washingtondc

Had actually been reading about stemoxydine recently and had this exact same thought process. Hairs are in anagen -> pushed into telogen via the trauma of being removed from scalp and re-implanted -> some time passes and they hit exogen and fall out (additional existing hairs in the recipient area may also fall out via exogen due to shock loss) -> then they go to kenogen before restarting anagen. If we can apply stemoxydine to shorten the kenogen phase, those hairs (the ones that are transplanted and also those lost to shock loss) may pass through kenogen more quickly and reach anagen sooner, resulting in earlier growth and better restoration of shocked hair. I'm no doctor obviously but it all makes logical sense to me. It sounds like stemoxydine has the added benefit of "waking up" a small number of dormant follicles anyway, which I'd gladly take (even if it's only 4% or a couple thousand hairs). I'm definitely going to ask my surgeon about this and assuming he doesn't think there's any risk involved, add it into my stack.

One twelfth of the way there. This is one month post-op. Most grafts have shed, there's still a tiny, tiny amount of lingering redness that the camera doesn't pick up. Nothing really going on growth-wise obviously as to be expected at this point. I think I've lost some existing hair compared to pre-op. Really really hoping I don't get hit hard with shock loss. That would probably happen in the next month or two I think?

Got the sutures in the gap area out today, here is what it looks like a little over 3 weeks post-op:

From what I understand it's been decently confirmed that combining microneedling and topical minox often yields results that are greater than the sum of their individual parts; this study shows how adding microneedling to topical min improved results: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/ I'm wondering if it would still make sense to add microneedling to oral minoxidil? I could see the boost from microneedling coming in two different ways with topical minox; creating a bunch of tiny wounds on the scalp might increase the absorption of the topical? Or maybe it's the increase in bloodflow to the needled areas that's increasing the amount of minoxidil that's helping the follicles? If it's the former, maybe microneedling wouldn't really help oral min work better, but the latter might. Does anyone know or does anyone microneedle in addition to oral min?

Just wanted to post an update of how the donor area is doing. That gap spot is very minimal now and is healing nicely. There are a couple sutures there that I'll have removed next week and then it'll be all healed.

I thought that too. I thought the trauma/removal from blood supply when the follicle is extracted pushed the hair into the telogen phase, and then it falls out within a few months as it shifts to exogen. But if the hair continues growing after it's in the recipient site, that would seem to indicate it's still in anagen? So then what pushes it into telogen/exogen causing it to fall out if it's still in anagen for some time after being in the recipient area? Anyone who knows more have any perspective on this?

Bumping this thread as I also just started oral Minox, taking the same route as many and starting with 1.25 before potentially increasing. Seems like there are a few of us in this boat all starting at around the same time; hopefully it works great for everybody. I hadn't used minoxidil much (definitely not to the degree I would have needed to to see effects) previous to now; just finasteride on and off for some years, so I'm hoping to see some benefit by adding it in. Honestly I wouldn't mind if it goes slightly systemic and thickens up my beard hair as well; that's always been pretty patchy. Curious to see how your experience has been so far @Melvin- Moderator? Or anyone else who's been on it for a bit?

I had an FUT done a little over two weeks ago, and looking at the transplanted grafts yesterday, many/most seemed slightly longer than they were when they were first implanted (though I could be wrong). I'm curious if anyone knows how this happens? From what I thought, hair only grows during the anagen phase, which requires the follicle to be connected to the blood supply. Once the hair is disconnected from the blood supply (catagen phase) it transitions to its period of rest (telogen phase) for about 100 days, and then falls out (exogen) before restarting growth. So how is it that transplanted hairs continue growing for a time after they've been removed from their location in the scalp and blood supply and transplanted into a completely new location? It would seem like removing them from their source would be equivalent to pushing them into catagen, and they'd stop growing. If they're still growing immediately post-transplant, that would indicate they're still in anagen. Does that imply that hairs that continue to grow after transplantation might remain in anagen and not fall out? I'm expecting all of mine to fall out, just curious if anyone who knows more than I do might offer some insight.

Thanks Dr. Wesley. Apologies again for getting too much up in my head about things too early on in the process; lesson learned about waiting for a finished product. Thanks also for all you've done and the reassurance, I really appreciate it.

I have to apologize, both to the forum and to Dr. Wesley's office. I spoke with Dr. Wesley on the phone shortly ago and I no longer have any concerns at all. He showed me a one week/one year result that looks far more questionable than mine at a week and great at the end (he may post it here) and the change is pretty incredible. I was wrong to let some of the comments about density get to my head like I did and freak out so early in the process. I suffer from generalized anxiety and let it get the best of me. To be even more frank, I lost the love of my life earlier this year and am admittedly not in a very good mental state right now. I lost a lot of hair during the course of my relationship and am doing this to try to get back closer to where I was while I get ready to get back out into the world, and so I've placed a lot of importance on it, which results in a lot of anxiety. I am completely reassured and have full confidence that this will be a great result. I look forward to being someone to send others who are freaking out in the future to and being able to tell them that you can't let post op photos affect your perspective of how the result will look. Like I mentioned in earlier posts, I'm going to take a step back from over-scrutinizing things now and just let time take its course. Sorry again.

Hah yeah looks like you made this while I was already writing my response above. Probably pretty unlikely they'd just skip a patch that big I guess.

Actually on further inspection I don't really see this missing patch in the 24 hour post op photo, which is kind of strange to me, but I'll gladly take it. Guess that just reinforces that scrutinizing photos is unreliable, time to take a step back from that. If these graft/hair numbers and photos from the clinic look up to par to be a good result it would probably help to hear that; aside from that though I'm going to chill out on all the investigation/comparison.

I did receive a few photos after a couple weeks from the clinic yesterday; these are probably an hour or two post-op. I also got the graft numbers: 2236 total grafts 563 singles 1363 doubles 310 triples By my math that's 4219 total hairs. You guys are gonna hate me for this, but... it doesn't look like there are many/any grafts in this part of my head?

Lol, alright, thanks, that's reassuring I guess. It does to me, but maybe I'm showing an error in judgement. Thanks. The immediate post op looks more dense to me at first glace, but I think it's mainly the scabs creating more darkness resulting in an illusion of graft density. When I find a specific hair in the post op picture, the vast majority of the time I can find the same hair present in the 2-week picture. There are a couple of spots I can tell a hair or two have shed, but the shedding seems minimal to me in that picture. At this point I definitely recognize that things are starting to shed and so it will be futile to make any assessments until a year down the road. It just felt like, looking at the foundation of what things will be growing from, the area will be even more sparse than my hairline had been pre-op, which obviously would be a step backwards in the hairline appearance and would be pretty devastating, just psychologically and also for the amount of money I paid. I'm sorry for the negativity; 2021 has been an incredibly hard year for me and maybe I'm just in a mindset where I now expect things to go badly for me. Dr. Wesley initially planned to harvest 24-2600 grafts for my procedure, so when he was only able to get 2200, the donor area was unable to be properly sutured shut and I learned I'll need a second procedure to graft into the scarring, the hairline density looked low to me and others on this site agreed, etc., it just feels like "Here we go again; nothing can go right."

Am I crazy? I see hardly any difference in the actual hairs present. First picture 26 hours post-op, second picture 2 weeks. Anyone have any thoughts?

I will, thank you, I emailed him too. But they haven't. This photo is one I didn't realize I had, 26 hours post-op. It looks denser at first glance because the skin is darkened from scabs, but if you zoom in, I see no significant difference in the grafts present. Or nowhere near 95%, at least.

Just now received some photos. Here is the donor strip, look all standard?

Update with photos since I'm just about two weeks post-op now. Edit: The below is once again wrong and an overreaction. I have complete faith that this is going to be great. Leaving it as a testament to how easy it is to overanalyze too early especially when you have anxiety. I also realize slightly later in the thread that shedding had in fact started in these photos. It's becoming increasingly likely to me that this transplant is a complete waste and an exercise in futility. I had the scabs washed off yesterday so things are clearly visible. Look at how sparse that is. I cannot locate a single graft that's missing when I compare to earlier pictures in this thread; I can't find one that's fallen out. Does anyone disagree? Please, please say so if you do. This looks totally abysmal to me. How can this have happened???? I did so much research and put in so much work.

Thanks. The thing is, one of Wesley's big things is he likes to go into areas of future loss so that the transplant still looks natural if more hair is lost. So he went back some too in decreasing density, and also filled in my part line that had thinned some. Does that mess up your theory?

Does anyone who's been here longer know of some examples where the density/hair caliber looks similar to mine and it ended up looking good? I could really use some positivity/reassurance right now.

I actually saw him today to have the normal portion of my sutures removed and expressed my concerns. He said he has full confidence and no doubt that the result will look normal and full. I've been trying to obtain pictures of intra/post-op for over a week now since the procedure, as well as graft count breakdown, but haven't gotten them yet. I'll try again today. Looking at the graft placement, I just don't see how it's physically possible that this winds up looking full like I intended; it would literally seem like magic if that front hairline portion winds up looking thick/full. All I can do at this point is just trust him and the process, but it's exceedingly difficult to ignore what's in front of my own eyes. Oh well; there is nothing I'd love more than to be wrong. I have to go somewhere to get the sutures that are in the gap/wound portion removed next week sometime because that's still healing. I don't have to travel back to the clinic to do that; they said most places in my vicinity should be able to do it. Got a prescription for oral minox and will be switching over to that today, in combination with the fin that i've already been on. I wish I could be more optimistic. It would be so nice to have my pictures look very dense and feel like it's going to look great, and have the general consensus here be that as well. I would feel excited during the next year if that were the case; now I'm going to have to do my best to never think about it at all. It's going to be a long year.

I found another photo I took a day previous to the first one I posted (this one is 5 days post-op) where you can see maybe a little more clearly. Do people still think the density may be lacking some based on this one as well?

Have you seen hairlines with this density/fine caliber of hair that have looked alright, especially outside, out of curiosity?

Edit: The below is an overreaction to BDK081522's assessment and likely a great example of why you shouldn't scrutinize early on. I suffer from generalized anxiety and let it get the better of me. I've spoken with Dr. Wesley and have full faith that this will turn out great. My apologies for letting myself get out of hand; I was wrong. dammit. I'm crushed. How the hell did this happen? How can a top surgeon not make the hairline as dense as it needs to be? How can he do it so well literally 5 days later (hairbackpls1) and do this for me?? I don't have the money to do another procedure anytime soon. I also can't just drop off the map again like I have for this one to recover. I can't do another FUT, my scalp laxity was already too tight for this one. I can't shave my head to do an FUE, and even if I wanted to, I don't know how much donor hair I have left; is it really even wise to take more donor hair to fix a restored hairline that wasn't done right when I may need donor hair for farther back down the line?? This has already been the worst year of my life. I was trying to do this to help feel better about myself, I did literally everything I could to research and make this the best experience possible. When my donor area ran into a problem I figured "Okay, that's life" and took it in stride. But now my hairline is going to be subpar too?? Just so crushed. I hate everything right now. Edit again in case you missed the first one: Disregard this overreaction; it's wrong.

I scheduled my surgery and put a deposit down before I scheduled my consultation, so I'm not sure I actually paid a consultation fee.