Using only 1's for hairline?

[zenmunk]

I'm considering having my hairline restored via FUE. I'll need around 1,300 grafts to do the job, perhaps less if I go a little more conservative. I have fine, straight, medium-brown hair.

 

I understand that docs typically use 1's at the front, and as they move backward toward existing native hair they use 2's, 3's and even 4's. I'm concerned that when buzzed to a #1 or less on the clippers that multi-hair grafts will take on an unnatural appearance. Is that a valid concern?

 

Given my hair characteristics, do you think it's possible for docs to use only 1's to restore the hairline? Or, perhaps 2's as well very close to the existing native hair, but mostly 1's? Even if the grafts were densely packed, do you think the hairline would appear very see-through?

 

Thanks.

[Thehairupthere]

It would look unnatural to have anything above singles in your hairline. If you still plan on buzzing your hair down than the hairline and the whole top will look see through, as buzzing will always show your scalp.

[zenmunk]

Thank you for your reply, Thehairupthere.

 

I've read a few posts where people claim that transplanted hair in the recipient site appears somewhat unnatural when buzzing one's hair down. In other words, any differences in appearance between the transplanted hair and the native hair are more apparent. Are you familiar with this viewpoint?

[Thehairupthere]

That can happen as native hair behind what was transplanted can miniaturize but the results should still stand for themselves. The density you can achieve is very good but it won't be as dense as when you were 15. It will give you a great cosmetic change.

[Levrais]

Zen,

I think when they talk about 1's in the hairline they're talking about in the very front row and then a mixture of 1's 2's and 3's as you go back. At least that's how it was in my case. I just got a very short hair cut and I don't think it looks pluggy.

[gillenator]

Zen,

I think when they talk about 1's in the hairline they're talking about in the very front row and then a mixture of 1's 2's and 3's as you go back. At least that's how it was in my case. I just got a very short hair cut and I don't think it looks pluggy.

 

Most HT docs approach the commencement of a new hairline that way. The first row or first two rows best be done in singles with the right angulation which is just as important IMHO to create the most natural result. Doubles can be situated behind the first row but I would deter from putting any triples in the second row. Third row may be fine, but will depend on each individual patient.

Edited September 12, 2011 by gillenator

[zenmunk]

Levrais,

 

Happy to hear it doesn't look pluggy, but have you noticed any differences between the transplanted and native hair, especially when cut short? If so, what kinds of differences? And, were you an FUE patient?

 

Thanks.

[Levrais]

Levrais,

 

Happy to hear it doesn't look pluggy, but have you noticed any differences between the transplanted and native hair, especially when cut short? If so, what kinds of differences? And, were you an FUE patient?

 

Thanks.

 

Hi Zenmunk,

Yes I'm an fue patient. When the hair is short the transplanted hair tends to be a little stiffer and spikes a little more than the native hair. I don't think its noticeable to the untrained eye. I will try to put up some pics at the shorter length in the next couple weeks.

[aaron1234]

The difference between transplanted hair and native hair is most apparent at the bottom of the hair where it exits the skin. Levrais is right that it's probably unnoticeable to the untrained eye. I would also add that it is only visible to me with bright lights and an inch or so away from a mirror. Step back a half a foot and you can't really tell. And I still have some cobblestoning left over from my poor first procedure - but that's another issue.

[Levrais]

Zenmunk,

I told my girlfriend about your question and asked her opinion. She says she can't see any difference in the hairs.

[zenmunk]

Levrais,

 

Do you think the differences you mentioned are a result of the trauma the grafts receive during the transplant? It's reassuring to know the differences are so minimal, and an untrained eye would probably not detect them.

 

aaron1234,

 

If only 1's are used in the hair line, as a opposed to multi-hair grafts, do you think that might minimize differences between the transplanted and native hairs where they leave the skin? My recipient sites are fairly small, and I have fine, straight hair, so I expect the doc won't use anything greater than single hairs in order to match the surrounding native hair. Perhaps the fineness of my hair will work to my advantage in that respect, even though it works against me in terms of density.

 

Thanks guys.

[zenmunk]

Oh, that's great news, Levrais! Thanks for asking her to check.

[aaron1234]

aaron1234,

If only 1's are used in the hair line, as a opposed to multi-hair grafts, do you think that might minimize differences between the transplanted and native hairs where they leave the skin? My recipient sites are fairly small, and I have fine, straight hair, so I expect the doc won't use anything greater than single hairs in order to match the surrounding native hair. Perhaps the fineness of my hair will work to my advantage in that respect, even though it works against me in terms of density.

 

For sure! Yes, 1 hair grafts are perfect in the hairline if done by a good doc. I've got to say that my 1 hair grafts from Dr. Paul look so natural in how they exit the scalp. I think most docs use 1 hair grafts for the hairline now. If they don't, then they shouldn't be recommended - like my first surgeon. :confused:

[Levrais]

Levrais,

 

Do you think the differences you mentioned are a result of the trauma the grafts receive during the transplant?

 

Zenmunk,

 

I think the difference is because some of the transplanted hair is from other parts of the scalp where its a better quality hair than the native hair. In my case, the doc took some grafts from the side of my head towards the front where the hair is soft and combined them with the thicker hair from the "safe zone" in order to have a soft hair line. So, I think its blended well and can't be detected unless your are 1) very close to me and 2) know what to look for. Lets say my hair loss is much less noticeable now than it was when there was bare skin there, lol. I don't worry that anyone will notice at this point.

[zenmunk]

I've got to say that my 1 hair grafts from Dr. Paul look so natural in how they exit the scalp.

 

That's great! Are you referring to Dr. Paul Shapiro?

 

In my case, the doc took some grafts from the side of my head towards the front where the hair is soft and combined them with the thicker hair from the "safe zone" in order to have a soft hair line.

 

That's awesome! That's what I hope my doc will do. I really want him to use the entire safe zone, including the sides of the head, and even venture outside of the safe zone when necessary.

 

I want him to do this for the reason you mentioned, but also because I think that kind of extraction pattern will minimize scar coalescence and the patchy look as much as possible, especially when buzzed to a #1 or less on the clippers.

 

I've noticed that even in relatively small FUE cases, that docs often extract only from the back of the head and leave the sides alone. The extractions seem grouped unnecessarily close together. I always wonder why that is...

[Levrais]

I agree about extracting from all over the head.

[zenmunk]

Levrais,

 

Do you think most docs would honor the request to venture outside of the safe zone in order to spread out the extraction pattern as much as possible for the reasons we've discussed?

[aaron1234]

That's great! Are you referring to Dr. Paul Shapiro?

 

 

Yes, I am!

[Levrais]

Levrais,

 

Do you think most docs would honor the request to venture outside of the safe zone in order to spread out the extraction pattern as much as possible for the reasons we've discussed?

 

I think thats best left up to the doc but most likely he will be able to cherry pic the hairs he wants from the best location

[Dr. William Lindsey]

I agree with the good comments above. We try to pack the hairline with singles, back about 1/4 to 3/8 of an inch and then we move to doubles. Only much further in do we use 3's.

 

Remember, you are not getting cured of baldness, you are getting coverage of bald scalp. The key is the perimeter which needs to look dense and yet natural, hense singles. Back in the middle you need bulk, thus 2's and 3's, spread a little apart, is the appropriate tool here.

 

Dr. Lindsey McLean VA

[zenmunk]

Thanks for your input, Dr. Lindsey.

 

I've noticed in various pics that doctors often restrict their FUE extractions to the back of the head even during relatively small procedures. The extraction points appear unnecessarily close together. In other words, there appears to be a lot of unused donor area. Can you give us some insight into why that's the case?

 

I understand that the quality of the scalp tissue, and even the grafts themselves, can vary throughout the donor, and "cherry picking" may be necessary, but that still doesn't quite explain these types of condensed extraction patterns.

 

In the following example, I'd like to know why the doc didn't extract from the sides of the head and perhaps a little lower as well: http://www.hairrestorationnetwork.com/eve/142984-fue-patient-1-year-post-op-also-**update**-2-year-post-ops-dr-feller-patient.html

 

My understanding is spreading out the extractions as much as possible is the way to go in order to minimize the potential for scar coalescence and the appearance of hairless areas especially when buzzed to a #1 or less on the clippers.

[Op.Dr.İlkay Hüthüt]

Duplicate post, edited by moderator.

Edited September 8, 2011 by Future_HT_Doc
Duplicate post

[Dr. William Lindsey]

It certainly easier to take from the back and often less noticable, but we do from the sides if indicated or preferred. I'm not sure what you are describing about the donor area. I'll tell you that we generally put the FUE holes pretty close together, but its uncommon--with small FUE punches (not minigraft or plug punches that I've seen used and being sold as FUEs), for the donor area to really look depleted.

 

That being said, I'll put up an update on a 2600 FUE case that I did last May in a week or so and despite 2600, with even a crew cut you can't really tell he's had much done in the donor area, but I suspect if we shaved it bald, you would see lots of tiny marks.

 

And, 2 weeks ago I did a small FUE on a guy who supposedly had a couple of thousand FUEs by 2 coalition doctors and I could see a fair number of small whitish scars, again only after shaving his donor area so that I could harvest more.

 

I hope that helps.

 

Dr. Lindsey McLean VA

[zenmunk]

Thanks, Dr. Lindsey. Your comments are certainly helpful.

 

I've also read that it's easier to extract from the back of the head (Dr. Bisanga noted that in one of his articles). Regarding it being less noticeable, I thought that spreading them out as much as possible, assuming you have the available donor area, reduces the appearance of scarring and "hairless" areas when the hair is buzzed to a #1 or less on the clippers. In other words, there's less chance that a well-defined pattern of thinner hair will be noticeable. I can understand if it's a large case, and you must condense the extractions, because of the limited available donor space, but I don't understand why it's necessary in smaller FUE cases. Is this position wrong? If so, please explain why.

 

I look forward to your update. Thanks again.

[Dr. William Lindsey]

You are correct. In my opinion though, I'd rather pack things together so there is more "virgin scalp" for future cases, than going back in a scalp that has a bunch of areas that have a little scar tissue.

 

But all of these are issues are best individualize when making a plan for all future treatments.

 

Dr. Lindsey McLean VA