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  1. #1
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    Default Help. Conservative hair transplant.

    Hi,

    Say you have a Norwood 6, you only have 3500 grafts to play with.

    Can you achieve anything worthwhile in this situation with only 3500 grafts.

    Getting as much coverage as possible with a high-ish hairline and a medium density - or to be more specific a density that is at the limit of what looks reasonable, maybe a thinning look but obviously not too much.

    I am obviously trying to work out what the best outcome you can achieve at the limits of density and coverage, how dense or sparse can you go before hair looks too thin.

    I have been on one of those graft calculator things (yes I know they are not particularly accurate but they surely are some way to a guesstimate of what works)..... http://www.hshairclinic.co.uk/hair-l...ft-calculator/

    I selected the 3-7 areas for coverage with a receded look. I also selected the density of 32 grafts per square centimeter which worked out as a total of 3500 grafts. So according to this it is quite possible to re-build a receded look with coverage with this amount of grafts.

    Is 32 grafts per square cm going to be a reasonable density?

    Can this work.

  2. #2
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    I have seen guys like this and they never look good. The hair always looks too "uniform" on the head for having hair that thin. Real hair does not recede to a NW 6 and leave a thin tuft of hair on the top. Plus, you have to contend with the issue that high NW's sometimes thin out in their donor areas as they age. I think you'd need more like 8,000 grafts to create any sort of natural look on a nw 6.

  3. #3
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    I think things like hair caliber, and hair/skin contrast really come into play.

    Look at this result:
    http://www.bernsteinmedical.com/hair...s/patient-uar/

    Baffling that such results are possible with less than 16 grafts/sq cm but there you go.

    I asked a related question in an earlier thread, essentially if doctors/patients had good experience creating something like the "Alton Brown" look:
    http://upload.wikimedia.org/wikipedi...brown_2011.jpg

    In my opinion, something like this *should* be an option for us high norwood patients. Unfortunately I didn't really get any useful feedback or comments.

  4. #4
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    Quote Originally Posted by baldymcgee View Post
    I think things like hair caliber, and hair/skin contrast really come into play.

    Look at this result:
    http://www.bernsteinmedical.com/hair...s/patient-uar/

    Baffling that such results are possible with less than 16 grafts/sq cm but there you go.

    I asked a related question in an earlier thread, essentially if doctors/patients had good experience creating something like the "Alton Brown" look:
    http://upload.wikimedia.org/wikipedi...brown_2011.jpg

    In my opinion, something like this *should* be an option for us high norwood patients. Unfortunately I didn't really get any useful feedback or comments.

    I've seen some of Bermsteins patients in person and they all looked good at the front but had no density in the back. These types of transplants just don't look very natural. It's not even a bald spot, it's like the whole back half of their head has a weird unnatural density. Maybe most people don't notice this but I can spot it from a mile.

    I agree about the Alton Brown look for high norwoods. It seems it would make a lot more sense to just "roll back the clock" a bit when donor is limited, creating a thinning/receding look over a bald look.

  5. #5
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    A lot of the "thin but even" transplants end up looking like Bob Odenkirk:
    http://i2.cdnds.net/12/36/300x225/mo...b_odenkirk.jpg

    Looks "ok" under certain lighting conditions and at certain angles but far from the "illusion of density" that many people are promised.

    An Alton Brown look is far better than being "horseshoe bald".

    Too bad this isn't presented as an option by most surgeons and they'd rather start people down the Odenkirk path.

    Re Bernstein: I agree that some of his work can be too conservative. But I suppose that nothing stops his patients from going back to get their midscalp+crown addressed. Maybe they just go to a cheaper surgeon for those "non critical" areas

  6. #6
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    if these 32 grafts are doubles it will be ok if they are triples it will be more than ok so it is important to check how is the summarize of the donour,are back there many doubles and triples which contribute huugly in a thick result.
    Quote Originally Posted by sausage View Post
    Hi,

    Say you have a Norwood 6, you only have 3500 grafts to play with.

    Can you achieve anything worthwhile in this situation with only 3500 grafts.

    Getting as much coverage as possible with a high-ish hairline and a medium density - or to be more specific a density that is at the limit of what looks reasonable, maybe a thinning look but obviously not too much.

    I am obviously trying to work out what the best outcome you can achieve at the limits of density and coverage, how dense or sparse can you go before hair looks too thin.

    I have been on one of those graft calculator things (yes I know they are not particularly accurate but they surely are some way to a guesstimate of what works)..... http://www.hshairclinic.co.uk/hair-l...ft-calculator/

    I selected the 3-7 areas for coverage with a receded look. I also selected the density of 32 grafts per square centimeter which worked out as a total of 3500 grafts. So according to this it is quite possible to re-build a receded look with coverage with this amount of grafts.

    Is 32 grafts per square cm going to be a reasonable density?

    Can this work.

  7. #7
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    Quote Originally Posted by baldymcgee View Post
    I think things like hair caliber, and hair/skin contrast really come into play.

    Look at this result:
    http://www.bernsteinmedical.com/hair...s/patient-uar/

    Baffling that such results are possible with less than 16 grafts/sq cm but there you go.

    I asked a related question in an earlier thread, essentially if doctors/patients had good experience creating something like the "Alton Brown" look:
    http://upload.wikimedia.org/wikipedi...brown_2011.jpg

    In my opinion, something like this *should* be an option for us high norwood patients. Unfortunately I didn't really get any useful feedback or comments.
    Interesting. Yeah It seems surgeons are reluctant to help us guys out that don't mind a thinning look. I assume that is because they don't want photos of thin looking outcomes getting out in the publics eye? only thick flowing locks are what they are after to promote their work.

    The result above with under 3000 grafts is surprising, it shows you that it can be done. Maybe this was an exceptional candidate......but his hairline is at it's original point, it's not even like they have been cautious with that.

    I am preferably after a receded look with long hair that I can style in a messy look. Something like this on Jude Law:



    I would scrimp as much on this as I had to. Both going higher with the hairline or scrimping on density especially around the crown.

    At the very least I think I could easily get away with a receding, thinning, low density splattering of 15-20 grafts per square cm which will be kept buzzed. If this is the best I could get I would be happy because it would look a hell of a lot better than the slaphead bare scalp look. Something like Wesley Sneijder had before his HT or something like Pep Guadiola has. ie. Both thinning buzzed cuts.

    Not sure surgeons would be happy to do this look though.

  8. #8
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    I'd bet a guy like Shapiro or maybe Feller would do this for you. You need a really artistic eye. As far as their concerns go about the result, I think they are more concerned with how their patients perceive the outcome than anything else. I have seen some examples sort of like what you're describing and I think they looked great - mature and a but receded, but very natural and much better than a thin transplanted look.

  9. #9
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    Quote Originally Posted by Yates Hair Science View Post
    Why wouldn't the surgeon want to do this for you?
    I think that's the question we're asking

    All the photo galleries of all the physicians (that I've looked at so far) all seem to propose a very similar strategy: a simple "U" hairline with very high density up front and gradually reducing density further back.

    I haven't seen examples of the "Jude Law" or the "Alton Brown" look. Perhaps these looks don't "work" for high norwood cases given the number of available grafts?

    Would love to see some examples though...

  10. #10
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    Quote Originally Posted by Yates Hair Science View Post
    Why wouldn't the surgeon want to do this for you? You can always add more density later. Most doctors prefer a conservative hairline it gives the patient the option to lower the hair line in the future. If you have an understanding with the doctor before the surgery, and this is what you want and surgeon agrees, then it can be done. At our clinic, Dr. Yates explains to our patients what he feels is best, and he listens to what the patient has to say also. I think it can be done as long as it looks natural, and the patient is happy.
    I would expect surgeons to create that Jude Law look. I was just wondering if something similar to his receded look could be achieved with 3000-4000 grafts. I assume you would have to be conservative and have low density and may need to go a little higher with the hairline to achieve this. So the density would not look quite as thick as Jude Laws hair in that photo but as long as you could get near enough to it without too much scalp showing through. I would not mind if the crown area looked thin as long as the front looked reasonable.

    It's the last thing I wrote about having a thinning, receding buzzed look as this may be the best thing that can be achieved, whether anyone who has had a hair transplant before has gone for this, I don't know. But IMO it will help get rid of the slaphead, bare skin look that I hate. You could maybe put in a reasonable density at the front to create a hairline a frame the face and then sprinkle the rest of the head in, buzz short, grade 0 or grade 1 and there you go.......

    Something along the lines of creating this but making it less patchy and more even but obviously still thin but giving coverage and getting rid of the bald skin look:


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