zaxter

Thank you for your comments! True, one of the things that I think contributes to the naturalness of the hairline is that Dr. Wong planted it just behind where I still had some stray native hairs that remained in the tuft area. The scar is just barely noticeable above my ears right after I get a haircut, especially in the sunlight. Perhaps I'll try getting a scar pic right after my next trip to the barber. Melvin, I know Dr. Wong is especially a wizard when it comes to doing crown work, but at age 51, I think I'm ok with things just as they are. Having the hairline, frontal, and mid-scalp has made a remarkable change in my appearance, so yes, PeloDinero and lukeyb, I am ecstatic and totally over the moon about it! If not for this board, I probably wouldn't have considered going through with a HT, or known about the differences between doctors, so I'm very grateful. I'll continue updating through the one year mark.

Here's my 9 month photos that I sent H&W last week. One thing my photographer friend couldn't do was catch a pic of the scar...which of course is a good thing. I'm getting used to having hair again!

And to answer your question about Fin, I'm still taking 1mg/day. Although I don't feel any side effects, I did gain 20 lbs over the first few months. Whether that was caused by the med, or just my poor eating habits over the winter, I really don't know. Over the past 5 weeks I've been on a strict keto diet, which helped me to shed nearly all of that weight gain. Whether fin is helping or not is really hard to say. Most of what little native hair that remained in my balding zone was miniaturized, so maybe it thickened those up a bit, adding to the transformation. Also, I'm not noticing any hair loss. I sometimes do hair pull tests, just like a dermatologist did on my head in my early 30's to look for hair loss, and I'm not seeing any hair coming out. My plan is to stay on fin long-term.

Thank you for your comments Melvin, n00b, and hockeyman. Hockeyman, your question about my density has prompted me to tell a little about my journey. The initial pics I sent through H&W's online consult page prompted his rep to contact me saying something to the extent that they weren't sure that my density could yield enough grafts to make me a candidate for a HT. I wish I could find those pics, but to give an idea, I posted a pic below taken post-HT, to show you how my density looks with short hair in natural sunlight. I think the pic makes me look like a diffuse thinner, and not a good candidate for a HT. I then let my hair grow a little and sent his rep a video showing a comb running through my donor areas. The video made them feel much more optimistic, and his rep relayed that I appear to be a good candidate, and 4000-4500 grafts could be possible. Honestly, I felt like the video made my density look greater than it really is. I then went to an in-person consult with another coalition surgeon I was considering. He described me as (and rightfully so) a tough case, with fine hair, average to below average density, and a lot of area to cover. He also estimated that a 1.6cm wide strip would yield 2400-2600 grafts, which he would transplant from my hairline to maybe just a little behind my frontal zone. He also told me his honest opinion that Dr. Wong would most likely get more grafts because he goes wider with strips, but at the risk of a more apparent scar. Well you'll see below, that his statement was not accurate. I went ahead and scheduled the HT with H&W, and then had growing concerns about my density. A month before surgery date, I shaved my hair really short and had a photographer friend take high resolution pics of my donor areas with a cm2 tool against my scalp so I could do a follicle count. What really concerned me was that I was counting as few as 50 follicles per cm2 in the area on the sides of my head. I sent the pics to Dr. Wong and scheduled a phone consult. Based on the pics, he rated my density at a 4 on a scale of 1-10. He also said with good laxity, 3500+ follicles could be possible. My minimum goal was 4000 grafts, and initially I was hoping for up to 5000. Even though that didn't leave me feeling terribly optimistic, I felt like I was in good hands with Dr. Wong. Never less, those thoughts of "what if he only gets like 2500-3000 grafts" would creep in. I met with Dr. Wong on surgery day and he examined my laxity and density. He really liked the laxity above my ears, and felt the back had average laxity. I don't quite remember what he said about my density, but I know he wanted to be particularly careful about strip width, since a wider scar could show through the hair on sides of my head where my density was lower. Now to the cutting. The first surgeon I saw said that he spends about 30 minutes excising the strip. Well, Dr. Wong spent every bit of 90 minutes removing that strip. Even though he ended up cutting it the same width (1.6cm) that the first surgeon said he would excise, he yielded way more grafts. He was very careful about finding that balance between maximizing grafts with as wide of a strip that was possible, without risking an apparent scar that could show in the low density areas above my ears. I'm sure the care he took in cutting minimized graft transection, allowing him to get more grafts than some other surgeons may have yielded from a strip that size. So, if my math is right, a 28.6cm long x 1.6cm wide strip yielding 3808 grafts gives me an average donor density of 83 follicles cm2, putting me at the lower end of average density. Dr. Wong's strategy included a conservative hairline that we both agreed on, and planting the hairline and frontal at 50-60 grafts/cm2. The remaining grafts mostly went into the mid scalp, and he did a little bit of work around the crown. He said he went as low as 10 grafts cm2 in the mid scalp, which initially concerned me. Obviously, his strategy worked, creating the illusion of density, and a dramatic transformation with just 3808 grafts on a very bald head. In searching this board (and the whole web) in the months leading to my procedure, I was hard pressed to find much material showing what 3k-4k grafts can do on an advanced Norwood VI head. So I now hope that others in my position may learn and gain from my experience.

Not the best photos, but taking selfies of my scalp isn't the easiest thing to do. After my next haircut, I'll have a photographer friend take some sharper pics outside. I'm 7+ months post-op, and my friends and colleagues who I told about my HT can't believe the difference. Every now and then I run into someone who I haven't seen in a while. Some can't put their finger on why I look different, while others immediately notice that it's the hair. I kept my balding head buzzed at about 1/8" to 1/4" length for a long time, some people who I see regularly say "oh you let your hair grow out". And to think that I almost backed-out a month before the procedure because I was concerned that my hair was too fine, my density was too low, and the extent of my hair loss was too great for a HT to make a worthwhile difference. Better pics to come.

Here's a pic taken on 12/4/17 at H&W, and one taken on 5/13/18.

After more than 5 months, my scalp is still showing some redness, especially along the hairline where the follicles were planted at the highest density. With my hair growing in, at least it's not very noticeable. Next update will be in mid-June.

Here's a couple of selfies until I can have a friend do some better quality pics. Growth has been fast enough that my colleagues can't help but to notice, and I'm getting nothing but compliments. Most importantly, I very happy with how it's coming along. Better pics to follow.

No side effects whatsoever.

Yes, I started 1mg Finasteride daily one month before my procedure, so I've been on it for 6 months now.

It's been about 5 weeks since I cut my hair super short, and it's just now long enough to lay to the side. I took a close look at some of my pics that were taken with a macro lens and noticed very small hairs scattered between the longer ones, so I'm looking forward to seeing the results in a few months with everything grown in. The sides were starting to get long, so I had my first haircut in 9 years on Saturday just to clean things up. I'm super pleased with how things are coming along, and other people are taking notice. Such a big change having a hairline to frame my face is making! I'll continue to keep you all updated. Here's a few pics taken 2 days ago.

Thanks again for your comments. Next month I'll get some pics in the sunlight, and with better color. jonh1125, I started Fin 1mg/day about a month prior to the procedure, and plan on taking it long-term. I don't intend on using anything other than Fin. hockeyman, the settings on my trimmer aren't numbered. I trimmed it pretty tight last week, with just enough length to be able to pinch some hair between my thumb and index finger. Currently, it's much shorter than I intend on wearing it once the front grows in. Dr. Wong estimated that he could get another 2000 if I were to undergo another FUT...decisions, decisions. As for a second procedure, let's see how I feel about these results, and if I want to go through this again. If I get enough coverage in the front and on top, then I just might hang on to those 2000 grafts in case the lobes above my ears start to recede. Luckily, those lobes haven't eroded at all over the last 5 years, which was one factor that helped me to decide to go through with the procedure. Hopefully, that will continue to be the case.

Here's some more higher resolution pics from today. Most of what you see in the recipient area are transplanted hairs that never shed. I took a close look at some of today's pics, and could also see quite a few tiny hairs that are just starting to come in. I'm looking forward to seeing what happens over the next 3 months. I'll keep you all updated!

Thank you for your comments! Given the naturally low density in my donor area, I was really worried about an apparent scar. SWdan, I can just feel the slightest indentation is some areas along the scar. Here's some pics taken at H&W's on surgery day compared with pics from earlier today. Next time, I'll try to get better color. FYI, I dyed my hair dark brown for the surgery, so now it's back to its natural grey.

I looked at the scar pretty closely, and there seems to be hairs growing out of the middle of it, making it almost undetectable. Even though I would have went as high as 5000 grafts, I have to say that Dr. Wong really found a balance between maximizing grafts and minimizing the potential for a noticeable scar.

When you say you had consults with several docs, do you mean in-person, or via email with photos? An in-person consult is what's gonna give you an idea of whether your donor density and laxity will allow for a 5000 graft session. Also, at the age of 30, have you considered future hair loss? Just some things to think about, if you haven't already. I believe that any one of the three docs you are wisely considering can create quite a nice transformation for you with 4000-5000 grafts. Just keep your expectations realistic. I'm 3 months post-op from 3808 FUT with Dr. Wong, and so far I'm very pleased with what I'm seeing. Feel free to reach out if you have any questions about my experience.

Next week I'll be getting some high quality photos taken, but here's a few reasonable ones from earlier today. Three months post-op, and my hair is growing! There's also quite a few hairs that are just breaking the surface. Hopefully we'll be able to get a better look at those next week.

Thanks for checking in hairlossPA. I am coming up on 10 weeks post-op. So far, I’m being patient and just looking forward to the day when I can take my hat off that has been concealing my pink scalp. My recipient area and donor scar are still pinkish, but that appears to be fading week by week. The back of my head no longer feels tight, and there’s no numbness at the donor area. I still have some numbness in the frontal recipient area where 2500 grafts were placed. Interestingly, I’ve experienced very little shedding. Also, no shock loss around the donor scar area. About 2 1/2 weeks post-op there was a day or two where I shed what appeared to be a few hundred hairs, but that seems to be the extent of any noticeable shedding. Overall, I seem to have lost less than 25% of the transplanted hairs, and the ones that didn’t fall out are growing at about the same rate as my native hair. Either I’m going to be a late shedder, or one of those rare cases that just doesn’t shed much. I’m keeping my recipient area, along with the rest of my head, buzzed short until I feel like all of the grafts are growing. I’m estimating that around 5-6 months post-op I’ll start letting my hair grow out…maybe sooner. I’m having some difficulty taking selfies that are worth posting, but I’ll try taking some today or tomorrow. For now, here’s pics from 5, 7, 9, and 15 days post-op.

Went back for my first hair wash today and all seems well. I’ll return tomorrow and the next day, then it’s back to the east coast. Here’s some post-op pics taken by H&W.

I had my first HT today, and I don’t think I could have chosen a better clinic. I’m sure you all know that H&W is a world class clinic, so I’m not gonna write an essay about what a nice facility they have, what a pleasure it was to meet and work out a plan with Dr. Wong, how attentive his staff was, how well they all work together, etc., etc. Overall, the experience was about as pleasant and professional as one would hope for. One of my biggest concerns was whether approximately 4000 grafts could be harvested from my mediocre donor regions. Especially since another surgeon estimated during an in-person consult that about 2400-2600 grafts was realistic. Well, Dr. Wong came pretty close to what I was looking for, while being careful and conscientious about the donor scar. Based on my laxity, he removed a 1.6cm strip today and harvested 3808 follicles. The strip was 28.5cm long, and he spent 90 minutes removing it. Here’s the breakdown: 1 hair: 639 2 hairs: 2435 3-4 hairs 734 total comes to at least 7701 hairs with an average density of 2 hairs per graft. I believe about 2500 grafts went into the front part, and most of the remainder went in the mid-scalp. He also placed some grafts around the edge of the crown. I’ll get more details about density of the different areas treated when I go to the clinic tomorrow for a follow-up. FYI, I’m at least 75% grey, so I dyed my hair for the procedure. I’ll be going back to grey after the dyed hair grows out. I’m looking forward to having my face framed again, and I’m anxious to see what kind of coverage I get on top. I’m not going to worry about the crown too much, so next year I’ll most likely return for a smaller session to add density to what was done today. I’ve been buzzing my head for the past 10 years, so at 50 years old I’ll be happy to frame my face with a mature hairline and have some coverage on top. I’ll be back at the clinic tomorrow for a washing, so I’ll see if they can email me some post-op pics to share here. I’ll keep you all updated with pics so you can see my progress over the next 12 months or so. I welcome your questions and comments!

As I said in a previous post, one fine coalition surgeon estimated during an in-person consult that a 1.6cm wide strip of my donor area could yield roughly 2500 grafts. Based on a video showing a comb running through my donor areas, the highly respected doctor who I finally chose said that he could harvest 4000+ grafts. With my mediocre donor density, it sounds like I’d need at least a 2.5cm and maybe even a 3cm wide strip to harvest 4000+ grafts. The few times I’ve seen strip widths posted along with patient results, the widths seem to range between 1-2cm. In fact, I don’t think I’ve ever seen a posted strip width exceed 2cm. So I have 2 questions. If I have about 2.5cm of up and down movement in my donor areas, does that mean that roughly a 2.5cm strip could be safely removed? Since strip widths aren’t posted too often, what are some of the wider strips that you’ve known to be safely harvested? When I look at 2.5-3cm on a ruler and hold that up to my donor areas, that just seems like a crazy large amount of scalp to have removed. Since my chosen doc is on the other side of the continent, I’m putting together more pics and clips that will hopefully be the next best thing to a personal consult. This week I’m having a friend take some pics of my donor areas using a macro lens (my hair is now chopped short enough that every follicle should show). I’ll also ask the doc these questions, but I’d like to hear some responses here from the veterans. Your thoughts and opinions mean a lot. Thanks!

I appreciate your comments. Today I buzzed my hair pretty tight and I’m going to have a friend take some pics of my donor areas using a macro lens and a metric ruler. I’m also going to make another video, this time to show my laxity. Although I’d like to see my chosen doc for a personal consult, traveling across the continent for that purpose isn’t feasible. With that said, I want to create something in the form of high quality pics and clips that would hopefully be the next best thing to a personal consult. MayiraP0chu, your comment about getting a wide enough donor strip has me thinking, and brings me to my next question, which I’ll post in a new thread. Thanks again!

After 5 years of poking around here, I am planning on having a 4000+ FUT procedure with a highly respected HT clinic. To give you an idea of my density, another fine Coalition Surgeon told me during an in-person consult that a 1.6cm wide strip could yield in the ballpark of 2500 grafts. Since 1.6cm is as wide as he'll remove from any patient, I decided to take a more aggressive route and look at surgeons who do wider strips. I have good laxity, and I'm exercising my scalp daily, so a bigger strip shouldn’t be a problem. Some more things to consider are that I am fine-haired, and have salt and pepper (more salt than pepper) hair. Also, I’m 50 years old, the area of balding on top has not spread in 5 years, and I have never been on meds. If I decide to go through with this, then I will be starting Propecia in a couple weeks. My biggest concerns are my fine-hair and average donor density. This has me thinking about the potential amount of surface area to be covered and the density of coverage. What could I possibly expect from a strip procedure of at least 4000 grafts? If my laxity and density allows, I’d go to 5000. I plan on going with a mature hairline, and I don’t mind being left with a bald/thin crown, as long as the balding area isn’t huge. Does that sound reasonable? Your thoughts on this would mean a lot to me. Thanks! FYI, the 2 dots on my head represent what the first doc felt could be covered with 2500 and 2600 grafts. In addition to sending pics with my online consults, I included a video showing a comb running through my donor areas. The video made the surgeons feel much more optimistic about my candidacy for a HT than the pics.

Thanks Spanker. Yes, Dr. Rahal and H&W seem to be coming up more than any other docs with regards to quality mega-sessions. I'm waiting to hear back from Rahal's representative with regards to cost/discounts, travel reimbursement, and Canadian taxes. H&W said they will respond to my online consult in a few days. The list so far is Feller, Lindsey, H&W, and Rahal.

Thank you Dr. Charles, Shampoo, and Newhairplease for your encouragement and suggestions. I see that Dr. Lindsey also does larger FUT sessions. We had some brief contact today, and he said he did a nearly identical case to mine a few days ago. He might be the first in-person consult doctor I see since I can take a road trip to his facility. More importantly though, he's highly regarded and I like the results I see in the before and after pics. I'm still gonna check out Dr. Rahal and Dr. Feller. Thanks again.