Are Hair Transplants Perfect?

[Melvin- Admin]

The importance of managing expectations is so important, and isn't talked about enough in my opinion. Do you guys think you can achieve perfection with surgery? Can a hair transplant be perfect why or why not? Would love to hear the communities input.

Are Hair Transplants Perfect?

[kirkland]

The twenty-five year old balding me, making his way in the dating scene and feeling more insecure about my looks, would say that a hair transplant is not a perfect solution. Either shaving my head or getting a hair system would be a better choice. The fifty-three year old me, married with less muscles and more fat, is perfectly content with a head of hair that looks thinning because it is a better choice at this stage of my life.

[kirkland]

So a hair transplant can't be perfect but at this point, perfection is not as important.

[aaron1234]

Totally depends on the level of loss (and of course the skill of the surgeon).  Having seen Spanker's hair in-person I can say that his HT/hair looks perfect.  He was also a NW2 before surgery - if that.

For me being a NW5-6, I had to accept a receded hairline if I wanted to eventually achieve full coverage.  It's not a perfect juvenile hairline, but it's perfect for me.  

[Gatsby]

No a hair transplant can never be perfect. It's not a one and done experience regardless of how natural the results are in the ideal candidate. The (perfect) results are influenced entirely upon the patient's expectations. I've seen incredible results where the patient is still unhappy with it and I have seen as little as 2,000 grafts give new life back to a patient where he/she feels it's a one and done! The problem is that the thought of future loss (be it whether you are stabilized on medication or not) will always be at the back of your mind or eventually will be something you will think about. I think 'natural' would be a far better metric than 'perfect' as it is the goal in all hair transplant work. More often than not this goal is never attained.

[HappyMan2021]

I agree hair transplants are about managing expectations and at heart are an illusion of density. Even objectively great HT's can look bad under harsh lighting, have small areas here and there that didn't grow, and people may be stuck with certain hairstyles. I'm being somewhat sarcastic, but I always see people with HT's on here with the same slicked-back hairstyle. Its like that is the uniform post-HT look. I think this is in part because doing some wild/hip Robert-Pattinson style haircut would expose the sub-natural density of HT's. 

I do think perfect HT's (those with none of the above) do exist, but there is a high degree of luck involved. Combination of elite doctor + incredible donor hair + one's body has a fantastic response to the surgery. 

Of course one is in control of seeing an elite doctor, but even that is definitely not a guarantee of a "perfect HT". I have seen results from Dr. Konior, Dr. Diep, and others - that while objectively "good", had small but significant flaws you'd expect to see from a no-name doc.   

Edited May 11, 2021 by SadMan2021

[RandoBrando517]

4 minutes ago, SadMan2021 said:

I agree hair transplants are about managing expectations and at heart are an illusion of density. Even objectively great HT's can look bad under harsh lighting, have small areas here and there that didn't grow, and people may be stuck with certain hairstyles. I'm being somewhat sarcastic, but I always see people with HT's on here with the same slicked-back hairstyle. Its like that is the uniform post-HT look. I think this is in part because doing some wild/hip Robert-Pattinson style haircut may expose the sub-natural density of HT's.  

I do think perfect HT's (those with none of the above) do exist, but there is a high degree of luck involved. Combination of elite doctor + incredible donor hair + one's body has a fantastic response to the surgery. 

Of course one is in control of seeing an elite doctor, but even that is definitely not a guarantee of a "perfect HT". I have seen results from Dr. Konior, Dr. Diep, and others - that while objectively "good", had flaws you'd expect to see from a Turkish hair mill.  

Isn’t that the nature of hair transplants itself? I’ve seen one perfect hair transplant on here, the rest have flaws. But to me density is the most important

[ertahaer]

No ı don't think so . however ıt can be close to the perfection. Tricky question  

[deeznuts]

I think perfect isn't the right word. But they can definitely check all the boxes, restore you to NW1 status with decent density (though not native density) in the hairline in the right candidate. So in my opinion, that's more than good enough. 

[gillenator]

Possibly a better question might be, "Does a HT need to be perfect?"....because IMHO perfection can never be achieved, and probably should not be the goal of a HT procedure...the limitations of surgery in itself can never replicate one's native origin, especially regarding native density.

Yet the goal of successful HT surgery is not to replicate the origin but rather to "produce a visual attainment of cosmetic coverage" that meets the patient's satisfaction.

[EvoXOhio]

A hair transplant is never perfect**
 

**unless you’re Aftermath 

[Huncholini]

It depends on your definition of perfection, for me that would be the hair I had when I was 15/16. I remember the thick luscious locks I had at that age and the reality simply is that no surgeon in the world can replicate that because 1) no surgeon transplants at a density of 90 FU/cm2 2) no patient has a donor good enough to return their scalp to its 15/16 year old self esp if they're already >NW2 3) Any ethical surgeon will explain to you that a hair transplant gives you the illusion of density, because I think max density they can implant is up to 40-50 FU/cm2. So IMO, hair transplants are absolutely not perfect.

[deeznuts]

14 hours ago, Huncholini said:

It depends on your definition of perfection, for me that would be the hair I had when I was 15/16. I remember the thick luscious locks I had at that age and the reality simply is that no surgeon in the world can replicate that because 1) no surgeon transplants at a density of 90 FU/cm2 2) no patient has a donor good enough to return their scalp to its 15/16 year old self esp if they're already >NW2 3) Any ethical surgeon will explain to you that a hair transplant gives you the illusion of density, because I think max density they can implant is up to 40-50 FU/cm2. So IMO, hair transplants are absolutely not perfect.

I think the max density might be closer to double that. When I consulted with H&W they suggested that they could do up to 80 which is pretty much near native density. Though I doubt they would do 80 on a guy with 80 naturally. 

[RandoBrando517]

3 hours ago, deeznuts said:

I think the max density might be closer to double that. When I consulted with H&W they suggested that they could do up to 80 which is pretty much near native density. Though I doubt they would do 80 on a guy with 80 naturally. 

De Freitas puts out donor density and 80 fu per cm2 is pretty rare in the donor 

[Melvin- Admin]

19 hours ago, EvoXOhio said:

A hair transplant is never perfect**
 

**unless you’re Aftermath 

This is true

[Gasthoerer]

On 5/12/2021 at 3:49 PM, deeznuts said:

I think the max density might be closer to double that. When I consulted with H&W they suggested that they could do up to 80 which is pretty much near native density. Though I doubt they would do 80 on a guy with 80 naturally. 

I seriously doubt that. 65 is already unreal transplanted density for the hairline and maybe something like 50 for the areas behind. 

[Gatsby]

Statistically 7/10 people (male and female) are dissatisfied with their hair transplant results. For many people the perfect hair transplant may be the one they avoided having.

[deeznuts]

8 hours ago, Gasthoerer said:

I seriously doubt that. 65 is already unreal transplanted density for the hairline and maybe something like 50 for the areas behind. 

Dunno, that's what their rep told me. You can always ask them yourself if you're looking for more density

[Gasthoerer]

1 hour ago, deeznuts said:

Dunno, that's what their rep told me. You can always ask them yourself if you're looking for more density

Maybe their rep was talking hairs not grafts or he had one glass of wine too much 😉

[deeznuts]

1 hour ago, Gasthoerer said:

Maybe their rep was talking hairs not grafts or he had one glass of wine too much 😉

Nah. H&W are known for dense packing. I found an article by Dr. Rahal talking about doing 70 graft/cm2. It's probably not too much of a stretch for a clinic with a ton of results of them putting 3000, 3500 grafts in the hairline to be able to attain 80 grafts/cm2. For what it's worth, they said they would use their judgment to decide what they should shoot for in the range of 50-80 grafts/cm2 so I doubt they actually go for 80 most of the time.

https://www.rahalhairtransplant.com/many-grafts-need-full-head-hair/#:~:text=Here are Rahal Hairline™,may experience in the future.

 

edit: like this dude had 4k grafts put in his hairline. I legitimately believe that 80 is possible if the patient has the donor density and the recipient density to warrant it

https://hassonandwong.com/hair-transplant-results/fue-hair-transplant-4035-grafts/

 

Edited May 14, 2021 by deeznuts

[Gasthoerer]

While I got your point, and some are really good ones, I still disagree in some aspects.

Like I said: In the very first hairline values around 65 can be achieved. Often this already requires several surgeries. The 70 of Rahal is close to that (and also partly marketing IMO), but the cases of him in here which come only close to this number, also required a second surgery to achieve that. 

In the area behind the hairline, the numbers are significantly lower for several reasons.

- The bigger multies would make it more challenging to dense pack.

- It is not required and

- Almost no one would have the grafts anyway.

I doubt that 55+ is achieved in other areas besides some extreme outliers. 

And to bring the 80 in perspective: 4000 grafts would only be enough for 50 cm2.

- That is much less area than my crown and I had 2900 FU with a good result

- For an average hairline of 16 cm this would be just enough to lower the hairline 3.1 cm.

- Even the case you have shown (which is an outlayer by himself, if you look into the HW cases in the forum) is bigger IMO as the treated area will expand deep into the areas where there is still hair. 

 

 

[deeznuts]

1 hour ago, Gasthoerer said:

While I got your point, and some are really good ones, I still disagree in some aspects.

Like I said: In the very first hairline values around 65 can be achieved. Often this already requires several surgeries. The 70 of Rahal is close to that (and also partly marketing IMO), but the cases of him in here which come only close to this number, also required a second surgery to achieve that. 

In the area behind the hairline, the numbers are significantly lower for several reasons.

- The bigger multies would make it more challenging to dense pack.

- It is not required and

- Almost no one would have the grafts anyway.

I doubt that 55+ is achieved in other areas besides some extreme outliers. 

And to bring the 80 in perspective: 4000 grafts would only be enough for 50 cm2.

- That is much less area than my crown and I had 2900 FU with a good result

- For an average hairline of 16 cm this would be just enough to lower the hairline 3.1 cm.

- Even the case you have shown (which is an outlayer by himself, if you look into the HW cases in the forum) is bigger IMO as the treated area will expand deep into the areas where there is still hair. 

 

 

I think you might potentially see 80 closer to the hairline I'd imagine. But yeah, looking at some results from other doctors it looks like they're putting 3k in a much smaller area and still only getting something like 60. Probably a bad example

I think the crown is a different beast though, the hairline is mostly singles and it's the thing that people actually look at so the density there is probably going to be a fair amount higher than anywhere else. Not really sure it's a fair comparison. 

Actually, I found an article from the Hasson and Wong website claiming 80 grafts/cm2. (control+f 80) https://hassonandwong.com/our-journey-to-fue/

 

Edited May 14, 2021 by deeznuts

[gillenator]

Bottom line...is it really necessary to try and reach those top end density numbers?...IMHO, no...why?...because once again the goal is to achieve the visual attainment of decent coverage...it also is critical to manage limited donor reserves for future loss because an extremely large percent of men suffering with MPB are going to require multiple procedures through their lives....think about it!

[gillenator]

Agree!

[deeznuts]

2 hours ago, qui bono said:

It looks god awful and unnatural at higher density as well.

I had a surgeon dense pack my hairline at over 70 FU per cm and its been an absolute nightmare. The hairline curved over so radically I couldnt straighten it, and that curve was so radical it created an artificial gap behind it. I couldnt even comb my hair because it was so rigid and my friends all laughed at it. It took me 15 months to figure out what they did.

Absolutely no need for that sort of density unless youre a NW2 going to NW1 and youre trying to match the transplanted hair to your native density (and in that circumstance I'd question why youre getting a HT in the first place).

 

 

 

Is it for sure the density and not the angling or multihairs grafts in the hairline?

I can see 80 being kinda reasonable if your native density is insane, and you've got minimal loss (NW2), and you've got minimal foreseeable loss, and you have very fine hairs, and you have high contrast between skin and hair. i.e. the perfect candidate for high density