How much should graft count figure into procedure chosen?

[esrec]

I am scheduled for 1800 grafts, I've come to understand that FUT yields more grafts (traditionally) but for anything under 3,000 FUE should produce a similar outcome.

 

Any other thoughts / feedback here?

[Melvin- Admin]

I think you mean FUT can harvest more grafts in a single sitting, when you say yield you're talking about the growth of the grafts, it's a hotly debated topic on here, but in my opinion the difference in yield via FUE vs FUT is insignificant, 1,800 grafts is relatively small for FUT, not sure why you'd want to do so little grafts with FUT, even for hairlines typically 2,000-2,500 is a good amount.

[esrec]

Got it. So the difference between grafts harvested between procedures is less consequential now than before?

 

And are you saying with a session so small it would be more optimal (cost, etc aside) to opt for FUE now and save FUT for a larger session one down the road?

[Melvin- Admin]

From the physicians I've spoken with that perform FUT and FUE regularly they don't state that the yield is much of a difference. Now with that being said if you have FUE with an inexperienced surgeon that does not specialize in FUE the yield will probably be lower. FUE takes a great deal of patience and surgical skill much more than FUT. So it's absolutely imperative you choose a surgeon who specializes in FUE and does them regularly. As for 1,800 grafts being to small for FUT that's really your choice, personally I wouldn't want to scar my head for just 1,800 grafts, so if you're going FUT why not get more? Have you thoroughly researched physicians?

[Stig]

From the physicians I've spoken with that perform FUT and FUE regularly they don't state that the yield is much of a difference. Now with that being said if you have FUE with an inexperienced surgeon that does not specialize in FUE the yield will probably be lower. FUE takes a great deal of patience and surgical skill much more than FUT. So it's absolutely imperative you choose a surgeon who specializes in FUE and does them regularly. As for 1,800 grafts being to small for FUT that's really your choice, personally I wouldn't want to scar my head for just 1,800 grafts, so if you're going FUT why not get more? Have you thoroughly researched physicians?

 

1800 is not a very sizable number of grafts and unless it is only being used to add density, it's never going to be quite enough to make a significant aesthetic difference to the hairlne or crown area. Your surgeon is either going for too few grafts or you probable don't quite need a procedure just yet. If it's the former, find a new surgeon as you really don't want to have to make two passes in 2 years.

[esrec]

I've been speaking with Dr. Bernstein In NY and Dr. Harris in Colorado.

 

I have some definite frontal loss, as I use courve and toppik to mask it daily.

 

I know that both have a great reputation and are pioneers in the space, but have differing opinions on the outcome.

 

Dr. Harris feels strongly he can produce equivalency in all aspects (quality, yield, long term result) with FUE, via SAFE and standard FUE method, where as Dr. Bernstein remains a bigger proponent of FUT from a results perspective.

[Melvin- Admin]

Both doctors are respected in their fields, personally though I think you can find better specialist in both fields, hasson and Wong for FUT or rahal both id pick over Bernstein, and while I respect Dr. Harris, many European physicians provide better results for FUE, dr. Lorenzo, dr. Erdogan, but nevertheless both physicians you've consulted are good. 1,800 grafts I'm assuming they want to play it safe and be conservative, can you post pics, it'll be easier to gauge whether 1,800 grafts will make a significant impact or not for you.

[Dr Blake Bloxham]

Esrec,

 

As you've probably noticed, you will receive differing opinions on this matter.

 

I'm sure you want all the information you can get, so I'll give you mine as well:

 

For a case of this size, I think you'll see better results from FUT opposed to FUE. Though people do disagree on the yield issue, the available data shows that there is more of a difference than we'd probably like there to be. Check out this study done by Dr Beehner (a Coalition doctor here):

 

 

What he did in this study was compare skeletonized (FUE) grafts to "medium/chubby" (FUT) grafts and evaluated survival (and, therefore, yield).

 

As you can see, the differences were statistically significant.

 

If you do still want to do this as an FUE, you may want to look into breaking the procedure up into two smaller parts. I think most agree that the best procedural technique and overall outcomes with FUE are achieved when really only dealing with a small number of grafts daily.

 

Good luck with your research. Hopefully this adds a bit of a different perspective and helps you reach a decision -- be it FUT or FUE.

 

Feel free to ask any additional questions!

[Swooping]

The most important thing is to ask yourself what YOU want. FUE is gaining tremendously in popularity and is overtaking FUT heavily now. Yield wise I think the difference is negligible. That is assuming you go with a top FUE practitioner.

 

We heard on this forum from a doctor that the ISHRS is performing a multi center study and is comparing the yield in FUT vs FUE. Preliminary results point to the survival rates being equal.

[Sethticles]

ask yourself, do you wear your hair short (yes - FUE) or not so short (no - FUT).... do you think you'll be a NW567 in years to come (no - FUT) (yes FUE so i can buzz cut with not scar....) then find the top surgeons in their field

[Melvin- Admin]

Esrec,

 

As you've probably noticed, you will receive differing opinions on this matter.

 

I'm sure you want all the information you can get, so I'll give you mine as well:

 

For a case of this size, I think you'll see better results from FUT opposed to FUE. Though people do disagree on the yield issue, the available data shows that there is more of a difference than we'd probably like there to be. Check out this study done by Dr Beehner (a Coalition doctor here):

 

 

What he did in this study was compare skeletonized (FUE) grafts to "medium/chubby" (FUT) grafts and evaluated survival (and, therefore, yield).

 

As you can see, the differences were statistically significant.

 

If you do still want to do this as an FUE, you may want to look into breaking the procedure up into two smaller parts. I think most agree that the best procedural technique and overall outcomes with FUE are achieved when really only dealing with a small number of grafts daily.

 

Good luck with your research. Hopefully this adds a bit of a different perspective and helps you reach a decision -- be it FUT or FUE.

 

Feel free to ask any additional questions!

 

Not to derail this thread but Dr. Bhatti already stated this study had nothing to do with FUT vs FUE yield. Dr. Harris I believe he's recommend as well is the doctor he's consulted with has already conducted his own study that shows the yield is on par with FUT, so studies conducted by physicians and not a third party should always be taken with a grain of salt.

Nevertheless, op do your research, remember these scars last a lifetime, do you ever wish to buzz your head in the future? Do you wear your hair short? If neither of these things matter than FUT may be a good option, but if this is something you wish to do down the line id think real hard before committing yourself to surgery.

[esrec]

@Dr Blake: Are you familiar with this ISHRS study? Didnt Dr. Harris himself recently publish something on the topic that was subsequently pulled from the forum? Wondering if this conflicts with your findings at all?

 

I want the best possible outcome for my hair. If I can achieve equivalent results from the two procedures (from the right surgeon) and avoid a scar in process I would opt there.

 

If results with FUT are still more predictable and consistent even in a top surgeons hands, I wouldnt want to sacrifice results for a small scar.

 

It sounds as if there's still some heavy debate on yield and quality differences (ie if they still remain) and surgeon skill is maybe the biggest factor, and can (maybe) offset most of these differences.

Edited September 10, 2015 by esrec

[esrec]

Not to derail this thread but Dr. Bhatti already stated this study had nothing to do with FUT vs FUE yield. Dr. Harris I believe he's recommend as well is the doctor he's consulted with has already conducted his own study that shows the yield is on par with FUT, so studies conducted by physicians and not a third party should always be taken with a grain of salt.

Nevertheless, op do your research, remember these scars last a lifetime, do you ever wish to buzz your head in the future? Do you wear your hair short? If neither of these things matter than FUT may be a good option, but if this is something you wish to do down the line id think real hard before committing yourself to surgery.

 

Thank you.

 

I dont wear my hair short now, but of course I cant predict the future. The scar itself is less concerning than changes in scalp elasticity or numbess that I've heard of but dont necessarily worry about. Trying not to be an alarmist, but still factor.

 

Perhaps im late on the scene--but the narrative seems to have changed in a positive way. 3 years ago I heard less debate on FUE vs FUT yield and quality which made the debate a little easier if outcome weighed most heavily.

 

Am I fair in this trend being more recent? Its certainly complicated my decision.

[mav23100gunther]

I've been speaking with Dr. Bernstein In NY and Dr. Harris in Colorado.

 

I have some definite frontal loss, as I use courve and toppik to mask it daily.

 

I know that both have a great reputation and are pioneers in the space, but have differing opinions on the outcome.

 

Dr. Harris feels strongly he can produce equivalency in all aspects (quality, yield, long term result) with FUE, via SAFE and standard FUE method, where as Dr. Bernstein remains a bigger proponent of FUT from a results perspective.

 

Both solid surgeons, but there are better out there. These two are probably in the 2nd tier, and Dr Bernstein is ridiculously expensive. He quoted me $8.5 per graft for FUT. Rather look into H&W, Dr Ron Shapiro, Dr Feriduni and Dr Rahal for FUT, and Erdogan, Lorenzo, or Feriduni for FUE.

[mav23100gunther]

ask yourself, do you think you'll be a NW567 in years to come (no - FUT) (yes FUE so i can buzz cut with not scar....)

 

Disagree with this, if you will be a higher NW, then you need to maximise your lifetime supply of donor grafts. In order to gain the most grafts, best bet is FUT until stripped out and then switch to FUE later.

[esrec]

Both solid surgeons, but there are better out there. These two are probably in the 2nd tier, and Dr Bernstein is ridiculously expensive. He quoted me $8.5 per graft for FUT. Rather look into H&W, Dr Ron Shapiro, Dr Feriduni and Dr Rahal for FUT, and Erdogan, Lorenzo, or Feriduni for FUE.

 

 

Thanks. How much of this is subjective? Knowing Bernstein pioneered very early on and continues to, and Harris recently received a top surgeon award in created the SAFE method, I'm curious how "2nd tier" these surgeons could be.

 

I understand price factors for many, but for outcomes purposes, I'd like to exclude this in my decision.

[Dr Blake Bloxham]

Esrec,

 

The ISHRS statistics? Yes. I'm familiar. In one of the big 'FUT v FUE-esque' threads, these were discussed in detail. The problem with the data -- and I don't want to ruffle any feathers and derail your thread too badly here -- is this:

 

Notice: This Practice Census is published by the International Society of Hair Restoration Surgery (ISHRS) and is a compilation of information provided solely by participating physicians. The information published in this survey was developed from actual historical information and does not include any projected information. Neither Relevant Research, Inc. nor ISHRS has verified the accuracy, completeness or suitability of any information provided here, and ISHRS does not recommend, encourage, or endorse any particular use of the information reported in this survey. ISHRS makes no warranty, guarantee or representation whatsoever and assumes no liability or responsibility in connection with the use or misuse of this survey.

 

 

In early April 2015, all 911 physician members of the ISHRS were invited to participate in the 2015 ISHRS Practice Census by email. Of the 911 ISHRS email invitations uploaded, 899 were valid email invitations. Of the 899 physician members invited to participate, 274 responses were received by the May 22, 2015, cutoff, representing a 31% response rate. The margin of error for the sample is within +/- 4.9%at the 95% confidence level. However, the margin of error should be treated as an estimate, since pure random selection is not possible in a voluntary study with an incentive for participation

 

I'm fairly certain I'm familiar with the other study being discussed as well. It's in progress, and not yet completed. So any results could only be inferred at this point. But, if it's what I believe it is, it's probably a bit different than what's being touted. However, take all that with a fat grain of salt because I'm not part of the study, nor have I discussed it with the primary investigator -- though I do intend to!

 

Bottom line: I believe results are much, much more predictable and consistent with the FUT procedure. However, you will have the linear scar. No way around scarring in a hair transplant procedure. But many find the linear scar more concerning than the circular scarring from FUE. You may be one of the patients who is a good FUE candidate ("FOX 1 or 2" if we really want to use the studies) and ends up hooking up with a doctor who really takes a slow and meticulous approach -- and, therefore, optimizes your chances. And I think you'd do well if this is the case. I still think the yield, even under these circumstances, would be a few ticks lower (20 - 25%ish). But many weigh this against the linear incision line and feel just fine with it.

 

Here's my whole thing though: "informed consent." All I want is for you, and anyone else, to have all the knowledge to make the decision. Understand the objective pros and cons of both procedures; decide what best suits your goals; and make an informed decision. If you review all the info and want to move forward with FUE. I'll be the first to congratulate you and ask that you 'keep us updated!' As long as you had all the facts and knew exactly what both procedures entail and the potential for both, you're good in my book.

 

I really hope this helps. Again, I don't want to turn your thread negative or into another 'FUT v FUE' thing. But feel free to ask any additional questions or send me a PM/email.

 

Best of luck!

[esrec]

Esrec,

 

The ISHRS statistics? Yes. I'm familiar. In one of the big 'FUT v FUE-esque' threads, these were discussed in detail. The problem with the data -- and I don't want to ruffle any feathers and derail your thread too badly here -- is this:

 

Notice: This Practice Census is published by the International Society of Hair Restoration Surgery (ISHRS) and is a compilation of information provided solely by participating physicians. The information published in this survey was developed from actual historical information and does not include any projected information. Neither Relevant Research, Inc. nor ISHRS has verified the accuracy, completeness or suitability of any information provided here, and ISHRS does not recommend, encourage, or endorse any particular use of the information reported in this survey. ISHRS makes no warranty, guarantee or representation whatsoever and assumes no liability or responsibility in connection with the use or misuse of this survey.

 

 

In early April 2015, all 911 physician members of the ISHRS were invited to participate in the 2015 ISHRS Practice Census by email. Of the 911 ISHRS email invitations uploaded, 899 were valid email invitations. Of the 899 physician members invited to participate, 274 responses were received by the May 22, 2015, cutoff, representing a 31% response rate. The margin of error for the sample is within +/- 4.9%at the 95% confidence level. However, the margin of error should be treated as an estimate, since pure random selection is not possible in a voluntary study with an incentive for participation

 

I'm fairly certain I'm familiar with the other study being discussed as well. It's in progress, and not yet completed. So any results could only be inferred at this point. But, if it's what I believe it is, it's probably a bit different than what's being touted. However, take all that with a fat grain of salt because I'm not part of the study, nor have I discussed it with the primary investigator -- though I do intend to!

 

Bottom line: I believe results are much, much more predictable and consistent with the FUT procedure. However, you will have the linear scar. No way around scarring in a hair transplant procedure. But many find the linear scar more concerning than the circular scarring from FUE. You may be one of the patients who is a good FUE candidate ("FOX 1 or 2" if we really want to use the studies) and ends up hooking up with a doctor who really takes a slow and meticulous approach -- and, therefore, optimizes your chances. And I think you'd do well if this is the case. I still think the yield, even under these circumstances, would be a few ticks lower (20 - 25%ish). But many weigh this against the linear incision line and feel just fine with it.

 

Here's my whole thing though: "informed consent." All I want is for you, and anyone else, to have all the knowledge to make the decision. Understand the objective pros and cons of both procedures; decide what best suits your goals; and make an informed decision. If you review all the info and want to move forward with FUE. I'll be the first to congratulate you and ask that you 'keep us updated!' As long as you had all the facts and knew exactly what both procedures entail and the potential for both, you're good in my book.

 

I really hope this helps. Again, I don't want to turn your thread negative or into another 'FUT v FUE' thing. But feel free to ask any additional questions or send me a PM/email.

 

Best of luck!

 

Thank you for providing such great detail and being so informative. I really do sincerely appreciate it. I believe you addressed everything fairly.

 

Another question---when you speak of yield is that separate from the quality of the grafts? The fullness and completeness of the looks is primary when I speak of "results".

 

Lastly, I've heard some feedback that scar severity is now overblown? Is the recovery that intense?

 

Thanks

[Melvin- Admin]

Thank you.

 

I dont wear my hair short now, but of course I cant predict the future. The scar itself is less concerning than changes in scalp elasticity or numbess that I've heard of but dont necessarily worry about. Trying not to be an alarmist, but still factor.

 

Perhaps im late on the scene--but the narrative seems to have changed in a positive way. 3 years ago I heard less debate on FUE vs FUT yield and quality which made the debate a little easier if outcome weighed most heavily.

 

Am I fair in this trend being more recent? Its certainly complicated my decision.

 

Well in my opinion and this is just my opinion FUE has gained in popularity, the increase in popularity led to more physicians practicing FUE, this has led to physicians naturally progressing at the procedure, just like anything in life, once something becomes popular more and more people will do it and this will lead to an increase in skill. Not all surgeons are created equal, like I said FUE takes a tremendous amount of surgical skill the leaning curve takes years, in my opinion now that it's been around for over 10 years more and more surgeons are getting over that curve and some are really pushing the boundaries in terms of yield, grafts extracted, and level of baldness that they are working on. Naturally, many surgeons don't wish to go through this learning curve because they already get good results with FUT so they don't see a need. Some surgeons particularly on this site are on a mission to discredit FUE in its entirety. So take what they say with s grain of salt.

 

My opinion if you don't care about the scar and you dont wear your hair short your probably better off going FUT because it's a lot cheaper than FUE. In regards to numbness etc. if you go to a reputable FUT surgeon the likelihood of this occurring is low. Can you post pictures of your hairloss? I'm interested to see why you were quoted only 1,800 grafts that's very low for FUT or FUE.

[esrec]

Well in my opinion and this is just my opinion FUE has gained in popularity, the increase in popularity led to more physicians practicing FUE, this has led to physicians naturally progressing at the procedure, just like anything in life, once something becomes popular more and more people will do it and this will lead to an increase in skill. Not all surgeons are created equal, like I said FUE takes a tremendous amount of surgical skill the leaning curve takes years, in my opinion now that it's been around for over 10 years more and more surgeons are getting over that curve and some are really pushing the boundaries in terms of yield, grafts extracted, and level of baldness that they are working on. Naturally, many surgeons don't wish to go through this learning curve because they already get good results with FUT so they don't see a need. Some surgeons particularly on this site are on a mission to discredit FUE in its entirety. So take what they say with s grain of salt.

 

My opinion if you don't care about the scar and you dont wear your hair short your probably better off going FUT because it's a lot cheaper than FUE. In regards to numbness etc. if you go to a reputable FUT surgeon the likelihood of this occurring is low. Can you post pictures of your hairloss? I'm interested to see why you were quoted only 1,800 grafts that's very low for FUT or FUE.

 

Thank you, also good perspective.

 

I don't wear my hair short, but do care about a scar, but not nearly as much as I care about quality of outcome. It sounds like, even within the debate, that at this stage, an expert FUE surgeon can produce long term results/benefit with FUE that can match FUT. The intangibles then take over once youve nailed the surgeon.

 

I'll post pics now.

[Dr Blake Bloxham]

Esrec,

 

Absolutely. Glad I could help!

 

I think there can be a difference with respect to both yield and quality/characteristics of the hairs that do grow with FUE. We discussed yield. But I also believe there is an increased propensity for "wiry" or "kinky" hair growth from FUE. It occurs because of damage done to the internal portion of the follicle during the graft delivery phase of the extraction. Now, it can happen with FUT as well. But to happen in FUT, a mistake must be made. Generally, graft mishandling or trying to force grafts into slits that are too small. But, it can happen in FUE regardless because of the way the grafts are delivered. Again, I don't want to sound like I'm fear mongering here. But it's a phenomenon I've personally observed. Does it happen every time? No. Does it happen to every graft? No. Again, hopefully this is a fair statement.

 

I think the scar severity issue is a very personal one. Some patients would be upset by what we would consider an excellent "pencil thin" scar. Others have no interest and they could stretch a cm and not care as long as they have hair in the front!

 

What I normally tell patients is something along these lines: most guys fall into what I consider the "normal healer" category. This means they don't have the insane double laxity factor, or a collagen disorder, or a history of keloid scar formation or anything like that. When we close these guys with our protocols, they tend to heal quite nicely. I feel most have a thin "pen line" scar. Those in this category who "stretch" end up with a line that's 1-2mm.

 

I do feel like there are ways to detect the people who will likely stretch. And these patients can be counseled accordingly (and it could be an indication for attempting the procedure via FUE). I also feel like these people are a definite minority compared to the ones I mentioned above.

 

Having said that, I don't want to "down play" anything or pretend like there isn't always some aspect of the patient's own physiology involved. There is. However, we generally get scars that I believe are very acceptable. These guys are able to shave down to a 3 guard before it's really noticeable.

 

Our recovery period for strip isn't really different than FUE. No working out for 10 days.

[esrec]

Esrec,

 

Absolutely. Glad I could help!

 

I think there can be a difference with respect to both yield and quality/characteristics of the hairs that do grow with FUE. We discussed yield. But I also believe there is an increased propensity for "wiry" or "kinky" hair growth from FUE. It occurs because of damage done to the internal portion of the follicle during the graft delivery phase of the extraction. Now, it can happen with FUT as well. But to happen in FUT, a mistake must be made. Generally, graft mishandling or trying to force grafts into slits that are too small. But, it can happen in FUE regardless because of the way the grafts are delivered. Again, I don't want to sound like I'm fear mongering here. But it's a phenomenon I've personally observed. Does it happen every time? No. Does it happen to every graft? No. Again, hopefully this is a fair statement.

 

I think the scar severity issue is a very personal one. Some patients would be upset by what we would consider an excellent "pencil thin" scar. Others have no interest and they could stretch a cm and not care as long as they have hair in the front!

 

What I normally tell patients is something along these lines: most guys fall into what I consider the "normal healer" category. This means they don't have the insane double laxity factor, or a collagen disorder, or a history of keloid scar formation or anything like that. When we close these guys with our protocols, they tend to heal quite nicely. I feel most have a thin "pen line" scar. Those in this category who "stretch" end up with a line that's 1-2mm.

 

I do feel like there are ways to detect the people who will likely stretch. And these patients can be counseled accordingly (and it could be an indication for attempting the procedure via FUE). I also feel like these people are a definite minority compared to the ones I mentioned above.

 

Having said that, I don't want to "down play" anything or pretend like there isn't always some aspect of the patient's own physiology involved. There is. However, we generally get scars that I believe are very acceptable. These guys are able to shave down to a 3 guard before it's really noticeable.

 

Our recovery period for strip isn't really different than FUE. No working out for 10 days.

 

Thank you again. Im trying to get out of my own way here as well.

 

You mention 7-10 days recovery with FUT, but what about the stitches in the back of the head? I have an image of a wound and it creating some serious downtime.

 

I plan on taking a month off from work. Im ok with temporary pain and waiting for what I hope to be a (relatively) minor incision to heal. I just worry about being less than 100% 2, 3 and 6 months out. I live a pretty active lifestyle.

[Melvin- Admin]

Thank you, also good perspective.

 

I don't wear my hair short, but do care about a scar, but not nearly as much as I care about quality of outcome. It sounds like, even within the debate, that at this stage, an expert FUE surgeon can produce long term results/benefit with FUE that can match FUT. The intangibles then take over once youve nailed the surgeon.

 

I'll post pics now.

 

I believe that to be 100% the case, it's very well documented on this site, I myself had an FUE procedure that I considered to be a success, I doubt my result would've been any different if I would've gotten an FUT, also please note that "kinky wiry" hair can occur in either procedure, it's not only FUE that can cause this appearance, and most of the time the hair characteristic fixes itself over time. David the moderator got this from an FUT procedure he had but it went away after a while.

 

I encourage you to really think about what would be best for you, comparing top FUE to top FUT the cosmetic outcome will be similar. However, the difference in price may be a lot. Unfortunately, even the best physicians can't tell if you will scar poorly, it's rare this happens on your first procedure though. Take a look at before and after videos from physicians that perform both, a good example is Dr. Diep, hes very good at both procedures.

[esrec]

I believe that to be 100% the case, it's very well documented on this site, I myself had an FUE procedure that I considered to be a success, I doubt my result would've been any different if I would've gotten an FUT, also please note that "kinky wiry" hair can occur in either procedure, it's not only FUE that can cause this appearance, and most of the time the hair characteristic fixes itself over time. David the moderator got this from an FUT procedure he had but it went away after a while.

 

I encourage you to really think about what would be best for you, comparing top FUE to top FUT the cosmetic outcome will be similar. However, the difference in price may be a lot. Unfortunately, even the best physicians can't tell if you will scar poorly, it's rare this happens on your first procedure though. Take a look at before and after videos from physicians that perform both, a good example is Dr. Diep, hes very good at both procedures.

 

Cost is not factoring into my decision. Im thankful to have some flexibility there. I mean that in the most respectful way.

 

I think I came into the process thinking the narrative was more clear--short hair, dont want scar, ok with 80% effectiveness--go FUE, dont mind scar care about hair quality/yield, still with FUT.

 

Since updating my research over the past month, it seems as that story has become more blurred, if even now in a positive way.

[esrec]

Cost is not factoring into my decision. Im thankful to have some flexibility there. I mean that in the most respectful way.

 

I think I came into the process thinking the narrative was more clear--short hair, dont want scar, ok with 80% effectiveness--go FUE, dont mind scar care about hair quality/yield, still with FUT.

 

Since updating my research over the past month, it seems as that story has become more blurred, if even now in a positive way.

 

Pictures posted. Not the best angles but you'll see the front / middle area has receded and my hairline even more significantly. Ironically, if I wasnt suffering from the frontal loss in the center I wouldnt be as far beyond my frustration point as I am. The hairlines, with my rather thick hair is easier to mask.

 

Feedback welcome