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1500 grafts - Denmark (Density and shockloss)

T

Tobi

member
Hello Hairlossexperiences,

I have tried to read pretty much everything on the forum, so that I can gather as much information for my next hair transplant in the future (hopefully many years from now).

However, I am now at my 10-month marker and would like some response and advice, but before that I will try to give as much information as possible – I know it takes 12-months for a full result, but doesn't think the next 2 months will change anything substantial besides texture etc.

Information about me:

  • 24 years old
  • No hair loss whatsoever at my mothers’ side of the family (grandpa still have a full set of hair and so does his son, absolutely no hair loss.)
  • Father is a Norwood 3 and have the same amount of hair loss that I had before the transplant at age 50. He does however in the last couple of years seem to have lost a non-significant amount at the crown.
  • I was born with a high forehead and basically a non-existent hairline.
  • Topical finasteride and minoxidil 4 times a week. (0,025% and 3% minoxidil – no sides whatsoever, maybe a bit ball ache at the beginning, but I wouldn’t say there are a correlation hence nocebo, at least for me)
  • Nizoral shampoo 1-2 times a week (1%).
  • Dermarolling 1 time a week. (however, I have not bought a dermapen, which I believe would give better results than my 0,5mm dermaroller. I know 1,5mm is the optimal every 7-10 days, but to be honest I have not bought one yet and thought 0,5mm is better than nothing)
I have wanted to change my hairline for a long time and started to research into hair transplant at a fairly young age (19 years old) but wanted to wait hence stabilizing my hair loss a bit more and therefore waited 4-5 years before the procedure. My hair loss did stabilize a bit and what I lost at around age 19-23 was not that much compared to age of 17-19. (no finasteride and minoxidil – stupid me was in denial mode and wanted to wait for as long as possible before meds and to be honest I was and still fear finasteride. So, the topical was a good solution for me even though I am sure there are some kind of systemic absorption and most likely accumulates and lowers my serum DHT.)

Since my young age we decided to do a conservative procedure and a conservative hairline. I acknowledge that I am in it for the long run and wants to safe as much donor as possible to future procedures.

Here I am 10 months later and would like to know what you think about the overall result and the density, since I do believe it is lacking a bit and a bit see through. I know that a hair transplant is an illusion of density, but when I compare my result to others here at the forum, I do feel like the majority does have better density with my kind of hair type.

Information about the hair transplant:
  • FUE
  • Doesn’t know punch size (0,7-1mm if I had to guess)
  • 1500 grafts
  • Mainly temples
  • Had the procedure in Denmark (was too scared to go overseas to Turkey etc. I am more informed now and will be going to a top 10 doctor in the future)
  • Price about 5800usd (I do think this is a very competitive price here in Denmark for a hair transplant with 1500 grafts) I had some discount about 800 dollars since it was at the beginning of covid-19, so overall about 5000usd.
Things to improve:
  • Multi hair grafts in hairline
  • Density
There are several multi hair grafts in the hairline, which do give a bit of unnatural look to the hairline (mostly right side). However, I am bit perfectionistic and don’t really think the ordinary eye would see it. I would like to improve it in my next procedure though.

I am confident that if I go back to the clinic at my 12-month marker they will offer a top up, so my questions go as follows:

  • Should I go back to the clinic and get a small top up (under 1000 grafts) to improve the density and put more single grafts in the hairline. (use the amount of grafts now but might risk losing more hair because I am still young and do not know what will happen regardless of the small amount of family hair loss.)
  • Should I set myself satisfied with the result for now (which I am, but I have indeed hoped for a denser result and safe the grafts for the future. Wait until 28-32 of age and then see how much my hair loss have stabilized and go to a top 10 doctor and get a much more dense result and have them “repair” the hairline.
Personal impact of hair transplant surgery:

  • It is way better than I started, and I now have a hairline, which have improved my life’s happiness significantly regarding hair loss. I generally try to tell as many as I can that I have had a hair transplant (of course not just random haha) , and many have approached me because they themselves have thought about it, and I have not met a single individual who have been like “that is weird” or something like that.
  • I can now style my hair, very happy indeed, haha
  • **** the wind and having to position yourself at a certain angle when having taking pictures. In general, really happy, but still a bit disappointed about the see through effect, but overall it isn’t something I can’t style away. I haven’t tried toppik and other products like that, which might help.
Information that maybe others will find helpful:
  • I had "extreme" (at least to me ;)) shockloss at donor site and will post a picture of this and this was still present at the 6 months marker and made me a bit nervous. However, from 6-8 months it all grew back and patience is the key here. (stay patient!)
  • Last week I tried to get a skin fade to know exactly how low I can get away with regarding scarring. So at 0mm the scarring is there and you can see the scarring and would be able to know that someone had something done at the back of their head, at 0.5mm not visible and at 1mm not visible at all. (I do believe the scarring will improve after several years and not really nothing I worry to much about.) I will post a picture, so that you can see the difference.
Thank you for your time! :)

All the pictures have been taken under the same conditions with flash (except the one were I mentions lightning). The see through effect is there no matter if flash is used or not. Furthermore, no gel or anything like that were used.

Pre OP:

IMG_5442PNG.jpgIMG_5486.jpgIMG_5495PNG.jpg

Post OP:
IMG_5469.jpgIMG_5470.jpgIMG_5473.jpgIMG_5474.jpgIMG_5475.jpgIMG_5478.jpgIMG_5479.jpgIMG_5480.jpgIMG_5487.jpgIMG_5488.jpgLightPNG.jpg



Right after postop:
IMG_5489.jpgIMG_5490.jpgIMG_5493PNG.jpgIMG_5494.jpg


Donor and shockloss from 6 to 10 months:
IMG_5492.jpgIMG_5491.jpgIMG_5485.jpgIMG_5435.jpg
 
Bigmac

Bigmac

Administrator
Staff member
Hello Tobi. Welcome to the forum and thanks for sharing your story.
It`s good that you waited until you were 24 and that you stabilised your loss with meds. While 24 is still considered young I can understand why you wanted to restore your hairline. In your immediate post op pictures, the density does not look dense enough. I believe the graft placement could have been better and multi grafts in the hairline should not happen. Regardless of this, I think your hair and appearance do look better.

I would wait for around 15 months post op to see what it looks like. If you feel it needs improving, then another HT to refine this one with somewhere in the region of 1000 grafts, less if possible would be better.

I`m not sure why they extracted all your donor grafts in a concentrated area. It would have been better to have it spread out a bit more. However, your donor looks good after it recovered from the shock loss. I`m pleased for you that it did recover so well as it must have been quite worrying at 6 months and still having visible shock loss.

Wishing you all the best.
 
T

Tobi

member
Hello Bigmac!

Thank you for your response!

I do agree that it is a bit weird that they extracted all of the grafts so concentrated! I'm planning on waiting at least 15 months before making a decision. However i do feel slight conflicted about going back to the same clinic even i get the top-up for "free". So if i decide to move forward with a second hair transplant, then it will definitely be one of the recommended doctors from here.

Yeah, i was indeed very nervous! I though that i would share the result here, even though i rarely post anything online, others might see it and not worry as much if it happens to them as well.

What is your opinion on getting a repair/top-up after 15 months, should i wait a few more years or have it "fixed" fairly soon (after 15 months)? I'm a bit nervous, since no one can tell me how my hair loss is going to progress (of course ;)) and therefore wants to make the most responsible decision.

Best regards and thank you for your opinion and some good points! :)
 
Bigmac

Bigmac

Administrator
Staff member
Yes, hair loss can and is unpredictable, especially when you`re young. Hopefully, the meds you're using prevent and really slow down any future loss. I first noticed my crown loss aged 24 but never knew about meds (showing my age) If I had known about meds, especially Propecia or Proscar I would not have hesitated to use them.
After 15 months I would assess the hairline. It may be that it looks ok and with styling, you can leave it as is. Me personally, I would consult with other clinics who I believe would be able to make this HT more natural at some point in the future.
 
T

Tobi

member
Hi again!

Yeah indeed i hope that the meds will slow down the future hair loss! Thank you for your inputs - i would also like it to be improved, particularly the density and the multi hair grafts, but might wait and se regarding future hair loss even though it seems stabilized now with the meds! :)
 
Bigmac

Bigmac

Administrator
Staff member
While you're waiting you could email your pictures to a few clinics to get their opinion on what they think would be the best course of action for you.
You may need the multi grafts punched out if they bother you. Having the hairline refined with single hair grafts and some added density would be my choice but you need to understand the risks of possible future loss. Obviously, take your time deciding and don't rush into anything.
 
T

Tobi

member
Hi again!

Yes, sir.
I do believe that is a very good option. To be completely honest the multi hair grafts doesn't bother be that much (but the density does). I hope that it can be "fixed" by implanting a lot of singles to the frontal hairline and improving the density my implanting more grafts.

I will for sure be taking my time and not rushing into things. The density however is something that needs to be changed and singles to the hairline.
 
Bigmac

Bigmac

Administrator
Staff member
Donor management and possible future loss are the main concerns for any young patient. Hair transplants need to be planned to take these into consideration. If a worst case scenario happened with you not responding well enough to meds and progressing to a high Norwood level you don`t want to be left with only transplanted hair that looks unnatural. These should be things to think about and hopefully, if you consult with a few clinics, they will advise accordingly.
 
T

Tobi

member
I do agree! A master plan is very important!

Even though that no one in my family is norwood 4+ the plan is to be conservative and save as many grafts for further use.
Having transplanted hair and loosing hair behind it and keep chasing hair transplants is something that i absolutely don't want to achieve. I acknowledge that i will never be able to have that "full set of hair with a perfect hairline", my goal is simple to have a decent hairline which is age appropriate now and 40 years from now!

I'm planning on being on meds for the rest of my life at least decades to come and i hope that finasteride will at least keep what i have for now. However, i do hope (as many of us) that in the next decade or so there will be medication that is more effective than finasteride and have a lower side-effect side, but i'm planning for the worst and the information/meds we have now.
 
janna

janna

Invaluable Member
Hi Tobi,

You sound very reasonable and realistic. I would assess where you are in terms of your transplant result at 14-15 months after surgery to decide how you want to move forward.

Best wishes on your result.
 
Bigmac

Bigmac

Administrator
Staff member
As another option you could FUE out the bad parts of the hairline, the temporal angles and the larger units, allow to heal, maybe use the hair removed to place back into the donor if possible to hide any obvious white dots. Then allow the meds to keep working for a while before deciding to do anything else.
 
T

Tobi

member
Hello Janna

Sorry for the late reply!

Thank you for the reply and i do hope so! Yes, i will wait and then decide what shall happen!

@Bigmac
I have thought about that, but i don't think that it's that bad and i have seen some cases (on this forum) where scarring is not that visible when removing FUE grafts from the frontal hairline to other parts of the scalp, which comforts me a bit if i want to change that in the future!

My plan at the moment is to wait a few months and then see if it's possible to improve the density and furthermore improve the hairline with singles!

Thank you for the second opinion!
 
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