Went for a consultation yesterday. What a joke.

[JoeTillman]

This is an interesting case. I'd like to address two issues that are brought up.

First, the consultation. What you need to realize is that the very reason why you feel you are a good candidate for surgery is exactly what precludes you from being the ideal candidate for surgery. Your hair is the same as it was even 15 years ago as a ten year old. This means that the hair you have now is at the highest native density you've ever had because it most likely has not diminished. This is the very defintion of someone in your position, having a congenitally high hairline and deep temples. It does not mean there is loss nor is there recession because recession means it has receded from where it once was. Yours has not. But the density you have now in the hairline is not easy to match. When building a hairline however the native density does not need to be matched as anything over a certain percentage is wasted hair. Why? Because once a certain density is achieved you gain a visual equilibrium to the hair you have now. It may not make sense but it's true. The rule of thumb is that once 50% density is achieved then it is indistinguishable from native density. This is, in my opinion, not true especially for patientsl like you that have dark fine hair on pale fair skin. You need a higher density but nowhere near 100%. To get what you want there are few doctors that can pull it off in one session but in my opinion AND experience it is best to approach cases like yours in two passes. What's more, and this is never discussed online, even in the hands of someone that could get the right density in one pass doens't mean it is possible for you. Why? Scalp tissue integrity. This refers to how your scalp tissue holds up to the dense packing of the tiny incisions made in your scalp. In some patients the skin will literally dissolve in between incisions if they are too close so a case that was being addressed with a plan for ultra density has to be modified by reducing the density to a level that the skin can accept. It happens more than people realize.

The second issue I'd like to address is your candidacy overall. Hair transplant surgery is a risk for anyone and everyone that goes through it. No guarantee is worth the paper it is printed on or the breath it is carried on because no one has full control over your result. What CAN be guaranteed is support IF the result is not what is expected. But what I see in your case is not exactly something that would scream "don't do it". I know why this bothers you because I've dealth with similar patients before. I think the recommendation you were given is not far off the mark and I do see areas where surgery may help you to feel better about your appearance. Bringing you in line with what a true NW2 should be is not out of the question and I don't think that anyone that decides to accept you as a patient is a butcher (by this qualifier alone that is). As long as it is approached with care and by experienced and ethical hands you might be ok. That is assuming you are being truthful about your family history which, as you stated, shows a history with zero actual hair loss.

I am not endorsing your position and I would encourage you to take a step back and think about what everyone is telling you. You do have a beautiful head of hair that everyone here is envious of. However, I have a feeling you're going to do something anyway so in a case like yours I think guidance and education is the best way to help you. FUE only, stay as far away from FUSS if possible, and go conservative and find someone that has a truly excellent track record of consistency. Then, ask yourself what you'd do if the result didn't grow well. What will you do if the density is not what is promised and you have a completely see through hairline that is thin and wispy. What will you do if you have recipient site scarring that is visible through the thin and wispy growth that did match your expectations? How will you "fix" the issue? Are you prepared to go through multiple surgeries to chase the ever elusive and impossible to achieve look of a virgin scalp? Once you are cut you are cut and there is no going back. These are real questions that you should answer before you have no choice.

I would like to see your photos in a larger format with higher resolution, if you don't mind. Click the link below to find my contact information .