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Third hair transplant - afraid over overharvesting


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Hi everybody

I have had two hair transplants and I'm looking for my third - and hopefully last. The first two were 1515 grafts in January 2015 and 2400 May in 2016 - total: 3915 grafts. I'm 51 years old.

The first had very good growth, I think. The 2nd was not so succesful. But overall it really changed a lot for me. I haven't been thinking that much about my hair since then, but now I can see, that my hair thinning has taken over.

Photos 1-6 is present photos. The first three is my hair when combed. The next three I messed it up, and ruined the illusion. Photos 7 and 8 are from 2010. So add nine years of hairloss. So I DID get something for my money. The first three transplant pictures are from my first. The new two are from my second. NUT the next photos is from the period, where I was very scared. Overharvested? It looks ok now, but I am still very scared of overharvesting. I don't have very short hair, but average short hair usually.

The questions that haunt me is of course: do I have hairs enough, where to to take them from and where to put them. I know: ask the doctor, but answers have been confusing and they don't answer the same. So I'm here for the second opinion.

How much do you think I need?

Does it look like I have 2000 grafts left? If I have 2000, how would I place them?

Personally I think the middle section is very important. Doctor always talk about the front, but even though I would like a bit there, it doesn't matter that much to me. So maybe 200. Crown? As you can see, almost all hair on the crown must be those transplanted. There wasn't much left 9 years ago. Would it be crazy to put 300 there? I use Toppik, and it is ok today, but a few more grafts would make it easier. And then 1500 in the midsection.

Even if I could get more than 2000, I don't want that. Firstly, I'm scared of overharvesting. Second, I want some in reserve, if it is possible.

Then where to take them from. The left side of my head is untouched. But I'm scared of my upper back.

 

 

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From the side!!.jpg

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  • Senior Member

Hi Hairlessmonkey,

Judging from your pictures I would say that 2000 grafts are certainly possible from your donor area if you are prepared to accept it being noticeably thinner than it already is. You also have the option of 500 or so beard grafts taken from beneath your chin for placement behind the hairline alongside scalp grafts to add to the overall density.

That's a potential 2500 grafts that can be implanted behind your hairline to thicken up your temples and mid scalp area and to add coverage to your crown area.

It will most likely be your last procedure. You could try growing out the back a little longer to help hide the scalp or following your next surgery you could have a course of SMP completed in that area to hide the visible scalp. Saying that you could have also SMP on other areas of your scalp to add to the illusion of having a full head of hair.

I hope that helps.

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I would use your last 2000 or so grafts (if that is what the doctor tells you you have left) to reinforce your current hairline and also the midscalp. Then grow it out and use a haircut that covers the crown.

Reason for this? The crown is known as a black hole for grafts and using your last ones there would be more risky.

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I'm not sure if you had permanent shock loss in the donor around the occipital ridge but if I'm honest I think it looks thinner than I would expect after 3915 FUE extractions.

Becareful with further transplants. I think 500 singles in the hairline and then 1000 multis in the midscalp to the vertex transition point. You could consider SMP to the crown and donor. I don't think you should push it further than that as you could have the moth eaten alopecia areata look. Just my 2 cents.

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Oh, I wasn't precise with back. That photos is from six months after the last transplant. Here are some present photos. I believe, they have taken too many grafts. When they performed the transplantation, they were were supposed to take 3000, but only took 2400. They didn't really give a good explanation.

There is a photo of my left side, that is untouched. I tried to "scramble" it a bit, so you can see it better.

 

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The donor looks better, I stick to my plan above but only this time you may get away with not having SMP to disguise the thinning in your donor area and you may well get the additional grafts from your scalp donor rather than going down the beard route.

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  • 1 month later...
  • Senior Member
22 hours ago, TheHairlessMonkey said:

RecedingTide, you are probably right. I think that 1500 grafts is a better target to have now. I can always get more, if there is more grafts left. But where to go for high graft survival? And what technique? Is there a special size of grafts etc. that I should consider?

Hi there. It looks as though one more procedure of 1500 or so grafts would have a nice impact. Are you on medical therapy?

Also, your previous procedures were both FUE? Did you consider FUT initially? 

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  • 3 weeks later...
  • Senior Member
On 5/30/2019 at 3:49 PM, TheHairlessMonkey said:

Oh, I wasn't precise with back. That photos is from six months after the last transplant. Here are some present photos. I believe, they have taken too many grafts. When they performed the transplantation, they were were supposed to take 3000, but only took 2400. They didn't really give a good explanation.

There is a photo of my left side, that is untouched. I tried to "scramble" it a bit, so you can see it better.

 

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Donor looks decent in those pics, choose your next doc wisely.

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