FollicleFella

Day 2! (If surgery date is day 0)

Healing seems to be coming along nicely. Had another wash/check in with Dr. Wong today who said everything’s looking solid. There is some inevitable forehead swelling that should dissipate in the next few days. Thankfully haven’t dealt with any itching or pain that I’ve seen referenced elsewhere. Luckily sleep hasn’t been an issue since I’ve been able to remain side sleeping as I didn’t get any temple work done. According to my review from this AM all the grafts seem to still be intact. Looking forward to the redness going away theoretically in the next 5-10 days. The slight white stuff seen on the transplanted area is residue from an antibiotic cream applied by the clinic.

13 hours ago, BurnieBurns said:

As least you're aware that multiple further surgeries are down the line. Other treatments would be minoxidil (especially oral), Ketoconazole, PRP (IF it's from a reputable source. There's a lot of plain 'Money-grabs' out there for this treatment.

Apparently Topical Dutasteride is meant to go less systemic than topical fin. Xyon should be releasing a version of that too. There's also Pyrilutamide that can be purchased on the grey market but still has studies to back its safety.

Right on I appreciate all this helpful information. Prp is of interest to me for sure since it seems minimally invasive/not a daily ongoing thing, though I haven’t done the proper research into it. Enough though to see some people swear by it while others considered it a waste of time and money so I appreciate your note on good sourcing perhaps being the distinction.

Xyon was the name given to me by Dr. Wong when inquiring about topical fin. Definitely heard of people switching to duta and having a better experience but my fin sides really put me off anti androgens for the time being/as long as possible. That said I know it’s better to use while you’ve still got hair to save versus trying to maintain an already burned down forest as it were. We’ll see if I work up the courage in the next year or so to attempt it again.

Definitely will be starting keto shampooing + dermarolling once enough time has lapsed post surgery. Dr. Wong told me I still have 4000 grafts in my donor area for future use and that’s not counting my extensive supply of beard/body hair ha. Hopefully between all that I can make it it a couple decades until I’m at a point in my life where a) the specific sides I experienced with fin are less personally relevant or b) god willing there’ll be some new tech/meds to ward off the Norwood reaper more efficiently without collateral affect.

Appreciate the intel and great choice with H&W! Really made the whole thing as chill as possible for me. If you’re traveling in from somewhere see what can potentially be done about help from them with flights/accommodation, particularly if you’re stepping into a cancellation by chance.

15 hours ago, hockeyman said:

That looks great. Not too high and not too low. You look like you have good temple points too. I was curious about your hairline height because I had a recent in-person consult and the recomendation was a hairline that was 7cm from my eyebrows. 

Appreciate it! Definitely some swelling in the forehead area so when you get yours and if it looks a bit off right away (as in your forehead looks bigger) don’t be alarmed it goes down haha. I do feel lucky at the temples, they haven’t gone much but will probably be the next thing I address along with the crown (hopefully not for many years!).

To answer your earlier question: according to Dr. Wong I had 7000 grafts from my donor area so after this 3025 surgery I should have about 4000 more for future work. Very pleased with that prognosis being medication free at this point and knowing I’ll probably need future surgeries to keep up appearances.

That’s cool your consult was so specific as to get into the cm distance of eyebrow to hairline. I would imagine that number should be different for everyone based on a) facial structure/symmetry b) current hairline to eyebrow distance and c) how you’re building the hairline around the potential of future thinning/loss.

Who was your consult through/what’re you trying to do?

42 minutes ago, hockeyman said:

I was wondering about the height of your new hairline. How high is the middle of it from your eyebrows? 

While I don’t have a ruler on hand maybe this shot will provide some useful frame of reference.

Dr. Wong said my hairline was “perfect” where it was (relative to what I am unsure), and I actually had to nudge a bit for it to be slightly lower than where he’d originally placed it.

Is there some ratio/distance from eyebrow to hairline that’s advantageous?

My guess is that given my age/current lack of any medication, he wanted something that would age appropriately alongside progressing thinning/loss.

Having done 3000 this go around and using the general ballpark figure I’ve heard of 6000 harvestable grafts in the donor area, I’m hoping to have 2x more 1500 graft surgeries in the future for touch ups over the next 20 years.

Any thoughts appreciated!

1 hour ago, Buck Naked said:

Looks very good so far. I like Dr. Wong's work a lot.

Appreciate it! I was definitely swayed by the longevity of their practice/results.

7 minutes ago, BurnieBurns said:

It's very rare for hair loss (especially diffuse thinning) to halt in your early thirties. It's absolutely worth trying topical. There's also modalities of treatment which won't be as robust but something is better than nothing. Looks like fine work either way. I'm having surgery with Dr Wong in November.

Yeah I’ll probably try the topical once enough time has lapsed post surgery to attempt it.

What other “less robust” modalities are you referring to?

I’m sure you’ll have a great result/experience there if you’ve never been before. Anecdotally I found out today when I went in for a wash that many of the techs have been with the practice for 10-15+ years.

4 hours ago, hockeyman said:

Looks great.  Did Dr. Wong provide you with an estimate as to your total donor capacity?

He did not but I appreciate the reminder to ask him that when I go back in tomorrow! Thanks

@BurnieBurns

I’m not on any medication and so you may be correct! Hoping the loss stabilizes at a point where the total result will hold strong for a good long while (if I can get 5-7 years out of this one I’ll be mighty happy). I’m planning on getting multiple procedures in my life knowing that what you say is true.

I did talk with Dr. Wong about this and obviously they recommend medication to anyone looking to secure as much hair as possible but if someone has a bad experience with sides to the point of discontinuation then what can you really say/do. I tried lowering the dosage, staggering intake, etc so I’m amendable to figuring out a way to make it work. The clinic offers a topical fin solution that I’m open to trying a bit further on in the healing process to see if I have a better go with that.

What’s up everyone. This forum was super helpful to me in researching ht/surgeons and so I wanted to pay it forward by offering up my own healing process/results after completing a 3025 graft procedure with Dr. Wong today.

I had considered several surgeons and ultimately went with H&W because I was very fortunate to get a spot on their cancellation list relatively quickly (like 3 weeks from my initial contact, super lucky timing, as the next option was like mid 2023). I’d been considering Konior (really nice guy who I did an online consult with) and others in that echelon/price range but I wanted to get this done and put it behind me rather than wait another 12-18 months after researching/saving for about that same amount of time. H&W was also *slightly* cheaper than Konior for 500ish more grafts with equally impressive results to the other top surgeons and a long history behind them so I pulled the trigger.

Since I’m at day 0 I can’t offer anything in terms of results other than some before pictures and my post surgery pics from today. That said I have nothing but good things to say about H&W from my experience up to this point. They were incredibly helpful/patient with scheduling issues I had (Doug is the man, and Christina in the office is mighty on top of it), assisting with travel/accommodation plans, always available for questions, and the facility is highly clean/professional. It’s a tech driven clinic for sure (they do 2-4 surgeries a day I believe, with the doctors doing the hairline stuff/incisions but the rest being techs) but they all struck me as a very cohesive team that’s got a lot of experience.

My total time at the clinic was about 10 hours, with probably 8.5 of that being in surgery broken up by breaks/lunch. Everyone was really nice, attentive to my comfort, and made me feel like I was in good hands. Face down for 4-5 hours of extraction which is the worst/most boring part but hopefully you can sleep a bit. I was surprised at how much it didn’t hurt. The post lunch implementation period of 3-4 hours was much more chill as you get to lay face up, watch netflix, mess around on your phone, etc.

You may notice that my hair loss in the before pictures isn’t very advanced. Particularly with a good comb over cut, hairspray, and the occasional fibers I definitely look like a guy with a decently full head of hair. Thankfully the hair I do have is relatively thick and there’s a decent amount of it, but I’ve been thinning through the pattern area with some slight hairline recession for about 2-3 years noticeably (I’m 31 now). I have a very “client facing” job where appearance does matter and so I wanted to get the procedure done before it became noticeable to anyone besides me and folks who really got in and took a look. I tried Fin for a couple months 2 years ago when I first noticed my initial loss but ditched it due to sides (thankfully went away after a month or so off). Given my progression/lack of medication, I think in the next 1-2 years my hair loss would’ve become pretty readily noticeable, which is what I wanted to avoid.

My hairline design was only slightly lower than were it currently sits and I did not get any temple/crown work done. I’ll potentially do those down the line if it feels necessary but the agenda for this first surgery was to dense pack my existing hair line and top 2/3 where my scalp was peeking through.

Happy to answer any questions and will update this as the weeks/months go on!