Author: Dr. William Rassman

An FUE hair transplant depletes the donor area. The greater the number of grafts, the greater the depletion and the see-through look you will develop. Each patient should research this subject before having an FUE with a large number of grafts. 5000 grafts for most people might be a bit too-much but that depends upon the original donor density you have. What is bothering me about the photo is that the surgeon who harvested your donor area went very high, well above the permanent zone which means that some of the grafts may fall out eventually if your balding pattern moves into your crown. More balding will also cause the scars from the FUE to show on your crown. That might imply that the surgeon made his/her decisions based upon their need for money if he/she charged you by the graft, not for your benefit. If you had this done in Turkey, then clearly whoever did your surgery had no clue as to what was permanent hair and what is not.

I had 4500 grafts in Turkey almost one year ago, I see holes in my transplant pattern.

Yes, I see what you are talking about. A session of 4,500 grafts requires a great deal of skill in handling the grafts. Grafts that are out of the body exposed to air for 10 seconds will die before they are put into the recipient area. Quality control therefore is very important. I suspect that the quality control may not be tight. I too would have expected to see much more density present. What is unfortunate, is that your donor area has been depleted by over half and another FUE in the donor area could cause you donor site depletion and a see-through donor area that looks like it is balding. My recommendation is to see a doctor with years of experience who knows how to manage your problem and won’t make you look worse in the donor area.

It doesn’t look like much of it has grown. What should I do now. Should I get PRP and ACell treatments offered by some doctors on the internet?

At seven months, you are seeing less that 50 percent of growth of what you can expect from your transplanted grafts. I would not expect the areas in the center to grow much more. I always tell my patients to go back and speak with their doctor as most reputable doctor will make things right financially. A-Cell and PRP is a waste of your money at this stage.

This is an impressive result; however, I don’t believe that you needed 4500 grafts to get this result. The readership is made to believe that this number of grafts were critical to your balding; however, that is absolutely not the case in my opinion. Your forelock was strong before you did the transplant to it hopefully wasn’t touched. I have had results like this with far fewer grafts.

The picture shows heavy donor site depletion suggesting that the 2,500 grafts you had were too many for your donor area density. This suggests that you had a lower original donor density prior to your original FUE and any more FUEs taken from your donor area will make you look balder in the back of the head. A strip surgery is an option but this is something that you and your doctor need to discuss. You might consider a strip surgery for more grafting.

See here for the limits for FUE surgery defined in one of my previous post in the Hair Transplant Forum: https://baldingblog.com/2017/07/21/many-fue-grafts-many-fues-grafts-one-know-safe-limits/

The average Caucasian has 6,000-7,000 hair grafts, the average Asian or African has 80% of those numbers, so you can do it again with some to spare. It is not uncommon to repeat the surgery a second time for more density.

There are always small nerves cut during the making of the recipient sites which cover a wide area of the frontal hairline. These nerves usually stop bothering most people within the first month, but sometime people feel the numbness for many months. These nerves will eventually heal and stop bothering you, just be patient.

At 5 days, you have far too many crusts on your beard. What you are seeing is probably the crusting not the Herpes. You should nevertheless start taking your acyclovir because wounds like this tend to bring on the Herpes, possibly in the recipient wounds themselves.Many doctors would have put you on the acyclovir just for having a beard and mustache hair transplant. You need proper washing of your crusts to get them off. See your doctor as you shouldn’t look like this at 5 days, it is poor post-operative management.