Category: Hairlines

A picture is worth 1000 words, and this nice patient of mine agreed to share his 4 month growth with everyone on this site. His business colleagues watch him daily and with the gradual growth of the transplanted hair, nobody has noticed anything unusual over these past 4 months. In the coming months, the hair will continue to grow and thicken, but because I’ve received quite a few emails asking what a transplant looks like as it grows in, I wanted to show this patient.

The “before” photo on the left was taken in May, and his “after” photo on the right was taken in September. He had 2,189 grafts transplanted. Please remember, this is only 4 months after the procedure and some of the hair has grown while other areas look like he is balding. Slowly over the next few months, the open areas will fill in continuing the gradual transition from a bald front to a non-balding frontal view. While it is growing in, if notice at all, it will look like the patient is losing hair, but day by day and week by week, the patient will be looking less thin. After 8 months, one can expect 80% of the growth and in 12 months, this patient will have over 90% of the results visible.

For more information about the post-op timeline, please see Post-Op Course in Follicular Unit Transplantation.

Thanks for showing photos of the guy a day out of surgery [note: Photos – Day After Hair Transplants ]. I don’t mean to be pushy, but can you show me some more patients, possibly a week or two after the surgery.

I took some pictures of a patient who came in just 10 days after surgery. These photos show the small shaved hairs that were placed in the bald area (particularly noticeable if the skin is white and the hair is dark). These hairs will most likely be shed in the next week to month as the follicles enter the dormant phase. In 3-6 months, the new hairs will begin to grow as very fine hair. And by 8-10 months, the hair will be thick and groomable. You can find the entire best-estimate schedule in our Post-Op Course page.

This patient is a Norwood Class 6, and had one procedure of 2,705 follicular unit grafts. Please click the photos to enlarge.

I want to have a widow’s peak like I did when I was younger. Can you transplant a widow’s peak?

Yes, you can transplant the widow’s peak. People have different types of widow’s peaks, with some having different directions. Any of them can be made. Here’s a widow’s peak that is 100% man made, along with the entire frontal hairline. The “before” photo is on the left, followed by the “after” on the right. The “after” photo was taken after two sessions totalling 3,702 grafts. Click the images below to enlarge.

This patient is also featured on the NHI website:

• Patient DK – Hairline photos

I received this letter from a patient that we did two procedures on, totalling 1584 grafts. It is the knowledge that we can change lives, that makes my day that much better.

Thank you very much for the work you did on me. It has completely changed my life. You guys are so professional and courteous. You go above and beyond to make people feel comfortable. Your work is flawless and undetectable. I have had two surgeries and people I work with (which is quite a few), have never noticed anything.

The beauty is in the illusion. If anyone reading this is contemplating surgery, just go ahead and book the appointment. I give you permission to look at my before and after pictures. Notice how much younger I look and how different my face is framed. It is the You, You’ve always wanted.

Best of luck and thanks again.

The first two photos were before hair restoration at NHI, and the photo on the right (in black and white) is the final result. This patient is an actor, and the photo was scanned from his headshot. Click the photos to enlarge.

Double click on this photo after you read this. When I met this person I assumed that he had a bad frontal hair transplant that did not take, but he informed me that he had lost his hair naturally and never had a hair transplant.

So what are we looking at? The hairs that are left in the front have full normal, coarse diameters to them. That is why I thought that they were hair transplants. This is not the normal balding mechanism. Normally, the hairs become thinner and thinner and then fade away, yet this did not happen to the hairs that remain after balding. Many prospective patients tell me that they can always tell a transplanted hair line from a normal non-transplanted hair line. I always tell people that 90% of the time I can not tell a transplanted hair line. In this person (picture above) it is exactly the other way. A normal balding hair line is shown and it looks like a transplant (which it is not).

This is just an unusual case that I thought would be of interest to the readers of this blog.

I am 50 with early gray coming on the sides and black hair in the front. I have had 10 hair transplant procedures over the past 8 years [not at NHI]. I go from happy about them (when I had bald areas and then they went away) to unhappy (now). I am bothered about my left frontal hairline in particular. It is obvious to me that it is transplanted. I am not an expert, but I know it is not right, yet it is not the pluggy look like your book shows in the back section. I comb my hair forward to cover the hairline which I should be showing off, not hiding. What is wrong with it and can it be fixed with 100% certainty?

It is clear that you are a perfectionist, for only a perfectionist would notice your problem. The problems are that the grafts in the frontal line are two hairs each, the hair seems to point outwardly, rather than forward and the frontal grafts are a straight line that line up like soldiers. These two problems are not uncommon when a transition zone of single hairs is not created at the leading edge of the hair line. The concept of a hair line should not be taken literally, for there is no ‘line’ in a natural hair line. You were created with a zone of single hairs that transition from a bald forehead to a full frontal hairline presentation. A good hair transplant doctor must create the same transition zone to accomplish the natural look. With your black hair, these changes are more noticeable than if your hair color was lighter, making it easier to detect a transplant. As the gray hair moves forward, the problem will become less noticeable, but I suspect that you do not want to wait a decade or more for that to happen.

The second problem is outward directional growth of the transplanted hair. Judging from your photos, that problem is the result of a radial placement of some of the recipient sites when the procedure was first done. The direction of the hair growth is totally controlled by the surgeon who made the recepient sites. Additional grafts placed in a better position and direction might influence the hair that is growing outwardly. Using the concept of ‘following the crowd’, the normal direction of the new hair can be transplanted to influence how the existing hair will lay.

The third problem is the ‘line-up’ of the hairs in a straight line that is easily detected. The frontal hairs should be irregularly placed so that no line is evident.

The last point of your question talks about certainty in outcomes. Any surgical procedure has risks of failure, so certainty in medicine is more an act of God than an act of a doctor. In my experience, the success rate for building a good transition zone is very, very high. The hope would be to complete the transition zone in one session with 500-600 single hairs in the front. Sometimes more is needed, particularly if your hair is coarse, black and straight. What you need is comfort and that is established with a visit to the doctor’s office. As a perfectionist, you will interview your potential new doctor with an open mind, but keeping some skepticism and doubt, so the doctor will have an uphill battle for your confidence. Ask the doctor to show you people he has done with black hair, you can look at the transition zone and see if you see a ‘line’ in the hairline. I always say, what you see is what you are ‘gonna’ get.