The MOST important fact to remember!!!!

[Jotronic]

If you are bald hair restoration surgery will NEVER restore a full head of hair. For a dose of reality, check out the following image. I have used my pitiful Photoshop skills to show what a donor strip with approximately 4800 grafts would look like if it was just laid on top of a bald scalp. This is assuming a donor strip of approximately 30cm X 2cm and full density of about 80 FU per cm2. If this doesn't make the reality of this procedure clear, nothing will.

 

[Cant decide]

Joe - Nice way to make the reality of this whole thing vivid. I was basically totally bald in the front and mid and Dr Rahal was able to restore those areas with density that I am told by people looks like a full head of hair to them (apart from nasty light, when totally wet, etc). That just goes to show how amazing the skill level of a good doc can be as well as the whole illusion of it.

[Travis1]

Hi Jotronic, pardon my ignorance here, but I got a question, understand that with each ascending norwood level, 1000 grafts are needed I'm now NW5, theoretically I will need 5000 grafts; will I have any chance to regain a hairline that I can style like a 20 year old?

[Jotronic]

CD,

 

I'm sometimes told that it looks like I have a full head of hair too but of course I don't. Results that give the appearance of a full head of hair can ONLY come from proper placement of grafts. Hair type, hair color to scalp color contrast, etc. also play key roles but make no mistake, no one with aggressive hair loss has a true full head of hair. It is a simple matter of math and the lack of enough donor hair to replace each hair that has been lost on a one to one ratio.

[ShiningDome]

That would make a killer mohawk though :cool:

[Jotronic]

Travis,

 

I don't hold to the notion that one should calculate 1000 grafts for each NW level. There are too many factors to consider for this to be a standard approach. If that were true then I would have been perfectly fine with about 6500 grafts.

 

You can have a hairline like a 20 year old but it won't look natural if you have any hint of thinning in your crown, which you will with 5000 grafts as a NW5. A low straight hairline (assuming this is what you are referring to) would require far more grafts because it would have to be dense. Density requires numbers so this completely wipes out the theory that 1000 grafts per NW level will suffice. This does not address the issue of how a 20 year old hairline isn't a good idea in general anyway but that is a discussion for another thread.

[Travis1]

Hi Jo, thanks for the insight, appreciate it

[chrisdav]

Good Post Jotronic.

[orlhair1]

Thanks for posting........a great reality check for people who have an illusion that you can fully restore a true full head of hair. Also a great reality check for people in their 20's or early 30's who pack a bunch of grafts into their hairline without enough reserves for the future when they may progress to a N5 or higher.

[NEWHAIRPLEASE]

Thats humbling huh.......

[Shampoo]

Also a great reality check for people in their 20's or early 30's who pack a bunch of grafts into their hairline without enough reserves for the future when they may progress to a N5 or higher.

 

To be honest orlhair I am a bit surprised when I see doctors even doing that. Many of the young guys wanting a transplant on what is obviously a full head of hair don't know any better....but the doctor should.

 

Unless something is invented via stem-cell or a similar technology that will allow for growing new hair follicles in the lab which creates an unlimited supply of donor hair...some of these young guys that are eating up their donor hair at such an early age could be in trouble when they get in their forties and fifties. I suppose it will help Hair Club for Men because if they are out of donor hair what will their options be? Shave it all off or get a wig?

Edited February 20, 2012 by Shampoo

[Bill - Seemiller]

Joe,

 

Why are you mocking my hairdo?

 

 

On a more serious note however, you are absolutely right. Creating a "full" head of hair with true density equal to natural hair before any thinning on a completely bald head is impossible. But world renowned surgeons do quite well at creating an adequate illusion of density for those with optimal donor areas.

 

Thanks for sharing,

 

Bill

[aaron1234]

Bill, are you related to Mr. T?

[RCWest]

This also shows you that you don't need anywhere near original density to be thick. That strip could be dissected and spread out over the front half of the scalp and still cover very well.

[Spanker]

Interesting post. And a little depressing. And probably not that good for business, but thanks for the sobering honesty.

[Jotronic]

Ah Bill, I remember those images well.

 

RCWest, that was the point of the post. To show that we are not getting full density but we can get great coverage and great coverage means an illusion of density. There is no such thing however as an illusion of coverage.

 

Here is what 4800 grafts, albeit in two sessions, did for me.

 

 

What this shows is that proper planning, placement and of course understanding the limitations of the result and the ensuing hair styles one chooses, the result can be extremely appealing.

 

Spanker, the only way this would not be good for business is if we were in the business of smoke and mirrors and promising full heads of hair. You would be surprised how many people state that this is their expectation from surgery so if I can scare people away with the truth then that makes life easier for everyone. This is not an issue exclusive to H&W patients. This is an issue exclusive to the law of supply vs. demand of which everyone must obey.

Edited February 27, 2012 by Jotronic

[Shampoo]

Yes the first picture is quite the eye-opener and a bit depressing, but then when you see the after pics and results the best surgeons produce on a regular basis it is amazing what artists they really are.

[hairthere]

Good thread Joe! Hopefully it makes people realize the limitations and possibilities of HT surgery with a top clinic.

[MrJobi]

Hi

 

I think it is important to stress the different between a full head of hair and the illusion of density. I have had over 5000 grafts and have the illusion of a full head of hair.

 

Of course I cannot style it 100% in every fashion but I do very well. With realistic expectations and the right characteristics, you can get a very good result

[Veritas84]

My greatest fear is when my hair gets wet after a swim. It will be darn evident that I'm balding.

[irishsailor]

Great post! Kinda keeps you in check about the reality of what can be achieved

[RCWest]

Joe, your last crown transplant looks great! This is the first pic I've seen since you had surgery on it. Dr. Wong really is good at recreating the swirl pattern.

[master_d]

very good post to keep everyone's HT expectations in check. I haven't had a HT yet, but I am kinda curious what a HT would look like wet if anyone is willing to post such pictures. This might be another way to show the illusion of coverage.

[Sean]

Awesome post Joe, I appreciate the knowledge you give. I always thought that the density in the back of the head is a lot more then the top of the scalp overall?

[skepticalguy]

Haha, Bill did the same thing that was done in joes diagram, He said, Fuck it, Just take all the donor, and BAM~ Put it right here~ I dont need the back of my head anyhow!