Are Hair Transplants an “Illusion” of density?

[John1991]

5 minutes ago, Gatsby said:

Looking good @John1991 🤘

You're looking much improved as well.  

[NARMAK]

1 hour ago, John1991 said:

Seems like an unwise use of money and time if those touchups make no difference in the life of the patient, though.  If the purpose of a hair transplant is to a) improve one's hair situation (to help one's overall appearance improve) and b) have the recipient area look indistinguishable from the rest of their hair and look natural then once a and b are accomplished, anything further seems unwise.  Especially given that "anything further" (more surgeries) requires thousands of dollars and months of recovery.  Hair transplants should be a means to an end, not an obsession in and of themselves to the point where one's only goal is to ensure the most perfect head of hair humanly possible.  Just my two cents.

I think you have some valid points but it's an aesthetic and personal choice for people. I've definitely seen an argument by people for a single pass to establish things and a 2nd pass to add density and refinement. 

Everybody has their own finances and i guess if one is in a position to do so, some may opt to whilst some are happy enough to just give it a one pass. 

[John1991]

Why go for a 2nd pass if the first one looks natural and indistinguishable from the rest of your hair, though?  What actual gain do you get?  It won't improve your odds with chicks, coworkers won't notice/it won't help your career, at best it will make you feel slightly better when you zoom on pictures in harsh light.  That's just not - in a rational worldview - worth thousands of dollars and months of your life recovering.  Sure, if the first procedure doesn't give a "good" result,  I understand going back to get the job done properly.  I know this is a hair transplant centered forum, but it's important that people not be too myopic.  Yes, the definition of "good" will vary person to person, but there comes a point where a very marginal improvement isn't rationally justifiable and the whole thing becomes an unhealthy obsession.  

 

To be sure, I'm not saying hair doesn't matter.  And I'm damn sure not saying looks don't matter.  I drove 14 hours, spent $11k, and months of my life recovering from my transplant just to have a slightly better hairline.  That's not rational and going back for another 500-600 grafts (for perfection) would be even less rational.  At some point, people need to get that the happiness they're searching for isn't going to be found in that minor extra improvement.  

Edited October 15, 2022 by John1991

[NARMAK]

48 minutes ago, John1991 said:

Why go for a 2nd pass if the first one looks natural and indistinguishable from the rest of your hair, though?  What actual gain do you get?  It won't improve your odds with chicks, coworkers won't notice/it won't help your career, at best it will make you feel slightly better when you zoom on pictures in harsh light.  That's just not - in a rational worldview - worth thousands of dollars and months of your life recovering.  Sure, if the first procedure doesn't give a "good" result,  I understand going back to get the job done properly.  I know this is a hair transplant centered forum, but it's important that people not be too myopic.  Yes, the definition of "good" will vary person to person, but there comes a point where a very marginal improvement isn't rationally justifiable and the whole thing becomes an unhealthy obsession.  

 

To be sure, I'm not saying hair doesn't matter.  And I'm damn sure not saying looks don't matter.  I drove 14 hours, spent $11k, and months of my life recovering from my transplant just to have a slightly better hairline.  That's not rational and going back for another 500-600 grafts (for perfection) would be even less rational.  At some point, people need to get that the happiness they're searching for isn't going to be found in that minor extra improvement.  

Yeah, i think in your example if the single HT was that good, most people wouldn't return but i think on average, most HTs don't achieve that and usually why a 2nd pass for more density is done. 

Although how many go for a 2nd pass is up in the air. I think for myself for example it would definitely not be a good idea to even think about anything down the line until i get to about 18 months post-op and see how it looks and personally i think if as i assume, there's still hairs due to pop through since the months 2 & 3 ugly duckling phase, even at 6 months it wouldn't be fair to start dwelling on future HTs for density. You really do need to get to that end point and only then is it fair to have a proper look and decide if it's even sensible or makes sense for you. 

I think with hair, a lot of people depending on your starting point can be a bit oblivious too. They won't always notice things as acutely if you started off like Norwood 2 or 3. If it was more dramatic say from Norwood 5 and above especially if you were doing a full shave. 

Tbh, chasing hair density becomes a vanity like you point out at some point. Marginal improvement for the grafts and costs. 

I honestly think this is again why it's almost so important to get on preventative medication like Finasteride as early as you can and notice hair loss. Makes me sad i let fear mongering put me off for so long. 

[HappyMan2021]

I'm likely going to spend ~18k in January to have Dr. Mwamba complete all of my repair issues (1st surgery was in June)

My hair, and overall my appearance look really good as is, and literally no one would ever notice my remaining bad angles, but I will not have peace of mind and be able to move on with my life until I am 100% repaired. 

I'm not doing this for chicks, career, or any other external validation. I am doing this for myself and my own peace of mind. 

Even though I am a repair patient, I think this applies to non botched patients as well. 

I think its perfectly reasonable for any one of us to want the best result possible, even if previous surgeries were 'good enough'. 

As long as money is not an issue and surgery is not adversely affecting other areas of life, I don't see what the problem is. 

Society is weird like this. It's cool for a guy to spend $40k on a nice car that will lose value the moment it's driven off the dealership parking lot. 

But spend $40k on multiple surgeries that will permanently improve your appearance, and all of the sudden you are a hair transplant fiend 🤣

 

Edited October 16, 2022 by HappyMan2021

[Ryan Daniel]

8 hours ago, John1991 said:

Seems like an unwise use of money and time if those touchups make no difference in the life of the patient, though.  If the purpose of a hair transplant is to a) improve one's hair situation (to help one's overall appearance improve) and b) have the recipient area look indistinguishable from the rest of their hair and look natural then once a and b are accomplished, anything further seems unwise.  Especially given that "anything further" (more surgeries) requires thousands of dollars and months of recovery.  Hair transplants should be a means to an end, not an obsession in and of themselves to the point where one's only goal is to ensure the most perfect head of hair humanly possible.  Just my two cents.

I completely agree

[gillenator]

John, I think your result to date is outstanding and very few individuals have that quality visual result in bright lighting…if I were you, no need for more surgery, enjoy your result my friend!

[DeadPoets]

On 10/26/2018 at 2:11 PM, Melvin- Moderator said:

I use Caboki all the time in the crown. In fact, it makes my hair look like a 10.  I can certainly live with needing to use hair fibers to make my hair look perfect. This is how I looked before, I keep these pictures as a reminder.

Hi Melvin,

Once caboki is in your hair, if someone were to run their fingers through it would it start to fall out and get on their hands? 

[gillenator]

The answer is yes pretty much for all topical cosmetics…the best way is to not let anyone run their fingers through one’s hair and a little hair spray helps too.

[Henry]

So this means that let's say youre a diffused norwood 5. People cant really pull of a long hair after a hair transplant? No matter how many grafts you move?

[NARMAK]

On 11/9/2022 at 2:45 AM, Henry said:

So this means that let's say youre a diffused norwood 5. People cant really pull of a long hair after a hair transplant? No matter how many grafts you move?

It's always a case by case basis. Ultimately some carry off the "Illusion" better than others if density, skin to hair contrast, hair calibre and other factors play in their favour. 

Usually people are told to grow hair longer with a hair transplant generally but i guess just as the saying to not go too short is mentioned, going too long could expose the density or rather lack of for some people. 

Ultimately until hair transplants get unlimited grafts, we can't act like everybody will have the same pre hair loss look. Even then, we do not know how much density surgeons will truly be able to recreate. Could we see them go even higher than native density? That's going to be something that needs a clinic study and multiple trials over the best method. Single setting, double or several etc. 

[gillenator]

It really does come down to every individual’s hair characteristics…obviously the diffused thinning pattern  of loss in the advanced state is the most challenging because as this thread implies, it’s the illusion of density, visually speaking…so placement of the grafts and how the hair is styled will have the biggest impact.

[mister_25]

37 minutes ago, TurkishHair said:

This thread is bs no offense but if I’m paying $35k for a transplant I’m expecting my hairline to resemble a 16 year old teenager hairline. If I just want illusion I would get a transplant at an hair mill in Türkiye. I’m paying $35,000 for a transplant with a top doctor so my hair will turn back into 18 year old me

Depends on how much loss you have. Yeah sure you can have a 16 year old hairline but what does that matter when your crown is the size of a beach ball?

Going for a juvenile hairline like that requires a lot of grafts. Which are a finite resource. Look at @Fue3361 who had a very high density transplant that you could consider close to or native level density. With those 3361 grafts for just that small portion imagine how many grafts he would need to replicate that on a Norwood 5. Like 12k+ grafts.

Have some realistic expectations. If you are a Norwood 2 or 3 and that’s all your ever going to be then I think you could get a juvenile 16 year old hairline with the density to back it. Norwood 4 I believe it’s possible but that’s all your donor area and it won’t be utilised properly if you go into higher Norwood stages. 

[Pbaird98]

1 hour ago, TurkishHair said:

My crown isn’t that bad it’s not even considered bald just thinning and the area is just a small patch. Im not even taking any meds, if I hopped on 1mg fin that would probably close on its own. My real problem is just a receding hairline but I have above average super thick donor hair so if that is transferred to the front I’m done and will look like my former 16 year old self 

Can you post up some pics? 

[JayLDD]

4 hours ago, TurkishHair said:

This thread is bs no offense but if I’m paying $35k for a transplant I’m expecting my hairline to resemble a 16 year old teenager hairline. If I just want illusion I would get a transplant at an hair mill in Türkiye. I’m paying $35,000 for a transplant with a top doctor so my hair will turn back into 18 year old me

I feel sorry for the doctor that inevitably is going to get called an evil butcher by you after your result isn’t completely perfect.

[gillenator]

Time tells all things!

[Rafael Manelli]

On 10/14/2022 at 12:46 AM, SeanToman said:

Another example of how pictures can be deceiving.  These are taken on the same day, same room, same hour.
The only difference is that I'm standing under a heavy light in the second image;

 

However, ANYTHING is an improved over what you used to have.
Hair transplants can definitely make someone look like they have a full head of hair!

But just know that lighting can be an enemy.

This is insane, the first pic looks perfect and the second looks totally transparent, sparse and even cobblestoned. Thanks for posting.

[SeanT1]

3 hours ago, Rafael Manelli said:

This is insane, the first pic looks perfect and the second looks totally transparent, sparse and even cobblestoned. Thanks for posting.

You're welcome! Yes sir, it seems to be a very common issue with hair transplants; heavy lighting will always be your enemy.

[Rafael Manelli]

Just now, SeanToman said:

You're welcome! Yes sir, it seems to be a very common issue with hair transplants; heavy lighting will always be your enemy.

Maybe if you got a second transplant...

[SeanT1]

Just now, Rafael Manelli said:

Maybe if you got a second transplant...

Absolutely, more grafts per square centimetre the better!
I personally worry about damaging existing transplanted grafts with a second procedure though...
As well as thinning out my donor too much.

[Rafael Manelli]

Just now, SeanToman said:

Absolutely, more grafts per square centimetre the better!
I personally worry about damaging existing transplanted grafts with a second procedure though...
As well as thinning out my donor too much.

I was just kidding, it's your choice. Personally I think if the surgeon is good he should have no issue implanting between existing hairs. Those hairs are terminal and strong and easily visible with the naked eye, let alone surgical loupes. Easy to avoid transecting.

The donor capacity is the main concern, and that's a more personal issue that varies dude by dude. 

I'm just so curious what sort of density is needed to overcome harsh lighting. 

Have you tried the harsh lighting but with toppik powder? 

[SeanT1]

1 minute ago, Rafael Manelli said:

I was just kidding, it's your choice. Personally I think if the surgeon is good he should have no issue implanting between existing hairs. Those hairs are terminal and strong and easily visible with the naked eye, let alone surgical loupes. Easy to avoid transecting.

The donor capacity is the main concern, and that's a more personal issue that varies dude by dude. 

I'm just so curious what sort of density is needed to overcome harsh lighting. 

Have you tried the harsh lighting but with toppik powder? 

I got SMP work done as an alternative to toppik.
For some men toppik works amazingly, I personally don't enjoy using it.
SMP can look great indoors, but you'll still have the same issues under the harsh sun.
Thanks for the advice though.

I agree that a top doctor could transplant follicles in between existing hairs, but I'm just happy & fortunate enough that my first transplant done by techs in turkey worked out!  I wouldn't be able to afford a top doctor.

[Rafael Manelli]

2 hours ago, SeanToman said:

I got SMP work done as an alternative to toppik.
For some men toppik works amazingly, I personally don't enjoy using it.
SMP can look great indoors, but you'll still have the same issues under the harsh sun.
Thanks for the advice though.

I agree that a top doctor could transplant follicles in between existing hairs, but I'm just happy & fortunate enough that my first transplant done by techs in turkey worked out!  I wouldn't be able to afford a top doctor.

Do you have a photo with the SMP? Maybe a strong lighting one? Or wet? 

Edited February 6, 2023 by Rafael Manelli

[gillenator]

It always gets back to this age old question, “How much density is really needed on a case by case basis to achieve a restored look?”

[whattthe]

Some interesting reading in this thread and really great points.. 

I am still prior to hair transplant, and only would say that I was surprised after reading my tricho report I had done on importance of thickness of existing hair. 

When I look in a mirror at home, I see myself having some hair on the front.  Take a photo and it feels like sometimes I have zero hair in the front. Prior to the results I would have just guessed it was all about the density and estimated that I had something like 300% higher average number of hairs on the sides or back than the front area.  

However after taking some time to look at the numbers in the summary table in my report, my opinion changed.  The average number of hairs was only 10% less (201 N/cm2) vs. (223n/cm2) on the frontal vs. occipital.   That left me very confused until continuing to read through and seeing the thickness numbers broken down.  The average shaft thickness in the front 38 um vs 66 in the occipital area. And the real kicker that explained why I saw almost no hair in the front I think was the number of actual thick hairs.  This was an eye dropping 11% thick hairs vs 78%.  

I had stopped taking anything to try and retain my hairs current state in my 20s (mid 40s now), due to sexual performance concerns or topical solutions at the time that bugged my scalp.  

Seeing the results of the thrico definitely motivated me to try and keep and increase the thickness of my existing hairs.  I started LLT in past month even. 

As far as HT density... I think there is already a lot of great thoughts here. 

it sounds important to not go too dense on the first round in order to give the grafts better success rate.  I was told by local Dr if I needed more density, it would be best to come back for a second treatment with a lot less grafts.  Seems to match some other comments here too.