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Albion71

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  2. Albion71

    HT 2, 8.5 months

    By Albion71,

    I've added a selection of different photos under different lights, in slideshow format.

    The density is better than following the Transmed hair transplant, but still quite thin overall I feel. After a spurt of growth around March/April, there's hasn't been much change in the last couple of months.

    The scar has not changed at all, and is still very wide and bare.

    I am meeting Dr Lindsey and Spex in a couple of weeks for a review.
  3. Albion71
    At Spex's suggestion, I've taken a few more photos showing the front of my hair under different lighting conditions.

    Brushed forward normal lighting



    Brushed forward flash



    Brushed back normal lighting



    Brushed back flash



     

     
  4. Albion71

    HT 2, 6 months

    By Albion71,

    Unfortunately, progress has been rather disappointing. After a spate of growth around the 3-4 month mark, particularly around the temples, there has been little growth at all of note in the past month. If anything, some areas seem to be thinner than a couple of months ago. Growth at the front in the middle has been virtually non-existent.

    I realise it's only six months still, but there has been very little sign of any new hair coming through in the past month, compared to 2-3 months ago, so I am not optimistic.

    Also worrying is the scar, which is still very prominent. I'm starting to conclude that this is not down to shock loss; I think there has been stretchback which is why the scar looks so wide.

    Front

    Left



    Right



    Scar



    Vertex



    Top



     
  6. Albion71

    HT2, six weeks after

    By Albion71,

    These photos were taken on day 45, just over six weeks post HT.


    I haven't suffered much - if any - shock loss, so my hair now looks pretty similar to pre-op, aside from a little redness in the recipient area. This is largely covered now by the native hair.

    The main contrast with my previous HT is that I have not suffered from any pimples bar a couple of tiny ones. By this stage following my previous HT I had pimples popping up all over the recipient area. Is that a sign things are healing more normally?

    The other main difference is that the scalp was not as red first time round - I'm guessing that's down to Dr Lindsey packing the front hairline more densely this time.

    The scar is a little red, but nothing out of the ordinary. When I went to see my barber for a trim, he said the scar was the best he had seen out of about 20 HT cases whose hair he has cut.

    I started using minoxidil foam four days ago. I tried Minoxidil once before about five years ago, for about 6-9 months, with partial success on the crown, but I didn't like the greasiness, and it made my beard much tougher. Hoping it will help cover up a bit more of my thinning crown. I am off finasteride completely.








  7. Albion71

    HT2, two weeks after

    By Albion71,

    A few more pics. I've started using the photo gallery so hopefully the pics are a bit cleaner.

    Two weeks after the HT now, most of the scabs gone. Scalp a little pink. All pretty normal.

    My scalp feels a little sore at the top of my head - no grafts put there - which I'm putting down to scalp tightness.







     
  8. Albion71
    So after much deliberation, I decided to have a second hair transplant.

    Those of you who followed this blog before will know that my first HT was far from successful.

    It was a major decision to have a second attempt, because at the back of my mind, I wondered if I was fundamentally unsuitable due to my physiology. However, it seemed to me the only way I could establish this was by having another another operation, with a top notch surgeon.

    This time I took the advice of Spex, who many UK hair loss sufferers will be aware of, and travelled across the pond, for FUT surgery with Dr William Lindsey on 22 December 2011 (photos at end of post supplied by Dr Lindsey).

    My decision was partly influenced by Spex assuring me that Dr Lindsey would be prepared to operate even if I had an inch or so of hair in the recipient area (I will need to be fairly presentable for work by mid to late January). In the event, I think a little more hair was trimmed than I anticipated, and in any case, Dr Lindsey felt it wouldn't make much difference because of shock loss. We shall see.

    Dr Lindsey's plan

    I flew into Washington on 21 December, and had my consultation with Dr Lindsey the same afternoon.

    One worry of mine, having lost so much donor hair during the Transmed HT (Transmed billed me for 2900 grafts), was that Dr Lindsey establish how best to use my remaining donor hair, given that I may one day end up a Norwood 6/7 like my father.

    He estimated that I could get about 2500 with this FUT (we ended up with 2495), and probably 1800 to 2000 in another FUT, with FUE a further option in the future.

    With that in mind, and given that I am already fairly thin in the crown/vertex area, I was a little concerned that Dr Lindsey's plan involved covering just the front third of the head, and would pack a lot of the transplanted hair very densely at the front hairline. I wondered if it might be better to use this hair further back on the head to achieve a wider, if slightly thinner, coverage.

    I checked with Spex, who assured me this was good practice, so I went ahead with Dr Lindsey's suggestion.

    But it means, unless I can regain (excuse the pun) some ground with Minoxidil foam, which I am yet to try, that I will certainly need another HT to attack that vertex/crown area fairly soon. And it will be pretty challenging to use my remaining donor hair to cover all the bald areas, if I follow my father's hair loss pattern.

    The surgery

    We kicked off at 730am. Dr Lindsey took out the strip, and punched the holes in my scalp, and then the technicians set to work inserting the transplants.

    There were never more than two technicians working on my head at any one time, in comparison to four at Transmed in my first op.

    As before, there was very little pain, except from my lower back, from sitting in one place for so long.

    The operation took about two hours longer than my previous HT, though this was partly due to my recipient area not being shaved, which made the technicians' job a little more time-consuming.

    I was back in the hotel by around 5pm – a long day. Dr Lindsey and Spex are both very anti hat-wearing, so I faced the world with my bare, blood-spattered head. It wasn't so bad. The doctor reckons I will be ok to wear a loose cap by my flight back on the 26th, four days after surgery.

    He is otherwise pretty relaxed, and told me to have a beer to unwind if I fancied one. However, he was very strict about no alcohol or anything blood-thinning for 10 days in the run up to the operation. There wasn't much bleeding, so I guess it proved very sensible. (In contrast, Transmed only asked me to abstain for 48 hours before surgery, but advised avoiding alcohol and smoking for two weeks afterwards.)

    Reflections

    I am glad to have gone ahead with this second transplant. If this one doesn't work, I will have to assume that the failing is largely down to me, rather than the surgeon. But at least I will have given it a try.

    I am still no wiser as to why the first HT did not work, and Dr Lindsey could not say either. He reckoned that around 900 grafts had survived, which is more than my estimate of 300-500.

    Dr Lindsey, Spex, and others have all suggested that the technicians may be the most common reason for a HT to fail. Their thinking - it is all very well having an experienced surgeon to extract the grafts and punch the holes, but his/her technicians are doing arguably the most crucial part – inserting the grafts. Any lack of experience or expertise here is critical.

    As expected, the professionalism of Dr Lindsey and his team was top drawer. But I should say that I was treated exceptionally well by Transmed too; there was no difference in quality of patient service.

    One thing that struck me is that Dr Lindsey has a very firm view on how to approach hair restoration.

    His approach to packing the front hairline densely differs to other surgeons I have spoke to, but obviously he has a strong track record of success with this method and wanted to stick with it.

    I found it interesting that he was very sceptical about minoxidil and finasteride – he reckoned that only about 1 in 20 of his patients used either – and is unimpressed by other treatments such as saw palmetto. He has no interest in trying beard or body hair transplants, and does not believe he will see hair cloning during his lifetime.

    Which leaves me wondering how I will ever cover all of my balding areas with the donor hair I have left...?

    But for the moment, I begin the long wait to see whether this HT will be a success.

    Photos - front above before



    Front left before





    Front right before





    Marking out the reciepient area - note the frontal area to receive extra packing





    Inserting the grafts





    Front left after





    Front right after





    Front above after



     

  9. Albion71
    Well, 11 months since my HT, I think I can say for certain that I'm not going to get the result I hoped for.

    I had begun to worry when my regrowth seemed to stall at the 6-7 months phase. Sometimes, the hair looked a little thinner if anything. Given my long-term pattern of hair loss, I don't think I've suddenly lot a load of native hair. So I wonder if some of the transplants have died. Is that possible?

    Throughout this post HT period I have been holding back on any kind of verdict, in the hope that I was a late developer. But after 11 months, I have to say it has been a disappointment.

    Front



    Front close



    Left



    Right



    Top



    Vertex


  10. Albion71
    Well, a week over 10 months on.

    Still poor density in the HT areas. The front hair line on the left side, where I saw the fastest regrowth early on, now looks thinner if anything. I suppose this may mean that native hair has fallen out, but I would still have hoped for better density from the transplanted hair at this stage.

    Front



    Front close



    Top



    Vertex



    Left



    Right


  11. Albion71
    I felt as though I had made quite a bit of progress over the past month, but comparing the photos with those taken 6-7 weeks ago, they don't look much different. Admittedly I've just had quite a short hair cut, but even so...

    Generally though, the last month has seen slow but steady progress, notably on the left temple, which had been slower than the right. I can see a lot of fine hairs there, which hopefully will thicken.

    The front hairline density is still pretty disappointing though. Hoping I am a late developer there.

    Front



    Top



    Vertex



    Front left



    Front right



    Front close


  12. Albion71

    Day 226 - 7.5 months

    By Albion71,

    Slight delay with the monthly updates as I've been on holiday for three weeks. It's been good to get away and not dwell on whether my HT is making progress!

    Now I'm back - well... I don't know, am I making the progress I should be?

    My hair seems a little thicker compared to previous months, but it's not really much different from pre-op.

    The crown seems, if anything, thinner now - not sure if it's the light shining on it from a different angle.

    The density at the front is what's most disappointing though - as demonstrated by the close-up posted below - that's where most of the grafts went and where I hoped to see most difference.

    I spoke to Transmed at the six month point. They didn't seem too concerned, and said they would review at the 10 month mark.

    I know it's still too early to draw conclusions - but it's hard to imagine a dramatic change in the pace of regrowth over the next 2.5 months.

    Front



    Front Left



    Front Right



    Front Close



    Top



    Right



     
  13. Albion71

    Day 184 - six months on

    By Albion71,

    A quick update with new photos at the half-year point.

    I continue to make slow progress. I'm not as far advanced as I'd like to be, but some of my worries have been calmed by helpful comments from FutureHTDoc, who pointed out that only 30% maturation is usual at about five months. There are enough examples of other HT patients who have had strong maturation after six months to keep me reasonably optimistic.

    I've moved house, so the lighting in the photos means the appearance of my hair may look a bit different to previously.

    Front



    Front Left



    Front Right



    Top



    Vertex


  14. Albion71
    Another month passes on the roller coaster of emotions that is my post-HT recovery.

    First, my positive thoughts. Broadly, I think I've made steady if unspectacular progress since early September, particularly on the right temple. My hair looks more normal from the front now, though it is still thin. And I can see a few shorter hairs that will thicken things up further when they get longer.

    But I've had plenty of negative thoughts too. I was hoping to be further ahead at the five month mark, but my hair still looks thinner than pre op.

    The left temple is very sparse, as is the front. Does this mean the transplanted hairs have not taken very well in these areas?

    The hair in the recipient area is much thicker further back, leaving me to wonder how much of this is native hair which has regrown after shock loss - rather than transplanted hair.

    The pimples have largely stopped appearing. This is good from an aesthetic viewpoint, but part of me worries that this means the regrowth phase is now over.

    I still realise it's early days, and hoping that I have plenty of progress ahead of me still.

    But as I say, emotionally it leaves me feeling a bit up and down.

    Front



    Front left (hair brushed back)



    Front right (hair brushed back)



    Top



    Vertex


  15. Albion71

    Day 93 - three months on

    By Albion71,

    I'm at the three month point now, and I'm hoping I'll start to see some regrowth happening soon, based on other people's experiences. As you do, I still scan my scalp each day for any new developments. Here's a summary of what I'm seeing, and what I'm thinking:

    1. Plenty of spots still, caused presumably by new hairs. But if that's the case, why are the new hairs not subsequently pushing through and growing out? Also, a few of the spots have left little scars which are taking a while to fade. Can that cause problems for the implanted hairs? (I'm not popping the spots unless they become really noticeable, and then only with a sterilised needle.)

    2. I'm applying plenty of Bactroban cream to the scalp, but it doesn't really stop the spots. Early on I applied it fairly gently, now I'm a bit more vigorous. Is there something I'm doing wrong?

    3. There are a few fine hairs coming through in the recipient area, but I'm not sure if these are hairs lost from shock loss coming back, or new hairs from the transplants?

    4. Quite a few transplants, particularly on the left temple, have still not fallen out. Does that mean those transplanted hairs haven't bedded in successfully?

    5. The scar is now completely covered, even with my hair cut pretty short. The barber had a job to find it the other day.

    I appreciate from reading other blogs that recovery from an HT is a bit of an emotional rollercoaster, till you start to see decent results. I'm not there yet. I think that in about another month, my hair will look fairly similar to the way it did pre op, even if there's not much regrowth from the implants by then. (I think Falceros advises avoiding social engagements other than with close friends and family for four months, and that will be pretty much the way it's going to be for me.)

    Here are the latest photos.

    Front



    Front Left



    Top



    Vertex



    Back


  16. Albion71
    Two months tomorrow since surgery in Istanbul. Two months of avoiding (most of) my friends. Thankfully the World Cup has given me something to do and the English summer has been the usual rubbish so I haven't missed being out in the sun...

    Not a huge amount of progress to report. No noticeable regrowth - but I am getting regular explosions of pimples, which hopefully means the new hairs are trying to poke through? I am using Bactroban on the pimples as recommended by Transmed, twice a day, but it's not keeping the zits at bay.

    I think one or two new hairs have appeared, but they're no more than 1mm-2mm long so I'm not getting excited yet. On my right temple, there are still a few transplants which haven't yet fallen out. Indeed, most of the pimples are on the left temple, so I'm guessing that the right side is lagging behind a bit at present. Is that common?

    At present, what with the zits and slow pace of regrowth, I'm going to to be hiding under a baseball cap for another couple of months, which is a shame but tolerable if I get a new head of hair at the end of it all.

    On the plus side, the donor scar is undetectable, even though my hair is not particularly long.

    Front



    Front Left Temple



    Top



    Vertex



    Back



     

     

     
  17. Albion71
    Four weeks after surgery. Another milestone of sorts: the first haircut. My local Kosovan barber in South London was very friendly, curious, and helpful. He used a grade four clipper to trim away most of the hair, using scissors for the more delicate areas.

    The result is a relatively tidy-looking haircut, the exception being the donor scar, which is clearly visible. My barber advised that for future cuts, clever use of layers could easily hide the scar without the hair needing to be too long. But use of the clipper should probably only be for the hair below the scar.

    It's the first chance I've really had to look at the scar properly. I guess it's a bit of shock, as my hair covered it comfortably before, but I'm hoping it will fade in time, and with a bit more length on the hair it should be covered comfortably.

    In the recipient area, one thing I've noticed, as mentioned before, is quite a few pimples. One bled after I washed my hair - fairly gently - earlier today. Is this something to worry about? I've read that pimples are common as the transplanted hairs come through, but after only four weeks...?

    Most, though not all of the transplanted hairs, have gone now. There are still a few around the temples.

    Not much shock loss yet - crossing my fingers I won't suffer too badly. Transmed - when I asked them - said that 20% of their patients suffered from it, and only 2% seriously.

    The soreness in both recipient and donor area has largely gone now.

    Back - hair clippered to grade four, scar a little more visible than I expected



    Front



    Top - note the pimples - transplanted hair coming through?



    Vertex




  18. Albion71

    Day 13

    By Albion71,

    Two days ago I had the staples removed by a nurse at my local doctor's surgery. All 44 of them (see photo). It was 'her first time', but she was very good about it, and said the way the donor area had been joined together was “beautiful”.



    A few of the staples smarted a little, and were a bit 'sticky' coming out. So they definitely shouldn't be in much longer than the recommended 10 days (this was day 11).



    The safe removal of the staples, and the knowledge that the scar was looking good, was a big lift; an important milestone in the recovery process. I also slept much better that night without those lumps of metal digging into my head.



    The scabs have been a bit slow to come off, so I have been following Falceros' washing instructions the past few days, very gently massaging the recipient area. Most have gone now, with those on the crown proving a bit more stubborn for some reason. Transmed says 90% should have gone after 10-14 days to ensure the healing proceeds as intended.

    I had one tiny pimple appear just inside the hairline on the left side, on day 10. I left it alone, and it had scabbed over by the next day, with two hairs sticking out the scab. It is visible in the photos. Hopefully it won't have damaged the hair follicle.



    Yesterday, was my first day out with friends – wearing a cap of course – which felt fine. Another milestone of sorts. It was also my first alcohol since the operation – pretty good discipline eh?

    Front view





    Top



    Vertex



    Staples





    Scar - this isn't the clearest shot, but it's quite hard taking a photo like this one-handed with an iPhone!


  19. Albion71

    Before

    By Albion71,

    I am 38, and I've been losing my hair since my early 20s. I'm currently about a Norwood III, progressing towards a Norwood IV A. My father was a Norwood VI / VII by his 50s, and I'm pretty certain I would end up that way too.

     



     



     

     

    After making no headway with various pills and potions (see profile), I began researching HTs extensively. I concluded that this site was the most comprehensive and objective on the web.

     

    Based on the positive experiences on here, I decided I would proceed with an HT, and eventually spoke to six clinics: two did face-to-face consultations; one did an online and phone consultation (Turkey-based Transmed, who I decided to go with); the other three were online only.

     

    I chose Transmed chiefly because of the (generally) glowing reviews on this site, particularly from the site administrator, but also, I must admit, because they were considerably cheaper than the other options I was considering.

     

    My plan was to have FUT surgery, to deal chiefly with the frontal hairloss, and then return for FUE in a few years' time, to fill in any gaps on the vertex or elsewhere, and also cover up the scar.

     
  20. Albion71

    Day 8

    By Albion71,

    Not much change in the photos. The scabs are largely intact. Today was the first day I have used any sort of massaging on the recipient area when shampooing, but it still didn't shift many of the scabs, so maybe I need to use a bit more force.

    Still getting a bit of soreness from the donor area, chiefly when I lie on it. The soreness seems to be more pronounced in one point on the right side. I emailed the clinic about it, but they said not to worry and to check with the doctor who is taking out the staples on Monday.



     


  21. Albion71
    Consultation

    I travelled to Istanbul four days before the operation (Sunday 30 May), as I wanted to combine the HT with a look round a city I'd always been keen to visit. I highly recommend it, particularly a hammam the day before to help provide a relaxed, restful sleep.

    I was picked up from the airport by a very friendly driver from Transmed, who would also ferry me to and from my hotel for the consultation and operation, as well as dropping me back at the airport for my return flight.

    Two days before D-Day, I had my consultation with Dr Melike Kulahci. There was some initial confusion as to whether I was having FUT or FUE. Although the door did appear open for me to have FUE, I had evaluated all the pros and cons of both before arrival and decided to stick with FUT.

    Dr Melike had suggested dealing with mainly the frontal area, also adding a few grafts to the crown/vertex area, but I was anxious that the top was not left out, as I could imagine a gap opening there with my current pattern of hairloss. So we agreed on a procedure involving around 2,900 grafts, of which 2,000 would be concentrated in the front, the remainder spread over the top and vertex.

    Operation

    I was picked up at 8am on Thursday 3 May, and after a few final checks, we were underway. The anaesthetic is administered using what feels like a hairbrush, with a slightly sharp needle in the middle of it. Dr Melike then began removing the grafts from the donor area, which you feel as a slight scratching sensation, before closing it up with staples.

    Then, as far as I could work out, Dr Melike marked out the areas where the grafts were to be transplanted into on the front and top of my head, while her team of helpers – or 'angels' as she calls them – diced and sliced the strip from the back of my head.

    The actual insertions of the grafts was carried out by the angels, with Dr Melike checking in once or twice. I was able to read and watch TV during the process, which took about five hours in total. The pain was very minimal, and at any hint that the anaesthetic was wearing off, I merely said the word and a 'top up' was provided.

    When it was over, I was given a de-briefing from Dr Melike on how the operation had gone – well, she assured me. I was also provided with also the necessary pills, lotions and shampoos, plus a sun hat to cover up the treated area. And then I was back at the hotel by 4pm.

    Initial photos - three hours after



    Close up, also showing the headband you have to wear to keep swelling down



    Recovery

    I was a bit surprised at how well I felt after the operation. I had lined up plenty of water and food in my hotel room and was expecting to just collapse there that evening. In the event, I felt well enough to go out for a short walk and even have something to eat.

    I had been given a headband and some ice compresses to use on my forehead and temples to keep the swelling down, though despite this, my left temple would became very swollen (though not uncomfortably so). (Incidentally, my hotel room did not have a fridge/freezer, so I had to ask the reception to refreeze the compresses, which they were happy to do.)

    The next day, I was whisked back to the hotel to be washed (my hair that is!), and instructed on how to look after my HT over the coming weeks and months. This included things like: avoiding touching the HT to minimise infection risk; not sweating excessively; best sleeping position; when to see a doctor about getting the staples removed; etc.

    And that was that. I returned to the airport on Saturday 5 June – and apart from having to pay an extra 20 Euros to check in my bag as the shampoo exceeded the 50ml size stipulated for liquids in hand luggage – the journey back passed pretty uneventfully.

    Now the recovery process begins. So far, I've not felt much by way of pain, just a little bit of soreness around a couple of the staples at the back. The painkillers seem to be keeping it all under control. There's a bit of tingling from the recipient areas, which is hopefully a sign that the grafts are 'bedding in'.

    Reflections

    When I told a few close friends I was having a HT in Turkey, they were generally horrified, assuming that such operations were only performed in places like Beverley Hills or Harley Street. If you have similar preconceptions, I can say that, based on my experience, the Transmed clinic is professional and sophisticated, and the service was first class.

    Looking at my 'new' hair now, in comparison to other photo diaries on here, I am broadly happy. I would maybe have liked the frontal hairline to be a couple of millimetres lower, but that might be something I address with FUE at a later date.

    One thing I would have done differently is get a shorter hair cut beforehand, probably a 'grade 4' all over. As only the recipient area was cut short before the operation, my hair looks pretty strange at present. I don't want to risk a visit to the barber until all the grafts have dropped out in about four weeks, so I'm probably going to have wear a hat throughout that time. Luckily, I'm freelance, so will work from home during that period. If you have to go into an office, it might be something to consider.
  22. Albion71
    Transmed has sent me some 'before' and 'after' comparison photos, which I've posted below. The before photos were taken in June 2010, just before the HT, the after photos were taken last week, on my follow up visit to the clinic.

     

    Firstly, I should say that they present a more positive picture, and actually I feel a bit better for seeing them.

    But - I don't think they tell the full story because:

    1. My head is tilting forward further in the after pictures.

    2. My hair is longer in the after pictures.

    3. My hair was carefully combed forward by the photographer.

    Underneath the Transmed photos, I've posted one of my own recent (one month ago) photos with the Transmed before photo - the angle is slightly different, but I feel it gives a closer representation of the actual outcome.

    What particularly bothers me is the lack of density in the front, which is why I find it hard to understand Dr Kulahci's assertion that 90% of grafts have survived.









     
  23. Albion71

    A degree of closure

    By Albion71,

    I'm pleased to say that I have reached an agreement with Transmed which I am happy with. I won't go into the exact details but I think it reflects the outcome of the HT.

    I should say that Transmed have been very professional throughout this, and I feel sad that my experience with them was not all I'd hoped for.

    This brings to a close my blog of my HT with Transmed. Obviously I have not had the outcome I wanted, and I've lost a lot of donor hair.

    My quest now begins to find another surgeon who can provide me with a better HT outcome.
     
  24. Albion71

    HT2, Day 8, stitches out

    By Albion71,

    Some progress photos eight days after surgery with Dr Lindsey.

    The stitches were removed today, and it was very painful - probably moreso than anything experienced during the actual op! I think the pain was partly down to scabbing around the stitches, although I did try to clean as much off as possible when I washed my hair. However, the nurses (it took two of them!) said the scar was healing beautifully. But it was considerably sorer than when I had the staples removed after my first op.

    In the recipient area, there is still a fair bit of scabbing and white crust. When washing the recipient area, I was perhaps over-cautious in the first 4-5 days post op, but the last couple of days I have been massaging reasonably firmly in that area. Based on last time out, it took about 12-14 days to become completely clear.

    In case anyone's wondering, I asked Dr Lindsey not to shave the hair in my recipient area before the HT, and he kindly obliged - the hair was left about an inch long. I'm hoping that if I don't suffer from much shock loss, I'll be reasonably presentable for work meetings in mid-late January.

    Front view



    Top



     

    Top close



    Scar after stitches removed - uncovered



    Scar after stitches removed - covered


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