Dr. Christina Vryonidou (HDC Cyprus) -- 7900 FUE Grafts, 2 Surgeries -- NW7 to ?

[zweistein]

First off I need to give a big shout-out to @Doron Harati: if not for his excellent responsiveness, knowledge, and communication skills I probably would’ve ended up going to a hair mill in Turkey – and like a friend of mine who did – still be shaving my head bald today. 

I believe that my results represent what an average NW7 can expect to achieve. Upon the initial video consultation with HDC, they were hesitant about performing a full density transplant (considering the aggressiveness of my hair loss – fully bald at age 20 – my average donor, and poor hair characteristics), and instead offered me a low density “shaved look” option. I wasn’t too interested in that so they agreed to perform a full density transplant in 2-3 surgeries, while tempering my expectations of the outcome. 

FUE 1: 3700 grafts, June 2022

FUE 2: 4200 grafts (1k beard), Feb 2023

I was very happy with the result of the first surgery, and as you can see by the large area covered in the second surgery, I imagined the end result could be a nearly full head of hair. But it seems that what people say about the crown being a bottomless pit is true – I was starting to become lukewarm on the result as the months passed. 

Additionally, the donor is now significantly depleted such that if it is grown out it looks thin and wispy due to hairs clumping together: 

But keeping in mind that hair transplants are an illusion of density, I kept growing it out, unsure of what to do with it. I had considered perming it, hoping the curls would provide extra density (I still wonder if this could work); or getting an SMP density treatment (this seems unpopular); then finally I went to the barber and asked for a slicked-back look. Even he was impressed by what it did for the crown coverage.

Only in very harsh lighting is the crown still visible. The barber mentioned he cut a bit too much off the back, but next time will correct it. The product he used (suavecito hair cream) also adds a mild shine to the hair which I like since I felt mine always looked dry despite my attempts to condition it. Now I only need to contend with the high hairline. 

 

Overall I am very happy with the end result considering where I started. I don’t feel particularly rushed to do a 3rd procedure, but when I do I’ll throw as many beard grafts into the crown as possible. I wonder how much more can be taken from my donor considering I will only wear it very short now — or is it possible that even short sides can start looking bad if I continue to deplete it?

Of course this is all without saying anything of the exceptional staff at HDC. They are absolutely top notch and took good care of me on both visits. Flying in from the USA was a breeze. Dr Christina is superb.

[Melvin- Admin]

Incredible journey wow. Do you have any grafts left? Would you consider a 3rd?

[Jackdaniels]

Nice progress. You are not Norwood 7 though. You are probably Norwood 6.  

Also what I can see is that your hairline is a bit too straight and there are many doubles in your hairline which should be single grafts.
With a third surgery you should remove the doubles from your hairline and  replace them with single grafts in order your hairline to look natural. 

Edited February 1 by Jackdaniels

[jjalay]

22 minutes ago, Jackdaniels said:

Nice progress. You are not Norwood 7 though. You are probably Norwood 6.  

Also what I can see is that your hairline is a bit too straight and there are many doubles in your hairline which should be single grafts.
With a third surgery you should remove the doubles from your hairline and  replace them with single grafts in order your hairline to look natural. 

He only has fine singles on the haiirline. Dont get the purpose of this post.

[Jackdaniels]

46 minutes ago, jjalay said:

He only has fine singles on the haiirline. Dont get the purpose of this post.

Anyone can see the doubles in the hairline which should be removed and replaced with single grafts.

A proper hairline should have single hairs in the front.

 
In the photos below we can see the doubles in the hairline. 
 

Edited February 1 by Jackdaniels

[Doron Harati]

@zweistein, thank you for your praises, it was very challenging but Dr. Christina achieved the result we aimed for, congrats!

@Melvin- Admin, we told he can have 3rd FUE, I assume the scalp bank has 2000+- grafts. yet the patient is still on his 20's so maybe it's better to wait longer, because the donor had natural diffused pattern, Dr. Christina was very picky which grafts to use.

@Jackdaniels, if you'll zoom the photo of FUE1 session, you'll see smaller diameters of the hairline incisions made of single grafts compared to the incisions behind the hairline, additionally the transplanted hair is soft as should for a hairline.

[jjalay]

45 minutes ago, Doron Harati said:

@zweistein, thank you for your praises, it was very challenging but Dr. Christina achieved the result we aimed for, congrats!

@Melvin- Admin, we told he can have 3rd FUE, I assume the scalp bank has 2000+- grafts. yet the patient is still on his 20's so maybe it's better to wait longer, because the donor had natural diffused pattern, Dr. Christina was very picky which grafts to use.

@Jackdaniels, if you'll zoom the photo of FUE1 session, you'll see smaller diameters of the hairline incisions made of single grafts compared to the incisions behind the hairline, additionally the transplanted hair is soft as should for a hairline.

His donor area doesnt look like he has more left and he has to shave his hair on the donor area now. Are you still offering fut for such higher NWs now or not anymore?

[Doron Harati]

13 minutes ago, jjalay said:

His donor area doesnt look like he has more left and he has to shave his hair on the donor area now. Are you still offering fut for such higher NWs now or not anymore?

HDC stopped doing FUTs since 2011, we don't see any benefits over FUE.

The downside side of FUT that you can't be selective with which grafts you want to extract especially with limited donors of diffused candidates, it takes a lot of experience to handle carefully candidates with natural depleted diffused patterns.

If he'll have a 3rd FUE with us, I assume Dr. Christina will approach his donor like she handled my donor on my 3rd session with HDC, meaning she'll punch with more "esoteric" areas, like near letral humps, behind ears, beard again of course, ect..

We always reserve this areas just in case of last resorts for the future.

If you'll check other other results, you'll find we did many cases with weak and diffused donors successfully with FUE only.

Edited February 1 by Doron Harati

[Ccd99]

These results are very inspiring, congratulations on your new look! I think your hairline looks great and will age very well as you get older.

Are you any medications?

Also do you have any more photos pre-op, curious to see your baseline, particularly your donor prior to 1st surgery?

PS: Have you considered trying hair fibres/concealer? It would give you a much more dense look!

Thanks!

Edited February 1 by Ccd99

[zweistein]

@Ccd99 Thank you. Here are photos taken for the clinic showing 6 weeks of donor growth prior to any surgery. To my surprise the side donor is looking very thin here too, so it is mostly just my bad genetics as opposed to donor depletion. At that point in time I had also been on minoxidil + microneedling for 5 months, which regrew some hairs on top. Currently I use minoxidil + RU58841 topical in the morning, and 2.5mg oral minoxidil at night. Unsure if I should recommence the microneedling. I used fibers regularly between surgery 1 and 2; I hadn't even considered them now but it is definitely option -- though there is something unappealing about relying on them for daily wear.

 

@Jackdaniels As for the hairline, maybe the straightness coupled with the height is slightly odd -- I'm not sure. I personally don't notice any doubles when looking in the mirror but maybe I don't have a good eye for it.

 

PRE-SURGERY, 5 MONTHS MINOXIDIL + MICRONEEDLING

[baddecisions]

It's a great and natural result, congratulations!

I can't actually find those doubles in the hairline. Maybe in the transition zone, but that is common an even required.

[wembley]

The result is in general good. But I can also see the doubles in the hairline which shouldn't be there. 

[zweistein]

Maybe something like this could be a worthwhile modification to the hairline? Although I'm not sure if they'll be able to find enough singles

 

[Doron Harati]

7 hours ago, zweistein said:

Maybe something like this could be a worthwhile modification to the hairline? Although I'm not sure if they'll be able to find enough singles

 

We can do this small peak easily👍🏻

A general enhancements can be done.

[A_4_Archan]

 

The final outcome appears natural, and you can enhance it with a subtle touch. It's important to acknowledge that a hair transplant is not flawless/perfect..imho in your situation, it has successfully enhanced visual appeal. Congratulations.