Hello ladies,

I wanted to write this post for any girl out there who is debating the use of hair transplants to correct/lower hairline.

I feel like no one really talks about it and everyone who gets these transplants just deals with it by covering them with their hair.  There are girls that get hairline lowering hair transplants with their FFS and I've yet to see any of them with up close shots of what the transplants look like with their hair pulled back.

I am active, I am and will always be the type with my hair up and back.  If you are the same type of girl, DO NOT get hair transplants for your hairline.  The hair transplants look good from 5 feet or more away from you but as soon as someone gets near you they will easily sport the transplants.  A lot of times when hair that is transplanted grows out of the scalp, the skin becomes raised almost like bumps on chicken skin or goose bumps... It's not the case for all some do look natural but a lot of them have that goose bump look that is a dead giveaway you have transplants and trust me when you get close in conversation with anyone, they will stare.  Especially in the sun or bright lighting, they really stand out!

I didn't know how to go about starting my transition, but I thought I would start with creating a more feminine hairline through hair transplants.  That turned out to be a waste of $12,000!  I just had FFS with a great surgeon who cut them out and pulled my natural hairline down to create the same feminine hairline that was there.  I spoke with other surgeons who were not capable of what mine did.  One surgeon wanted me to wear a balloon expander under my scalp for three months to stretch the skin before FFS to cut out the transplants.  Other surgeons recommended putting more transplants to fill it in.  The truth is, it's not possible to create a natural hairline through transplants.  It will only look good from far away.  These doctors recommended more transplants because to me that's the norm for them and ultimately why I chose not to go with FFS surgeons who make you feel like you're just another number going through the assembly line.

I know so many of you starting out your transition have this question on your mind about where to begin. 

I'd say finding a highly skilled FFS surgeon should be the first person you go and see instead of the hair transplant clinic.

I am a brunette with dark brown hair.  With that being said, transplants may not look as bad and noticeable for someone with blonde hair.

I hope this helps somebody and wish I could've seen a post like this before I wasted all that money.

So basically you can choose between "goosebumps" or a scar running all along the hairline - both of which may or may not be visible depending on the way your body heals and on good luck and of course to a degree on the skill of the surgeon... ?

Exactly!

With the way that Dr. Lee closed my scar and how nice it's healing, I am confident that this was the best choice as there are already hairs starting to grow out of the scar and the pigmentation is fading fast with proper care.

But then again. A lot of hair transplant patients who had it done properly are very happy with it and say the same thing - they feel it is more natural and less visible than a scar... so I guess it depends - it can go good or not so good either way.

I think I am preferring transplants as I only want to fill in the "corners" at the temples. My scars always are very light and I think they are visible, so I would like to avoid a scar like that all around my upper face, if possible.

Also what I think is, that the chance of nerve damage on the scalp is less, the more distance between the scar and the forehead is.

Quote from: anjaq on February 14, 2017, 02:52:18 PM
But then again. A lot of hair transplant patients who had it done properly are very happy with it and say the same thing - they feel it is more natural and less visible than a scar... so I guess it depends - it can go good or not so good either way.

I think I am preferring transplants as I only want to fill in the "corners" at the temples. My scars always are very light and I think they are visible, so I would like to avoid a scar like that all around my upper face, if possible.

Also what I think is, that the chance of nerve damage on the scalp is less, the more distance between the scar and the forehead is.

Yes you are right again.  A lot of patients are happy with the transplants.  Those patients usually will always wear their hair down so that the transplants blend in and are covered by other hair or they will part the hair, pull it down and cover the transplants. 

My message was to anyone who is active and works out and always wears their hair up and pulled back in a ponytail or bun.

Again, the nerve damage and scar all goes back to the skill of the surgeon.  You find the right one and voila...  20 days after surgery and you're already looking and feeling great.


AND unfortunately there is no such thing as properly... a hair transplant is a hair transplant.  It's a human poking holes in your head that will never ever come close to replicating a natural hairline or natural hair density.  They will never admit this to you until you ask, which is what I finally did after two failed hair transplant surgeries with one FFS surgeon's team to explain my concern about pulling my hair back all the time in high ponytails. 

They said in an email and I quote

"If you wear tight ponytails or up-do's frequently, I regret to say that hair grafts are only meant to look good (or even excellent) with loose hairstyles, or in a low ponytail.  If you tighten them upwards, the difference between the transplanted hair and the rest becomes more evident.  With hair grafts it's more or less like the difference between a natural forest and an area that has been afforested by humans.  One looks natural, irregular and dense, while the other looks uniform, less dense and somehow lined up.  The more upwards you tighten the grafted hair, the less natural it looks, regardless of how good the surgeon who did the job was."

Hi Gatita

My experience has not been the same as yours as I am very happy with my entire transplant which was done in two stages the second one 3 months ago. I had my hair up in a high ponytail yesterday and I did not see the goose bumps you talk about, maybe I am lucky...This thread made me go and check in the mirror...even where there was scarring from the first round there is only now discoloration after 15 months, the second round has just finished erupting through my scalp last week...so will have to keep an eye on it

Liz

Quote from: ElizabethK on February 14, 2017, 06:21:41 PM
Hi Gatita

My experience has not been the same as yours as I am very happy with my entire transplant which was done in two stages the second one 3 months ago. I had my hair up in a high ponytail yesterday and I did not see the goose bumps you talk about, maybe I am lucky...This thread made me go and check in the mirror...even where there was scarring from the first round there is only now discoloration after 15 months, the second round has just finished erupting through my scalp last week...so will have to keep an eye on it

Liz

Hi Elizabeth thats wonderful!  I'd love to see up close clear pics of that!

Congratulations, where did you go?

Yeah mine looked smooth at first too and then after a year and a half, it became easy to identify the grafted hair.

Thanks to everyone who has posted in this thread. I wear my hair in a ponytail every day. I had transplants to my crown and had a satisfactory result, though it's hard to say how much regrowth was transplants vs hormones.

For the hairline, I had scalp advancement during FFS and had been planning transplants to hide the scar and fill in the temple areas. However, I talked to Mayer and he recommended that I consider a Fleming-Mayer flap. Several surgeons recommended that I consider a revision scalp advance to improve the scar and bring in the hairline at the temples instead of using transplants. And of course FacialTeam recommended more transplants only.

I'd love to see more closeups of transplants.

Quote from: cej on February 14, 2017, 06:33:26 PM
Thanks to everyone who has posted in this thread. I had transplants to my crown and had a satisfactory result, though it's hard to say how much regrowth was transplants vs hormones.

For the hairline, I had scalp advancement during FFS and had been planning transplants to hide the scar and fill in the temple areas. However, I talked to Mayer and he recommended that I consider a Fleming-Mayer flap, several surgeons recommended a revision scalp advance to construct the hairline instead of transplants. And of course FacialTeam recommended more transplants only.

I'd love to see more closeups of transplants.

Right, exactly... For the crown, it doesn't really matter as much as the hairline.  From what you said above, more surgeons who know the truth about hair transplants on the hairline will steer you away from doing it because it won't turn out to look natural.  I talked to Mayer himself and he said they are no good for the hairline.  His Fleming-Mayer flap is pretty amazing from the results I have seen.  Unfortunately I was not a candidate for that because the two scars from the previous transplants ruined my flap area to be used.  Then there are other FFS surgeons out there that will always recommend transplants with FFS because it's their norm.

I don't think FFS surgeons are as familiar with hairline aesthetics and what it takes to achieve a natural look with transplants... rather, I'd seek out a specialist, who pretty much does only this, and who does a significant amount of work with (cis) female clients as well. 

But, as you pointed out, it can get very expensive.  I think it's possible to get the best of both worlds -- advance the scalp first, then cover the scar and perfect the hairline with transplants (which will be less expensive because fewer are required).  I'm sorry, but I think the hairline scar is every bit as likely to be visible with the hair pulled back, if not more so, than transplants. 

Alternatively, stop wearing pony tails (they're bad for your hair anyways, causing snarls and breakage) and switch to hair bands that sit right at your desired hairline in the first place. 

But if one is dead set against transplants, or can't do them for technical reasons, there's another option for pale scars -- permanent makeup, basically tattooing the scar with skin-colored pigment so it blends in completely. 

Quote from: Sophia Sage on February 15, 2017, 01:13:16 AM
I don't think FFS surgeons are as familiar with hairline aesthetics and what it takes to achieve a natural look with transplants... rather, I'd seek out a specialist, who pretty much does only this, and who does a significant amount of work with (cis) female clients as well. 

But, as you pointed out, it can get very expensive.  I think it's possible to get the best of both worlds -- advance the scalp first, then cover the scar and perfect the hairline with transplants (which will be less expensive because fewer are required).  I'm sorry, but I think the hairline scar is every bit as likely to be visible with the hair pulled back, if not more so, than transplants. 

Well - I would think a scar is always also visible if one looks close enough - and I mean for both things one would need to look closely - to see the transplants or to see a well made scar running right at or 2mm behind the hairline.

I think for people who have a receding hairline, the hairline incision is almost mandatory - you would have to fillin too much with transplants. Personally I would think that a case like mine is good suited for transplants as I only need to fill in the corners and actually there are some hair there already, but only small ones and irregular/patchy...

Quote from: gatita on February 14, 2017, 05:48:07 PM

Yes you are right again.  A lot of patients are happy with the transplants.  Those patients usually will always wear their hair down so that the transplants blend in and are covered by other hair or they will part the hair, pull it down and cover the transplants. 

My message was to anyone who is active and works out and always wears their hair up and pulled back in a ponytail or bun.

I heard the exact same about the hairline incision - it loooks great because people often wear a fringe or open hair anyway, so the hairline scar is not exposed - pulling back the hair however would expose the scar completely, so I was told it would actually be better to get transplants for that.

So it seems to be undecided - both methods seem to work, but in both cases depending on the situation of the hairline before the surgery, there is a chance that it will be visible on close inspection, that something was done.

QuoteAgain, the nerve damage and scar all goes back to the skill of the surgeon.  You find the right one and voila...  20 days after surgery and you're already looking and feeling great.

I am not sure about this - Even first class surgeons like Dr O used to say that there is a loss of nerves involved in forehead FFS and it will not always return. I never heard of a surgeon so far who could promise that there will be minimal damage that will always recover. The nerves are cut - there is no way around this. They will have to regrow from where they were cut. If that happens or not so much seems to me not much in the skill of the surgeon, but more in the ability of an individual body to heal, maybe in the hormone therapy to give a healthy healing grounds, and in my view the damage is less severe when cutting more back at the head, when the area to recover is smaller.

QuoteAND unfortunately there is no such thing as properly... a hair transplant is a hair transplant.  It's a human poking holes in your head that will never ever come close to replicating a natural hairline or natural hair density.
.....
They said in an email and I quote

"If you wear tight ponytails or up-do's frequently, I regret to say that hair grafts are only meant to look good (or even excellent) with loose hairstyles, or in a low ponytail.  If you tighten them upwards, the difference between the transplanted hair and the rest becomes more evident.  With hair grafts it's more or less like the difference between a natural forest and an area that has been afforested by humans.  One looks natural, irregular and dense, while the other looks uniform, less dense and somehow lined up.  The more upwards you tighten the grafted hair, the less natural it looks, regardless of how good the surgeon who did the job was."

Well, I assume the email is from a surgeon who does hairline advance with surgery and does not do hair transplants except to cover up the scar, possible? It would be as biased then as asking Facialteam about it , who will always recommend hair transplants...

I do think however that id a surgeon would do it "properly" , which you say does not exist, he would avoid placing the hair follices in neat rows like a afforested area. They could place them more irregular if they wanted, right? Of course density may be an issue - they can only put the hairs as close together as their method allows - so there is a limitation, which I would say is a good reason to avoid covering very large areas with transplants. It is in my opinion more of a method for smaller patches.

This is for example what I would need to get fixed:

Quote from: anjaq on February 14, 2017, 02:52:18 PM
But then again. A lot of hair transplant patients who had it done properly are very happy with it and say the same thing - they feel it is more natural and less visible than a scar... so I guess it depends - it can go good or not so good either way.

Yeah YMMV. To each their own.

I myself did hair transplants a couple years before FFS. I had thought it would be in leu of it but turns out it wasn't enough. BUT it was enough to be able to pull my hair back. I also only filled in the corners and didn't touch the top of the hairline itself (it's hard to make it look natural apparently).

Now that I have a hairline scar after FFS, I kinda wish I'd have waited to do transplants immediately after FFS and recovered all at once like that but oh well. I'm not doing transplants again. They look pretty bad for months after and you can't even cover them or risk losing them.

I have a thread on my Transplant results from 2014. I think they came out pretty good.

I think the result of Debra looks very natural and not artificial at all. And it is quite a large area as those corners were quite large already.

Quote from: anjaq on February 15, 2017, 06:00:23 AMI do think however that id a surgeon would do it "properly" , which you say does not exist, he would avoid placing the hair follices in neat rows like a afforested area. They could place them more irregular if they wanted, right?

Correct, and there are actually scholarly articles on the matter, which people who focus on hair transplants should be aware of, but which FFS surgeons might not have gotten around to. 

Likewise, there are issues of creating an appropriate angle for the hair to grow out.

The one thing I have get to see is getting a good mix of follicle thickness in transplants.  At the hairline, many of the individual hairs will be thinner, almost like long vellus hairs.  But these kinds of hairs are not easy to harvest (from the back of the neck, perhaps) and then transplant... I think they're less likely to survive the journey.

QuoteOf course density may be an issue - they can only put the hairs as close together as their method allows - so there is a limitation, which I would say is a good reason to avoid covering very large areas with transplants. It is in my opinion more of a method for smaller patches.

The issue of density is also something discussed in the trade.  Density varies from individual to individual, but more importantly there's the technical issue of planting the hairs far enough apart that they each have a better chance to establish their own blood supply.  Sometimes it's better to do it in two waves -- after the viability of the first batch has proved itself out, going in and increasing the density a second time around. 

But, as Debra has pointed out, transplants take a long time for their results to manifest.  Most transplanted hairs will go into something like "shock" -- the catagen phase begins, followed by the telogen phase; the hairs fall out, and the follicles stay dormant for a few months.  Then they slowly start growing back.  Hair only grows about six inches a year on average, so it might be two years before you've got the results you want. 

Again, transition is a marathon, not a sprint.

Quote from: Sophia Sage on February 15, 2017, 01:13:16 AM
I don't think FFS surgeons are as familiar with hairline aesthetics and what it takes to achieve a natural look with transplants... 

Well some are and some refer you or are in partnership with transplant specialists... I've spoken to both.

Quote from: Sophia Sage on February 15, 2017, 01:13:16 AM
I'm sorry, but I think the hairline scar is every bit as likely to be visible with the hair pulled back, if not more so, than transplants.   

I guess this comes down to a matter of personal preference.  I prefer the scar over the transplants.

Quote from: Sophia Sage on February 15, 2017, 01:13:16 AM
Alternatively, stop wearing pony tails (they're bad for your hair anyways, causing snarls and breakage) and switch to hair bands that sit right at your desired hairline in the first place.   

You are so right on this one but when you are running miles at a time or doing high intensity interval exercising... the hair bands just don't work.  I think people say ponytails are bad, but I feel like it's just a matter of training your hair.  Over time it becomes accustomed to constantly being up and builds tolerance and strength to withstand it.

Quote from: anjaq on February 15, 2017, 06:00:23 AM
I am not sure about this - Even first class surgeons like Dr O used to say that there is a loss of nerves involved in forehead FFS and it will not always return. I never heard of a surgeon so far who could promise that there will be minimal damage that will always recover. The nerves are cut - there is no way around this. They will have to regrow from where they were cut. If that happens or not so much seems to me not much in the skill of the surgeon, but more in the ability of an individual body to heal, maybe in the hormone therapy to give a healthy healing grounds, and in my view the damage is less severe when cutting more back at the head, when the area to recover is smaller.

In my case yes there was a temporary loss of nerves...  Within the first 7 days after surgery I had two appointments to see Dr. Lee.  On the first post op visit which was 2 days after surgery, I could not feel or move my right brow.  I had another appointment a few days later and I could move and control both my brows.  I am now in day 21 and 80% of the numbness and feeling is back and improves everyday.

Quote from: anjaq on February 15, 2017, 06:00:23 AM
Well, I assume the email is from a surgeon who does hairline advance with surgery and does not do hair transplants except to cover up the scar, possible? It would be as biased then as asking Facialteam about it , who will always recommend hair transplants...

The email was from an FFS surgeon's team who works in conjunction with a hair transplant clinic.  The woman sending the email has transplants herself and I have a friend who met her and said yes... it was noticeable that when you got close to her the transplants were noticeable.

Quote from: anjaq on February 15, 2017, 06:00:23 AM
They could place them more irregular if they wanted, right? Of course density may be an issue - they can only put the hairs as close together as their method allows - so there is a limitation, which I would say is a good reason to avoid covering very large areas with transplants. It is in my opinion more of a method for smaller patches.

Correct, density is the issue here and yes they are limited to how close they can put each follicle.  It's a delicate matter because if it's too far then it looks unnatural and if it's too close, they run the risk of killing the follicle next to it which both situations is a loss.

Quote from: Debra on February 15, 2017, 07:36:41 AM
Yeah YMMV. To each their own.

I myself did hair transplants a couple years before FFS. I had thought it would be in leu of it but turns out it wasn't enough. BUT it was enough to be able to pull my hair back. I also only filled in the corners and didn't touch the top of the hairline itself (it's hard to make it look natural apparently).

Now that I have a hairline scar after FFS, I kinda wish I'd have waited to do transplants immediately after FFS and recovered all at once like that but oh well. I'm not doing transplants again. They look pretty bad for months after and you can't even cover them or risk losing them.

I have a thread on my Transplant results from 2014. I think they came out pretty good.

Very nice Debra, your work looks fantastic and I actually have seen you and your photos on that site before as I was scouring for answers.

Thats interesting that you say you can't cover them or else you risk losing them.... Hmmmm.  My surgeon actually said it was ok to wear a hat after a week or two post op.  She is supposedly one of the best in the world.  I got botched.

I had my hairline reduction by Dr. Lee also and my scar is almost invisible.

For someone such as me who has the half circle baldness to start off with and now have what appears to be a full head of hair. Not only did the transplants look really good but this was also helped along with HRT to stimulate dormant follicles in my head. My surgeon seemed to think I had a wasteland and that no amount of HRT was ever going to change that. He corrected himself at our last consult and was astonished at mow much new natural growth I had  along with the implants.

The skill of the surgeon is paramount when doing this kind of procedure. He told me straight up that I will never have the head of hair I had at 14 but I will not have to wear a wig. That for me sealed it, with a good cut and style you can just about take care of 'just about any kind or issue.

I think the other thing you need to consider is lifestyle...what is it you like to do...are you a beach babe or love the night clubs, water sports or skydiving...what ever. My lifestyle is far different to many others. I do not have to worry about the dating scene, parties or a swinging social life.

Because of my individual follicle transplants I will be able to cut and style my hair to look natural even up close but I know that it will not be the deciding factor in wether I pass or not, there are too many other things to worry about for me. My surgeon will keep implanting as long as I keep paying but has said the value of further transplants are to supply bulk. Most of the current implants are not so long as they are the second growth ones or are really thin and wiry. These will take time to thicken and mature over the next few years.

I will be having my hair Styled, coloured and cut at the end of April, by this time the implants will be 5 months old but I will certainly be able to see the hairstyles that will work for me...I only put my hair up in a ponytail when I am really hot. Once that is done I will post the full series of Pics again...from 2015 to present and both procedures.

Liz   

Quote from: gatita on February 15, 2017, 12:33:49 PM
In my case yes there was a temporary loss of nerves...  Within the first 7 days after surgery I had two appointments to see Dr. Lee.  On the first post op visit which was 2 days after surgery, I could not feel or move my right brow.  I had another appointment a few days later and I could move and control both my brows.  I am now in day 21 and 80% of the numbness and feeling is back and improves everyday.

Well this is not what I was talking about , as can maybe be seen from the picture I linked. The numbness in front of the incision is probably due to swelling and fades as it goes down. But the incision for forehead surgery just has to cut through the nerves running up to the scalp. There is no way around cutting them, except maybe with Dr Zuchowskis method of going in with an endoscopic tool. So the area behind the incision will always be numb initially and the nerves then hopefully can grow back.