NewHare

I'm about three and a half weeks out from my fut and still have some spots of lingering scabs on my donor scar. Is this normal ?

I don't want to force them off as that may cause further problems. Is there anything I could do or should I just wait ?

I was way off. Glad I asked. Thanks guys !!

I'm 3 weeks out from FUT and still feeling stubble throughout my recipient area. Are they already starting to grow (doubtful) or have they just not fallen out yet ?

When do they fall out ? Or are there some cases where they just don't ?

Do you know approximately how many total grafts you had transplanted so far??

Doesnt have to be an exact number, just approximately.

 

Reason why I'm asking is because most people have anywhere between 5,000 to 9,000 total donor hair grafts available, and that is it. You cant get anymore then that.

 

It also depends on which Norwood you are. If you're a severe NW7 you're probably in the 5,000 range of available donor hair. You simply dont have anymore after that, and you'll have to start digging into the beard-hair and body hair

That's hard to say, my first two were old 80's style plug jobs done by apparently unskilled surgeons. Very different from today. Last two procedures were 2k and 1500 or 3500 total. I'm an nw 5 or 6.

But the first two are anybody's guess. They also left me with bad scarring, which complicates matters further.

I've had four in total and even though I've been told by coalition docs that I could have another I'm very leery. I would much rather rely on a more tested way of determining this than just subjective opinion.

Also how long until fu's are securely anchored and one can wash their hair more aggressively ?

Anyone ?

Is there a certain donor density that is reached ? Is it just subjective ?

For those who have had multiple procedures, how do you judge when to stop and not have any more ? I've had multiple procedures, and having consulted with a few docs (some top docs) they tell me I can still have another. Though to me the donor is looking pretty thinned out at this point.

I'd like to know how is this judgement made ? And when is enough. Worse than being bald on top, would be to have a freakish gap or irregular thinness in the back donor area. Or a scar that shows through.

Also when is it safe to say the fu's are securely attached and you can begin to more aggressively shampoo again ?

That is correct. Patients have no say over how I or my staff perform any part of the procedure. In fact I have that in my consent form and it must be agreed to and signed before a procedure may commence. There can only be one chef.

 

As for your question to the moderators. My inclusion of a qualified doctor into my established practice is far from unprecedented in general medicine or HT in particular. I know of several other Coalition members off the top of my head who have included new associates who still work in these practices to this very day. To name a few in no particular order:

Dr. Robert Bernstein,

Dr. Michael Behneer,

Dr. Robert True,

Dr. Ron Shapiro,

Dr. David Segar (my mentor r.i.p.),

Dr. James Harris,

Dr. Edmund Griffin,

 

At one point most if not all of us were apprenticed to a more experienced HT doctor. Without this right of passage there would be no continuous existence of a method or practice. A successful practice needs to bring on new personnel as it ages. But it must be done responsibly and systematically. Those doctors listed above have succeeded in doing that, and I shall as well.

Doctor Feller could you clarify this statement. Are you implying that if one booked a procedure with Drs Bernstein, Beehner, ect they would have no say as to whom actually worked on them, be it Drs Bernstein, Beehner, or their associates ?

Yes it is a given that established doctors having associates is far from unprecedented, however that is not what is being discussed here. Or is it ? No one is questioning you having an associate, the question appears to be which doctor performs which part of the procedure.

It seems we are mixing two very different concepts. One were two doctors of varying experience work interchangeably, another where one can go to a clinic and choose between two or more doctors and have that and only that doctor perform the procedure.

Please clarify and make that distinction between these two very different concepts. So we can all better understand. Thank you.

I finally had my procedure Fri Jan 8 with Dr Beehner at the Saratoga Hair Center. Dr Beehner and his staff are consummate professionals who immediately make you feel welcome and at ease.

I arrived early around 7 AM and was warmly greeted by one of the staff who offered coffee as we went over the paperwork. Shortly there after Dr Beehner arrived and we proceeded to the photo room where we discussed the days events and took pre-op photos. From there we went to the O.R. where vital signs were taken, the plan was further discussed and Dr Beehner drew in the areas to be worked on. The room was very clean, well maintained and appeared to be well stocked. The atmosphere light, friendly but always very professional.

At this point I was given several drugs to numb the area. I then laid in a prone position and Dr Beehner proceeded to remove the strip. The donor was sutured, strip dissected, recipient slits placed and Dr Beehner's team then took over and began the all important placement. The team were very careful and professional at all times. As I recall I believe two had twenty some years of experience, and another young lady had over a decade. The procedure took in total approx seven some hours. And at the end Dr Beehner came in to look over the work and personally placed the last fu's in the hairline himself.

My only disappointment came when the Dr notified me of the low graft count - 1528 grafts/ 3234 hairs - however this has nothing to do with the Dr and all to do with my multiple prior procedures. I would imagine my donor area was a veritable scared mine field. This was my main concern, and I wanted someone with the experience to be able to walk that field. I am in my late 50's and considered a repair patient. Having had multiple late 80's style plug work. Dr Beehner a) removed large unsightly plugs, dissected and replanted them b) softened the harsh hairline. c) redesigned and softened the temple points d) added overall density to the frontal third region. e) removed old donor scar(s).

I was offered a next day shampoo, which I took them up on. The young lady also inspected the entire transplant with magnifiers assuring me there were no escapees.

All things considered it was a very exciting and pleasant experience. However as the proof is in the results final judgement will have to be reserved as I begin the arduous waiting period.

I'll just add I tried my best to be as accurate as possible however with meds on board at the time my sequence of events my not be fully accurate. However I tried as best I could to convey my experience as I saw it....

Do your research, believe in your Dr and yourself and grow well !!

Thank you guys. Great advice !!

I'm concerned about losing FUs during sleep in the first few days post surgery. Especially along the sides/temples and hairline. What precautions can I take to ensure I don't cause any harm to my HT ?

Also, how long until they are secured in place ?

Thanks guys for clarifying that. Wasn't aware of the distinction between the transplanted and native hairs.

I used Rogaine foam 2x daily for the first 6 months after my procedure, and then 1x daily thereafter. It certainly helps boost blood flow to the scalp and therefore to your hair follicles.

Home1212 you seem to have gotten great results from Rogaine in your first 6 months of use. If you were to have stopped after the 6 months would you have experienced any loses then thereafter. I'm concerned with what will happen after I stop usage. (6 months or so post op)

As I've said I would like to use it post op to boost growth - both donor and recipient - but am concerned about what will happen afterwards... Will I lose all the gains I made, will I shed and not recover the lost hairs, ect ?

Thanks guys for your input. I would like to give it a try. I certainly would want the grafts to grow more quickly and more robustly. As well as the donor hairs to grow back faster. But I'm concerned about coming off of it down the road.

Anyone ???

I was thinking of trying Minoxidil post op. However only in the short term to aid in regrowth and possibly help along the newly transplanted follicles. I'm late fifties, and my frontal third is mostly if not all transplanted hairs. I was told by docs I consulted with I would not benefit from any long term meds at this point. However I'm wondering if in the short term post op will Minoxidil help, and if so is there also a possible down side such as shedding, or any other negative concerns ? Which then I would probably leave well enough alone.

If the benefits do outweigh the negatives when should it be started and when should it then be discontinued ?

Thanks Gil, I'll get back to the group with my findings. I think this may be a better way to go in that I was concerned with the mess of a gel. Especially in public. The liquid appears to have the same amount of aloe and can be misted on throughout the day.

While looking for Aloe Vera Gel for my upcoming procedure I noticed right next to it was a liquid version ( a dietary supplement, 'Aloe Vera Juice' ) I looked at the labels and both were 99% organic Aloe inner fillet juice at 58ml for a 2 oz serving size. The only difference was the gel had a thickener added to the juice.

Certified organic aloe vera juice (99.7%). Less than 1% of the following natural, food grade sources: citric acid (oxidation inhibitor), potassium sorbate (mold inhibitor).

http://www.lilyofthedesert.com/product/preservative-free-juices/

I know most here say to use the gel. Is the gel better post op for any reason ? Has anyone used the juice version instead of the gel ? I thought the juice version might be easier and cleaner to just spray on and later rinse off instead of dealing with the gel.

Also how long after the procedure can you apply the aloe ? Can it be applied right after, or is it better to wait a few days ?

One other thing, will the Citric Acid pose a problem post op ?

Thanks...

http://www.youtube.com/watch?v=0opDXxppUxs

Thanks Spex !!

I've already downloaded your vids along with many others and converted them to mp3 to listen to while in the car. Great info...

Thank you Bill your forum has been most helpful in preparing for my upcoming procedure.

Petchski could you elaborate on the ATP Spray you mentioned. Not really familiar with that. Have you used this in the past ?

esrec, yes getting through the first few months can be very stressful. Not at all ready to deal with this again !

Also I noticed no one mentioned Biotin, which I thought sped up hair growth. I hope I didn't waste my money as I already stocked up...

Copper peptides, emu oil...

Thanks Petchski.... are these for the donor or recipient areas. or both ?

I'm hoping to speed up the healing and growing process as much as possible. And minimize any problems with the donor scar especially prior to the stitches being removed.

What are some of the tried and true measures one can take to achieve best results ? Both pre and post procedure. I'm looking at around 2k FUT.

Scalp exercises, vitamins, supplements, shampoos, ect.

Interesting approach albeit a little too invasive for my taste. I suppose one of the trade offs might be losing some hairs via the FUE approach, though no one has actually shown that be true. A study would be most helpful.

Whatever your decision I wish you all the best. Having plugs myself I fully empathize with your position. Do let us know how you make out.

NewHare, here's a link to a linear excision of the hairline (also called a brow-lift?) from one of the docs. To clarify, the whole line(s) of plugs are taken out in a strip just like an FUT strip in the back donor. The plugs are trimmed down into FUs and replanted in front of the sutured incision along with new grafts from the back. So all plugs along the hairline are completely removed in the initial procedure. Then in a second procedure once the incision has healed (I'm told in about 6-8 weeks for my case) and blood supply reestablished, a second procedure is done to fill in behind the linear scar back to the existing hair. A doctor or long-time member of the forum could definitely better describe it but I think that is the gist of it.

 

https://www.drvogelplasticsurgeon.com/gallery/corrective-hair-transplants/case-1#galleryNav

 

I don't see any appearance of a scar in the final results but the pics might be a best case scenario. It all depends on your situation too. In my case, this is what is recommended for me due to quality of donor and intensity of plugs. I believe this will yield the best result for me but it is most certainly the most invasive, which I am apprehensive about.

 

From my research I've gathered that the individual extraction of the plugs can cause damage and some percentage don't survive the process.Hopefully others more knowledgeable than me can chime in on % yield from punching out grafts vs a strip.

 

Good luck in your research, I'm interested to hear what you turn up.

 

NewHare, yes I didn't mention this plug removal/recycle approach ("Lucas" technique I believe) as the one doctor recommends the complete excision over this due to the number of sessions required/slower process and better yield from taking all out in a strip.

Albatross could you share some before and after photos of the 'excision' technique. I am not familiar with it, however I would be concerned with having a scar running across the frontal area.

Here is a case by one of the coalition doctors where the plugs were debulked/redistributed over two sessions. How many sessions were you told the excision process would take and how well will the plugs be camouflaged then thereafter? Also could you elaborate on the 'better yield' you mentioned in percentages between the two procedures ?

http://www.hairrestorationnetwork.com/eve/166773-old-pluggy-grafts-made-more-natural;-3738-grafts;-dr-beehner.html