echoes

Thanks for the update, really nice to hear from you. Sorry to hear that the redness has persisted after all these months (but at least like you said it is pretty minor and not very noticeable).

 

Did Dr Erdogan say that you had any risk factors or have any ideas on why this happened to you?

He didn't mention any specific risk factors.

The only explanation that comes to mind, is that my skin tends to scar easily and form big scars. One physician explained awhile back that this is linked to having flexible connective tissue (eg, my joints are relatively flexible, I have flat feet, etc.) I mentioned that to Dr. Erdogan but he didn't indicate that this was any concern for the FUE. Who knows.

Some people seem to say that fair-skinned patients are at higher risk, but I am not convinced. There are plenty of cases of fair-skinned patients not getting redness while others do. I haven't seen any real evidence or rationale for that. Anyway I am somewhat in the middle, as far as white caucasians go so I doubt that'd have been a big driver one way or the other for me.

Hey Echoes, any updated pictures to show final results?

 

Also, what ended up happening with the redness situation? I have pretty sensitive skin so I would be somewhat concerned that I would encounter similar complications, so would be great to hear if this ended up going away?

Hi jcs87, thanks for writing! When I saw your post I took some photos to share, but I haven't had a chance to get to it. I'm not sure if the photos really show it, but please have a look. The overall transplant I think went well, results are now stable and are pretty similar to what I shard in my last update, so I'll focus on the recipient redness - it's still there. In the current state, it's only noticeable under specific lighting conditions (if there is a light coming down onto my hair from directly above, for example).

This is despite me having tried a few things:

- hydrocortisone (recommended on this forum, and by ASMED)

- aloe vera, almond oil (recommended on this forum, and by ASMED)

- aspirin paste (recommended on this forum)

From months 0-4 the redness made huge improvement But from month 4 until today (16 months post-op), improvement is slight if any.

I take hope in that a few members have posted that their recipient redness took a few years to fade!! Not sure what else there is for me to do? To be clear, overall transplant result is good. My concern now is more long-term, if the skin is damaged and if something changes with my hair and this recipient area becomes more visible...

**EDIT** sorry the one photo seems to come out upside down, even though on my PC it displays fine; I don't see any way in the post editor to ensure the attached images display the right way...

Congratulations on your excellent result (so far, with more sure to come).

How is recipient area redness? It looks like you still have a tiny bit?

Looks like you've made great progress so far, and you seem to have handled the ugly duckling phase with grace.

The best should be yet to come. Glad as well that you suffered very little recipient area redness.

Can you post some side by side of original hair and current? Also, have you had any side effects taking finasteride?

Hi pandapanda - for a general before/after comparison, if you scan through this thread you should be able to see the evolution. Let me know if you're curious to see a specific angle.

Side effects of finasteride. In 11 years of taking it, no sexual side effects. Some people report it causing anxiety, though I haven't experienced anything serious or debilitating. Of course, I do sometimes get anxious about things (like anyone I suppose) - would I experience less of that if I weren't on finasteride? Hard to tell.

Hi , other than the redness issue are you happy with how things have progressed so far ? I'd love to see a top down picture of your vertex similar to the one in your pre op pictures . I believe you had 900 grafts placed there do you feel this was enough to give good coverage back there ?

Other than redness I am really happy with things! By now the ugly duckling phase feels like a distant memory...

Regarding vertex, do these photos help? Note my hair is wet here. Yes, I had 900 grafts placed in a roughly 50cm2 area in the vertex, and I'm happy with the result. My goal for the vertex was not to restore full density but just to give it some light coverage. Possibly in the future, I might lose more in the vertex area and want to reinforce slightly.

8 month update with photos!

Sorry for the delay; here are a few photos I just took - some with dry hair and no flash, others with wet hair and flash.

Am sharing these with ASMED as well to see what they might have to say about the redness.

You must be at 8 months now. Happy with how things have turned out? Would be nice to see an update if you have time.

Hi DEB1982, sorry for the delay in writing!

Current status at about 8 months post-op:

* I don't feel like I have gained much density in the last month or two. It could be for me that peak growth was months 3-6 (after ugly duckling), and from month 7 on it just fills in more slowly?

* Recipient area redness is still an issue. I spoke to ASMED about this at month 5, and they asked me to wait until month 6 to see if it would resolve itself. It didn't so they suggested 1% hydrocortisone, applied 3 times a week over a one month period. I have just finished that, and don't notice any improvement.

I've been quite busy but in a few days I'll manage to take a few good photos, both to upload here and to share with ASMED to see what they suggest now for the redness.

This is the result I'm really excited about and it's really starting to come together , you have very similar loss to me and I think similar hair characteristic. Out of interest what was the thickness of your hair caliber in microns ?

 

You mentioned that you spoke with dr erdogan about how your hair may look in the future what were his thoughts ?

 

Also in your vertex what kid of coverage are you expecting? Was another procedure spoken about to add more density to this area in the future ? Or is this not a concern for you ?

 

Did you suffer any shock loss in either recipient or donor ?

 

Did you have any facial swelling ? I'm not sure how I will explain this to my kids if I get bad swelling like some guys seem to get

 

Thanks in advance

Actually I'm not sure what my hair thickness was, the punches used were 0.7mm on the side and 0.9mm at the rear, if that gives some sense.

Vertex and future loss: The vertex was planned to receive 900 grafts over 50cm2 (density of 18/cm2). I'm not sure exactly how strictly they stuck with that plan. Also, once at a certain age, having an intact hairline but a density of 18 follicular units per cm2 in the vertex is probably an acceptable look? Probably I will progress to Norwood VI eventually and need another procedure to deal with the expanded vertex. Dr. Erdogan estimated me having a remaining donor capacity of 4000 after this procedure.

Shock loss: yes, in the recipient area (specifically in mid-scalp)

Swelling: Yes, for about a week after the procedure.

Looking good so far! Has really started to sprout now.

Thanks!

Echoes sorry to be a pain but are you able to update. I'd imagine you have seen a big change since you last updated 6 weeks ago. You are coming up to 5 months now so would be good to see.

 

I'm there next week and a little anxious as you can tell.

Hi DEB1982, not a pain at all. I appreciate you following my progress and I'm glad to be of help, after so many previous posts on this forum helped me.

Here is my 5 month update

Yesterday I got my first normal haircut since the procedure (it was my second haircut since the procedure, but the first one, I only had them trim the sides since the top was still thin and short). It was actually because of the haircut that I had in mind to post another update here.

Obviously I am looking much better now, and feeling great about the results so far, and looking forward to continued progress!! Only issues now are some lingering redness and numbness in the recipient area, though both seem to continue improving, albeit slowly.

Sorry for the delay, I've been terribly busy the past few days! Here are some photos from 14 weeks post-op

Finally I'm past the point of being extremely self-conscious in public, and am now only slightly so. The recipient area redness is still there, though much fainter than before, and furthermore it's now hidden a bit by emerging hair. Hopefully over the next few months it fades completely. There is continued tingling, itching, etc. in the scalp so all seems to be progressing well!

It was at around 12 weeks post-op that I finally got my hair trimmed, and just the sides at that. The top hasn't been touched yet, though I suppose that around 18 weeks post-op I will be back to getting normal haircuts.

There certainly were times a month or two ago that I looked at my fugly recipient area and questioned what I'd done, but patience (and more patience) is everything. Prepare yourself in advance for months of looking awful. If you're lucky then you might get through it faster, but be ready and be patient! I'm already feeling very excited and am looking forward to the months of further growth.

DEB11982, I hope this helps as you prepare! I'll keep posting updates, probably every 3-4 weeks at this point...

Any update Echoes? You must be a little over 13 weeks now. Hopefully just coming out of the ugly duckling phase.

 

I have under two months to go now until my procedure with Erdogan. All becoming a little real now.

Hi DEB1982, I'm indeed coming out of ugly duckling phase! This coming weekend marks 14 weeks - I'll have a chance to upload some photos then.

How you getting along Echoes? Must be just over 2 months now, half way through the worst of it.

Thanks for asking, sorry for the delay in replying. I got a notification you posted but have been travelling for a few days.

I'm now a bit past 10 weeks and am really pleased with improvement the past few weeks. I'm starting to notice regrowth in the recipient area. Lots of tingling and itching, which are hopefully signs of continued growth. Still some redness though it seems to be slowly improving (the photos this time make it look worse than it really is. especially the top view). Still some numbness, and I expect it may take a few more months for that to go away.

I hope I'm well past the worst of it! My appearance is better than a few weeks ago so hopefully the ugly duckling phase is almost at an end. I'll post another update in a few weeks, hopefully things continue to progress!

dude how long did they take to reply to your email consult? lol

 

its been about 2-3 weeks

Do you mean the initial consultation? I don't remember exactly but it was something like 2-4 days. I guess this may depend on their current volume.

After the initial consultation email response time has generally been within a day or so, both in the weeks before surgery and after surgery.

Hang in there mate , I've got a feeling this is going to be another stunner !!!

Thanks for the encouraging words! It really helps, now in the ugly duckling phase where progress is slow, and my recipient area still looks red and bare!

Here are some photos from yesterday morning at 7 weeks post-op. I'll keep uploading photos every week or two for awhile, hopefully it helps some readers here. Apologies that the lighting doesn't match the past few weeks, I just moved!

I still have some numbness in the recipient area, though less than a few weeks ago. I think I see a few translucent hairs coming up in the recipient area and I'm hoping this is the beginning of the regrowth!

Your native mid scalp hairs havent grown much, Is this due to shock loss? Did asmed comment anything on this? Hope atleast sides and back are growing back fast

Yeah, I think I have had some shock loss there, no comment on it from ASMED. I'm not too worried about it at this stage. After all, it's something every clinic warns you may happen, and is usually just temporary.

Here is my week 6 post-op update.

Still very much in the ugly duckling phase!

hkuser since you asked about the side and rear I included a photo of that as well, the photo makes it look thinner on the sides than it really is.

The recipient area redness is slowly fading away. To reassure myself I need to look at photos from a week or two ago to realize that yes, the redness is fading, just slowly. And every time I try to convince myself that in just another week or two it'll be gone but who knows. By the way I'm always taking these photos in the morning right when getting up, for consistency. Over the course of the day the scalp gets slightly redder (I suppose due to activity, increased blood pressure and heart rate).

I feel like I'm starting to see some translucent fuzz coming up in the recipient area, though maybe it's just my mind playing tricks.

Still taking biotin and MSM to try to speed up hair growth to get some more scalp coverage.

Looks fine, shame you still have a bit of the redness though. Hopefully that settles down soon. Has anyone said anything to you? Did you have the PRP treatment?

I did get PRP. I was planning to spend the €300 on it, but ASMED included it for free. This might be because they describe PRP as optional except for some cases where they say it's mandatory. I'm not sure, but maybe because my surgery was over two days and was relatively big (>4000 grafts) they decided it was mandatory for me and therefore included??

I have been lucky with the timing of my operation and have been able to hide well. I just finished a master's degree a few weeks before the FUE and am starting a new job in September, so having a few months off really helped! I am wearing a hat now everywhere I go, but I can't wait for this to end! This afternoon I will wear a cap and go outside to try to get a little sunburn on my face to help blend it LOL.

Sorry, missed responding on this. A hat is definately out of the question for me, at least in the office. Thankfully I'm not really client facing although I do have meetings with externals ocassionally. I think I'll just keep meetings of all types to a minimum the first week (hide out in my offce ) after which I will be 3 weeks post op and hopefully at the stage where its not obvious.

 

BTW, I took your advice. I am now staying in the clinic on the night of the surgery. They have advised I can stay that night and the following two night (after which I fly home), but for now I have said I'll just go with the one night in the clinic. I think I'd prefer the luxury and facilites of the hotel (room service, wider choice of menu etc).

 

So how are things just over 1 month post op? Still some redness? Anyway issues arisen?

Sounds good! Yes, I would say the morning after surgery when ASMED washes your scalp is a good time for you to move to the hotel for the comforts there that you mentioned.

Photos after 4 weeks are in the OP (a few days ago I was able to edit it to upload them). For some reason now I seem to be unable to edit the OP, so here are some photos from this morning, almost 5 weeks out (4 weeks and 5 days...)

Still significant redness, though it seems to be improving slowly. An email with my patient coordinator a few days ago reassured me not to worry. I seem to have much worse redness than is average, so your scalp should get back to normal sooner, unless you know that you have sensitive skin.

No I do not recommend putting ice directly on recipient area. It can cause vasoconstriction and possibly decrease the blood flow to the grafts.

Thank you, I understand this would be a critical error, especially early on. I'm almost five weeks post-op, still risky?

I guess for now I'll stick to aloe vera and ritual sacrifices to the hair deities.

I agree and have never suggested to patients to apply heat to an area that is still red or inflamed. You may want to try cooling the Aloe Vera or Vit. E oil before applying to affected area. Time is probably the best thing for removal of redness but I understand that everyone would just like a way to make it happen sooner.

Thanks Dr. Charles. Would you even recommend occasionally applying an icepack to the recipient area?

I don't think it would in the long run as its damaged skin rather than bruising, the hot water may actually dry it out and make it worse.

 

If you want to try something, you'd be better off moisturising an hour or so before you take a shower daily. Just applying oils like olive oil, rosehip oil and etc.

True, the heat may irritate the skin. I guess I wondered if there were benefits to stimulating blood flow. I will try using some oils to moisturize!

I have read that many have applied aloe vera gel and distilled with hazel to the recipient area to combat the redness. I never used anything apart from vitamin E oil for the first week post op, but my redness lasted for nearly 2 months - it takes a long time to go away for some!

Yeah I'm already using aloe vera and sometimes witch hazel, just trying to accelerate this somehow...

I had a FUE done by Dr. Erdogan of the ASMED Clinic about a month ago and have been documenting my experience here.

I still have significant redness in the recipient area and I have been wondering... people often use hot compresses to treat bruises. The heat stimulates bloodflow which helps the bruise vanish more quickly. So I'm wondering if anyone here has any comments or thoughts on what effect a hot compress might have on redness in the recipient area? Good idea or bad?

I've just emailed my coordinator at ASMED and will share here their response to this question as well.

You started finastride when you were just 22, so did not finasteride save your hair?Did you keep losing and ended up with thinning? What about side effects?

Finasteride is more effective at preserving the vertex than the hairline, although it does slow down loss at the hairline.

I think you are right, most people will probably be quite facinated and think its quite cool. I actually don't mind telling people and if I'm honest I'm one of those people that slightly enjoys the attention (I blame it on middle child syndrome ) but I also have a fairly prominent role in the office so while I don't mind being open about it (my family and all my team at the office already know I'm going to have it done), I equally don't want to be the 'talk' of the office. I've planned it so that I have 12 days post surgey to heal before going back to work so I might just make a judgement on that Monday morning as to whether I can get away with it, although even if I'm lucky to have little redness then my super short hair cut will attract some comments.

 

Anyway, hope your redness settles down in the coming days/weeks.

Good luck JustJax! After twelve days it will definitely be obvious without a hat. If I were in your position, maybe that morning I'd just send a quick email to your team with a one sentence explanation. Might be more awkward if you are client-facing in your role.

Does look red, is it sore? Hopefully it settles down in the next week or so. How soon did you feel back to yourself after the surgery? Are you back at work? Did you tell everyone? I was kinda hoping to keep it on the down low myself but I do worry that mine is going to be too obvious, especially with such a short hair cut too. Might attempt to use the sunburn excuse for a week or so

 

As for the hotel. I've actually emailed the clinic this morning to see if I can have a room at the clinic for just the evening of my surgery. Might even pay for the Radisson on the same night so I don't have to check in and out again.

The recipient area has no soreness at all, and hasn't had any pain since right after the procedure. I do feel very frequent tingling sensations, occasionally even feeling like a little sting. Those sensations reassure me of scalp healing and rebuilding. By the way, the donor area, even though by now it looks fine has periodic itching.

I felt back to myself around day 5. That was when the swelling was basically gone so my face looked normal, and donor area soreness was no longer bothering me when I laid down to sleep.

In terms of other people seeing it, I've been lucky in that I have had a bit of time off before starting a new job in late September so I've been able to avoid that issue.. However I did go on a week-long trip with my parents that we do once a year. My mother made fun of me for my very short haircut, then she noticed the redness which I said was a burn and she let it go at that. We are much more sensitive about our appearance than other people.

There were a few people who I was open with about it and they were totally cool with it:

-a girl I was dating a few months ago at the time I was deciding it. She didn't think it strange or anything.

-a friend of mine from Istanbul that I met up with a few days after the procedure. At that point with the grafts not yet fully in place and scabs still on the scalp, it would be unhealthy for the grafts to be covered with a hat all evening so I told him about it, and he was very casual about it, remarking how many foreigners were coming to Istanbul for this. While we were at an open air bar he ran into a friend of his from Istanbul... who it turns out also did FUE a few years ago!

I think I have at least another week or two of looking awkward. I will try to wear a hat as much as I can, and where I can't try to pass it off as a burn. Yes, everyone who found out has been cool, but somehow we still just want to keep this to ourselves don't we?

Have you been using aloe vera gel to try and reduce the redness? The thought of going back to work like this after 3 weeks scares the hell outta me, specially coz I cant wear a cap... Guess no choice though, have to bite the bullet and tough through 4-5 weeks before hairs grow a bit long and redness reduces.

 

Thanks again for sharing pics and all the details, very helpful and keep it coming. Cheers

I have been using aloe vera gel, though on average just twice a day. If I were more aggressive with aloe vera maybe it would help a tiny bit, but no care routine can change the fact that I have sensitive skin and I got a very high graft density at the hairline...

Good news for you is that if you know your skin isn't particularly sensitive and you are getting fewer grafts/lower density then I think your redness should be much less than mine, hopefully.

Glad you find my experience helpful! I will keep taking photos periodically (and I will try to be more consistent about lighting than I have been...) to update.