12-Month Update: I have finally reached the 1-year milestone, which, for the vast majority of people, more or less represents the final result with the possibility of further improvement over the next 6 months in texture as the hair matures. However, I recognise that the crown (vertex) sometimes takes up to 18 months to see the full result due to reduced blood supply in that region.
The pictures were taken after a haircut. The hair is dry; it was towel-dried, and no product of any kind has been added.
Am I happy with the result? Yes – I am very happy. Transplanting into diffuse hair loss is challenging for many surgeons. I think the result looks age-appropriate and natural. There have undoubtedly been significant improvements in coverage and density, particularly considering the number of grafts used. The FUT scar is invisible at a number 3 cut. If I add hair product and blow dry it, it looks fuller, and in less harsh lighting, it looks even better again.
Would it benefit from a touch-up? Yes, further density is needed in the crown area, in part of the mid-scalp, and, perhaps to a lesser extent, in other regions. However, at my age, I can get away with it and, therefore, will likely not bother, although, in time, I may consider a touch-up of the crown area to fill it in. That said, if I were much younger and could afford it, I would most certainly get a touch-up.
What were my expectations? The clinic set the expectation that ‘
with double day FUT + FUE treatment based on the photos provided it’s realistic to expect full coverage with great density.’ The clinic estimated I would require 5-6000 grafts(units), but when I had the assessment in person at the clinic on the day of the procedure, they advised that my hair and scalp were in better condition than they thought. They, therefore, transplanted 4,244 grafts (9,601 hairs) as they advised that ‘
there was no room to fit any more.’ (Note: I had attended an in-person face-to-face consultation with a local hair transplant surgeon, and after performing a trichoscopy, he advised that a minimum of 5,250 grafts would be required).
Below are pictures of the crown immediately before the procedure, after the graft placement, and after the 12-month growth. It currently has a noticeable lack of density, which got me thinking - perhaps not enough grafts were transplanted to that region? Possibly, grafts failed to grow? Maybe the trauma of the surgery killed native hairs, notably the miniaturised ones in that region, or were they transected? Or perhaps it is simply that grafts are lying dormant and waiting to emerge?
What does the clinic say about my results? I reached out to the clinic, and they pointed out that achieving a ‘perfect density’ is influenced by subjective perceptions and comparison to similar cases from an objective point of view. Therefore, if I view my results in the context of similar cases, it is a successful one. In addition, I should remain patient as the crown can continue to show improvement up to 18 months post-procedure.
Has the result met my expectations? Yes and No – While not expecting ‘perfect density’ and happy with the overall improvements, based on my understanding of the ordinary meaning of ‘great density,’ the crown region has not yet met the expectation the clinic set. The lack of hair in my crown was the catalyst that started me down the road of having a hair transplant, so still having a noticeable lack of hair there irks me somewhat. Particularly bearing in mind that some of the current visual improvements can also be attributed to a) on my own volition deciding to wear my hair much longer than I did previously to improve coverage to help create the illusion of density, b) taking Finasteride which the clinic did not discuss it with me, and c) applying topical minoxidil which the clinic also did not discuss it with me.
Below are two pictures taken on the same day which show how the hair is styled contributes to the illusion of density (I have observed that the majority of people who have had a hair transplant and appear to have achieved a fantastic result subsequently style their hair in some variant of a slick back to help create the illusion, a hairstyle that I will now work with my barber to achieve to help conceal the crown).
The clinic promised ‘great density’, and the term ‘great’ is subjective. According to the Oxford English Dictionary ‘great’ means of a ‘quality considerably above the average’. Additionally, the American Merriam-Webster Dictionary defines ‘great’ as ‘markedly superior in quality.’ Further, according to ChatGPT AI, ‘great density implies a high concentration of healthy, thick hair follicles in the treated area, creating a full and natural-looking head of hair.’
Having gained knowledge over the last 12 months and reviewed the results of similar procedures, I have concluded that the clinic incorrectly set my initial expectations, and I, lacking in knowledge, started with unrealistic expectations. I appreciate that a one-and-done for my level of hair loss is a rarity. I had two procedures: Day 1: a FUT, where the hairs were transplanted to the crown area, and Day 2: FUE, where the hairs were transplanted to the mid-scalp and front.
Hopefully, as the existing crown hairs mature, new hairs will also emerge over the coming six months. Perhaps forum users can share pictures (other than anecdotal evidence) of others who experienced improvements in their crowns from months 12 to 18, as I have not been able to locate any?
Was it worth the money? Yes - I paid AEK €6,500, which is €1.52 per graft. Other quotes I received ranged from Dr Bicer (Turkey) at €18,000 to Dr Yaman (Turkey), who initially quoted €6,400 and then reduced it to €5,500. Having seen the recent variable results from Dr Yaman, I am glad I did not go with him.
Having followed the results of other surgeons on this forum for the past year, would I choose AEK again? Yes – if I had the same budget constraints. However, if I could afford it and time was on my side such that a lengthy waitlist of two years was acceptable unless a cancellation opened up, I would also consider someone like Dr Tsvetelin Zarev in Bulgaria or Dr Felipe Pittella in Brazil, who would be approximately €21,500 for 4,244 grafts. However, they would likely use many more grafts, so they would probably work out somewhere in the region of €45K, maybe more.
What have I learned over the last 12 months? A hair transplant is a transformative process that can improve or worsen your physical appearance with consequent wide-ranging and lasting effects on your self-confidence and mental well-being. There are a large number of cowboy operators out there who have ‘Excellent’ ratings on Google and Trustpilot. Luckily forums like this saved me from going with a hair mill (Blue Magic – 4.7/5 on Google and 4.6/5 on Trustpilot), with whom I had paid a deposit and had surgery scheduled. You need first to educate yourself to give yourself the best chance of success; for example, I should have been on Finasteride for 12 months before the surgery. You also need to have realistic expectations and understand that the goal of the transplant is to create the ‘illusion’ of a full head of hair. I would advise others to research thoroughly using forums like this, do a deep dive, critically appraise as many recent examples of their proposed surgeon’s work as possible, be wary of lighting used in photos and the use of hair products and styling notably the slick-back which covers up many issues, and spend as much as possible on getting the best surgeon they can afford, even if that means waiting to save enough money. It is a lifetime investment, and a botched job will cost you more in the long run, both financially and mentally.
