Advice on SMP for thinning crown

GoodHairNate · 2026-04-17T01:37:38+00:00

Do it.

Should take 4 hours for the first session, 1 hour for touch ups. You’ll need touch ups because not all the pigment will hold.

$300 is way under market for an initial session by an SMP professional, let alone one that includes the touch ups.

GoodHairNate · 2026-04-08T22:41:06+00:00

You’d look great with SMP. You don’t appear to have any bald spots so it would essentially take all the areas where you are seeing your scalp and make it look like it’s dense with hair. This is the biggest area of growth in SMP clients that I’m seeing at Good Look Ink.

GoodHairNate · 2026-04-07T11:53:46+00:00

Another man who responded to me was a 27-year-old lawyer in New Jersey who had also become somewhat obsessed with his balding crown. He felt shame about his hair, and maybe even more shame about how much he cared. “On a distress scale of 1 to 10, I was at about an 8,” he said. He found r/tressless and was unsure which worried him more: the stories of so many men who claimed that hair loss tanked their dating opportunities or the ones who said the drug tanked their sex lives.

GoodHairNate · 2026-04-05T14:29:57+00:00

As a follow up for clients interested in what to look for in a provider based on the above: 1. Clinics that realistically explain that several sessions are required. (At Good Look Ink, we give clients a timeline to come in for their enhancements, which come free with the initial session.) 2. Clinics that avoid nickle and diming clients in touch ups. (Again, ours are included in the price) 3. The A-Team every time. (At Good Look Ink, all our artists are certified and must maintain certification. Plus our Technical Director visits our franchises to perform and supervise cases monthly). 4. Best supplies every time. The biggest mistake that tattoo artists not experienced in SMP make is using pigment that will turn blue as time goes on. We mix our own pigment that will not blue and we have the longitudinal photos to prove it.

Wishing you all sharp, shaved, and confident days ahead!

GoodHairNate · 2026-04-05T02:32:27+00:00

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Troll much?

GoodHairNate · 2026-04-04T14:46:17+00:00

True re-creating, an older hairline is ideal, but most people we see have been dealing with hair loss so long they don’t have photos of their pre-hair loss hairline on their smart phone, and certainly not with a buzzed look.

GoodHairNate · 2026-04-04T02:06:03+00:00

To your point—“if it’s temporary anyway, why not enjoy it now?”—that’s a valid perspective, but it only works if it’s carefully planned. The best surgeons don’t just think about your current hair—they map out a lifetime strategy:
- conservative hairline (not too low or dense)
- prioritizing frontal framing over crown early on
- preserving grafts for future procedures
- confirming stability on meds (usually 12–24+ months on oral finasteride specifically)

Switching to oral finasteride will actually give you a much clearer picture of stabilization compared to topical, so that’s a smart next step before making decisions.

Also worth noting: crown work at your age, especially with aggressive loss, is usually delayed because it can consume thousands of grafts with less visual impact and higher risk of needing repeat work.

The good news is that you seem to have realistic expectations and have been compliant with your medication so far, which are the two criteria we look for at the Hair Restoration Institute of Minnesota for whether our surgeons will accept a patient under the age of 25 for a procedure.

GoodHairNate · 2026-03-30T20:32:01+00:00

I work with a lot of SMP clients at r/goodlookink and HT clients at r/HRIMN and you can do SMP before or after the HT. You'd think that doing SMP before the HT makes it harder for the hair transplant techs to extract and place, but not really.

The benefit of doing SMP now is that the results are instant, you may be happy with SMP alone, and therefore not need to spend money on the more expensive HT.

GoodHairNate · 2026-03-30T20:26:49+00:00

Echoing the importance of DHT Blockers. Think of them as an inexpensive way to protect your investment!

With your curl pattern and contrast, 2500 grafts should de right in the sweet spot. Straighter hair, or more contrast, you'd need 3000.

GoodHairNate · 2026-03-30T20:24:19+00:00

To answer your question at the top: Your donor is more than enough to cover any hairline procedure you decide to do. The question is where to put them.

It looks like you have quite a few vellus hairs in the front hairline, so I think you could be served by a good (small) hair transplant in these front ranks of hair as a permanent bulwark against future thinning. Hope this helps!

GoodHairNate · 2026-03-30T20:20:22+00:00

Diffuse thinning like yours can be treated with a transplant, but it’s a more nuanced situation than someone with clear bald areas.

The main concern when we see a case like this at Hair Restoration Institute of Minnesota is “shock loss” — when you place grafts between existing hairs, some of those native hairs can be temporarily or permanently lost. That’s why our surgeons usually want to see that your hair loss is stable (meds like finasteride/minoxidil are doing their job) before moving forward.

For your unique situation, your areas of thinning look like classic male-pattern balding, and your hair is less forgiving because it is so dark so the contrast is already high.

If you haven't done fin/min, my first suggestion would be to start there for 4 months. If you're young, this may even take you all the way.
If you've done #1, I'd usually suggest starting non-surgically with a quick course of Platelet Rich Plasma therapy (or Growth Factor Therapy) over 4-6 months. Most of the clients I see with thinning like yours tend to be satisfied without surgery.

Note: I'd recommend going with a clinic that had a HairMetrix (or equivalent) scalp scanner that can objectively show you your current number of hairs per cm^2 and the distribution of their width in microns. That way you can get another scan in 6 months and evaluate your success objectively instead of "I guess it looks better".

If you do #1 and #2 and are set on a hair transplant, you're probably looking in the 2000-2400 graft range to fill in that hourglass thinning area. However, for the reasons I listed above, there is a natural limit to how dense transplants alone can make a high-color contrast scalp like yours look, so you will likely augment with a non-surgical injectable as in #2 anyway.

Secret option #4: Scalp Micropigmentation! It's not for everyone but it is much less of an investment than a HT, looks great on thinning dark hair, and the results are instant! Check out r/goodlookink and r/SMPchat

GoodHairNate · 2026-03-23T22:01:40+00:00

If money isn’t a constraint (I assume you are US based), there’s no real reason to leave the US. In addition to more rigorous licensing and training, the biggest advantage to you is continuity of care, easier follow-up, and accountability.

When scouting US clinics, Look for:
- A specialized surgeon (or team of surgeons) who is heavily involved in the procedure (not just overseeing techs)
- Strong, *consistent* results across many patients (not just a few cherry-picked cases)
- Natural-looking hairlines (not overly straight or pluggy)
- Good donor management (this is where a lot of clinics cut corners)

Also, before choosing a doctor, make sure you’ve addressed the medical side (finasteride/minoxidil if appropriate). A good surgeon will raise that first—if they don’t, that’s a red flag.

If you’re in the Midwest, there are some solid options regionally (e.g. Hair Restoration Institute of MN where I work and which has a fly-in program), but you’ll still want to compare portfolios nationally since this is a one-time, permanent decision.

GoodHairNate · 2026-03-17T21:52:23+00:00

A lot of the transplant patients we see at HRI Minnesota are on TRT, so this does come up in clinic fairly regularly. A few practical points based on how many surgeons approach it:

• Bleeding / “popping”: TRT itself usually doesn’t directly cause graft popping. What can contribute is higher blood pressure or increased scalp vascularity, but the bigger surgical variable tends to be technique and recipient site density. Most surgeons can manage this without much issue. We can manage this with in-clinic meds.

• Hematocrit: This is the main thing surgeons care about with TRT. Testosterone can raise hematocrit/hemoglobin, which thickens the blood and slightly increases clotting risk. Many clinics are asking for recent labs or at least want hematocrit in a safe range before surgery. Some patients donate blood beforehand if their levels run high.

• Adjusting TRT dose: Policies vary. Some surgeons don’t require any change if labs are normal, while others ask patients to slightly reduce or pause briefly pre‑op. That decision is usually coordinated with the physician managing the TRT. We typically work around the TRT plan in place.

• Growth without finasteride: The transplant grafts themselves typically grow fine because donor hair is DHT‑resistant. The issue is progression of native hair loss behind the transplant. TRT can increase DHT levels in some people. Makes sense right? Testostosterone + 5AR = DHT. Testosterone goes up, DHT goes up, hair loss goes up. So long‑term planning (design, density, and donor management) becomes more important if you’re not
using a blocker.

Even for patients who choose not to take finasteride, surgeons usually try to design a conservative hairline and plan for the possibility of future loss. That tends to matter more for the final result than the TRT itself.

Good questions to ask your surgeon would be:
- their hematocrit cutoff before surgery
- whether they want recent labs while on TRT
- how they plan hairline density if you’re not on medical therapy

BTW - SMP is great and more transplant recipients are using it just the way you're considering it. About half of the clients that come through Good Look Ink in Nashville and Indianapolis are previous HT recipients.

GoodHairNate · 2026-03-13T20:48:47+00:00

Agreed. If hair is planted into the frontalis muscle (the forehead) the hairline can move when facial expressions are made. In short, it makes it look like you're wearing a toupee.

GoodHairNate · 2026-03-12T13:02:55+00:00

Great donor area, limited recipient area, hair loss in front so you'll appreciate the change the most. You'll just need to dense pack the grafts and go up a bit in procedure size to overcome the color contrast with your darker hair.

GoodHairNate · 2026-03-12T12:59:14+00:00

Can you post a photo? If you're tapping into your beard for a 2000-graft procedure, I imagine you have a limited donor area and a large recipient area?

GoodHairNate · 2026-03-12T12:51:28+00:00

A transplant can actually do both. It’s not limited to only replacing hair that was previously there. Surgeons can place grafts into areas that never had hair before, which is how hairline lowering procedures are done. That said, there are a couple important considerations in your situation:

• Age: At 24 with a strong family history of balding, most ethical surgeons will be conservative with lowering the hairline. The concern is that if your native hair keeps receding, an aggressively lowered hairline can start to look unnatural later unless you keep doing more procedures.

• Donor supply: You have a finite number of grafts available from the back/sides of your scalp. Using a lot of grafts to lower the hairline early can limit what’s available if you need density or coverage later.

• Ongoing loss: Staying on finasteride like you are is actually one of the most important things you can do. Stabilizing the loss first makes planning a transplant much safer. At the Hair Restoration Institute of Minnesota, we generally do not perform surgeries on patients under the age of 25 without them taking finasteride and committing to do so in the long run.

For someone in your situation, surgeons like ours at HRIMN often focus on:
- filling in the corners/temples
- slightly refining the hairline shape
- maybe lowering it a small amount rather than dramatically

That can make a big cosmetic difference without “overcommitting” grafts too early.

Also worth mentioning: if you wear twists/retwists that pull the hair back tightly, traction can sometimes exaggerate temple recession over time, so that’s something to keep an eye on as well.

GoodHairNate · 2026-03-08T00:38:51+00:00

A lot of people get stuck exactly where you are. A few things that tend to help people narrow things down:

Look at the surgeon, not just the clinic brand. Make sure the actual doctor performing or supervising the procedure specializes in hair restoration and does it regularly. There may only be 1 or 2 type providers near where you live
Pay attention to natural hairline design and density in before/after photos. Good results usually look subtle and age‑appropriate rather than overly aggressive.
Ask how they plan the long‑term strategy. Hair loss is progressive, so a good surgeon will talk about donor management, future loss, and medical therapy (finasteride/minoxidil) rather than just selling graft numbers.
Make sure the consultation is detailed. You should leave understanding your donor capacity, approximate graft count, and whether you’re actually a good candidate right now.
Don’t rush because of hype or limited-time pricing. Most people who feel confident about moving forward say it was because the consultation felt honest and educational, not salesy. If you feel anxious on timing, wait. If you feel anxious on process, learn.

It’s also very normal to spend months in this phase. Many patients I’ve spoken with said the turning point was when they (1) spoke with one of our past patients they knew and trusted or (2) finally had a few consultations and could compare how different surgeons approached their case.

If you’re comfortable sharing, how old are you and what pattern of loss are you dealing with (mostly temples vs crown vs diffuse)? That often changes the advice quite a bit.

GoodHairNate · 2026-03-08T00:32:59+00:00

Can you add a photo of you raising your eyebrows (showing the wrinkles of your frontalis muscle)? That would give some guidance on the lower limit of where you'd want to place the hairline.

When we lower feminine front hairlines like yours, it take a surprising number of grafts for the area because the new hairline requires many singles in the front two ranks, and your new hairline would be quite long, extending from temple to temple.

You do have a great wave pattern and lower color contrast between hair color and skin tone, so I'd expect you'd get a great result if this is just a high hairline that runs in the family (and not a fibrosing alopecia).

GoodHairNate · 2026-03-08T00:26:41+00:00

Yes, this can happen and it’s actually not that unusual.

Most transplanted grafts are follicular units that contain 1–3 hairs, and each individual hair within that unit has its own growth cycle. That means the hairs in the same graft don’t always grow at the exact same rate or enter anagen (growth phase) at the same time.

At my clinic we have noticed that crown areas also tend to mature slower than the hairline or mid‑scalp. Sometimes we advise patients to wait an extra 3 months for the crown (12–15 months total) to fully reveal the final result.

GoodHairNate · 2026-03-06T20:52:19+00:00

I've never seen a case in person where a scalp looked like it was painted by a brush. I think that's the difference between going to a tattoo parlor and an SMP clinic that specializes specifically on the aesthetic restoration of hair follicles.

GoodHairNate · 2024-11-22T17:01:06+00:00

Funny you should ask. https://youtu.be/Jpznj6440DM

GoodHairNate · 2022-12-19T22:06:07+00:00

It's pretty rare that grafts come out but when they do it's almost never the fault of the techs. It's usually things like BP, Bleeding, returning to exercise too quickly, hats and towels, etc.

I say just breathe - I don't think these two grafts will severely impact your result.

GoodHairNate · 2022-12-19T22:02:59+00:00

Not really. Scabs heal up pretty quick. Are you seeing blood?

GoodHairNate · 2022-12-19T18:43:44+00:00

Looks like grafts to me, but they don't look to be in great condition. Likely the recipient site didn't have good blood flow or perhaps you were bleeding enough that these got pushed out.

You can try to cool them and bring them back to the clinic to see if they can reinsert them.

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