Are Hair Transplants an “Illusion” of density?

[gillenator]

I have always stated over the years that many HT doctors are of the opinion that hair caliber is the single most critical factor considered in attaining the “illusion” of coverage.

Only minoxidil appears to improve hair shaft diameter.

[vance7]

The comments about shockloss have got me slightly worried about my second surgery that's upcoming.

Is there any chance that existing grafts from my first surgery could be damaged if:

a) the transplanted area for the second surgery is slightly further back and therefore not in direct contact with the existing grafts;
b) I've been on oral fin for one year and topical minox for five years?

I don't recall any shockloss from the first surgery 18 months ago and I wasn't on fin then, and also stopped minox for six months afterwards for reasons I can't remember, but I don't know much about shockloss or what damage it can do to existing transplanted grafts

 

[gillenator]

Transplanted hair is not as susceptible to shock loss as native hair, especially native hair that is diffusing.

[vance7]

On 5/21/2023 at 5:44 PM, gillenator said:

Transplanted hair is not as susceptible to shock loss as native hair, especially native hair that is diffusing.

Thanks @gillenator.

Hopefully being on fin for a year will help as well 

[gillenator]

22 hours ago, vance7 said:

Thanks @gillenator.

Hopefully being on fin for a year will help as well 

Oh yes my friend, being on finasteride for a year is ideal and should help with shock loss.

[ScottishGuy21]

Followed this thread prior to my HT and again after. It really is essential reading for anybody planning a procedure.

There’s far too many social media outlets pushing results that are quite frankly impossible to achieve. How many people post surgery are left disappointed and psychologically damaged because of these unrealistic expectations? If only they’d stumbled upon this forum and thread first they would have saved themselves a lot of angst.

Here we have pages upon pages from real patients operated on by some of the best Dr’s in the world. Blunt honesty about the pro’s and con’s. It’s funny re reading post transplant how much more you can relate to things!

I’m very happy with my own transplant but it does still have the usual weak spots under severe UV light or when parted in a certain way. As a NW5 however given my starting point is absolutely delighted with how it looks. That being said if I was coming in blind and duped Into expecting coverage and density like It was in my teens I’d feel a little disappointed. This is why education  is essential for patient well being.

 

Edited June 14, 2023 by ScottishGuy21

[TheGreatPretender]

5 hours ago, ScottishGuy21 said:

Followed this thread prior to my HT and again after. It really is essential reading for anybody planning a procedure.

There’s far too many social media outlets pushing results that are quite frankly impossible to achieve. How many people post surgery are left disappointed and psychologically damaged because of these unrealistic expectations? If only they’d stumbled upon this forum and thread first they would have saved themselves a lot of angst.

Here we have pages upon pages from real patients operated on by some of the best Dr’s in the world. Blunt honesty about the pro’s and con’s. It’s funny re reading post transplant how much more you can relate to things!

I’m very happy with my own transplant but it does still have the usual weak spots under severe UV light or when parted in a certain way. As a NW5 however given my starting point is absolutely delighted with how it looks. That being said if I was coming in blind and duped Into expecting coverage and density like It was in my teens I’d feel a little disappointed. This is why education  is essential for patient well being.

 

I guess that's why for us in NW V (diffused not 100% gone) it's easier to get thrilled with less then most. 

To be fair I have been stumbling with a receding hairline for a long time and I miss my long hair. So what I am planning to do is to at least be able to restore it to the point where I have enough to conceal it while long under shoulder length and ensure that the minimum level of density is reached. I can always add volumizers and other hair care products to enhance the transplant as well. 

I don't really mind the ocasional bald spots as I was used to having then back in the day and never made much of it so long as I can reach the minimum goal. Maybe consider extensions past a certain point though I am aware that the maintenance may come with a price. 

After that I will likely move on with my life and do the things I want to do. 

[Z--]

5 hours ago, ScottishGuy21 said:

Followed this thread prior to my HT and again after. It really is essential reading for anybody planning a procedure.

There’s far too many social media outlets pushing results that are quite frankly impossible to achieve. How many people post surgery are left disappointed and psychologically damaged because of these unrealistic expectations? If only they’d stumbled upon this forum and thread first they would have saved themselves a lot of angst.

Here we have pages upon pages from real patients operated on by some of the best Dr’s in the world. Blunt honesty about the pro’s and con’s. It’s funny re reading post transplant how much more you can relate to things!

I’m very happy with my own transplant but it does still have the usual weak spots under severe UV light or when parted in a certain way. As a NW5 however given my starting point is absolutely delighted with how it looks. That being said if I was coming in blind and duped Into expecting coverage and density like It was in my teens I’d feel a little disappointed. This is why education  is essential for patient well being.

 

Agreed. Most people who post results tend to post them in favorable lighting and its important to remember that hair tends to look worse in direct overhead lights or at night when it gets oily.

Also, there's this weird trend here lately where folks post photos of their hair with fibers in...not sure how that's going to help anyone, but w/e.

[TheGreatPretender]

Just now, Z-- said:

Agreed. Most people who post results tend to post them in favorable lighting and its important to remember that hair tends to look worse in direct overhead lights or at night when it gets oily.

Also, there's this weird trend here lately where folks post photos of their hair with fibers in...not sure how that's going to help anyone, but w/e.

Funny thing my hair looks awful when oily, howeaver when it's not it is as it's thicker then it actually is. Probably in part due to the shampooing. 

[ScottishGuy21]

41 minutes ago, TheGreatPretender said:

I guess that's why for us in NW V (diffused not 100% gone) it's easier to get thrilled with less then most. 

To be fair I have been stumbling with a receding hairline for a long time and I miss my long hair. So what I am planning to do is to at least be able to restore it to the point where I have enough to conceal it while long under shoulder length and ensure that the minimum level of density is reached. I can always add volumizers and other hair care products to enhance the transplant as well. 

I don't really mind the ocasional bald spots as I was used to having then back in the day and never made much of it so long as I can reach the minimum goal. Maybe consider extensions past a certain point though I am aware that the maintenance may come with a price. 

After that I will likely move on with my life and do the things I want to do. 

If it’s done right you won’t need concealer or extensions. I style mine in a side part and it looks much thicker but even when it’s not styled it looks ok. I only use a small amount of sea salt spray to hold it in place. In harsh outdoor light it holds up very well, it tends to look a little thinner under direct UV light for eg in my bathroom. I can cope with that.

[TheGreatPretender]

Just now, ScottishGuy21 said:

If it’s done right you won’t need concealer or extensions. I style mine in a side part and it looks much thicker but even when it’s not styled it looks ok. I only use a small amount of sea salt spray to hold it in place. In harsh outdoor light it holds up very well, it tends to look a little thinner under direct UV light for eg in my bathroom. I can cope with that.

Hah looks exactly like mine a few months after I descended into this nightmare. 

You have no idea on how much I miss my ponytails and the memories of having girls touching it. 

"Pain reminds you the joy you once felt was real" - Niander Wallace 

[RTC]

I really can't stand this phrase 'illusion of density'. Become very cliche and corny at this stage

[ScottishGuy21]

19 minutes ago, Z-- said:

Agreed. Most people who post results tend to post them in favorable lighting and its important to remember that hair tends to look worse in direct overhead lights or at night when it gets oily.

Also, there's this weird trend here lately where folks post photos of their hair with fibers in...not sure how that's going to help anyone, but w/e.

That’s why I’ve posted shots in harsh light and various styles in my own thread. It’s not fair on people doing their research to try and deceive. 

Oily yes likewise, doesn’t look as strong. Maybe I’ll add that pic to my own thread for perspective. And obviously goes without saying wet it’s a lot thinner.

Edited June 14, 2023 by ScottishGuy21

[gillenator]

IMHO pics from various angles, various lighting, etc. are telling.

[GoliGoliGoli]

On 4/23/2023 at 8:27 AM, gillenator said:

I have always stated over the years that many HT doctors are of the opinion that hair caliber is the single most critical factor considered in attaining the “illusion” of coverage.

Only minoxidil appears to improve hair shaft diameter.

I would think average number of hairs per graft is a more important factor

[gillenator]

I used to think that too however the average graft contains 2.3 hair shafts and since that number is low, the peripheral thickness of each hair shaft is imperatively critical in providing optimal visual coverage.

[Sunset Dune]

On 6/14/2023 at 10:48 AM, RTC said:

I really can't stand this phrase 'illusion of density'. Become very cliche and corny at this stage

“Illusion of density” isn’t the case for everyone, sure if you’re stage 5 and up you’ve already lost most of your hair and a hair transplant would give you that “illusion of density” but if you still have a good amount of hair on your head with above average donor and quality hair characteristics a transplant can do wonders and actually bring your hair back to the way it was in the heyday. 

[GoliGoliGoli]

7 minutes ago, Sunset Dune said:

“Illusion of density” isn’t the case for everyone, sure if you’re stage 5 and up you’ve already lost most of your hair and a hair transplant would give you that “illusion of density” but if you still have a good amount of hair on your head with above average donor and quality hair characteristics a transplant can do wonders and actually bring your hair back to the way it was in the heyday. 

Have you had a HT? They do not return you to your "heyday", at least not in a single pass. 

Edited July 18, 2023 by GoliGoliGoli

[TheGreatPretender]

On 7/18/2023 at 4:38 AM, gillenator said:

I used to think that too however the average graft contains 2.3 hair shafts and since that number is low, the peripheral thickness of each hair shaft is imperatively critical in providing optimal visual coverage.

In essence it's the combination of both. 

[StillAlive]

This thread is solid gold @Melvin- Moderator. Should have its own golden pin button on top of the site, really, same as the recommended surgeons

There is no question in my mind that I now look a thousand times better than before my transplant and thankfully, I'm at an age and stage in my life where I don't feel the need to go crazy with transplant-on-transplant, chasing some unattainable 'perfect' ideal. 

I got my transplant exactly because my baldness got to a degree where I felt it was altering what I 'felt' as my true face. Once my hairline was back and I recognized the dude in the mirror again, I was and continue to be, delighted. Anything else is just gravy on top. 

[GoliGoliGoli]

29 minutes ago, StillAlive said:

This thread is solid gold @Melvin- Moderator. Should have its own golden pin button on top of the site, really, same as the recommended surgeons

There is no question in my mind that I now look a thousand times better than before my transplant and thankfully, I'm at an age and stage in my life where I don't feel the need to go crazy with transplant-on-transplant, chasing some unattainable 'perfect' ideal. 

I got my transplant exactly because my baldness got to a degree where I felt it was altering what I 'felt' as my true face. Once my hairline was back and I recognized the dude in the mirror again, I was and continue to be, delighted. Anything else is just gravy on top. 

This is a very healthy outlook and is generally why I think most guys shouldn't get HT's until they're pretty far gone where what they get in a first pass is a major aesthetic improvement. There was a case of a guy on here who was NW2 and got I think 2000 grafts to fix his hairline and give him temples points, and he ended up being disappointed with the result and feeling like he needed a 2nd pass more density. HT's will not return you to your "heyday" in a single pass. I think people get caught in a trap of chasing the ideal hairline with ideal density and it's really not a great idea unless you have tons of money in the bank. 

Edited July 19, 2023 by GoliGoliGoli

[GeneralNorwood]

38 minutes ago, GoliGoliGoli said:

This is a very healthy outlook and is generally why I think most guys shouldn't get HT's until they're pretty far gone where what they get in a first pass is a major aesthetic improvement. There was a case of a guy on here who was NW2 and got I think 2000 grafts to fix his hairline and give him temples points, and he ended up being disappointed with the result and feeling like he needed a 2nd pass more density. HT's will not return you to your "heyday" in a single pass.

If you area speaking about patient that i think, it is because he had over 700 grafts implanted to create temple points and only 1300 were used to do the hairline. 

I think you can be satisfied after 1 HT when you are Norwood 2, however it requires dense packing. 40 grafts per cm2 is not dense and Norwood 2 won't be happy about this density, because this kind of patient has little recedeed hairline, but it is usually very dense 80 grafts/cm2. Altering the hairline to Norwood 1, but lowering it density visibly is not good idea. It's like "wtf, i had much more dense front before HT..." 

Edited July 19, 2023 by GeneralNorwood

[jfally]

SO much wisdom in here and I most definitely concur with the sentiment.

Naturally we all fixate on what we are most self conscious about.

When we spend so much time, mental energy, and money, trying to fix some of these trouble areas, certainly we'll then be that much more critical of them on the other side of the 'solution'.

Sort of reminds me of the super fit fitness models on social media that will post candid photos from a photo shoot showing the pic to be used from the shoot, and then a pic of them w/out filters and not 'sucking in', looking entirely different, taken literally 10 seconds apart. We don't see them out in the wild/real life looking anything other than the normal selves.

Folks don't see us from 5" away with a magnifying glass trying to look at crazy particular angles or hair parted methodically to find some open real estate. That's usually us, to ourselves.

Great post man.

[gillenator]

On 7/19/2023 at 5:45 AM, TheGreatPretender said:

In essence it's the combination of both. 

Both are factors to consider in attaining the illusion of coverage.

[StillAlive]

Also, something else to keep in mind that really helps with staying positive :

It may be an illusion of density and some of us may have the 'slightly thinning/starting to bald' look, but unlike our previous condition where we knew it was all headed south and it was truly depressing to look at, now we know that unless something goes terribly wrong, that's it, we are keeping that look into our old age. That's a tremendous boost to your psychology and it becomes ever more apparent as you get older, particularly when it comes to your hairline and frontal third that define your face.

Edited July 21, 2023 by StillAlive