn't help you now, but I just wanted to comment. Yours is a very depressing case, somewhat like my own. I hope you still have enough grafts left to get a big improvement. If you decide to try again, I suggest you only put a small amount of grafts in the area that didn't grow rather than try to dense pack it again and get the same results. It's tough having to wait just to see if a small amount of hair grows, but it's better than waiting and still only a small amount grows, yet you wasted all of your donor and paid a lot more money for it.

It's what I always say. Crowns do matter even when you think it won't bother you so much. Once you get hair in the front and see a bald crown, suddenly the crown is a much bigger problem to you then it was. A few hundred beard grafts in a U shape along the crown hairline would really finish this off.

Wow! Incredible results, Melvin.

You've had a pretty good improvement from where you were at the start. I don't think you could ever hope to get anything resembling dense hair with how much loss you had to start with. If you've got it stabilized where it's at then perhaps it's time to look into a hair transplant.... unless you are happy with the improvements you've had and staying at that level. There's nothing wrong with that. If you feel fine with it then that's all that matters.

There's always going to be some degree of these, but it's going to be much less with better Drs. It depends on skill and how much they actually care to do quality work. For example, a clinic doing multiple HTs per day and just trying to get them done as fast as possible is probably going to have more issues. It also depends somewhat on punch size. Smaller punches make it harder to get grafts out intact, but this goes along with skill. There is also a factor of the patient physiology. I've seen some patients where the grafts just seem to pop right out on there own and on the other end, some people's donor grafts need to be dug out.

You need to wait several days or else you risk grafts coming out or getting infected. You can/should spray the area every few hours with a saline solution using a spray bottle to keep the area from getting too dried out and also help remove any dried blood. You should ask your Dr for exact instructions. They should have told you or given you written instructions of what to do.

A few days after surgery your head is going to be swollen, so you are not going to look right. There is nothing to worry about. It will all go back to normal shortly.

Wow. Even your crown is starting to look pretty good at this point. Another session may make you look completely full. Good luck.

I live in the USA, so I'm not sure how it works exactly in the UK, but it's probably very similar. Here you would go to your primary care Dr and just tell them you need blood tests done and give them the list. They may say you need to have a complete physical as they may only do some of those blood tests as part of a physical which is fine. It should be pretty easy. It's not like you'd be the first person to need blood work done for pre surgery.

He had a lot of grafts. I really wonder what the donor area looks like.

I agree with all 3 of your statements. However if it grows well then the patterned placement may not matter because it's dense enough that you won't be able to tell. The hair line too low and the angling to one side will both be issues for sure though.

The short answer is it will most likely be easily noticeable. However it really depends on how much area you are covering, how many grafts you will use, if you have enough hair to hide the area, etc. We would need to see pictures to give you a good answer. You may be able to get away with it simply because they haven't seen you in years, so they don't really know what you looked like before the HT.

5 days sounds about right.

For everyone who feels this site should review Drs yearly, I say this is already happening. That's what honest, actual patient accounts of their hair transplants are all about. We get real reviews of the Drs. If there seems to be too many verified actual bad reviews we can suggest the Dr be removed and the moderator/owner of the site should make the decision. This is what happened with Dr Diep. If the site owners decide to keep bad Drs then it jeopardizes this entire site and thus their entire income flow, so it isn't in their best interest to keep bad Drs I know there have been other Drs removed from the recommended list over the years as well for the same reasons, which is that they got sloppy and were no longer producing consistently good results, so it works. Did it take too long for Dr Diep to be removed? Perhaps, but there is no perfect way to ever do this. In fact there were several people still voting to keep him, so it's hard to say if this site should have acted sooner if there are members who post here who are happy with their results from him. How would you do yearly reviews of every Dr anyway? You can't force people to post reviews. Is it right to remove a Dr simply because nobody posted a review of him/her in the past several months? that doesn't make sense. Sure there is a lot of mention of certain Drs but I've seen that change over time. You get one or two people who post a lot and had a great results and that Dr gets mentions for the entire year about how great they are which keeps more people going to that Dr because the name pops up all the time and the cycle keeps going. Does that mean that Drs who people haven't gotten all excited about aren't performing great work? That's crazy to think that.

Are you suggesting we recommend or not recommend Drs based on how many people post reviews of them? All you're going to do is make this forum be filled with paid fake reviews to make Drs look good, so they can be on our recommended list. Once that happens this place is useless.

Don't assume the pattern is going to stop at the point you are at now. The area can expand to the sides and down the back of your crown. You still have a lot of hair in the crown area that is thinning. It would be best to keep that if you can.

Cocaine is fine. Just don't take Finasteride. That stuff can kill you. 😆 Seriously though, I never understand why anyone wants to take illegal drugs.

I highly doubt you will be happy with a hair piece. You don't have enough surrounding hair to support a decent look in my opinion.

As far as the design, you will need to build up the sides. You can't just add some grafts in the frontal 3rd to get a hairline that looks good buzzed and then have those very low sides. It would look OK if you were NW 6 with high sides and just got some grafts towards the front, but it will look silly and worse than you do now with nothing on the sides.... and believe me I know what I'm talking about here because I have that problem and I'm working hard to eliminate it because it is so horrible looking.

I am an extreme NW 7 with hair loss similar to yours except I had a hair transplant when I was a lot younger and still had a large donor area. If I was already at your point when I was starting I probably wouldn't use any scalp donor at all, at least at first. You have very little usable hair on the sides and back of your head. If you are looking to have a buzzed look, so you can get away with using less grafts, then you need to look at using beard and chest hair. Do you have a lot of hair in those areas? You don't want to try using any scalp donor because you don't want to be creating any FUE scars that could make it look worse rather than better. If you can get 8000 chest and beard grafts then you may turn out OK, but it's going to cost you a lot and take several years to get there. If you don't use any scalp donor then it may be worth trying because you may not have much down time. Your head is already shaved, so you don't have to worry about having a shaved head after the HT, you won't have a bad looking scalp donor area because you won't be using that, beard donor heals very fast, so that's not a big issue. I've had several beard donor sessions and I go back to work in a week to 10 days without anyone really noticing. Chest donor is even less of a worry because nobody sees that in normal daily life. The only real down time/ugly duckling risk in this case depends on if you get a lot of redness in the recipient area or not. You could try a small session to test that.

Just because someone can't give you scientific information on why or how something happens, doesn't mean they don't know it happens. With many things in life, if you spend enough time on something with all different scenarios, eventually you will have a good idea of what works and what doesn't even if you don't know anything about the science behind it all. A 10 year old can sit at an airport all day watching airplanes take off and land. At the end of the day he will be 100% sure that planes can fly even if he has no idea how or why.

Long term cases are always hard to evaluate. If you look at "Before" pics from 1999 and compare that to the hair transplant a person had back then, you don't really get the true reality of what that person would look like today if they hadn't had the transplant. For example, in this case the "Before" video and pics of Elon are from late 1990s. You have to assume with how much hair he lost at a young age that he would have much less hair today if he did nothing. So you have to try to imagine what his hair would be like today if he continued to lose hair for the last nearly 25 years and then compare that idea to what he actually looks like now. When you think of it that way, I think he looks incredible. By the way, He is also a good example of a long term hair transplant result for those who ask that question of how long does a hair transplant last.

OK. I'll agree with that. I'm scheduled to get another 600 or so grafts in a couple of months. If my thinning crown was a lot smaller area then I'd put all the grafts in the front half to thicken that up. I wouldn't mind having a thin crown if it were a much smaller area and it would make more sense to thicken up the front as that would look much better. As I said, the perception changes as the crown gets larger and thinner. I am an extreme case with a very large NW 7 crown area to cover, so where I am now, it would look better to put most of the grafts in the crown. I wish it wasn't that way, but that's where I am. But there are very few guys in my predicament, so I can see why most would want to add the grafts to the front. Again, the thinking changes as the crown area increases. So you should always be thinking long term and try to save a few grafts for later. Interesting conversation.

I'm curious.. and this is an honest question. I'm not trying to say you are wrong... But do you have a balding crown now? Most guys think they would prefer a balding crown until they actually have one. Do you think you would you feel the same if you had a NW 7 completely shiny bald crown? Again, honest question because I think I'd probably choose the better hairline if I had little to no crown loss too... until I did have crown loss 😔