Your donor area was either over-harvested if you had an FUE or developed a scar from a strip surgery which, when it occurs, usually occurs in that location. You did not state if you had FUE grafts and if so, how many or if you had strip surgery. If it was FUE, the number of grafts for that area was too high. If it was a strip surgery, most likely the wound was closed too tight which will cause this type of hair loss.

We obviously see complications from both (a)  too many FUE grafts for a given area of the scalp and (b) strip wounds that are too tightly closed.  Most doctors and patients think that the donor area can stand almost any stress but in this post I suggested that stress (FUE or strip surgery) can cause hair loss by impacting the donor area blood supply. You should wait this out and in about six months after the procedure, the hair may return. Scalp MicroPigmentation is a good option for this problem if it needs to be treated.

See link below.

https://scalpmicropigmentation.com/scar-covering/

 

 

Wow, your hair loss at this stage is an advanced Class 3 pattern but the real question is where is the hair loss going? Of course you can have a hair transplant now, then do another in a year and a year later do another etc., if you get what I am saying.  You don’t want to be addicted to having hair transplants every year until you use up all of your donor hair and then have an incomplete job to show off, not good.  At 18, we always discourage boys in going the hair transplant route. You need to consider yearly measurements with the HAIRCHECK instrument by a doctor who has one, then you also need to consider taking the drug Finasteride which is the only drug that MIGHT stop the hair loss. If your family history is one of advanced balding, then you and your doctor need to work out a Master Plan for your future with regard to hair loss, drugs and eventual surgery when you are much older.

Wait at least six months before transplanting a pox scar so that everything is healed before going forward with a hair transplant into the cheek. For a POX scar, Scalp MicroPigmentation is similar and faster with the results and probably much less expensive, see below. The picture shows a thumb size scar which was not transplanted but covered with Scalp MicroPigmentation, much smaller than the POX scar to which you are referring.

https://scalpmicropigmentation.com/scar-covering/

https://scalpmicropigmentation.com/wp-content/uploads/2016/04/scalp_micropigmentation-new_hair_institute-147-scalp_scars.jpg

Your surgeon put the hairline too high and the shape is all wrong, A Male hairline is V-Shaped with slight corner recession. Yours is rounded and not rounded naturally. Fortunately, because your doctor put it too high, he left enough room for an experienced surgeon to build a natural hairline in front of the hairline you have. It will take another surgery.

I doubt that this patient will regrow anymore hair. I believe the transplant was a failure considering that very little hair grew. The patient also reported that his donor area was heavily scarred. This was probably from over-harvesting his donor area, a common surgery done around the world by ignorant doctors. If the donor area was over-harvested, there will not be enough grafts for another surgery.  An FUE with 5,500 grafts requires a very skilled team of people paying attention to a lot of details.  Donor density is something that is rarely measured by doctors like the one who did this.

If a graft is left out of the body for 10-20 seconds, for example, it may die yet it can be transplanted. That would mean a dead graft was transplanted.  This could have happened thousands of time during the surgery. Not everyone can perform 5,500 grafts successfully.  But the worst part of this is that the hair that was transplanted is lost forever from the donor area. The scarring in the donor area produces a bald donor area that complicates the situation. This man came to the doctor with hair, it was shaved off at the time the 5,500 grafts were done, probably lost it as a result of shock loss and now almost one year later is balder than he was when he started (see photo).  This patient most likely will not be able to do another surgery so he should consider Scalp MicroPigmentation.  This is an excellent option which will look great, it is just not hair.

See https://scalpmicropigmentation.com/bold-shaved-look/

This is an accurate course for this type of surgery.

I would have expected more frontal density, as well, based upon your Class 3 pattern with a strong front forelock and 3,500 grafts. Actually I think that 3500 grafts were actually an excessive number of grafts for that area. You and your doctor established expectations when the surgery was done, so go back and review these expectations with your doctor. I would have expected more density but some of the grafts may not have grown causing the reduced density you are seeing.