GHTJourneya

3 Month Update Some progress, but not much, but my donor area and my shock loss have been recovered. I just had a PRP session which is supposed to promote some growth. I think that the photos below look a bit better than the actual situation, as native hairs from the back get longer and partially cover or shade the transplanted area. So far my progress is on par with the expected growth curves. I will try to find high quality photos from right before the operation, too.

Thanks Melvin! I recently saw your interview with Konior, (great content by the way, really useful!) and it looks like he thinks that the result of a good transplant primarily depends on the doctor. From what I've read so far, It sounds like stress can only cause some telogen effluvium, (although I think that has to be severe stress, high bpm or abnormal oxygen levels or bp) so worst case scenario the result of your transplant comes a bit later than expected. Thank you for the information, we really appreciate it!

Phd material, Thank you for your effort, really appreciate it

Hello guys, I was unfortunately tested positive 2 months and a week after getting my ht done, and I am now wondering if there are any tips regarding that, when healing after a ht. Do you think that covid can affect the progress of my hair transplant at that stage? I am fully vaccinated & boosted, and my symptoms for now are not too bad. Just a little bit of fever, typical sore throat and some coughing My understanding is that, like native hairs, there is nothing else apart from telogen effluvium that may happen to both one's native hairs & transplanted ones, due to covid. But, as it is normal and as I have not yet fully healed, I am curious to know if covid can somehow affect graft survival. I guess I will find out eventually, so far the progress has been smooth

Both PRP and microneedling bring growth factors, which is a good thing. It may speed up your recovery and even stimulate native hairs, but I do not see it as something that is absolutely necessary. For what it's worth it can only be beneficial rather than harmful.

Did I mention NW5? I think my case was a NW2-3 with some diffuse thinning, although it looks much worse right now due to shock loss. In general, I think if you are >NW2, you should do 2 operations to achieve the best result. Not only can you fix whatever went wrong with the first one, but you will also hurt your donor area less. Hopefully I don't have to shave my head again for the next operation

I am not using anything in particular, but there might be some aloe in my Klorane shampoo. It is better than it was, and I think that the camera makes it look a bit worse than it actually is, as you said

I do not think that redness is related to inflammation, but even if it is, I was told it is normal especially in areas that are more dense (closer to the actual hairline). I do not need another operation, but I am going to do it to lower my hairline, it is scheduled in 1 year and 3 months from now. How did alleviate your anxiety by the way? I am going to update my before-after pictures soon, thanks for reminding me

2-month update: No changes really, I believe I am just past the shedding phase. There is probably less redness and some of my native hair that went through shock loss are starting to grow again. I am feeling a bit low, but I guess everyone has to go through this tough phase. Hopefully things will change really soon. Current treatment: oral minoxidil, fin interchanged with dut, laser cap (3x/week), washing 3x/week with Ketoconazole, the rest of the days with normal shampoo (Klorane)

It does not make too much sense to me either, to be honest. The only problem that I had in the past was that sometimes there were some fibers left on the skin which got mixed with minoxidil and I got a few pimples here and there. I was told by my dermatologist that the skin should be clean and free of fiber leftovers before applying minoxidil so as to maximize absorption. I am not sure if it matters much, but since we are not allowed to be out in direct sunlight, I don't like the idea of having a hat on/off and have fibers all over the place (and have to wash my hair again), as much as I'd like to

The ugly duckling phase sucks, I am going through it as well, we all know how difficult it is! On the other hand, your donor looks great, though! Regarding hair fibers during that phase, a lot of doctors are against it (during the first 3 months or) and my guess is that most people won't bother washing their hair and might end up going to bed with hair fibers every night, it would be interesting to see what other people say about that

Thanks Melvin! The only stimulant I am using at the moment is oral minoxidil (and some vitamins? Also I'm not sure if Ketoconazole shampoo 2% is considered a stimulant). I will start using my laser cap (3x/week for 30') in 2-3 days from now, but I can see some really thick, short singles popping out, just a few. Let me know if there is anything you are using to speed up the growth, too

One month in, some shedding, some redness, a couple of pimples here and there, all as expected! It is better than I though it would be, I am supposed to start my LLLT 3x/week in a few days

It is difficult to tell just from the photo you posted. For what it's worth, this is good news and it does look promising. One is supposed to shed between weeks 2-8, but at the same time some growth may happen. Each individual has a different response and growth patterns, whereas some individuals experience less shedding and some others experience shock loss, shedding and late growth. It does not matter too much if you are an early grower or not, but it if you are anxious about the result, early signs of grow may alleviate your anxiety. If anything, your situation looks promising, normal and for some totally expected, for others early growth. You will be able to tell in a month or two from now, but it won't matter much at that point, I don't think.

At Dr. R. de Freitas, supposedly one of the best in the world, and to be honest I am extremely satisfied with how smooth it was. I think this little wound is not related to my HT, I think I rubbed my head too much around that area because I was worried there were scabs. It is likely that it was an ingrown hair or something else and I messed it up a bit 🐒

The fact that you can't tell is a good sign I guess. Mostly on my temples, this little red dot is included in the transplanted area, although I am not entirely sure it is one of the transplanted follicles. I lowered the temples but I also added some more grafts further back, so I don't really know what happened

To be honest I do not really know. I was under the impression I was a very good NW2, I will share pictures before and after. I was placed under super bright lights with wet hair, then got shaved and told by Dr. Freitas himself I am thinning, hence I should also use a bit of Dutasteride in my routine. I guess Dr. Freitas has hyper super duper standards and scrutinises every little detail. I do not doubt the judgement, I think you need to be that strict with patients in order to have super dense results. You might be thinning, you might not. Go to a dermatologist and ask them to evaluate your situation. Whatever it is, if you can't see it or if you are not sure (like I was, I couldn't see it), then it's most likely reversible with fin, dut and/or a post-op prp. Best of luck

Although I am not particularly worried about this, I put it up mostly for educational purposes. I am post-op day 13, and as I was washing I noticed a little red spot, so I rubbed it a bit and it ended up becoming even more red 🙈. It is a tiny dot, and only one, but I was wondering what happens to these? Was it some kind of ingrown hair? (photos taken from 10cm away and 5mm away with a little gadget that I have) Sorry for that level of nerd hypochondria.

Has anyone seen improvement by using low laser therapy (LLLT) caps post-op (starting after day 20-30) ? In theory, it might reduce shedding and speed up the recovery process, but at the same time I do not want to put my follicles at risk. I know it has a great safety profile, but I am reluctant to wear caps or hats post op. I do own a laser cap (272 diodes) and I can potentially use it to improve things, but should I? Are there any non-affiliated surgeons that do recommend wearing caps post-op?

@Breest I think there should be a stairway to Norwood Reversal as a sticky topic, but no one really bothers... You are posting photos in this forum, which means you are interested in improving your situation. Contrary to what other people say, I am a big believer of hair loss reversal. Consider trying this plan: 1) Go to a dermatologist to get an evaluation. Doctors usually give you an DHT blood test, to see how much dht & free testosterone you have in your body. You are likely to be prescribed with a combination of finasteride & dutasteride, as well as minoxidil (fortified with azelaic acid, either 5%, or 10%). 2) On top of your medication, you can buy a cheap dermaroller off amazon (go for a low needle count, with 1-1.25mm length) and do it 2-3 times a week, but careful not to apply minoxidil on your freshly wounded scalp (wait for at least 30' before applying minoxidil). 3) You can also buy an LLLT cap, but these are expensive and they might not be as effective, but it always depends on your financial situation. 4) In the mean time, choose a good clinic, (there are amazing, affordable doctors in Spain & Portugal), because it usually take a couple of years to get a HT. In the meantime you will be gaining some ground, your hair will be thickening up and even your donor area will most likely improve if it is currently thin. 5) If you smoke please quit smoking and if you drink too much, please try to reduce that. If anything, it will only help you improve the situation and your lifestyle. The average donor area has between 5K-6K follicles to provide for HTs, it is extremely rare for someone to only have 1K. I do believe you can get more than 3-4K after a couple of years of medication. You might as well ask your doctor to use body or beard hair to thicken up your central area & crown, where people do not care as much about the quality of hair. If a donor area is too thin, you may as well do micropigmentation to make it appear thicker. Consider these things, and when you do have a HT, post it here and let us compliment you 💪

I am pretty sure that most of us go through some anxiety pre-op, mid-op or post-op. For some unknown reason, I was not anxious at all 5 days post-op, but now that I realise I am getting into the ugly duckling phase, I am getting more anxious. I closely monitor my blood pressure, heart rate and oxygen levels, and the only concerning thing is that sometimes my heart rate goes to 90-95bpm, other times at 80-85, and hopefully most of the time around 75. Blood pressure & oxygen levels are always very good. My questions are: 1) Is it likely that anxiety will affect the outcome of my HT? My understanding is that generally speaking, telogen effluvium, (stress-induced shedding), is completely reversible, not very well understood and unlikely to happen anyway, unless there is a super-duper drastic event (like death of a parent), and even in that case it won't affect graft survival(?!) 2) How do you deal with post-op or duckling phase anxiety? I try to consume less coffee, follow a healthy diet and avoid alcohol to keep cortisol levels low. I avoid pills like xanax, as we already go through enough trauma and chemical imbalances with fin/dut/minoxidil/anti-inflammatories post-op.

I also asked this on Reddit and it seems a lot of people are interested in this question. Although there is no definite answer to this, my theory after reading a lot of articles and trying to get my head around it, is this: When follicles are transplanted (moved into other areas of the scalp), they have a really short lifespan without constant blood supply, hence clinics do their best to keep them refrigerated, hydrated and properly stored and they can only do so for 3 hours. Before the ugly duckling phase, and right after the new follicles set in place, (within the first 14 days), the follicles start growing a bit. This is because they are now connected back to the blood supply grid, and they get all the nutrients they need to grow. If you see follicles growing a bit, then it probably means they are well connected to the grid and will most likely make it. The ones that remain there without growing too much, are less likely to survive. When the hairs of these follicles shed, there will be no new hair coming out (!?). There are a lot of doctors that achieve >90% survival and off course each transplanted follicle might be in different hair phases (some of them might just be right before telogen, or anagen), and it might be more complicated. What do people think about this subject?

Well this is before the so called shedding phase. I am expecting all these little ones to start shedding within the next week. I am more than likely to go into shedding & shockloss within the next days. I will post updates

Update, 10 days post-op: Crusting is gone, donor area 90% healed, there are a few scabs here and there, but overall really good progress, I guess. There is some kind of anxiety regarding the result and how it will progress, but I think any level of stress at this point is unlikely to affect the outcome?!

I used Whatsapp, but you can also use emails if you prefer that. I did not talk to Dr. De Freitas himself, I talked to his team a couple of times before the procedure. They will probably contact you asking for a blood test 20-30 days before the operation, as well as for the payments, if you haven't done so. But all these closer to the scheduled dates.