3000 graft FUE but low density

[Milo]

I had 3000 graft FUE done one year ago with a highly regarded FUE Dr. I was told I was Norwood 3 and was a good candidate for FUE. I have had a slow receding hairline and could see that it was heading to Norwood 4, which I dreaded. I am in my mid 40s, and the Dr said receding at my age slows down, but since I was worried about it getting worse,  I decided to get a HT.

I chose the Dr because of the many success stories that have been posted on this forum and has done many FUE procedures. However I am now at the one year post HT and the density is very low. The Dr initially suggested around 2200 grafts but told me that he ended up doing close to 3000, since he was able to get good extraction yield. Based on research I concluded that this should have been enough to provide decent density (I accept it would not be the same as original hair). The hair regrowth started off well around 5 months and lasted for about 2 months and then seemed to stop. Unfortunately I did not take pictures after the HT, as I didn't want to keep thinking about it. Since I have read that it can take up to year for the end result, I tried to stop obsessing and examining it every day.

However with the one year mark approaching I started to get get really worried that the end result is not going to be as expected. It is very difficult to conceal the low density areas since it is both temples. Part of the reason for me getting a HT was not having to obsess about hiding the receding temples, but now it is worse because of sparse hair coverage. Even when I try to cover the temples with other hair you can still see the scalp under a normal light. I recognize that everyone can have a different result, but I expected this Dr to provide a much better result. I have my one year follow up with the Dr coming up, but I need some advice on why the density is so bad. I don't want to name the Dr, before giving him a chance to explain, but I am worried he will say I need another HT. I really don't want to go through another HT again and was expecting that 3000 grafts would have been enough. When I compare my result to others with a similar number of grafts, I don't believe there is 3000 grafts there. I have been taking FInasteride since the HT and been using Minoaxdil on the crown, as I minor receding there. I have attached photos before the HT and today (just after one year). I am scared to go to a hair salon in case they the make it look worse and am having to resort to getting a close family member to cut it for me. I am now more insecure about how thin my hair looks than before the HT and my constantly checking it in the mirror to make sure no scalp is exposed. I really need to find out why my HT result is a failure.

[Melvin- Admin]

Can you post some better quality photos? it’s hard to gauge the full result when we can only see a small portion of the hairline. 

[JayLDD]

There are undoubtedly a number of patients (I'd guess 3-5% for most) that go to top surgeons and yield poor results,  ultimately no one is going to know why your case didn't turn out ideally. Personally I wouldn't recommend going back to the same surgeon if you had an initial poor procedure as you might be better served by a surgeon using separate procedures and techniques, but if there was financial incentive to do so it might still be the best option. In the circumstances he ought to offer a free touch up or a partial refund at the least however. I would definitely reveal who he was and make a fuss if he didn't or made you pay for a touch-up which imo is unethical for any surgeon who has a patient with poor results (although its obvious from the photos who the surgeon was to be honest).

Unfortunately while you say you don't want another hair transplant, if you're very insecure about it which it seems you are (and for good reason) that is your only option to fix the situation.

Edited August 21, 2018 by JeanLDD

[Sean]

Milo, I can see your concerns.  I hope you can get it resolved “safely”.  Hopefully, at your followup, the doctor works with you and can get you repaired via touchup or can reimburse so you can get repaired.  Depending on the level of damage on scalp, the repair cost may be more than the original cost of the transplant.  Very unfortunate situation, but there are quite a few cases like this with similar pattern of concern or worse.   It is a terrible feeling for sure that you end up wasting time trying to maneuver hairs and possibly using concealer to get by when you go out.  Even photos are a pain because you just don’t want them anymore.  Obviously, looking at the situation in the mirror is understandablely upsetting.  I really hope, you are not left hanging and this is resolved at the end of the day.   Best of luck man.  

[Milo]

16 hours ago, Melvin-Moderator said:

Can you post some better quality photos? it’s hard to gauge the full result when we can only see a small portion of the hairline. 

Attached are some more photos which should be better quality.

 

Thanks for the kind words of support posted so far.

I really want to understand why the transplanted grafts did not come back after shedding. Unfortunately I only have my memory of what it looked like before shedding, but I can't believe the density in the transplanted area after the procedure would be so low with 3000 grafts.

Edited August 21, 2018 by Milo

[Melvin- Admin]

I can see why you’re not satisfied with the corners. However, the middle looks pretty good from what can be seen. I see the hairline was lowered about an inch. Do you mind posting a picture with your hairline pushed up? So we can really see how the middle density is, also it appears like the corners have been spread apart.

Do you mind posting pictures with your hair combed normally? Again I’m sorry you’re not satisfied with your results. Also, is your hair wet in these photos? 

[Sean]

Milo, i think it is a good idea to post actual immediate post op photos detailing where grafts were placed and incisions were made.  That may help see where there should be growth.  Side by side comparisons of before and after help.  Best of luck.

[Melvin- Admin]

Yes I agree with Sean, side by side comparisons would be great. Additionally, I think it is worth noting that spreading the hairline apart at the corners will show scalp. Hair restoration is an "illusion" which allows patients to layer and feather their hair follicles together which covers more scalp. Consequently, this gives a "fuller" and "denser" appearance. In addition, whenever your hair is wet it will clump together and this is why the scalp may become visible. I suggest taking photos with dry hair and combed normally. If possible side by side comparisons would be great as well. This gives the community an accurate depiction of your results. If the results are lackluster, we will be more than happy to reach out to the clinic for you if they are recommended.

Warm regards- Melvin 

[Legend007]

I think I know who the doctor is also by the hairline drawing . hopefully I’m wrong . 

[HairLossMentor]

OK... your goal was to wear a trendy hairstyle, spiked, messy, etc. But because of the low density, you need to comb it forward. Same problem you had before. But now your combing forward to conceal the density not the recession.

I understand and am a repair patient myself. 

One thing that working against you is your hair color and skin tone, dark hair and light skin. Lots of contrast, making your HT look thin. 3000 grafts should have been enough for your to achieve your goal - style your hair, etc. But you can't. So by that definition, it's a failure. 

From my experience, your best approach is to contact the doc first. If he/she is recommended and has a good reputation, you will be taken care of. This happens sometimes. It's a risk we take. Get all the facts from the doc and then ask guys here for advice.

It sucks to hear this - but looks like you will need a second HT. Not a big one. But speaking from experience, you should get a big jump in density. So all is not lost. 

[Milo]

On 8/22/2018 at 6:10 AM, HairLossMentor said:

OK... your goal was to wear a trendy hairstyle, spiked, messy, etc. But because of the low density, you need to comb it forward. Same problem you had before. But now your combing forward to conceal the density not the recession.

You summarized it perfectly! I was not expecting to have to worry about trying to comb over thin looking hair where exposed scalp is evident.

I accept the density would never be as good as normal hair. Yes, I agree the middle does look pretty good since the hairline was lowered, but the sides are way lower, in comparison. So I can ultimately comb it to hopefully give the allusion that the density is not as low, but this is not easy to achieve and I had to style it looking like a comb over! 

Unfortunately I didn't take any post op pictures to compare, I wish I had now.

I was hoping someone could provide some insight, with a large number of grafts that I had , the resulting density was so low. Did some of the transplanted grafts not grow back? This ultimately makes me nervous/hesitant to get any further HT, since I don't know how good the result would be. 

[Melvin- Admin]

The last picture looks like a successful result. Hair transplants are the “illusion” of density. Rarely, do HT patients ever achieve true density. By true density I mean hair dense in every situation, harsh lighting, wet, greasy etc. 

I have had a successful surgery, but if I were to wet my hair and spread my hairline apart you will see scalp. So I style it so it looks denser. It may be a case of mismatched expectations. IMO your hair looks good. Others may chime in here and share their opinions id love to hear them.

[Sean]

Milo your photo is pixelated.  If you have a hd camera , it may help. Take a few shots, front and sides.  That may help illustrate.  

[wazaam]

I think the work is below average based on what has been presented. 

The last picture looks good but the previous  photos clearly shows a lack of density in the corners. 

As Sean mentioned we may need some more photos at different angles to make a better analysis. 

A lot of grafts  have been used on a relatively small area in your case. 

 

[LonelyGraft]

Based on the hairline design I’d guess this was dr diep

[newpatient99]

OP, did the doctor ever get back with you?