Is extracting from a transplanted hairline a bad idea?

[starr]

You saw Rahal, you got a typical front loaded North American strip job and now you are dealing with the consequences. But you have choices. Use them.

 

I think thats well said. Dr. Rahal did an amazing hairline - I could not stop smiling for the first year or two. But I think he should have advised me that this might limit me the day when the crown would go...

 

I'm happy to have this forum in order to get some ideas and advice, but I have to say...now I'm confused!

 

Cheaper to get FUE outside of Canada. However, not with the top doctors. But I need a mix of beard and scalp, which if I understand correctly, most still dont have a track record for good work in this area... Ugh. Back to square zero.

[scar5]

You are far from square zero;

 

(Although there is a great psuedo-punk song called, 'Square One Here I Come' by The Hives which could have it's lyrics adapted to the poor HT guy who gives his savings and future dreams to wealthy HT docs, without missing a beat)

 

IMO

You get on meds, take great pics, send 'em to Turkey or India, get SMP, then start filling up your crown with FUE and beard, cut your hair the right way.

[starr]

You are far from square zero;

 

(Although there is a great psuedo-punk song called, 'Square One Here I Come' by The Hives which could have it's lyrics adapted to the poor HT guy who gives his savings and future dreams to wealthy HT docs, without missing a beat)

 

IMO

You get on meds, take great pics, send 'em to Turkey or India, get SMP, then start filling up your crown with FUE and beard, cut your hair the right way.

 

LOL thanks that made me laugh. We could even change it to the starving artist who gives his gig money to wealthy HT docs so he can keep auditioning with a solid chance of booking! OK...thats my rant.

 

I think I agree with the direction about getting back on meds after a 7 year break. Getting SMP done so I can live with myself without a system (or feel more comfortable under my system) - get the FUT scar covered up while Im at it, and start researching FUE options outside the box (the box being Canada/US)...

 

I'll keep reading posts here and hopefully get more info to fill in the gaps or solidify my plan. Right now, I'd really like to find a recommended Dr. that has affordable (though not suspiciously cheap) FUE with a track record of doing GREAT mix of beard and scalp. The hair under my chinny chin chin wants to relocate.

 

And to think a few years ago after doing laser hair removal on my chest I was thinking of doing my neck. Whew! Close call!

 

Will see what Ko says about the FUE...

[HairRun]

@starr did you relocate them?

[Rahal Hair Transplant]

Hairrun and all,

This particular topic is over seven years old so frankly, I doubt that the OP will reply.  I hope he does as I would also like to hear more about this and see some additional photos of the top of his head.  Hopefully he had a subscent procedure to meet his goals without having to harvest hair from his transplanted hairline, which I suspect was and is very possible.  More of my thoughts below   

I was not involved in this particular case as I didn’t work directly with Dr. Rahal at the time however, I know he is very thorough in his evaluations and always goes over both the short term and long term hair restoration plan with patients.  This includes a discussion about the progression of male pattern baldness and the potential need for subsequent procedures in the future. 

Also, it sounds like he only had one procedure sometime before 2015 (likely strip given the time period) and most patients have a plethora of donor hair left for subsequent procedures as needed - especially if both strip and FUE is combined. 

Despite any detailed discussions between doctor and patient, many patients are focused on their initial, short term plan to restore their hair as quickly as possible. I’m sure for quite sometime this patient was very happy and then when he realized his hair was getting thinner due to the progression of genetic hair loss, the familiar feeling and emotional upset of thinning hair and going bald overcame him. This is very common and normal.   This is why it’s important to have a long-term strategic plan in addition to a short term one involving only the first procedure.  And I know Dr. Rahal always goes over this with his patients  

interestingly enough, I was involved in a team meeting hosted by Dr. Rahal just the other day and one of the topics we covered was the complexities of crown restoration.  This topic has always been very controversial amongst all hair restoration physicians because the crown is one of the most difficult areas to make both natural and dense/full looking.  

The overall conclusion and consensus is that sometimes less is more because sometimes even adding twice as many FUs to the crown will have a similar result. This is due to the difference in the hair growth pattern of the crown (the natural whorl pattern) versus the rest of the scalp. Variables that ultimately affect the appearance of fullness include

1) hair color to scalp color contrast ratio

2) hair shaft diameter / hair coarseness / hair texture

3) the overall circumference of the area to be covered, etc.  

4) density of the transplanted hair

5) placement and angulation (should mimic the natural whorl pattern)

6) average number of hairs per graft (the higher the better)

Along with the above, how much donor hair is available throughout the patient’s lifetime will inevitably affect how many FUs can and should be added to the crown.  Dr. Rahal has a scientific formula to calculate this. 

Now back to this patient’s case, I haven’t seen photos of the top of his scalp only his crown by looking at the avatar he posted. But frankly, it’s not unusual to see men with a nice looking hairline and hair in the front with a thinner/bald looking crown.  The patient may just be more sensitive about this area given that natural hair loss has progressed.  But depending on the above factors I mentioned, he could very likely still use scalp hair in the crown area and since it’s pretty hairless at this point, even a lesser amount of grafts could create a pretty cosmetically significant result. Sure, it would still look on the thinner side but it would no longer be bald which would make a huge difference.  I’m sure Dr. Rahal had this in mind as he would not transplant a lower, youthful looking hairline without considering the potential need for subsequent procedures in the future.

Long story short, I’m sure something can be done for him if it hasn’t been already.  Besides, back in 2015 he likely had strip so he would likely have plenty of donor hair left via FUE to help him meet his goals.

Like I said even though this topic is old, somebody obviously bumped it so I wanted to add my two cents  

Best wishes,

Rahal Hair Transplant

Edited July 8, 2022 by Rahal Hair Transplant