Pics for evaluation

[LMS]

I also have blonde hair and its always been super fine it kind of sucks lol.

OP whats you ancestry? You look east baltic ie. Lithuania, Estonia, Latvia

[35YrsAfter]

IMHO, this is why FUHT may indeed be a better option for those who are headed for the higher Norwood classes. Better yields considering our limited donor supplies.

This is why I believe that FUE is better suited for those who have limited hairloss in their family histories and do not wish to have a long donor strip scar. Keeping a higher more age suited placement of the hairline also helps preserves that limited donor supply as you pointed out earlier.

The art of hair restoration is such a mixed bag. We all, including me of course, have opinions that are heavily influenced by our personal experiences. I have seen a few mature strip scars that are barely visible while running a comb up the back of the patient's head. I have seen the white FUE dots that aren't noticeable unless the patient's head is shaved to the bone. I've personally had thousands of FUE extractions and the only area where they are even barely visible to the naked eye when light hits the shaved skin at a certain angle, is where a larger punch was used. The best strip scar I have ever seen on a shaved head oddly enough, was done by the very clinic that butchered my head years ago with shotgun scars. I'm still in the process of fixing those scars with beard hair. The doctor who plugged up my head years ago still practices hair transplant surgery and was dishonest with me while I sat in the chair back in the early 80's. Of course with the larger clinics, it's often a crap shoot related to the quality of doctor you get unless you specifically request a particular physician with a decent reputation.

Every week here at Dr. Cole's office, we seem to have between one and four patients in for strip scar repair. I commonly see scars wider that an inch from ear to ear. I have even seen multiple wide strip scars crisscrossing the back of a patient's head.

Personally, here at work, I'm seeing great results and promise with the use of ACell and PRP in patient's donor and recipient areas, when used in conjunction with minimal depth FUE. In light of the donor follicle regeneration we are seeing with minimal depth FUE, I'm personally leaning more toward FUE in the right hands as being the preferred method for larger sessions.

Today I had 500+ beard hairs extracted and placed in my shotgun scars and crown. My donor and recipient areas are being treated with ACell over the next few days.

The most discomfort during surgery I experienced today was from holding my head in a particular position for an extended period of time. Only local anesthetic is necessary. I personally hate needles and get a little anxious before surgery, but every time the pain has been insignificant. I began typing this post approximately an hour after my surgery. I feel fine and the only pain is a slight burning sensation on my neck where the grafts were removed. Kind of like when you scrub your skin too much to the point it feels slightly raw. On the pain scale of 1-10, it's less than a 1 without any pain medication like Aspirin or Tylenol.

How many people have a job where you work with people day in and day out and all of a sudden, you're sitting in a surgical chair with your friends and coworkers huddled around you assisting your doctor/boss in restoring your hair?

35YrsAfter works at Dr. Cole's office.

[Gandolf]

It looks like you are certainly doing your homework. I'm curious about why you were so quick to discard Dr Feller. I imagine he would have adjusted the hairline to match your opinion, wouldn't he?

Because the way you are describing it, you seem to really be just looking for reasons to "NOT" do this.
It seems pretty clear you'll get a good transplant, but is there some other reason that's holding you back? Happy to learn more about you, this is informative for me as well.
All my best,

Dr John Frank, MD

Hey Dr. Frank,

Regarding Dr. Feller, as soon as he showed me the hairline he drew in the mirror, I told him I was looking for something a little more aggressive, especially in the corners of the hairline and asked if he'd advise that. His response was that he wouldn't recommend it but I could always make it lower in the future. He was pretty dismissive about my concerns I felt. To me, that simply made no sense, to take the plunge on do a HT now that wasn't going to meet my satisfaction, only to plan to come back later and lower it.

And there was more to it than the actual diagnosis from Feller that caused me to discard him as an option. While I was in the waiting room before my consultation, the patient he had just operated on earlier in the day came out with head bandaged and I could see the recipient area. After a quick look at my head in my consult Dr. Feller said, and I quote "did you see the guy in the waiting room before you came in? Your him. I'd do the same exact procedure." I asked some questions and it turns out this guy was considerably younger than me and had very different hair characteristics, which I was able to see in the waiting room. I also felt that his hairloss especially in the crown area was significantly different than mine (his was worse and at a younger age). Given several important differences between me and this patient, I don't understand how he would advise to do the exact same procedure. I just felt that, in addition to his diagnosis being too conservative, I had just used PTO from work and spent hundreds of dollars between gas, hotel, toll fees, etc to get a 2 second diagnosis like that. And there were many important aspects of HT that I know as someone doing my research he should have asked. For example he never even asked me about family history of baldness and what the other men in my family ended up looking like.

Because the way you are describing it, you seem to really be just looking for reasons to "NOT" do this.
It seems pretty clear you'll get a good transplant, but is there some other reason that's holding you back? Happy to learn more about you, this is informative for me as well.
All my best,

Dr John Frank, MD

You might be right about this. I just think the main thing holding me back is that my true desire is to have not just an improved hairline but also my natural density back up top. Propecia has stopped my loss and I regained a little in the crown area, but my hair can still look pretty bad in harsh lighting or outside. Due to the current limitations of HT surgery I worry that I just won't be able to get what I truly desire. I would imagine none of the good doctors would implant hairs into my crown and vertex to add density due to the risk of shockloss. Certainly none of them recommended it in my consultations.

[Gandolf]

OP whats you ancestry? You look east baltic ie. Lithuania, Estonia, Latvia

Primarily Scottish on my dad's side and German on my mom's side. I am lighter complected than either or my parents though, but there are a handful of family members who have the extremely light coloring that I have (from my dad's side of the family).

[drybone]

Hey Gandolf

........the guy was dismissive about my concerns and thus there was no point doing it if it wasnt going to be what I wanted...............

Any doctor who refuses to give you what you want will NEED to tell you exactly why not.

A reasonable explanation would be that some guys who are 20 dont know if they will go totally bald in 10 years and we have to realize we will keep receding after the procedure.

Your doctor seemed instead to 'steer' you , almost over ride your own intellect like your wishes were not relevant in the real world.

That to me is insulting. Ive seen your pictures. There is no reason why you cant have a lower hairline but you have to have a little recede by the temples.

Ive seen tons of men 20,30 then 40 50 even 60 years old have full heads of hair but a little receding at the temples looks great. Women love a little recede as long as the middle is thick and full.

So go get a second opinion. Third, fourth. Dont worry, you will find a guy who will do it or tell you whats up.

[Gandolf]

Crown Too?

Hey Dr. Frank,

That's just it; I don't know. I don't know what it would take to make me truly satisfied which is why I'm waffling back and forth over this. I don't think an "illusion" of density is enough to please me, I want real density that will look good in all lightings.

I already have plenty of hair to have the "illusion" of density all over the top, as long as the lighting isn't bright and unfavorable, but in strong lighting my hair on top can look quite thin and see through. Maybe given that I already have a decent amount of hair in the crown and vertex I'd be able to get good coverage with a reasonable number of grafts?

But untimately I'm still conflicted over doing something now with the current technologies versus waiting for something better to come along. I'm holding out hopes that in the not-too-distant future we will have treatments that not only move existing hairs from point A to point B but actually generate new hair folicles. I know there are people who 15 years ago probably thought this technology would be a shoe in within the next 10 years or so, so there IS a risk to keep waiting and waiting. You might wait around so long that your best years are behind you.

Specifically, I am waiting to see what the hairloss community sees next with Dr. Coen Gho who is claiming 80-90% regrowth in the donor area with his technique where he essentially removes part of the follicle and claims that it will regrow in both the donor AND recipient site. Have you heard of this treatment and do you have a medical opinion on whether or not this would truly work? Obviously if his claims can be substantiated, this would be a game changer as it would multiply the donor supply but the fact that there aren't more doctors promoting this make me skeptical.

[drybone]

Hey Gandolf.

I know for me Im on a tight budget. I cannot afford to 'hope' the hairs grow in both places.

I am willing to trade off the fact there will be a line in the back when shaved for the fact the hairs WILL grow in the front.

When more and more doctors are practicing it as fact, then I will consider it .

[DAVE52]

I just think the main thing holding me back is that my true desire is to have not just an improved hairline but also my natural density back up top. Propecia has stopped my loss and I regained a little in the crown area, but my hair can still look pretty bad in harsh lighting or outside. Due to the current limitations of HT surgery I worry that I just won't be able to get what I truly desire.

You will never get your natural density back

[Jotronic]

Gandolf,

I've just read this entire thread. Here are my thoughts. Leave your crown and vertex alone. The whole point of this procedure is to get a cosmetic improvement that is obvious. You have so much hair that I doubt you'd notice any difference regardless of how many grafts you get. I think most excellent clinics would turn you down for crown work for this reason alone. I know I would. Put all thoughts about surgery for these areas to bed. It is a waste of time not to mention hair and money.

[Gandolf]

Gandolf,

I've just read this entire thread. Here are my thoughts. Leave your crown and vertex alone. The whole point of this procedure is to get a cosmetic improvement that is obvious. You have so much hair that I doubt you'd notice any difference regardless of how many grafts you get. I think most excellent clinics would turn you down for crown work for this reason alone. I know I would. Put all thoughts about surgery for these areas to bed. It is a waste of time not to mention hair and money.

Hey Joe,

Thanks again for your input and I know that with the current methods, most/all of the top doctors wouldn't go in and work on my crown. I think the pictures I posted at the beginning of this thread show me in average lighting and don't do justice to how shitty my hair can look either in bright lights or outdoors. I've posted more pictures below to further highlight. As you can see, in the indoor picture I look like I have absolutely ZERO hairloss whatsoever in the crown but in the pics taken outside, it's clear that I have lost a significant amount.

While it might not be advisable to treat the crown, I have to disagree with you that there is zero room to improve it at all. Under bright lights my hair is somewhat see-through up top and adding to the hair count would lessen this, wouldn't it?