Change in Perception after HT?

[WherefromHere]

Posted once before but I wanted to see if anyone was able to relate or had to make the same tough decision. And see if Doctors also would ever agree that its not worth trying to go for more, but to cut the losses and do what can best be done to look natural from here on out..

 

 

I ask because is it ever ethical to tell someone that yes, a HT should really never have been done in the first place without knowing what pattern of hairloss one may be experiencing and with the quality of hair one has now, that it would be best not to do more and only try and correct what was once done?

 

Or is it only recommended to no matter what, since there is a scar etc, or you already started the process... to just add more and do HT after HT as time goes on knowing that the quality of hair will never be able to give a great overall result?

 

I know there are some who have been in or are in my position, had either a non satisfactory result and don't enjoy having a scar on their head, or made their decision at too early of a time and only now see that their pattern of loss or quality of hair will not achieve a satisfactory result in the end.

 

It seems that the notion is to always go for more or camouflage or add and add etc, and that you can NEVER shave down since there is a scar, but yes we all know there is a scar but just cause there is a scar is it worth adding more hair on top for an unsatisfactory end result just because of insecurity of the scar? There are good things being done for scar revisions these days so I just thought I'd ask why its always pushed to do more, when sometimes it may be best to do less?

[OtherSyde]

It seems that the notion is to always go for more or camouflage or add and add etc, and that you can NEVER shave down since there is a scar, but yes we all know there is a scar but just cause there is a scar is it worth adding more hair on top for an unsatisfactory end result just because of insecurity of the scar? There are good things being done for scar revisions these days so I just thought I'd ask why its always pushed to do more, when sometimes it may be best to do less?

 

 

...Your scar isn't that bad, with some hair length. Your frontal hair looks fine, at least I think. Especially with some styling gel in it or something.

 

I mean I can't shave down without a visible scar either, but if we're going to shave our heads then why did we ever get HT's to begin with?

 

And even if you don't want to do more transplantation, a scar revision by a skilled and renowned HT surgeon would be well worth it even if you have to fly a long distance on an epic journey; it would be life-changing if the scar and insecurity are as bad as you say. Although, if you're going to have a scar revision anyway, I'd take the opportunity to just do a small FUT touch-up job on the frontal area if it's bugging you; it wouldn't be expensive, and would kill two birds with one stone.

 

But maybe I don't fully understand your situation... Can u post more detailed pics and maybe describe in greater detail why it's as bad as you say? I can't see anything terrible in your three blog pics...

[OtherSyde]

OK... I located your first thread about this whole thing and read it.

 

I hate to plug my surgeon like a shameless whore, but I only do it with honest intentions; Click my blog link below and look at my full elaborately-explained and photographed progression... Specifically, look at the scar. Or the virtual lack of a scar in the later pics; yes - it's still there, as no scar simply vanishes, hiding under the hair as a fairly subtle hairless thin pink line, but still nigh invisible with as short as a #3 grade hair cut. I'm in the military and never let my hair get very long at all. Dr. Gabel did a bang-up job on my dome. And yes, to be fair, there are a few other surgeons on here that are also extraordinarily proficient at low-profile scars.

 

I don't know who you went to for FUT, but they might have not had the best scar-minimization techniques; did they do a double-layer suture, or only single layer? It also sounds like they might not have had the artistic awareness or foresight to build the frontal hairline with only thin single-hair grafts, gradually fading to doubles and triples as he moved back - instead just poking them in there without much rhyme or reason, and thus creating the unnatural look..?

 

 

Also... Ten thousand dollars?!? I'm getting my second HT in less than 3 weeks, and I've already pre-paid for 1,500 grafts. I won't say exactly what I paid because apparently it's not classy or kosher on the forums, but I can tell you it is a $H!T-load less than ten grand. I mean a LOT less. Like nearly half as much less. You only want 800 grafts? I'm assuming using FUT so that the scar can be re-done at the same time? I would tentatively guesstimate that to be around $2,800 to $4,000 max, plus any travel expenses.

 

[EDIT] - Oh, and one other thing - you generally can't transplant hairs into scar tissue; it lacks the necessary type of tissues and intricate network of supporting blood vessels, and at least from what I've gleaned from these forums 90% of the time the grafts just can't survive there - it's like planting a lily in hardened desert clay-mud with no water in the ground. Someone correct me if I'm mistaken here though - I would honestly love to hear that follicles can live in scar tissue; that would eradicate my only (very slight) remorse at having a scar.

[WherefromHere]

Hey, thanks for the responses. I understand what you are saying, but those are all points I am already aware of and know about. In other words, I know the process about doing more procedures and removing the old scar to make a better one while also making the previous work better and more natural looking. Bad part is when I had the procedure, my hair was coarser and thicker, even in donor area. My work now still doesn't look the worst and the doctor was aware of the process of using singles along the hairline and having any larger grafts be further back... Since he explained that process to me before doing the procedure. However, still there are larger grafts along the hairline anyways and it doesn't look as natural as it should. Other top HT docs I've visited have even said yes it's not a bad job but could be made better.. Which is promising to hear. Only bad thing is the rest of my hair is going quickly all over the rest of my scalp which was not obvious during the time frame of first procedure... Which means I can see now that my hair thickness/diameter will not really achieve a great end result without being completely see through. And my hair is getting this way despite finasteride, while dealing with the side effects on top of it.

My intention was never to ever shave my head.. That's why I got a HT in the first place since I liked that idea of staying ahead of the loss before it shows or becomes worse. Sounded like a good plan but nature seems to win the battle at times. I never intended to shave my head but it is becoming apparent nature is winning the battle despite the preventative measures.

 

As for the 10,000 grand that is not price in regards to corrective work by adding another HT.. 800-1200 grafts would cost more around 3000 or so. That is removing old scar to make it better and add to hairline to make it more natural. The 10k was if it was to extract all grafts or as many grafts from hairline for HT reversal and back into scar in back.

 

I agree with you on all viewpoints and I know what you speak about... What I am referring to is that there are many individuals who have had successful HT's and multiple ones at that to in the end not have the coverage in the end they are happy with despite the best techniques.. And then bigger scars from ear to ear etc who prefer now to just be natural and let it all go. I'm aware of that scenario... Just don't want to be in that position.

[Mickey85]

 

[EDIT] - Oh, and one other thing - you generally can't transplant hairs into scar tissue; it lacks the necessary type of tissues and intricate network of supporting blood vessels, and at least from what I've gleaned from these forums 90% of the time the grafts just can't survive there - it's like planting a lily in hardened desert clay-mud with no water in the ground. Someone correct me if I'm mistaken here though - I would honestly love to hear that follicles can live in scar tissue; that would eradicate my only (very slight) remorse at having a scar.

 

FUE doctors like Lorenzo and Feriduni have successfully implanted grafts into scar tissue without much issue. The yield most likely will not be as good as with natural tissue but it works at reducing the scar visibility. I tell everyone to try avoid the linear scar if they are a Norwood 3 or 4 and have the donor for it as it can be a bigger hell to fix that. Scar revision also has the same chance factor as it depends on the individual's physiology and the surgeons talent.

[Midwest00]

Perhaps some scar pigmentation(temporary one first)to help cover/ blend the scar? Concealer such as Dermamatch may help any miscoloring. If I were you and chose to get another procedure, look for a reputable surgeon with skills for making pencil thin scars. Konior is one that has done this for me. Exceptional work. You are at the right place to seek advice and share you stories. I am sure there are several that share your concerns.

 

As far as a haircut goes, I have a great wife that cuts my hair and fades it paying close attention to the hair around the scar leaving just enough to conceal, but not too much to create a "flap look".

 

 

The best saying I heard was someone saying "once you have more hair all you want is...more hair". In regards to your perception there are some cognitive things that I try to do daily to help with perception. Digging up old photos from when hairloss was at its worst can make you look at "how far you have come" as opposed to "how far you have to go". I like to take two hands and cover up the HT to remind myself of what it would look like if i did not have hair in those paticular places. Cognitive thereapy can impact your perception and help create a glass half full attitude for some.

Edited March 9, 2013 by Midwest00

[GNX1]

I tell everyone to try avoid the linear scar if they are a Norwood 3 or 4 and have the donor for it as it can be a bigger hell to fix that. Scar revision also has the same chance factor as it depends on the individual's physiology and the surgeons talent.

Mickey u cant tell anyone that cause FUT is the Gold Standard...:rolleyes: any technique that could and often does require another technique to repair it shud b avoided like the plague!

 

it seems like every other day someone is posting about how to repair or conceal their FUT scar. I really feel for those that have spent thousands to fix their baldness only to create a new horror that imo can be worse then being bald.

[michaeljames]

Posted once before but I wanted to see if anyone was able to relate or had to make the same tough decision. And see if Doctors also would ever agree that its not worth trying to go for more, but to cut the losses and do what can best be done to look natural from here on out..

 

Ethics and Scar Revision

 

I ask because is it ever ethical to tell someone that yes, a HT should really never have been done in the first place without knowing what pattern of hairloss one may be experiencing and with the quality of hair one has now, that it would be best not to do more and only try and correct what was once done?

 

Or is it only recommended to no matter what, since there is a scar etc, or you already started the process... to just add more and do HT after HT as time goes on knowing that the quality of hair will never be able to give a great overall result?

 

I know there are some who have been in or are in my position, had either a non satisfactory result and don't enjoy having a scar on their head, or made their decision at too early of a time and only now see that their pattern of loss or quality of hair will not achieve a satisfactory result in the end.

 

It seems that the notion is to always go for more or camouflage or add and add etc, and that you can NEVER shave down since there is a scar, but yes we all know there is a scar but just cause there is a scar is it worth adding more hair on top for an unsatisfactory end result just because of insecurity of the scar? There are good things being done for scar revisions these days so I just thought I'd ask why its always pushed to do more, when sometimes it may be best to do less?

 

Hello Where from Here,

 

Many of us on the HTN forum can empathize with your position regarding your scar, Before commenting on that I would like to share a thought regarding ethics with HT surgeons.Ethics is always a personal choice but in general most doctors or other professionals who are confident in their abilities and who hold high ethics will not comment on the work of peers without full scope of information. However, many of the recommended surgeons here are able to provide alternatives for hair transplant scar revision.

 

Seeking the consult of an HTN recommended surgeon may be of certain benefit for you. All the Best, Michael

[WherefromHere]

Thanks for the responses... however, I think people are misreading the full understanding of the original post. My question is, despite the donor scar... as in regardless of it.

When medications (propecia) cause side effects, and yet the hair is still becoming quite thin and see through all over despite its use, then one must weigh the benefit/risk ratio or quality of life ratio.

 

With that, yes a HT has been previously done... looked fine blended with native hair prior and still looks ok with hair dry and or not styled... but when sweating and or styling with gels/creams, or after use of minoxidil... all the transplanted hair looks quite "wire" like and thin. that is not a good look, and the rest of the hair is very thin and see through..more so when sweating.

 

I am a very active individual.. the scar shows already through wet hair despite length of hair. Only doing more transplants makes me wonder if instead of just having the frontal hairline looking thin and "wire" like when sweating, that all transplanted hair would look like that across entire scalp if I was to do additional procedures.

 

It seems my hair quality just isn't quite suitable for a full natural result based on my characteristics.. I would like to just wear my hair buzzed or very short..which I can not do at this time since the grafts up front would look out of place due to previous procedure (improper angles, larger grafts in some places, and gappy from less density). Not sure if additional procedures could allow that to be more natural and allow for the buzz cut, or if it is better to just forget transplants all together and laser out all the transplanted hair, buzz down and get on with life.

 

I know the consensus is that one can NEVER shave or buzz down after a donor scar.. but I for one can tell you that I much rather do that than have a crappy looking result all over my head chasing something that may not be quite realistic only to have more and more scars on the back of my head.

 

Thoughts are still welcome.

[hairz]

Sorry to hear about all of your problems. Can you post pics so we can tell you what we think?

 

I am going for my HT in 7 days. When I read threads like these, it starts to make me think. I am kinda scared of what will happen. I hope I am doing the right thing.

[WherefromHere]

Hey Hairz,

I believe there are 3 pics already posted. Like I said, I've visited all of the top docs or spoken with all the top ones in the country and they all say my previous work wasn't all that bad and it makes some people uncertain if would want to take me on as a client due to how I complain about my previous procedure. I have been told that yes my previous procedure isn't the best but its not bad and sometimes things won't be perfect since its man made work and not native.

 

I don't know where you stand with your hairloss and I do believe if you go to a top doc for your first time you can be satisfied. As for myself, my hairloss is not stabilized and my hair quality is very fine/thin. And as I've stated I'm very active and sweat all the time. Doctors all tell me they can definitely improve my look and fix me up, but I'm not looking to just improve. I want to know will I have a full natural result in the end... Or if all my native hair falls out on top am I going to be stuck with a very see through gappy appearance that looks like 'wire' all over my head when sweating. And my donor hair seems quite more thin as well. The only way I will do additional procedures at this point is if I can fill in my areas and buzz my head down and look natural in that form. Otherwise I rather just forget about the depression of hairloss and shave it all and get back into things I truly enjoy doing again since like many I don't participate in water activities, get caught in the rain, or those types of things cause I'm too preoccupied with my hair.... Which is ridiculous

[WherefromHere]

I will add this.. Not sure why this differs but out of a shower my transplanted hair is undetectable in comparison to my native hair. But when I sweat, or when the hair is fully dry the 'roots' of the transplanted hairs become more noticeable. That is what concerns me the most.. Is that typical of transplanted hairs...?

[hairz]

Hey Hairz,

I believe there are 3 pics already posted. Like I said, I've visited all of the top docs or spoken with all the top ones in the country and they all say my previous work wasn't all that bad and it makes some people uncertain if would want to take me on as a client due to how I complain about my previous procedure. I have been told that yes my previous procedure isn't the best but its not bad and sometimes things won't be perfect since its man made work and not native.

 

I don't know where you stand with your hairloss and I do believe if you go to a top doc for your first time you can be satisfied. As for myself, my hairloss is not stabilized and my hair quality is very fine/thin. And as I've stated I'm very active and sweat all the time. Doctors all tell me they can definitely improve my look and fix me up, but I'm not looking to just improve. I want to know will I have a full natural result in the end... Or if all my native hair falls out on top am I going to be stuck with a very see through gappy appearance that looks like 'wire' all over my head when sweating. And my donor hair seems quite more thin as well. The only way I will do additional procedures at this point is if I can fill in my areas and buzz my head down and look natural in that form. Otherwise I rather just forget about the depression of hairloss and shave it all and get back into things I truly enjoy doing again since like many I don't participate in water activities, get caught in the rain, or those types of things cause I'm too preoccupied with my hair.... Which is ridiculous

 

I've seen your pictures now. I can see what you are talking about.

 

How many grafts did you get? What about the grafts per sq/cm? To me it looks like they did't use one hair grafts in some areas. Are you sure they did?

 

Please see the attached photo and tell me if this looks like your hair as it is hard to see in your pictures for sure. If it is like the before photos then it was done wrong.

 

I've seen Dr. Rahal's work in person and could not see a single detection of HT and it looked native. With that said, if you have some grafts in the bank, I would talk to him and see what he has to say.

[hairz]

Top 5 reasons why people reject the idea of hair transplants:

 

 

1. They look almost as fake as a bad toupee

2. They don’t fill in the bald spots evenly or completely

3. The surgery is painful

4. Recovery time is too long

5. The surgery leaves unsightly scars

 

We agree that conventional hair transplants often leave a lot to be desired. Traditional hair transplants are based on extracting hair follicles along a thin strip.

Follicles are individually separated under a microscope with no (or very little) transection of the hair follicles.

 

Most of this can be avoided if you go to the right doctor.

[OtherSyde]

Most of this can be avoided if you go to the right doctor.

 

Absolutely; in modern HT culture, these things are highly frowned upon and essentially none of the Coalition Member HT docs that you'll find on this board would be caught dead perpetrating these crimes of the 80's and 90's, except for the one about the scar; if you do FUT, you WILL have something of a scar, and even if it truly IS credit-card-thin, it will still be visible as a thin hairless pink line if you shave your head.

 

One thing to note: Dude, you have a scar now. Forever, You can get it revised, got another HT or not, or do absolutely nothing; you will always have a scar now. The best thing to hope for here is to make it thinner and less visible, and get a good HT that looks more natural.

 

And even if all your hair falls out to the point of a Norwood 4 or 5, look at Bill here: Hair Restoration Social Network - Hair Loss Patient Blogs

 

Look at how incredibly natural his front hairline looks now. The guy was approaching chrome-dome status; if he can come back from almost nothing, then you can manage something like it too. You just gotta pick the right doc, take action, stop stressing out, and believe, man!

[Mickey85]

Mickey u cant tell anyone that cause FUT is the Gold Standard...:rolleyes: any technique that could and often does require another technique to repair it shud b avoided like the plague!

 

it seems like every other day someone is posting about how to repair or conceal their FUT scar. I really feel for those that have spent thousands to fix their baldness only to create a new horror that imo can be worse then being bald.

 

I can't say I disagree with you champ. I know FUT is favored by alot of people here and they don't look at it with the skepticism and critical eye that I and a few others do which is fine, I don't mean to try convert those fine individuals. I do however like to express my sentiments in the flaws about the procedure. It does seem like a weekly or bi-weekly occurrence that a patient posts a thread in regards to a stretched scar and is looking for remedies for it. FUT can fix the debacle alot of people have at the top of their heads but can leave a big problem at the rear and sides of the head. It is a gamble even with the best donor closure.

 

That is why I'm an advocate for FUE for anyone up to a Norwood 3 to 4, Norwood 4s usually need good donor area for a convincing look. I don't think it can give a convincing look on Norwood 6s or 7s, FUT is better at that. I do believe it is a generally superior procedure with more advantages than drawbacks compared to FUT.

[WherefromHere]

Hairz,

That is my point. I'm sure they didn't use one hair grafts in some places since its obvious they didn't even though the doctor stated only one hair grafts should be used along hairline.

And I agree with most posters here... Such problems can be avoided with the right Doctors. I did visit Dr Rahal and he recommends, along as other doctors, on removing the old scar and improving everything with additional grafts. That is something I was very close to jumping into since it sounds very ideal.

My point is yes I have a scar, but I have noticed that my donor hair has become quite thin as well as the texture of my hair all over. No doctors I have visited have measured my hair in back other than a visual look, and have all looked at me during ideal conditions. Hair dry and flat... Looks like I have a full head of hair.

The thing is I wonder is it worth extra transplants aside from the donor scar. The donor scar can always be revised if needed or want to shave down later. But I am wondering if doing additional work would have the skin/additional scaring of recipient area to make it harder to shave down later if warranted or the satisfaction of a full look is not able to be done in the end. I can see how thin my hair is already that I am not quite sure how much coverage would be realistic. Most doctors have recommended just doing another 800 -1200 grafts up front to fix what is there now, but I can see the rest of my hair is thinning and going quite fast where I'll be right back in for additional work. The other thing is I am trying to get off meds due to side effects. It's a tough call to make by any stretch. Accept hairloss and nature and enjoy life otherwise or keep playing the gamble that one can stay ahead of it.

[GNX1]

I can't say I disagree with you champ. I know FUT is favored by alot of people here and they don't look at it with the skepticism and critical eye that I and a few others do which is fine, I don't mean to try convert those fine individuals. I do however like to express my sentiments in the flaws about the procedure. It does seem like a weekly or bi-weekly occurrence that a patient posts a thread in regards to a stretched scar and is looking for remedies for it. FUT can fix the debacle alot of people have at the top of their heads but can leave a big problem at the rear and sides of the head. It is a gamble even with the best donor closure.

 

That is why I'm an advocate for FUE for anyone up to a Norwood 3 to 4, Norwood 4s usually need good donor area for a convincing look. I don't think it can give a convincing look on Norwood 6s or 7s, FUT is better at that. I do believe it is a generally superior procedure with more advantages than drawbacks compared to FUT.

yea if one needs a chit load of grafts and they dont have enough body hair or a thin beard then FUT is likely most people's only hope for now till something new and better comes along and are gonna have to roll the dice with how the scar will end up looking several years down the road or sooner.

 

although Dr.'s like Umar and the like have successfully transplanted thousands of grafts via body/beard hair he is the exception and certainly not the rule and when using mostly body hair the results are fair at best compared to head hair but some have ruined their donor supply with botched FUT transplants and FUE body/beard hair is their only option now or their just so far gone with a NW7 that they have no head donor hair left.

 

like u said fixing one problem to create another is something many will experience and I feel for them and they shud be educated on what choices they have and what possible complications can arise.

[WherefromHere]

Thanks everyone for all the input and different thoughts. I continue to go through the up and downs still of thinking I know the best route to go.. But it's hard to say. As much as I would like to do another procedure and have my life back looking natural, the very fine/thin hair caliber that I am experiencing scares me to hold off and gain as much input as possible before jumping further into a puddle that I'm not sure I'd be able to get out of. If I do continue, I do feel Shapiro or Rahal would be my choices.

I know as I've stated before most would just add more since process was done once before, but its becoming harder to imagine a great, full, or satisfying result in the end with the type of caliber of hair that seems to becoming more evident which is very thin and doesn't style well. Prayer hopefully can lead me down the road that will make me most pleased with the look and lifestyle I want to enjoy, instead of the constant worry daily as how my hair will look

[Paulygon]

I will add this.. Not sure why this differs but out of a shower my transplanted hair is undetectable in comparison to my native hair. But when I sweat, or when the hair is fully dry the 'roots' of the transplanted hairs become more noticeable. That is what concerns me the most.. Is that typical of transplanted hairs...?

 

could the difference be due to how the hair is combed out of the shower vs. after sports/sweating (I know its not combed but I mean, the directions they are laying in)?

maybe you run your hands in through your hair in a backwards direction during sports but in the shower you just run your hands upward and forward (ie. after shampooing).

I've noticed that my HT grafts have very strong looking roots compared to native hairs in that region.. but I love that!

 

perhaps you are unfairly critiquing yourself.. we ARE our own toughest critics!

[OtherSyde]

I've noticed that my grafts have very strong looking roots compared to native hairs in that region.. but I love that!

 

perhaps you are unfairly critiquing yourself.. we ARE our own toughest critics!

 

This, and the fact that no one is going to zoom in 10x and examine the individual caliber of your individual hairs - no one will ever notice, and if anyone does, the odds of them attributing this little quirk to a massive hair transplant are negligible.