Low density after 1800 first FUE. Go for second HT?

[newguy2021]

51 years old, never taken any hair medications (no fin, no dut, no minox), probably between a NW2 and NW3 before surgery, generally healthy hair, no balding in crown.

I had my first and only HT (1800 FUE) done Sep 2021 with a fairly well-known and respected US surgeon. Main goal was to reduce hairline asymmetry (left hairline was significantly higher and receded than right). I was hoping to be one and done, but alas. While my hairline is better and more symmetrical, the density on the left is low. I feel like I have traded hairline asymmetry issues with obvious density asymmetry issues. 

It bothers me enough that I would like to get it fixed. Perhaps address temple points as well this time around? I think my donor density is decent since only had a small first procedure.

Thoughts? Leave it alone? Go back to the same surgeon? Only fill in hairline for higher density and don't do temple points? The original surgeon is not known for temple points. Cost is not an issue (e.g., open to going to Konior, though his wait-list will be long) and open to international travel (e.g., eugenix).

(All the paired photos are top before, bottom after. The top-back view photo is after).

[newguy2021]

Here is the donor area view as best as I could take.

[Hairy Henderson]

Hair doesn’t really look bad, not sure I would mess with it.

[Mike10]

I my opinion, the surgey was a success. I would leave it at that

[BaldReaper]

I dont see any low density

Edited March 4, 2023 by BaldV

[newguy2021]

Here is another picture that I think shows the right and left density differences better.

[A_4_Archan]

3 hours ago, newguy2021 said:

Here is another picture that I think shows the right and left density differences better.

Yeh i understand your point bt ..left side is little sparse bt tht looks natural...even the hairline is soft and thr is adequate density ....so as other people said i would say the same tht dont mess with it ...only think of a surgery if your are too much concerned abt it...

[Rafael Manelli]

3 hours ago, newguy2021 said:

Here is another picture that I think shows the right and left density differences better.

You’re brushing the hair back and to the right in this pic, making the right look thicker. Try brushing it all straight back evenly.

[FITA]

I can see why you’re thinking of having a second surgery. Definitely worth contacting a few clinics to see how many grafts they would recommend and taking it from there?

Perhaps Dr Lorenzo in Madrid might be a good fit for something like this. His wait times aren’t as crazy as some of the others either.

[bear56]

either the hair is wet or you using some hair product ( gel , hair spray etc) that makes your hair look thinner than it is.  when you look at your picture from the back it looks like you have good density and your hair looks dry and fuller. experiment with thickening products wax of clay and wear your hair more messy style than it will look a lot fuller.

[BDK081522]

From the pictures, the density difference can be attributed to how the hair is styled. The hair on the left (pic) is layered on top of itself creating a visually denser result. The hair on the right (pic) is fully exposed and this is the most vulnerable spot for any transplant. You have a high skin color to hair color ratio making it even easier to see underlying scalp. Remember, you'll never have native density but visually it could look slightly more dense with a touch up procedure. Your first transplant was really well done in my opinioin. The hairline is very soft and natural looking and the density overall is pretty good. Konior could help with the density issues and give you the temple points you're looking for. 

[Gatsby]

I think it looks great and I wouldn't touch it. At 51 and not being on any meds your hair looks perfect. No hair transplant is perfect however.

[Jayson1361]

On 3/4/2023 at 12:50 PM, newguy2021 said:

Here is another picture that I think shows the right and left density differences better.

You could try a touch up procedure. I see what you’re trying to do. But, since you’re not losing hair there anymore I’d try combing the hair to left, try a wax product, maybe even lighten the hair a touch for a different look. A different hairstyle could easily blend that in. 

[newguy2021]

Thanks everyone for the great feedback. Much appreciated. Not surprisingly I see a mix of suggestions from leave it alone to go for a touch-up.

 

I did my first procedure not because I was balding (ok perhaps I was marginally balding), but mainly to improve left-right symmetry as my left side hairline has always been a lot higher than right (been noticing that since I was 16 yo). While now it's a lot better after first HT, the low density still bothers me every day and am leaning towards considering a touch up.

 

I know I am being a tad hair-greedy, but what are my risks with a 2nd procedure? I have plenty donor hairs left, am not trying to lower the hairline, 51 yo and generally not balding anywhere, and only trying to some density to the left side. Shock loss or permanent loss to existing hairs on left front the primary risk?

 

I ideally want to do temple points as well. Would eugenix even take up a minor case like mine? I think I may need 500 hairs in front and perhaps the same number total for both temple points. i would love to go with Dr. Sethi if he agrees 😀

 

Cost is a non-issue.

 

[newguy2021]

Update: I did email consultation with Eugenix and they came back with a good plan after a few back and forth. Total 800-1050 grafts from scalp, including temple points (600-800 front, 150 left temple, 75-100 right temple).

 

I also had a virtual video consultation with my original surgeon. He recommended 500 grafts to improve the left front density. He is open to considering temple points at the time of the procedure, but based on his hesitation, I don't think that will happen. He had also said no to that at the time of the first procedure.

 

I am now doing Whatsapp back and forth with Eugenix asking for the flagship package. Let's see how that goes.

 

Any suggestions or thoughts?

[HairFunk]

A little more wouldn't hurt... make sure it's someone who is good with refinement! 

[newguy2021]

So I have been exchanging a lot of information back and forth with Eugenix reps. and am narrowing down my choices.

 

The unadvertised duo premium package looks interesting. Both doctors do design and planning together, Dr. Sethi does all slits, Dr. Bansal does all extractions, and she also does crucial implantations. Since my case is small about 1000 grafts, I was told by Rishab that she would do about 300-500 crucial implantations, leaving the rest to the technicians. It is possible upon my request she may do more implantations, again just because my case is small. This package is quite expensive, but I am leaning towards it. Upon searching, I only saw one other person here go through that package.

 

In Dr. Sethi and Dr. Bansal solo packages, they do design, planning, and slits. All extractions and implantations are done by techs. 

 

Is it worth to go for the duo premium package? It will be about $11 per graft (including tax). 

 

 

 

 

[Otis james]

What do you put inbuilt hair, mate? It doesn’t look a good match for you… too wet and greasy. I really think this issue could be solved with a more mat based product. 
loads of people do this!! Pile a load of wax in the front… the back looks dry to me but the front looks wet! Really doesn’t help you….

Edited April 5, 2023 by Otis james

[Adam561]

It is looking great. @newguy2021, may be if Dr. Sethi or Dr. Bansal evaluates and agree to do the temples (according to the face aesthetics) Keep us posted.