Approaching 6 Months: 2 Questions

[Leftwithrope]

Hey guys,

I'm approaching my 6 month mark in 2 weeks and have a few questions in mind.

1. From months 6-12, how drastic of an improvement can one notice? I know that one will see improvements in maturation, but what about popping/sprouting of new hair? Some people seem to believe that sprouting of new hairs generally end at month 6, and the only improvement from there is maturation.

2. What can a second hair transplant do for you if you have a dense result (say a previously norwood 3A patient getting to a Norwood 1 after his first transplant). The general concern with hair greed is the possibility of blowing precious donor hair on trying to achieve natural density, and also that not more than 50% of native density is needed to provide an illusion of density. Will a second smaller pass on an already dense result make for an undetectable result?

[LaserCap]

There can be a HUGE difference between 6-12 months.  First, did you do PRP with the procedure?  This helps bring the grafts in sooner and can also help reverse the miniaturization of the native hair. 

Typically, when hair starts coming in, it is NOT the quality of the hair that is in the donor.  The hair will be very thin, almost like vellus hair.  It is not uncommon for patients to say, "I don't see anything, I just lost all my money." On top of that, not all hair come in at the same time, it can be staggered by several weeks.  Then the hair starts maturing and taking on the quality of the hair from where it came from.  How many times I have patients call at 12 months to say, "I can see a huge difference."

Transplants do not propagate.  Where the grafts were placed, that's where you will see new growth.  This does not promote growth elsewhere. NOTHING regrows hair.  Medical therapy, and I hope you are doing something, (Propecia, Rogaine, Laser and PRP), can help halt or slow the loss and sometimes can help enhance the hair that is dissipating and going away.  I am under the impression that when patients go through the process, do a procedure and add the meds, they will see very positive results because of the patient is being proactive and doing everything he can. At that point you are really taking advantage of everything available to you.

With regards to a 2nd procedure, this can be in the same area or on a different area, (say farther back into the pattern or in the same area to add density).  This was and still is, very common in the industry.  The universal belief is that grafts compete for blood supply. Some doctors will leave a separation in between grafts to make sure everything survives.  Months later, typically 12 for most doctors, you can return and work around the separations and "fill in the gaps."  By that time the first round is "in" and can not be damaged.  The other reason why you want to wait is to allow the donor to heal before harvesting again.  BUT now I have seen techniques that I call 3-dimensional.  I think this has to do more with how the incisions in the recipient site are made.  Instead of being 1 dimensional, (doing the apertures side by side), now they are done in such a way that the hair shingles and works together to allow for more density.  It is now not uncommon to achieve great density with just one procedure, all pending on how many grafts you decide to move forward with. 

You bring up a good point.  If you are completely bald and have nothing, the first procedure, again pending graft numbers, the change will be dramatic.  The second, not so much because there is hair there already.  Take a ton of photos and put them away.  6 months later do it again, and another set at 12 months.  If things go right, you will see the change.  If you started with some native hair, you better be on medications because eventually you will lose that hair and will have to return to do another procedure to replace what you just lost and not raising the bar of density.