HTs and the "illusion of density"

[harryforreal]

Also, here is a comparison of a plucked transplanted hair versus a plucked hair from the middle of the back of my head. The shorter transplanted hair is clearly thicker and darker. Don't ask me why - I'm no scientist. I just know it doesn't look like any native hairs on my head!

 

http://www.hairrestorationnetwork.com/eve/182316-pre-op-anxiety-post2461262.html#post2461262

[harryforreal]

Just to get an idea of what your HT standards are, could you please point out in this video which transplants you think look unnatural:

 

For me, I'm mainly looking at where the hair exists the skin - not top down photos where all you see is a mass of hair. And here is where I offer the word of caution: especially if you are new to looking at such images, where there formerly was little or no hair, you now see...HAIR!!! Looks amazing!

 

But I must agree with Spanker, to really know the hairline you need to see it in person. He drove across country to look at a hairline if I recall correctly (from a post several years ago). This will be more telling than such a video.

 

Again, if you're just looking for hair coverage, then a HT might well be for you!

 

If you're looking to go on dates and have potential dates run their fingers through your hair....eh....better look at some HT in real life I say - and even then you might be happy with what you see! But maybe not!

[Dutchie]

Looking at your photo album I can see why you're not happy with your HT:

 

Hair Restoration Social Network - Hair Loss and Transplant Photos

 

Who was your doctor??

[harryforreal]

Haha, yes, nothing to be happy with I don't think ^^

 

Oh, well, I prefer not to say. What's done is done. Why it looks like that, I don't know - technique? Aesthetic sense? something weird with physiology?

 

It's not just a question of the HT itself, but the actual hairs that are growing are just too thick and dark for that part of the head. But, yeah, the HT itself was hardly a home run!

[Dutchie]

Haha, yes, nothing to be happy with I don't think ^^

 

Oh, well, I prefer not to say. What's done is done. Why it looks like that, I don't know - technique? Aesthetic sense? something weird with physiology?

 

It's not just a question of the HT itself, but the actual hairs that are growing are just too thick and dark for that part of the head. But, yeah, the HT itself was hardly a home run!

If I were in your shoes I'd go to a top HT doctor and get that mess fixed

[JON86]

There are two sides to the coin. Thicker donor gives more coverage but looks less natural up close. Thinner hair gives less coverage need more grafts but hairline looks softer and more natural. I am guessing you had fue and wondering does the doctor you went with do strip and fue or just fue? Just wondering where their area of expertise is supposed to be. If fue was this by machine or by hand?

[harryforreal]

If I were in your shoes I'd go to a top HT doctor and get that mess fixed

 

The doc added more to increase the density - but it doesn't change the fact that the hairs in front are so dark - basically black, and thick. So I don't see how going to a "top doc" is going to change this.

 

Here is a patient of Rahal complaining about the same thing (in post 35):

 

That was one of the options I was considering or FUE ing them out. There's not amount of time that will make this look these course black hairs in the front blend with my blonde hair.

 

http://www.hairrestorationnetwork.com/eve/181838-fue-rahal-1431-a-4.html

[harryforreal]

There are two sides to the coin. Thicker donor gives more coverage but looks less natural up close. Thinner hair gives less coverage need more grafts but hairline looks softer and more natural. I am guessing you had fue and wondering does the doctor you went with do strip and fue or just fue? Just wondering where their area of expertise is supposed to be. If fue was this by machine or by hand?

 

Yes, but how does one get thinner donor hair???

 

It was FUE, and it was machine, though the doc did do strip for many years prior to machine, and now does exclusively by hand.

 

But again, the primary complaint I have read about machine (neograft or artas) is low survival rate of grafts; my FIRST complaint is the dark, thick hair shafts at the front. I'm not crazy about the evenness of the density, but if the thicker donor up front looks unnatural up close, it's really irrelevant if one is concerned about someone getting close enough on a date to run one's hands through the hair.

 

But I'm always open to hear any new thoughts!

[Dutchie]

Yes, but how does one get thinner donor hair???

 

It was FUE, and it was machine, though the doc did do strip for many years prior to machine, and now does exclusively by hand.

 

But again, the primary complaint I have read about machine (neograft or artas) is low survival rate of grafts; my FIRST complaint is the dark, thick hair shafts at the front. I'm not crazy about the evenness of the density, but if the thicker donor up front looks unnatural up close, it's really irrelevant if one is concerned about someone getting close enough on a date to run one's hands through the hair.

 

But I'm always open to hear any new thoughts!

So you had Neograft or Artas done then??

[Noodles123]

Were you a rahal patient? Or a shapiro patient. Both of these doctors used machines before abandoning them. I see the issues you mentioned. The placement at the hairline is sparse in contrast to your native hair, which highlights the difference in density. I think increasing the density would help.

[JON86]

Only reason I brought up the conversation about donor thickness is it's good and bad for each side. I have medium fine hair can have a nice hair line but my density will require more grafts. I wish I had thicker donor . Was wondering if it was a machine because it looks like some of the grafts might not have survived and that seems common in machine procedures and will make it look uneven. It's hard to tell if the doctor used all one hair grafts in the front as this would soften up your hairline. If he did not another doctor might be able to soften it up with more one hair grafts.

[harryforreal]

Yes, machine, and the hairs seemed to grow fine I THINK (but who knows maybe not?) - but in those original pics on my profile from several years ago the density was quite poor, just as blahblah1982 mentions:

 

I see the issues you mentioned. The placement at the hairline is sparse in contrast to your native hair, which highlights the difference in density.

 

And I certainly agree: the difference in density between my native hairline and the transplanted hairline was quite absurd.

 

http://www.hairrestorationnetwork.com/eve/182288-hair-transplant-reversal-2.html

 

But in post 24 of this thread I provided the above link to several pics I took just a couple of weeks ago. The doc went back and increased the density AND targeted single hair grafts to soften up the hairline almost two years later for free (though it could STILL be touched up in a couple spots), but again the issue to me is the coarse, dark hairs, even with the added density in front - just looks bizarre!!!

 

But the 2's and 3's are what I think look most bizarre and exaggerate the dark hairs, and that is why I am going to target some of the 2's and 3's in the hairline with electrolysis and see what that does to improve it, but AGAIN, even if it softens it up a bit, I'm not sure that the color will make much sense. Look at the color difference in the link I provided again and you'll see what I mean.

 

I actually want to decrease the density at the very front (by changing some 2's and 3's to singles hopefully), but it won't change the fact that the color is basically black at the front.

[Melvin- Admin]

Theres a couple of problems, one the density, looks like maybe 800 grafts survived it's very sparse, second the artistry, I'm not a fan of the design, in my opinion it's not enough zig zag, I know people talk bad about zig zag hairlines, but I think by doing this you're placing a lot of single hair grafts in the front behind more single hair grafts and then 2,3 and 4 hair grafts, this will give your hairline that softness but also density.

 

Harry I can see why your not happy, the result was poor, but dude look at this way your 40 years old and you still have a ton of hair, your basically ahead most guys your age, this can 100% be fixed, I've been saying this like a broken record, robotic FUE is not good, the yield is bad it damages the donor and just not worth it. In order to match the density of your native hair you'll probably need 2,500-3,000 grafts, I'd say go for it, if you were 20 I'd say no, but since you're over 40 I'd say it's a lot safer, I think you could have a very nice result.

 

The thickness and hair color in the hairline is all about graft selection, FUE surgeons can cherry pick grafts, the robot couldn't cherry pick, I think the surgeon could find the softest area of the donor that matches the color on top and perform the extractions accordingly. Things could be worse as thisguy said you could be Norwood 6 at 30 like me I'd do backflips if I had that much native hair.

[harryforreal]

The original HT was 1000 grafts - and it was a machine (neograft) but not robot. So the doc did cherry pick, especially when he went back the second time added another 300-400 grafts, targeting singles. Most of the grafts the second time never shed but continued to grow, so at the very least I'm quite confident in that the grafts the second time grew fine. Honesty, I just don't think the placement is very dense. BUT EVEN THEN....the black pubic hair look!!!

 

I'm definitely not a fan of the design!

 

The simple fact is that anyone can see a difference between the transplanted hairs and the native hairs. I'm just not convinced that going for more density - which always seems to be the mantra - will make it look natural. PLUS there is the bumpy texture - and in my case permanent redness that has only begun to disappear after two V-Beam laser treatments (which is why I had to shave the hairs in front down in the recent photos). 2500-3000 is a lot plus down time, plus potentially more bad results, when at this point I'd just like to actually slowly raise my hairline with electrolysis to get rid of these dark, coarse hairs. I mean, I've been doing a combover of these black hairs now for 5 years - if I'm going to do a combover, I'd rather it be over natural looking skin than weird black hairs!

[Melvin- Admin]

1,400 grafts is not nearly enough grafts to match the density of a Norwood II, I can understand the apprehension it seems like the first surgery was not executed well, in order for the difference in density not to stick out you needed at least 2,500-3,000 grafts.

 

You could just remove the grafts and move on, you still got a thick head of hair I'm sure with clever styling no one would even suspect you have recession. What may have occurred with the curl and color was the graft may have been damaged and thus grew coarser then native hair. Cherry picking by machine is not the same then cherry picking by hand. But nevertheless, if your done with transplants remove the grafts and get back to how you were before. Hopefully, the general hair restoration population will become aware about the dangers of doing neograft or artas.

[harryforreal]

Hopefully, the general hair restoration population will become aware about the dangers of doing neograft or artas.

 

Hehe, yes - that is the ASSUMPTION many people make - but I don't buy it necessarily, and I felt that that would be the direction this conversation would be steered in without any evidence to support such a statement when the question of a machine being used came into play. But the grafts have grown fine - they are quite healthy. As I said, with the second HT most of the grafts did not shed and were growing virtually from day 1.

 

Also, in a conversation I had w/ Dr. Feller in one of the linked threads, Dr. Feller states that damaged grafts either 1) do not grow or 2) grow thinner; neither of which seems to be an issue here.

 

Yes, the amount of tissue surrounding the graft DOES affect the quality of the graft. A single hair graft devoid of virtually all surrounding tissue is a poor quality graft no matter which method is used. However, the super thin graft produced using FUE is a far inferior graft compared to the super thin graft produced using FUT.

 

A damaged graft will first and foremost simply not grow. Or, it may grow, but produce a hair with a thinner shaft. Or the hair may become kinky and thin, which means it will become incapable of picking up scalp oils giving it a dry or frizzy appearance.

 

Post 28: http://www.hairrestorationnetwork.com/eve/182316-pre-op-anxiety-3.html

 

HTsoon, You have dark hair, I do not. I am more inclined to believe it is a difference in hair color/shaft diameter that creates the real problem. Of course the hair could have been damaged, but I am not willing to make such an assumption when the hairs are growing so thick and well - TOO thick and well!!!

 

I would love to hear that softer hairs can be transplanted densely - but when I've asked about nape hair, for example, I've been told repeatedly that this is not a good option.

 

As I said, at this point having had 2 HT's, I feel most all HT's I've seen (that is via photo or video), do not look 100% natural - even though they may look very good! I've seen a few that look exceptionally good - but then again, that's in a photo on the internet.

 

That being said, I do think that certain hair colors and types hide a HT better than others - dark hair, for example, such as yours. Or gray hair.

 

But lighter hair colors where the hair is still quite dense and thick, I have more reservation, even though again I've seen some that looked good.

 

For my part I always appreciate the input - if I didn't I wouldn't be willing to share. Presently my plan is to zap a few hairs and see how they look. If I kill them off completely and I miss the dark, black hairs, you are correct, I have enough where I could actually go back and harvest some more! But at some point it just gets to be....eh....enough already!

 

[mrkellymac10]

Much of what I read and hear about HTs is in regards to "expectation management" and the "illusion" of having a head of hair when you undergo a hair transplant.

 

I'm wondering if people can expand on this concept a bit. Does this mean that even the best HTs are still readily detectable to those who are familiar with this process? What makes HT scalp coverage an "illusion" versus a reality? Is it that a HT never produces realistic density? Does a HT ever produce a truly undetectable result?

 

I have perused many threads on here and have scrutinized many of the post-HT photos. Obviously there is a spectrum of results in that some do not produce a very natural result and some look great. Of course it is always going to be harder to really tell when just looking at photos vs seeing a result in real life, so maybe some of you who have actually had the procedure done or who have seen many results up close can comment.

 

Thank you.

 

I can tell you from my own real life experience that the most important of the important is the hair line. My doctor put in multi haired grafts into my hairline and it does not look natural and it can be seen across the street. I am going to visit with Dr. Feller to see if he can repair my hairline. He was not my first doctor that was someone in the midwest. Do your research cause there is plenty of info on this sight.

[gillenator]

When Gillenator stated most need 3-4 transplants, was he referring to FUE? As I would assume most NW6 can get the required number of grafts in 2 FUT's?

 

No, I was not referring to FUE but rather the fact that undoubtedly 2 larger sessions to begin with and then several more as the progression continues over the years. And this would be providing that the individual would have the donor supply and means to have those procedures.

[harryforreal]

My doctor put in multi haired grafts into my hairline and it does not look natural and it can be seen across the street.

 

Yeah, this bothers me greatly, too. Hopefully in another week or two I'll address some of the multi haired grafts with electrolysis. I'm hoping that helps. I already tried putting single grafts in front of and around the multi-haired grafts, and it helped SOME, but still looks weird.

 

Most transplants that I see on here always have multi-haired grafts in the hairline.