404hairnotfound

I'm rather confused. This thread was started by someone named Follically-challenged...are you saying that is you and you somehow changed your handle or something?

My bad - I had a thread similarly titled from around the same time as folically-challenged - got e-mail notification and assumed the thread was mine! Sorry for the confusion!

deleted

Hey guys,

 

Thanks for listening to me vent. I know it might seem weird to be irritated by something I didn't do anything about for ten years, but the idea of permanence is a bummer.

 

I appreciate the support.

 

Anyway, will Rogaine stimulate any hair growth that could potentially contribute to donor site? Can they harvest the donor site only once? Can hair that was transplanted act a donor site at any point?

Donor hair is usually harvested from the safe zone - the hair follicles that live in this zone are resistant to androgenic alopecia - so using Rogaine on this area is superfluous. With FUT the donor area can be harvested from more than once depending on the laxity of the scalp. Typically a couple of transplants via strip harvesting are possible (I've had two). They will cut out the old scar, excise a new strip, and sow it up together. The second surgery will not typically yield the same number of grafts for the same length of strip due to existing scar tissue. I had 40% less yield the second time around. Not sure what you mean by hair that has been transplanted acting like a donor site. Typically the transplanted hairs are not re-transplanted.

Ah! That makes sense.

 

I suppose what I also consider a full head of hair is probably slightly different than everyone else's definition given my Norwood level. I am not against multiple surgeries, but of course I am looking at most bang for buck as well as overall quality. For instance, I realllllly like Dr. Hassan and Dr. Wong. They seem to do a lot of FUT on guys like me.

 

It would be nice to get some sort of virtual simulation to be able to predict what could be done for me given how far-gone I am.

The problem is that a simulation will never accurately predict the final outcome; graft count alone is only one variable, everybody's hair characteristics are different and everyone heals differently. Which is why surgeons don't normally use simulations in their practice. It would likely lead to a lot of disappointed patients.

 

At your norwood level you have to keep your expectations realistic. There is just too much ground to cover and not enough donor hair to cover it all. If I were in your shoes I would focus on the frontal 1/3rd and pack as much hair as possible into that area. That would frame your face from the front and make a big difference visually. I would likely extend only as far back as the mid scalp with decreasing density as you go back to try to maintain the appearance of a natural progression of hair loss.

 

Definitely get more opinions, but be aware that there are doctors out there that will operate on just about anybody. That's not always a good thing.

 

Regardless of what you end up doing or where you decide to go, I wish you the best of luck.

404,

 

I can edit both if you'd like. It may be helpful to add a more descriptive title and an addendum to the first post. Let me know what you'd like it to say and I'll make some edits.

Blake_Bloxham, I have sent you a PM. thanks.

this is totally due to the stoppage of minoxidil at 6 months

 

happened to a friend of mine

 

it all grew back within the next 18months albeit not as dark, which was good because it looked like his hair was dyed when on minox

 

looking good 404

you are right about the starting and stopping minox, which syncs the growth phase

 

give it a full 24 months after you stopped minox before thinking of a round 2

(if you start fin then add another year)

 

congrats on the baby

Thanks rev333. I am back on the minoxidil now (foam this time) and will stay the course this time.

jus goes to show 12 months is not the end all be all for many. been tryn to tell ppl that for years but they read a few ignorant posters that say "if at 12 months u don't see full growth then ur Ht is a failure" the only failure is those who listen to ppl who don't know WTF their talkn about!

 

I've seen ppl even keep growing past the 18 month part. ESPECIALLY if they have BHT but even with head hairs some are just slow to grow.

I agree BUSA, I am still seeing maturation at 16.5 months post op, just keeps getting better. Now that I've restarted minoxidil I should see some more regrowth within the next few months as well. In any case I will keep this thread updated up to 24 months to see the difference between 12 and 24 months post op. If the result is much better at 24 months than 12 months (which is looking to be the case so far) than I would consider that a big win, considering that I am not taking any DHT inhibitors.

 

Yeah, he suggested 3000 for the hairline alone... My issue is, it's not easy for me to constantly return to Turkey and have more work done. Is it possible that he suggests this many grafts as he understands that?

Yeah, some docs prefer to do mega sessions in order to cut down on more surgeries in the future. The problem with this approach in your case is that your hair loss has not advanced to the point where this would be a good idea. Your balding pattern has not yet been clearly established yet, so if you take 5k grafts and pack them densely into the thinner areas now, it may look good for a few years until your hair loss advances to the point where you need more grafts, leaving you with a very unnatural looking balding pattern. The other issue is that you have plenty of healthy native hairs right now, many of which may be lost to permanent shock loss, leaving you with a net hair count lower than expected. The best approach in your case is to wait until hair loss progresses further before doing anything. The second best approach is to start with a smaller surgery and work your way back. I think 3000 for the hairline is overkill.

 

Yeah, I tried using it, it didn't do anything but wrinkle my face... I stopped after 6 months of using it. I would definitely like to fix my odd hairline either way as it has always bothered me..

~2000 grafts into the frontal 1/3rd should be plenty. You could do that to start with if you want to address the hairline, and then work your way back to the mid scalp and crown as the loss progresses

 

Is it good to use minoxidil liquid on transplanted area? Will It faster the process or will it damage the follicles????

It will hasten growth, I would wait minimum 2 weeks post surgery before applying it though

 

Thanks for your kind replies guys, the reason I ask is I was quoted 2000 grafts by another highly respected surgeon in Turkey, however, Dr erdogan said would never be even close to enough for me..

2000 grafts would be enough in the short term, likely not long term though. I echo the sentiment that you should not do anything yet, your hair now looks as good or better than a lot of people get post HT. Have you tried using minoxidil?

Say you have 20k grafts in your donor, and you extract 4k, you have 16k grafts over the same area, which does not (should not) change. How can there not be a loss of density?

 

Now certainly, visually the density is not depleted that much, as we know the spacing between follicles increases by less than the diameter of the graft, but I cannot see how actual density would not decrease.

Maybe the better term to use is perceived density. If you extract 4k with strip you are still short 4k, but the overall donor area is now smaller, so perceived density does not change (provided that the scar stays thin of course)

404,

 

I agree: taking multiple strips and then undergoing the FUE route will likely yield the most grafts. This is actually a pretty popular method - undergoing multiple strips until you're "maxed out" and then going back for one last pass with FUE. I think the other way around - FUE then strip - would actually decrease your strip yield. FUE actually creates quite a bit of fibrotic scarring underneath the scalp, and this would likely create a pretty poor strip.

So it would be advantageous for a patient like me (average/less than average donor density but good scalp laxity) to go with another FUT procedure before I do FUE? A FUE surgery was next on my list as I did not want to get cut open again, but I am reconsidering if it means I would be able to harvest more grafts in the long run by doing another FUT.

 

I do not understand, why do you feel FUT doesn't deplete density?

In the sense that with FUT the hair is excised in a strip and closed, leaving the surrounding hair at the same overall density as before (provided that the scar does not stretch), whereas with FUE grafts are extracted all over, diluting the overall density of the hair in the donor area.

I have already had one FUT surgery, roughly 2500 grafts. I would imagine something like FUT, FUT, FUE would yield more hair than FUT, FUE, FUE since you are excising the strip of hair and not diluting the overall density - which then allows for FUE once scalp laxity becomes problematic with FUT. Or is my thinking flawed and FUT or FUE order does not affect the potential grand total graft yield?

404 I'm a bit confused; you seem to be content with the outcome and happy with Dr Rahal's work overall, but the title of this thread "Dr Rahal disappointing FUT result" suggests otherwise?

The thread was started back in September around 12 months post op. I've recently added a 15 month update. My results at 15 months are an improvement over 12 months.

 

http://i.imgur.com/VIA2VvZ.jpg (more a couple pages back)

 

I was not able to edit the first post anymore or change the thread title so that likely adds to the confusion.

imgur: the simple image sharer

 

 

 

 

You`re sure you`re in the right thread here :confused:

I think he's referring to the 15 month pics

 

http://i.imgur.com/VIA2VvZ.jpg

First off 404 congrats on the birth of your kiddie.

there's a definite improvement so looking much better and hopefully the minoxidi will add a little more to the final result.

Have a good day

Thank you 1966kph! Hopefully he didn't inherit his dad's hair! lol

 

Who did the procedure.. Dr. Rahal or Dr. Pires?

Dr. Rahal did the procedure, I am not sure who Dr. Pires is...

No one said that slow growing was BS; only that it's wheeled out too many times to excuse shoddy work.

 

Clearly there's been improvement in this patient's result but is it a result that puts you in mind of Rahal, the hairline king?

 

My answer would have to be "Hell, no"

Cryingoutloud, yes while this does not strike me as a typical 'Rahal' class result for more than 2500 grafts packed into the frontal 1/3rd it is an improvement over what I started with, as I now have some semblance of a forelock which I did not have before as the new pics show. Hopefully a few more months and some Minoxidil is needed for things to get better.

Please read my post again carefully, and notice I agree with you for that matter.

 

Just I emphasize again, (we discussed about it before), we should wait at least 15-18 months to ask for a refund. And, I am not opposite of refund. But I say, doctor mistake or malpractise should be proven before. At least we should hear doc. opinion and explanation, I think doctors will do this after this time, not before. We should totally eliminate time factor before ask for refund.

 

And here good doctor-patient relasionship seems to be established again, thats the good news and important.

I would not ask him for a refund as the work was done and I do have an improvement from what I had before. Though I would ask him to do a touch up session to fill things in if there is not that much improvement in the next few months.

A couple more higher resolution pics (click the image to see full size)

 

http://i.imgur.com/ab38VKu.jpg (straight 'head on' angle)

 

http://i.imgur.com/m5nkZxT.jpg

 

The hair is longer in these pictures than the 12 month pictures which allows me to utilize some creative styling to make the density appear fuller. Styling the front up/back makes it look fuller.

I was hoping to see an update but it appears I was right, 404 has left the building. Its been two weeks and nothing. He was posting quite often before "the call".

If you see this, 404, I feel for ya. Please come back and update us on your progress.

Hey muscleheadofhair, just want to be clear that I didn't abandon ship after my call with Dr. Rahal, I have just been busy with life

 

The situation is slowly improving, and I am committed to sticking it out for a little longer to see what the 'final' result is like before drawing conclusions.

 

Rahal has been very dedicated to make sure that I am satisfied in the end. Unfortunately this game is not an exact science and everybody's physiology is a bit different when it comes to hair growth. I think what sets clinics like Rahal apart is how they deal with patients when things don't quite go as expected.

double post

Hey guys,

 

My wife and I just had a new baby so I have been preoccupied and did not get a chance to update at the 15 month mark, though I did take photos and will post them now to give you an update on my situation.

 

A few quick shots from the front:

 

http://i.imgur.com/Hfkz2hN.jpg

http://i.imgur.com/qg7DaMv.jpg

http://i.imgur.com/VIA2VvZ.jpg

 

So the good news is that the situation has clearly improved since the 12 month mark. While still not 50% density, it is clearly an improvement from a few months ago and I would consider it cosmetically viable at this point.

 

I have jumped back on Minoxidil recently and have been going through the dreaded Minoxidil shedding phase so currently my hairline looks a bit worse than these 15 month pictures indicate. I am hoping that the foam version (sans propylene glycol) is better tolerated this time with fewer side effects. Hopefully the addition of minoxidil will push the perceived density of the hair closer to 50%. Minoxidil is the only medication that I am currently taking for my hair loss.

 

I will update again sometime between the 18 - 21 month mark.