The Sweet Spot, Density, And What is Possible. Two Articles

Hair Transplant
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I’ve had a lot of questions lately asking about what is possible with hair restoration and what kinds of hair styles can be had. I posted the article below on my blog quite a while ago but when I was chatting with Dr. Hasson about these questions and my own thoughts on the subject he decided to write his own article on the subject. I think it is worth the time to read it and it is very important for new patients to understand this when they are doing their research.

First is my article then Dr. Hasson’s article:

Over the past several years of having my hair back I have learned a few things about how transplanted hair behaves over time. I’m not saying that it acts differently than non-transplanted hair or anything like that but more rather what the conditions are that allow it to look it’s best.

If you’ve never had a hair transplant understand that it acts just like non-transplanted hair if the procedure was performed correctly. You cut it when it grows long, you style it every day, and you can even have highlights or dye applied to it (obviously from my photos:))

What I have learned over time however is that if you have had a large area addressed with transplanted hair there is a sweet spot so to speak regarding the length and how it positively or negatively affects the appearance of your hair. By this I mean that certain lengths make it look fuller than others. I have found that for me a medium length will make the density seem the strongest. When I cut my hair really short the results seem to be a bit thinner and when it is really long (like shown in my HT# 3 gallery) it also can appear thinner. I am not really sure why this is the case but it has been confirmed over and over as I have had my hair at drastically different lengths.

So, the lesson here is, after your results have grown in you may want to experiment with different styles to find the one that best accentuates your appearance. If it looks too thin, let it grow a bit more or cut it a bit shorter. Good luck!

Jotronic

Dr. Hasson’s article:

Hair Styles And Density, What Works?

Frequently patients ask us about styling options after the hair grows in from their hair transplant. Will they be able to style their hair in any fashion or will they be forced to style it in a particular way to maintain coverage and naturalness?

In general,if the transplanted hair is directed correctly the styling options will increase with higher transplant densities. At low density it is important to comb the hair in a particular direction to maintain the hair shingling effect to bridge over bald scalp until the hairs reach the next FU at which point the hairs from that next FU will take over the coverage function. In addition lower densities will require longer length hair for coverage. However, there is a point where the hair can be too long thus making the hair appear to give less coverage. Each patient is different so it is up to the individual to find the best length to maximize coverage.

If an individual intends to part their hair through a transplanted area that was previously bald the transplanted hair density required rises dramatically. The shingling effect is largely negated here and what becomes impacted is the distance between transplanted FU’s. Generally for a part to look natural transplanted densities of 50 FU per cm2 and up are necessary. Obviously the hair characteristics such as shaft diameter, color and curl will come into play as well.

As you can see the patients expectations with regard to styling should be an important part of the pre-op consultation. With sufficient donor availability patients with ever demanding expectations can be satisfied but it is important to identify those patients who are demanding in the absence of sufficient donor. These are the patients who should be counseled more extensively to avoid later disappointment.

Victor Hasson MD

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H&W’s gallery certainly looks good.

BTW where are your photos and are they recent?

Could you snap pictures of your crown, top, left & right sides and back in some bright lighting?

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» H&W’s gallery certainly looks good.
»
» BTW where are your photos and are they recent?
»
» Could you snap pictures of your crown, top, left & right sides and back in
» some bright lighting?

Sure thing, here are some pics from earlier this week. Check the bottom of the post.

http://www.hairsite.com/hair-loss/forum_entry-id-76555-page-0-category-2-order-last_answer.html

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what i would fear is what happens as you continue to lose more hair?

Although hanginthere talks a lot of BS about natural treatments and i’ve disregarded just about every post he makes, i think he posted a sensible question.

I reproduce it below because I have the same question. As your horse shoe retreats into the setting sun, how will your transplaneted hair look then ? It seems to be that you’ll be chasing a rainbow.

I plan to have my first transplant when I’m 37 (3 yrs from now) and it will be FUE only. Even at that age, i fear that my hair might stage a strategic retreat and I’d be ruined with a transplant. You just never know with genetics. Your donor supply is running thin as well. And since you are promoting strip transplants… the strip transplant scars criss-cross your scalp.

You better pray long and hard that the cure for our misery comes out soon.

I am not anti transplant, but I and I think a lot of other board members who are not rabidly supportive of every nice result, feel that people with this level of hairloss, (NW6+) are not good candidates for transplants. Course the docs eagerly accept their money and say , they were informed of all the risks

but IMO (I am entitled to have one , ) guys with this level of hairloss have a hard time, finding enough grafts to begin with , to make their hair look presentable. He does look great for the amount of loss he had going into the procedures.

What happens when his hairline (partline) the hair beneath that, on the sides, recedes down about one more inch?
How in the world can you keep chasing a hairline that is going south as quickly as his is, at his young age?

I think getting procedures in your mid 20s should be outlawed, especially with guys who are thinning this rapidly.

10 yrs from now his hair is going to look ridiculous , and there is no way there is enough body hair scalp hair to fix it, if it continues to thin at the current rate

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Freddie,

I can appreciate this position. However, I think Hangin’s prophecies for doom and gloom for me are useless because my “horseshoe” as you put it cannot go much further. I mean really, have you seen my pics? My sides were recessed backward toward my ears. They can’t go much further. My sides have dropped already where I no longer have the parietal humps that define a NW6. My sides cannot drop another inch else I’d be a NW8.

There is always the “chance of” when it comes to hair restoration. Don’t let anyone try to tell you otherwise. If they do they’re either an idiot or they are lying to you. But to take it to the extreme that no one should have a hair transplant is silly. I’m far better off because of it, from both the bad and the good.

In your case, with the limited amount of information I have about your case, I would recommend one of two options.

1.) Accept the fact that you WILL lose more hair and just plan for it properly when getting a hair transplant. Don’t go too low with the hairline and understand that the higher density in the hairline will not be possible for the top and the back if everything goes. It simply comes down to the numbers and no matter what anyone tells you you do NOT have enough donor hair to pull off high density front to back if you go south toward a NW5/6/7. Also get on preventative meds and don’t worry yourself so much about this. As long as the work is natural, which is the whole point of hair restoration, then no one will know. And “natural” btw does not equate with “full” or “high density”. Natural can still be thin but fuller than where you’d be without hair restoration. What I always tell guys is this. If you have one, then I guarantee you that there is a chance for a second or third.

2.) Don’t do anything, shave your head, forget about the hair loss boards and move on.

That is it. Those are your two options. I think you are potentially in a good mental position for this as long as you don’t let the doomsayers freak you out too much. Hair restoration can be a good thing if you don’t make numbskull moves.

Btw, I don’t have scars that “crisscross”. I have one donor scar.

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I have seen hair loss where it does progress to near total baldness where even the horse shoe thins out and disappears! Its all about genetics.

Of course having hair at a younger age might be worth the trade off of misery at an older age.

IMO if you started balding at an early age (which you did), the likelyhood of it getting more severe over time is greater.

If I were you, I’d get on propecia / avodart just to put the brakes on any further movement. Anyone not on drugs after (or before for that matter) a transplant is asking for trouble down the line.

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» I have seen hair loss where it does progress to near total baldness where
» even the horse shoe thins out and disappears! Its all about genetics.
»
» Of course having hair at a younger age might be worth the trade off of
» misery at an older age.
»
» IMO if you started balding at an early age (which you did), the likelyhood
» of it getting more severe over time is greater.
»
» If I were you, I’d get on propecia / avodart just to put the brakes on any
» further movement. Anyone not on drugs after (or before for that matter) a
» transplant is asking for trouble down the line.

I’ve seen it too, Freddie. Remember, I work in this field and have seen tens of thousands of cases that are not shared on the forums. I’m not a 22 year old that has lost three hairs and am afraid to even try Propecia because I READ about limp dick syndrome. I know better than most on these boards what can happen but what you are talking about is rare. Realistically I have been teetering between the NW6 and NW7 region for years so I would have a higher chance of this than a NW3 at my age but because I HAVE been taking Proscar for nearly nine years (and am holding steady) and my family history is well known I have a strong idea of what is in my future. Ultimately this is a gamble but the more one knows the higher the chance that the gamble will work in one’s favor.

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» am afraid to even try Propecia
» because I READ about limp dick syndrome.

» because I HAVE been taking Proscar for nearly nine years (and am holding
» steady) and my family history is well known I have a strong idea of what is
» in my future. Ultimately this is a gamble but the more one knows the higher

I don’t understand, Proscar and propacia are the same.

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» I don’t understand, Proscar and propacia are the same.

Marco,

I tend to be specific when I mention I take Proscar because when I tell people my dosage they ask when Propecia came out in a dosage larger than 1mg. Saying Proscar instead of Propecia when talking about my own intake is to keep confusion to a minimum.

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-Jotronic, This message is in response to your wondering about your hair looking good and bad depending on the length of which you have it at. I have been cutting hair (unpro) for over 20 years and can tell you that hair,ESPECIALLY hair on the thinner side,will look DRASTICALLY different depending on whether or not its just at the right length. The thinner the hair,the shorter your medium length hair strand must be cut. Ive seen this time and time again on guys hair that ive cut and even on my own.Id have some friends that seemed as though they had very thick,strong hair,but when I would trim it closer than a one inch length,there scalp would be ultra visible and there hairs sometimes would look very whispy and sparse. Anyone reading this that is wondering about whether Soccer great David Beckham(spelling?) is losing his hair? I can tell you,he IS,but just slowly through hair miniaturization. As long as he keeps his haircut just right,and at its appropriate “sweet spot”,he will look good for several more years. However,ive noticed that he cant wear his hair like he used to.It isnt his fault,his hair is miniaturizing slowly and unless he gets on the ball and does something ,he will one day run out of options and have to wear his head shaved 100% of the time. I doubt he will want to do that considering his vanity level and weird head shape. As for me? I especially noticed the “sweet spot” of my hair lengths when my hair began to thin over a decade ago. I watched my sweet spot go from a rather longish medium strand ( two and a half ! inches } all the way down to roughly an inch long “sweet spot” before going on an intense Rogaine program. Now adays my hair looks thickest again at around the two inch hair strand length. Since radically changing my Rogaine program over five years ago now,things have DRASTICALLY changed in regards to my overall hair thickness,volume,and color. I no longer really worry about “sweet spots” so much and can wear my hair any way I wish. Now,back to Jotronic. My advice to you,having studied your hair quality,pattern of loss,and hair transplantation progress over the years(since 2002),id say that there are three things you should do to give you the optimal hair thickness effect- 1. Use Topik,a little will go a long way on your type of hair 2.Go back to the highlighted,long “Choppy” style you had back around in 2004? I believe? and 3. Always be sure to add a hair thickening lotion of your choice BEFORE blow drying. NOTE: If you dont like Topik,go for one of the colored thickening spray ons,again,a little will go a long way with your hair characteristics. Gotta run, All the best, J

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» » I don’t understand, Proscar and propacia are the same.
»
» Marco,
»
» I tend to be specific when I mention I take Proscar because when I tell
» people my dosage they ask when Propecia came out in a dosage larger than
» 1mg. Saying Proscar instead of Propecia when talking about my own intake is
» to keep confusion to a minimum.

Oh, actually I misread your post and it might be ambiguous. It is not you who will not try prop due to fear of LD syndrome, you were referring to the fear of some younger posters.

12

I’d step it up to Avodart if I were you. Or alternate between Avodart and Propecia as I do.

On propecia I was able to put the brakes on my hair loss but it still continued to slide ever so slightly. Its a miracle drug no doubt about it but if you want a dead stop on your hair loss, my guess is Avodart is your ticket and its what you should be on.

13

» I’d step it up to Avodart if I were you. Or alternate between Avodart and
» Propecia as I do.
»
» On propecia I was able to put the brakes on my hair loss but it still
» continued to slide ever so slightly. Its a miracle drug no doubt about it
» but if you want a dead stop on your hair loss, my guess is Avodart is your
» ticket and its what you should be on.

Been there, done that with Avodart. I was on it for almost three years, saw no improvements whatsover, switched back to Propecia. I was hoping for regrowth above and beyond the small amount I had with Propecia. In the end it was a waste of money for me but I know it works really well for some.

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were you on the real avodart or the generic stuff ?

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» were you on the real avodart or the generic stuff ?

The real stuff. Although I know what you mean there is no actual “generic” Avodart, not legally in North America anway.

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Why don’t I remember you? Your username seems familiar but I can’t place you. Regardless, your observations about the sweet spot echo what I’ve been saying and I’m glad someone else gets it:) Regarding your Rogaine (intense?) regimen, have you considered going with Loniten 10mg instead? I’m teetering on the edge of pulling the trigger for it.

Regarding the suggestions you gave, you are the only other person besides myself that has ever mentioned a hair thickening agent in the hair BEFORE blow drying. I did a video a few years ago on my other website, hairtransplanttv.com, showing how I style my hair and that it behaves like natural hair. In the video I show and mention that I used a small dab of Alberto hair mud and mixed it in with my still damp towel dried hair. Blow drying it then makes it pretty full and gives it good body. Before my latest HT I switched out to using Redken hair conditioner. Yes, conditioner. It is in a medium sized tub and looks like hair paste but softer. I mistakenly “borrowed” a bit from my girlfriend to see how it would work out and it is awesome. It wasn’t till later that I figured out what it was but it works great just the same.

Regarding the toppik issue, I have only used it a small handful of times when going out but other than that I’ve stayed away from it so I don’t get mentally additicted to using it. Concealers have a tendency to do that where one gets so used to using it that they cannot ever leave the house without it. However, with my hair so short in the crown I decided to see just how well it would work. The result is below. Forgive the cell phone pics. My dslr wasn’t handy.

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-Joe, Good to hear from you. Funny to finally message each other after following your journey this many years. I remember when you just started posting and ONLY had your “before” pix of your surgery back in the 90’s. I never thought you would get this far. Hasson & Wong is in my top three of BEST HT Clinics in the world. They are one of three places that have really set the bar for all other clinics. I gotta make this one quick,ill post again in a few hours after work is done. Just wanted to say real quick that with a volumizer and some Topik,its easy to see that your going to look INCREDIBLE. Those test pix you shot with your cell is good proof of that. You are really thin in the back but with that Topik,I cant believe just how thick your hair looks. It looks great all over. When yur latest transplant grows in,you get highlights,a bit longer hair,and a volumizer,I HONESTLY think you will be set for life and will finally be able to breath a big sigh of relief. I think you are set for good Joe. Will write again after work. Gotta run, J

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-Joe, Tired as heck but I know I promised to post when my work day was done so- Before I hit the hay,I wanted to address one more thing. I understand your reluctance to be a steady Topik or Fullmore,etc user. Its an extra expense and a pain to depend on yet another product. Im going to make a recommendation for you. Ive done hair for years,effects make up for film,and have Art Directed and Production Designed several semi famous cult /indie hits. Ive been around the block and seen a LOT of thinning hair and bad transplants. Your hair is thin. The good thing is that although its so thin,Hasson and Wong did an EXCELLENT job with your transplants. Even better is the fact that those transplants are PERMANENT. With your type of hair(as long as its cut just right and colored),the use of a thickener and Topik will look EXCELLENT . If I wasnt so sure,id say forget the stuff and just live your life. My advice is to buy yourself the Large size Topik(its the most cost effective) with the addition of the "diffuse sprayer"adapter piece that they sell as well. Its perfect for applying Topik to tricky areas like wayy back in the crown. Its only like $22.00 dollars and will make the application of your Topik VERY even,unnoticable,and WAY easier to apply. The other plus is that the adapter uses the Topik “dust” wayyy more efficiently and you end up with zero Topik ever being wasted. I was very skeptical of the adapter attachement until the first time I used it. It goes on almost like an airbrush. The level of naturalness is SUPERIOR. It worked wonders for me back in the day!! Again,I want you to know that I am not putting down your hair transplant work in any way. You look like a guy with a healthy ,thin,and permanent head of hair. But with the addition of a volumizer and even just a SMALL dash of Topik,you will look like a guy who never even needed a transplant in the first place.Thats all for now . Oh yeah,you asked about Linoten 15mg? I was on it and it didnt do anything for me. Neither did Rogaine for the first five years. It wasnt until I started applying the generic Minox from Costco,four time a day that I noticed a change. Even that took a long time for me to notice. Im a very picky guy with an eye for detail and I always want and expect the best. I didnt think the minox was doing anything for years because of my skeptical nature. Not until other people began mentioning how good my hair looked over and over again did I take things seriously and finally realize what had happened with my hairloss. Gotta run. Best regards, J

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» change. Even that took a long time for me to notice. Im a very picky guy
» with an eye for detail and I always want and expect the best. I didnt think
» the minox was doing anything for years because of my skeptical nature. Not
» until other people began mentioning how good my hair looked over and over
» again did I take things seriously and finally realize what had happened
» with my hairloss. Gotta run. Best regards, J

How about some pictures dude? I want to see what your hair looks like with 4X minox. If you have a before picture (any before picture) showing the hair loss you had, that would be great.

After reading your stuff, i started using rogaine foam 1X a day (after my evening shower). I leave it in overnight and wash it out in the morning. Its a nusiance but what can I do.

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Hi Freddie. Pic will be posted soon.As for you,im glad your trying to get on a Minox program. If you can deal with 1 times a day,perhaps then you can move up to 2 or three times a day over time. It was a huge pain for me to get used to my current Regimen. It took me 5 years before I got up to putting Minox on four times day dau bro. Besr regards, J