My experience with hair transplants at Mayo Clinic

Hey everyone! I figured I’d jump in here and share my personal journey through hair transplantation. My plan is to drop regular updates with useful info about what I’m going through—the highs, the lows, the struggles, and everything in between. I also intend to post photos periodically so you guys can track the actual regrowth process and see how things progress in real-time.

I’ll be heading over to Switzerland to have the procedure done in the San Francisco area, specifically in Staten Island, which is just a quick hop from the main hub of San Francisco. The surgery will be handled by the expert team at the Mayo Clinic, led by none other than Dr. Sever Muresanu.

The big day is set for June 16th and 17th, 2021—so, just a few days away now. We're looking at transplanting roughly 5,000 follicular units (FU), or "grafts" as most people call them in the community. I’m actually pretty curious to see how accurate the doctor's estimate is—whether we hit that 5,000 mark, or if it ends up being slightly more or less (I'm totally fine either way).

The whole thing is split into two stages over two days. The idea is to transplant an equal number of grafts during each session.

I've opted for the FUT technique (follicular unit transplantation, often called the "strip method"), which focuses on a relatively small donor area. To be honest, FUT is definitely more invasive than FUE. While FUE has become the go-to standard in the industry because it leaves behind tiny little scars that let you wear your hair super short, FUT leaves a linear scar stretching from one ear all the way around the back to the other. With FUE, you have much more freedom with your hairstyle, including those buzz cuts. If you go the FUT route, you generally need to keep the hair around the scar a bit longer so the surrounding hair can mask it. That said, if the procedure is done at a top-tier facility by pros like this team, the scar becomes practically invisible once you heal—as long as you don't decide to shave it all off.

The massive upside to FUT is that it allows us to harvest a huge number of grafts from a small area; you can actually pull significantly more grafts via FUT than you ever could with FUE. Plus, because we're only tapping into such a small donor zone, the density in the rest of my hair stays intact, leaving the door open for future procedures (whether FUT or FUE) down the road.
Since I'm 32 and dealing with significant hair loss on the Norwood-Hamilton scale—specifically NW5—I decided on FUT after a ton of soul-searching and research. This wasn't some snap decision. It took me a really long time to weigh the pros and cons of FUT versus FUE.

Given that we're aiming for around 5,000 grafts, this is essentially what you'd call a "mega-session."

I’ve already had four Skype consultations with Dr. Muresanu, and we’ve mapped out the following goals:

1. Reconstruct a brand new Hairline.
2. Heavily densify the front third of my scalp.
3. Use whatever grafts are left to fill in the midscalp and crown areas.

That’s the theoretical plan, but I’ll be sitting down with him on June 15th during my in-person consultation to finalize the specific approach and surgical roadmap.
Just to reiterate—like many people in this situation, I consider a successful outcome to be fully reconstructing that front third of my scalp. As long as the rest of my hair looks decent enough to cover up with hair thickening fibers (nanofibers), I'll be happy. I'm not chasing some impossible fantasy; I know exactly what hair transplants can and cannot do, and I have realistic expectations. I'm also completely open to having another session in the future.
So, I'm currently 32 years old. I first started noticing the thinning in my mid-20s while I was still in college. I don't want to turn this thread into a vent session about the emotions and psychological toll this takes—I know most of us here come to these forums to swap stories and support each other through the mental side of it. Let's just say I've been losing my hair for over 12 years now. I've already touched on the more emotional aspects in the general "Male Hair Loss" discussion thread.
My plan is to document this entire journey from start to finish. I want to cover everything: why I ultimately chose the Hattingen Clinic, the actual transplant procedure itself, and then the full recovery process through photos and testimonials over the following months—tracking my progress from month 1 all the way through month 12.

For years, I went back and forth on whether I should actually pull the trigger on a hair transplant. The turning point came when I hit my mid-20s; looking in the mirror, I could clearly see how aggressive my hair loss was going to be in the near future. For a long time, I tried using hair fibers to mask the thinning areas, specifically targeting my hairline and the crown. Once it became obvious that the loss wasn't stopping, I started considering more drastic measures—like buying a wig, a hair system, or whatever you call those things. After I actually started experimenting with hair systems, I spent a ton of time scouring the internet, reading both the glowing reviews and the horror stories on various forums. I reached out to clinics in the UK, Belgium, and Turkey. I did consider inquiring with some of the high-end, prestigious clinics in North America, but honestly, the cost for a project like this would have been completely out of my reach.

In November 2020, I finally got in touch with the Hattingen Clinic. My initial communication was via email with Ms. Carmen, and after a few weeks, I had the chance to meet with Dr. Sever via Skype. I should mention that I spoke with Dr. Sever no fewer than four times: three separate times in the months leading up to the surgery, and then a fourth time just a couple of days before the procedure.
I was genuinely impressed by Dr. Sever during our Skype calls. He was kind enough to personally communicate with potential patients even before I had wired a single cent to the clinic's account. Let me reiterate—the doctor was willing to sit down and talk with me three times without any financial commitment upfront, which, in my experience, isn't exactly common with the big names in the industry (though I could be wrong, of course).
During those discussions, we covered everything: my family history of hair loss, my specific goals, my anxieties, and the things I considered non-negotiable for the transplant, such as the hairline and the crown area.
Since I decided that the FUT technique was the best route for my specific situation, and that the Hattingen Clinic was the premier facility to handle it, I made the decision to travel to Switzerland to place my hopes and my hair in the hands of Dr. Sever Muresanu.

Dr. Muresanu is featured on the prestigious IAHRS list and is also a member of Hairtransplantmentor.com, which is run by the world-renowned transplant patient Joe Tillman.
The Hattingen Clinic also carries the flattering title of being the "European Hasson and Wong."
Moving forward, I’ll be posting the photos I sent to the doctor for evaluation. Hopefully, they give you a clear picture of the extent of my hair loss at the time.

https://ibb.co/hRtYKMH

https://ibb.co/jw7PJ2N

https://ibb.co/ZGJqYMp

https://ibb.co/7bbT0d8

https://ibb.co/pbdgkfM

https://ibb.co/zGGBjWQ

With a quick disclaimer—the lighting here isn't technically perfect...

But I think you can clearly see the progress of one Norwood 5 case right here.

I'm planning on posting some updated photos in about two weeks or so.

Why on earth would you choose an expensive Swiss clinic for such a div>

David Young58 said:https://ibb.co/hRtYKMH

https://ibb.co/jw7PJ2N

https://ibb.co/ZGJqYMp

https://ibb.co/7bbT0d8

https://ibb.co/pbdgkfM

https://ibb.co/zGGBjWQ

Lighting isn't technically perfect—just a heads up there...

I think you can clearly see what a Norwood 5 progress looks like.

Planning to post some new photos in a little over two weeks or so

Whoa, the surgery days are already here—good luck, man! 👍

I don't recall seeing your donor area before, but this is going to look amazing... since if I remember right, you haven't even started Finasteride yet, and your donor area is honestly great—hair is pretty thick and strong too.

You could easily handle two more FUEs after this one—assuming you're okay with doing the whole process again, of course. 👍

David Young58 said:Hello to everyone here who might find value in reading my account of the hair transplant process. I’m planning to use each subsequent post to share some practical details about what I’ve actually gone through—the hurdles I faced, the things that were genuinely difficult to deal with, and perhaps even some useful insights along the way. I also intend to post regular photos to document the regrowth, just so anyone interested can follow along and see how the entire process unfolds over time.

I’ve decided that I’m going to have my hair transplant procedure done over in Switzerland, specifically in the San Francisco area within a little spot called Staten Island, which sits just a stone's throw away from the main hub of San Francisco itself. The whole operation is being handled by the team over at the Mayo Clinic, led by Dr. Sever Muresanu.

The surgery is scheduled for June 16th and 17th, 2021, which means it’s only a few days away now. The plan is to transplant roughly 5,000 follicular units—or grafts, if we’re using the usual slang. I suppose it will be quite interesting to see just how accurate the doctor's estimate actually turns out to be; I'll be watching to see if they hit that 5,000 mark, or if it ends up being slightly less or perhaps a bit more, though I'm certainly not complaining if it goes over.

The procedure itself is split into two distinct stages, spanning over two separate days. I suppose the plan is to distribute the workload fairly evenly, so they should be transplanting roughly the same number of grafts during each session.

The procedure is slated to be performed using the FUT technique—follicular unit transplantation, or what some call the strip method—which essentially targets a relatively small area. I suppose it’s worth noting that FUT is inherently more invasive than FUE. While FUE has pretty much become the industry standard in the US hair transplant market, FUT leaves behind a visible linear scar that stretches from the left ear, all the way across the back of the head, to the right ear. Now, FUE isn't exactly scar-free, as it still leaves tiny micro-scars, but they are significantly smaller. This gives someone who chooses FUE a bit more freedom with their hairstyle, even allowing for those very short, buzzed looks. On the other hand, if you decide to go the FUT route, you probably need to keep your hair a little longer around the scarred area just so the surrounding hair can mask it from view. That said, provided the FUT procedure is handled by top-tier professionals at a high-quality clinic, the resulting scar tends to be practically unnoticeable once you've healed—assuming, of course, you don't opt for an extremely short haircut.

I suppose one could argue that the primary advantage of the FUT method lies in its ability to maximize the number of grafts harvested from a relatively small area; it seems quite possible to extract significantly more grafts through FUT than what you could ever hope to achieve with FUE alone. Furthermore, since the FUT procedure only requires a minimal donor site, the density of the hair in all other areas remains largely untouched, which I guess means there is still enough coverage left to allow for subsequent procedures down the road, whether you eventually decide on FUT or FUE.
At 32 years old, staring down a Norwood 5 classification on the Hamilton-Norwood scale, I’ve reached a bit of a crossroads. After spending several years overthinking this, weighing my options, and trying to find a solution that actually makes sense, I have finally decided to go through with a FUT procedure. It wasn't some impulsive whim or a snap decision made on a whim. Honestly, it took me an incredibly long time to settle on one path and decide whether FUT or FUE would be the more logical choice for my specific situation.

Given that the surgical plan calls for roughly 5,000 grafts, I suppose you could reasonably characterize the entire procedure as a mega-session.

I’ve had four separate Skype consultations with Dr. Sever Muresanu so far, and through those discussions, we've eventually settled on our primary objective;

Constructing a completely new hairline.
What’s the best way to go about thickening up that first third of my hairline? I'm looking at ways to add some density to the front area, specifically that top section.
3. Use whatever grafts we have left to fill in the midscalp and crown areas.

While all these steps have been agreed upon in theory, I suppose the actual approach and the specific roadmap for my treatment won't be fully settled until I sit down for my in-person consultation on June 15th.
I should probably mention again that, much like a significant percentage of people, I would consider a successful operation to be one that reconstructs about one-third of my scalp, provided the rest of the areas are sufficiently filled in so that I can apply hair fibers or thickeners. Honestly, I wouldn't have any real issues with that, as I am quite aware of the actual limitations of hair transplantation and I don't harbor any unrealistic expectations. I am certainly open to undergoing another procedure down the road if necessary.
I am currently 32 years old. I first noticed the initial signs of thinning in my mid-twenties while I was in college. I don't really intend to use this thread to dwell on the emotional experiences that most people—who, let's face it, come to these forums to exchange opinions—have endured. It is enough to say that I have been losing hair for over 12 years now. I’ve already touched upon some of the more personal, emotional details in a separate communal thread regarding male pattern baldness.
My intention here is to document the entire process: from the initial reasoning behind why I chose the Mayo Clinic, through the actual surgical transplant, to the photos and testimonials documenting everything that happens during the recovery period over the following months—from month 1 through month 12 post-op.

For years, I agonized over whether I should even bother with a transplant. I suppose the turning point came when I hit 25 and realized just how progressively my hair loss was going to advance in the near future. For a long time, I relied on hair fibers to thicken the areas where the thinning was most pronounced, particularly around the Hairline and the crown. Once it became clear that the loss wasn't stopping, I considered a more drastic move—buying a hairpiece, a toupee, a hair system, or whatever you want to call it. After I started wearing a piece, I began scouring the internet for reviews, looking at both the glowing testimonials and the cautionary tales found on various forums. I reached out to clinics in England, Belgium, and Turkey. I did wonder whether I should be contacting prestigious clinics in North America, but I ultimately decided that such an undertaking would likely be beyond my reach.

In November 2020, I established contact with the Mayo Clinic. My initial communication was via email with a Ms. Carmen, and over the following weeks, I got to know Dr. Sever through several Skype consultations. I should note that I spoke with Dr. Sever no fewer than four times—three times in the months leading up to the procedure, and a fourth time just a couple of days before the surgery itself.
I found Dr. Sever to be quite impressive during our Skype calls, mainly because he is kind enough to communicate extensively with potential patients before a single cent has even been transferred to the clinic's account. To reiterate—the doctor was willing to speak with me three times without any financial commitment on my part, which I suspect isn't common practice among the big names in the industry (though, I suppose, I could be wrong).
During our discussions, I spoke with him about my family's history of hair loss, my own specific desires and anxieties, and what I consider to be the most critical elements of the upcoming transplant, such as the Hairline and the crown.
Since I concluded that the FUT technique was the best option for my specific situation, and that the Mayo Clinic was the premier institution to handle it, I made the decision to travel to Switzerland to place my hopes and expectations in the hands of Dr. Sever Muresanu.

Dr. Muresanu is featured on the prestigious IAHRS list, and he is also a member of Hairtransplant mentor.com, which is run by the world-renowned transplant patient Joe Tillman.
The Mayo Clinic also carries the flattering title of being the "European Hasson and Wong."
Moving forward, I will be posting the photos I sent to the doctor for evaluation. I hope they provide a clear picture of my current state of hair loss.

David Young58,
I've had a look at your photos.
-And for a first procedure in your case, choosing FUT is 100% the right call.
The clinic you've selected is excellent.
Good luck.

Rachel Brooks63 said:Why on earth would you choose an expensive Swiss clinic for such a <> trivial procedure, instead of some (I assume) 10 or 15 times cheaper clinic in America? Honestly, we don't even know if you're from the US, so options like clinics in Mexico or South America—where the exact same procedure might be 20 times cheaper—are even on the table, right?

Hey, Jose Miller3. Look, since I'm relatively young at 32, but I'm dealing with a high Norwood 5 stage, I decided a long time ago that I was going to shell out a serious amount of cash for HT. I'm from the US, but that’s not really the point here.
It took me a while to make up my mind, but I finally pulled the trigger on the FUT option.
I picked a top-tier clinic because I want an incredible result. Of course, there's a chance I could have done this somewhere much cheaper and gotten a very similar outcome.
But that’s just not who I am. For myself, I want the absolute best. I've been saving up for years specifically for this procedure. Believe me, I'd be just as relieved if I had only paid 4,000 or 5,000 Euros for HT. Anything that cost ten times less would have been an immediate "no" for me.

I didn't even consider local clinics, nor any in the surrounding regions, because they just don't have the reputation. That's the simple answer.

Since I'm going with FUT now, I'll probably look into FUE in the future and try to find a more budget-friendly option then.

For now, the plan is to finally get rid of these bald spots I've been carrying for years and get my life back to normal. In my opinion, you shouldn't skimp even a little bit when it comes to this kind of thing.

So, I wouldn't exactly agree that HT is a "trivial" matter.

However, the travel and lodging costs *are* trivial. I can agree with you there.
Between travel, the stay, and extra expenses, I'll end up spending about 600 Euros. I definitely wish I wasn't forced to deal with those extra costs, but it is what it is.
I'll be staying in Switzerland and Germany for 16 nights. And that's quite a long stay.

Samuel Lee8 said:David Young58,
I just took a closer look at your photos.
-and honestly, choosing FUT for your first procedure is 100% the right call in your case.
The clinic you picked is top-tier.
Good luck.

Hey Samuel Lee8. Yeah, while FUT might not be an absolute "must" for me, I really think it's the smartest move to make right now. I've been doing my homework on sites like Shapiro Medical Group (they're definitely among the best in the USA) or even checking out Maral Clinic (those old pros who deal with HTA).
They provide charts showing how a certain amount of FUT grafts can cover a Norwood 5,5000 situation pretty effectively. I actually love those visual breakdowns; they make the math so much easier to wrap your head around.
For instance, my hairpiece area is about 12.5x12.5. But once you factor in the hair that needs to extend toward the back, we're looking at closer to 12.5x15.
Usually, for a Norwood 5, people talk about needing roughly 200 square centimeters of coverage. Of course, the big question remains: how much donor hair is actually left in between?
We'll see how everything plays out soon enough. At the end of the day, there are no guarantees.

Benjamin Rodriguez6 said:Man, the surgery days are already here. Good luck, brother! 👍

I don't recall seeing photos of your donor area before, but man, if you haven't even started on Finasteride yet, you are sitting on a goldmine. Your donor site looks incredibly solid—those hairs are actually thick and strong. Honestly, once things really start moving, your results are going to be absolutely explosive.

You could easily handle another two FUE sessions after this one, provided you don't lose your mind dealing with the whole process all over again. 👍

Well, the moment has finally arrived. Honestly, I thought this was never going to happen—especially with that red list hanging over our heads like a dark cloud.
Thank God, I’m finally down to the wire—just a few more days left until this whole thing is behind me.

Yeah, looking at the photos, the donor area seems pretty solid. But let’s be real—the pictures only tell half the story. Once you actually get in there with a USB microscope, the reality hits a bit differently. Dr. Sever already pointed out that my donor density is just average, so we'll see. It's going to be interesting to find out exactly how many grafts we can actually pull from all of this.

I'll definitely get that report submitted. 😉

David Young58, good luck man, and thanks a ton for laying out your whole experience in such detail for us!

Morning, everyone. I’m coming up on my fourth full day post-HTA at the Mayo Clinic, and honestly, I’m starting to feel physically better, so I figured it was time to drop an update here.

June 15, 2021
Consultation Day

I headed over to the Mayo Clinic's new facilities (they moved in March 2021) located in the scenic little town of Staten Island. There's a direct line from San Francisco that takes about 12 or 13 minutes, plus a quick 3 or 4-minute walk from the bus stop.
The clinic is on an upper floor and features a reception desk, a waiting area, a restroom, the doctor's office, and a station for patients to wash their hair (which I didn't realize until the next day). I knocked on the door, and Dr. Sever Muresanu stepped out to meet me—the same guy I’d been Skype calling four times leading up to this.

I wasn't sure if I should expect a massive crowd, but that day, it was just the two of us. Total privacy.
After some casual small talk with Dr. Sever, we got down to business.
Using a comb with a specialized handle, he mapped out a part in the area where the skull has that specific "ridge"—you know the one, right between the ears.
His very first reaction when looking at me from behind was that he expected to see more hair than what was actually there... I was honestly stunned. I sat there in a total daze for maybe 15 or 20 seconds while he examined the parting area with his magnifying tool—basically a high-tech microscope for the scalp. I actually started panicking, thinking there was no way I could hit that 5,000 graft estimate. I was just sitting there thinking, "WTF?!" We hadn't even started, and I was already getting bad news...

Luckily, things took a much better turn pretty quickly.

After a bit of mumbling to himself, the doctor pointed out that a visual inspection, combing, or just running your fingers through your hair doesn't always reflect the microscopic reality of the follicles. Fortunately, I fell into the "good" category.😉

He told me that while my overall scalp density looks average, my follicle grouping is actually excellent.
Once he finished checking the back of my head, he moved on to the sides, checking the left side first and then the right (more combing and magnifying).
At this stage, the doctor noted that my donor area is pretty average, and the density there is slightly lower, but that’s pretty standard for most people.
He also checked my scalp laxity by doing a sort of pinching test. It wasn't "fantastic," but it was definitely very good.

Then I asked him what he thought about the hair I still have left (I posted photos above, and you can see there's still a bit of life left in the forelock and the bridge). He examined my mid-scalp and crown and confirmed that a good portion of it is undergoing miniaturization, though in some spots, it’s quite advanced.
The conclusion? "We will go through your hair." Basically, while they work on the recipient areas, they’ll be punching new holes through existing follicles. This means one part of the hair might go through a heavy shed and never grow back, but another part of the hair will stay intact and recover.
After that, the doc sketched out my new hairline. I'll dive deeper into that in my next post.

June 16, 2021
Day 1 of HTA, Phase 1.

Things kicked off just after 7:00 AM. I have to admit, I actually slept pretty well. I wasn't feeling stressed at all; instead, I had this really solid gut feeling that something good was about to happen. Honestly, my adrenaline was through the roof.

I headed down to the lower level with Dr. Sever and stepped into the operating room. It’s a serious setup—you’ve got an automated surgical bed, massive overhead lighting, and all sorts of specialized equipment. There's also this long, heavy-duty workstation in the room equipped with four different microscopes. The Hattingen Clinic uses high-end stereoscopic microscopes that allow them to perform absolute miracles when it comes to preparing the strips and dissecting grafts. Honestly, that level of precision was one of the main reasons I decided to pull the trigger and have my procedure done here.
Another thing that really blew me away was the level of expertise in the room. Their technicians aren't just some rookies; they’ve been in the game for over a decade. You can tell they’re incredibly well-trained and fully prepared for whatever task is thrown at them.

I went through the hairline design process with Dr. Sever again today. I’m really sorry, guys, but I completely failed to snap a selfie of the session. Honestly, my head was just spinning with everything we discussed; I was way too focused on thinking about the long-term outcome to worry about my phone. The hairline itself is conservative, which is exactly what I was looking for. One thing to note: Dr. Sever designs the lines to be slightly asymmetrical near the temples. He argues that chasing perfect symmetry is a mistake and actually looks fake—his approach is all about ensuring the final result looks completely natural. It’s not a new concept to me, either. Even the team over at Bisangin suggested this exact same strategy for my hairline.

I sat down with the doctor and went through a massive pile of photos—some were official scans from my medical records, while others were just stuff from my own private collection. Most of them were shots from back when my hair loss was really hitting its peak, showing exactly how much my hairline had receded and how things looked during different stages of the process.

I also showed him some shots of me wearing the Hairpiece. I included a few where the piece was sitting lower, but mostly I focused on the ones where it was positioned a bit higher up.

I pointed out exactly where I stick my hairpiece on my forelock. What really impressed me was that he actually sketched out the hairline himself before I even had a chance to show him where I wanted it.
My piece actually had this rounded shape to it, which basically meant it was covering way more area in the temple zones than where my actual natural hairline was drawn.

We actually talked about this. I told him straight up that my 3D perception is pretty much non-existent, so I asked if there was any way he could show me what it would actually look like, just so I have a rough idea.
The doctor made his move, then just buried his face in his hands like he couldn't believe what he was looking at.

He gave me a pretty good idea of how my hair is actually going to look once I've dealt with the ocean, daily showers, and swimming pools.

Then he went ahead and gave me his take on what the results would actually look like once everything dries down and the final density settles in—around a two. Honestly, that part really stuck with me in a good way.

You have to keep in mind that my original hairline was already shot years ago, so I’ve honestly forgotten what it feels like when hair actually grows properly. You know, when the hair grows at a natural angle and isn't thinning out—where it actually covers a specific area of ground. It sounds easy enough to say that it's just "logical" how things work, but in practice? It’s really not that simple...

I mean, I knew I was going to be looking at a pretty conservative hairline design, but honestly, what they laid out for me wasn't much different from just wearing a hairpiece. It was that close. Still, I decided to go ahead and accept the plan they offered—though we did make one minor adjustment regarding the distance from the glabella toward the forelock after I stepped in to clarify exactly where I had measured it myself.

Since hair growth isn't actually going to kick in for another three months, I won't really know what my final hairline looks like until about the five or six-month mark—and I won't see the full density until I hit the one-year point.

And that's when everything kicks off—the actual surgery begins.
First, you take the pills, then you lie down on the bed. They place your head through this clear frame, which—honestly? It’s easily the most uncomfortable part of the whole process. It’s not that it actually hurts, but you don't feel like you have full access to the air around you, and you're basically blind to what's happening. I ended up stuck in that position for at least 60 minutes or so. While I was lying there, the doctor mapped out the strip zone. It was roughly 13.5 cm long with a width of about 2.5 cm. (For context, the maximum they ever did at the Hattingen Clinic was 3 cm due to skin laxity!)
You also get local anesthesia. To be honest, I thought the whole process of getting numbed up was a joke. You feel a few quick stabs, and that’s about it. I honestly don't get how some guys claim this part is excruciatingly painful.

Then the team rolls in. It’s Laura Sever and the four technicians. Honestly, Laura is such a sweetheart. She made it very clear right from the start that the operating table isn't the place to try and play the hero; she told me if I feel even the slightest bit of discomfort or any kind of pain, I need to speak up immediately.
They injected some extra solutions and more anesthesia to keep things numb.

Honestly, nobody really prepares you for that exact moment when they start the cutting phase. 😉

Though, looking back, I think it’s fair. The sensation is just... weird. It’s almost like hearing someone scratching or scraping something against a cardboard or wooden surface somewhere in the distance. Obviously, there’s zero pain or discomfort involved. I didn't experience any of that "popping" sensation people talk about online. Once the strip is harvested, the stitching begins. The whole process is pretty quick. You’re fully aware that they are closing the skin back up. There’s this distinct feeling of pressure when the clamps are applied, and you feel a sort of tightness deep down, but again, no actual pain. It’s just that sensation of being "squeezed" for about a minute.

Once the strip is ready, it goes over to the technician's station. I took a few photos, so I’ll post one here. Hopefully, it isn't too gross.

https://ibb.co/g91326z

After that, you can actually watch the technicians work. They cut the strip and prep everything under microscopes for the next stage.
You can get a good look at the final product and the individual steps. I actually got to see how they group the grafts into:
sets of 1, 2, 3, and 4 hairs.

Meanwhile, Laura started making the new incision sites for the follicles. If I remember correctly, she uses a 4mm depth with a 0.8 or 0.9 punch. I can't recall the exact specs.

The rest of the procedure is a long haul. Once the grafts are prepped, they go into a solution to ensure they stay viable. Laura mentioned they could sit like that for a good part of the day, but they aim to implant them within a couple of hours. They operate on a "first come, first served" basis—basically, the first graft harvested is the first one placed in the recipient site, and so on.

Once the recipient area is all set (there's more anesthesia, obviously; the stinging sensation is maybe a 1.5 out of 5), we take a break for lunch.

At any point, you can ask for water, a trip to the restroom, or even some of the chocolates they have sitting out.

When the break is over, you head back to the chair. You can lean back comfortably; the bed setup is actually great. I wore comfy stretchy pants—basically pajamas—and bare legs, wearing one of their medical shirts.
When you're finished, you absolutely have to wear something button-down, because you cannot pull anything over your head.

The entire implantation process lasted until about 4:00 PM.
My back and neck didn't hurt at all.

I was able to check out what was happening on my scalp through a mirror. Laura showed me how the implanter works. It’s kind of like a "tattoo gun"—you press a button, and the hair pops out.

Laura personally handled my 5,500 incisions. Seriously, no one besides the doctor touched my scalp, not during the strip harvesting and not during the incisions.

Then the technicians coordinate with the doctor to get everything implanted. Here was the final count for the day:

2,700 grafts.

They told me straight away that we’d surpass 5,500 by tomorrow, and we might even hit 6,000.

At the end, I was given a solution that I need to spray at 6:00 PM, 8:00 PM, 10:00 PM, before bed, and if I wake up in the night. You spray it onto something that looks like gauze so that it gets completely soaked.
On top of that, you wear a Bandan, so you can move around the place normally.

I took a very short walk around 9:00 PM. I also have Ibuprofen and antibiotics to take. Ms. Carmen helped me via WhatsApp to set up my bed at a 45-degree angle (it helps prevent swelling—can you imagine? Hahaha).

I used a travel pillow. I actually went full BDSM on myself, tying my left leg to the bed and my right hand to the chair, surrounded by soft pillows. The doctor gave me a look when I told him tomorrow, but I just wanted to be certain I wouldn't accidentally bump into anything or scratch myself.

Miraculously, I fell asleep almost immediately since I was exhausted from the previous days. I passed out around 5:30 AM, practically in the same position. I'd say the pain level was a 1.5 out of 5. Honestly, it barely hurt at all.
Tired, but not totally wiped out, I was waiting around at 7 AM for phase 2

https://ibb.co/5FmxC83

The Bandan and how everything looks once the whole thing is finished

June 17, 2021

Day 2, Phase 2

I arrived at the clinic at the usual time. The morning routine kicked off with prep work—tablets, lying on my stomach, getting the strips ready. We tackled the left side first, then moved to the right.

Left strip = 1,700 grafts

Right strip = 1,800 grafts

Everything I mentioned in my previous post still applies to today. I spent the morning sitting up while Dr. Laura Sever handled a huge chunk of the midscalp mostly by herself. I kept my mouth shut and didn't chat too much; I didn't think it was smart to be constantly questioning things and getting in the doctor's way. She did mention, however, that she’d be placing a high concentration of three-unit and four-unit grafts in the midscalp area. To create that visual illusion—basically making the newly recreated hairline and the areas behind it look more natural—it's obvious that the hairline and midscalp need to project a higher sense of density. That makes the midscalp a critical zone.

Most of the left strip was done under Laura's direct supervision, though two technicians jumped in to assist her toward the end (I believe they were still working on the right strip simultaneously).

Break time: lunch, some Ibuprofen, and a little something to help me relax—I can't remember the name of the pill.

Back in the chair. The right strip ended up being slightly larger. Given the massive total number of grafts we were dealing with, the whole day turned out to be quite long.

I have to admit, my back started acting up, and my neck got pretty stiff, so I had to ask for a few breaks.
It took quite a while before the doctor finally moved from the midscalp over to the crown. The technicians were helping out there as well.
Once the primary plan was executed, we moved into the "stick and place" phase.

In this stage, any remaining available grafts are placed in specific spots the doctor deems necessary. Think of it as the final "touch-up" phase.

I had about 50 units left over (among other things), so they used those to slightly beef up the hairline.

Finally, once everything was wrapped up, the aftercare instructions were the same as Day 1. I was given my solution, a Bandan, and scheduled for a one-day post-op checkup.

I headed back to the hotel and went for a short walk. Sleeping was a bit harder and definitely less comfortable. I had been warned that the pain would likely be stronger than the first night, but honestly, it wasn't that bad. I’d rate it about a 2.5 out of 5 on a scale of discomfort.

The only thing is, due to the lack of sleep, the stress, the adrenaline, and just pure exhaustion, I’m feeling pretty wiped out. I'll write a separate post about that.

The following day, May 18, I showed up for my follow-up. The doctor took all the necessary photos, we washed both the donor and recipient areas, and they explained how I should behave over the coming days.

Since I had the procedure on Wednesday and Thursday, the doctor told me that the window leading up to Sunday is absolutely critical, especially regarding potential injury.

From Monday—which is today, as I'm writing this—the grafts should be fully accepted thanks to the body's internal healing processes. I've already started monitoring the recipient zone a bit more closely today.

All in all, here is the recap:

382 single grafts - 6.08% = 382 hairs
2271 double grafts - 36.19% = 4,542 hairs
3027 triple grafts - 48.24% = 9,081 hairs
594 quadruple grafts - 9.49% = 2,376 hairs

6,274 total grafts = 16,381 hairs

Average hairs per graft = 2.61

On the Hattingen Clinic website, they state their average is 2.2 hairs per graft.

What can I say?

The initial estimate of 5,000 possible FU through FUT proved to be spot on. Kudos to Dr. Sever for that. The prediction that I'd have over 5,500—maybe even up to 6,000—after the first strip also turned out to be correct. Credit to Dr. Laura for that accuracy.

The surgery was split over two days. In the end, we were talking about a "Gigasesion."
I know people will have questions about the survival rate because this is an absolutely massive amount of hair.

Laura assured me that I can be confident the survival rate will safely be above 90%.

When I asked Sever, he told me the incision width would be a maximum of 3 millimeters, if not even smaller.

I tried to dig a little deeper into the details. I've attempted to describe the FUT process below (of course, I'm just a layman like the rest of you), hoping that maybe this might help someone else out.
Listen guys, if you're considering going for an HT and you find yourself at a high Norwood stage, don't be too quick to dismiss FUT.

I'm currently waiting on some photos from Dr. Sever, which he took right after my 1-post-op day.

Also, I have my clip removal scheduled for June 30th, so that should provide some fresh photos.

I'll be posting updates here regularly, including photos at the 3, 4, 6, and 8-month marks, and so on.

I'm just hoping the HT turns out well. I'm not looking for absolute perfection.

According to their plan, the density will break down like this:

50+ for the hairline
30+ for the midscalp (covering most of areas 3 and 4)
Around 30 for the crown

I don't have the typical presentation you see all over the internet. I'll have to ask the doctor to measure the exact area covered by the HT. Based on my own measurements, it was definitely around 180 cm², but looking at it visually now, it seems like some additional areas are included, so we could easily be looking at 200 cm²+ total.
A simple calculation of 6000+/200+ gives me a clear idea of the graft density per square centimeter.

I have to admit, after finishing my HTA, I was pretty wiped out. If I recall correctly, the last testimonials regarding HTA on this forum were probably back in 2017.

That post-op feeling is actually quite interesting. I went through a phase of total disproportion.
One minute you’re in that "happy phase"—thinking the solution is finally within reach, moving from live consultations to the actual surgery itself...

And then, strangely enough, I hit a bit of a low. I remember walking around San Francisco the evening after the second part of the procedure (once the HTA was wrapped up) and just feeling depressed, dissatisfied, or whatever you want to call it...

The most common thoughts that kick in are: Was all of this even worth it? How is it going to look? Did they do it right? What about the Hairline? And so on.

I had that exact feeling on my first day post-op when I went in for my check-up and hair wash. I was given a post-op kit—nothing massive, but it doesn't need to be—along with instructions on how to behave and, more importantly, how to maintain hygiene.

On that first day post-op, I arrived in a small town near Columbus, close to Blumberg.

If anyone needs a very affordable place with an awesome host, I can highly recommend Phillip. He’s a great guy; he’s already driven me to the store for groceries twice and helps me out with just about everything I need.

By that first day post-op, the swelling in my forehead had already started to take hold.
When you start swelling up while also dealing with those intrusive, negative thoughts... it isn't exactly pleasant.

Luckily, I managed to shake off those useless thoughts and that mental funk by the next day. I’d say that period of insecurity was very brief, maybe a day and a half at most.

But by the morning of day two post-op, something even worse was waiting for me.

When I woke up, I felt incredibly strange, right on the edge of having a fever or the flu, or something like that.
Obviously, you aren't burning up, but that increased blood flow in your head is something you just can't prepare for.
I realized something wasn't right with my head, and visually, things were looking pretty rough.
When I looked in the mirror, I really had something to see.
My head had basically taken on rhomboid dimensions.
Aside from a heavily swollen forehead, the swelling had migrated down to my eyes, so my cheeks were completely puffed out from the eyes toward my ears. I looked like a diamond.
Thankfully, the swelling didn't continue its journey down under my eyes.

Roughly...

https://ibb.co/R6WP77N

https://ibb.co/6wPv6w2

Given that I underwent a gigasection just two days ago, it’s not surprising. But it was very, very uncomfortable.

Day two post-op was the most physically demanding for me. In terms of pure discomfort, it felt worse than day one and two of the HTA.

Fortunately, all that shit is slowly passing.

By the third day, the swelling had decreased significantly.

By the fourth day, my cheeks looked okay, and the forehead swelling was much less intense.

By day five, I was almost back to normal, and by day six—which is today, as I write this—I am completely fine.

I still feel like the skin on my forehead is a bit soft and baggy because it lacks the usual tension of normal skin, but it feels like I've cleared the worst of it.

Also, the incision in the donor area doesn't have that thick swelling it had on days two and three. I still feel plenty of tightness around the cut, but those should vanish in about seven days. Plus, I'm not taking ibuprofen anymore.

Currently, my post-op care involves gently massaging the recipient zone with the shampoo I was given starting from day three, while using stronger, circular motions on the donor area. It hurts a little, but nothing major.

Throughout the entire recovery, I've been eating normally, though I'm avoiding overexerting myself.

Starting tomorrow, which is day seven post-op, I plan to start wearing a hat and taking short walks around the neighborhood.

P.S. Luckily, I don't have that itchy sensation I was so worried about.

Every now and then, I get some tingling or a slight itch, but fortunately, it passes very quickly. This happens in both the donor and recipient zones.

Day six looks good to me. My mood is in a good place. Our boys are still holding strong at 1/8. That's where things stand for now.

A little update for you guys, including some higher-quality shots

My hair loss situation right before the surgery, taken on the morning of June 16th

https://ibb.co/CwM50TQ
https://ibb.co/0ZLmMbs
https://ibb.co/PGvwtqv

1 day post-op. Just finished washing my hair

https://ibb.co/XLDx0hn
https://ibb.co/KVHyVfZ
https://ibb.co/KhjWgWx

The Donor Area

https://ibb.co/Jcnh5s2

https://ibb.co/h1BwLdb

https://ibb.co/0Fp7NL7

The next round of photos will be on June 30th, once I finally get these battery terminals off.

There’s a very good chance I’ll end up selling some parts right after that, too.

I have to admit, having a brand-new hairline feels incredibly surreal.
If you look back at my previous photos, you can see that weird strip of pale skin that hasn't seen any sun exposure yet—that’s exactly where my hairpiece used to sit.
It’s pretty obvious right now that the new hairline doesn't perfectly align with the old hairpiece; it’s sitting a bit higher up.
That said, I'm really hoping that once things start growing in, everything will level out and look more natural. If that happens, I’ll consider this whole AT&T procedure a total win.
When I wash my hair and check the new hairline while it's still wet, it actually looks like it blends in perfectly with what I already have.

I sent my latest progress shots over to the doctor today, and he assured me that everything is looking exactly as it should.

Starting tomorrow—which marks day 8 post-op—I’m moving up to washing my hair once a day. I should be able to use a bit more pressure when massaging the recipient area to help break up those scabs.

It’s such a strange, interesting sensation to finally touch my scalp again, especially that crown area I lost so many years ago. Now, it's back.

Of course, I'm just working within the limits of what could actually be covered.

Recovery is moving along nicely so far. Next stop: getting these clips removed and heading in for the post-op checkup.

David Young58 said:I suppose I have to admit that having a brand new hairline feels somewhat surreal.
If you look at my previous photos, you might notice that pale strip of skin that hasn't seen any sun exposure; that was the area where my hairpiece used to sit.
It’s fairly obvious that this new hairline doesn't perfectly align with where the hairpiece used to be—it's positioned a bit higher up.
Still, I'm hopeful that once things start growing in, everything will settle into a more natural state. If that happens, I’ll consider AT&T to have been a complete success.
When I wash my hair and check the new hairline while it's still wet, it actually seems to blend quite seamlessly with what I already have.

I sent the latest photos over to the doctor today, and he assured me that everything appears to be progressing exactly as it should.

Starting tomorrow—which marks day 8 post-op—I’ll be moving down to washing just once a day. I'm supposed to use a bit more pressure when massaging the area to gradually work away those scabs.

There is a strange, almost nostalgic sensation in being able to touch my scalp again, specifically that crown area I lost so many years ago, only to find it back now.

Of course, this is all within the limits of what could realistically be covered.

Recovery seems to be moving along well enough so far. Next up is getting the clips removed and heading in for the post-op checkup.

David Young58, everything looks incredibly clean and well-executed. I have to admit, I'm feeling a little envious. 😁

As for what you mentioned about the new hairline not matching the old hairpiece placement, I don't think that's much of an issue.
-Down the road, it might be a good idea to let your hair grow out a bit longer (maybe 2 to 2.5 inches) across the whole scalp.
That way, you get a better sense of density and can achieve a lower hairline look.

The only thing is, you're headed into what is arguably the toughest stretch, lasting just over three months.
-That is, until the transplanted hair sheds and the new growth actually begins.
Shock loss is always a possibility.
It’ll probably feel like the longest three months of your life.

You might be able to speed things up slightly if you decide to use a Minoxidil solution.

If you're up for it, it would be great if you could post updates at the 3, 4, 6, and 12-month marks.

Samuel Lee8 said:David Young58, everything looks really great—clean, professional, and well-executed. I’m feeling a little anxious, though. 😁

Regarding what you said about the new hairline not perfectly matching where the hairpiece used to sit, I honestly don't think that's much of an issue.
-In the future, it would probably be a good move to grow your hair out a bit longer (maybe 2 inches) all over.
That way, you get better density and a lower hairline look.

The only thing is, you're heading into the toughest stretch now, which is going to last just over three months.
-That's until the transplanted hair sheds and the new stuff starts growing in.
Shock loss is definitely on the table.
Those three months are going to feel like the longest of your life.

You might be able to speed things up slightly if you start using some Minoxidil solution.

If you can manage to post photos of how things look at the 3, 4, 6, and 12-month marks, that would be awesome.

Hey there, man.

I agree with you—it shouldn't be a problem that the hairline doesn't follow the exact same line as the old hairpiece.

But honestly, it's incredibly close. What I really love about this hairline is that there isn't a harsh transition moving toward the temples.

In my opinion, the hairline was placed exactly where it should be.

A few major highlights:

1. A soft transition with no weirdly protruding or obvious receding corners (granted, the forehead is a bit higher).
2. The density at the hairline is insanely good—about 65cm2.
3. By positioning it slightly differently, I saved a massive amount of grafts for the other areas.
4. Having slightly longer hair and a 3D pattern suggests I'll end up in the same or even better shape than I had with the hairpiece (not to mention how much more natural it looks).

The hairline is a total graft-hog; it’s incredible.

North and Laura told me that to get a real hairline and drop it down by about half an inch, you need to prep around 1,000 grafts.
More or less, everyone should be aiming for those kinds of units. Just putting it out there in case anyone needs the info, though most of you probably already know.

I ended up with just over 350 individual grafts, which is technically below average. Even so, my graft count provided so much satisfaction in the end. Luckily, these guys are skilled enough to harvest grafts with such precision that it's nothing short of amazing.

I'm planning on keeping my hair a bit longer. But I have to be smart about this and try to navigate the transition from the hairpiece to my new permanent style smoothly.

Man, that hairpiece was heavy... seriously indescribable.
I'm fully aware of the next three months ahead. On one hand, I'm glad I'll be halfway through my post-op recovery in Germany by then. It's not a huge chunk of time, but any progress helps.

If anyone has suggestions for night shifts in the States, or anything involving working with smaller teams, hit me up.

Of course, I plan on posting photos so everyone else can see the progress—to see if it all made sense and whether the final result is crappy, good, solid, or absolutely fantastic.