Hair-here

I obviously chose not to name the doctor. I honestly just don’t think this was their fault at all and I wouldn’t want to give them any negative press. They were very responsive throughout the process and even afterwards with suggestions and advice. And everything looked good when surgery was done. I think this is just the reality of any surgery, results aren’t guaranteed and everyone’s body reacts differently. To be fair, the doctor did offer a free follow up procedure which seemed very generous but I was just unsure that the amount of grafts suggested would be significant enough. i was planning to just go back to buzzing my head and forget about any more surgery but seeing some of the high NW docs like Pitella, Zarev, and Eugenix I’m now reconsidering. Even though I keep my hair short and have buzzed/shaved it usually, I have an objectively bad head shape for shaving and really think it would look better with some hair. My intention with posting was to hopefully hear from some people who had poor yield transplants who went back for another surgery and what their results were. I’m just trying to figure out if it’s worth giving surgery another shot.

It’s been about 20 months since my hair transplant. 3000 grafts with one of the top frequently recommended docs. Well over $10k spent. And it just didn’t yield well. It’s patchy and just not what I expected at all. I don’t get it. I know there’s no guarantees in surgery but it just really sucks to go through all that for such a disappointing result. My surgery seemed to go smooth. I didn’t bump my head. I stayed 4 days after just for careful head washes by the staff. I made it past the initial 14 days and thought my grafts were in for good and the wait began. i probably am the kind of case where I should have skipped surgery- a NW 6/7 in my 40s who wasn’t on any meds or any hair regimen at all really. But I was very realistic though with my expectations and went in knowing 3000 grafts would give me back a hairline and some density in my front third only and leave a bald crown. I just wanted to keep buzzing my hair and the new hair would erase the dreaded horseshoe even if I was still left with a donut. I thought any new hair would be better- balding is still better than bald, right? Us advanced NWs have a different view of hair. I just wanted to see a hairline again even if a mature pushed back one. I gave Finasteride another shot after my surgery, even though my previous attempt 15 years earlier (when I still had a nice head of hair) gave me some mild but unpleasant side effects. I just don’t know what went wrong. My doctor had no explanation either but fully agreed it did not turn out well. My mind has gone to a number of things but none seem likely: Did the large whitehead pimples in the months after surgery hurt my growth? My donor isn’t looking so great either. I like to keep it buzzed down and had always planned to do that even after surgery. Probably SMP would have been suggested for my situation but I really wanted some real hair. I was totally ok to keep looking like your average balding (but not bald) mature Dad, I just don’t get why it failed. It’s frustrating. I’ve recently consulted with the top advanced NW docs and plan to give it another shot though. To those who have had poor yields, any idea why? My pics show 18 months after surgery and a week after surgery. No pic but before surgery, I was pretty slick bald on top.

The more I read, some people suggest the extra oiliness could be coming from shampooing too often. Cleaning the natural oils off can cause the scalp to dry out and make more oil creating an overly oily condition. I currently shampoo daily even though Im a NW 6/7 so I’m basically just shampooing my bare scalp.

Yes I always shampoo daily, though I have a very short buzzed hair style and basically a NW 6/7 pattern of loss. i have been using the nizoral usually once per week and then a basic shampoo the rest of the time.

I actually do rotate shampoos as well but it’s hasn’t really helped. Maybe this isn’t a known issue?

I followed my surgeons directions after the surgery. Im just surprised it didn’t go away over a year after surgery. Id like to listen to the dermatologist I saw but I just am not confident they are familiar with hair transplants and worry daily nizoral would be too harsh on my scalp and head, especially as I have a 2nd surgery planned in a few months.

I have had an oily scalp for almost 2 years after my transplant. I did also start fin right after my transplant so not sure if that could cause an oily scalp. Is this common? And anyone have any solution? I only know it’s noticeably oilier because my transplant didn’t go well so I continue to buzz my hair very short and I can feel how oily it is. I went to a dermatologist who said to use nizoral every day. The derm was not a hair “expert” and I had heard that nizoral daily is not recommended. Any thoughts on the topic? Thanks

Oh I’d love to be hair greedy but my donor won’t allow it. When you’re a NW 6/7, the whole hair restoration game looks a little different and you gotta be happy with whatever you can get. As it is, my current surgery plans to require a fair amount of beard hair to be used.

So I’ve taken fin pretty consistently but at different dosages if that counts for anything. It was about 14 months at 1mg/day, 3 months at 1mg/every other day and then 2 months at 1mg/twice a week. There was a 3 week break a couple months ago but otherwise I’ve taken some dosage of fin for about 20 months. My donor is weak tbh- my whole situation kinda sucks having wasted 3000 grafts on a poor yield surgery last time around. I’m realistic though. I’m not expecting a full lush head of hair. I’m just happy to even aim to replace the horseshoe with a donut (as in a stronger frontal 1/3, a mature hairline and likely less crown coverage). I will also be using a fair amount of beard hair as well due to the weak donor. At the end of the day, I think I’d be OK with a thinner donor if it gets me more hair on top where I really want it. When you’re a NW 6/7, you have to be realistic and so I’m keeping that in mind.

In about 3 months, I am planning on having my 2nd transplant. This time with a top advanced NW doc. My last transplant with a different doc though also very well regarded (which was a failure due to very poor yield) was about 1 3/4 years ago. I’m in my mid-40s and a NW 6/7. Prior to that first surgery I hadn’t been on any meds. I had tried fin in my 20s and got scared off by some mild sexual side effects. I had a bunch of consults prior to my first surgery and most docs thought fin and min wouldn’t do much for me at this stage given my advanced hairloss. But the doc I chose for that first surgery said to try fin again since my remaining side/back hair could drop even lower so I decided to give fin another shot. So for a little over a year after my surgery I took 1mg/day but had mild sexual side effects so then tried it at 1mg every other day. Still has sides. Then I took a 3 week break to clear my system and tried again most recently at 1mg/twice per week. Still had sides. They aren’t terrible- just lower libido and sometimes softer erections- but still just kind of annoying. I’m really leaning towards quitting fin and maybe trying oral minoxidil. The issue is I’m 3 months away from my 2nd surgery and I know changing or adding meds can cause sheds and I don’t want to impact the surgery by giving an inaccurate picture of my loss due to sheds. if I were to quit fin, when should I do that? My doc for this surgery said don’t start minox until after the surgery which I will do. But he left it more up to me what to do about the fin. What do you all think? Part of me wants to quit fin right away, and hopefully shed whatever fin was holding onto and that will give the doc a clearer picture of where to transplant, as opposed to quitting months after the surgery and losing hair in areas which would now be weak since he didn’t know to transplant there because there was still fin-affected hair. If I quit now though I’m not even sure if I’ll shed it all in 3 months. Plus I don’t even know if my current regimen of 2 pills/week is even effective. It’s hard to gauge since I don’t have much hair to begin with. i know many will say its not worth doing another surgery without being on fin but i think I’ve given it a good shot at different dosages and the sides are starting to feel not worth it. Im open to trying minox and my new doc is a big believer in that. In a perfect world I would have started minox prior to this surgery to strengthen things up but at 3 months out it’s not worth the risk of shedding impacting this surgery. i could quit fin and start minox and delay my surgery (would have to delay it a year due to work) but I really don’t want to do that unless really necessary. It was very hard to get a date with this doc and I don’t really want to spend another year with a failed transplant on my head. Thank you all for any thoughts or suggestions.