7Shel

Great work. This is going to be a very nice result. Just a matter of playing the waiting game.

Five days is definitely fine. I’ve had six transplants and resumed normal sleeping between the fourth and fifth nights after each procedure. Never had an issue with losing a graft.

If you can’t reach the surgeon today, I’d consider going to an urgent care/emergency room. Or perhaps contact your normal physician. I’d then make sure you speak to the surgeon first thing tomorrow morning. Normal treatment would be a course of antibiotics, but you shouldn’t self-prescribe. You need to seek a medical opinion. I’m very surprised the surgeon didn’t provide contact information for emergencies. At minimum, there needs to be a way for you to reach someone via email, text, etc., even if it’s a nurse at the clinic.

I’d agree. Second photo seems to indicate infection. Have you called your surgeon’s after hours emergency line? Every surgeon should provide you with one. In terms of the forehead pain, that’s probably normal. Does it feel tight and hurt when you try to raise your eyebrows, for instance? That’s just the residual pain of the local injections. Can take 5-7 days to wear off.

Well, coincidentally, I was expecting to share a review in the coming days, but I'll give a brief overview here. I had a FUE procedure with Dr. Wesley 10 days ago. As you can see from my history, I previously had five FUT sessions with another surgeon. Dr. Wesley was able to capture 1725 grafts via long-hair FUE. That brings my total graft count to approximately 10,000! I'm very hopeful that this procedure will address the remaining weaknesses I still had (thinning in mid-scalp, crown, and some pitting in the hairline). I have every expectation that it will be a great result, but it's also good to know that Dr. Wesley estimated I could easily get another ~1500-2000 FUE grafts if needed. Thank goodness for my donor supply. I can share more details and photos, but I'll say that the experience with Dr. Wesley was excellent. High marks all the way around for him, his team, the approach, and aftercare instructions/strategy. As I mentioned, I'm on day 10 and the whole experience has been a breeze. I had no swelling or pain, extremely minimal redness, and all crusts were gone as of day 8. Numbness was legitimately gone by day 2, which was a very nice surprise. Only minor annoyances were some slight itching (didn't require topical intervention), a few hours of hiccups the day after surgery (resolved with 1 tablet of Baclofen), and a case of messy hair. The last reference is obviously tongue in cheek, but it's amazing how much I rely on hair pomade to control my hair. I returned to work on Monday (day 6) and my co-workers knew I was getting a procedure, but they still laughed at my non-styled hair look. I will begin normal styling routine tomorrow, so back to normal and no further worries there. Before the procedure, I had some concern about how well the donor area would be covered with my existing hair because I wasn't sure it was quite long enough, but it really is barely noticeable, even with several small bands shaved down. By tomorrow, with some light combing and pomade, I doubt you'd be able to tell I had anything shaved. Regardless, it's growing back quickly and I'll probably get a haircut in about another two weeks to blend everything. Anyway, I'm quite pleased with Dr. Wesley and my experience. I'd absolutely recommend speaking to him if you're considering either FUE or FUT, as I was very impressed by examples of all of his work. I think he's highly underrated and should receive more attention than he does. Feel free to ask any questions, but will probably end up starting a new thread if helpful.

Wanted to provide a check-in. I’ve decided it’s necessary to move forward with my first FUE procedure to address some weak areas. I’ve attached a few photos which show further loss behind previously transplanted areas (photos 3 and 4). This area in the mid-scalp has created sort of an island effect. It’s not noticeable when my hair is styled, so some may wonder why I feel like I need to address it, but I feel that it’s enough of a problem when my hair is wet, unstyled, etc. Additionally, I’ve attached photos (1 and 2) that show the gaps behind my hairline that I’m concerned about. My plan is to address the gaps and mid-scalp with ~800-1000 grafts. That should hopefully leave me with another ~1000 to fill in any further crown loss (or address any other weak spots that may develop). As mentioned previously, I also have beard grafts available for the crown. I have a consult scheduled in August with Dr. Wesley and have discussed the situation with Dr. K. While all of my procedures have been performed by the same surgeon, I’m thinking I may need a “closer” for the remaining work. I’m at the stage where I need to ensure there are no more wasted grafts. Would welcome any other suggestions or thoughts.

Totally understand what you’re feeling. My take is that it’s a very good result, but you’re going to need an additional 1000 grafts or so to feel content. I would be unhappy about the area you highlighted too. Luckily, seems like a very solvable situation. Hey, I’m about 8500 grafts in and I still have some thin areas that bother me. It’s a long-term game, and reinforces my feeling that one session rarely gets people to where they’re totally happy.

Still curious about transplanting between existing hairs when the existing hairs are transplanted, not miniaturized native hairs. It seems like the majority of doctors still want to shave instead of going the no-shave route. Are the results going to be worse?

Interesting topic. Here’s a question: does the equation change when you’ve already transplanted a decent amount of hair into an area, but then want to add even more density? Is transection still a risk? Would it still be a poor decision to not shave the area?

I’ve not been a huge fan of hair fibers. Used them from time to time, but I always found the application to be messy. I went in for what was effectively my 12 month check, and the doc agreed that it was reasonable to add 600-800 FUE grafts to the thin spots behind my hairline and I’m the mid-scalp. He estimates I can get 2000 FUE scalp FUE total without really depleting the donor area. I’d like to proceed with adding 600-800 to the areas mentioned, but also additional grafts to the temple points. This would potentially be risky. If my crown loss became very significant, I’d have to rely on maybe 500 or so FUE grafts from the scalp and the remaining from beard hair. Not the worst scenario, but I’m conscious of getting to a point of diminishing returns. I’ve obviously spent a lot of time and money on procedures, and you’re right that the results are overall very good, especially considering my starting point. I had email conversations with two other well-known docs, and there were differences of opinion. One suggested 1000 grafts in the crown and then 500 as a spot treatment to the thin areas. The other doctor’s recommendation was very surprising: 1000 grafts to the hairline and immediately behind it and then assess the crown later on. Both indicated they’d want to do a full shave FUE, which is potentially a problem for me because I have a very forward facing job and can’t realistically return to work after a 2 week vacation with a buzz cut, redness, residual scabs, etc. I’d be looking at no shave FUE, but I know that’s less than optimal. I do wonder if a stick and place approach could work?

Wanted to post a few 10 month photos (hit the 10 month mark about a week ago). Not a huge amount of change, but wasn’t really expecting it. However, I’m curious to see if the hairline continues to mature through month 12 and a little past that. I find it tough to see a difference between pre-op and today, but it was such a subtle amount of work that it’s probably difficult for me to see. Crown has filled in slightly more. No photos of the donor scar, but this is what my donor region looks like after a haircut a few days ago. I am a little concerned about shedding. Whether it was a seasonal thing or something stress related (I’ve been working a ton of hours in a very high stress environment), I felt like there was an increase in shedding over the last month or so. I’m probably going to head in for a check in the next few weeks to see if anything else is going on. I also think I’m at the point where my native hair may be thinning in the mid-scalp. There’s a small spot between the frontal and crown work that has no transplanted hairs, so I’m guessing the native hairs are miniaturizing. I know the subject of hair greed has come up, but these small areas of concern still impact me. I think most of us who have experienced hair loss and then had successful transplants can relate to still having some degree of insecurity.

Good topic and presentation! He looks great and I’m sure he’s quite happy. My general approach is similar. I have yet to undergo FUE, but completed my fifth FUT procedure last June. I started in a worse place than this patient and also had more hair loss after quitting Propecia in 2015. I’m now about 8300 grafts in and feel fortunate to have transformed my appearance dramatically. I feel more fortunate that FUE is still available to me, even if it’s not certain I’ll have another procedure. Definitely think this case illustrates the importance of careful planning and having a vision of what you want your end result to be. Good work!

Thanks, I appreciate it! I generally keep the hair at maybe the equivalent of a 3 guard and the scar isn't visible. My barber usually trims with scissors (just preference), so the 3 guard length seems about right. My guess is I could pull off a 2 guard without drawing attention to it. Full transparency, I wouldn't be able to go any shorter than that and the scar is wider than many people might be willing to deal with, but that was inevitable. Five surgeries is five surgeries. I was comfortable taking the chance and wanted to get as many grafts as I could via FUT. Even though I don't necessarily know if I would want to wear my hair shorter, I may still fill in the scar with some FUE grafts just to give myself the option.

Posted a few more photos. These were taken under overhead bathroom light, but I think you can see what I meant about being able to cover my crown fairly easily. I also tried to get a few shots of my temple points. Aside from my initial procedure, temple points have been untouched while we focused on front and mid-scalp. I really think I'm going to go for it over the summer and add some grafts there. AB: I would definitely consider using beard donor to fill in the crown. PlzRespond: I believe about 500 grafts and I'm 36.

Thanks, guys. You’re definitely right about combing over the crown, Melvin. The photos I posted from my last visit purposefully exposed the crown because we wanted to get a better idea of how things were progressing. Normally, I comb it over and you really can’t see the hair loss. I’ll take some photos in the next few days with my normal style, which will give you a better idea of the coverage I can get. Spanker, would you leave the crown alone because future loss is to be expected? I’m kind of torn right now. I want to wait a full year or more to see where I’m at and then add more grafts if I’m not happy, but I also know that it’s a moving target and I don’t want to chase loss in that area when, as I just mentioned, I can cover it for now. Curious what your thoughts are on temple points too. I don’t want to get too greedy, but I do think a little more framing would be nice.