It occurs to me that the issues of direct post-operative outcomes are dealt with on the forum, but the advancement of alopecia even after surgical intervention is not dealt with as much.
(If I did not find a the thread that deals with such issues, please refer me.)

After the hair transplant surgery, and there has been renewed growth in the scalp, the native hair does continue to miniaturize even with medication and at a retarded rate.

My question is:

1. What does a well done hair transplant, done by the best surgeon look like if no continued surgical intervention is done to maintain the illusion of density ?

2. If the patient does decide, not to pursue further surgical interventions, does the hair transplant stand the test of time? Does the scalp look patchy after the native hair has miniaturized to point of pre-vellus diameter?

3.Can the transplanted hair age naturally along side the native hair,to give a blended overall natural thinning look and not a patchy appearance?

4. Generally how is placement of the transplanted hair done in relation the native hair within the atrophic zone?

5. Does the patient grow wary of having to do follow-up surgeries to always maintain the illusion of density?

6. At what point may the patient accept that the time has come to "call it quits" and stop chasing the illusion of density?

7. Does this come when chronic physiological diseases such as diabetes, heart disease, arthritis begin to occur, or perhaps other life threatening diseases?

Perhaps this might be a totally personal decision on the part of the patient as to "how young they feel" and how young they want to look?

Thanks.

Mmhce,

I've answered some of your questions here.

I'll wait for other dedicated members to come around and address some of your other questions

All the best,

Bill (Falc)

I can certaintly relate to your general query. My op, which gave me virtual restoration, has been a success; however, a won battle doesn't end the war. Already, I am seeing the beginning signs of the future to come -- and it includes the same continuation of alopecia, though at a "retarded rate". That said, I'll answer your ?s as I see 'em.

1. It would continue to look like a "well done hair transplant". I would kill for my hair to not change an iota from where it currently is (I'm like 10ish months out from my HT).

2. The HT will stand the test of time insofar as it relates to how much native hair deteriorates over time, juxtaposed with your "tolerance" for whatis and is not acceptable density. Basically, you should almost always *be prepared* to undergo further operations at a later date. Of course, as you go through an op there is less and less ground that you ever would have to even worry about.

3. Not totally sure what you mean here, but from what I'm assuming, I'd say ya.

4. Geneally speaking, the goal is to always maximize the "illusion of density". Transplanted hairs are situated -- and angled -- to supply maximum perceived density, naturalness, while working with native hairs.

5. It's all relative. It's part of the game, though, like I mentioned earlier, to always be prepared. Of course, you don't *have to*, and you may not ever *need to*, but you are obv at an overall disadvantage to go into a war that you may not be able to properly go about finishing. That said, even if I knew I wouldn't, for w/e reason, ever attack my crown and vertex, I would still have gotten my hairline done.

6. You should pretty much go into getting HTs w/ high confidence that you will be able to suitably confront your MPB. You have to factor in age, rate of loss, pattern of loss, $, will, hair charachteristics, and what you will and won't be satisfied with. IMO, some people prolly should "call it quits", but for many, I think with proper planning and execution quite a bit can be accomplished.

quote:

1. It would continue to look like a "well done hair transplant".

This is not always true. In fact it's probably usually not true if your first HT is when you are a stage 3 and you don't get any more. If you get the front dense packed and then a few years later you lose a lot more hair, your HT will not still cover the front and be "stand alone" like some people here will lead you to believe. Most likely the area of loss will widen leaving you with a large tuft of dense packed HT hair with 1 or 2 or more centimeters of bald scalp on each side between the side hair above your ears and the transplanted hair on top.

quote:

5. Does the patient grow wary of having to do follow-up surgeries to always maintain the illusion of density?

This depends on the person and how fast you continue losing your hair.

quote:

6. At what point may the patient accept that the time has come to "call it quits" and stop chasing the illusion of density?

I disagree with thanatopsis_awry who feels you "should pretty much go into getting HTs w/ high confidence that you will be able to suitably confront your MPB". I guess it depends on what he means by "suitable confront". I think if you're destined to be a NW 7 or even a 6 in many cases then you most likely won't end up satisfied unless you drastically reduce your expectations of getting decent coverage over the entire area AND be willing to spend double or triple the amount of money you are being quoted for. In other words you have to be willing to be a NW 3 with a high hairline after spending $30000. If you're not destined to be a NW 6 or 7 then this may not apply, but I feel you were asking about possible problems in the future if you start a HT now.

Unfortunately if you continue to lose hair at a fast rate you really can't "call it quits" until you run out of donor hair. I started my HT as a NW 5 and tried to play catch up with my hairloss until I ran out of donor. The bald area widened by several centimeters on each side and 6 centimeters down the back.