fritz68

Looking good, much better than pre-op now! And through the worst part too, plain sailing from here on in. Congrats.

A huge difference with just one session. It's gone from something I would notice without even looking for it, to something I wouldn't notice unless I looked for it. If that makes sense

If the reason really was that you were being too gentle, then that wouldn't have influence the separation of the external hair from the actual graft, it would already be in telogen phase irrespective of whether the hair is hanging on or not. Regarding what to use as a guideline, 5 or 6 months, I don't think you can use general guidelines, it will all depend on how long your hairs, on average, stay in the telogen phase.

Here's a 2 week post op pic, it's taken with mobile camera so not great detail, but I'm delighted to say that I was able to return to work on Monday, and even meet girlfriend on Saturday, without anyone noticing (and my girlfriend is observant). The last time I had this done the area was red, raised and pitted (and very noticeable) for almost 2 months.....this time it already looks just like it did pre-op with the exception of grafts that haven't shed yet. Brilliant.

Thank you David, much appreciated! WIsh I could say I did brave the Arizona heat but the limits of my bravery consisted of 100m walks to Trader Joe's. Amazing dust storm though, didn't even need Toppik for 2 days after.

thanks RC, yes, I'm relatively lucky with starting point. That's correct re, doc.

I believe there are several renowned docs who say weight training is ok 1 week post-op, Shapiro I think, and at least Dr. Alexander's technician said it was ok when she was removing the sutures. I think doctors tend to err on the side of caution which is fine. But there are no studies on this (as far as I know), just empirical and anecdotal evidence. If there was a biologically plausible reason as to why weight-lifting would increase scar tension (and not just blood pressure and 'straining' of neck muscles as I often read) I'd be more inclined to believe it. I do 2 x 45 mins sessions of core exercises, about 12 sets total per workout, with each set lasting 25-35 seconds, so it's about 12 mins total out of 168 hrs per week. I feel more tension on the wound if i simply lie on my bed and put my chin to my chest (for example to watch TV) than lifting weight above my head when it's aligned with my spine. But I think everyone has their own ideas on this so no right answer

Ok, thanks for your advice orlhair1!

Thanks! I'm not sure if he specifically said why, but he said he didn't think a tricophytic closure was used (Dr. Alexander uses a 2 layer tricophytic closure). For the record I never performed scalp stretching exercises for the first procedure (surgeon didn't believe in them) and started weight-training 8 days post-op (according the post-op instructions). I've also started weight-training again (just 2 x 45mins per week), I don't believe an increase in blood pressure or 'straining' adjacent neck muscles increases scar tension, but am careful with head movements. The stretching was only on both sides of my head, not on back, suggesting scalp tightness in that area and perhaps poor closure was the cause.

I recently (11 days post-op today) had 1550 grafts on my fontal hairline with Dr. Alexander in Arizona. It was essentially a 'redo' of a poor hairline transplant I received from a former coalition doctor. Issues I presented with were (a) poor density of 15-30 grafts per sq cm (b) scar stretched to approx. 0.7mm to 1cm © squint (about 1cm higher on right side) and unnatural hairline. I decided upon Dr. Alexander after (in contrast to first procedure) a thorough review of the coalition doctors who didn't require shaving (don't mind shaving recipient but can't shave donor with scar and not walking round with long back and shaved front). His policy of one patient per day was important for me. Despite flying from Europe, I thought the extra 4-5hrs to Arizona were worth it. The difference between my first and second transplants were night and day. Dr. Alexander was meticulous in his attention to every detail of the process, as were his technicians. He also spent a lot of time revising the scar. I apparently have a highly vascular scalp which Dr. Alexander explained (I think, although I was half out of it) can lead to a more rapid local decline in lidocaine/epinephrine concentrations, necessitating more frequent injections of both. It also sounded like he was cauterizing blood vessels at the back but I might have been imagining it.It was actually quite painful as the scar area became hypersensitive, but I didn't really care if this was the price to pay for a job well done. The first transplant (and not this one) was also performed using a 'stick and place' technique, which I think might be harder for technicians to deal with if the patient is a bleeder, like I am. At least I remember the technicians saying how difficult it was in the first transplant as so many hairs were popping out again. Now it's the waiting game, but even in my naivety I remember being very sceptical after the first transplant as there were so many things that didn't fit. I'm taking nothing for granted but I do know I've gone to a top-notch surgeon this time, so I'm quietly optimistic. At 11 days out there's a densely packed hair line, which I expect will shed anytime soon, so I'll be a very happy man if these hairs decide to come back again. If the scar's improved it will be a home run. Will keep you updated at later dates.

The success of finasteride has obviously enabled doctors & younger patients to take the risk of using proportionately high percentages of donor hair on the frontal third. I don't see any long term problems as long as the patient never stops taking finasteride and previously unidentified long-term safety issues with the drug don't show up forcing it off the market. I've been using it for about 13yrs and have maintained thick hair in crown but thinning in frontal zone (second small session coming up). If I have to come off it I'm going to look bizarre.

Some of Rahal's hairline work is the most dense and natural looking I've seen. Get's me wondering if (a) he's doing something other surgeons aren't or (b) these examples have limited hair loss and he's able to use much higher densities in smaller areas to create this effect. I don't mean to be controversial, but it would be very surprising if Rahal knew anything technical that Feller didn't about how to perform an optimal transplant wouldn't it? Saying that, HT 'science' seems to be at least as much empirical evidence based on years of performing transplants, which explains why one surgeon says it's fine to rub scabs off at 7 days whilst others (like Rahal) require that the scabs aren't touched for 2 weeks.

Thank you David, will do!

Well it's now gone 14months and I've decided to go in for a 2nd session with Dr. Alexander in Arizona. I narrowed it down to a few excellent choices, but Dr. Alexander was the only that ticked every box and made the idea of flying the extra 5hrs (after 9hr flight to Boston) worth it. I'm much more positive going into this 2nd session as (1) I now know FUT works (2) I only need thickening behind the hairline so it will be much less noticeable in the first 3 months post-op (3) I now see what a huge difference a 2-3cm lowering of my hairline has made in my appearance. Now I can pretty much sit back with a certain amount of confidence knowing that things should be looking very good by early next year (procedure in June). To cut a long story short, the first 10-12 months were psychologically tough hairwise...but now that I got past that I'm delighted I got this done, money very well spent.

Another point is that tonight I was out with closest friends, guys I've known for years, and we were talking about surgery. One guy mentioned that the worst he'd seen was hair transplants, that it was a brutal process. I never told a soul I did this, but I was able to explain that I don't believe it's painful and that the patients are actually conscious. If you compare my before and after there's a marked difference, but the change happens so slowly it's hard to tell. Even I have to look at before photos to remind myself of how far I've come.

@wisiorek, if you're looking like I do now at an earlier stage then you've every reason to be positive. Hope it goes onwards and upwards. @wb280, of course we're all experiments of one so I can't predict what will happen in your case but based on my experience, if you'd be happy with another 20%, then I think you'll achieve that between now and 18months. If that's where you are, my guess is that, like me, you'll want a 2nd pass to get things looking almost perfect, but you'll look good enough to not be desperate to get it done. That's a very good feeling, when you feel that it's not detracting from your looks, even if it's not perfect.

I see now it's your native hair at 4.5 months (just saw your immed. post op photos and read you were shaved). It looks like it was a very large area you covered with 3500 hairs, the post-op pics look immaculate but even with 90+% growth the spacing between the grafts must dictate that you'll need a second pass to match the hair behind no? Or did Dr. Path think one might be enough?

Hey there wb280, I'll say that I'm in much better shape than I was only a few months back, but I'll still need another pass to get it to the stage where there isn't a marked jump in density between transplanted and native hair. There simply isn't enough hairs even with shaft thickening in the next 6 months. I don't know how much of your hair in your old pics is native hair but it's much more than I had at that stage.

Hi wb280, really hope you get some satisfaction, not sure how far you've come since your 4.5 months pics you have in your profile so can't comment (I saw ur other post on 2nd pass) I remember Dr. Lindsey posting that he'd ideally see patients post-op at 16 months, but at 1 yr there was about 80% of final result. So you might be only 60% of the way there with respect to the final aesthetic impact. At 10 months I began to see a lot extremely thin hairs that were almost invisible to naked eye that have thickened up in last 2 months. Are you seeing that? It's hard to tell but I wondered if doubles initially came in as singles before the 2nd shaft came in.

Thanks for your comments guys. A few points to note: (1) I think I'm an exceptionally slow grower so hopefully if you're in early stages you'll be one of the guys who have great results by 6 months or so. (2) I stopped minoxidil at month 4, restarted at month 9. Not sure if this is coincidental (3) I still have stubble, but it seems like some of it is perpetual stubble, i.e, grafts that neither grow nor fall out. (4) Once grown in, the first 3-4cm that grew was so wispy/kinked that it needed to be clipped off. It didn't match hair behind. (5) The longest wait is probably if you have hair transplanted in front of thick hair, as the hair needs to both grow and mature until it looks decent.

Spex, thanks for your advice. I've actually read your bit on patience about 100x, helped get me through the first 11 months or so Mattj, thank you, yes FUE would definitely be a possibility, but am not so keen on the shaving part. Agree, my case does emphasise importance of patience. My growth timeline was as follows: 3-5 months nothing much, just wispy stubble 7 months-longer but wispy and thinking it had been a complete failure 9-10 months looking better but still nowhere near density of original hairline behind and clear demarcation between the 2. But occasional good hair day 12 months. Blending in, lot more good hair days and getting compliments on hair. It's an extremely long wait when you're expecting fireworks at 4 months. Can't decide. Thank you, I realise I'm lucky, with a great starting point. I think humans are neurally designed to take what they have for granted, and happiness (albeit transient) can be achieved by either getting back what you lost or getting more than you already have. I'm lucky to be in the 2nd category, although those in the first category are lucky to be born in an age when they're able to do something about it.

Dear all, I'm posting my results 10 (first pic) versus 12 months (other 2 pics) post-op after an approx. 1700 graft frontal zone FUT. My hair is otherwise quite thick with exception of transplant Perhaps it's not so clear from photos but I've seen a nice improvement in the last 2 months. At 10 months I was 100% convinced I'd need a 2nd pass. Now I'm not quite so sure. My options are to leave it as is, wait another 4 months or so before making a decision, or going ahead and booking a 2nd FUT. Any thoughts much appreciated

Very positive change in your overall look, amazing. IMO I don't think you'd get much change to your overall look by lowering your hairline another cm, it looks good where it is. I'd use the grafts to thicken up the existing hairline. A very thick hairline looks better than a medium thick hairline that is 1cm lower. Did you see much of a change from 9 to 13 months? It's hard to tell due to the way the light hits it in the Lake Garda photo.

Thanks a lot for taking the time to reply Hairthere, qwerty and RCWest. It was temple to temple, although from the pics it looks like centre only. Reason being the temples seemed to grow in without going through a resting phase, it's very thick in the corners, and has been since about 5 months or so. The centre didn't even start growing in until about 6 months. I'm not sure how many were placed in the hairline, I only know that I had 2000 total including the scars (I asked for a breakdown of singles, doubles etc but they didn't have it). I'd guess it was about 1700 or so in hairline and it was lowered about 2cm.

Hello, I had hairline lowering earlier this year, somewhere around 2000 grafts (paid for 2000 but some were used in a scar not from earlier HT). My original hairline was where it suddenly becomes dense and non-transparent, so you can see where the new hair is. The pic was taken at 8.5months post-op. As you can see it's still very transparent in the centre portion. There is some stubble there, but not a lot. I have some gel and minoxidil in this photo. There are some very solid hairs growing, but it's patchy. I realise it's hard to judge based on one photo but would those of you who've been through it all before predict that I'm going to need another pass to thicken it up enough to match the hair behind.....or does this look on target for an ok result at 12-14 months? :confused: Thanks!