Ayan

6 hours ago, Melvin- Moderator said:

They gave me a finasteride gel with azaleic acid and caffeine. I’m actually considering creating my own natural anti-androgen formula. Though, they do not have faith in natural anti-androgens. If I can show significant reduction in local DHT and a minimum reduction in DHT serum, I’d rather use that.

What was the brand name of the gel, man?

On 1/27/2020 at 11:07 PM, tressless_doc said:

Hello community. First of all, I tip my hat (exposing my scalp:P) to you to salute respect towards the fight.

I'm a 28 year old physician, And I have androgenic alopecia. This thread will document my hair transplant journey with Dr. Ramachandran at Apollo Cosmetic, Chennai, India

Procedure: FUT, 2700 grafts

Prologue: The relationship I have shared with my hair is not so different from most of you guys. When I was 17, I saw my temples recede. I went to an Egyptian Dermatologist who told me these recessions were normal. Medical school opened my eyes to the possibilities of medical prophylaxis against balding, so I had decided to take Finasteride 1mg and Minoxidil topically to fight it. I continued these medications till I turned 23, then stopped. Bad idea. I was basically Norwood nothing, by the time I was 28, I lost my vertex, had a tuft for a forelock. By this time, I had networked enough to know who doctors go to for their transplants. I met a few friends who had amazing hair, told me of a surgeon in South India, decided to visit.

The Meeting: It was a breeze booking an appointment. I would later sit on a flight for nineteen hours to make the trip, to get my hair back. Bummer I forgot my travel Pillow!

Dr Ramachandran was a very calm, man (with a head full of thick hair!) who saw me at 11am. Asked me calmly what my expectations were. After close inspection of my hair and testing the laxity of my scalp, he decided FUT was the best procedure for my hair, to maximize results. He would try to get 2k grafts if I was lucky! (didn't give me big expectations). He booked an OR right after the holidays (Local new year). It was a breeze both getting the consultation visit as well as an appointment. 

Instructions: Wear a shirt. Bring a sandwich (they would provide me with that sandwich), wash hair twice, night before and day of with Providone-iodine. Minoxidil was already stopped 10 days prior (I came prepared!) and I arrived the day of the surgery, calm and ready.

A narrow area where the donor site was marked was shaved by him personally, areas were marked.

The surgical procedure itself was painless. He would talk to me through the whole procedure. A Long strip ear-to ear ~25cm and ~2-2.5m wide was excised. The tissue yielded 2700 grafts of mostly 2's, followed by 1s and 3's. All in all, approx 4600 hairs were moved. Excision of the tissue was ~2.5 hours. Closed with a trichophytic closure, double layered, inner nylon, outer vicryl rapid for self-absorption (I would return back to my country, he didn't want to trouble me with running to get them removed).

The donor tissue was removed in two parts. While he excised the left occipital portion, his technicians sat under microscopes and dissected the hairs. 

After the donor excision, came the planting. The actual planting lasted around 6.5 hours. He decided to go around my forelock giving it a change for a while. I would later argument it with LLLT, medications and other methods. He did-not recommend any medications or treatments. The transplanted hairs would be DHT resistant. Since I had thick vertex hair, and minimal vertex thanks to the minoxidil, I deduced to continue my finasteride and replace this with topical finasteride compounded, at a later time.

Again no pain during the planting. It was rather relaxing., I slept few times and woke to the movement of the table, the light was bright. He was kind to place an eye-patch. There was also a TV for those who want to stay awake for the procedure. However, I was already slightly sleepy and wanted to nap!

He allowed me to use the restroom once. However he and his team of 10-12 who worked on me NEVER LEFT THE OR, never left the operating site. Shows true dedication to his work. He does everything himself, from marking, to shaving to removing the donor tissue, to implanting. Except the dissection, everything was done by Dr., Ramachandran. I have great respect for surgeons and the work they do. Personally I swayed away from a surgical profession due to my inability to stand still for five minutes. And he stood at his spot for nine-whole-hours working on my scalp. He does only one hair transplant per day if that is the case of the day. Brings tears to my eyes.

He undersold but over delivered with 2700 grafts, covering the entire bald area he marked. 

After the procedure, he provided me with a kit comprising of a cap, gauze, a sterile spray bottle and some saline, that I would spritz q1-2 hours to prevent scabbing/clotting. He says the scabbing will occur anyway, I just shouldn't pick on them, but I can try the saline spray if I want. I did want. so he gave me a spray bottle. He also provided pain meds, steroids (to prevent edema) for 5 days. He did-not recommend any finasteride, minoxidil, said it was up to me and I could start after x days. Instructed how to shower my hair starting day 4 and provided wound care instructions for the donor site. 

Right now, as I write this, I am 11 days out. The grafts are likely anchored well. There is some scalp numbness but no pain. I still sleep up Bec its more comfortable and I dont want to compromise blood supply to the donor area, risk any scars. I also have some silicon scar cream that I intend to apply from day 14, and finally, he told me to scrub the graft sites hard on day 14

---------------

Overall, the procedure and after care with Dr. Ramachandran was excellent. 

The following thread will photo-document my journey from tresses to tress! There isn't much on Dr Ramachandran on these forums. Very few posts, despite him being a Veteran surgeon who went from plugs to mini-micrografts, to FUT and FUE. His clinic did-not even try to make me take up PRP or any other secondary treatments. In my humble opinion (as well as the numerous physicians he has operated on) he is truly a professional and ethical surgeon. I vouch for his craftsmanship.

 

My only expectation is that I dont want to have a shiny scalp. Time will tell if this expectation, can be my new reality. 

Photos to follow.

PIC 1: Donor site Marked, shaved by the surgeon himself.

PIC 2: Recipient site

PIC 3 Post op DAY 0,  1 hour after (He offered to comb over after the procedure, LOLLOL 

Post op day 1: You can notice there is some swelling. Saline sprays that night helped clean up some of the serous fluid build up around the grafts

Just a pic of me Before, the night before, to remind myself how bald I was!

Hello Tressless_Doc,

Looks fantastic. Well done! May I know the cost of the procedure in Indian Rupees? Are you Egyptian? Why did you choose to go with FUT instead of FUE? Can you please share your most recent scalp pictures? Thank you.

Ayan