Nebulosity

13 minutes ago, bornwithhighforehead said:

Gosh. I must have strike the lottery to receive both poor recipient density and poor donor extraction all at once from a well accredited doctor here.

There's also this case: 

And this case:

And this case doesn't look great, although he only showed up to around 6 months... still look like the grafts were very widely spaced:

I think we know enough to observe that there's a pattern. I think most good hair transplant doctors would look at my graft placement and agree that it is going to turn out too thin. I might be able to sort of conceal it, grow it long and bushy and cover it up for a while. But it's too widely spaced, without a doubt. Melvin, I think you can see it too. I realize you want to be fair, but being fair doesn't mean that forum users need to pretend we don't see something.

1 minute ago, bornwithhighforehead said:

I did not observe any double ones so far. It's been only  3 months since my 2nd FUE so may not see the full results yet but I'm positive everything will be good.

Great. In your Bhatti hair transplant, you didn't get that many multi hair grafts in your hairline. So I'm sure that extracting them was not necessary. I think you'll get a great result too. Will you do SMP or anything so that you can wear your hair short in the back?

16 minutes ago, bornwithhighforehead said:

Here’s the result of my recipient after a year with the same doctor. I had to go for a 2nd fue to get it fixed.

 

Did you get all single hair grafts along your hairline in your 2nd FUE?

17 minutes ago, bornwithhighforehead said:

Is the loss temporary? If not I Guess it only happens if you have miniaturized hair which is going to drop anyway in the near future. The transplant just accelerates the process.

 

Yea it's mainly loss of miniaturized hairs as I understand it.

4 hours ago, jonnyalex said:

Be very careful about considering a hair transplant without Fin. Yesterday in the Italian forum, I seen a Rahal patient who's hair completely thinned out and he was left with just a hairline and a heavily diffused NW7 pattern in a matter months after the surgery!. 

Yea, the main risk of not using finasteride immediately after a hair transplant is loss of the native hairs surrounding the transplanted hairs. There's a paper on it called 'Effects of finasteride (1 mg) on hair transplant.'

I value my health more than my hair. I'd like to see that thread though.

4 hours ago, jonnyalex said:

I knew from your initial photos who this doctor was. Why does his work always seem so different to any other doctor? The graphs are always way further apart than normal, those gaps are just too wide. Also, I can't understand why any doctor would harvest your donor in that manner? I mean just.. why? 

Yes.

I asked him why he suggested such a low hairline and then made it so widely spaced out. He didn't answer all at once, and would only answer it as two separate questions in two separate instances. Firstly, apparently my hairline is "conservative" (as stated in an email). Secondly, he "did his best" using the available grafts (stated during a Skype call). But he never answered all at once why he encouraged me to get a lower hairline than I originally intended and also made it so sparse.

8 minutes ago, AltonMeyer said:

I'm really curious to know the number of implanted grafts, did you get around to counting them all?

I actually want to. I'm looking for an image processing app that will count blue dots or something.

42 minutes ago, Aftermath said:

Spoke to dr hasson about 3 weeks ago and he told me that it’s a pretty even split now, 50% FUE 50% FUT.

 

also have a look at this thread, frontal grafts were extracted and this was a repair with FUE

 

Thank you. I appreciate the artistry, tech, and great work of H&W. They're at the top of my list. However, there is one issue I am wondering about. I have decided that after three months I'm quitting finasteride for good. I won't dare even use topical finasteride again after I quit. I've heard that H&W expect their patients to use finasteride, and in my online consultation I indicated that I'm on finasteride, which is currently true. But since I'm not showing any signs of crown hairloss, and I want to get an actually conservative hairline, I think it will be ok to not use finasteride anymore. If H&W are still willing to take my case, I'd probably choose them as I'm sure they would do the best work possible.

Others that I am considering: Feriduni, Cooley, Nadimi, Wesley
From what I've seen, all of the doctors I'm considering do good work. My impression, however, is that H&W plan their procedures more meticulously, and are determined to make every case a success and set realistic expectations. So I'll probably choose H&W.

Here are some more images of the donor area:

[1] In all its “glory”:

[2] In more forgiving lighting:

[2] Annotated to illustrate the irregularities:

[3] More of the same, from different angles:

[4] Now, a photo from a few days after the procedure. Note that Dr Bhatti bragged about only extracting from the safest donor zone, as if that was a good thing...

I’ve added lines showing where the boundaries of extraction probably would have been, had I gone to a top doc.

All he had to have done was just be more meticulous and extract from a larger area. I asked him about this, and he said that the area above where he extracted was not the safe zone... yet it seems that all top doctors extract higher up, and would have for me. It seems odd to be "cautious" about extracting higher, while telling me that I'm showing no signs of hair loss at the crown, and then not being cautious at all about the cosmetic effects his irregular extraction pattern would create. He said that extracting from the lower part would have left long scars... but I’m pretty sure that’s only true below the red line. He could have extracted higher and further forward on the sides. And he could have extracted more uniformly within the region of extraction (you can see that the distribution of extraction matches the irregular pattern visible in my donor area now). But he didn’t do any of that. He messed up my donor area, but he didn't have to. He is impervious to questions about this, and I've lost all confidence that he could even acknowledge that he caused any damage. Seriously, I would like Dr Bhatti to come on to this thread and explain why it was a good thing to extract from such a narrow area. Wouldn't FUT have produced a better cosmetic result in the donor area? What is the point of FUE, if you're going to produce results like the below? The below image is the donor area of another former Bhatti patient.

I know that people are going to say that I should wait. I agree that my result will look better as time goes on. But that doesn't mean that observations cannot be made now. It's my responsibility as a board member to point out what I see as poor work, to warn others so that they don't suffer as I am now.

I think, with enough time and around 2-3 procedures from top docs, I can finally get a good result. As I gather more information, I'll start a fresh thread regarding the repair. This forum will be my 2nd home for around 2-3 more years. Apologies in advance. 🤞

25 minutes ago, DrTBarghouthi said:

Sorry to hear about your experience. I do think that there are few issues here. I do think the hairline can be raised a bit by extracting the grafts and recycling them higher up. You will need more singles in the transition zone. As for the donor, I think you may have a bigger safe zone than what was extracted but it will be hard to only judge based on photos. Nonetheless it looks good once hair is longer and could still improve. SMP is a nice option to hide the areas of scarring should you decide to shave closer. 

All the best!

Thanks. I am planning to do all of the above.

7 minutes ago, Fozzie said:

Sorry to hear you are not happy. I've never really been a fan of moving a hairline down so much but if someone want's it it done, I would only go to a top tier surgeon like a Konior or a H&W personally.

Thanks. Well I'm actually planning to raise it. I'll have the grafts extracted and placed further up. Then on a subsequent procedure I'll have single hair grafts implanted to create a natural looking hairline. I agree what I got was too low. A lot of things were happening in my life, and my judgement was way off at that point. But I think some of the blame should be placed on the doctor for encouraging such a low hairline. I'm going to have like an 18 month ugly ducking stage, instead of the usual few months. Oh well. I'll have more time to develop software alone.

I've already discussed it with H&W and Cooley, and will also get a consultation with Feriduni. This is something I have to fix.

1 minute ago, Dazed said:

I have begun receiving notification of every post on here and I have turned all notifications off.  I have zero interest in this topic so please stop notifying me of every post.  You might as well remove me entirely from the forum because I have achieved my goals and have nothing to add to the forum.

If you use Gmail, create a filter. Any emails from this forum can immediately be sent to trash. Instead of commenting on this thread, consider creating a new topic so that a moderator is notified and can help you.

I'll post a more detailed thread about my results with Dr Bhatti later on. For now, I think it is my responsibility to give back to this forum by giving my honest assessment of Dr Bhatti. I doubt that he'll give me a refund, so let me just say the following for now:

Dr Bhatti told me he would implant single hair grafts in the first two rows, but actually I could only find a few in the front row, and I see a few multi hair grafts in the front row of my temple points already at 3 months, which does not look natural at all. He hurriedly extracted from my donor zone, and only got around 60 single hair grafts out of a supposed total of 2369. He said he would divide some multi hair grafts to produce single hair grafts. When I asked him about that, he said they got "around two hundred." Yet it seems that I only got around 60 single hair grafts in my scalp. When I asked him questions the days after my procedure, even though I never took up much of his time before or after the procedure, he ignored most of my questions, and offered to Skype instead of addressing my questions by email. When I Skyped him, he asked me how long ago I had had my transplant, which means he probably didn't know any other details of my transplant. He absolutely refused to discuss density, and just said that he did his best given the availability of grafts. Yet he was the one who repeatedly encouraged me to lower my hairline further than I had initially asked for.

Save yourself a lot of problems, and don't go to Dr Bhatti. I regret my decision immensely. I would pay hundreds of thousands of dollars to just reverse what has been done.

13 minutes ago, VicTNYC said:

Oh I see, then the way your donor was harvested and now looks makes sense especially if the surgeon rushes the extraction with a motorized tool. Still, donor could improve.

On the bright side, you’re pretty damn lucky not to have any crown hair loss issues given your age of 40 since it looks dense, so thats a plus. 👍🏻

Do you mean that grafts were extracted right next to each other, or some other kind of damage occurred?

My plan is to get a multi-procedure repair. [1] Remove many of the frontal grafts that have been implanted and implant them further back for more density. [2] Implant single hair grafts in the front, because right now I have mostly multi hair grafts in the front row.

I'll also consider asking for some follicles to be implanted into the sparse spots in my donor zone.

Lastly, it was a big mistake to go to this doctor. He should not be an IAHRS member, or the IAHRS is meaningless. It was Dr Bhatti. If anyone is considering going to this doctor, look up the results people post in this forum. Consistently horrible results. I'm ashamed to have gone to such a sub par doctor.

18 minutes ago, VicTNYC said:

Your donor looks a bit better and could possibly improve over the next few months to be honest.

Did your surgeon use a manual or motorized tool for graft extraction?

He used a motorized tool. You can see an example of some of the "work" by the same doctor above in this thread, from the user 'bornwithhighforehead'.

The doc said there was no sign of hair loss at the crown. Then he bragged that he extracted from only the safest zone. Logically, if some of the extracted follicles were not permanent, then some of the follicles on my midscalp or crown would not be permanent either. And it doesn't look like I really have a really huge donor supply...

Here’s how it looks now at a “2” length:

Another angle, at a “1” length:

Honestly, I think it looks bad. Even at 3 months with some shock loss. It can’t all be shock loss. It looks like there are big white dots closely spaced.

It’s been 95 days and this is what the donor area looks like buzzed down to a “1”.

Here is the only good picture I have of how my donor area used to look:

59 minutes ago, matt3480 said:

Looks fine to me. Very common to have some shock loss in donor for several months after. I had the same and it all grew back by month 4 or so. 

I feel the trauma of the surgery just screws with the remaining donor sometimes and causes some hairs to stop growing as quickly or even altogether for a few months. They do resume growing eventually.

That isn’t pitting in your other pics, either. I got scared about that same pocked appearance after my first HT because I hadn’t noticed it in other peoples’ pics. I soon realized, as you said, that it’s impossible to pick up the surface in such detail unless you get the right lighting and angle....which 99.9 percent of people who take update pics don’t capture. I then went back and looked at peoples’ update pics who took really up close pics and noticed they all had this pocked appearance after all. It looks knarly (especially if you had no hair there before) for several months but my skin is 100 percent healed and completely normal in these areas now (which it doesn’t matter as my transplanted hair covers it now).

The pitted and shiny skin was definitely my biggest fear at first because I simply didn’t know that was normal due to everyone else’s pictures not picking this up. Skin takes a long time to heal....like a year. 

 

 

 

Thanks for the reply. I’m glad to hear that this is normal, because I love the #2 guard and I’ll do SMP or even FUE reversal to be able to do it. I still think the extractions should have been more spread out, but at least I can expect some real improvement.

Yea, regarding the pitted appearance: I was obsessed enough that I managed to find some fairly close up pics of someone’s recipient area after a transplant from a top doc, where there was a pitted appearance. What a relief that was. I’ll add them to my “is this pitting” thread in case someone else is similarly obsessed with their pitted appearance in the future. My recipient area is basically ok now.

I’m hitting the gym today and will be doing so 5 days per week to focus my anxiety on the core powerlifts. It helps a lot.

This place is like a support group, as well as being great for information. I really appreciate all of the great help and solid analysis and information.

Donor area, 3 and 37 days post transplant. This does not look good. With 2369 grafts, it looks like many had to have been taken very close together. The areas where I have signs of shockloss looked bad already just 3 days after the transplant. I did trim it down once, so that’s not 37 days worth of growth in the pic with longer hair. More like 2-3 weeks.

12 hours ago, txtransplant said:

Doesnt H&W mostly do FUT? AKA strip?  If that's the case...huge mistake for you.

Yes good point. I think they focus on strip, bur also do FUE very well. I’ll be checking how many repair cases like mine that they’ve done. I am giving them a chance, and will consider them along with some other surgeons who are better known for FUE repair work and with background in dermatology, facial plastic surgery, or scar minimization (Cooley, Wesley, Nadimi). I’m planning in person consultations and will ask for photos of patients who got similar work done as what I intend. The reason I’ll consider H&W is that they seem to know how to design a hairline and get good survival rates even for FUE patients. What I’m not so sure about is their success in frontal extraction with scar minimization.

5 hours ago, Shampoo said:

Neb....I am happy to see you have chosen Hasson/Wong as your new doctors...and to wait 11 months. Wise decision. You'll worry thru all 11 months...lol....but you can do it! You will be impressed with the entire Hasson/Wong operation. Promise me...when you visit Hasson/Wong you will listen to their advice whatever that may be. Remember they have performed 1000's of hair transplants, and are respected worldwide...and you really have one experience. Whatever their advice...let go....trust them...and let them handle it. 

Yes I will trust them, although I plan in person consultations with other doctors. I have to get this right. But just from my brief dealing with H&W, they seem to know what they’re doing. They’re the only ones who could explain what their general approach would be likely to be.

Got a reply from H&W. They said I’d be a good candidate, and that they’d like me to send them new pics at 11 months post transplant. They read my objectives, and said that it could take several procedures to achieve them: Two removal+transplantation sessions, and possibly one more for refinement. There’s just no way that I’m going to put another few thousand holes in the back of my head to fill in more density into a youthful hairline, when I need to consider any future loss. Nope. I plan to have 1000+ of the grafts that were implanted removed and reimplanted into the temple areas and in a very narrow area around the front of the forelock. That way, the number of new extractions from the back will be minimized, and a high enough density will be achieved. I need to take this very seriously or I’m going to end up in a perpetual spiral.

If you’re reading this and wondering why I went with a low hairline, basically I didn’t do enough research. That, and the doctor encouraged me to get a low hairline, and implanted follicles at a density that amateurs on a forum can recognize as not being dense enough.

Thanks for the replies. I’ve been looking more at results and found that the appearance of pitting is very common in the first months after a hair transplant, and it goes away over the months. I bet persistent minor pitting is more common than people admit too.

I’ll use aloe vera cream.

Does anyone use retin-A cream on their recipient or donor zone?

5 minutes ago, bornwithhighforehead said:

I think to be fair to the doctor, perhaps you should wait another few weeks for the donor? For my first FUE with him, donor looks fine after 3 weeks. Unfortunately, I can't keep short hair anymore because of the scars.

 

After one week.

 

25 days.

I plan on getting SMP on my FUE scars after I finish fixing my hair. Also, I will consult a dermatologist about treating the scars to reduce their appearance.

You’re right about waiting. I’ll definitely just wait and do nothing for some months. But actually your second pic at 25 days just shows that the hair is longer. It looks good at that length, that much is true.