Spaceman

2500 grafts of 80 micron hair, all on the hairline.  Damn Legend, you are going to have a seriously dense hairline. Congratulations!  

Regarding post-op care, just follow Hasson’s instructions. I did. Things got a bit crusty for me around days 4-7 but the scabs came off clean and on-time and the result turned out great. Sometimes less is more. 

Hattingen is a husband and wife team, Drs. Sever and Laura Muresanu. 

On 11/30/2018 at 6:25 AM, AnalogFeel said:

I had 4K grafts done so you can see why I'm expecting the best results in hair transplant history

🤔

On your other thread, you mentioned your hair was thinning everywhere. If you’re showing any signs of miniaturization in your donor area and proceed with a HT then the transplanted hair may not grow, and if it does, you may lose it in 1-2 hair cycles. That would be a disaster. 

Were your consultations in-person? If not, then you should have your donor carefully and thoroughly examined in person by a doctor that you trust to accurately diagnose your hair loss. Don’t go to a hair mill for that consultation, even if they turn out great HT results. 

I encourage you to document your experience, regardless of whether or not the surgeon is recommended on this site.  For the first few days, above all, don’t bump your head. Also, use a neck pillow to sleep as it helps avoid pressure on the incision.  I’d leave your hair long. It will give you more options to conceal the scar down the road. Number 3 may not be enough to cover the incision initially. The surgeon will shave a bit on the margins of the incision so you may need your hair a bit longer initially for cover. You can always cut it later, after the staples are removed. Finally, I don’t think you need to fly back to have staples removed or to be rechecked in two weeks, unless you have complications of some sort. Best of luck!

Wavy hair also helps hide issues with changes in hair direction after a HT procedure. Either due to graft angles in the recipient, or in the case of FUT, changes in hair direction where the upper and lower parts of the strip incision come together. 

Swelling starts right away, but gets worse for a few days as fluid moves from your recipient area down into your face.  My swelling peaked about the same time as Phil’s. And I looked like a Neanderthal too. A Neanderthal who’d been punched in the face.

In my case, I needed to be back home on the second day post-op (the second day of the next month in your example) so that’s when I traveled. I could have managed traveling on any of the post-op days 2-7 if I needed to.  At the same time, I understand thappa’s advice. If you are able to hang out in town for a while to recover, that would probably be ideal. It would also allow you to return to the clinic for multiple washings. 

Even so, most strip surgeons (and even the ISHRS) still use FUT to describe strip surgery in their literature. I wonder if “FUSS” as a name will ever be widely adopted?

I flew on the morning of the second day after a large FUT surgery. Pain was manageable with meds given to me by the surgeon. I wouldn’t say I was comfortable, but I made it home. Also, I’m glad I didn’t fly on days 3-4 because I had a lot of swelling and it was at its worst during those days.

If it’s thinning everywhere, including the sides and back then you may have diffuse unpatterned alopecia (DUPA). If that is the case, then you probably would not be a candidate for a HT. Do a google image search for diffuse unpatterned allopecia to see what it looks like.

Your safe zone looks fine and all of the grafts should come from there. I don’t know why he’d want you to stop Finasteride.  You still have some hair in your recipient area and Finasteride helps strengthen that hair. If you suffer shock loss on top after the procedure then continuing on Finasteride would help prevent it from being permanent. Consider getting additional surgical opinions.

To answer your questions directly, I don’t think it is standard practice for typical MPB patients. And I was on Finasteride before, during, and after my procedure.

Did you have hair loss or miniaturization in your donor area?

I don’t think it’s possible to change the direction. That was determined by the angle of the recipient site incisions. If your follicles had significant curvature to them then how they were inserted into the recipient sites may have played a part as well.  But the direction of 3000 grafts is not changeable after the grafts have attached in the first few days. 

If you haven’t already, you can seek out a good stylist to help you find the right product and technique to style them in the direction of your choice. 

Yes, I took Zyrtec occasionally post surgery, and didn’t have any issues. Actually it helped a bit with itching.

Im not sure about mixing up a topical solution myself. I think I’ll ask a compounding pharmacist about it and see if they can do it with a proper base and hopefully using pure cetirizine without fillers. If not, then I’ll probably pass. 

20 hours ago, Melvin-Moderator said:

The issues I see is for one the sample size is really small less than 100 people. The second issue is the exact composition of the cetirizine, the study says galenic lotion, but then lists off what appears the be the vehicle for penetration 96 Celsius ethyl alcohol and 16% cyclo silicone pantamer. I'm not sure if this concoction can be purchased or would this have to be compounded in a pharmacy? and if so what is the cost? I'm not entirely sure it would be worth all the hassle for very little clinical evidence. However, this is a good topic and thanks for posting this on the forum.

Yes, it is a small sample of only 85 total subjects, 18 of which were control.  At the same time, two things stood out for me.  First, the density measurements were made in a reasonably objective way, using trichoscan.  Second, the standard deviation of the density increase of the treatment group was relatively small.  Subjects were measured to have a mean density increase of 30.31 with a standard deviation of only 4.21.  That means most subjects saw a density increase between 26 and 34. Unfortunately I don't think any drug company will ever fund a large scale clinical trial as cetirizine is already generic and very cheap.    

23 hours ago, jj51702 said:

There was a big trial over on hair loss talk forum years back. I also heard people on some German forum tried it too. There was mixed results with some claiming it helps and others saying it doesn’t. I think it would def be worth a try if you suffer from inflammation on the scalp along with hair loss.

Yes, I've seen some comments on Reddit from around that time too.  Nothing conclusive though.  I may try it, as I've taken cetirizine (as Zyrtec) orally for allergies and I have no side effects to it.

7 minutes ago, cali101 said:

Why are there doubles and triples in the hairline?

On average, 1 in 8 follicles is in telogen state at any time. It is in a resting state with no hair. That means some of the doubles, look like singles when they are extracted. The 2nd follicle in the graft is in telogen. So a graft with a single hair but two follicles can easily be mistaken for a single and implanted in the hairline. It is also possible for a triple to have two follicles in telogen.

You need a high powered microscope to see the telogen follicles, and you need to examine every graft that goes into the hairline very carefully. Many FUE-only clinics do not have microscopes. It is normally not an issue for FUT surgeries because every graft is separated and sorted under a high powered microscope.

Even with skilled technicians at the microscope, it’s possible to miss a few. I don’t think having a few doubles in the hairline makes a significant cosmetic impact, however, having a lot of them does tend to create a tree-trunk effect and make the hairline seem less natural. 

Has anyone here tried topical cetirizine as a hair loss treatment? If so, what was your experience?

There was a study published last year that showed topical cetirizine had clinically significant benefit in treating androgenetic alopecia.  Cetirizine is a popular OTC oral antihistamine but this study suggests it has potential as a hair loss treatment when administered topically. 

Thoughts?

Quote

A preliminary study on topical cetirizine in the therapeutic management of androgenetic alopecia.

We found that the main effect of cetirizine was an increase in total hair density, terminal hair density and diameter variation from T0 to T1, while the vellus hair density shows an evident decrease. The use of a molecule as cetirizine, with no notable side effects, makes possible a good compliance by patients.

https://www.ncbi.nlm.nih.gov/pubmed/28604133

https://www.docdroid.net/2FwL4QP/101080-at-0954663420171341610.pdf

It’s likely that you can get this fixed.  Your procedure and touch up were modest so you’ve probably have enough donor to reshape and thicken your hairline. 2000 grafts or so would give you a major improvement.  I’d look at Konior or Gabel for your case. They do excellent hairline repair work and the size of the procedure is right in their sweet spot. If you are in Europe, look at Devroye or Feriduni. In Canada, Dr. Wong. Keser in Turkey if money is an issue.

On 10/17/2018 at 9:40 AM, chillgazer said:

Gee, thanks for making me feel better about my current situation. If I could truly accept myself as bald and finally like what I see in the mirror, I wouldn’t have registered or posted on here. It’s not completely unrealistic to have these surgery goals because I’ve seen Gabel transform Norwood 6/7 folks. I’m already well aware I won’t have the crown I had at 18.

It might be easy for the majority of men to let nature take it’s course and accept your losses, but as a transgender man, it’s a different experience. I’ve hid behind glasses and ball caps, shave my head every three days- yet I still feel disgusted with my appearance.

You have an advanced pattern. Given that you’re in Portland have you actually consulted with Gabel? Did he think you are a good candidate and if so, what kind of procedure did he recommend? I would at least consult with him in person, tell him your goals, and see what your options are, even if you cannot afford him right now. And if he happens to tell you aren’t a good candidate or that your goals cannot be met, then listen to him.

I think you are going to have a tremendous result. It looks great at every stage.

The press release said that their process is set to begin preclinical testing. From Wikipedia, only about 1 in 5,000 treatments/compounds that make it to preclinical testing becomes an approved treatment or drug and usually it takes 5-10 years, sometimes longer.  

I do think we will get there one day, but it is likely to take a long time and will likely be very, very expensive at first. Probably six figures expensive. 

You are looking great Dan, and your result will only continue to improve over the next few months. I see a little more swagger in your smile, too. ?

On 10/30/2018 at 2:31 PM, Shifty said:

I stopped losing hair,  so I do not think any more will fall out unless the transplant makes it via shock loss. As far as hair loss goes I have that going for me lol. 

You seem pretty confident that your hair loss has stopped, yet you’re only 42 and lost most of the hair between ages 39 and 41. Are you sure it’s stopped and not just paused? Is that what Diep said? Or maybe you’re basing it on family history?

It’s really important that you have a reasonable and realistic picture of where you are likely to end up before you start down the HT journey. Surprises down the road can be disastrous.