Avoid Jumping To Conclusions

[Bill - Seemiller]

I’ve seen several dozen times before. Literally, almost every time a patient posts progress pictures showing any kind of concerns or what appears to be less than optimal results, forum members jump to conclusions Making statements that a particular “results” is sub par and that’s a particular surgeon should be removed from recommendation, etc. Meanwhile, a particular patient is only 4, 5, 6 or 7  months out from surgery. 

 It is pretty common knowledge that it takes up to 12 to 18 months for a hair transplant to grow and mature. Moreover, everybody grows at different rates.  But  because many patients are fast growers and see a lot of growth in the early months, forum members often jump to conclusions that everybody must follow the same path.

God for bid some patients only start experiencing signs of  nominal to moderate growth six months after surgery because, those patients must be doomed and the doctor must be dismissed. 

But this kind of misinformation only serve to create chaos and unnecessary panic in the patient  since in many cases, these patients end up being late bloomers and  obtaining optimal results within 12 to 18 months -  just like they are supposed to. 

But for whatever reason, this kind of miss information and panic has been going on for over 10 years and even veteran forum members fall into this false dogma that hurts both the patient and the physician who performed the procedure.

 So as reminder I would like to explain that the final hair transplant result is not seen for 12 to 18 months and everybody grows at different rates. Sure, some patients may see a lot of growth at four months while other patients may barely see new signs of growth at six months.  This is very common and can and does happen all the time.

 I do understand however, we are for all members are coming from. We have to ask ourselves questions like:

At what point do we begin to worry that a particular result  is subpar? If the patient doesn’t experience Any signs of real growth at 6 months, is it a failure? What about 8 months? What about 10 months?

The above are valid questions and while there is no concrete answer, it’s normal for members to panic when these types of situations occur. 

 But speculating  that a slow grower is a no bro are only serves to cause damage to both the patient and surgeons. Thus, regardless of our intuition, it’s always best to wait it out and give a hair transplant procedure a chance to fully mature before evaluating the success or failure of the procedure.   I know it’s hard, but it’s necessary.  

So in my opinion, let’s try not to jump to conclusions and remain positive that if a four member has gone to a top-notch surgeon recommended by this community, that they will likely have an excellent results when the hair transplant matures. In the event it’s a failure, we should trust that the surgeon will do everything he or she can to make things right.   And the publishers and moderators  of this community, with your help will be sure to hold physicians accountable  to provide patients with the best after care  to resolve their concerns. 

Thoughts?

Bill

[JayLDD]

Good post. In my opinion if there are definitely situations slightly earlier on in the process where people can be worried such as if they're at 6 months with virtually zero growth for example. Results don't tend to go from bad to good beyond the 7-8 month mark either, but someone who was on the fence at 7 months might have a great result at 12. 

On the other end of the scale, a result with sub-50% growth at the 8 month mark should be recognized as a problem, in the thousands of results I've seen I haven't seen a single one where more than 30-40% improvement in terms of sprouting occurred from this point. 

[Melvin- Admin]

I agree Bill,

There seems to be an expectation that the results should be almost perfect by 6 months. Unfortunately, no two people are the same, sure some lucky guys grow a substantial amount of hair by 6 months, while the rest grow slowly, but steady.

[BlessUp]

Pics would work. Anyone got pics from month 12 to month 18 that show the difference 

[fortuneplant]

Good reminder post Bill.

 

I just reached my 11th month and there's a significant improvement compared to the 9th month. Two months can make a difference.

[matt3480]

At the same time, let’s not string people out time wise, either. If you don’t have good growth at 6 months, your chances of it being a great result is very small after 12 or 18 months. That’s just fact. There might be the 1 in 100 who is a legit late grower.....but a 1 in 100 chance is not good enough odds to dismiss someone’s dismal 6 month results as being too early to tell. That’s a disservice to them.

We also have a pretty good idea of which surgeons are real good and which are not. A 6 month mediocre result by a top surgeon would definitely lend itself to waiting some more time. However, a mediocre 6 month result by a bad surgeon is just what it is....a transplant that isn’t going to be good. 

Edited September 28, 2018 by matt3480

[pkipling]

Thanks for this post, Bill. The unnecessary panic that people experience from time to time doesn't do anyone any favors. It also makes me wonder why the growth timeline (and it's unpredictability) isn't made more clear by the surgeons of these patients. Either these surgeons are making it very clear that the timeline is approximate and these patients choose to ignore it, or the surgeons are sugar coating the experience for them and selling them a bag of goods by promising guaranteed results much earlier. Either way, this is important information for us all to continue to promote and stand by. 

[Bill - Seemiller]

On 9/25/2018 at 1:29 AM, BlessUp said:

Pics would work. Anyone got pics from month 12 to month 18 that show the difference 

 I know of several patients who have seen improvement between 12 and 18 months however, keep in mind I’m not talking about between 12 and 18 months, I’m talking about between 6 and 18 months  even 6 and 12 months.  There are clear differences in a plethora of patients between 6 and 12 months. 

Best, 

Bill

[Payam]

Its really hard not to jump to conclusions.. at 6 months the low density is really apparent if you have poor growth since the hairs that grew get thicker and the gaps more obvious, and every day you look in the mirror hoping for sprouts between the gaps but nothing, it's a nightmare.. I don't understand how the situation can improve that drastically unless you somehow magically have an enormous number of sprouts after 6 months. 

[Melvin- Admin]

17 minutes ago, Payam said:

Its really hard not to jump to conclusions.. at 6 months the low density is really apparent if you have poor growth since the hairs that grew get thicker and the gaps more obvious, and every day you look in the mirror hoping for sprouts between the gaps but nothing, it's a nightmare.. I don't understand how the situation can improve that drastically unless you somehow magically have an enormous number of sprouts after 6 months. 

Take a look at the difference from month 6 to 15. His hairline was sparse and see through and at 15 months completely filled in, 6 months is the halfway line not the finish line.

 

[fortuneplant]

Good example Melvin.

[Spaceman]

 

6 hours ago, Melvin-Moderator said:

Take a look at the difference from month 6 to 15. His hairline was sparse and see through and at 15 months completely filled in, 6 months is the halfway line not the finish line.

 

This patient actually had good growth at six months. Most of the difference in the six month and 15 month pictures appears to be maturation. There was additional growth to be sure, but from the pictures most of the difference seems to be in the texture and thickness of the hair. 

No doubt that six months is only the halfway point. And for crown work, halfway may be even later. And significant cosmetic changes occur between six and 12 or even 15 months. That is established beyond debate. At the same time, as @matt3480 said, it’s uncommon to have very poor growth in the front at six months and a good result at one year. 

Edited September 30, 2018 by Spaceman

[Payam]

9 hours ago, Melvin-Moderator said:

Take a look at the difference from month 6 to 15. His hairline was sparse and see through and at 15 months completely filled in, 6 months is the halfway line not the finish line.

 

I don't understand, it's as if we are looking at different pictures, this guy has mostly uniform growth at 6 month so of course he can expect a nice result. Still look at the low density areas in his hairline and you will see they mostly remain at the 15th month.. there is no drastic change in the problem areas.

[Melvin- Admin]

9 hours ago, Payam said:

I don't understand, it's as if we are looking at different pictures, this guy has mostly uniform growth at 6 month so of course he can expect a nice result. Still look at the low density areas in his hairline and you will see they mostly remain at the 15th month.. there is no drastic change in the problem areas.

You choose to see what you want to see, it’s quite obvious that he had a substantial amount of hair growth after 6 months. Furthermore, that “problem” area is not actually a problem it is the front of the hairline which means it requires only “1” hair follicular units. Therefore, by nature “1” hair follicular units should expose more scalp. This is what you call a “soft” hairline which provides a natural appearance. 

Below are the photos that show in my opinion without a doubt proof of additional growth.

 

[Spaceman]

Most of the transplanted hair in the six month picture is super thin and wispy, light colored and 1-2 cm long. Perfectly normal for six months. The most significant cosmetic change between six and fifteen months is that these hairs thickened, darkened, straightened, and grew to 4-5 cm in length. Also perfectly normal and expected. There does not appear to be a large amount of new growth on the hairline from six to fifteen months as Melvin suggested. Perhaps @Max Power can weigh in. And Max, congratulations on a nice result. You look really transformed.

Edited September 30, 2018 by Spaceman

[Melvin- Admin]

There are obvious gaps where there is no growth however, I will not argue that the hairs did mature and grow in diameter, but to state that all of the hairs grew at six months I think is flat out false. Having had three hair transplants myself I can assure that there is additional hair growth past 6 months (for most patients). Yes, there is maturation past 6 months which will aid in a fuller appearance, but there is growth past 6 months and even past 8 months. Every patient is different, but there are some patients that continue growing past 12 months and some that stop growing at  6 months, but the majority of patients fall in between and generally see the full results around the 12 month mark. In the end, if its your opinion that there was no additional hair growth past 6 months than I can agree to disagree.

Warm regards- Melvin

[Spaceman]

26 minutes ago, Melvin-Moderator said:

...to state that all of the hairs grew at six months I think is flat out false... In the end, if its your opinion that there was no additional hair growth past 6 months than I can agree to disagree.

 I never stated that, nor is it my opinion. What I said was this:

18 hours ago, Spaceman said:

This patient actually had good growth at six months. Most of the difference in the six month and 15 month pictures appears to be maturation. There was additional growth to be sure, but from the pictures most of the difference seems to be in the texture and thickness of the hair.

 And then later, this:

1 hour ago, Spaceman said:

...There does not appear to be a large amount of new growth on the hairline from six to fifteen months...

 I think you took too much liberty in your characterization of my viewpoint. 

[Spaceman]

By the way, Melvin, your 3 year pic looks fantastic.

[Max Power]

On 9/30/2018 at 1:22 PM, Spaceman said:

Most of the transplanted hair in the six month picture is super thin and wispy, light colored and 1-2 cm long. Perfectly normal for six months. The most significant cosmetic change between six and fifteen months is that these hairs thickened, darkened, straightened, and grew to 4-5 cm in length. Also perfectly normal and expected. There does not appear to be a large amount of new growth on the hairline from six to fifteen months as Melvin suggested. Perhaps @Max Power can weigh in. And Max, congratulations on a nice result. You look really transformed.

I was flipping through my personal journal of photos from month to month to try and weigh in here.  Overall I think I fall somewhere in the middle of this discussion.  At 6 months I'd say I had established a pretty good idea of how everything was going to grow in.  I remember this was the first month I felt comfortable going out without a hat on consistently!

Post 6 month I do believe there was a combo of maturation of the hairs as well as some new hair growth.  I wouldn't say there was a TON of new hairs that came in, but for sure a few.  My hair line seemed to establish itself early on in the process, with a lot of the hairs behind it filling in later on in the process.

Not sure what your guys take is on the color as well, but with the maturation of my new hairs came almost a slight color darkening.  Not sure if that is normal, but I dig it and I feel like it gives me added density.

Such a cool discussion, thanks everyone for their comments and feedback!

[PAI Medical Group Virginia]

Something you fail to mention which I think makes part of the equation is the fact that some doctors will place a small number of grafts over a large area.  The grafts will be there but the results are so diffused that the patient will see nothing.  This typically starts with the consultant that will over-promise.  "You'll have a full set of hair with one procedure."

[Legend007]

Hair naturally darkening is a good sign it’s growing and aging well.. best  wishes .. 

[Spaceman]

Thanks Max, appreciate the clarification.

On 10/2/2018 at 12:21 PM, Max Power said:

Not sure what your guys take is on the color as well, but with the maturation of my new hairs came almost a slight color darkening. Not sure if that is normal, but I dig it and I feel like it gives me added density.

Yes, early hair growth tends to be very thin and lighter in color, and the hair thickens and often darkens as it matures. Also, for many people the donor hair color can be subtly different than the native hair in the recipient area. That difference persists after transplant but can diminish over subsequent hair cycles..