Garageland

Baldagain,

Check out my results on my hairloss website I had the same dilemma as you. Dr Hasson lowered my hairline and softened it from 3 previous ht's in the 90's. In order to soften a hairline you need to change it's appearance and that is by placing lots of single hairs in front and around the old grafts. The only other option would be to take out the old grafts and then you have the risk of scarring in the hairline and you would have to place grafts in front to cover the scarring or wear your hair forward at all times.

Jin,

Thanks for the additional photos. The Crown is opening up and I think you could be heading for a 6. The first photo of your donor again appears to be solid the other photos are too dark to tell anything clearly. I still think that the hairline might have to be shifted upwards so you can get better coverage towards the crown. Looks like you have good potential options though.

Tommygun,

You look like a 5A from the view in your mirror of the top and back of your scalp. Glad to see you are have started meds, if they work for you then it should hopefully prevent you moving into 6 territory. 4500 grafts would give you a new hairline coverage through the frontal area to mid scalp and a lighter density on the crown. 5000 would be even better.

Good observation the crown seems to have also improved I know the patient is on meds and was at the time of surgery. I will dig to find out when he started the medication and get a shot of the back of his head if we have one.

Hello Garageland.

What can you tell us of a change in personality do you notice a vast change in apparent happiness,smiling more ect ect because with results such as this its got to be world changing for the patients.

If their happy its a job well done.

Have a good day

Good question and overall from what I have noticed it is a general confidence that people have. It is difficult to tell if they smile more as usually when they come for a consultation they are very nervous and uncomfortable discussing such matters. It is great to see a big smile on their face once the new hair starts to grow in. I think that repair patients who can get a successful turn around from their previous situation go through the biggest change in personality. We all know the familiar story of not going out without a cap, avoiding social situations and becoming a recluse because of how they look and I experienced these same feelings.

Hairsearch- Sorry I missed your question. I don't have the size of the recipient area but in measuring many patients with this level of loss the area tends to be in the range of 175cm2 to 200cm2 but depends on the size of head, where the new hairline is set and how far the sides have dropped. My area of coverage is a whopping 236cm2 and that is not including the area where my crown dips down just the area I have had transplanted.

Can't decide, I have medium brown hair and pale skin here are my temporary SMP pics taken the day after in my crown. I think it looked even better when the hair was a bit longer either way it did make a nice improvement whilst it lasted.

Can't decide I also had it done in my crown to add the illusion of better density. You can see my photos in my blog on this site. It worked really well and looked amazing initially. It has all faded away since.

This Vancouver area patient was in his early 30's when he came to see Dr. Hasson regarding hair restoration surgery. 3888 grafts were dense packed in the hairline and frontal zone to create this result just short of 11 months post-op. 1275 singles hair grafts were used along with 2323 doubles and 290 3-4 hair grafts. The strip size was 30cm x 1.5 cm.

We knew going in he was a good candidate and would have a great result and needless to say no one was disappointed in the outcome.

Free consultations with Hasson & Wong representatives in the following locations.

New York March 16th-20th, Miami March 28th-29th, Toronto March 21st-22nd, Manchester March 21st.

Sorry guys I don't know this patient personally I will try to find out some information and an update for you.

Thanks very much for your comments. Fortune you pretty much hit the nail on the head with your comments about him with the 80's movie star I like that, and if you could see his face the change is even more startling.

From all the results that I see in person and in photos over the years the guys that get the biggest transformation are those that have lost everything in the front. There is huge potential to drop 10-15 years in their appearance by restoring a hairline and frontal zone.

Great photo Voxman! Good luck with the next procedure I will be following your progress with interest.

Hopefully EJ will see this thread as he has had extensive beard hair work with Dr Bisanga. I have met him he looks great.

Congrats on your recent surgery David and for the excellent documentation and photos. Healing all looks great and I look forward to following your progress. As others have mentioned the scar also healed very well from your previous surgeries and with your colouring I don't suppose it was an issue for you?

Sounds like an interesting party! As others said I am sure you will be fine at this stage.

You should email them again or pick up the phone. One and a half weeks is too long to wait and perhaps the clinic didn't get your email or the person you have been dealing with is off sick or on holiday.

Hey PMA, you have got to the stage where it starts to get interesting and the next 3 months will be more enjoyable that the last.

Thanks for putting up the 3 different photos I think it empathizes brilliantly just how different light makes someone hair look vastly different.

This patient in his early 50's from Vancouver first came to see Dr. Wong when he was 37. It took him well over a decade to finally have surgery. The transformation is quite remarkable and if you could see his face he almost looks in his 30's again, ok 40's :-)

With 5162 grafts ( 1307 single hair grafts, 3231 - double hair grafts, 624 - 3-4 hair grafts, strip size 33cm x 1.8cm) Dr. Wong was able to give essentially complete coverage. These photos were taken 1 year from his surgery.

Free consultations with Hasson & Wong representatives in the following locations.

Seattle March 3rd-12th, New York March 16th-20th, Miami March 28th-29th, Toronto March 21st-22nd, London March 13th, Manchester March 21st.

Torn,

Thanks for posting the updated photos, in my view you should wear your hair back as it immediately gives better coverage and the area behind the hairline which is just called the frontal area btw looks fuller as a result.

If you have the laxity and you need the most grafts then another strip followed by tapping out the donor with FUE that will get you the most amount of grafts. But that will depend on the location of your existing scar(s)

Looking at the hairline you will probably get away with not taking any old grafts out although the temples have been closed off a bit aggressively imo but the trauma to the skin would most likely be too great to take them all out. I would beef up the hairline and work back through the frontal area to the mid scalp if donor allows.

You should loosen up your scalp with exercises for a couple of months and see if you can get 2500 plus. Some donor shots will determine better the numbers possible.

Lots of information in the sticky at the top of the page.

Spex wrote this some time ago take a look it has some useful and relevant info in there.

http://www.hairrestorationnetwork.com/eve/145591-hair-transplant-tips-info.html

If you are going for FUT/Strip then scalp exercises are recommended as they work. If you can do 1/2 an hour every day for 2 months. Some people have naturally very loose scalps and this is not a requirement but still advisable.

If you have limited movement then you must do as much as you can.

Good luck.

Hairline is really taking shape now Squatch and the improvement is clear to see already. Nice to hear that the hat gets some days off now.

Bump for the video that I promised.

Welcome to the forum.

You appear from the photos to be a decent candidate albeit a couple of issues. Firstly I can't see the back of your head to see how much the crown has opened up and what the donor is like. When it comes to restoring patients with extensive loss like you it all becomes about the donor.

If you can post some photos of the back of your head it will give us all as idea of what might be possible as at this stage or it is just guess work. From the donor hair that I can see at the sides it looks promising.

If the donor can support a large number of grafts being moved over a couple of sessions then my issues are the height of the hairline currently. You have maintained your low juvenile hairline now again I can't see how high it is from your brow but it looks to be quite low maybe 5-6cm at a guess.

Restoring the new hairline at this height would be a bad idea imo as you have so much coverage required as much as you probably won't like the idea as you have gotten used to this low hairline you need to take it up 2-3cm and rebuild a mature hairline or you just won't have enough hair to get back towards the back of your scalp.

I would still consider meds in your case you look like a 5A currently but that might end up being a 6 as the sides can drop further and the crown can open up. Doctors will provide surgery for you without meds as you are 39 and have lost most of what you have got but there will be more hair loss in your case.

How many grafts you need will depend on the size of your head, the caliber of your hair, if all is average then upwards of 5k would get you a coverage through the new hairline and mid scalp and approaching the crown. A second session is likely if you want to deal with the crown for more than anything but a very light dusting. I think to get good coverage you will need 7-8k depending on where you position that new hairline.

FUE or FUT look around the patient and clinic results section for guys in your position with advanced loss. There are many people that will tell you which way to turn but spend some time on the forum and work out what is best for you. I wish you all the best.

Sorry to hear about your situation and that no one has reached out to help but the photos are not great to be able to offer advice on what might be best for you.

Only photo 3 shows me anything. It looks like the you have quite a dilemma.

I agree with the options that you have to either add density into the immediate hairline by placing single hairs around the old grafts to make this area more natural. The down side of this will be that the mid scalp which is already looking thin will look even thinner in contrast and it will still be as it is now a unnatural pattern of loss.

Ideally you would have enough grafts to do the above and add density into the area behind and the mid scalp. You may be limited on what you can get again with strip as you most likely have several scars and limited laxity?

The other option would be FUE if your laxity is limited again the number won't be great as you will need to keep more donor hair to cover existing scarring in the donor.

I would need to see clearer photos of the hairline with the hair pulled back to expose it and some of your donor area. Cases like yours really need in person assessments and whilst it might not be the most convenient thing to do it is essential in your case.

If the old grafts are too pluggy and you don't have enough donor to fill in the front and mid scalp the other option might be to punch out some of these of grafts so you don't have this rim of hair in the hairline. Again this should be done in small sessions and you need to get advice from in person consults.

If the hair is viable it can be trimmed and redistributed behind the hairline.

I think you should get your donor evaluated by other docs as you might have more than 1600 grafts. I had a similar case to you with mini and micro grafts into the hairline.

I think this underlines the need for EVERY patient to take clear consistent and regular photos of their hair before surgery and during the first year and more to monitor growth and potential loss of native hair.

I think it makes sense to do this to monitor how stable you are before considering surgery. Being able to see in photos how much hair you have or have not lost over a period of a year is essential.

FBO- I wish you all the best with what you do next I would suggest some in person consults to work out the best approach.

No problem I know how stressful it can be as been there and done that 5 times now. I wish you all the best with your surgery and I hope you have a great result.