MaximumMM

On 1/12/2024 at 9:13 PM, TakeAction said:

I'm in a similar situation, have SMP a little lower than I'd like and getting a procedure in a few months.

Your hair looks amazing with a buzz, no one would think you have hair loss from the frontal view.

Did you find that the SMP allowed you to "avoid" the ugly duckling phase? Saw another guy say that. 

2000 grafts in the crown should help a lot and the SMP will increase the visual density even further.

Sorry, I just saw this. Yes, the I basically just kept my smp look after the transplant so that was fine, shock loss and recovery aside. I have just had my second and plan to do the same again.

Thanks for the advice! Currently remembering what a pain in the ass it is to sleep after the op 😂

Hi there. Thanks for the response but I think you may have misread my post. 

I'm in Turkey now, getting my beard extraction done tomorrow. The question is whether to ask for more than 500...

Hello! I've just had my first day of two sessions with Dr Turan at Fuecapilar. This is my second procedure, concentrating on the crown. The first was 4.4k to the hairline and mid-scalp.

They estimate they'll be able to take around 3-3.5k, including 500 from the beard. 

I was really hoping they'd be able to supplement more from the beard, as I think I need it. They suggest any more than that won't blend in so well. The beard hair is dark, probably a little more so than my hair, but not by much.

Any opinions here on whether it would be wise to ask them to take more? I know other clinics that specialise in beard do routinely take more (notably Eugenix). Cheers 🙏

Thanks. I'm not sure it's shock loss. I had proper shock loss on that side which was much much worse, and recovered after about four months. It wasn't in that spot though. It seems unlikely to me that the rest of it would recover but one spot would remain, but I suppose it's possible. 

It started growing properly at about 4 months, and has been gradual improvement since then.

Thanks both, much appreciated. Yes, I'll definitely grow it out more before too long to check in on it.

Hi there. A bit of an update here and request for opinions.

I had the procedure with Dr Turan in March (4.4k grafts more or less) and am now at about 6.5 months. The procedure was fine, with quite bad shock loss that seems to have recovered.

I am keeping it shaved down as I don't plan to grow it out until after my second transplant to fill the crown, due in April. As I don't want to have partial coverage with a mostly empty crown, and am used to wearing it shaved that's by far the most comfortable option for me.

I am letting it grow for a week or a bit more occasionally to keep track on growth, which is what these pictures are. I realised that makes it a little harder to evaluate!

I've also included a picture of how I usually wear it with it cut right down. If the transplant doesn't grow out well I guess I'll just keep it like that, which I definitely don't mind. It would still be worth it for me to have actual hair rather than just SMP (you can see how it used to look at the start of this thread). But obviously I very much hope it's a success and I can grow it out to something like a fullish head of hair. I have realistic expectations though given that I gave a large area to cover.

I am also noticing for the first time a bit of residual patchiness at the bottom of my hair on the above and alongside my ear on the left hand side, which isn't there on the other side.

How do you think it's looking in general? I know it will look better grown out, but hard to tell exactly how it will look. 

And do you think that area of patchiness is cause for concern? I'm not sure if it's residual shock loss, overharvesting (seems unlikely based on the clinic's reputation), shedding from finasteride which I've recently started, retrograde alopecia (no sign of this when I saw a specialist earlier this year before the procedure), or nothing in particular. Maybe it will look fine once it's grown out.

Thanks very much for any opinions.

Hi there. A bit of an update here and request for opinions.

I had the procedure with Dr Turan in March (4.4k grafts more or less) and am now at about 6.5 months. The procedure was fine, with quite bad shock loss that seems to have recovered.

I am keeping it shaved down as I don't plan to grow it out until after my second transplant to fill the crown, due in April. As I don't want to have partial coverage with a mostly empty crown, and am used to wearing it shaved that's by far the most comfortable option for me.

I am letting it grow for a week or a bit more occasionally to keep track on growth, which is what these pictures are. I realised that makes it a little harder to evaluate!

I've also included a picture of how I usually wear it with it cut right down. If the transplant doesn't grow out well I guess I'll just keep it like that, which I definitely don't mind. It would still be worth it for me to have actual hair rather than just SMP (you can see how it used to look at the start of this thread). But obviously I very much hope it's a success and I can grow it out to something like a fullish head of hair. I have realistic expectations though given that I gave a large area to cover.

I am also noticing for the first time a bit of residual patchiness at the bottom of my hair on the above and alongside my ear on the left hand side, which isn't there on the other side.

How do you think it's looking in general? I know it will look better grown out, but hard to tell exactly how it will look. 

And do you think that area of patchiness is cause for concern? I'm not sure if it's residual shock loss, overharvesting (seems unlikely based on the clinic's reputation), shedding from finasteride which I've recently started, retrograde alopecia (no sign of this when I saw a specialist earlier this year before the procedure), or nothing in particular. Maybe it will look fine once it's grown out.

Thanks very much for any opinions.

Hi there. A bit of an update here. I had the procedure with Dr Turan in March (4.4k grafts more or less) and am now at about 6.5 months. The procedure was fine, with quite bad shock loss that seems to have recovered.

I am keeping it shaved down as I don't plan to grow it out until after my second transplant to fill the crown, due in April. As I don't want to have partial coverage with a mostly empty crown, and am used to wearing it shaved that's by far the most comfortable option for me.

I am letting it grow for a week or a bit more occasionally to keep track on growth, which is what these pictures are. I realised that makes it a little harder to evaluate!

I've also included a picture of how I usually wear it with it cut right down. If the transplant doesn't grow out well I guess I'll just keep it like that, which I definitely don't mind. It would still be worth it for me to have actual hair rather than just SMP (you can see how it used to look at the start of this thread). But obviously I very much hope it's a success and I can grow it out to something like a fullish head of hair. I have realistic expectations though given that I gave a large area to cover.

I am also noticing for the first time a bit of residual patchiness at the bottom of my hair on the above and alongside my ear on the left hand side, which isn't there on the other side.

How do you think it's looking in general? I know it will look better grown out, but hard to tell exactly how it will look. 

And do you think that area of patchiness is cause for concern? I'm not sure if it's residual shock loss, overharvesting (seems unlikely based on the clinic's reputation), shedding from finasteride which I've recently started, retrograde alopecia (no sign of this when I saw a specialist earlier this year before the procedure), or nothing in particular. Maybe it will look fine once it's grown out.

Thanks very much for any opinions.

Hi there. Any update? And what did you pay? Thanks

18 hours ago, gillenator said:

It’s all a matter of what cannot be seen under the surface of the scalp…why would the risk of transection in a previously grafted area be higher you ask?…it’s because the surgeon cannot see under the surface, he can transect what he cannot see and you paid lots of money for those grafts which are close to sprouting the surface, why would you risk damaging/losing some of them?…also, the outer surface of the scalp can look completely healed at 4 1/2 months post-up however what we cannot see is the level of trauma and inflammation under the surface and remember, it’s trauma and inflammation that induces shock loss…realistically, it takes a solid year for the  entire head to recover.

Thanks. I'm still not clear on why the risk or transection would be higher *earlier* though (that was my question). I get why it's a thing in general. A surgeon isn't going to be able to see under the surface any better at 12 months than at 7.5 months. 

Nor am I really clear on whether the risk of permanent shock loss would increase if the procedure is done earlier. I appreciate it's difficult to quantify with any certainty, but I'm just trying to make an educated guess. If weak and diffused hair is more likely to permanently suffer shock loss, I'm not sure whether implanted hair which is firmly planted but still possibly healing (maybe inflamed) is also more likely to be permanently lost. Temporary shock loss is not a big concern. 

Hi @gillenator. Thanks very much for your response. A couple of follow-ups:

Why would the risk of transection be higher with an early procedure?

In relation to shock loss: do you have any view on whether the risk of shock loss increases if a second surgery is done too early? I had some shock loss in my donor but now at 4.5 months it seems to be pretty much fully recovered.

2 minutes ago, A_4_Archan said:

@MaximumMM

This has no specific answer as there are some people who see more growth in the later half of a time frame and there are few who see it in the first half ...but if you are willing to go for it thn you should take suggestions from your doctor as he/she is the one who is solely responsible for this and you should do what your surgeon advices you...

Yes, true, thanks. The risk of permanent shock loss to existing hair follicles is the other aspect I've been able to identify through my research.

9 hours ago, SeanToman said:

Hi, from my understanding we want our follicles to settle safely after surgery, allowing them to grow health and return to their normal state so a second surgery doesn't cause permanent shock loss. 

Thanks. This seems sensible. There's not much information about this online.

From what I read permanent shock loss is rare.

@gillenator you seemed to be quite knowledgable on a thread about permanent shock loss. I wonder if you have an opinion on whether, or how much, the risk of this might increase in a second surgery where the follicles are possibly not fully healed. In my case I would be having circa 3k grafts, possibly at 7.5 month mark, in a second surgery to be placed in the mid-scalp and the crown, with minimal overlap of existing implanted grafts (they are in the hairline and mid-scalp), although I imagine there would be some. 

15 hours ago, A_4_Archan said:

@MaximumMM

Now if you implant all the remaining grafts all over mid scal and crown and than after 12-14 months if your first surgery don't turn out to be fully successful and if you need around 500-1k grafts to fill in the first transplanted area than what will you do? From where can you get those grafts than as you would have used all the available grafts for mid and crown

Yes, I think that's the main issue. I think it's fairly possible to tell at 7 months how it is growing in though, even if you don't know exactly what the final outcome will be. 

19 minutes ago, A_4_Archan said:

@MaximumMM

I don't think there is much technicalities in this..its just that the scalp takes.more time to get completely healed ..it looks good from outside but there can be a chance that it might not have been completely healed from underneath...even if some people would have been completely healed within 6 months but there might be few people who can take more time..so its jst abt being safer 

Plus its more of a logical issue rather than technical as when you don't see full results in 6-7 months than how can you plan for 2nd session and can a doctor take a call om whether a patient needs a touch up or not...so even if there is no healing issue and if the surgeon performs a surgery after 6-7 months at different area of a scalp and than if the previous area don't get the desired outcome and lacks density than the patient has to go again for the 3rd time for a touch up...so from my understanding its more of a logical issue than technical and even if there is no other harm in performing a surgery after 6 months an ethical surgeon will not agree to this idea..

 

Yes, I agree it's a logical question of where you want the hair placed. In my case I'm going to want my last remaining 3-4k grafts placed evenly around the mid-scalp and crown as there's a large area to fill, so I don't imagine to details of how the hair grows out will change the task that much. But maybe I'm wrong.

I suppose I'm really trying to understand what the actual risk of implanting on scalp that hasn't healed sufficiently is. 

2 minutes ago, A_4_Archan said:

@MaximumMM

Generally 12 months wait would be wise as you may need some touch up if there is lack of growth in your current transplanted area and unless you see full results you can't do that..

And even if you go for a surgery i think most of th doctors will ask you to wait for at least 9 months even if the area to be implanted is different...though you may ask your surgeon with whom you are going to have your surgery with as he/she is the sole responsible person for evrythng...

Thanks. I know it's generally 12 months, but I'm really looking to understand why, technically. 

Hi there,

I've had a first transplant of 4k grafts to my hairline and mid-scalp. The second will be to fill in the upper mid-scalp and crown.

I know the most common advice is to wait 12 months, however I also see some clinics will do them as soon as 6 months, or 8 months. I have personal circumstances which mean it will be very much easier to get it done around the 7.5 month mark. 

What are the considerations? How big of a risk is it? Is it just potential shock loss on implanted hairs if the grafts are going around them. Mine would mostly be in new areas, maybe 5/10% overlap.

Thanks...

On 4/19/2022 at 8:48 PM, Rahal Hair Transplant said:

Sean,

In order to evaluate the density of the hair transplant, we really need to see other angles of the scalp. For example I posted a picture of the hairline which is great but a picture showing a 45 degree angle from the front and a picture of the top would certainly be helpful.

At eight months postop, you are not fully grown and the hair could still look thicker in the next several months. That said, I agree that it likely won’t be a substantial difference between now and then and will likely need additional density. Did the surgeon explain that you would likely need a second hair transplant? Or do you feel that you didn’t have adequate growth?

it is perfectly safe to get a second hair transplant in the same area as long as you’ve given the hair transplant a chance to fully mature. In my opinion, give it another 4 to 8 months to grow out completely and then undergo another procedure if you still feel it is necessary.

in the meantime, I suggest contacting your surgeon, expressing your concern and asking about density and whether or not he feels you had adequate growth.

it would also help if you post preoperative and immediately post up pictures so we could see where the grafts were placed and what the growth looks like to date.

Best wishes,

Rahal Hair Transplant

Hi there,

Can you comment on why it's important to let the implanted hairs fully mature before implanting on them?

I'm considering a transplant somewhat overlapping transplanted areas (not much, the second will be to fill in the crown, the first was for the hairline and mid-scalp) and wondering why advice for the time you must wait varires between 6 to 12 months. Thanks.

I've got the quote back and it's really expensive! About £700 for the following:

DHT levels, Testosterone, Free testosterone, FSH, Estrogen, PSA prostate, Luteinizing hormone, Estradiol.

I am thinking I'll just get the 3 or 4 most important ones.

Does anyone have an opinion on what those might be?

11 hours ago, pahey345 said:

I was told that by the interpreter who works for Dr. Turan. He said Dr. Turan was most likely going to retire / transition to do a limited amount of surgeries on a VIP type basis in the next 1+ year. 

Right, interesting. The contact person there said not the case 🤷

On 3/5/2023 at 5:59 AM, pahey345 said:

I’m still waiting on the report and when I get it I’ll post the results. Dr. Turan does 2 patients per day and he’s grooming his replacement Dr. as she was present for much of the procedure. Dr. Turan is probably going to retire in the next 1+ year so I’d highly suggest anyway wanting a surgery from him to get on the schedule asap. 

Hi there @pahey345. I am booked in for January and asked them about whether Dr Turan is due to retire.

They said absolutely not.

Can I ask what led you to believe he was due to retire?

3 hours ago, candvlc said:

Before starting finasteride, it's recommended to consult a healthcare professional for guidance on appropriate blood tests. These may include DHT levels to assess efficacy, testosterone levels for baseline and monitoring, free testosterone for hormone balance, estrogen levels for potential impact, and PSA for prostate health. Reputable medical sources and healthcare institutions can provide more detailed information. Seek personalized advice from a qualified professional for your specific needs. 

Thanks very much, that's very helpful.

It's my understanding that you can't really assess efficacy from DHT levels btw, as it depends on androgen receptors.

14 hours ago, Bhumik Shah MD said:

 

From purely hormonal perspective the following should suffice. LH, FSH, Total Testosterone, Estradiol and DHT. 

I would be careful interpreting the lab values though, as hormone testing on finasteride is not validated for efficacy or side effects. But I certainly understand wanting to know those numbers "just in case."

Thanks very much.