I have just created my surgery blog with Dr Path from just over 5 months ago. It is the first blog website on here for an FUE performed by Dr Path. I would really appreciate all of your input. Here is the link. The surgery is far from standard, there were definitely some ups and downs. Thanks in advance...
I had my FUE surgery with Dr Path on the 8th of April 2015, I was a little apprehensive as Dr Path would be predominantly be seen as a strip surgeon however through online consultation and numerous emails I decided to go with FUE. I am in my late 20’s have a receding hairline and like to shave my hair short on the back and sides, also FUE allows me to “tap out” if my hairloss progresses too far and I won’t be left with a nasty FUT scar if I shave down. I have shaved my head before and know that this is a viable option for me, but would just rather have hair. One of Dr Paths nurses confirmed that around 10% of his cases are FUE, but that this is growing in recent times.
A little background about my hairloss. I have been receding since I was 18, I started using 5% minoxidil at 23, and have been using various dosages of finasteride since i was 25. Going on and off fin due to some side effects but am using a lower dosage now with acceptable side effects. My hairloss had definitely dramatically slowed/stopped prior to my surgery but I was unhappy with what I had so opted for the surgery.
So I met with Dr Path the day beforehand to go through my goals and for us to reach a plan together. I have always had a high hairline and a weak temple point on my right hand side. I never wanted a Brad Pitt style juvenile hairline, I just wanted to drop my hairline about a centimetre, close the temples and strengthen the temple points. Through online consultation Dr Path suggested 1,000 grafts would be needed but upon the pre op consultation the number was closer to 1,500 in order to get a density of approximately 50 grafts per centimetre. We took great time creating the correct hairline, you can truly see the doctors passion in this regard as this is the artistic element of hair restoration. The Dr also uses a laser technique to help guide the hairline to make it as natural and in the proportion to my face as possible, I’m assuming this is linked with the golden ratio (i.e. symmetry and distance that occur in nature and how we perceive beauty etc) The initial hairline and temple points were a bit too aggressive but we started all over again until I was satisfied. I spent maybe 2.5 hours at the pre op surgery consultation; the doctor has a true wealth of knowledge and explains different aspects of the surgery using humorous anecdotes. The doctor shaved my hair including a small portion of my existing hairline (maybe half a centimetre) so that he could blend the new hairs with my native hairline.
The day of surgery I arrived at 9:00am, the estimated time for 1,500 grafts was 4-5hrs. Well it took close to 12hrs as I will explain below. I was the only patient being operated on on the 8th of April. The surgery started at 10am approx. The doctor used a number of motorised punches including the SAFE system, the average punch size I believe was 9mm. He was the only one to use the motorised hand tool while his technicians used forceps to extract the graphs using 2 forceps. This was the first area that caused the surgery to take so long. My hair below the surface is very spread out kind of like an anchor, so it made it more difficult to extract the grafts. The Dr explained that there is a test for this called Fox Negative/Positive and that years ago if someone were deemed to be negative they would recommend against FUE. The Dr said that this would not affect the overall outcome of the surgery but made the extraction process A LOT longer than usual. In this regard the Dr said I had less than 10% transection rate overall. All grafts were examined under microscope before implantation. The Dr mentioned he usually gets 80-85% yield per grafts implanted with FUT, and a bit less with FUE 75-80%.
The second point was that the Dr noted that I was a “bleeder” although I don’t bruise easily and heal very quickly usually, but was surprised that I didn’t have swelling and black eyes post op as “bleeders” usually do. This slowed down the extraction process because I bled a lot over the day.
Also they needed three times the amount of anaesthetic to keep me comfortable, administered three times more often than the average patient. I am quite a large fit guy, 6 foot 2 and approx. 95kgs (210lbs) so maybe my system broke down the drugs faster, also I have a high tolerance to alcohol so maybe this meant I needed more I’m not sure//. But these three points all made the day a lot longer than expected, but I really have to praise his team as they were very professional and very pleasant throughout the whole day.
They extracted the units along my right side and back of head, then we took a break for lunch. Continued back straight after extracting my back and left side, all the while technicians were checking the extracted grafts and discarding transected/damaged grafts. I think the extract process was finished up around 6pm.
The Dr than created the recipient sites and the nurses implanted, we had discussed beforehand to have the sites positioned to mimic my existing hair rather than just all pushed forward. As my hair is a bit wild I suppose and not just straight down it leaves the skin in a lot of directions. This took longer but again I would seriously doubt that this would even be an option for less skilled surgeons as they would likely just use the straight forward method. The implantation of the grafts was so much more enjoyable than the extraction. I was on my back, there was no pain and I really felt we were on the home stretch. Towards the end of the implantation process the Dr noted that he would need more than the 1,500 grafts that we had agreed upon and paid for prior to surgery. The Dr said that he would do this free of charge and gave me 128 grafts for free. The breakdown is below.
There were some post op complications. The first day was fine but the second day I went into have my hair washed etc the nurses noticed that I had an infection across a number of the grafts. The Dr prescribed a stronger antibiotic (500 mgs Ciprofloxacin 1 tablet twice a day), gave me a cream (Fucidin Sodium Fusidate- Antibiotic 15g ointment 2%) to use on the recipient area twice daily and told me to wash my hair with watered down pre op antibacterial shampoo. He also took a swab of the puss and sent it to a lab to see if they could grow anything from it, this later came back negative. The infection finally cleared. By day 5 it had really cleared up, the Dr was initially very worried as these kind of infections can be very damaging if not caught early, so he was happy that this wouldn’t affect the outcome. The Dr even opened the clinic to see me on the Sunday over the Thai New Year’s eve celebration (Songkran, where Thailand basically shuts down for 3 days and celebrates) to check on me personally. A+ for patient commitment!! Here is the link to the forum post from then also http://www.hairrestorationnetwork.com/eve/179124-help-2-days-post-op-infection-recipient-area.html
As I mentioned before the Dr harvested 128 more grafts as there was not enough to cover the area, I went for another touch up 10 days after my surgery to help blend the temple points into my existing native hair better. I posted this in the link here asking for advice with photo evidence. http://www.hairrestorationnetwork.com/eve/179225-post-hair-transplant-temporal-bald-gap-existing-hair-advise.html
Here is the breakdown for the temporal point touch-up which the Dr agreed to do free of charge, after some discussions and emails. Again a great sign of his commitment to the patient.
Overall at the time of writing this (5 month mark) I am a little nervous that the number of grafts have come through is not as expected. I know I have to wait another few months but I would have expected maybe more grafts but for them not to be as thick, maybe a lot of thin hairs that will mature over the next years etc. I would like to get your opinions?