3000 Grafts 20 years DHI Hair Transplant - Feedback on Design and Small Gap Between Grafts

[Ekin]

 

Hi everyone,

I recently had a DHI hair transplant with 3000 grafts, and I’d love to get your feedback. How does the result look so far, and what do you think about the design and density?

I’ve noticed a small gap between the grafts and was wondering if this is normal or something to be concerned about. Has anyone experienced this before and could explain why it happens?

For context, I’ve been taking Finasteride for 5 months and am also using a variety of vitamins, including Biotin, Omega-3, hair vitamins, Magnesium, Zinc, Ashwagandha, Iron, and Vitamin B12 to support the healing process.

Looking forward to your thoughts and advice!
 

 

 

 

[Britanium]

Ok so I'm hoping the clinic gave you some comprehensive instructions for post op care? And that you're following then? I ask this because it looks like you need to be cleaning the area better, I'm not trying to be harsh, just honest. By all means let us all know who the clinic is?

I'm just going to be upfront and say that I'm not a fan of the hairline or the temporal points, not many grafts have gone in to those in particular so I don't think they will grow in that well. 

Sorry Im aware that I'm not being particularly positive here, but I don't believe in just praising a result for the sake of it. 

If you're only 20 then I'm guessing you went to a clinic which had little Dr involvement? 

[Al - Moderator]

I flipped the photos to be facing the correct way as they were upside down.

Do you have any BEFORE pictures, so we can see what you started with? At 20 years old with hair loss, that low hairline may cause you problems some years later when you continue losing more hair.

By the way... welcome to the forums

 

 

[Berba11]

On 10/11/2024 at 11:31 PM, Ekin said:

Looking forward to your thoughts and advice!

Would be beneficial to see your pre-op photos and for us to know the name of the surgeon. 
 

3,000 grafts for a 20 yr old is a lot of grafts, and to me the hairline looks quite aggressive for any aged patient, let alone a 20 year old. 
 

As @Britaniumsays, I’m a bit confused by the temple points. When you zoom in on the picture you can see your real temple points but the grafted shape is smaller and totally different. It’s as though they disregarded where your actual temple points are and created brand new ones higher up and further back… Maybe you can shed some light on the planning of the temple points and the surgery as a whole given your age and the number of grafts? A list of vitamins isn’t really the kind of context that is useful for feedback!

As for the gaps between grafts… Totally normal part of the process during scabbing and healing. 

[Gatsby]

I would drop the vitamins and just take the finateride. It can take up to two years to see the full benefits of finasteride. Please take this in the spirit it is indeeded. I was to be brutally honest you've made the mistake I did (only I was 18!!!!) and that is you really are too young for a hair transplant. The hairline you have designed is quite low. The longer a person waits for surgery the better the results will always be because surgery is like trying to hit a moving target. Stick with the finasteride and all the best.

[Ekin]

On 10/12/2024 at 12:51 AM, Britanium said:

Ok so I'm hoping the clinic gave you some comprehensive instructions for post op care? And that you're following then? I ask this because it looks like you need to be cleaning the area better, I'm not trying to be harsh, just honest. By all means let us all know who the clinic is?

I'm just going to be upfront and say that I'm not a fan of the hairline or the temporal points, not many grafts have gone in to those in particular so I don't think they will grow in that well. 

Sorry Im aware that I'm not being particularly positive here, but I don't believe in just praising a result for the sake of it. 

If you're only 20 then I'm guessing you went to a clinic which had little Dr involvement? 

Hello, first of all, thank you very much for your honest response and feedback, which I truly appreciate. I went to the Cinik Clinic, and although I had hoped to have the temples extended, the doctor declined, saying it would lead to unrealistic results. As a result, the temples were only treated with 20 grafts per cm². He focused mainly on filling in my receding hairline and gradually worked towards the temples in the areas where I already had some hair.

I was able to communicate with him in Turkish, which was particularly helpful in clearly expressing my wishes.

I received comprehensive care instructions, which I am following closely. I have been taking Finasteride for 6 months now and am considering switching to Dutasteride if I continue to experience no side effects, in order to further minimize the risk of future hair loss as I age.

My family has a tendency to develop receding hairlines, so I doubt I will experience significant further hair loss, but I still want to be cautious.

Check out the new pictures I commented on for someone else regarding this.

[Ekin]

Vor 10 Stunden sagte Berba11:

Es wäre von Vorteil, Ihre präoperativen Fotos zu sehen und für uns, den Namen des Chirurgen zu kennen.
 

3.000 Transplantationen für einen 20-Jährigen sind eine Menge Transplantationen, und für mich sieht der Haaransatz für jeden älteren Patienten, geschweige denn für einen 20-Jährigen, ziemlich aggressiv aus.
 

Als@Britaniensagt, ich bin ein bisschen verwirrt von den Tempelpunkten. Wenn Sie das Bild vergrößern, können Sie Ihre echten Tempelpunkte sehen, aber die gepfropfte Form ist kleiner und völlig anders. Es ist, als ob sie ignoriert haben, wo sich Ihre tatsächlichen Schläfenpunkte befinden, und brandneue erstellt haben, die höher und weiter hinten... Vielleicht können Sie angesichts Ihres Alters und der Anzahl der Transplantate etwas Licht auf die Planung der Tempelpunkte und der Operation als Ganzes werfen? Eine Liste von Vitaminen ist nicht wirklich die Art von Kontext, die für Feedback nützlich ist!

Was die Lücken zwischen den Transplantaten angeht... Völlig normaler Teil des Prozesses während der Schorfe und Heilung.

Yes, feel free to take a look at the pictures. They were done using a 0.7 mm clinic tool to effectively maximize density. The goal was to achieve 50-70 grafts per cm². By the way, I had the procedure done at the Cinik Clinic.

[Ekin]

9 hours ago, Gatsby said:

I would drop the vitamins and just take the finateride. It can take up to two years to see the full benefits of finasteride. Please take this in the spirit it is indeeded. I was to be brutally honest you've made the mistake I did (only I was 18!!!!) and that is you really are too young for a hair transplant. The hairline you have designed is quite low. The longer a person waits for surgery the better the results will always be because surgery is like trying to hit a moving target. Stick with the finasteride and all the best.

It’s a misconception that waiting is always the best approach when it comes to hair transplants. Why wait until you have significantly receding hairlines before addressing the issue? That doesn’t make much sense. The key isn’t about waiting but rather how well you take care of your hair post-surgery. I already plan to switch to Dutasteride to maximize my fight against hair loss. Additionally, I’ll be doing 7 PRP treatments per year and I pay close attention to my diet and exercise, as poor habits can also contribute to hair loss. I’m even considering stem cell therapy in the future to further support hair growth.

[Ekin]

Vor 11 Stunden sagte Berba11:

Es wäre von Vorteil, Ihre präoperativen Fotos zu sehen und für uns, den Namen des Chirurgen zu kennen.
 

3.000 Transplantationen für einen 20-Jährigen sind eine Menge Transplantationen, und für mich sieht der Haaransatz für jeden älteren Patienten, geschweige denn für einen 20-Jährigen, ziemlich aggressiv aus.
 

Als@Britaniensagt, ich bin ein bisschen verwirrt von den Tempelpunkten. Wenn Sie das Bild vergrößern, können Sie Ihre echten Tempelpunkte sehen, aber die gepfropfte Form ist kleiner und völlig anders. Es ist, als ob sie ignoriert haben, wo sich Ihre tatsächlichen Schläfenpunkte befinden, und brandneue erstellt haben, die höher und weiter hinten... Vielleicht können Sie angesichts Ihres Alters und der Anzahl der Transplantate etwas Licht auf die Planung der Tempelpunkte und der Operation als Ganzes werfen? Eine Liste von Vitaminen ist nicht wirklich die Art von Kontext, die für Feedback nützlich ist!

Was die Lücken zwischen den Transplantaten angeht... Völlig normaler Teil des Prozesses während der Schorfe und Heilung.

 

[Berba11]

21 minutes ago, Ekin said:

 

And the surgeon?

[Matthias]

3000 grafts indeed are a lot at your young age and the attempted reconstruction of the temple points may have been a waste of grafts. 
Also 5 months of medication may not be sufficient to be sure that you will tolerate them long term.

Design itself looks passable.

[Gatsby]

1 hour ago, Ekin said:

It’s a misconception that waiting is always the best approach when it comes to hair transplants. Why wait until you have significantly receding hairlines before addressing the issue? That doesn’t make much sense. The key isn’t about waiting but rather how well you take care of your hair post-surgery. I already plan to switch to Dutasteride to maximize my fight against hair loss. Additionally, I’ll be doing 7 PRP treatments per year and I pay close attention to my diet and exercise, as poor habits can also contribute to hair loss. I’m even considering stem cell therapy in the future to further support hair growth.

The whole point is that MPB is genetic. You can take Finasteride or dutasteride and oral minoxidil to stabilize your hair loss. But over the life span your genetics will not go away. You then have senile alopecia to contend with after your middle age where hair stem cells just start to die. Look at a guy without MPB. Look at his hair at 25 compared to 75. It has thinned out all over the scalp to some degree by 75. As I have said many times previously, having a hair transplant is like trying to hit a moving target. The most important thing with hair isn’t just medication if you are considering surgery. It is planning. I’m not suggesting that guys live a life of hair loss and miss out on their young years. But it is a fact that the more baldness you have, better planning can be made. With someone who is a Norwood 2-3 the results are never truly ultimately known because genetic MPB is progressive over the lifespan. If I had have had surgery (if FUE was around at the time) I would have run out of donor long before I could achieve 50% coverage. Then my hair transplant would be marooned and using only beard hair for the rest on its own would look ridiculous. Finally I am not suggesting that we wait until we are Norwood 7 before we begin having surgery. What I am saying is that if young people (like myself at 18) had have waited until they were 25 to have surgery then their results would have been measured better in the planning stage leading to longer lasting results over the lifespan. For patients who have surgery earlier than this then planning is made on an unknown variable leading to unknown and less desirable results.

[Berba11]

1 hour ago, Ekin said:

It’s a misconception that waiting is always the best approach when it comes to hair transplants.

With respect, you don't know what you're talking about.

For example, you are now totally committed to having a low hairline. If you'd waited a year or two to properly stabilise your hair loss and then had a smaller, much more conservative surgery then you'd have been well placed to make the case for an early surgical intervention.

Instead you've rushed in having only been on finasteride for 5 months, which is nowhere near long enough to know if it's effective for you, and during a period in which your hair loss will be at it's most aggressive. Even if you stabilise your hair loss you've now committed yourself to a fairly aggressive, juvenile hairline forever. That's why it's often best to see where things are heading and then proceed more cautiously and with more knowledge in the bank (and grafts!). You want a hairline then has longevity built into it - it needs to look natural for life, not just for tomorrow. The majority of your life will not be spent in your 20's, and contrary to what early 20-somethings tend to think, your best years will probably not be in your 20's either.

You have an awful lot of hair, and a very, very dense, strong forelock meaning that despite the recession, your face was still perfectly well framed. Aesthetically speaking you get diminished returns from a HT when you already have enough hair to frame the face. To blast 3,000 grafts into the temples at 20 years old is reckless and thoughtless by the surgeon in my view given the case.

If you'd waited a couple of years, stabilised your hair loss somewhat and then did something a little more mature that will still look good in 20 years time I think you'd have been better off both in terms of longevity, aesthetic enhancement and donor management/graft usage:

 

 

[OliverAtom]

15 minutes ago, Gatsby said:

The whole point is that MPB is genetic. You can take Finasteride or dutasteride and oral minoxidil to stabilize your hair loss. But over the life span your genetics will not go away. You then have senile alopecia to contend with after your middle age where hair stem cells just start to die. Look at a guy without MPB. Look at his hair at 25 compared to 75. It has thinned out all over the scalp to some degree by 75. As I have said many times previously, having a hair transplant is like trying to hit a moving target. The most important thing with hair isn’t just medication if you are considering surgery. It is planning. I’m not suggesting that guys live a life of hair loss and miss out on their young years. But it is a fact that the more baldness you have, better planning can be made. With someone who is a Norwood 2-3 the results are never truly ultimately known because genetic MPB is progressive over the lifespan. If I had have had surgery (if FUE was around at the time) I would have run out of donor long before I could achieve 50% coverage. Then my hair transplant would be marooned and using only beard hair for the rest on its own would look ridiculous. Finally I am not suggesting that we wait until we are Norwood 7 before we begin having surgery. What I am saying is that if young people (like myself at 18) had have waited until they were 25 to have surgery then their results would have been measured better in the planning stage leading to longer lasting results over the lifespan. For patients who have surgery earlier than this then planning is made on an unknown variable leading to unknown and less desirable results.

@Gatsby, this is a fantastic and insightful comment. Your emphasis on the importance of planning, especially for younger individuals, is something everyone should seriously consider before opting for a transplant. Thank you for sharing such a thoughtful and detailed perspective that highlights long-term outcomes over impulsive decisions.

[Ekin]

Vor 1 Stunde sagte Berba11:

Und der Chirurg?

Dr. Cinik

[Ekin]

46 minutes ago, Gatsby said:

The whole point is that MPB is genetic. You can take Finasteride or dutasteride and oral minoxidil to stabilize your hair loss. But over the life span your genetics will not go away. You then have senile alopecia to contend with after your middle age where hair stem cells just start to die. Look at a guy without MPB. Look at his hair at 25 compared to 75. It has thinned out all over the scalp to some degree by 75. As I have said many times previously, having a hair transplant is like trying to hit a moving target. The most important thing with hair isn’t just medication if you are considering surgery. It is planning. I’m not suggesting that guys live a life of hair loss and miss out on their young years. But it is a fact that the more baldness you have, better planning can be made. With someone who is a Norwood 2-3 the results are never truly ultimately known because genetic MPB is progressive over the lifespan. If I had have had surgery (if FUE was around at the time) I would have run out of donor long before I could achieve 50% coverage. Then my hair transplant would be marooned and using only beard hair for the rest on its own would look ridiculous. Finally I am not suggesting that we wait until we are Norwood 7 before we begin having surgery. What I am saying is that if young people (like myself at 18) had have waited until they were 25 to have surgery then their results would have been measured better in the planning stage leading to longer lasting results over the lifespan. For patients who have surgery earlier than this then planning is made on an unknown variable leading to unknown and less desirable results.

I appreciate your detailed response, but in my case, my family – including my grandparents, aunts, uncles, and cousins – have only ever dealt with hair loss around Norwood 2-3 maybe 4, mainly with receding hairlines. None of them have experienced hair loss as severe as Norwood 7, so I’m not too concerned about that happening to me.

Before my surgery, the clinic evaluated my hair as being thick, and they mentioned that I have a lot of donor hair at the back of my head. They even said that I could be a good candidate for a second, or possibly a third, procedure if needed in the future. However, I don’t plan on having another surgery unless things significantly change and the results stay as good as they are now.

I do agree that maybe the hairline was placed a bit lower than it should have been, but I actually wanted it even lower. Fortunately, the doctor refused to go any lower, which, in hindsight, was the right decision.

Do you have any advice for me for the future? I realize now, after reading your detailed responses, just how uninformed I was before this. Thanks again for all your insights.

[Gatsby]

@Ekin my advice isn’t from Reddit, a cheap or elite surgeon’s advice. It’s from my involvement and experience in the world of hair loss over the past 40 years mate. At 20 the frontal lobes have not even matured to comprehend life at 30! I too wanted a very low hairline to make myself (at the time happy). I too didn’t wait at least 12 months on Finasteride before surgery to see how I would respond that will dictate surgery (another part of planning that I failed to mention). My father and his brother both died of old age with a full head of hair. All the decisions you make in life are based on thoughts, feelings and emotions because in late adolescence that’s how the mind operates. My surgeon told me that I had a great donor for as many punch grafts that I could want. At 18 he was correct in his assessment. But I’m not going to have an 18 year old’s donor density at 57!!! 
The best thing you can do now is absolutely nothing. Literally. Stay on Finasteride and never go off it. Its peak benefits hit after two years so once again patience, like all things to do with hair, is needed. I’ve included a photo of me at 18 just to show that so called good hair genetics is not always a strong indicator for the future. All the best. 
 

[Britanium]

Cynic is a hair mill, but usually one of the better ones in terms of results. However it's a huge risk as it's all down to whichever techs you have on the day. We have seen a varied range of results over the years from this particular clinic, I will actually praise them when they turn out ok, but in you're particular case I believe it's not been done with you're best interests, either short or long term. 

We will just have to wait and see how it develops. Of course right now you have a strong donor area and the rest of you're hair appears OK, but absolutely nobody will be able to tell where you will end up! Despite being on meds, fact is if you have already faced hair loss at such a young age then you will continue down the Norwood path, at best the med regime may hold it off, but no assurances can be made after 5 months. 

All the PRP in the world isn't going to make any difference either, and isnt used or promoted by more elite Dr's, same with stem cell. This is going to be a waste of money and generally speaking a cash grab from hair mills, ever wonder why the better clnics don't need to do this? You're better off sticking to the meds that are proven to work, and waiting a year to see how the hair grows back in.

Edited Monday at 04:09 PM by Britanium

[Ekin]

 

Today was the day to remove the scabs. It’s been 10 days, and honestly, I’m not sure how I feel about it. The density looks really high, but whether that’s a good or bad thing will only become clear once the hair starts growing. I think I’d be happier if they had placed the grafts in layers, like 1-hair follicles in the front, 2-hair follicles a bit further back, and so on. But it’s still okay for now.
What do you guys think? 

share your honest opinions.

[Ekin]

Am 14.10.2024 um 00:52 Uhr sagte Berba11:

Es wäre von Vorteil, Ihre präoperativen Fotos zu sehen und für uns, den Namen des Chirurgen zu kennen.
 

3.000 Transplantationen für einen 20-Jährigen sind eine Menge Transplantationen, und für mich sieht der Haaransatz für jeden älteren Patienten, geschweige denn für einen 20-Jährigen, ziemlich aggressiv aus.
 

Als@Britaniensagt, ich bin ein bisschen verwirrt von den Tempelpunkten. Wenn Sie das Bild vergrößern, können Sie Ihre echten Tempelpunkte sehen, aber die gepfropfte Form ist kleiner und völlig anders. Es ist, als ob sie ignoriert haben, wo sich Ihre tatsächlichen Schläfenpunkte befinden, und brandneue erstellt haben, die höher und weiter hinten... Vielleicht können Sie angesichts Ihres Alters und der Anzahl der Transplantate etwas Licht auf die Planung der Tempelpunkte und der Operation als Ganzes werfen? Eine Liste von Vitaminen ist nicht wirklich die Art von Kontext, die für Feedback nützlich ist!

Was die Lücken zwischen den Transplantaten angeht... Völlig normaler Teil des Prozesses während der Schorfe und Heilung.

Take a look at the new photos and maybe you’ll be able to judge the result better?