Amiele

Looks like clean work. Do you know if this will be a one and done procedure or do you think you’ll need another procedure to achieve the desired density? Curious that you’re not feeling any tightness, did you do scalp elasticity exercises prior to surgery? 
In your next update can you please post some pictures of your scar? 
 

Did Dr Cooley prescribe the Xyon topical dutasteride? Are you applying it over your entire scalp? 

Sorry for all the questions, I’m jut curious. 😀 happy growing!

7 hours ago, Vaz430 said:

Here are some. To be clear I was already worried about density from the start. He said he couldn't place them closer cause it would be hard for them to grow if he put them too close. But I think from the start it wasn't as dense as many others have from the start. Also I think the right side had higher density than the left from the start.

Did the doctor elaborate on why implanting the grafts closer together would prevent growth? Does he perform a lot of surgeries where the recipient area isn’t shaved? 
While Dr. Haber may be on this website’s recommended list, I personally would only opt for doctors who focus solely on patients with hair loss, as it looks like he also sees patients for general dermatologic complaints. 

It looks natural and the coverage is great from where you started. You’ve had 7,000 grafts transplanted over two FUTs which have yielded a fantastic result. Were the graft counts what Dr. Cooley initially suggested or did you press for higher numbers? I’m also curious what Dr. Cooley estimates you have left in your donor, that is, do you have enough scalp laxity for a third FUT, and how much can be extracted via FUE? 

@BeHappyI believe that a Norwood 4 or below who is on medication — stabilized — and has adequate donor caliber, and who starts with FUT for their first two to possibly 3 procedures, shouldn’t have to worry about running out of donor. Using myself as an example because I’ve had two FUTs, albeit on the low-end in terms of graft count, but my crown still isn’t where I want it to be. 

Could fin stop working for me and then have to worry about accelerated loss of native hair? Sure, but then I’d switch to dut. 

I’d also like to know how often crown surgeries require touch ups? More so, how often do patients need a second crown procedure because not enough grafts were used on the first procedure? 

@Thanks4TheHelp It looks like your hair length and the way your hair was “styled” was covering up the thinning. Is your hairline receding? If your derm suspects you have a vitamin deficiency then they may order a complete metabolic panel, CBC, and vitamin D levels. If the derm determines that it is MPB then please don’t wait to start medical therapy.

@TimeForAChange With that many grafts I think Dr. Wong set you up for an excellent outcome. Do you have pictures of what your hairline looks like and did you voice concern about your hairline to Dr. Wong prior to the procedure? Your procedure reminds me of JohnnySins procedure with Dr. Wong, and I’m really curious to see how your and his cases turn out. 

Are the doctors that you consulted with on the recommended list? 

I agree with others that an FUT for the first procedure doesn’t seem worth it for 1200 grafts. 

Quote

because he doesn’t want to make the donor area too big for the first HT and keep the scar thin and small

Does the doctor anticipate a second procedure to meet your goals? 

I've always been curious about the Regrowth Labs and Follics brands, which are sold at minoxidilexpressDOTcom - they ship from the UK. They manufacture topical finasteride and dutasteride products. 

Apparently the Regrowth Labs and Follics products are made in the U.S., although I believe the bulk active ingredients and excipients are sourced from China. 

They're owned by Sapphire Healthcare LLC, https://www.sapphirehealthusa.com/about. 

7 hours ago, Doron Harati said:

My crown procedure\3rd procedure result took significantly slower due to slower blood supply compare to the frontal area.

@Doron Harati How much longer did the crown transplant take to grow? And when you say slower, do you mean slower to mature or slower for transplanted hairs to start growing? 

And sorry for all the questions, but I have one more - how do you know it was due to slower blood supply? 

18 hours ago, Cooper said:

I don't generally wear my hair very short in the back

but that was a thought I had if I have fue and shave to graft the scar

 

I think a benefit to being able to cut the hair short is that doing so minimizes the contrast between dense and less dense areas, say if a transplant doesn’t provide the density you needed or if you start thinning on top down the road. Sure, trichophytic closure can minimize an FUT scar, but hair can generally be cut shorter with FUE.

I’ve also wondered if shave FUEs provide better results than no-shave, as no-shave can be more fatiguing on the surgeon and their staff. 

If you’re leaning towards FUE then would you also plan to get your FUT scar filled in? 

I’ve never had any issues getting 2.5 mg tablets or 10 mg tablets (split in half) of generic oral minoxidil here in the states, for which I’ve had/have prescriptions for both. But I’ve never asked the pharmacist for brand name Loniten, which I’m sure is way more expensive than generic. 

@Gatsby Thinking big picture here: if the OP adheres to medications and the meds at least maintain his current hair for the next few decades, then how many grafts does he need to fill in the area of his current SMP while leaving donor grafts in the bank?

@JohnnySins With that many grafts I’m sure you’ll have an excellent outcome in 12 months. I’m curious if you contemplated first using, or maybe if Dr. Wong even suggested that you first use, topical or oral minoxidil to get some regrowth in your crown before proceeding to a transplant. It’s possible that oral minoxidil would have thickened your hair and provided you with enough regrowth in your crown to an extent where you would no longer have felt that a transplant was warranted. 

See Figures 6-8 from this resource: https://www.ishrs-htforum.org/content/24/4/121/tab-figures-data 

And here: https://www.regrowhair.com/autocloning-hair-restoration-with-acell-matristem/

I’ve had ACell administered with both of my hair transplants. I think it’s more so used to improve healing and graft survival than to regrow hair. 

50 minutes ago, Gatsby said:

If scalp tension caused MPB then FUT would cause greater hair loss not greater hair restoration.

Well said. I didn’t read the information in the OP’s link, but I recall reading somewhere that Botox - Clostridium botulinum toxin which causes flaccid paralysis of muscles - can be used to treat male pattern baldness. Lo and behold a quick google search unearthed this: https://www.jwatch.org/jd201111100000001/2011/11/10/growing-hair-with-botox 

Brad Pitt 

8 hours ago, jim1973 said:

I've been on oral Finasteride and topical Minoxidil for roughly 7-8 years.  It maintained for a while but stopped working.  I switched to oral Minoxidil (5mg/day) and oral Dutasteride (.5mg/day) 9 months ago and my hair loss continues to get worse.  It’s absolutely doing nothing for me (positive or negative).  My hair continues to become thinner and weaker.  Most people state that oral should always work better than topical but I'm wondering if there have been situations (stomach issues) where topical may work better.  I'm also considering Pyrilutamide or RU58841 as a topical but not sure how effect (or safe) that would be.  If anybody has any thoughts on the matter, I'd love to hear.  Thanks.  

Are you certain that DHT and blood flow are the issues? If you’ve been taking oral minoxidil 5mg and oral dutasteride daily for 9 months and your hair loss continues to worsen then perhaps something else is at play such as vitamin deficiency and/or stress. Maybe discuss with your healthcare provider about getting some lab work? 

27 minutes ago, Gatsby said:

The company promoting this (and did the in house 'research') sell protein shakes and shampoo with claims that they treat hair loss. Considering It's also in Australia I wouldn't be holding my breath.

They also sell in the U.S. — company is owned by Dr. Shapiro. https://helphair.com. I drank HelpHair protein shakes (they ship from Miami, Florida) on a daily basis for most of the 12 months after my first HT, and have been drinking the shakes daily since my second HT that I had in December 2022. Don’t know if they’ve helped, but they certainly don’t hurt. 

Any reputable hair transplant surgeon would recommend you start medical therapy first and wait until at least your late 20’s before pursuing a hair transplant. In all honesty your hair looks good, and you are very fortunate to still have a solid crown. When I was 22 my crown was already completely destroyed and my biggest regret was not starting finasteride and minoxidil sooner. 

15 hours ago, antomicblitz said:

Now at 4 months post surgery. It's been a month since I switched from finasteride to dutasteride and continuing with the minoxidil application. I got a shorter haircut to try and do a better comparison to my first photos. I am super happy with the results, but I wonder if maybe I should do another transplant to fill in the temples more if they don't expand more after a year. I can still cover it pretty well when my hair is grown out so I don't think it would be that noticeable, but I sometimes wish my temples were a bit more filled in. I don't know if it would look weird or unnatural if I fixed it too much.

The crown coverage looks good for only 1,000 grafts, especially at only 4 months postop. Have you noticed increased shedding since switching to dutasteride?

@Capelli3000 If it was me, I’d want to give the grafts all the help possible, so have you considered getting a prescription for oral minoxidil? 

I waited until after my sutures were removed to sleep on my side. This was my second FUT, still a single scar, so my donor area has been tender for a longer time period than my first surgery. 

I’m starting to get white hairs at 32. Haven’t dyed my hair yet, don’t know if I ever will, but I can see the appeal. I’ve been going to the same barber for the past 14 years, with an occasional trip to Great Clips when I’m out of town. Barber over hair dresser 100%.