Ok, I have gone down this thought road before and asked the question before, but I wanted to revive this discussion:

Is it possible, realistically, to have just one hair transplant and be content with it...One and done. I know several here who have. But it increasingly seems like most go back for a second.

Parameters for this question: First, take out hair greed. I am not too worried about the future manageable loss in the crown, and I am not too worried about having a bad hair transplant (plan on going to what i consider one of the best--even though I realize there are patients that are not happy even going to the best) doctor. So, in other words, take those parameters out when answering this question

I am a a 4v and in my early 30's. I was told more of a 3v by one doctor, but I tend to look at myself a little differently. I am looking to get 4000+ in the front 2/3, not an aggressive hairline, but a hairline nonetheless. Temple reconstruction is also necessary.

I have attached pics. Let me know what you think about my question, then more specifically me.

Thanks,
Eman

Front.jpg (167 Kb, 197 downloads)

Back

Back.jpg (168 Kb, 160 downloads)

Left side

Left_Side.jpg (10 Kb, 121 downloads)

Right Side

Right_Side.jpg (10 Kb, 88 downloads)

In my view, 4k would last you a long time. Maybe a couple of the docs who post will offer some opinions.

I'd get on the meds asap to make sure you don't lose that hair in the crown though.

Eman,

You ask a very good question and it is one that I've been thinking about for a while now. First off, let me define what "one and done" means in our office since we basically coined the phrase.

One & Done means that one area is completed in one session, not the entire scalp. This refers to getting desired density in one pass vs. two or even three. What it takes to accomplish this is numbers and the ability to dense pack. Take for instance Bobman. Advanced NW6 with two big sessions, one for the top and one for the back. The front does not need to be touched again because the goal of coverage and density was achieved in one session leaving the back open for the second, which was accomplished. This was the plan going in and the goals were met.

Another example would be Pushing40. One session of 4000(ish) grafts to the front half of his scalp and he most likely will not have another procedure in this area. You can also include Evolution and Domie as additional examples.

The problem with O&D is that because results have improved so much over the past several years expectations have increased as well. In addition, you have more patients having great results and they discover that the process isn't as negative as they initially feared it to be so once everything comes in they realize that a second session will only improve things even greater whereas a few years ago they might not have considered a second because one was good enough. That's one reason why I had a second (and a third) and is why you see others like Londonlad, even after 7761 grafts in one session, coming back for round two to make things just that much better. To convey this in a post seems a bit limiting but I think you get the gist of what I'm saying.

That said, when I look at your photos, I think you have the right idea with 4000 grafts and I would compare your hair loss pattern to the one timers I mentioned above (pushing40, Evolution, Domie) and I would expect (hope) that one would be enough for you given you don't get hair greed and of course the work turns out as planned. You appear to have excellent donor hair as well and I suspect at worst average density but perhaps even above average density.

I hope this helps to address your questions.

Dewayne- Been on finasteride almost one year.

Jotronic- Thank you for the reply. That is a great way at looking at it. I never thought of it that way. Once an area is completed it is done especially with the results that H&W are getting. That is what I like to hear. I do have thick donor with above average density and decent to good laxity I think.

Thats a good question and one that can only be answered after the growth is completed.In alot of people even when dense packing is done there are a spot or two that need to be touched up . That why I like clinics that offer strip and fue. Or at least a strip doc that can do fue on his own patients for a touchup if needed,even if his clinic doesnt offer it.
If you have an intact crown and mid section and you have hairline work done and lets say you want or need a touchup and 75 grafts will complete perfection ,do you want another strip for 75 grafts. Well for one thats crazy and no clinic will do that. So your basically stuck until you need another session ,or change doctors and pray somone will do 75 fue on you.
Ask your doctor if he can perform a small fue on you if needed. My doc doesnt offer it but can do it in appropriate cases

Hey E-- Honestly, in your case, your posts, and talking to you, I think you should do FUE---

I think your BIGGEST concern is the scarring aspect, of which there is no guarantee that you will have "acceptable" scarring.

You look like a great candidate for either procedure, IMHO.

Talk to you later,
Jason

Pleasegrowplease,

"...say you want or need a touchup and 75 grafts will complete perfection ,do you want another strip for 75 grafts. Well for one thats crazy and no clinic will do that."

How do you think clinics have been doing eyebrow transplants for the last several years? Such a small strip, if it can even be called that, leaves zero evidence of surgery in the donor area.

Yeah I understand that but strip recovery is is worse compared to fue no matter how long or short the strip.
Dont get me wrong Im strip guy myself I just like the option of fue for 75 opposed to strip.
That just my opinion.
I would tend to think that most eyebrow transplants are the fue route now.
Every person Ive ever read that has had both said the fue recovery is so much easier,even though strip isnt that bad.
I only believe in fue for small procedures at this time and fue is ideal for a touchup.
Plus if you have a great scar why risk anything

PGP,

Dont' get me wrong, I understand your point, but a small strip of 75 grafts is much different than a strip for 2500 grafts. It could be taken from a different area and there would be virtually no sign of surgery later on. I also disagree that most eyebrow transplants are being done by FUE. I just don't see that being the case. As far as FUE being less of an issue during recovery, I didn't find that to be the case when I had my small patch done. It hurt like hell during recovery but that's just me, the strip rep talking

I would be interested in a doctor who offers both procedures on how he would address a very small touchup after strip if another large strip session wasnt needed.

Hey Eman, we are very similar in hairloss and same areas, pretty much identical. look at my before pics with no meds at all,then when I Decided to do the the ht with the doc I chose. he got me on propecia and rogain 2 1/2 months prior to the surgery. I had a tight lax area and he went a little conservative. No major hair line. Just a great natural hairline for my age with a dense pack. The doc actually got 2953 grafts which was great from my donor area. We did fut and he said I would be good for 1 procedure and this would make a great look for my case. But I did read up as youself and alot 0f guys get that hair greed. The doc and I decided to wait 1 year after the procedure and see if I am fully satisfied,but we also discussed a 2nd procedure for touch ups after the year and we talked about fue for the 2nd procedure. Eman look up my discussions and pics,im just about 14 days post op and I am pretty pleased with the results. Just get on the meds as soon as you can to keep what you do have. the fue was a breeze in the surgery and boy was I nervous about my scar,but My scar looks great and I am cutting my hair in about 2 weeks so that everyone can see the scar since you cannot even tell from my pics,all you see is just a small line on my hair,cant see scar and the great thing is no one even detected that I had an ht done. I waqs back to work 4 days later. Had the ht on a thursday in miami and flew back to boston on Saturday and back to work on Monday. I could wear an addidas visor on my job,but I was golden with my ht. You can where a visor because you have the same hairloss in the same areas and no one can see the frontal loss with the visor.

sorry eman,I meant my fut was a breeze,fue is the touch ups if I get hair greed

Quote:
"Parameters for this question: First, take out hair greed. I am not too worried about the future manageable loss in the crown, and I am not too worried about having a bad hair transplant"...
---Eman.
That's a LOT of parameters!
It seems to me that most
guys who go back in the chair for round(s) 2,3..
do so NOT because they were unsatisfied with
their first procedure BUT because; either:

(i) they were so happy--as jotronic stated---that they wanted more. MrJobis talks about this as well (ht 3x over and brags endlessly of his woman slaying mondo mop).
OR
(ii) additional loss.
Given what you say, I wouldn't worry at all about (i) because that is just a matter of desire.
(ii) on the other hand could still become an issue if you have excessive balding in the crown, and have pretty good coverage on top from your first procedure, then it might look unnatural.
no?

quote:

I think you should do FUE

Bspot,

I understand you have spoken to Eman before so you may have a unique insight into his case but I'm curious as to what results you seen on the forums or even in person that would justify your recommendation for FUE much less one that was a O&D.

Get asked this ALL the time and the honest answer is if you choose your doc carefully you will always want more . Not necessarily need more but you will want more. Your expectations change as it comes in so slowly that you end up forgetting where you once were and the goal posts move as time goes on.

You will not need more depending on YOUR goal but you will WANT more - Nature of the beast. Hair and money - doesn't matter how much you have got you always want more

See the topic i wrote on growth and number of sessions - Many vets can relate to it

Growth + Number of Sessions

Yeah one and done with fue is VERY rare

quote:

Originally posted by Jotronic:

quote:

I think you should do FUE

Bspot,

I understand you have spoken to Eman before so you may have a unique insight into his case but I'm curious as to what results you seen on the forums or even in person that would justify your recommendation for FUE much less one that was a O&D.

Sorry if I led anyone to believe that an FUE transplant would be one and done.

I assumed everyone would know that we have never seen one (only lower levels of loss), and even further that I would not promote that approach with fue regardless.

No, fue could possibly be done differently perhaps a 2 day 1500 graft per day session for the frontal = 3000 grafts.
However, I doubt it would be one and done.

I would imagine that 8-10 months later another 1500-2000 grafts could be done.

I rarely see any true "one and done" strip patients regardless of session size, because hair greed sets in or guys just need a ton of work.

Jason