Jonulous

Your question reminded me of a video by one of the members here, that aired one issue to do with transplanted hairs often being all synced to go into growth and resting phase within a couple of months of each other. It mainly counsels patience while the next growth phase returns.

At 21 months for me, I would say I do notice a few more stray fallen hairs around the place.

Resuscitating my thread for an 18 month check in.

I took these on the actual 18 month day yesterday, when I also happened to have let the hair up top reach a similar length to what it was on the day it was buzzed right before the surgery. These shots are paired with right after a hair cut in the afternoon yesterday. A little bit of styling product was added by the barber for the post haircut pics.

Then for a bit of self-encouragement, the last pic is a shot of me from around 10 years ago, well before I'd gotten on any medications or researched good hair surgeons.

I guess it's also about 17 months since going consistently on the 2.5 minoxidil capsules, along with my longer term Fin at half the regular dose.

Things go well. I'd always wish for it being little less diffuse through the mid scalp (where nothing was done). But styling choices can conceal all that pretty well I must concede.

Hope that everyone else's journeys are going well.

At last I've made a set that seems about right for a 12 month review. My well traveled laptop was playing up a bit the past week, hence I've been slow with the pairing and labeling.

Decided to focus right in on the areas that received the actual grafts, more so than the full hair shots of previous entries. Probably haven't quite scaled the before and after pics to be exact matches, but the shape of the work does seem to be easy enough to pick out in this series.

But give me a prod if anyone wants more global head pics.

It's graduation day!

Or the HT equivalent. I mark one year today. Annnnddd, I haven't gotten the pics done yet. But will get them done over the weekend certainly.

Enough now to reflect that it feels like a good set of choices leading to Brussels and the crew there at BHR. Plus I tacked on a nice bit of travel winding my way back home in the weeks after surgery.

Well I got my usual photo set mostly done. But not all the cropping, pairing and labeling. I'll revive that for May, when I hit the anniversary.

Here's an experiment turning a quick phone video into a motion gif.

Happy to post some reflections in this thread.

Prior to Oral: November 2019 to February 2022 5ML topical 2 x per day, reduced to 1 x per day when I used a derma roller. Had a slight drying effect on the scalp, but not to the point of causing dermatitis. I was on a pre existing Finasteride regime.

Feb to April 2022 was taking a daily capsule from an Australian compounding pharmacy with 1 mg + 1 mg Fin and Minox. In prep for a transplant I started ramping down the Minoxidil for a few weeks, by alternating the above capsules with a regular Fin tablet and back to topical every other day. Then stopped all Minox on 5 May ahead of the surgery until early June/July when I finished off the capsules.

20 July to the present (March 2023) changed it up to 2.5 mg capsules, from the same supplier, at 1 per day.

Recognising we can't run two versions of our life for comparison, I feel fairly comfortable saying that my progress through peak ugly-duckling seemed pleasantly fast in the weeks following surgery.

I don't notice a lot of side effects. Confounding the potential effects on other hair beyond the scalp, I was a pretty determined consumer of laser hair reduction treatments in the early 00s, so those follicles don't have a lot to work with now anyway. I think my eyebrows probably need more frequent trimming in recent times, and the gap between haircuts I've chosen to reduce a couple of times from 6 weeks down to a month.

As to my take on what standard of evidence to rely on...well, I mean to find a point of hopefully commonality, we're all pretty comfortable with the notion that no form of invasive surgery uses the double blind placebo standard. Like, we didn't decide that transplants are X percent effective by putting real grafts in one part of some volunteer's scalp, and pretend grafts in another.

Having practising surgeons iterate and follow informed speculation on the procedural side is exactly how it's meant to work with advancing the field. Having them iterate similarly with off-label medication, when there's little or no chance of getting large controlled efficacy studies, seems also like a pretty reasonable way to push the hair restoration field forwards.

Celebrating double digits - month number 10. And right on the tails of a haircut for once.

Things I like most about the HT as it matures include the realism of the singles along the (very slightly lowered) hairline. Things I'm still getting used to include the extra springiness of the zone with most of the grafts. It really wants to be styled and tamed with product, but I'm terminally lazy about reaching for styling or hold compounds haha.

Here's yet another slight variation on the recurring themes of before-after shots.

Presenting month number 9, including new treats from the vaults 🗝️.

Thank you Zinedine, Hairlinedreamer and Melvin for the last round of positive feedback. Only observation this time I think is that longer wet hair is a little more see-through than when it was shorter. Due to getting more plastered down by the water, no doubt.

Came pretty close during this past week to disclosing what I'd had done to a friend at work. He'd been on medication since his 20s and wondered what my 'regime' was. But so far I only went as far as talking Fin and minox. We'll see.

I definitely like that shape achieved around your hairline. 👍

There are at least a few cases floating around of people in the NW5 range being able to replenish everything except maybe the epicentre of the whorl with 6-6.5 k total. If your harvest went well this time you can likely get there also.

Looking all very natural and full, H-dreamer.

It's an interesting thing with the darker tones being brought out by your being on Minoxidil. Though when the pics are viewed at full rez the lighter browns are still visible in the mix.

18th of the month means...it's update time 🎆

Following broadly the same set I normally include, just with a couple of different angles for sake of variety.

All goes well for month 8. My hair's maybe a little long to get great comparison shots of the hairline at present, but wasn't due for a cut for a couple more weeks.

I forget if this was technically flouting the post-surgery instructions a bit...but by about the fourth week I took to dabbing on a little bit of a skin blemish concealer where redness was most apparent. I picked a product that was light weight, rather than the more cakey compounds that are often marketed for same purpose.

Note this is skin concealer, which is a different thing to hair loss concealer.

Update-lite mode for December (month 7). Just three pics and a clip.

The changes detectable to me, as owner of the head in question, are mainly subtle things like an improvement of the skin within the recipient zone. It's noticeably less sand-papery in texture as time goes on. It's natural but overcast daylight in the short video with the brush through, and hair is recently washed but not containing styling add-ins.

1 hour ago, Jayson1361 said:

It’s been fun watching this journey. Particularly due to your sense of detail, but more so your writing which demonstrates an attention to detail or rather perhaps emotional importance. Your first shots, wet, from the front, really shows your progress. I admire your write ups as personal as they are and as matter of fact as they should be…showing an emotional maturity and insightful detachment as you simply reconcile a perceived problem. 

Thanks Jayson

Oh funnily enough, the wet hair shots are about the easiest of the bunch to do. That's just me with my phone under the bathroom light. For many of the others it's all tripod, 10 sec timer, wrestle with the autofocus of my digital camera to actually lock onto the damned hairline!

Happy November. Just a couple of days past my 6 month milestone, with a haircut done yesterday to mark the occasion. I'm possibly going to do more basic progress photos for months 7 and 8, then a full run again at month 9. All seems quite satisfactory at this point.

1 Wet hair in indirect but bright light

2 Viewing the recipient from above at Day 1,  2 weeks and 6 months

3. A front shot with dry hair

4-6. Day  minus 1 before treatment,  and at 2-6 months from three angles

7. Close up right corner

8. Close up left corner

9. Donor

Thought I would share my little anecdote from this past week.

For context I'm coming up to 5 years into my Finasteride routine, and a few months in with switching to an oral version of Minoxidil. Also had a hair surgery in western Europe this past May which has its own thread.

My tradition is that I have this like imaginary giant wall, where I keep the regular doctor health consultations sitting on one side, and anything to do with aesthetic procedures/medicine on the other. The only real cross-contamination up to now was getting my Finasteride prescriptions from the regular doctors, since it's completely on-label and they're all generally up to speed on that.

For my new Fin prescription, I'd left it kind of to the last minute and the soonest appointment I could get was at a nearby clinic where they give most of the consultation to interning medical undergraduate students, with the supervisor coming in at the end for any heavy lifting such as writing of prescriptions.

In front of his two internship students, this doctor (who seemed quite a cool guy generally) started to rattle off the reasons I might like to consider adding oral minoxidil to my daily regimen....If you're confused, I've been getting that prescription through a separate tele-health provider who partners with a compounding pharmacy. And per my 'giant wall' between regular health checks and aesthetics, I elected not to share this fact with the doctor or his pair of MDs-in-training. But given he was quite relaxed about discussing pros and cons of it with his students there, I take that as a sign of it coming into a bit more awareness with regular practitioners.

So maybe when I next need a refill of Min I'll pop in to see this particular doctor, and either fess up that I was already on it or just go for a reset where it gets added to my medical notes from that point forward.

Thanks all for the feedback. I’ll send you another giant dump of photos soon @Raphael84.

Probably now far enough into the growth phase where I can say more about the little bits of design options where I had to state a preference, and see how those choices have turned out.

I guess choice #1, once I was there for the proper in-clinic interrogation of my hair and its thinning pattern, was how committed was I to a lowered hairline. The graft estimate to that point could have achieved one out of two of my goals – rebuild the hairline but with inadequate blend into the forelock, or work within the existing hairline for a decent blend between native and grafted hair. I came down on the side of wanting to do some of each, and so we pushed the proposed grafts upward by about 500 (essentially the rows of singles needed to give me 3 mm extra along the centre of the hairline and a bit over a centimetre toward the corners.

Hindsight view at 5 months: glad I included the slight lowering of the hairline, even with the weeks of redness that entailed. Speaking of…

My choice #2 – the sides of the hairline down to the temple points. This was always in the “probably won’t” column for me. Not because I like the shape and position I have now, but due to being uncharted territory with how long the skin would remain shaded red or pink. On my particular scalp, it seems to be the case that the close-packing of the singles did increase the amount of redness along that line compared to the other grafted zones. However the skin on the face and its margins is actually pretty fast at healing (due to all those helpful blood vessels). So I figure if I go back at some point for a tune up I can include a few hundred singles for reshaping the left and right indents above the temple points linking with where the first surgery concluded up at the corners, with maybe 6-10 weeks of the dreaded crimson halo to deal with.

Choice #3 was how much artistic asymmetry to put into the hairline design. The one you see drawn in some of my photos had something of a slant from higher on left side to lower on right. I asked on the morning of the surgery if that could be made just slightly less sloping, though still with some of the asymmetric design, and it only took a couple of minutes with the marker for everyone to be nodding their heads in agreement.

Hindsight view at 5 months: I’m sure the first draft would have been great by the time it reached this length, but I’m still happy with making it just that bit more subtle.

Maybe clarify in your first question if you mean the in-clinic consultation, or the back and fourth that might happen in the lead up to someone getting a clinic appointment. Certainly it's reasonable for your face to face consult to be with the surgeon. But as for online submissions etc, you might struggle to find a doctor who steps in at that initial inquiry point.

On the second point I think there are, but the popular ones tend to have waiting times exceeding a year.

Continuing the prior pattern. My angles of the hairline shots are way off in some of them!

1 Wet hair in indirect but bright light

2 Viewing the recipient from above at week 2,  2 months and 5 months

3. A front shot with dry hair

4-6. Day -1 before treatment, 2 months, and 5 months from three angles

7. Close up right corner

8. Close up left corner

9. Donor

Hey hair-restorers,

I'm still working on the 5 months pic set...mainly getting the really up-close shots where I used natural light out on the balcony. Probably by tomorrow.

Let this short clip fill the void for today.

Happy 4.5 months and it's started to really blend in nicely above your temples.

Actually one final pic - the donor taken a couple of days after a 1-2 blend by the barber. Seems not excessively dotty at this stage of the recovery.

Four month greetings.

Arraying the progress shots in a similar order to last times, because....yeah-SCIENCE!

All medications and other stuff unchanged from last month. Shape of new hairline is forming up. I anticipate some more of the 2s and 3s implanted among the existing forelock hair will further sprout in the next few months.

Thanks TheEye, Hairlinedreamer and IMM1979.

I feel like someone should really invent a neck brace, that like forces us into holding the same pose for each round of the before and after photos. Consistency in that is really hard for me to pull off, 😆.

Looks like I was at about week 10. Though from memory that starting time was governed by when all the things turned up in the mail.

Mr Rolandas's youtube channel has videos for a six month month experiment he did with needling, but more focused on improving/blending the punch scars on the donor scalp.