What an HT Should Look Like at 6 Months | *4 Cases Inside* | Feller & Bloxham, NY

[Dr Blake Bloxham]

I've recently had several community members reach out concerned with their 6 month "results." Despite a lot of information online reassuring HT patients that 6 months truly is the half-way point as far as maturation goes, there does seem to be this underlying idea that if it doesn't look good at 6 months, you're in trouble. And to make things worse, we do frequently see examples of 6 month patients who are ahead of schedule on the community -- furthering the misconception that if things aren't "looking good" by 6 months, it won't look good at 12 -- or 18 -- months (which is untrue).

 

So what should an HT look like at 6 months? What does it mean to be "on schedule?" What things should you see? And what does it mean if you're not there yet?

 

To try and help, I decided to share a few examples of 6 month follow-ups who have come into the clinic over the past several weeks. I think each of these are a good example of what an HT should look like at 6 months.

 

So I'm going to share 4 different cases; describe where these patients "fall" on the 6 month average ("ahead of schedule, "on schedule," etc); and point out some classic 6 month characteristics. I hope this thread provides some comfort to those patients around the 6 month mark nervous with their progress. You are probably right where you should be, and look somewhat like these patients:

Case #1: 6 months post-op, 2,200 grafts VIA FUT

 

 

 

6 month rating? I would say this patient is slightly above average. Not only is his density solid and fairly uniform at only 6 months, but you can also see in the "top-down" shot that he has good growth in the more posterior regions where I worked -- and generally the further you go back in the scalp, the slower the maturation.

Classic 6 month characteristics? Note the texture differences (still a little "wiry"), the shorter length, slightly slower maturation of the singles at the hairline compared to the multi-FUGs behind them, and the slight color difference of the transplanted hair. This is all normal and expected for 6 months.

Case #2: 6 months post-op, 1,200 grafts via non-strip technique

 

 

 

 

 

 

6 month rating? I would rate this patient as "on target" or "on schedule" for 6 months.

 

Classic 6 month features? The classic "wiry" or "kinky" appearance to the hairs; the patient is also exhibiting some very classic 6 month styling. Not only is he doing the very common "side part" at 6 months (this usually suits patients best at 6 months), but he's also starting to get enough new transplants to style them with his existing hair (you can see him combing these together in the left side shots), and he's experimenting with newer styles in general (he complained about not being able to ever style before and his hair always "sticking up" like seen in the pre-op pics -- though it's exaggerated in those images). If you find yourself with much easier styling options, using less concealer, or finally being able to work with your existing hair, you're right on track for 6 months.

Case #3: 6 months post-op, 3,500 grafts via FUT

 

 

 

 

 

6 month rating? Slightly above average. I say above average simply because the patient has maturation very far back in the scalp. I was able to work all the way from the hairline into the crown on this patient. I usually tell patients that the crown noticeably lags compared to the frontal regions, and very little progress (or subtle, vellus-like growth) is normal at 6 months. This patient, however, had fairly impressive growth in the crown region at 6 months. And while I didn't get great top-downs, you can see the immature growth in the crown (short, "frizzy," hairs standing up) in the right-side shots.

 

Classic 6 month characteristics? A lot of noticeable texture differences and the side-part styling; but what I find most "classic" on this patient is the loss of the "comb over" he was using before surgery. 6 months is usually the point where patients start to rid themselves of these crutches. Comb overs are cut, concealer use decreases dramatically, and they begin to rely on the cosmetic effect of the transplant. If you find yourself changing these things around 6 months, you're on target.

Case #4: 6 months post-op, 2,500 grafts via FUT

 

 

 

 

6 month rating? Ahead of schedule. Although there are some very classic 6 month traits here, this patient looks more like what I would expect at closer to 8 or 9 months. However, all patients do mature differently; so I did want to include one of the "ahead" 6 month examples we often see online and confirm that he is ahead of schedule.

Classic 6 months characteristics? Although well-matured, the patient still has some classic texture changes -- he noted that his naturally "wavy" hair was extremely curly and wavy. He also has some lack of uniformity across the front. As you can see, some follicles are growing slower than others and the hairs are, therefore, slightly shorter, thinner, and lighter in color.

 

The top-down shot also shows something very classic for 6 months: a growth gradient. I was fortunate enough to work all the way back through the mid-scalp and into the anterior crown on this patient. And as you can see in the 6 month shots, the hair in the frontal regions is more matured compared to the hairs in the mid-scalp and crown. The frontal hairs are thicker, have more of a "wave," and provide more coverage when compared to the hairs behind which are thinner, less dense, and provide less coverage all around (even with the strategic styling). This is normal. There is no reason to be concerned if the frontal portion of your transplant looks better than the more posterior portions at 6 months.

 

So I hope this presentation helps those who find themselves around the 6 month mark and feeling slightly concerned. And even if you find yourself "behind" these mostly "on par" 6 month cases, there is no reason to panic; everyone matures at different rates and "slow growers" are a real thing. But chances are that you somewhat resemble at least one of these patients and are right where you should be for 6 months.

 

Thank you for reading. I look forward to your comments.

Dr. Blake Bloxham, Great Neck, NY

Feller & Bloxham Medical, PC

[mikeyhwk]

Very helpful post, thank you for sharing this Dr Bloxham. I see so many threads of guys freaking out about growth at 4-5-6 months, thinking they are doomed to poor results because they compare themselves to guys who were way ahead of the curve. This should help guys get some real perspective.

 

Id love to see this done just focusing on the crown as you mentioned that it lags behind, so what is considered average at various stages.

[TakingThePlunge]

Great resource for those questioning their early results!

[MayiraP0chu]

Neat idea Dr. Bloxham! Great post to fall back on.

[Al - Moderator]

While this is nice, what would really be helpful and informative is if you can get photos of these same people at 12 months. Then you can compare the 6 month progress to the end result. I think that would be much more telling than just a 6 month photo because with just one snapshot in time we can't really assess where they are in the process at any certain time without seeing the end result.

 

Thanks

[Dr Blake Bloxham]

Very helpful post, thank you for sharing this Dr Bloxham. I see so many threads of guys freaking out about growth at 4-5-6 months, thinking they are doomed to poor results because they compare themselves to guys who were way ahead of the curve. This should help guys get some real perspective.

 

Id love to see this done just focusing on the crown as you mentioned that it lags behind, so what is considered average at various stages.

 

Thank you. And yes, I do hope this helps some of the patients worried around the 6 month point.

 

While this is just my complete subjective observation, I believe the crown maturation lags by at least 3 months. Usually I see it just waking up around 6 months (the same way the front starts to wake up at 3 months) and it takes at least 15-16 months to say that it's "fully matured." Having said that, I usually don't fully evaluate a crown until 18 months because a lot of people do mature even slower in the crown.

[Dr Blake Bloxham]

Great resource for those questioning their early results!

 

Neat idea Dr. Bloxham! Great post to fall back on.

 

Thank you.

[Dr Blake Bloxham]

While this is nice, what would really be helpful and informative is if you can get photos of these same people at 12 months. Then you can compare the 6 month progress to the end result. I think that would be much more telling than just a 6 month photo because with just one snapshot in time we can't really assess where they are in the process at any certain time without seeing the end result.

 

Thanks

 

Thank you for viewing the thread and commenting. I'll absolutely post updates at 12 months when these patients come back in for their year follow-up.