Tav1

Walky - you posted the above in another thread, so you're really offering quite a bit of conflicting information. You state your Doc's results are "very satisfying" yet you started this thread? Very confusing.

orwell - are you 100% on those dark scabs on the frontal portion? Keep track of them and in touch with your Doc for any follow-up as appropriate. I had my HT around the same time as you did, had a few scabs like yours, and unfortunately, one became necrotic. Not a scare tactic - just a 411.

You look great. Very nice and appropriate transformation. Nobody but you would say you don't have a full head o' hair. Enjoy!

I'm a little late with this progress report. Unfortunately, I've had to deal with a small bit of necrotic tissue, which I sort of suspected from my last update. I didn't freak out, saw the Doc, and we are taking care of it with a combo initially of Cipro for seven days to make sure there is no further infection, then also (and longer term) with Nitro-Bid mixed with Bacitracin Zinc twice daily. Dr. Umar was surprised, as I don't smoke and have not had any previous work done in the impacted area, but it is what it is. To his credit, I am seeing him weekly going forward to make sure things are on track. I think I'm looking at around six weeks for this situation to resolve itself, then the Doc will suggest when some grafts can be implanted (if and when necessary) into the impacted area. I've been promised that there is no further expense to me for any of this - either ongoing care for the necrotic area or for new grafts to correct/address the issue, so props to the Doc and his practice for that approach. The rest of my head looks just fine - nothing out of normal for being around three weeks post op at this point, so this little situation is a bit strange, but from what I understand, it does happen rarely, and unfortunately, I'm one of those rare instances. I've taken photos, and happy to post them up if anyone is interested.

Thanks wylie - will do. Just a day shy of two weeks. Going in for a two-week check-up with the Doc tomorrow, which will be exactly 14 days from my last procedure. Mostly going well, with the usual donor itch, a few stubborn scabs, and a bit of swelling that sort of moves down from the forehead to around and under the eyes. Nothing out of the norm, as I understand. I did develop a little bit of an infection - about the size of a dime or quarter - in the frontal region around day 11 following the loss of a few grafts while patting my head post shower. You can see it in the crap "selfie" I took - it's on the right frontal portion, just back from the hairline. Very strange, as I was doing everything correctly. To be honest, I'm a bit concerned, as I've followed all the post-op procedures to the letter, so I'm not certain what the cause might be. I'll report back tomorrow after my visit with the clinic. I was told not to touch or massage the area, but to simply apply Bacitracin Zinc to keep the area moist. Keeping my fingers crossed it's nothing serious... Happy growing -

Brilliant idea - also, if your Doc suggests ointments immediate post op, but sure to take extra care so that things don't stick to whatever you're wearing, particularly if you sweat on the job, heat is involved, etc. Doesn't appear from your profile that temple points were touched in surgery, so a hat might be fine with the suggested plastic, just make sure the front stays down below your hairline where grafts were implanted. Four/five days is a bit early to risk without proper precaution in my opinion.

OK busa - calm down there dude. You're the best informed non-experienced hair transplant non-patient in the history of the interweb. Congrats. Don't stick yourself too hard pinning that merit badge on your chest. I'd say it will hurt worse than the initial FUE injections, but you wouldn't actually know what I'm taking about. That said, I wish you the best of luck once you apply all of your years of research towards actual reality.

I'll be curious to see what our respective doctors say, so please so send an update either via private message or otherwise by us continuing to hijack this thread -

I'd be interested to know Busa, as I've read many of the posts on this forum, including a recent one where you stated you've been active on hair loss forums for 15 years, which I'd have to imagine means you've been through this transplantation and have great experience. But I'm having difficulty finding anything here that you've posted documenting any overseas surgery you've had, your direct experience with any clinics, or the results you've achieved. Could you point me towards any of those threads? I'd be interested to read your first-hand experience and results, combined with your 15 years of experience, as it seems you comment quite often. Cheers.

Sorry to hijack your thread briefly BaldingInReverse, and your progress thus far looks fantastic. Mr6435 - I did something like you did, granted my accident was a few days after my last day of surgery and not the day after like yours, but regardless, mine looks worse than yours does. I immediately emailed my doctor a picture, and his response was to apply bacitracin zinc gently to the impacted area (just enough to keep it moist daily - nothing more) and avoid touching, rubbing, massaging, etc. the area in question. Just give it a chance to heal, and stop with any patting, spraying or otherwise to the impacted area, and most certainly, no attempt should be made to remove any scabbing in that location. Check with your doc of course, but that was what I was told. And I am not scheduled to see my doctor for any follow up for a solid week after this happened to me yesterday, so I am presuming his recommended course of action until that time. Otherwise, I assume he would have asked me in earlier rather than sticking to my scheduled two week follow-up. Cheers and best.

I sent you a message with my thoughts, but defer to others here who might be able to advise you as to best options for strip in SoCal. Cheers.

As I recently stayed local (in my case, Southern Cal) for my procedure and we are about the same age, I'll offer a few suggestions: first, search this site, you'll find plenty of comments on Ziering, his practice and related docs. Ditto with Pak, although not as much. Have you conducted consults with both and/or others? Have you narrowed things down to FUE/FUT based on your comfort level, current condition, desired outcome, etc? I did several in-person consultations and a few more online, with clinics in the U.S. as well as overseas. And I received a fairly wide variety of recommended approaches. After determining FUE was the best route for myself personally, I further narrowed things down with graft count recommendations, which in some cases ranged between 2,500 and 4,500 suggested grafts. Knowing what I wanted to achieve (which was a real potential for meaningful transition in appearance, particularly at the hairline) and considering a few other factors such as donor capacity (mine was very good), I opted for a more aggressive (and hopefully life-altering) approach. Not here to pitch anyone in particular, but if you are still open and searching, while determined to stay local, I recently wrote up a thread on here about my experience with a clinic in Redondo Beach. Hopefully those with specific experiences with the clinics you mentioned will chime in. Cheers and let us know what you decide.

zx_toth - saw your thread on your HT and wish you the best as well. The (hair) race is on dude!

Thanks farmcat - just getting through the first week or so now, and oddly enough not really concerned about shedding the grafts or looking strange - just don't care. For me, the tough part is over, and at this point, I'm happy to wait out the months to start sprouting. Rawkerboi, Umar's pre-op instructions noted that Minoxidil be stopped at both the recipient and donor sites two weeks prior to surgery; on the post-op side, the clinic provided propylene glycol (PG-free) Minoxidil and suggest applying it three days after surgery, then continuing the PG-free stuff for four months before switching to whatever brand of Minox foam.

Thanks David. I'll most certainly keep this thread updated with progress photos and updates with the idea that whatever I can offer might potentially assist someone in the future.

For some time now, I’d been contemplating doing something beyond what had become a daily routine of finasteride and minoxidil usage, which, quite frankly, helped me considerably over the past decade. I seem to recall becoming a member of this forum years ago, but email account changes and usernames and all the rest were long forgotten, so I’ve started anew. An aside prior to my transplant story: as long as any side effects are tolerable with the combination of these two aforementioned drugs, I’d still encourage anyone out there with hair issues to give both of them a solid year of dedicated use, taking before and after pictures and objectively comparing results. Everyone is different, as is their individual level of success under the finest/minox routine, but for me at least, it got me through my 30’s and I can honestly say I had better hair at 40 than at 35. Fast forward, and I’m a few years past 40 now (although I really don’t feel it), but my frontal/temporal recession started to continue - along with a slight bit of crown thinning – and the situation just continued to nag at me. I’d made all the usual excuses for not seriously investigating surgical alternatives (work, life, etc.), but something just clicked in my brain earlier this year, I re-discovered this forum, and I began reading pages and pages of posts here. I’d be remiss if I didn’t thank all of you who’ve shared your experiences, and most certainly those senior members, doctors and advisors, whose comments and postings I’ve read many of over the past few months. For most people willing to take the time to read and search this forum, I’d argue you’d be 90% of the way there, with your questions answered here before taking the plunge into hair transplant options. The remaining 10% to get you there is a combination of personal fortitude to start the process in earnest, do a series of doctor consults to assess individual invasive or non-invasive action options, and finally, make the most informed decision and action plan as to what is best for you based on your own goals. All of that said, I can’t really imagine I can offer anything particularly substantial in contrast to the wealth of knowledge already here on this site, but for whatever it might be worth to some, I’ll dive into my experience, and fully commit to updating this thread with photos and observations for at least the next 18 months, if not beyond. Certainly there are numerous qualified clinics and doctors both in the U.S. and abroad. And I researched many of them. It seems as though with FUE in particular, “hot zones” crop up in on a somewhat randomly rotating basis from country to country as Doctors progress in their advancements. And it seems as though overseas remains a very viable alternative for us here domestically. For me personally, where to go for the surgery was of little concern, as I typically travel 100,000 miles or more each year for work, most of it outside of the U.S. Other US cities, Canada, Europe/Eastern Europe, I looked at them all, but to be honest, I felt most comfortable staying local for a variety of reasons both work related and personal. Or maybe it was, since I’m sick to death of sitting in a chair at 30,000 feet for hours at a time. The bonus for me was the fact that Dr. Umar’s clinic is literally ten minutes from my house. The double bonus related to available open dates Dr. Umar had for what would be a three-day procedure – the calendar just worked out perfectly. I finally decided to “pull the trigger” while on a trip in China in mid-March 2015, did all the correspondence with Dr. Umar’s clinic via email, and actually went from deciding to schedule, to day one of my surgery within three weeks time. So good timing and location swung my decision somewhat, and of course a careful review of Umar’s work. Dr. Umar’s original recommendation was 3,500 to 4,000 grafts to restore a solid, but realistic hairline considering my age, address the temples a bit for framing and fill out just a small amount of crown thinning. I settled on the conservative approach of 3,500 grafts. Day one of surgery was April 7, 2015, bright and early (7:15 AM) at Dr. Umar’s clinic in Redondo Beach, California. His clinic occupies two floors – one suite downstairs and one in the penthouse of a multi-use structure which also houses an athletic club. Anyone familiar with the area will know what I mean when I say it’s about 50 feet from the boats in King Harbor. I live at the beach, so no big shakes to be on the ocean, but for anyone prepping for life-altering surgery, positive vibes from the ocean aren’t necessarily a bad thing… So I checked in with one of his staff in the penthouse clinic first thing, got a room assigned where I could change, stored my backpack, etc. Those of you considering a HT do what I did – I wore baggy shorts, flip-flops and a button up shirt. Once you put on the gown and booties, you’ll be confined to various laying positions for hours on end, so wear whatever is most comfortable – trust me, I was glad I did. I brought socks if my feet got cold, and they provided a blanket if the rest of me did. It can be a gigantic pain in the ass to hold still for hours at a time, and the last thing you want is some restrictive clothing binding into your crotch as you lay face down. Next up, blood pressure check, HIV check (they do the OraQuick swab, so no blood needs to be drawn) and the usual pre-op pills in a cup. Blood pressure was a little on the high side (no shit, I’m about to have 1,500 grafts moved from one part of my skull to the other), but nothing too high as to not proceed. Dr. Umar came in, and we discussed the hairline as he marked me up. Upon further inspection, the Doc noticed I have an odd recession of hair that sort of curves in a smallish line on the left side of my head (if looking straight down at my dome) from the midscalp towards the crown. Sort of looks like a sperm facing backwards atop my head. It was hard to spot from my consult pics, as my hair was a little long (for me at least) at the time. Regardless, we decided we’d address it as we proceeded. Hairline now decided upon, time to shave down for the ol' Telly Savalas, then lay flat on my stomach on what looks very much like a massage table. OK, so everyone has a different take on the initial scalp injections. For me, they sucked. And no, they didn’t suck less the next day or the last. They continued the same level of suckage back or front, regardless of day or state of mind. But the Doc did work some solid mojo to make the injections less painful by pinching and messaging the skin, so props to him for that. Lying perfectly still during the extraction process - while the chair remains flat or tilts you slightly right or left - was something I found quite challenging. But the Doc understood this pretty quickly, and they gave me a small injection to help keep me calm. As the hours ticked by, the injections and/or meds started to wear off a bit, so the latter part of each session was a bit tricky for me. I didn’t want more meds, so I just tried to focus on the positive and listen to “hits from the 80’s” the tech decided to pump into the room. Dr. Umar hums along a bit to some of the songs, and quite honestly, that kept me calm. Sort of a “he calm, me calm” sort of Zen thing I suppose as I stared at the floor/the Doc’s shoes/etc. for hours on end. Post the morning extraction, up for lunch out on the killer balcony overlooking the harbor (they order from an Italian sub/calzone/salad joint). Shortly thereafter, back to the chair, facing semi-upright this time for temple/frontal implanting. The Doc does the slits, the tech does the implanting. Dr. Umar’s implant tech has been with him for a decade, she’s got great hands, she’s very serious, and I felt as ease with her. I’d joke around a bit with the other non-implanting assistant techs, but I left his primary tech to do her work. Dr. Umar comes in during this process to look things over, in some cases make a few adjustments, etc. I will say that for me, the extractions and prep process I came to not like nearly as much as the implanting. Implanting the grafts was sort of like getting a very light scalp massage. As an extra bonus, you typically face forward in a semi-reclined position (at least for the areas I was having addressed), so I just caught up on the news on the tube during this portion of the procedure. Around 1,500 grafts give or take on day one. In at 7:15 AM, out at around 6:30 PM. Slept fine all things considered, although sleeping upright on your back isn’t my preferred position. Made a nice mess of the provided pillow covers with all the gunk on my donor however, but that was to be expected. Day two, up, quick neck down shower, out and at the clinic at 7:15 AM again. Otherwise, lather, rinse and repeat as extractions are done and new grafts implanted working back from the frontal hairline placed the first day. Started to become a fan of the 80’s music we pumped into the room again on day two. Although we had originally decided on 3,500 grafts, towards the end of day two, the Doc and I got to talking about the snake-like recession midscalp and small spot on the vertex, so we decided on day three we’d address it with either 500 or 1,000 additional grafts. I left it up to him, and in the end, he decided 500 would do the trick. So to keep on schedule, we did slightly more grafts on day two versus day one, which allowed me to come in again on day three and get out mid-afternoon. Day three mercifully ended with all the usual post-op things – a baggie of goodies, my week’s worth of Cephalexin pills, some pain meds, prescription AVO Cream and bacitracin zinc. Post-op, you mix the AVO and zinc ointment and apply on the donor area twice a day. The zinc ointment once per day on the recipient areas starting day three out from post-op. No issues now in the week or so since this whole thing started, other than annoying donor itch, staring in the mirror and the usual paranoia of losing grafts from sleep, etc. Follow up via email with the clinic has been good, with me asking the usual questions one would expect (although the post-op instructions are pretty specific). A couple of tips for what it’s worth: first, as I suggested earlier, wear comfortable clothing. Trust me. Loose fitting, comfortable stuff. I’ve learned this from years of airplane travel, but it really came in handy with all the “staying perfectly still” that is required for a successful procedure. Second, leave a bottle of water (or in the case of Dr. Umar, they gave me Gatorade) with a straw in the room during the procedure. One of the techs will simply hold it under the table so you can suck up some fluid while on your stomach, or otherwise while lying on your back. Saves everyone time, you don’t have to get up, and the Doc and techs would prefer to keep moving to stay on schedule while your meds are still effective. Third, don’t drink too much liquid night before/day of surgery – it prevents interruptions due to numerous restroom breaks. Forth, since I live at the beach in California and it’s pretty much been sunny every single day for the past year, I purchased a really soft bandana that provides UPF 50+ UV protection. Better than a hat, particularly as I’ve had work done on the temples, making hat scraping nearly impossible. I’ve gotten clearance to work from home for the remainder of April, so I might hit the deck for a little vitamin D once in a while with the dome adequately protected. Notes on Doctor Umar/clinic staff: there is no “sell job” involved here. No patient coordinator or sales person to encourage anything, sell anything or talk you into anything. Some might consider that a positive, others a negative. I considered it a positive, as I’d done my homework and didn’t need any further encouragement to take the plunge. Doctor Umar has been reviewed on this site before, and he’s pretty much as described – low-key, friendly, mostly business and professional. I’d describe the vibe this way: by the time you make your appointment and get to the office on day one, you are there to get the work done, and they are there to do the work. Not that there isn’t banter and whatnot, but it is a clinic that does the work efficiently without a lot of needless handholding. For the three days I was there up in the penthouse office, it was me, the techs and the doc – never saw anyone else, patients or otherwise. As has been discussed on this forum before, Dr. Umar does leave the grafted areas “unmolested” post-op for the most part aside from essential cleaning (as to not disturb the grafts), and you leave the office each day with nothing covering your head. So immediate post-op isn’t necessarily sexy. He also subscribes to the method of keeping the grafts moist with ointment for the first week, and this makes things a bit messy as well. That’s it for now. Including a good number of pre-op pictures to give you an idea of my “before” situation, but at this time, I really only have one post-op picture, as I can’t for the life of me find my camera. But I’ll get additional shots up soon. Again, I most likely can't provide more than many here have already outlined as to the experience, but if you are looking into Dr. Umar, I can certainly help guide you with what to expect.