Is a second pass almost always required on the hairline? See through in harsh lighting.

[asterix0]

I was wondering, if surgeons can generally shoot for around 35-40 grafts cm^2 safely, this will probably be adequate density when you grow your hair out longer on your crown and midscalp, as the hair layers.

However, right on the hairline, if you style your hair up, won't it always be see through in certain direct light conditions? For example, harsh bathroom lights shining right down on your head, flourescent store lights in stores, direct sunlight when looking at a car mirror outside, etc.

 

[LaserCaps]

It all depends on the doctor.  There are some that believe grafts compete for blood supply and feel the need to leave a separation in between the grafts.  They'll explain they are placing a foundation to which you can continue adding grafts in the future.  There are other doctors, however, that can create density in a single procedure.  Some doctors are truly brilliant and with a great deal of experience and techniques. Always review photos of results, particularly of cases similar to your own.  And, yes, look for results of 1 procedure and of multiple procedures (in the same area).

[1978matt]

Yes it will probably be a bit weak under harsh lighting, and it also depends on your starting position too.  For example, if you were a solid NW3 and restored to a NW2 it may look better because theres a wall of hair behind it which helps to block out light.

Contrast this to someone who started off a NW5 or 6.  They may have to comb it to the side to get the layering effect to block out light because the density behind is also low.

Edited June 29, 2022 by 1978matt

[NARMAK]

The more extensive the hair loss and coverage you need, the more likely it is you will get a see through effect that "bothers" you imo. That's when usually people go for a second pass and imo, it can and does include Norwood 2 and 3s depending on how much new hairline you had restored. Sometimes people are on that Norwood scale with a high hairline and not only want to restore the hair but bring it lower. That's when issues can also seem to occur. 

Assume you will need a 2nd pass for full looking density imo and not "One and Done" and your goals will be much more realistic, you can use hair fibres to blend in the interim and imo have a better overall result. 

Say for example somebody got a 2500 graft FUE and the survival was 98%, that's only 50 grafts that didn't grow or survive. Now say somebody got 5000 grafts and a 95% survival which is still considered great btw, that's 250 grafts that didn't survive. More than triple the grafts didn't survive, but hypothetically splitting into two sessions with 2500 each, and a 98% yield would mean you have a maximum survival chance. 

We're all impatient imo. Me included. We want instant gratification yet seem to fail to grasp the majority of the time that hair loss, weight gain or most of our issues didn't just suddenly arrive. They build up over years and the solutions not going to be quick. It takes as long sometimes, but actually i would argue with concerted effort and good choice, less time than it took you. 

[Ryan Daniel]

Is this a question for your hair or in general? Show a photo?

In general, almost everyone ends up requiring more and more hair. It's not easy copying natural density.   Hair transplants are all about accepting what you get and deciding whether you are happy with the illusion or not 

[asterix0]

31 minutes ago, Ryan Daniel said:

Is this a question for your hair or in general? Show a photo?

In general, almost everyone ends up requiring more and more hair. It's not easy copying natural density.   Hair transplants are all about accepting what you get and deciding whether you are happy with the illusion or not 

I'm 6.5 months post transplant so I may have some more thickening to go, I'll post some pictures in a few months when it is closer to the final result.

It is more-so in general, if you don't opt for super dense packing and are transplanting on practically slick bald areas. 

If you go to a clothing store and the fitting room for instance, usually there are very bright, flourescent lights right on top of you that make the hairline seem quite see through, happened to me yesterday.

However, in normal room lighting, windows open with a light on etc, as long as not right above my head, the iPhone camera for instance shows pretty representative what I see in the mirror, a pretty good hairline.

 

[Eugenix Hair Sciences]

21 hours ago, asterix0 said:

I was wondering, if surgeons can generally shoot for around 35-40 grafts cm^2 safely, this will probably be adequate density when you grow your hair out longer on your crown and midscalp, as the hair layers.

However, right on the hairline, if you style your hair up, won't it always be see through in certain direct light conditions? For example, harsh bathroom lights shining right down on your head, flourescent store lights in stores, direct sunlight when looking at a car mirror outside, etc.

 

Hair transplants provide an illusion of density. The highest density that can be safely transplanted are 50 to 60 hair per sqcm. The density will always be lesser than the original density of 100 hair per sqcm. Tbh, the density is going to look lesser under certain lighting and look more in others. However, you can style it in a manner which is comfortable for you.

[John1991]

11 hours ago, Eugenix Hair Sciences said:

Hair transplants provide an illusion of density. The highest density that can be safely transplanted are 50 to 60 hair per sqcm. The density will always be lesser than the original density of 100 hair per sqcm. Tbh, the density is going to look lesser under certain lighting and look more in others. However, you can style it in a manner which is comfortable for you.

The average frontal hairline of a man even with no hair loss isn't 100 FU/sq cm.  We had this brief back and forth before, but that number doesn't even pass the common sense test. If 100 FU/sq cm were accurate, hairlines transplanted at 50-60 FU/sq cm wouldn't look consistently dense under harsh lighting.

As to OPs question, obviously the answer is no.  How dense the hairline ends up depends on the ability of the Dr. to dense pack, the availability of the recipient area (partially dictated by how much loss has occurred), and the quality of the hair in the patient. Patients that are NW5 and up (and perhaps NW4 and up) may struggle to to achieve full coverage with frontal density in the 55-60 FU/sq cm range, though.  That's not so much a situation of multiple procedures as one of supply/demand of available hair to transplant.

Edited July 1, 2022 by John1991