I have seen changes in hair character on occasion. One man that I remember well, his hair changed to kinky. He loved it. I did a second transplant on him, and the same thing happened. Since this is rare, something in the patient must have caused this change. Seeing changes in your hair, from straight to wavy, is often a good thing as it improves coverage.

Results like this are seen in men under 25.  The older you get, the less likely you will get results like this. 

This man had two sessions of grafts, 7000 and 5000.  Most of the grafts clearly did not take.  Assuming that all follicular units are excised in the donor area, the total donor supply equals 25% of the total hair supply.  The average man has 50,000 follicular units (grafts) on his head, of which 12,500 reflect the donor area (12,5o0 is 25% of the total follicular units).  This means that if the surgeons did only FUE, nothing would be left in the donor area (maybe 500 or so). In such a surgery, the patient will likely become either bald in the donor area or heavily overharvested in the donor area if partial follicular units are excised.

There is a misconception that many patients and surgeons must replace the recipient area density. Nothing could be further from the truth.  First, look at the above numbers.  Assuming that a patient has a Class 7 balding pattern, he is only left with his donor area remaining, which contains 12,500 grafts.  A Class 7 balding area contains 37,500 Follicular Units (grafts).  If all of the grafts in the donor area (12,500) were moved to the entire bald scalp and 100% of the grafts grew, then the patient would have achieved only 33% of their original recipient area density and become bald in the donor area.  This is simply mathematics.  So, transplanting into the recipient area should not blindly remove as many grafts as possible and move them into the recipient area.  A surgeon, with proper knowledge of both the original donor density and hair mass of the patient’s donor area, can make appropriate artistic and mathematical calculations to obtain good results with less than the original recipient area density achieved.  I have done this thousands of times on very bald men, even those with a Class 6 or 7 pattern of balding, and never removed 12,5000 grafts over the 33 years I have donr hair restoration surgery.

FYI: 50% of recipient area density in a man with black hair and white skin is as good as 100% recipient area density. This was demonstrated by Dr. Manny Marrit some years ago when he plucked out 50% of the hairs on one side of the head of a man with medium-weight hair, which was black, and his skin was white.  No one could tell the plucked side from the on-pucked side.

This man needs an expert hair transplant surgeon to figure out what was done and how to give him a satisfactory appearance, if possible.  This is something I have done a thousand times or more.

This 59-year-old male has had multiple hair transplants with me as he progressively lost his hair over many years. The last transplant was in 2019.  He would have had a Full Norwood Class 6 balding pattern, but he kept the hair on his head with diligent medications and strategic transplants following a Personalized Master Plan he and I set up at the onset of his balding.  When I did the last transplant a few years ago, I suggested that he get Scalp Micropigmentation (SMP) for his hair rather than get another transplant. He worked outside the United States for an oil company, so scheduling was difficult. Finally, one month ago, he came in to see me specifically to get SMP done.  His hair is straight, as you can see in the frontal view, so straight hair draws the eye to the scalp, making it hard to use various styling techniques to cover the see-through nature of his straight hair. He could have grown the hair longer, but he didn’t want to do that. Now, with the SMP, I believe that he is finished with his reconstruction.  He maintains himself on finasteride daily without side effects. The after photos are in the second row.  I always talk about the value of SMP in men or women with see-through hair transplants or thinning hair as a great adjunct to their reconstruction, as shown nicely in this man. I would like to call your attention to his frontal hairline.  It is not as straight as a line, as I built a transition zone between the thick hair and the forehead using 400 single hair grafts in a random placement when I reconstructed his hairline. 

 

AFTER SMP Photos below:

 

 

 

https://asia.nikkei.com/Business/Pharmaceuticals/World-s-first-tooth-regenerating-drug-to-enter-testing-in-Japanhttps://asia.nikkei.com/Business/Pharmaceuticals/World-s-first-tooth-regenerating-drug-to-enter-testing-in-Japan?fbclid=IwZXh0bgNhZW0CMTEAAR3DPl497ybmhRYfC5dqTLB2v7QkgL51JdRd7DzFjCnymE8dFidmtSptKR4_aem_Ab3aNSyQheJAHcRzqLHuN2K9X_fBesqRxP_3b7n-3BvAXjaC9cGJ8QVcyrHoPAPiWueM6Bi8W5uBsR9e-AxrwBmY

I was at a hair transplant meeting last week and heard an amazing discussion of cloning that reflects we are closer than I thought to achieving hair cloning. The above link suggests that a drug might regenerate a tooth, certainly on the complexity of a hair follicle.  I see a bright future for hair cloning, although getting it through the FDA might take 5+ years once it is achieved.  Be patient. 

About me: 48, thinning since +- 25, first bald spot around 12 years ago. Somewhere between NW4 and 5 right now. It’s pretty bad.  Then, 4,5 years ago, I bought a lot of finasteride, and I started with 1mg/day and 5% minox twice a day… I hated that I had a big bald spot on the back of my head, and I thought..why not give it a try? Tried for a little over 8 months. No visual difference! Nothing! Sadly, I was a non-responder. I gave up.  Then I heard about microneddling so I tried to add this to my routine.  That was 3 months ago, and today I see a lot of new baby hairs filling up my bald spot. I think that in another few months, my hair will have grown back.

Microneedling seems to transform many men with hair growth unachieved through other mechanisms. 

 

You likely lost your native hair by not taking finasteride, a mistake. There appeared to be a lot of native hair loss that was present before the hair transplant. I don’t know enough about you to give you clear direction. In effect, it seems that you are no better than you were before the hair transplant, as you largely replaced your natural hair with transplanted hair, and much of the transplanted hair might not have even grown out. The before picture is on the left.