TheHairLossCure

You should see more growth, ninjathen. As a general rule, full growth is seen at the 12-month mark. Even after the 1-year mark, the shaft diameter of the hair should mature thus giving you more coverage. So, while the improvement may not be drastic, I imagine that you will indeed see some improvement.

You really do have a nice, healthy head of hair. And I agree with the other posters ??“ enjoy it! Your frontal hairline is on the higher side. This by no means makes you appear bald, though. I wonder if you have male pattern baldness or a congenitally higher hairline. This information be would useful. In my mind there is nothing wrong with your desire to have a lower (but still natural looking!!) hairline. Your hair looks good??¦why not have it look better? HT work is, of course, surgery. And there are associated risks. So, I think the knee-jerk response with a young guy with a good head of hair is that the risk is not worth the potential reward. This is not always the case, though. You will likely suffer some long-term troubles if you aggressively lower your hairline. Still, some subtle work may be in order. You really need to have your hair evaluated by some elite physicians to see what the general consensus is. If the risk is too great, top surgeons will not take on the case. By ???top??? I mean doctors with both skills and ethics. If the risk is low or within reason, your doctor(s) must fully explain all the pros and cons of moving forward with surgery. At that point you can make a truly educated choice.

Concealers should not cause complications at 3 weeks post-op ??“ not in terms of the health of your scalp or the survival of your grafts. If you have hair in the recipient area, concealers should give a positive boost to your scalp coverage.

Shock loss, as you know, is hair loss that results from the trauma of surgery. You may notice some shock loss in the weeks following surgery. 3, 4, or 5 months post-op? No. Hair loss at this stage ??“ if you experience any, that is ??“ is the result of progressive MPB or some other cause. In terms of shock loss, though, you are in the clear.

I believe it could. If you keep chewing, even after the surgery, there may be complications from the toxins generated by nicotine. Obviously, smokers still get hair transplant surgery. Great results are possible. But I don't think anybody is going to say that chewing is going to contribute positively to your results. If anything, the impact will be negative. If I were you, I would stop for as long as possible. I know - easier said than done, right? Still, you should give your hair the best possible shot. Please discuss this with your surgeon. And good luck to you.

Strip lends itself to large sessions and dense packing, while FUE lends itself more to smaller sessions and ???detail??? work. Harvesting 2,000+ grafts in a single, relatively short day is routine with strip harvesting. You are not going to get 2,000+ viable grafts in a day with FUE. You can do consecutive days with FUE, of course. Please note: I picked the word ???lends??? carefully. Sometimes patients opt for small strip sessions. On the other hand, sometimes patients opt for large sessions with FUE. There is no hard fast rule. In my experience, both surgeries are effective (separately and in combination). Certainly there are surgeons who are radically for one method and against the other. If you do multiple consults with several independent doctors, I think you will see a trend and gain a more balanced view of what is appropriate for your own hair restoration.

That really depends. You will need to ask your surgeon. Scabbing should be a non-issue after a week plus. Redness/pinkness will still be a challenge though. You can go back to work after a week, but you need a strategy (i.e. a hat if possible, makeup over the visible pink areas, "creative" hair styling if you have strong hair surrounding the recipient area, etc.)

Someone may notice the pinkness. The question is, will people recognize the pinkness as the result of HT surgery? I can't imagine they will. You should discuss with your clinic the idea of blending away the color with makeup.

???It is hard to really give opinions blind.??? True. I would only add that hair growth following a transplant is irregular. That is to say, not all the grafts begin to grow at the same time. This may be the reason you perceive some patchiness.

Latin, I think you might have misunderstood me. I am not suggesting that you or anybody else should accept 100 fu/cm2 as ???the average??? donor density. I was merely stating that some previous literature has described 100 as average. I would describe it ??“ 100 fu/cm2 ??“ as very good, but not off-the-charts. I would add, though, that different doctors have different ways of calculating follicular density. There is such a thing as a ???follicular cluster,??? which might be considered as different from a follicular unit. That is, a ???cluster??? of four hairs, for example, might be counted as two 2-hair follicular units in a tight bundle, or a single 4-hair follicular unit. Depending on how your doctor is counting, you will get different numbers. BTW, a donor density of 150 fu/cm2 is totally off-the-charts. That number is either a low hair density, or an *extremely* high follicular density. Regarding your comment about grafted density: sometimes 40-50 is sufficient, sometime more or less is required. It is highly variable, depending on the hair characteristics (as I am sure you know). That said, I think 40-50 grafts/cm2 is a totally reasonable first-pass grafted density.

There is a lot of literature out there that suggests that 100 fu/cm2 is average in terms of donor hair density. Although it is not abnormal, it is not what I would call "average," particularly in men with MPB. I consider 80 to be an average donor density.

Lasering the grafts is a possible approach. Remember, though, that laser hair removal requires multiple sessions and, depending on the skin/hair contrast and other factors, the hair may never be destroyed fully. Rather, the hair may simply grow in lighter and wispier. If you remove the grafts, you will not get re-growth. Still, it is hard to say whether or not this is the best approach as scarring is a risk. Obviously, one needs to assess this on a case by case basis. If you do not like the look of the old HT, you might also consider camouflaging the old work with new graphs and/or reshaping the hairline, etc. Certainly, you should get opinions from some physicians.

Hi Chops...ditto

Shock loss is not totally predictable. Of course, if your procedure is performed correctly, the chances of shock loss are less. You may get shock from the first and/or the second surgery, though. I would add also that transplanted hair is typically more resilient than thinning native hair. So, if your doctor transplants grafts into a naturally thinning area of scalp, you might experience temporary shock loss. If your second surgery addresses the same area of the recipient zone, the previously transplanted hair should be less susceptible to shock loss.

Chops, Talk to *several* doctors about your case. In doing so, hopefully, you will see a common thread in terms of what they say regarding your donor supply and your long term hair loss pattern.

HT surgery can be overwhelming immediately post-op. You don't really "get hair" after right the surgery. You get a donor incision, scabs, and pinkness. Of course, this passes. And hair does come. As previously mentioned, you are in the early stages with your work. We often hear that transplanted hair starts to come in at 3 months. In general, I think it is more like 3-5 months. It's a challenge, but hang in there.

Long run, You are looking great! What a nice transformation. And very natural, to be sure. Congrats!

Interesting comments from Dr. Lindsay. I agree. Guarantees in medicine, while designed to allay patient concerns, are usually sales strategies. During a consultation, a doctor might explain that a patient needs, for example, 40-50 grafts per cm2 in order to satisfy expectations. During the surgery, though, the doctor might modify the strategy **within reason.** There may be an area of the scalp with pre-existing hair where dense-packing might be risky (i.e. because shock loss may occur, because hair loss may be accelerated, etc.). I say "within reason" because, while surgeons cannot foresee all variables, they should conduct a thorough consultation and adhere to their strategy as much as humanly possible.

I've heard of using flex spending for LASIK. Hair transplants and hair removal procedures (and cosmetics in general) are not eligible items to the best of my knowledge.

Hair loss is progressive. This is true. It is important for patients to know this. The last thing a person wants to do is have surgery after surgery without really getting the appearance of more hair. That being said, most patients with hair loss do not progress to a Norwood class 7. Many patients with a 3V pattern, for example, are destined to reach a class 5 (or perhaps 6). That might not be a happy thought but, once the patient and doctor know the worse-case-scenario, planning is possible. Furthmore, meds can retard the progression and "buy time." It sounds to me like you may be experiencing early loss in your crown area. First, remember there is still hair there. So, enjoy it and try not to worry about what may be. Second, since your first transplant is turning out well, know that, if need be, you can likely have work in the crown. As previously mentioned, Minoxidil is often a good topical to add to the mix. You might also talk to your doctor about incorporating Nizoral shampoo. I think you will start to feel better about everything over the next few months as the growth from your new transplant starts to kick in.

I agree with Bill's points. A few related points: a. Thicker hair at a moderate density will often deliver a similar result as thin or moderate hair with a high density pack. So, it follows then that a patient with thicker hair may require fewer overall grafts to reach a given goal. For example: a Norwood III with thinner donor hair might need 3,000 grafts to fill in the front/hairline area. A Norwood III with thicker donor hair might need only 1,500-1,800 grafts to get the same sort of result. It can be pretty drastic! b. In the same vein, curl is another hugely important factor. Patients with curly or wavy hair tend to get a fuller look than patients with straight hair (with all other factors being equal). mmhc, I scanned your articles. Good find.

During a consultation, the doctor will first listen to the patient's concerns and then determined the cause of the problem. If the cause is MPB, for example, and surgery is a possible solution, the doctor will consider the patient's goals (long-term and short-term), the current level of hair loss, the worse-case-scenario level of hair loss, the hair supply versus demand, donor hair density, follicular density, scalp laxity, hair shaft diameter, wave/curl of the hair, hair/skin contrast, whether or not a patient is on an oral or topical therapy to retard hair loss, etc. There are, of course, other factors to consider as well. But, I believe I have hit most of the biggies here.

Regarding FUE versus strip: Generally speaking, strip surgery is actually easier to conceal post-op. The surgery involves removing a strip of tissue and closing an incision, as I am sure you know. The edges that are sutured or stapled together are hair-bearing. You should be able to comb your hair over the suture line and totally conceal it, unless your hair is cut very short in the back. Typically, FUE involves shaving the donor area. So, while the donor area heals markedly faster with FUE, the small donor incisions are visible after surgery. This problem is not a persistent one, though, as, like I said, the incisions shrink and heal rapidly. For all intents and purposes, the recipient area will look the same with FUE and Strip. If you work with your doctor, I am sure, together, you can come up with a strategy whereby the donor area is concealed, within reason.

Rick, The scabs in the recipient area take about a week to flake off. You will have fading pinkness in the recipient area for a few weeks to a few months. You can concealed the surgery (a) with surrounding hair immediately after surgery (depending of the length of the hair and the size of the grafted area) or (b) with concealers or make-up after the grafts shed. Please check with your physician regarding what you can apply and when you should apply it (if appropriate). Shaving the recipient area can be important if the session is big and/or the recipient has pre-existing hair. Placing grafts into small incisions is a tedious process. If a surgical team must place grafts between longer hairs, the process will go slower. This is not necessarily a problem. Not shaving can be impractical, in terms of the duration of the surgery, with larger surgeries. Now, if you wish to treat a small area in the recipient zone, shaving may not be a requirement. Furthermore, if you wish to treat a totally bald area (i.e. receding hairline, etc.), there is no reason to shave. If you need 1,500 grafts, as you suggest, I suspect shaving and concealing the recipient area will be a relative non-issue. Hope that is good news

Sonia, If you really require no more than 300 grafts, I would think FUE is a great option for you. When you say you need 300 grafts for the hairline, I am assuming that your goal is to touch up some small areas along your existing hairline. Is that right?