Balding Bad

JANUARY 20, 2023 UPDATE (30 DAYS POST-OP)

Well, it's been exactly a month since the op! And I gotta say, that ugly duckling phase is no joke. I was hoping I would be one of the rare cases where I would be spared the shed of the freshly transplanted grafts, but no such luck. 98% of the transplanted hairs have shed. There are still a few lingering transplanted hairs that remain at the same length they were initially transplanted at, no growth or anything. Also, a decent amount of my native hairs in the frontal third and a substantial amount of natives near my right temple also shed. I'm glad that I'm able to partially conceal my frontal third and retain my "normal" look with my Trump comb over.

The donor area looks great! Can't tell there's been anything done! The top center of my donor area seems a bit thinned out, but that's actually just how it normally is...so that's not due to overharvesting or anything. It still occasionally gets itchy in the donor area and there is very minor pain still in the corners of my recipient area. I still haven't dared to scratch my recipient area with my fingernails yet, just using the pads of my fingers for now.

Since this is the first 30 days, there isn't much visually to admire, but here's the "progress" so far! (sorry for the lighting that causes that hot spot...)

Congrats on the stellar results!

I'm guessing his results were probably so good he started living his life to the fullest and forgot all about this site...

Good for him!

JANUARY 8, 2023 UPDATE (18 DAYS POST-OP)

Now I know I said I wouldn't give anymore updates regarding shedding, however I had a rather alarming situation this morning as I washed my face. I was rubbing on my temple points and the right side of my temple shed off a TON of hair like it was nothing!

The shedding that was happening prior was all on or near the recipient area of my frontal third, so to me it seemed normal since that area endured a lot of trauma. Meanwhile my temple points where untouched at all from the procedure, so for my right temple to suddenly shed at least 40-50 follicles in one go this morning was a severe shock to the system. It shed so much that my right temple was visibly thinned out!

Later on the evening when I took a shower, I was happy to notice that the shedding from my frontal third was significantly less if not normal. I can only hope that means the "shock loss" shed phase for me has ended...which would mean it lasted for just about a week. 🤞

Photo depicts my shed after only ONE RUB of the right temple! 😳

17 hours ago, Gatsby said:

@Balding bad at 16 days post op you are traveling in the horrible zone of the ugly duck. Expect the unexpected and pay it no attention. By that I mean keep yourself as distracted and as busy as possible for the first three months. By all means keep a photographic record each month but I have found that the less attention you give to this period then the easier and quicker it passes. All the best!

Appreciate the advice!

It's just hard not to notice when tons of healthy hairs are falling by the way side each and everyday. I had ton more shedding again of health native hairs, but decided it'd be a repetitive post at this point...but I'll try to not pay any attention.

JANUARY 6, 2023 UPDATE (16 DAYS POST-OP)

At this point, I can only assume that I am experiencing shock loss. Tons of native hairs are shedding after each wash. Even simply running my hands or comb through my native hairs causes strands of healthy hairs to rain down.

The transplanted hairs are shedding more and more and my recipient area is looking more and more patchy. This doesn't concern me since this is to be expected, but I really do hope the shock loss ends sooner than later...

So what's the latest update?

Fascinating thread...looks like you're improving quite nicely. Any updates?

JANUARY 5, 2023 UPDATE (15 DAYS POST-OP)

Officially over the 2 week mark, so I decided today to hit the gym (after a 3 week absence) and start using normal shampoo again (no more baby shampoo). Not sure if it's just the natural progression of my recovery, but I felt like I lost A TON of normal hairs in the shower along with numerous amounts of grafts.

I know the grafts are supposed to shed, but I do wonder if lifting weights again today (moderate amount of intensity and I was sweating too) had anything to do with the uptick in shedding. I didn't count how many hairs (normal or transplanted) I shed today, but it was definitely a lot more than I'm used to and made me raise my eyebrows...

Also, it seems like the right side of my recipient area is shedding more than my left. I can feel the difference in density. Is that normal for one side to shed more than the other?

And does anyone think going to the gym (lifting weights) had anything to do with today's uptick in shedding?

UPDATE: I just went and combed my hair before and easily lost about 15 native hairs before...definitely doesn't seem normal... Could this be shock loss?

The corners seem to be coming in and it seems you have a few about to sprout near the front hairline, but overall, yes, I would be concerned too if I was in your position. 

But just a reminder, you're not even at the half-way mark yet...anything could happen! As others have stated, you might just be a late grower. Wishing you the best though!

Wishing you the best with your results @Capelli3000!

JANUARY 2, 2023 UPDATE (12 DAYS POST-OP)

It seems the shedding of the transplanted grafts is beginning. In the shower before I noticed a decent amount of grafts in my hands every time I rubbed on them. I didn't keep track of how many strands of hair I shed today, but in a way I'm kinda happy the shedding is already starting because that means the sooner it starts, the sooner the hairs start to grow!

Hey @Gatsby Happy New Year!

I just went through this epic odyssey of a thread and I'm stoked to see where you started and where you are now! Unbelievable!

You've always been very helpful in my threads and posts so I wanted to spread some positivity your way! Can't believe it took me this long to find your thread!

Hope all is well on your next procedure! 😎

JANUARY 1, 2023 UPDATE (11 DAYS POST-OP)

First off, Happy New Year! And what a new year this will be for me indeed. Will this be the year I finally have hair again on my frontal third?! I sure hope so! 🤞

It's only been 11 days since my operation so I don't really have any major or dramatic updates to share. I'm only posting one today since my goal is to post at the top of every month. 

In the shower today, the shed ticked up a bit. We landed at 87. At this point, I think the shedding has stabilized and I'm back to what I normally shed on a given day in the shower.

My donor area has been starting to get a bit itchy the past few days, but it's nothing unbearable. I find it's best to just rub it with the pads of my fingers instead of my nails and that should hold it over. Ultimately, ignoring it is the best option because I find if I give in to the itch, it just begs to be scratched more. 

For the sake of consistency, here are today's photos:

1 hour ago, hybonix said:

Excellent write up! This is a very detailed report and I loved reading it. It's fun to see more SMG threads popping up now! If you are open, oral min is a lot easier to take than topical. Also, have you looked into taking finasteride as well?

Lastly, do not count the days and just live life normally. Progress will come and you will be surprised at how quick the time does fly by. Excited to see your 6/9/12 month progress report!

Wow, the legendary @hybonix has responded to my thread! 😄 

I was ultimately set on SMG for awhile, but it was YOUR thread and results that made me pull the trigger, so a big thanks to you bud!

I'm not opposed to topical Min. I don't find the daily application to be a hassle, but perhaps I should look into oral Min since that would help me save a lot of time in the evening...

And yeah, I've been on Fin for over a year now. I'm still titrating my dosage since I experience mild sides, but eventually I'll figure out the perfect balance I'm sure.

Hoping my results end up as good as yours! 🤞

HAIR WASH UPDATE (December 31, 2022)

Nothing out of the ordinary to report. Just wanted to make an entry noting that the shower shed today was dramatically less than yesterday. It seems with each passing day the shed is coming back down to normal. Today's shed was 68!

Hoping that number continues to drop as the days and weeks progress.

I think I'm gonna start up topical Min on Jan. 9th, which would mean I was off of it for a full month.

Anyways, Happy New Years Eve everyone! Wishing everyone self-growth and hair growth in the new year! 😄

SCAB REMOVAL UPDATE (December 30, 2022)

The remaining bits of lingering scabs were finally removed in today's wash. Moreover, just an update on post-wash shedding. Today's count was approximately 124.

My take on the whole situation is my intense hair shedding from yesterday (283) was likely due to being able to properly wash my scalp. The rigorous rubbing caused hairs that were supposed to shed but never could to finally shed. And since there were so many unshed hairs, it culminated in a mega shed session.

11 hours ago, HairRun said:

Those looks like normal hair, I think implanted ones have a j shape. I think you were gentle with your head last couple days so when you massage your head to remove scabs, you will get an increased number of hairs pulled.

Ask the clinic for oral minoxidil. I've been using it and wow, it is way more effective than topical which I've been on for over a decade. 

Thanks for the advice! Do you find that you're getting concentrated hair growth while on oral Min or are you finding new hairs where you typically never had or in areas where you never thought would grow? 😄

SCAB REMOVAL UPDATE (December 29, 2022)

So finally got around to cleaning/scrubbing off the scabs on my recipient area and boy, oh, boy was that a nice feeling!

What was not so nice...the amount of shedding that occurred. 283! That's the amount of hairs I shed during this wash...and those are the ones I was able account for. I'd imagine the final count was probably closer to the 300 range, if not over.

Once again, not sure if this is just part of the shock loss process or if it's a combination of factors. Like I stated yesterday, it could just be an accumulation of a week's worth of hair that was supposed to shed but never had the opportunity to due to gentle and minimal handling of my hair/scalp. It could also be due to the fact that I've been off of Min since Dec. 11 in preparation for my procedure. And secondly, it could also be due to the fact that I've been off Fin this week since I didn't bring my supply with me and I've stayed at home longer than I anticipated (although I doubt a week off Fin would contribute to THIS MUCH shedding).

OR it could be since I decided to keep my longer hairs, it just seems way more noticeable as opposed to had I buzzed it all off I probably wouldn't have noticed as much.

Regardless, every time my hand went through my hair there was always a ton of lost/stray hairs to be found.

Like a madman, I placed each strand of hair on my tile to keep track:

I would say it was 40% normal long hairs and then 60% short, thinning, wispy, miniaturized hairs.

My question, is this normal or am I shedding more than usual? 😬

On a positive front, my donor seems to be holding up quite well a little over a week later.

6 hours ago, Gatsby said:

I remember 11 months ago post op having a nightmare that I had scratched my grafts during my sleep. When I woke up I was thanking the Lord big time! 🤣 However I'm glad this thread has been raised again. I'm two and half weeks away from my next transplant. I've spent the last six months playing with my new hair and I'm worried that it's become an unconscious habit. I think I'll be wearing oven gloves after this surgery.

Haha nice, glad to see I've inspired a senior member such as yourself with the idea. The student has now become the teacher!

@AsianBoyHairLoss so I'm curious where you landed on your decision?

As someone who does actually sleep scratch my scalp during my sleep, this was 100% a concern for me. In fact, I found that I did scratch one of my grafts as I slept. What I found worked for me was wearing gloves to sleep and then keeping my hands tucked under my leg as I slept. Sure it'll put your arms to sleep and you'll wake up with pins and needles, but it's worth it.

ONE WEEK UPDATE (DECEMBER 28, 2022)

Okay, can't believe it's already been one whole week, but here we are!

No real updates to provide other than my wash/shower before in which I noticed a ton of shedding. I counted up to 128 hairs lost in the shower and then more after the fact. I feel like there's 2 possible explanations. 1.) It's shock loss. 2.) It's been about a week of gentle hair washing and today I was a little less gentle, so I probably had hairs that were initially supposed to shed that never did because it never got the contact necessary to cause it to fall out...who knows?

Anyways, the SMG guide states that day 7-8 is when I should start removing the scabs. I'm erring on side of caution and will start the more forceful rubbing tomorrow during my wash.

New FUE HT thread can be located here: 

Hello folks – Merry Christmas! My gift to you all today is my documentation of my recent FUE HT procedure, which occurred on December 20 and 21, 2022.

Important stats:

• 1’s – 455
• 2’s – 1,646
• 3’s – 208
• Total: 2,309 grafts or 4,371 hairs total
• Total lifetime grafts estimated: 5,000-6,000
• Total lifetime grafts remaining: 2,691-3,691

I already have a detailed thread regarding my backstory/struggle with hair loss, so I’ll spare you the extraneous details. For those who are unaware of aforementioned backstory, here’s a link to my prior thread.

OVERVIEW:

I was initially planning on undergoing this procedure a year ago (December 2021), but ultimately delayed it in lieu of giving medical intervention (Fin) a try first to see if my frontal third could potentially recover and regrow but sadly it did not. Fast-forward eight months later to August 2022 and after lackluster results with Fin, I decided it was time to finally commit to a HT!

I contacted Matt Zupan, who I absolutely must commend. Back when I contacted him in 2021, he never pressured me to undergo the procedure. In fact, he advocated that I give medical intervention a try first before going down the surgical route. With a clinic as well-known and well-renowned as SMG, their waitlist was, unsurprisingly, booked several months ahead already. Their earliest opening was in April/May of 2023. For me, that wasn’t ideal since I think the best time to undergo a procedure such as this is during the Fall/Winter months when it’s easier to conceal such an operation.

I kept in constant contact with Matt and eventually it was brought to my attention there was vacancy for December 20 and 21. I was initially reluctant to take those particular dates due to how close it was to Christmas. My primary concern was that given a major holiday was right around the corner, I would most likely end up with the “B-Team” or potentially have some of the staff mentally checked out, but I can attest that this concern was unfounded!  Everyone was on top of their game and I can't extol Dr. Josephitis (Dr. Joe) and the team of techs enough! Moreover, being from out of state, I knew traveling could potentially present a unique set of challenges, but in the end, it was not an issue in the slightest.

THE WARMUP – Day 1 (December 20, 2022)

Total duration: 3 hours – 1.5 hour for consult and haircut / 1.5 hour for the actual procedure (incision at the recipient site)

Photos taken at hotel prior to procedure:

I arrived at 1p where I finally met Matt Zupan in-person. He gave me a quick tour of the facility and I even got to meet Dr. Ron Shapiro briefly. After that, I got to meet the man who would be performing the procedure on me: Dr. Joe! He was extremely friendly and attentive and answered all my questions and addressed all my concerns. Dr. Joe examined my hair and we discussed what the final hairline design would be. He was initially a bit aggressive (in my opinion). He wanted to bring down my recessed corners a bit, however I told him I was more in favor of a conservative hairline and wanted to simply maintain what my current hairline was.

Photos of the hairline design:

Once it was marked up, I was given a shirt to change into and then brought into the stylist room where Dr. Joe performed the haircut for me! And I got to hand it to him, he’s got solid barber skills! I’ve seen photos from friends and what other’s have posted online of their haircuts they received at their respective clinics, and I was often surprised at how sloppy and uneven some of the cuts were, but with Dr. Joe he gave me a helluva solid buzz. He even managed to give me a decent fade on the top since I wanted to retain the longer hairs on the top of my head.

After the haircut, I was offered Valium to help me relax and to take the edge off, but since I was not nervous at all, I kindly rebuffed the pills. Once in the operating room, it was just Dr. Joe and another technician, Tiffany, who was simply fantastic! They sat me on the operating chair, akin to the kind at the dentist, and I was handed an Apple TV remote to pick out something to watch. I ended up just opting for music since I didn’t want anything playing in the background that could potentially distract Dr. Joe or Tiffany. They assured me they would be in their own bubble once the procedure began, but I opted to just play it safe and have chill tunes play in the background instead.

They numbed my forehead via injections and even used a small massage wand to distract from any potential pain or discomfort from the needle. I’ve read a few accounts where people say this is the most painful part of the procedure, but I suppose everyone’s pain tolerance is different and, for me, it was completely pain-free. I just felt a minor pinch. Nothing more. After giving it a few minutes for the anesthesia to settle in, Dr. Joe began his incisions at the recipient site.

Once Dr. Joe completed all his incisions, I was given a black surgical bandana (headgear) to conceal/protect my head and I went about my merry way back to the hotel.

Photos after incisions were made (the purple hue is a dye used in order to make the incisions stand out more for placement the next day):

THE MAIN EVENT – Day 2 (December 21, 2022)

Total duration: 8 hours – 30 min break for lunch and one quick bathroom break

I arrived at 7a where I was greeted by Pamela at the front desk who took my lunch order for Jimmy John’s for later in the day. Once that was taken care of, I was given a zip-up shirt to change into and it was back into the operating room, although this one was a different room. This room was equipped with multiple magnification sets on the table on the sides.

The team of technicians were: Peng, Vicky, Carla, Tiffany, and Jenglia* (I’m certain I’m spelling her name wrong). There might be one or two technicians I'm missing, but those 5 technicians were the ones I primarily interacted with.

Dr. Joe checked my head and inspected the incisions made from the day prior and we discussed/finessed the final hairline. I was offered Valium again, which I declined once again, however this time the techs insisted I take the pills (10mg) since the operation was going to be significantly longer. Moreover, they reasoned the Valium would help with the anesthesia as well, so I relented.

It was back onto the “dentist chair” again. Although, instead of laying on my back this time around, I was on my stomach for the beginning portion. Once again, the same technique of using a massager on my back and head was employed to distract from the anesthesia shots. I received anywhere from 15-25 injections to numb my head. Full disclosure, that number is only an estimate since I didn’t count, but all I know is I received substantially more shots and they injected in a grid pattern this time around.

Once the anesthesia had settled in, Dr. Joe double-checked and prodded around with a sharp tip to ensure I felt absolutely no pain. Good thing he did because I ended up needing maybe 2 or 3 extra shots since I could still feel some sensation in the peripheral area on the back of my scalp. Once I was fully numb, Dr. Joe began expertly extracting the follicles from the back of my head with the aid of Carla, who served as a spotter or a second pair of eyes and kept the donor area clean as Dr. Joe worked.

In total, the numbing + extraction process took maybe 3 or 4 hours.

Once all 2,309 grafts were removed, I was granted a bathroom break and then it was lunch time!

After lunch, I was offered Valium again. I denied it once again, but the tech (Vicky) was able to convince me to take it one final time. So it was back in the seat. Except now I was back on my back again so a few more incisions could be made and all the extracted grafts could be placed by the technicians. During this process, I finally decided to watch a movie (Venom). While that was happening, I had 4 or 5 technicians actively working on placement. Dr. Joe came in perhaps once or twice to check in on the techs. After about an hour of watching the movie, I ended up falling asleep for the remainder of the procedure. When I woke up it was about 4p and the techs were essentially finished and Dr. Joe came back for one final round of inspections and answered any questions or concerns I had at that point.

It was during this time I learned that my lifetime donor grafts were estimated to be between 5,000-6,000 grafts, which Dr. Joe indicated was below average. I was a bit disappointed to hear that, but not surprised since Asians typically have less hair when compared to Caucasians.

After that, I changed back into my button-down, had my surgical cap placed over my head, and that was a wrap! I ordered my Uber back to the hotel (although Dr. Joe was willing to drive me back to my hotel, but I politely declined. What a guy though!) and my first FUE HT operation was officially in the books!

Once back at the hotel, I made sure to stick to the regimen of spraying the recipient area with the provided Liposomal ATP spray every 30 minutes. I even hoped on my laptop and did a couple hours worth of work!

Photos after extracted follicles placed into recipient area:

POST-OP – Day 1 (December 22, 2022)

There was absolutely no swelling during my 2 days of surgery and none the very next day, which I was pleased to see. I was informed by Dr. Joe that swelling only occurs in 10-20% of patients. My head, both donor and recipient area, was scabby and slightly bleeding. I used the provided disposable pillowcase coverings/protectors that were provided by SMG, which is an absolute must because it was covered in spackled blood.

I headed over to SMG at 10a for my first wash. Jenglia* (once again, probably not how her name is spelt) was the one who handled the wash. She was very gentle and helped remove the scabs that had formed and used cool water for the entire process. Overall, it took about 30 minutes from wash to towel dry finish.

Once my head/hair was cleaned, it was off to the airport!

I was comfortable enough with how I looked post-op that I didn’t want to wear a surgical cap or any type of headgear, however Dr. Joe recommended I do so to protect it from the elements (it was in the negative degrees) just in case, also especially since my head was still so fresh.

My flight back home was about 2.5 hours and during this time I was bundled up since it was absolutely frigid in Minnesota. Not only that, but I made sure not to have the air vent on the plane blow directly on me because I removed my headgear every 30 minutes to spray. So I think me being slightly overheated ended up contributing to the headache because once I was off the plane and back in fresh, cool air again, my headache eventually began to dissipate.

Once I was back home, I had dinner and took a couple of Advils and my headache was completely gone. SMG provided Tramadol to help with any potential pain, but luckily for me, I never experienced any physical post-op pain and opted not to take it at all. Moreover, since Tramadol is an opioid, it was the main reason why I didn’t want to take it. I'm sure everyone is aware of the potential horror stories related to opioids.

Photos of day 1 of post-op:

POST-OP – Day 2 (December 23, 2022)

Despite not swelling for the first 2 days of the operation and the day after, I was a bit surprised to see that the right portion of my forehead/temple and the upper portion of the bridge of my nose was moderately swollen (I looked like an Avatar due to my swollen nose. If I colored my skin blue, I would have been a dead ringer for a Na'vi 😜). I was informed by Dr. Joe that if swelling was to occur, it would typically happen 2 or 3 days after and it seemed that this was the case for me.

SMG provided 2 icepacks, which I used to help with the swelling. Near the end of the day, the swelling did subside a bit.

I also did have a mild headache when I woke up, but after eating breakfast and popping 2 Advils, it went away.

This was the first day I had to wash my hair on my own and naturally I was a bit nervous at first, but once you get the hang of it, it's really easy. I used the baby shampoo that SMG provided and followed their instructions by wetting my scalp first by using a cup of water to drizzle gently onto your head. Then I lather up the shampoo in my hands first before gently tapping the grafts to work in the suds. The donor area you can be a little more liberal with. I would use the pads of my fingers in a circular motion to massage in the soap.

I’m happy to report that I didn’t have to deal with any post-op oozing or bleeding. My donor and recipient area looked really clean. There was really no redness or scabbing going on. If you had no knowledge of my HT, you would have been unable to tell I had anything done in that region.

Not sure if this type of surgery takes a lot out of your system, but even though I had a pretty good night’s rest the night before, I ended up taking a 3-hour nap later on that day.

Photos of day 2 of post-op:

POST-OP – Day 3 (December 24, 2022)

Day 3 was more or less similar to Day 2. I continued to use the Liposomal ATP spray despite the instructions stating it should be tossed out after 48 hours. I figured an extra day wouldn't hurt. The swelling was still there and I continued to ice it in intervals throughout the day. I also took Advil in the morning to help with the minor headache I had.

Photos of day 3 of post-op taken after washing:

POST-OP – Day 4 (December 25, 2022)

Another slight headache when I woke up this morning, but Advil helped alleviate that. The swelling on the right-side of my forehead/temple and upper bridge of nose was almost gone. I made sure to keep icing it throughout the day and by the afternoon it was completely gone.

My donor area looked fantastic! With the exception of some minor redness, it essentially looked like it was back to normal. Once again, if you had absolutely no knowledge I had a HT, you would be unable to suspect I was still in recovery.

Photos of day 4 of post-op:

Overall, I am very satisfied with my experience thus far.

Dr. Joe, you are a standup guy! The tech team was fantastic! I can't praise my experience at SMG enough! Thank you all!

And now we play the waiting game...

I plan on giving monthly updates. So, I suppose the next one will come next week at the top of the New Year.

Anyways, thanks for reading this super long, detailed post. I plan on posting photos with each corresponding day soon. I’ll need to edit the photos first but stay tuned for photos!

Also, if you have any questions or want more clarity on anything, feel free to ask!

EDIT: PHOTOS HAVE NOW BEEN PAINSTAKINGLY ADDED!

- Walter White