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So i read that you CAN'T achieve full density after hair transplants. But let's assume following: 

Let's assume that i know for a fact I'm gonna be a Norwood 3 my entire life (after I'm 21 years old). I have average donor hair/hair thickness with NO diffuse thinning. Is it possible to restore it back to Norwood 1 or 2, so it looks full even after it's wet and with bad/good lightning so I don't have to "style it a certain way so its appears full"?

I understand the logic that u cant do that with a high Norwood scale. But with a lower scale around 3? I Can't see why THAT is not possible?

I hope your guys understand what I'm asking. Let's get a debate going. Cheers!

 

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I think the number one reason that most patients don't go for the optimal highest density is because it's not necessary to look fully restored.

In fact, the key to successful hair restoration is "achieving" an illusion of density or adequate coverage.

When we are very young, we don't notice the diffusion until we get older but everyone has it to some degree.

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Gillenator

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I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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Hi Swish, 

When you say "full density" are you referring to native density? Meaning that if your non-thinning hair has a density of let's say 80 follicular units/cm^2, then why can't a transplant be done at 80 FUs/cm^2 to match this? 

If so, Gillenator makes some excellent points above. You do not really need to 100% "match" the native density to achieve a uniform look with the native density. Furthermore, trying to match "pound for pound" like this when the native density is so high is a recipe for disaster. Technically, it is very possible to implant grafts at this density. In doing so, however, you are risking real complications and all but guaranteeing they won't all grow. "Packing" this many grafts into an area destroys the blood supply to the region and often results in localized skin death, AKA the dreaded "necrosis." And even if you don't get necrosis, this is too much damage to the skin. It will heal with some bulky, inflammatory scarring and never quite look right. 

The goal with dense packing, and I am someone who does this pretty much on a daily basis, is so take the transplants right to the limit of where you know it is safe and you will hit that "sweet spot" where density is excellent, it will all grow in well, and the risk for complications is negligible. This should lead to a nice, thick result and uniformity with the native hairs. 

Having said all this, it is possible to safely match the native density with hair transplants. However, it will require a second pass. After the first round grows in and does well, a second conservative pass should be well received by the new blood supply and should not cause excessive scarring and will get you up to that "native" level. The real question is whether you "need" to do this to be satisfied with a dense pack pass. As Gillenator expertly noted above, the answer is probably not. You should be content with something that is nice and dense, but not technically at the exact scientific density of your native hair. This is sort of the beauty of a hair transplant. 

Hope this helps. Best of luck. 

-- Dr Bloxham 

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Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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25 minutes ago, Dr Blake Bloxham said:

 

Thanks for the answers! That was exactly what i was hoping and looking for. Because i might do a HT when I'm around 25-30 ish(Due to genetics, because only my father reached to norwood 3 in my family with normal density). I was just wondering why i should get a HT, if have to style my hair in a special and avoid certain light or swimming activities to avoid obvious lack of density or bald spots because its just not possible to achieve. I saw a post that @Melvin-Moderator about density and was therefor worried. Because he (you Melvin if u are reading this :) )  claimed that a HT is only an illusion and you have to style and watch out for certain lightning to see obvious lack of density.  Maybe i misunderstood what Melvin said and he can correct me if I'm wrong?

And I'm not talking about 80 FUs/cm^2 but rather maybe 50-60ish FUs/cm^2. Because i have seen some results who claimed they packed this, but the results weren't that satiating, and you could clearly see what was transplanted and what wasn't. But i also saw some who were just fine.

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4 hours ago, Swish said:

Thanks for the answers! That was exactly what i was hoping and looking for. Because i might do a HT when I'm around 25-30 ish(Due to genetics, because only my father reached to norwood 3 in my family with normal density). I was just wondering why i should get a HT, if have to style my hair in a special and avoid certain light or swimming activities to avoid obvious lack of density or bald spots because its just not possible to achieve. I saw a post that @Melvin-Moderator about density and was therefor worried. Because he (you Melvin if u are reading this :) )  claimed that a HT is only an illusion and you have to style and watch out for certain lightning to see obvious lack of density.  Maybe i misunderstood what Melvin said and he can correct me if I'm wrong?

And I'm not talking about 80 FUs/cm^2 but rather maybe 50-60ish FUs/cm^2. Because i have seen some results who claimed they packed this, but the results weren't that satiating, and you could clearly see what was transplanted and what wasn't. But i also saw some who were just fine.

You can never have full density with hair transplants alone. Now if you're a norwood II and wish to only fill in the hairline then yes, you can transplant 60fu per cm2, but what happens when the rest starts to thin? If you consider that a typical norwood 6 area is over 200cm2. You simply don't possess the donor supply necessary to completely fill the entire scalp with "full" density. This is why we use the "illusion of density" if this isn't acceptable. I would warrant against having a hair transplant.

Hair loss will progress, especially at the age of 21. I can assure you that I was once 21 and didn't suffer from diffuse hair loss either. They say the only thing certain is death and taxes, but who ever said that must've not had hair loss, because hair loss will progress, and it's not a matter of if, it is a matter of when.

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I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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12 hours ago, Swish said:

I was just wondering why i should get a HT, if have to style my hair in a special and avoid certain light or swimming activities to avoid obvious lack of density or bald spots because its just not possible to achieve.

 

Well it really depends on what route you want to take. Let's suppose you are NW 3 as you said. If you are already shaving your head and are comfortable doing that because you don't want to be styling your hair a certain way to try to hide the thinning and bald areas, then perhaps you should skip the hair transplant.

However if you still have some length to your remaining hair and trying to style it in a way that doesn't look too bad, then you already (your words) "have to style my hair in a special and avoid certain light or swimming activities to avoid obvious lack of density or bald spots", so then a hair transplant, even if it isn't extremely dense, will give you more hair to style and make it easier to cover any areas that bother you.

 

Edited by BeHappy
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8 hours ago, Melvin-Moderator said:

You can never have full density with hair transplants alone. Now if you're a norwood II and wish to only fill in the hairline then yes, you can transplant 60fu per cm2, but what happens when the rest starts to thin? If you consider that a typical norwood 6 area is over 200cm2. You simply don't possess the donor supply necessary to completely fill the entire scalp with "full" density. This is why we use the "illusion of density" if this isn't acceptable. I would warrant against having a hair transplant.

Hair loss will progress, especially at the age of 21. I can assure you that I was once 21 and didn't suffer from diffuse hair loss either. They say the only thing certain is death and taxes, but who ever said that must've not had hair loss, because hair loss will progress, and it's not a matter of if, it is a matter of when.

So in a perfect scenario where i don't get diffuse thinning(or so little that's it not even noticeable) its actually possible to restore from norwood 3 to 1 with " illusion of density" with around 60 fu per cm2, so i don't have to worry about the styling, lightning etc... so it looks kinda full in any of those scenarios. Because that's what i would call a perfect transplant and therefor would consider it. I would also only go for FUT because i heard and read that it can yield more and i don't mind the scares, i actually think they look dope to be honest.

But in a realistic scenario it will diffuse maybe allot maybe less, depending on the genetics. And that is why i cant pack everything to the hairline area because the rest would eventually need to get filled as well as you are suggesting. Am i understanding this right? 

Thanks for the reply.

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36 minutes ago, BeHappy said:

 

Well it really depends on what route you want to take. Let's suppose you are NW 3 as you said. If you are already shaving your head and are comfortable doing that because you don't want to be styling your hair a certain way to try to hide the thinning and bald areas, then perhaps you should skip the hair transplant.

However if you still have some length to your remaining hair and trying to style it in a way that doesn't look too bad, then you already (your words) "have to style my hair in a special and avoid certain light or swimming activities to avoid obvious lack of density or bald spots", so then a hair transplant, even if it isn't extremely dense, will give you more hair to style and make it easier to cover any areas that bother you.

 

Well I'm 23 now with norwood 2 with no major thinning, only slightly in the temples. But i had that since i can remember. I just wanna take the route where I'm gonna be a norwood 1 or 2 with a normal or dense hairline where i don't have to worry about my hair looks very thin in certain positions/activities for a long period of time.

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3 hours ago, Swish said:

So in a perfect scenario where i don't get diffuse thinning(or so little that's it not even noticeable) its actually possible to restore from norwood 3 to 1 with " illusion of density" with around 60 fu per cm2, so i don't have to worry about the styling, lightning etc... so it looks kinda full in any of those scenarios. Because that's what i would call a perfect transplant and therefor would consider it. I would also only go for FUT because i heard and read that it can yield more and i don't mind the scares, i actually think they look dope to be honest.

But in a realistic scenario it will diffuse maybe allot maybe less, depending on the genetics. And that is why i cant pack everything to the hairline area because the rest would eventually need to get filled as well as you are suggesting. Am i understanding this right? 

Thanks for the reply.

The perfect hair transplant doesn’t exist. Perfect scenarios don’t exist either, there is only reality. The reality is you will continue to bald, it’s not a question it’s a fact. I may come off insensitive, but I’m just giving it to you straight.

Hair transplants are meant to be an illusion not to transplant hair loss; hair for hair. If this unacceptable do not consider surgery. You’ll eventually become unhappy and regret your decision, and will join the “how do I undo my HT” guys that come on here all the time. Once you start this journey, there’s no going back or undoing. One and done scenarios don’t exist either. Prepare to have a few HT’s over the course of your life.

Case and point 

 

I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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40 minutes ago, Melvin-Moderator said:

The perfect hair transplant doesn’t exist. Perfect scenarios don’t exist either, there is only reality. The reality is you will continue to bald, it’s not a question it’s a fact. I may come off insensitive, but I’m just giving it to you straight.

Hair transplants are meant to be an illusion not to transplant hair loss; hair for hair. If this unacceptable do not consider surgery. You’ll eventually become unhappy and regret your decision, and will join the “how do I undo my HT” guys that come on here all the time. Once you start this journey, there’s no going back or undoing. One and done scenarios don’t exist either. Prepare to have a few HT’s over the course of your life.

 

I guess a perfect hair transplant is subjective for each individual. But you make it sound that every male-individual goes bald at some point in their life and that is of course not true. You see plenty of people in their 40-60 with great amount of hair that even teenagers wish they had. Some people reach norwood 2-4 and then they stop receding for decades. Even if their hair diffuses you cant tell without a microscope.  

Here is an example: A boy of 25 age is a norwood 2 and his entire family for many generations don't go bellow norwood 3 due to genetics. Wouldn't that boy be a good candidate to get his hairline done? Because I'm sure there are many people in that kind of situation.

I understand what your are saying if you go beyond a norwood 3 or 4 and up there. But i just can't see why it's not possible to achieve great HT with dense results in that case. 

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40 minutes ago, Swish said:

I guess a perfect hair transplant is subjective for each individual. But you make it sound that every male-individual goes bald at some point in their life and that is of course not true. You see plenty of people in their 40-60 with great amount of hair that even teenagers wish they had. Some people reach norwood 2-4 and then they stop receding for decades. Even if their hair diffuses you cant tell without a microscope.  

Here is an example: A boy of 25 age is a norwood 2 and his entire family for many generations don't go bellow norwood 3 due to genetics. Wouldn't that boy be a good candidate to get his hairline done? Because I'm sure there are many people in that kind of situation.

I understand what your are saying if you go beyond a norwood 3 or 4 and up there. But i just can't see why it's not possible to achieve great HT with dense results in that case. 

Yes there are individuals who don’t bald beyond Norwood II or III. Those individuals don’t start balding in their early 20’s. 99.9% of men who bald in their 20’s will continue to bald later in life. Those who were Norwood II at 23 maybe Norwood V by 50.

And trust me you’ll still care about looks at 50. We don’t sell hair transplants, I’d rather give it to you straight than play with highly improbable scenarios, to make you feel better about going through a procedure that will likely leave unsatisfied at some point. Now if you were okay with the illusion of density and understood that hair transplants don’t cure your hair loss, I’d say go through with it.  But you will likely either have to a) have additional procedures to keep up with density or b) style your hair in a way to make it look like a full head of hair. This is the reality, I have nothing to lose or gain by telling you the truth. 

Playing the relative game is a dangerous proposition. Below is a picture of my father age 62, brother age 42 and me 33 at the time. I’m the only one who went completely bald by 30. 

B295C471-689F-4CCE-B4BB-8953FBF7E898.jpeg

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I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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23 hours ago, Melvin-Moderator said:

The perfect hair transplant doesn’t exist. Perfect scenarios don’t exist either, there is only reality. The reality is you will continue to bald, it’s not a question it’s a fact. I may come off insensitive, but I’m just giving it to you straight.

Hair transplants are meant to be an illusion not to transplant hair loss; hair for hair. If this unacceptable do not consider surgery. You’ll eventually become unhappy and regret your decision, and will join the “how do I undo my HT” guys that come on here all the time. Once you start this journey, there’s no going back or undoing. One and done scenarios don’t exist either. Prepare to have a few HT’s over the course of your life.

Case and point 

 

Thanks for the tip, lol it seems like lot of folks come on here asking to undo the work they got done, i have never been on any forums in the past so i am not that familiar with the discussions.  Like I stated i had less than 2000 grafts in the past by Dr Alvi Armani when i was 26  which i was so happy with (btw i just realized there was lot of negative feedback regarding his work) but given that I am 38 my hairline is slowly receding and based on the research i did apparently HT Dr's can fix it or remove the transplanted work.  Having said all that, I completely agree with everything you said man!

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When I was 21 I had a full head of hair with massive density and used to get compliments all of the time...I would have never presumed that I would have hair loss in my future.

Only 2 years later I started finding hair all over my pillow and by the age of 25, I could start seeing some of my scalp with advanced recession of my hairline...by the age of 29, I was wearing a full hair system!

As Melvin stated, it's not a matter of "if", it's a matter of "when" for those of us who have MPB in our cards.

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Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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On 7/24/2019 at 12:29 PM, Melvin-Moderator said:

Yes there are individuals who don’t bald beyond Norwood II or III. Those individuals don’t start balding in their early 20’s. 99.9% of men who bald in their 20’s will continue to bald later in life. Those who were Norwood II at 23 maybe Norwood V by 50.

And trust me you’ll still care about looks at 50. We don’t sell hair transplants, I’d rather give it to you straight than play with highly improbable scenarios, to make you feel better about going through a procedure that will likely leave unsatisfied at some point. Now if you were okay with the illusion of density and understood that hair transplants don’t cure your hair loss, I’d say go through with it.  But you will likely either have to a) have additional procedures to keep up with density or b) style your hair in a way to make it look like a full head of hair. This is the reality, I have nothing to lose or gain by telling you the truth. 

Playing the relative game is a dangerous proposition. Below is a picture of my father age 62, brother age 42 and me 33 at the time. I’m the only one who went completely bald by 30. 

B295C471-689F-4CCE-B4BB-8953FBF7E898.jpeg

Have you ever herd of guys or saw any guys guy started thinning out and receding in their early 20s. But then only end up with a noorwood 3 with some thinning in their 50s? Ive herd some people like that. But its not as common i guess.

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That would definitely be the exception and not common at all.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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my father was norwood 3  at 25 & only slowly started diffuse at 50.

70 now & still has an ok hair on top but it is diffused bad now. But ok for his age.

 

He kept his hair long so i am unsure if he had diffuse hair from 20-40s but hairline was bad.

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On 7/27/2019 at 6:28 AM, gillenator said:

When I was 21 I had a full head of hair with massive density and used to get compliments all of the time...I would have never presumed that I would have hair loss in my future.

Only 2 years later I started finding hair all over my pillow and by the age of 25, I could start seeing some of my scalp with advanced recession of my hairline...by the age of 29, I was wearing a full hair system!

As Melvin stated, it's not a matter of "if", it's a matter of "when" for those of us who have MPB in our cards.

What did you end up doing with your loss, Gil? Did you continue to wear a system, or move to a transplant?

 

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I had 4 separate FUHT procedures for a grand total of 6900 grafts.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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On 7/28/2019 at 7:53 PM, Phillyman1996 said:

Have you ever herd of guys or saw any guys guy started thinning out and receding in their early 20s. But then only end up with a noorwood 3 with some thinning in their 50s? Ive herd some people like that. But its not as common i guess.

That would be as common as someone winning the lottery twice.

I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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Kudos!

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians:  Dr. Robert True & Dr. Robert Dorin, New York, NY

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