Dr Hasson 1755 Grafts to front and SMP into crown

Well I did it again over 7 years on from my repair with Dr Hasson and 3 years on from my scar repair and hairline refinement I decided my scalp was loose enough to go for one last session!
I had been working on my scalp exercises for several months before the surgery but on and off for a year or more now. My original idea had been to give a little extra density to the crown but with the number of grafts that were going to be available the logical decision to add density to the frontal area would have had the biggest impact.
Due to the extend of my loss and despite having a decent number of grafts in the past I am still limited to how I style my hair as all Norwood 6 patients are. I have a very large area to cover and my crown is huge. Once the decision to SMP the crown and mid scalp was made it seemed to make sense to place the grafts into the frontal area to give me greater density here with a view to wearing my hair a little shorter.
For those who don’t know my case if that is possible lol!

I had 3 old style transplants in 1996/7 and 1998 for around 450 grafts each time, the first one at the age of 23, the result was 3 wide scars and a pluggy unnatural hairline which was initially covered by my native hair. I had very aggressive hair loss and progression to a Norwood 6 pattern, I was not taking any medication or using Rogaine partly because in the early stages neither were available in the UK and I was put off using Propecia by a hair Trichologist.
After loosing nearly all of my native hair by 2002 aged 29 I had pretty much given up on ever looking normal and covering this unnatural hairline that people would double take. By accident in 2005 a pop up for hair transplants started my obsession again into researching what could be done. On the 1st of June 2006 I had a 4856 graft procedure with Dr Hasson, this procedure was going to be my last throw of the dice to get as much coverage as possible and hide that old pluggy hairline.
The hairline was lowered a fraction and many grafts were placed into the frontal area to cover the old mini and micro grafts, the density was then reduced as we went into the mid scalp and the crown was given a light coverage. To maximize the number of grafts available it was agreed that a new scar should be taken. After one year there was quite a transformation both in my hair and personality and I enjoyed this new look for 4 years.
In 2010 I had a scar revision with Dr Hasson to remove part of an old scar that had stretched, at the same time I guess around 300 grafts were gained and these were split into 623 singles to refine the hairline. Nearly everything you see on the top of my head is the result of hair transplants.
I won’t go into the full detail on here but have done that on my blog if you would like more detail. My latest surgery was on October 10th 2013.

My graft breakdown of the 1755 grafts of which 584 were single, 1048 were doubles and 123 were 3’s or 4 hair grafts.
On day 10 post op I had SMP into my mid scalp directly behind where the new grafts were placed and through the mid scalp to the lower part of my crown. I also had SMP into my old donor scars.
Here’s how I looked before my latest surgery after around 6500-6700 grafts or thereabouts.

Post Op Day 3 - This photo diary is to hopefully help new patients with their research on the post op healing process.

Swelling in my forehead.

Day 4
Swelling has moved from my forehead to the bridge of my nose.

The Density was higher on my left side which is why it looks a little more red.

Day 5 and time for a haircut to even things up. Swelling has more or less gone now.

Day 6 Looking tired!!!

Day 7

Day 10 before SMP into Crown.

Old donor scar from 1997 that is too low to revise before SMP

Day 12 Post Op after SMP

Great job! I also looked at your pre- H&W photos also and the transformation has been amazing. Apparently you didn’t add any grafts to the crown this time and relied exclusively on SMP. I’m not questioning your judgment, but what went into your decision not to put, say, around 200 grafts into the crown? Just wondering because I will probably have to make a similar decision. Thanks.

Day 15 Post op

Day 16 Close up SMP

SMP into old scar

Day 18

Day 23

Compare SMP before and after

1 Month

Bob,

Thanks for the comment. It was a really tough call, if I had another 4000 grafts I would have spread them all over. We expected a little less than the 1755 that I got. I initially thought of putting them in the crown but wanted additional density at the front. Putting 200 grafts into a crown of my size wouldn’t have made any noticeable different as I have a very big crown.

If I put all of the grafts into the crown it would have made a nice improvement but by putting them in the front will allow me to try a few new styles in the new year hopefully.

The SMP allows me to keep my hair short currently without there being a noticeable difference between the front and crown.

So here are the 2 month updates. I had a haircut a couple of weeks ago by the other half at the sides and back to even things out and have kept growing the top.

Here we are at month 3. Feeling lots of stubble over the entire recipient area which is a good sign of early growth.

So here we are at the 4 month mark. My hair is longer than the 3 month update that I posted so it is difficult to assess in person let alone from the photos but this is just the start I have lots of stubble around the hairline and frontal area that I can feel with my fingertips. The back of my scalp above the scar is still feeling partially numb although more feeling returns here. I had a little shock loss around the scar which is growing back as I can feel some stubble around that area too.

I think the biggest noticeable difference is my lack of anxiety this time round compared to 2006 when I was constantly looking for progress in the mirror on a daily basis, as I am comfortable that it will grow and it will add a nice improvement and of course I have every faith in Dr Hasson and his team this surgery has been so much easier than last time around.
Last time around I was a patient that had been burnt 3 times with poor surgery and had so much to loose again, another poor result would have been devastating for me. I had so much resting on the 2006 repair to make me look normal again.

Compare 3 to 4 months

Well here we are at the 5 month mark. Any changes?

Feeling is returning slowly but surely to the back of my scalp above the scar, scar has healed very well, small amount of shock loss around the temple ares on the left hand side has grown back.

Growth is kicking in very well and I have posted some nice close ups to demonstrate that. I also can feel lots of stubble still in the frontal area so more improvement is to come. Pics were taken today as it is bright and sunny in the same location as all the other sets of photos.

perfect result,
I also like the way SMP was used, fantastic !

IMHO SMP is THE most spectacular evolution since FUE !

Bart

Hi,

I like the change! Do you happen to have before SMP pics of the crown?

So we have reached the 7 month stage and the hairline and front continues to get thicker. I can still feel a little bit of stubble coming through and some of the new hairs are still quite short and wispy. I will try some new hair styles once I get to the full one year mark but for now my hair seems to naturally want to fall over to this side despite wearing it back for many years.

Everything has now has recovered in terms of the scar healing and the feeling at the back of my head above the scar has returned fully.

Month 8

The hairline continues to thicken and after a haircut yesterday I thought I would try a new hair style out, feedback is welcome.

Better late than never here is my 9 month photos from my latest hair transplant with Dr Hasson for 1755 grafts to the frontal half of my scalp. The difference is clear to myself as I look in the mirror and I am very glad that I took Dr Hasson’s advice to deal with the front rather than the crown. In terms of healing my scalp after five FUT sessions feels normal again and I am still able to cut my hair to a reasonable length. I could never go down to a grade 3 or 4 because of my previous scars but I am happy with the length I can wear it at the back and sides.

There still remains a sweet spot in terms of length of the top and it seems better to wear it shorter than I used to as the density is better at the front I don’t need the length to make it look fuller. Also where the crown is thinner it is easier to keep it shorter and it lays flatter on my scalp.

I have had several comments about how helpful it is to see photos month by month from the same angle next to each other so it is easy to compare the progress month on month so I made these 3 photos so it would be even easier to compare.

It demonstrates how taking consistent photos under the same lighting, same room and conditions is the best way to clearly document your progress.