AB2000

I haven't seen recent patients like that, but I do recall walking behind a man in a terminal who had a shaved head revealing the signature smiley face FUT scar.  I didn't have the heart to bring it up with him in conversation.

On 7/12/2023 at 7:47 PM, Imotski said:

Can somebody translate pls?

Do you use Chrome?

12 hours ago, Noble001 said:

Secondly, I still haven’t seen growth in the transplanted grafts and also there are visible scaring in the transplanted area.

 

Most of the transplanted grafts will not immediately grow.  A small percentage will, but don't expect much to do this.  What happens is that during the surgery and immediate recovery the root of the graft gets anchored under the skin, receives blood and continues to live in the new location.  From the shock of the surgery, the root goes dormant for a number of months, with growth usually occurring between the 3 and 12 month mark.  In my experience the hair follicle part of the graft, not the root under the skin but the hair coming out of it, these start to fall out around day 7 after the surgery, and some might be still hanging on by day 21.  They are not growing since the root is in the dormant phase.  Gentle hair washing should help the hair follicle parts fall out.

That's where the Matrix plugs into his head.

Good to know for future patients.

2 hours ago, SLA said:

This is really unbelievable, @Gatsby. They way you style the hair, there is not an ounce of hair loss that can be detected.

They may start calling you up to do hair commercials soon.

 

He's not only the Hair Club President ...

15 hours ago, Gatsby said:

.

Flock of Seagulls!

7 hours ago, wprevil said:

Theres no argument. But with all due respect, I shouldn't have to repeat myself about not being able to take meds due to my medical issue after posting it. Then insisting its still a good idea to, defeats the purpose of my health.

Finasteride is not for everyone.  For example, I had chest hairs put into my hairline.  If I took Fin, which causes body hair to fall out, then my HT wouldn't have worked.  So there are circumstances where it's not going to be part of the plan for the patient.  Dr. Pittella is a surgeon who plans his designs as if the patient has no plans to be on Fin, whereas different ones might expect you to go onto it to not lose more native hair and alter the long term appearance.

Hopefully you are aware of what your "end destination" Norwood level is projected to be, if you were to take zero meds.  Then have your HT doc work as if you were at that future level of baldness.

Having a hair transplant will in no way stop balding hair from continuing on their trip to the Norwood Reaper.

We've seen bad results where patients get a lot planted in the frontal third, but then some years later, after their balding pattern continues, be left with strange looking clumps of transplanted hair with a large gap behind it from the newly opened real estate.

1 hour ago, WreckedOne said:

Honestly, it doesn't sound tough to stop with HT, I had enough of it trust me, but I'm in the middle - I'm not bald, but I don't have hair too, and it's constantly visible I did something. So I have to do something to just get out of that situation, either somewhat fix it with the last HT,

How are you going to prevent LPP from flaring up and destroying your next hair transplant?  Because the condition is an autoimmune disease, meaning it does not get cured and can recur with any future HT.

On 10/31/2023 at 7:49 AM, DarkJester said:

No worries. Thanks for the feedback.

They have given a guarantee certificate but it only kicks in after 12 months. So let's see. If its not as good as I except it to be then I'll take it up with clinic.

 

Either way, whatever they have transplanted, it would be better than what I had before lol

What is concerning is that 5,000 grafts were removed but only a fraction made it back onto your balding area. If that's the case then you are worse off because there would be less donor available for a repair job.

Pain is subjective, so that is hard to answer.  But of the different areas I've had numbed for removing grafts - the scalp, beard, chest, arms - the worst by far was numbing the beard.

40 minutes ago, BeHappy said:

I didn't want to shave my head and then have all the scars and work showing for months while being required to work where I'm in close surroundings with hundreds of people every day.

The problem is not that the beard and chest grafts aren't growing. They are growing very well. The problem is that I am still losing hair

In your case, with the hair growing out sparsely you might not need to have the head shaved for a procedure?

Also, do you know why your hair loss is continuing into the safe zone?  Have you been checked for LPP?  If you are suffering scalp inflammation that would be something to address to stop further loss.  If you continue losing more then your scars are going to become visible as if you had your head shaved for a FUE.

If I'm following the thread correctly your last two procedures with Dorin have each been about 500 grafts, which were a combo of beard and body hair, @BeHappy?  Since these have been small surgeries have you been able to figure out how effective these have been?  90% survival, 100%?

Your problem, other than a shortage of donor, is all the scalp scarring.  A surgeon might have good technique, but if your body is working against you by not allowing hair to grow out through the scar tissue, then more transplantation won't help as much, so hopefully you can find out if it's a problem or not going forward.

I'd suggest giving Dr. Umar a try, with a similar sized test procedure.  He is probably one of the top specialists for body hair.  The surgical tool has been designed to use difficult hair types, including those from below the head.  The arm hair he used to put into the nape of my neck worked out great.  There wasn't the problem you described where the donor skin was falling apart from the extraction process.

Another reason to see what he can do is that a lot of his surgical work includes men with Acne Keloidalis Nuchae (AKN).  If you look at his youtube videos you can see a number of examples.  It's a type of skin disorder where little hair grows out of and once he removes/minimizes it, he's also been able to get hair transplanted into the area, so he might have a good idea on how to work around your scalp reduction scars.

I think I forwarded you this link before, BeHappy, the NW7 patient was able to get coverage with little scalp hair involved.  A result like this, when combined with moderate FUE or some toppik would cover your scarring, leaving just the denuded beard and the little white dots being visible.  This was about 10k grafts over three surgeries:

I'd have to go back and check when I get a chance, but I think I had a Bactine wound healing spray from a Walgreens for the early post op care.  The distilled water was for moisturizing and was applied periodically but not in the middle of the night.

12 hours ago, jjalay said:

No smoke, no sweating for the first 4 weeks at least. Use a baby shampoo for the first 2-3 months, no scratch for the first 4 weeks.

That's another point, it's good to have baby shampoo ahead of time.  The protocol I was given post surgery was to avoid running water the first couple of days, and use a spray bottle to keep the scalp moist.  The transition was a couple of days of pouring just a couple of cups on the head, and when starting showering about five days out, just a gentle setting on the shower head.

The scabs shouldn't be peeled off.  They can be massaged with fingers under running water, and they'll come off on their own.  In my case I believe I was told they shouldn't be coming off the first week after the surgery.  On the other hand, if the scabs from the transplanted hairs are still there a couple of weeks out that can be bad for the HT outcome as well.

The place you go to should have written instructions for you to follow.

My first FUE procedure took place over four days.  I had no idea that I needed to buy my own pain killer after the surgery, and when I was driving across half the country the pain really kicked in, and I had trouble sleeping the first night after.  A fair amount of numbing injections were used and these don't deplete from the body immediately so my face was swollen up quite a bit too.  What's funny is that subsequent surgeries I bounced back much easier, as if the body knew how to recover easier.

If it's your first time going into this, I've read that either best to either fly back home relatively soon, or give yourself a few days afterwards to recover at a hotel near the site of surgery.  Grafts going into the crown probably mean using a neck pillow so it might also help getting used to sleeping with one if that's the case.

You've barely touched your beard as a source.  If it is within your means, save up and consider going to Eugenix some years down the line.  I agree with the above.  You are a high Norwood and there is only so much you can achieve if the number of grafts you've had.  Putting many in the crown means less up front where you are lacking.  Also, going to a top tier surgeon can also optimize the outcome for high NW.

8 hours ago, Gatsby said:

Coming very soon. 🙏😉

You believe you can drop into a hair clinic on a lark and get a good hair transplant?  Wouldn't reliable surgeons have a longer waiting list?

On 10/1/2023 at 3:35 AM, Gatsby said:

He definitely should have picked up on the LLP. I don't know what his policy is on unhappy customers as you were definitely not a candidate at the time. For what it's worth you could look at surgeons like Dr Bisanga and Dr Sethi on their thoughts moving forward. Fifty per cent of my transplant is beard so you may not be out of the game yet.

At the time of my last surgery there in 2020 the clinic was not screening patients ahead for LPP, or alopecia scarring.  This autoimmune disease acts in a way that the inflammation leads to sub dermal scars which will kill off hairs in a non male hair loss pattern.  From reading the forum over the years it does not appear at all common for HT candidates to pre-emptively get tested before going for surgery.  One of the reasons might be that LPP is rare in men.  It usually happens to women, so many doctors would not be looking at it as a cause for hair loss in the guys asking for service.  It would be interesting to know if LPP is picking up in men in recent times.

When I did an in person follow up for photos in 2022, Dr. Umar said he had begun screening new patients for it.  Too late for the OP, but a good practice for other doctors to start following.  He took two biopsies when I was there and it was found in me as well.  When I've done hair transplantation I've found that my scalp remains red for months, as it appears it did for WreckedOne as well in his follow up photos above (eg. 11 months post op first procedure).  All this time spent in inflammation causes a lower yield.  Prior to my visit in 2022 I had done some hair dying with a Just For Men product, and by the time I went there I could notice some low level stinging in my scalp.  I believe this is what triggered my LPP outbreak at that particular time.  I've probably had it in the months after each of my surgeries earlier, as well.

My treatment was to go on oral antibiotics for half a year, apply a prescription ointment onto my scalp, and yes, I've used Umar's Gashee products - scalp oil and the botanical supplement capsules.

Umar's point during out conversation is that LPP might be the cause of why some hair transplants don't work out when they should, based on proper procedure and skill set.  I think WreckedOne risks the same thing happening with whoever he does further repair work with.  Autoimmune diseases do not go away and he brings it to the next surgeon.  If he wants to succeed he: 1) needs to verify the LPP is dormant with a dermatologist who specializes in scalp conditions and 2) have a follow up plan for post surgery where he is on the meds to get the surgery triggered LPP to stop much sooner.

I've always thought that for elective cosmetic surgery that the patient needs to bring a minimum threshold of mental health and centeredness before proceeding.  It is not fair to the surgeon and his staff if they have to deal with someone irrational and questioning this late in the process.  Even when the surgery and results go as they should, such candidates can continue to agonize of their choice and have regrets.

Did the examination with the dermatologists include scalp biopsies to see if Scarring Alopecia is occurring?  From your description it might be sub dermal inflammation.

57 minutes ago, Med said:

Thanks for the reply. If I go with Pittella, I will just need to negotiate the hairline with him. I have noticed in his recent work he tends to taper the hairline to a midline point. I am hoping for more of a rounded forelock area. I am sure he could accommodate my request?

 

Whoever you do wind up going with please do share your results here down the line.

I went back to see your earlier posting.  The problem with the blood flow and needing to go on thinners makes sense why the H&W surgery didn't turn out for you.  I assume you have it under control since then?

Your shaved head look with the ink works much better than SMP alone.  Getting more real hair in there would improve the illusion of coverage.

By body hair were you talking about from the chest and arms?  Or beard?  Your pics didn't show how much beard hairs you have growing, but if you have them, then it's a better idea to use that up first before going to chest.

The last time I went to Dr. Umar was in 2020.  He's been improving his automated punch over the years and it works well for safely extracting body hairs.  These ones grow out at a sharp angle so this punch was designed to work for this graft type in addition to regular head donor.

There should be good options these days compared to when you first started.

This is what Dr. Pittella did with a similar patient using 12k grafts.  He does large sessions, and it looks like he did this surgery over three days: