This 28 year old patient received a total of 4086 grafts in three sessions over a six year period. The patient began his hair replacement journey six years earlier at the age of 22 when he presented with progressive thinning in the frontal and crown regions. He was on finasteride at that time and felt that it was helping to control his hair loss process. An initial session of 1800 grafts was performed to enhance density in the frontal hairline and temporal recessions. Over the following years he showed progressive miniaturization despite continuous stabilization with DHT inhibitors. He was bothered by the progression thinning density and underwent two additional fill-in sessions at two year intervals to keep pace with his thinning. An additional 2286 grafts were place over that time span to enhance his lost density. The staged restoration approach has resulted in a near complete replacement his frontotemporal hair.