2nd Procedure Worthwhile?

[TheEmperor]

I received 4500 grafts in the first session (I was a NW5). My crown is still bald.

 

The hair tranplant is much thinner than I had anticipated, and the hairline is higher than I would like. Also there are some issues that I find myself styling around or else they would be detectable (I cant comb my hair backwards because the "jaggies" are visible and the hairline does not have enough density, and is too high to pull off)

 

Overall I recognize that I look better. Combed forward and across, cut to enough length so the hair overlaps and covers, yet not so long that it gets unruly, everything looks decent.

 

So here is the dilemma. I dont think I can do everything I want with (say) another 2500 grafts.

 

The crown is not that big, and will probably take 1500-2000 grafts, leaving only 500 or so to supplement the front.

 

500 Grafts will probably make the front a little less see through, but Im doubting it will lower the hairline any. That said, I dont see myself combing the hair back to expose the more dense hairline, because the hairline is just too high.

 

2000 Grafts in the crown will still be pretty thin, and wont make a big differnence to my "look". Thin coverage to the crown will be just that --thin-- and overall I will not look any more youthful or better.

 

THe only way to really improve my "look" would be to use 2000 grafts in the front to thicken and lower the hairline a touch. That would leave 500 grafts for the crown which is nothing.

 

On top of that, the scar is already 3-4mm throughout. If it heals any wider, I would be cursing myself for getting a second procedure. There is also the healing period to think about.

 

Has anyone been on the fence about a second procedure and have any insight to share?

 

I guess I am fortunate that I dont "need" a second procedure, although much of that is because I rely upon skillful haircuts and styling. A gust of wind can make things go bad real fast.

 

Im just not sure if covering the crown would be worthwhile. And I think it would look awkward to go any lower/fuller in the hairline with nothing in the crown.

[TheEmperor]

I received 4500 grafts in the first session (I was a NW5). My crown is still bald.

 

The hair tranplant is much thinner than I had anticipated, and the hairline is higher than I would like. Also there are some issues that I find myself styling around or else they would be detectable (I cant comb my hair backwards because the "jaggies" are visible and the hairline does not have enough density, and is too high to pull off)

 

Overall I recognize that I look better. Combed forward and across, cut to enough length so the hair overlaps and covers, yet not so long that it gets unruly, everything looks decent.

 

So here is the dilemma. I dont think I can do everything I want with (say) another 2500 grafts.

 

The crown is not that big, and will probably take 1500-2000 grafts, leaving only 500 or so to supplement the front.

 

500 Grafts will probably make the front a little less see through, but Im doubting it will lower the hairline any. That said, I dont see myself combing the hair back to expose the more dense hairline, because the hairline is just too high.

 

2000 Grafts in the crown will still be pretty thin, and wont make a big differnence to my "look". Thin coverage to the crown will be just that --thin-- and overall I will not look any more youthful or better.

 

THe only way to really improve my "look" would be to use 2000 grafts in the front to thicken and lower the hairline a touch. That would leave 500 grafts for the crown which is nothing.

 

On top of that, the scar is already 3-4mm throughout. If it heals any wider, I would be cursing myself for getting a second procedure. There is also the healing period to think about.

 

Has anyone been on the fence about a second procedure and have any insight to share?

 

I guess I am fortunate that I dont "need" a second procedure, although much of that is because I rely upon skillful haircuts and styling. A gust of wind can make things go bad real fast.

 

Im just not sure if covering the crown would be worthwhile. And I think it would look awkward to go any lower/fuller in the hairline with nothing in the crown.

[Severn]

Who did you have your first procedure with?

[TheEmperor]

Originally posted by Severn:

Who did you have your first procedure with?

I have not told anyone on the forum who did the work, because I do not want to be perceived as bashing or praising his work. By keeping him and myself anonymous I can be more objective. There is good and bad in it. There is no other way to put it.

 

He is a top-5 doctor and I dont think he did anything wrong. I think my expectations for density were set a bit high, and there may have been some reduced growth in the hairline. I have seen him use "jaggies" on other patients and it looks good, but for whatever reason, in my case they seem pronounced.

 

I think the graft allocation strategy, angulation, and overall design were well done. The scar ended up on the wider side of what is advertized.

 

Let me caveat by saying that I would not be confident that any of the other top-5 docs would necessarily do a better job. So while I am not thrilled, this is not negligence. I have seen other patients who have less hair who seem thrilled with their results (although they tend to be a bit older.)

[TC17]

TheEmperor,

 

I empathize with your situation even though I have yet to undergo a transplant. I'm somewhat limited in what I can do with my hair now, and realize that even if I were to strip out and then do FUE to max out my grafts, I would probably not be satisfied with the coverage and density because of the likelihood that I will progress to a NW 6 or 6.5.

 

At the end of the day, you're the only one that can answer the question as to whether you should undergo a second transplant. Scar stretching would be a huge concern of mine, as 3-4mm on a virgin scalp seems a bit large. I would assume that in a second procedure it would be that much more difficult to achieve a nice scar.

 

I feel that many of us have convinced ourselves that hair in the crown doesn't matter. Personally, I believe that's a load of BS. To people who aren't losing their hair, a bald spot is bald, and nobody differentiates between baldING and bald. Without pics it is difficult to even offer any advice, but unless your hairline is totally messed up, I would add the 2,500 to the crown. If your doctor is as good as you said, it is unlikely that the hairline was done in a way that does not look good. I don't know how old you are, but if you're younger, I can understand the desire to have a lower hairline, but as you age the higher hairline will look very nice.

[lovestospoon]

I would put 2500 in the hairline to lower it a bit and increase the density. I would not focus on the crown and rather just use concealers there since they are harder to detect on the crown vs. the hairline.

[lovestospoon]

Also be sure ure using rogaine to maintain the crown.

[M1A1]

The Emperor,

 

Your desire to remain anonymous is greatly appreciated. However, how do you feel about sharing pictures with out revealing your identity? It would defnintely help others in seeking an HT and truly help them manage their expectations. This is why forums like this are so important. Results good or bad need to be seen...With the understanding that your privacy needs to be portected...

 

If you went to a top five doc and aren't happy, do you think it was an issue of communication or unrealistic expectations. Did you and the doc discuss a long term plan, or was this a supposedly one and done idea? Your help is greatly appreciated.

 

Best

[TheEmperor]

Originally posted by M1A1:

The Emperor,

 

Your desire to remain anonymous is greatly appreciated. However, how do you feel about sharing pictures with out revealing your identity? It would defnintely help others in seeking an HT and truly help them manage their expectations. This is why forums like this are so important. Results good or bad need to be seen...With the understanding that your privacy needs to be portected...

 

If you went to a top five doc and aren't happy, do you think it was an issue of communication or unrealistic expectations. Did you and the doc discuss a long term plan, or was this a supposedly one and done idea? Your help is greatly appreciated.

 

Best

 

I'll see if I can post some pics. I have been thinking about it for a while. I can tell you that I could post pics that make the work look like a home run, and other pics that would make it look terrible. Its all about lighting, style, and angles.

 

I communicated that I would probably be back for a second but that this procedure would need to stand on its own. There may have been a miscommunication about result, but they may have been describing what would look like in two procedures. I'm not sure. I just know that graft-for-graft, that I did not get as much coverage as many other patients. This may be because my hair in not as thick.

 

The thing that really caused me to pause and reevaluate a second procedure are the scar width, and having to go through another ugly duckling phase.

 

I did not think the doctor would have to plant in the front again, but I feel that it needs more. Also, if the scar were wider, I would be screwed, and there is no assurace it would not be worse.

 

I'm okay for now but wondering if I should just supplement what I have now for future loss rather than using the majority to improve the cosmetics.

 

On the plus side, hair looks natural when wet and I can go to the public pool and look like a stud again.

[Bill - Seemiller]

The Emperor,

 

I admire your intent to remain objective. Whether or not you decide to disclose the doctor's name is totally up to you.

 

Ultimately, you will have to decide whether or not a second procedure will get you the kind of result you want and then, whether or not you'd want to embark on a third procedure for more density.

 

Interestingly enough, a thin covering in the crown can make a huge difference over a bald spot. For instance, my crown will never be super dense, but I feel much more confident with a thin and natural covering than a bald spot.

 

Good luck in your decision whether or not to undergo a second procedure.

 

Best wishes,

 

Bill

[rpachigo]

c'mon tell us please.

[mrkneed]

What the heck is a "Jaggie"?

[M1A1]

The Emperor,

 

Thank you for making the decisions to post the pics and share them with other members of this community. Now this may sound strange, but can you post the bad pics with the good pics... I think this will give a more balanced result for the viewers of this forum to see. Even people who have a full head of hair have bad hair days. LOL.

 

As far as the scar is concerned, it sounds like you were dissapointed...What did the doc say about this? Did you get good post op care, or did you feel like they were not responsive to your concern?

 

Yes, the ugly duckling phase is a bitch and you have to be mentally strong to go throught with it. We could be talking about you looking like a science project for anoter 4 to six months...Have you shared your true feelings with the doc? If this is a top 5 doc and he is as good as you say he is, his bedside manner should be spot on. Usually the very best doctors strive for excellence, not only in results, but in caring of their patients. Is he this type of doctor?

 

One last thing, if you look like a stud in the pool with your hair wet under harsh lights or even outside in a public pool-that must be a great feeling...

[thanatopsis_awry]

Hmmm....from all you've expressed, it seems that the #1 decider in whether going through another HT would be worth it is how many grafts you'd get. You obviously have made a nice improvement post-HT, but you have reasonably high expectations, and rightfully so; a 2nd HT would assuredly improve you, much like the first, the question is whether you can stack the cards in your favor (vis a vis grafts) to get you a "superlative" result, in which the end result will approximate something worth the risks/sacrifices of going with a 2nd HT to begin with.

 

The risks of a scar are immutable, as is the recovery phase. Scalp exercises + the right clinic could give you an excellent shot of superseding the ~2500 figure you initially mentioned. Replace 2500 with, say 3500 and how does this impact your perception of the risk/reward.

[aaron1234]

Emperor,

 

You were very supportive with my thread on my average results and I won't forget that. It sounds like we are in the same boat. I'd love to see your pics.

 

My thinking is that we have put our feet on the field and now there is no turning back. You are not completely satisfied with the results of your first HT. I can all but guarantee that if you don't go for a second procedure your feelings about your hair will stay the same. The only possible way to improve your situation is to go in for round 2. There are no guarantee's but if you trust your doctor and you are honest with him, than I think the second time around will be much better.

 

If we choose to get an HT, we should make the best of that choice. I'm not entirely happy with my first round, but I'm going to do whatever I can to improve on that. Cause settling with what I have now is not an option.

 

I agree with Bill, a thin crown is better than a slick bald one. But maybe using the remainder of your donor for the front for your next procedure, and then use FUE down the road to give you some hair on your crown.

 

Bring on those pics man!

[generic1]

Originally posted by TheEmperor:

Originally posted by Severn:

Who did you have your first procedure with?

He is a top-5 doctor and I dont think he did anything wrong. I think my expectations for density were set a bit high, and there may have been some reduced growth in the hairline. I have seen him use "jaggies" on other patients and it looks good, but for whatever reason, in my case they seem pronounced.

 

 

By any chance, do your "jaggies" look anything like mine? I'm only 2 months post-op, so you'll only be able to see what mine looked like the day after the procedure. I've always thought of them as "piers" because that's the way they look on a map.

 

http://tinyurl.com/jaggies

 

http://tinyurl.com/piers482

 

Like you, I've seen my top-5 clinic produce good outcomes using this method. But I wasn't aware of their "jaggy" technique until after the procedure and have no small amount of anxiety about what the result will be.

[TheEmperor]

Originally posted by generic1:

Originally posted by TheEmperor:

Originally posted by Severn:

Who did you have your first procedure with?

He is a top-5 doctor and I dont think he did anything wrong. I think my expectations for density were set a bit high, and there may have been some reduced growth in the hairline. I have seen him use "jaggies" on other patients and it looks good, but for whatever reason, in my case they seem pronounced.

 

 

By any chance, do your "jaggies" look anything like mine? I'm only 2 months post-op, so you'll only be able to see what mine looked like the day after the procedure. I've always thought of them as "piers" because that's the way they look on a map.

 

http://tinyurl.com/jaggies

 

http://tinyurl.com/piers482

 

Like you, I've seen my top-5 clinic produce good outcomes using this method. But I wasn't aware of their "jaggy" technique until after the procedure and have no small amount of anxiety about what the result will be.

 

No, my jaggies look different.

[TheEmperor]

Originally posted by aaron1234:

Emperor,

 

You were very supportive with my thread on my average results and I won't forget that. It sounds like we are in the same boat. I'd love to see your pics.

 

My thinking is that we have put our feet on the field and now there is no turning back. You are not completely satisfied with the results of your first HT. I can all but guarantee that if you don't go for a second procedure your feelings about your hair will stay the same. The only possible way to improve your situation is to go in for round 2. There are no guarantee's but if you trust your doctor and you are honest with him, than I think the second time around will be much better.

 

If we choose to get an HT, we should make the best of that choice. I'm not entirely happy with my first round, but I'm going to do whatever I can to improve on that. Cause settling with what I have now is not an option.

 

I agree with Bill, a thin crown is better than a slick bald one. But maybe using the remainder of your donor for the front for your next procedure, and then use FUE down the road to give you some hair on your crown.

 

Bring on those pics man!

 

Thanks. I probably should go for #2. I have noticed that there is a "level set" over time, that I have gottn more used to my result. For better or worse. I want more hair, just not sure whether I should risk a larger scar and more hiding under a hat.

[TheEmperor]

Originally posted by thanatopsis_awry:

Hmmm....from all you've expressed, it seems that the #1 decider in whether going through another HT would be worth it is how many grafts you'd get. You obviously have made a nice improvement post-HT, but you have reasonably high expectations, and rightfully so; a 2nd HT would assuredly improve you, much like the first, the question is whether you can stack the cards in your favor (vis a vis grafts) to get you a "superlative" result, in which the end result will approximate something worth the risks/sacrifices of going with a 2nd HT to begin with.

 

The risks of a scar are immutable, as is the recovery phase. Scalp exercises + the right clinic could give you an excellent shot of superseding the ~2500 figure you initially mentioned. Replace 2500 with, say 3500 and how does this impact your perception of the risk/reward.

 

Good point. 3500 would make more of an impact. That would be 1500 in the crown and 200 in the front. Yeah, 3500 would do the trick, but I have learned not to expect it.

 

Someone who gets 4500 usually only gets 2500 in #2.

[Severn]

I got curious of what these "jaggies" were after looking at generic1's pics. At first it looks like it would create an unnatural pattern, but I started looking online.

 

I looked at H&W's video site where they show some very close up hairline shots as the comb is brushing through. When you freeze frame, you can definitely tell they patterned the "jaggie" effect. However with the hair grown out, it looks like a natural hairline. Others I've seen without a pattern breakup look like a "wall of hair" and somewhat odd.

[patientgrowth]

i had my procedure done be hasson and wong. i never had a pattern like this in the frontal hairline. it is misleading to say that hasson and wong do this sort of thing. it is very obvious of the pattern in the above pics and wondered who would use such a prominent pattern in the frontal zone. there are ways to create a natural looking hairline without creating such a pattern.

[generic1]

it is very obvious of the pattern in the above pics and wondered who would use such a prominent pattern in the frontal zone.

 

My HT was done by Shapiro Medical Group

[MrJobi]

Seldom do people with advanced hairloss get away with only 1 procedure for a full restoration. As far as not being satisfied with a jagged look, select a different doctor ( after speaking with the first about your concerns).