Rolandas

Day 7

First week has passed and suprisingly I'm healing quite well. Started wearing a hat, more aggressive head wash. Scabs are looking nasty!

4 hours ago, Parasol said:

Hey Rolandas. I just want to say thank you for all the hard work you do. You are a positive force in an industry that takes advantage of desperate people; one that all too often ruins people’s lives.

I’m about two months post op on my third surgery, and your channel has been a great comfort and educational source since you started it last year. 

I’m especially enjoying this most recent batch, where you’re documenting your post op recovery. The information is invaluable. Anyone considering a transplant, and anyone that just got one should follow along. This is round three for me and I’m still learning new things from you!

Congratulations on your second procedure. The work looks impeccable and you’re healing really well! I look forward to following the rest of your journey!

Thanks man for such kind words!

I'm in no way an expert, just another dude sharing his experience and to be honest I'm surprised you still find new things after having 3 transplants! I guess this industry is indeed very very broad. Every surgeon has his own unique take on things.

Best of luck with your recovery too!

1 hour ago, Mycroft said:

If you're interested you may want to look further into how microneedling is used on the face to treat acne scarring. I'm sure the same principles would apply to donor scars, though you of course have the extra complication of hair all over that area.

I've seen some indication that a good PRP protocol might also have benefits as far as improving marbling of scar tissue, and that may be an option as well. It was used for treatment of injuries long before anything to do with hair rejuvenation.

The thing I've been wondering is specifically how much went into the crown vs the midscalp. Before the second surgery you were thinking you would likely need less in the crown than the midscalp thanks to medication. Did you find this to be true, or did the doctor comment on it?

I'm very well aware of primary use of microneedling, but I didn't though it could improve such a deep scar tissue as FUE.

I can't remember exactly now the numbers, but yeah, wast majority of grafts went into mid scalp. Crown was much better. Actually it was just a top of the crown that's been treated as remaining mid and bottom is pretty strong (due to finasteride).

When he measured recipient area for mid scalp and crown on the day of surgery he was under impression it will be the same like he measured last year, but after numbers came back from the tech he said my whole recipient area is actually a bit smaller.

13 minutes ago, James5150 said:

     Work looks great and your YouTube channel is awesome! I also have very similar fue scarring as you. I was surprised because my skin is so white and yet the the scars were somehow whiter. I think most guys that had a fue procedure would be surprised to see how hypopigmented their scarring is if they shaved their head.                                                           
     I use a derminator 2 to micro needle my hairline and temples and decided to experiment on my donor area. After using it three times a month for about 4 months it actually did reintroduce some pigment into my fue scars. The scars are still there but they are improved. 

First of all appreciate kind words.

Now the most important part - HOLY MOLY. Microneedling improved your donor? I was thinking about such thing for a long time whether it's even possible. David DiMuzio said he had done some "holes" with FUE punch in his recent surgery into his FUT scar and just after 4 days he sais it looks a bit bettern. Of course that's very premature, but it got me wonder...

Do you have any pictures to compare before & after microneedling?

If you're still doing it - keep me updated!

1 hour ago, JohnAC71 said:

2nd Ht 🤩Woop Woop. We can look forward to some of your awesome videos and very detailed posts 👌 really hope this will give you as good as result as your first Ht. loved following that journey and your ever improving video skills 😉

Appreciate your support John! I've posted already quite a few videos since the surgery on my channel haha

1 hour ago, Gatsby said:

Well done Rolandas! I'm sure that this second surgery will follow the same path of your first surgery. That being the case then you will get great coverage and natural results. Do you know what size punch Dr Ferreira uses? Thanks for sharing!

Thanks Gatsby! Definitely hoping for good survival!

Dr. Ferreira was using 0.8mm & 0.85mm punch sizes on both first & second surgeries (both motorised & manual). He said he could really go lower than that for me, even though I have fine hair, my grafts are growing in kind of straight line as opposed to just in 1 bunches, so surface area is slightly wider than it could have been. He said technically its possibly but he doesn't want to compromise graft survival due to less supportive tissue.

8 minutes ago, RandoBrando517 said:

How much did you pay this time around? Did you get any discounts since you’re indirectly giving Dr. Ferreira a ton of free exposure. I didn’t know of him before seeing you here and YouTube 

I paid €5200 for the surgery itself. It was 2€/graft (at an old rate, 2€/graft after 4000 grafts). Dr. Ferreira indeed gave me 281 grafts for free too say thank you for exposure.

I didn't try to negotiate. I just said "give me the number and I'm transferring the money right now". At the end I wouldn't mind to pay full price of 3€/graft as he is charging right now for the first 4000 grafts. To me what matters are results.

24 minutes ago, Curious25 said:

I've been catching up on your videos over the last week, the content is great - I was really impressed with your final results from your first surgery and the way you were able to style your hair with the hair band, it worked really well.

No doubts this will leave you with a killer head of hair, so all the best, and keep up with the documentation!

Thank you kindly!

19 minutes ago, hairlossPA said:

how does someone implant that 6 graft grouping? they're all at different heights. implanting it as a full grouping of 6 would mean 3 bulbs are a significant amount below the other 3 bulbs

That's an interesting question! I will see tomorrow Dr. Ferreira. Will ask him! (NERD GANG haha)

20 minutes ago, teeplant said:

@RolandasI saw that the Dr suggested that you might have minor keloid scarring but this doesn't look the case to me. Hard to tell from the video? Keloid scar are usually raised. Do you feel any bumps?

Indeed he said its "something like minor keloid". It's slightly raised. I can't tell you right now for sure as I'm trying not to touch my donor, but I haven't even thought about it before the surgery! Never came to my mind.

He gave me a good analogy with other scars on my body. They are all slightly raised (and I've got many), although not as white.

21 minutes ago, BLE123 said:

The recipient looks very natural even when shaved down but the donor scarring seems quite apparent, how do you see it Rolandas? I guess you're unlikely to ever have your hair that short again though so not really a concern.

Scar tissue is indeed very white. It seems like there's literally 0 pigment. Strange as it was much better at month 6-8 (after that I stopped looking at my donor).

Nonetheless I don't mind to limit myself with slightly longer hair on the sides and have great looking head of hair on top. No point of skin fade with horse shoe pattern haha

Will start from 1.25mg/day and see how it goes. I know what kind of results i can expect from topical, so I want to explore oral route.

5 minutes ago, asterix0 said:

great writeup @Rolandas and happy growing! 

How is your donor feeling, any discomfort? 

I thought your frontal third looked really good from your earlier videos, what made you want to strengthen it versus putting those grafts into your midscalp/crown? Unless Dr.Ferreira thought 2000 was good enough to give the illusion of full coverage in your midscalp/crown?

 

 

Thanks. I'm trying to balance everything right now (recovery, filming & editing videos, answering emails & messages), so didn't really put that much effort into this write up

I have 0 pain since day 1. Never had any discomfort in any part of my scalp, so yeah.. Healing extremely well so far!

My crown closed a bit due to Finasteride (a lot of improvement from Month 6 to Month 23), so required less grafts than he originally thought.
My mid scalp gained quite a few hairs too, but these are very thin, miniaturised. He said they will still impact overall look, so he implanted around them.

I'm planning to start oral minoxidil, so this should help these hairs too. And overall, mid scalp doesn't require a lot of grafts/cm2 to create illusion of density, unlike hairline & crown.

I've got a gut feeling that I would like to have another 1000 spread all over, but think it's hair greed. Nontheless if everything will grow well and oral minoxidil will work without sides, then I'm sure it will be a huge turn around.

Oh, by the way. I've asked Dr. Ferreira as a joke during the surgery if he has seen 7 hair graft before, to which he replied "Oh yes, of course. As a matter of fact I just implanted few 6's & 7's into your scalp".

This was of course a surprise to me as he isn't documenting those. It's simply not that many and will take unecessary space on his screen during the surgery.

On my 2nd surgical day I've asked to take a picture for me of 6's or 7's hair graft should they find. Sadly Occipital area is the best of course, and this was done during the first day, but frankly they have found one 6 hair graft. Looks cool!

I had my 2nd FUE Hair Transplant surgery done with Dr. Ferreira in Portugal on 03/06/2021 & 04/06/2021 (2 day surgery).

Since it's not my first post, I won't get into much detail about why I chose him and how he operates. You can find more information on my first post from 1st surgery.

On my first surgery I had done only frontal third, so remaining mid scalp and crown were still bare. This was of course the plan all along - 2 step approach.
2nd surgical goal - increase density in frontal 1/3, fill in mid scalp & crown and reinforce existing temple points. More info in here.

Here's my before & after 1st surgery shaven. 

Footage of recipient & donor area here.

(I do apologise for quality of pictures. I should receive pictures from Dr. Ferreira in upcoming weeks).

It wasn't a huge surgery, just 2881 grafts, but over 2 days. During my last surgery I had over 50% of popping due to my very elastic skin & excess bleeding, so Dr. Ferreira wanted to take it slow this time and make sure it's very well under control. This time, he said it was only about 5% as he was implanting the grafts in stages - about 500-600 grafts at a time and spreading implantations at a time.

First day we finished with 1231 grafts (3686 hairs & 2.99 ratio).

Dr. Ferreira said my donor has very minimal to no miniaturisation. He actually tried to find one under microscopic evaluation upon my request but couldn't see a clear example.

Day 1 finished. Main focus - reinforcing frontal 1/3 as well as mid scalp.

Day 2 same process. 1650 grafts (4562 hairs & 2.76 ratio).

Grant total - 2881 grafts (8248 hairs & 2.86 ratio).

These are approximate numbers - Frontal 1/3 - 700 grafts, Temple Peaks - 100 grafts each side, Mid scalpp & Crown - 1900-2000.

My overall thoughts and overview of the surgery in video format on my YouTube channel is here.

Dr. Ferreira estimated I've got about 2000 grafts in the donor available for next surgery should I need. This of course should be done carefully in order to preserve donor.
So far donor area looks pretty good. There's a lot of hairs in between extractions from both 1st & 2nd surgery. I did a small analyze with close-ups in here.

Overall I'm very happy with the way it's been done and the way it looks. So far following my post-op instructions and hoping for the best!

I'm posting a lot of updates on my YouTube Channel if someone would like to know & see more about my surgery and my recovery.

I will post here pictures as soon as Dr. Ferreira will send them over to me.

8 hours ago, giegnosiganoe said:

Honestly, I've debated with myself on whether your starting position is preferable. Your donor is incredible, you're a NW5, whereas I'm a ~NW3V with diffuse thinning elsewhere. I think you'll win the long game lol. We'll see how the meds work for me.

And you just control it with meds. Fin/Dut/Min/Microneedling/RU/CB/Onion Juice (<-- think will work best for you)

I'm doing all this transplants just to get to half of your baseline

2 minutes ago, SD1984 said:

Look at @Rolandas, he too had 3500 grafts and needed all those grafts in just the frontal third to give him good density. This is partially bc he is caucasian unlike the guy in the video.

While it looks pretty good considering I was 95% bald in the whole frontal third, I don't think it's dense enough considering my hair caliber. I will be putting some more grafts in there on my 2nd surgery in June.

Dr. Ferreira's patients are all pretty bad with updating their progress online 🤣 i guess they forgot about hair loss all together lol

Looks amazing for just 5 months! 😲

9 hours ago, duchaine said:

considering your hair caliber and the big bald area (lol), 3700 is not that much|!

Imagine If I'd be slick bald NW6! O_O That's why I'm trying to be proactive and not letting myself to drop down!

1 minute ago, duchaine said:

I have had good results from HLC but considering your results, I'm thinking to go to BF for a second HT if need.
You used less than double of my HG for a such big area. great!

I don't think area is necessarily big, it's just frontal third. Also 3659 grafts is quite big number, but considering my hair type it's not even enough!

Numbers are just that - numbers. Some people will need more, some less. It all depends on area to cover, amount of native hair present, hair shaft diameter & average hair per graft ratio to create density.
HLC is a solid choice. I really like their work.

14 minutes ago, JohnAC71 said:

@Rolandashey dude ! Hope your well. I was wondering if you have seen any further improvements beyond the usual 12 month point ?

I also realise that it’s only a matter of time until we see transplant number 2 🤩

Hey man,

I've actually updated this on my channel about a month ago.

And yes, my 2nd HT is scheduled for 3rd & 4th of June. Can't wait!

Hey man,

First of all let me tell you this: I admire your willingness to research more and approach future hair restoration with caution. Remind me of myself when I started doing the research. I'm sure you're setting yourself for a success (if you keep being curious).

I think @qui bono replied very well to all your questions.

I will add few things:

3. Low Norwood levels tend to dense pack hairline quite a lot, so it visually matches native density (as an example forelock being strong and need of rebuilding temples, which will require quite high amount of grafts). On another hand if someone has lost most of his hairline, then overall lower density will still achieve great coverage as there's nothing to directly compare to. Hope this makes sense
Also worth mentioning that hair thickness in my opinion plays key role how dense your final result will look like. You can transplant 3000 hairs with hair thickness of 45 microns and it will look much worse worse than 3000 hairs with 80 microns. Illusion of density could be almost double.

If I were you I would try following:
- Topical Finasteride
or
- Topical Dutasteride
or
- Dutasteride Mesotherapy

I won't go into detail about Dutasteride, but recent studies and mostly anecdotal evidence shows it doesn't penetrate deep enough to go systemic (as it's molecular structure is denser than the one required to penetrate the skin properly) while reaching "just enough" depth to be effective.

And of course I suggest to go and see a really good surgeon who could check your whole scalp and estimate your final pattern (keeping in mind future loss). Of course this won't be 100% correct, but could give you an idea if you're heading towards NW6. If that's the case, then I'd strongly suggest to look into FUT rather FUE. 


Best of luck!

On 4/6/2021 at 6:46 PM, Parasol said:

@Rolandas seems to have thin blonde hair too. Bruno Ferreira did an excellent job on him.

To me it looks like medium/dark brown

Just now, tressful11 said:

My goal is hairline repair. Not donor repair. I might SMP for donor later. 
My first surgeon didn't just butcher my donor, he botched the entire job. I've an extremely unnatural pluggy hairline with multihair grafts in the front

Then reach out to lots of top surgeons, ask for their specific plan and take it from there.