Is this a good density under lights?

[AJ_HT]

I had a failed hair transplant a few years ago. After which, last year, I underwent another hair transplant surgery with an apparently very good clinic.

However, now I am at 11.5 months post the surgery and I can see that while my hair looks good in normal lights and at home, the results look really bad in bright lights, and sometimes bad even in normal sunlight. The doctor said that the results are fine, but I'm not convinced.

I'm sharing some pictures of my hair in different kinds of lights, and would really appreciate if some members and mods could help me understand whether this result is okay or should I take it up with my doctor. I know I can never get my original density back, and I'm not even expecting that. But is this the kind of density that a good hair transplant gives? I had got about 2600 grafts done only in the frontal area and I was NW 5 before the transplant.

 

 

Edited November 14, 2021 by AJ_HT

[Gokuhairline]

it does look a bit sparced however from what i am hearing a HT is the illusion of density at best and under harsh lighting it will be exposed. 

[AJ_HT]

1 hour ago, Gokuhairline said:

it does look a bit sparced however from what i am hearing a HT is the illusion of density at best and under harsh lighting it will be exposed. 

Yes I understand that. However, does it show THIS MUCH? I mean, this isn't even harsh light. It's just sunlight. And the density seems fine at the sides. It's the center that is a problem.

Edited November 14, 2021 by AJ_HT

[JDEE0]

23 minutes ago, AJ_HT said:

Yes I understand that. However, does it show THIS MUCH? I mean, this isn't even harsh light. It's just sunlight And the density seems fine at the sides. It's the center that is a problem.

Sorry to say, but no is the answer. Hair transplants are the illusion of density, yes, but in short, this just refers to the fact that grafts aren't implanted at your native density of approximately 100+ FU per cm/2 and instead are implanted at around 50-60 maximum which gives you roughly half of the density you had before beginning to bald. 

As a result, we can only say that HT's provide the illusion of density because they're not usually even close to natural levels, but it doesn't really matter for the most part as the newly implanted density of 50+ cm/2 is enough to make it look dense enough to the naked eye (in most conditions).

in your case, your results aren't achieving this illusion of density and I wouldn't be happy with this look either. What clinic did you go to?

Edited November 14, 2021 by JDEE0

[TEXAN35]

Before pics will help but if you were norwood 5 and you only used 2600 the result is good . It may look like  you have some hair loss but the outcome looks natural . You can always get more procedure to add density if your donor was not overharvested. Its difficult to move from NW5 to NW1 from single procedure. I think 2500 graft/session is a sweet spot. High graft sessions are riskier.

Personally for me, how efficiently the grafts have been used is a very important criteria for a transplant success. If someone uses 3000-4000 graft in a small area and makes it dense I would not necessarily call it success. On the other hand if only 2600 graft can transform you from NW5 to current situation it is pretty ok.

 

I would say wait for sometime let this stabilize and then may consider to make this even better.

[AJ_HT]

25 minutes ago, TEXAN35 said:

Before pics will help but if you were norwood 5 and you only used 2600 the result is good . It may look like  you have some hair loss but the outcome looks natural . You can always get more procedure to add density if your donor was not overharvested. Its difficult to move from NW5 to NW1 from single procedure. I think 2500 graft/session is a sweet spot. High graft sessions are riskier.

Personally for me, how efficiently the grafts have been used is a very important criteria for a transplant success. If someone uses 3000-4000 graft in a small area and makes it dense I would not necessarily call it success. On the other hand if only 2600 graft can transform you from NW5 to current situation it is pretty ok.

 

I would say wait for sometime let this stabilize and then may consider to make this even better.

Considering that I'm almost at the 12-month mark, how much time would you suggest waiting?

Also, the doctor had told me that the density would be pretty good (so this is definitely not what I had expected). And they've done it well on both the sides - the density is actually pretty good. But the centre seems like it's almost empty when seen under any kind of light (or even sunlight). I fear that it's a job not done well, and hence wanted some opinions on it.

I'll share some before pictures in a while so that you could evaluate better. Thanks a lot for your input! :)

[ITA]

@AJ_HTCould you also share some pictures of the procedure if you don't mind?  Thanks

[digi23]

4 hours ago, AJ_HT said:

I had a failed hair transplant a few years ago. After which, last year, I underwent another hair transplant surgery with an apparently very good clinic.

However, now I am at 11.5 months post the surgery and I can see that while my hair looks good in normal lights and at home, the results look really bad in bright lights, and sometimes bad even in normal sunlight. The doctor said that the results are fine, but I'm not convinced.

I'm sharing some pictures of my hair in different kinds of lights, and would really appreciate if some members and mods could help me understand whether this result is okay or should I take it up with my doctor. I know I can never get my original density back, and I'm not even expecting that. But is this the kind of density that a good hair transplant gives? I had got about 2600 grafts done only in the frontal area and I was NW 5 before the transplant.

 

 

Can you get any clear photos with a better camera? Its difficult to see with these blurry photos, but density seems to be quite low, should be able to make it denser. This totally depends on hair characteristics, if you have thin hair for example. This is why you sometimes need two transplants, the second one smaller just to add density.

[AJ_HT]

35 minutes ago, Egy said:

@AJ_HTCould you also share some pictures of the procedure if you don't mind?  Thanks

Sure. I will upload some pictures immediately post-op in a while. 

[TEXAN35]

I think you should wait for a couple of more months. Usually 12-15 months should be the final result. 

But yes probably you may be short of your desired density.

I think the problem is not in the procedure but the surgeon overpromising and not getting the expectation right for 2600 grafts for NW5.

Not sure how many grafts were wasted in your first failed procedure but if you still have 2000-3000 grafts remaining and you already are NW5  natively that means you are in a good position.

Did you take any medication (prop+minox). Another problem might have been loosing more of your native hair during last one year which the doctor didnt take into account.

Also as mentioned, its not unusual for people with finer hair to need more than one procedure for required density if that's your case. I am  also in similar boat. One transplant and required density is around 75 % mark but I am ok with that and will consider another later.

[AJ_HT]

10 minutes ago, digi23 said:

Can you get any clear photos with a better camera? Its difficult to see with these blurry photos, but density seems to be quite low, should be able to make it denser. This totally depends on hair characteristics, if you have thin hair for example. This is why you sometimes need two transplants, the second one smaller just to add density.

Sure. I'll try and click some better, clearer pictures and upload them.

It's actually been mentally draining for me to get multiple transplant procedures, and still not getting the results needed. This was a repair transplant, and I'd expect the doctor to tell me that I would need multiple procedures for good density. Nothing of that sort was told to me while getting the procedure done, and now getting another session just seems painful 😢

 

[HappyMan2021]

it does look like it lacks density under bright lights. How old are you? IMO it does look "natural" in that your lack of density in bright lights makes it look like you have slight natural recession, but yes not the look you are going for of a strong, dense, youthful hairline. 

Probably need 3rd HT to make you satisfied. 

That being said, I wouldn't let this cause you anxiety. Unless you're working environment is somewhere where you are under bright lights constantly (model, newsanchor, movie star?) no one will notice. And when you are out in the bright sun really doubtful people will notice. 

[AJ_HT]

10 hours ago, Egy said:

@AJ_HTCould you also share some pictures of the procedure if you don't mind?  Thanks

@Egy Here are the pictures of the procedure:

[AJ_HT]

8 hours ago, SadMan2021 said:

it does look like it lacks density under bright lights. How old are you? IMO it does look "natural" in that your lack of density in bright lights makes it look like you have slight natural recession, but yes not the look you are going for of a strong, dense, youthful hairline. 

Probably need 3rd HT to make you satisfied. 

That being said, I wouldn't let this cause you anxiety. Unless you're working environment is somewhere where you are under bright lights constantly (model, newsanchor, movie star?) no one will notice. And when you are out in the bright sun really doubtful people will notice. 

I'm 33. So I do go for seminars and events with bright lighting, and also have to give speeches on and off, although not that frequently. Now I'm dreading undergoing another surgery, but I don't know what else to do. I'm taking finasteride 1 mg daily. Do you think PRP or any other treatment would help?

[Gatsby]

I don't believe that PRP long term would really be of benefit (others may disagree with me). You could consider adding minoxidil. Depending on how stabilized your your hair loss is and the condition of your donor you could consider another surgery. But in truth you may still feel that it's not giving you the density desired. I would consider definitely talking with your surgeon about this and you feelings. All the best!

[Balding Bad]

Yeah, that density looks quite poor under harsh lighting, however considering you were a NW5, your current hairline is miles better than no hair!

[HappyMan2021]

2 hours ago, AJ_HT said:

I'm 33. So I do go for seminars and events with bright lighting, and also have to give speeches on and off, although not that frequently. Now I'm dreading undergoing another surgery, but I don't know what else to do. I'm taking finasteride 1 mg daily. Do you think PRP or any other treatment would help?

I only wanted 1 surgery but ended up needing 2 repairs/follow-ups. It sucks but its not uncommon to need 3 or even 4-5 HTs to truly be happy. Lack of density is a common irritating fact with hair transplants. 

I feel like the cause is the doc didn't put enough grafts in that area, so the only solution would be to put grafts in. PRP or anything else wouldnt work.

In the meantime you could potentially put toppik in that area if it makes you feel uncomfortable. But be careful toppik should really ever only be used on the crown. If its on the hairline some of it could dust on your forehead and be obvious. But if your concealer had a super strong hold I could see it working. 

[TEXAN35]

Yes getting another procedure is a pain along with shaving the head for few months . The doctor could have done more graft but as others have mentioned that transplant provides an illusion of density and to maintain that illusion in extremely harsh light is very difficult to attain. So not sure if few more hundred graft would have given you complete satisfaction or rather a separate procedure. On the bright side you have come a long way from NW5 and your hair doesn't seem to put a negative impact on your appearance at least under not so harsh light.

[AJ_HT]

On 11/15/2021 at 12:32 AM, digi23 said:

Can you get any clear photos with a better camera? Its difficult to see with these blurry photos, but density seems to be quite low, should be able to make it denser. This totally depends on hair characteristics, if you have thin hair for example. This is why you sometimes need two transplants, the second one smaller just to add density.

@digi23 I tried clicking some more pictures, which seem slightly better quality (though not the best). Please see if this helps! So the density at the sides is just fine, but feels like I wasn't given good density in the center.

@Balding Bad I've also attached pictures of my head before the transplant (after the first failed surgery).

Honestly, I'm not sure if I was NW 5 before the surgery (although the doc said I was).

I just feel like they could have done a better job with the density, especially since mine was a case of corrective surgery, where poor density after the first transplant was my major concern.

What do you guys think? I'm kind of losing sleep over this because even after spending so much time and effort twice, it doesn't look as I had expected it to. Just want to understand whether I'm being reasonable or my expectations are/were too high ☹️

Edited November 20, 2021 by AJ_HT

[digi23]

38 minutes ago, AJ_HT said:

@digi23 I tried clicking some more pictures, which seem slightly better quality (though not the best). Please see if this helps! So the density at the sides is just fine, but feels like I wasn't given good density in the center.

@Balding Bad I've also attached pictures of my head before the transplant (after the first failed surgery).

Honestly, I'm not sure if I was NW 5 before the surgery (although the doc said I was).

I just feel like they could have done a better job with the density, especially since mine was a case of corrective surgery, where poor density after the first transplant was my major concern.

What do you guys think? I'm kind of losing sleep over this because even after spending so much time and effort twice, it doesn't look as I had expected it to. Just want to understand whether I'm being reasonable or my expectations are/were too high ☹️

You might be evaluated as a NW5 in the future, because of minituarized hairs in the crown, looks like you have some crown hair now, so you were basically like NW3.5-4 now. But 2600 grafts is NOT enough for that area to be filled. The frontal third is about 3500 for good density. Maybe more with thin hair.

Yes if it were me I would probably try to do a smaller procedure of about 600-1000 grafts for get some density.

Who is the Dr in your case? It helps the community here when you say the Dr so we get more info on all Drs and their results.

Edited November 20, 2021 by digi23

[Balding Bad]

2 hours ago, AJ_HT said:

@digi23 I tried clicking some more pictures, which seem slightly better quality (though not the best). Please see if this helps! So the density at the sides is just fine, but feels like I wasn't given good density in the center.

@Balding Bad I've also attached pictures of my head before the transplant (after the first failed surgery).

Honestly, I'm not sure if I was NW 5 before the surgery (although the doc said I was).

I just feel like they could have done a better job with the density, especially since mine was a case of corrective surgery, where poor density after the first transplant was my major concern.

What do you guys think? I'm kind of losing sleep over this because even after spending so much time and effort twice, it doesn't look as I had expected it to. Just want to understand whether I'm being reasonable or my expectations are/were too high ☹️

Compared to what your hair was like before, it's quite an improvement.

But yes, I would have to agree with you that the density is not great considering the amount of grafts you received in the front hair line. Unfortunately you may want to consider going in for additional grafts, but perhaps with a different doctor.

[SeanT1]

You could try some root sprays in the meantime or hair fibre? 
Micro pigmentation can improve the illusion of density by blending the hair into the scalp better.

 

Don't have any personal experience, however.  Just word of mouth.

If your patient enough, go for another transplant.  This forum has some great doctor recommendations.

[AJ_HT]

On 11/20/2021 at 10:52 AM, digi23 said:

You might be evaluated as a NW5 in the future, because of minituarized hairs in the crown, looks like you have some crown hair now, so you were basically like NW3.5-4 now. But 2600 grafts is NOT enough for that area to be filled. The frontal third is about 3500 for good density. Maybe more with thin hair.

Yes if it were me I would probably try to do a smaller procedure of about 600-1000 grafts for get some density.

Who is the Dr in your case? It helps the community here when you say the Dr so we get more info on all Drs and their results.

@digi23 my apologies, I have not been very active on the forum, and I just saw your comment.

My surgery was done at Eugenix. I have just posted a detailed review of the same on the forum here: