MCS

Did any of your docs do a series of 50X sectional photos of your scalp to see if there were any post-op transplanted hairs sprouting? If not, have the doc doing the 2nd opinion do it, as there is no way to see anything with the naked eye. I go in and have them done every 4 months post-op to track progress, especially when I've had three procedures. I just recently went in this week and saw the latest results which do show some smaller dia. hairs just starting to sprout. The doc agreed that it takes longer on multiple procedures because of the vascular compromise (less blood) and repeated scarring from graft incisions. I will post if I get the pics.

That's good to know. I have been taking 15mg biotin, MSM, saw palmetto, Vit A, P5P, omega 3s, C, E, zinc, NAC, choline, and a ton of other stuff. I will be adding niacin as well. My hair grows pretty fast. Did you know your doc didn't do tricho at the time you had your procedure?

That a plausible theory. The question then is whether the hairs eventually grow back from the shock loss. :confused:

What has your surgeon said about this???

Now at 8 mos. post-op. Neither my first nor my second procedure took this long to see results. While the scar line isn't visible at this length, at this point, I'm really thinking something went wrong here. The worst thing is that I still cannot go out without using a concealer (i.e. Toppik). As I told my doc, the whole reason for me going in a third time is so I won't have to keep using damn Toppik. Sometimes This really sucks when friends that know I've have HTs blurt out, "You're still bald". Toppik looks great once applied, but I risk embarrassment and can NEVER rest my head against anyone furniture unless it's black! As you can see in the below photos: 1) There is still a linear depression directly below the rear scar line that has not minimized or healed (as I white-lined in the below photo). And, as you can see, the thatch of hair directly below this weird depression is more dense than above then strangely thins out again on the neck line. I never had these inconsistent variables of sparse and thick like this before. 2) Diffuse thinning remains on rear of crown and just above scar line. Thoughts: 1) Permanent shock loss from multiple procedures 2) Delayed or no growth possible because of multiple procedures as I had complained about here: http://www.hairrestorationnetwork.co...ml#post2298975 Procedure #3 scar - 4 mos. post-op 3) Vascular compromise (decreased blood flow to the area caused by injury to the scalp from multiple procedures) and this may have resulted in sub-optimal graft growth These posts are giving me some hope, but still think I'm cutting it awfully close: Timing of Growth After Multiple Hair Transplants - Balding Blog Blood Supply and Delayed Growth in Hair Transplants: Hair Restoration Paper | Bernstein Medical - Center for Hair Restoration You can see my pre and early post-op photos here (click on the thumbnail, then click "Photo Info" for the description): http://s57.photobucket.com/albums/g2...PHOTO%20ALBUM/ Any advice and suggestions would be greatly appreciated at this point. Attached Thumbnails

Now at 8 mos. post-op. Neither my first nor my second procedure took this long to see results. While the scar line isn't visible at this length, at this point, I'm really thinking something went wrong here. The worst thing is that I still cannot go out without using a concealer (i.e. Toppik). As I told my doc, the whole reason for me going in a third time is so I won't have to keep using damn Toppik. Sometimes This really sucks when friends that know I've have HTs blurt out, "You're still bald". Toppik looks great once applied, but I risk embarrassment and can NEVER rest my head against anyone furniture unless it's black! As you can see in the photos: 1) There is still a linear depression directly below the rear scar line that has not minimized or healed (as I white-lined in the below photo). And, as you can see, the thatch of hair directly below this weird depression is more dense than above then strangely thins out again on the neck line. I never had these inconsistent variables of sparse and thick like this before. 2) Diffuse thinning remains on rear of crown and just above scar line. Thoughts: 1) Permanent shock loss from multiple procedures 2) Delayed or no growth possible because of multiple procedures as I had complained about here: http://www.hairrestorationnetwork.com/eve/165185-delayed-no-growth-possible-multiple-hair-transplants.html#post2298975 http://www.hairrestorationnetwork.com/eve/166063-procedure-3-scar-4-mos-post-op.html 3) Vascular compromise (decreased blood flow to the area caused by injury to the scalp from multiple procedures) and this may have resulted in sub-optimal graft growth These posts are giving me some hope, but still think I'm cutting it awfully close: Timing of Growth After Multiple Hair Transplants - Balding Blog Blood Supply and Delayed Growth in Hair Transplants: Hair Restoration Paper | Bernstein Medical - Center for Hair Restoration You can see my pre and early post-op photos here (click on the thumbnail, then click "Photo Info" for the description): http://s57.photobucket.com/albums/g207/CS2006/HT%203%20PHOTO%20ALBUM/ Any advice and suggestions would be greatly appreciated at this point.

So, you've had 3 HTs done as well. Did it take longer for the grafts to finally grow out on #3 as compared to the first 2?

Aside from the scar line (which isn't an issue unless I pull my hair back like in the pics) there is some improvement, but I am still having to use Toppik to fill in the "blanks" where the hair has not yet grown around the sides and top of the scalp. :confused:

I am now at 7 months post-op and the hairs have not grown through the scar yet. Doc confirmed that he used tricophytic closure. WTF is going on??? Anyone?

Perhaps the band appearance or depression I complained about before http://www.hairrestorationnetwork.com/eve/165185-delayed-no-growth-possible-multiple-hair-transplants.html#post2298975 was just part of the scar healing. What I see now is a narrow "bald" scar line remaining on my right side only which shows if I pull back my hair (HT #3 pics below). As you can see, most of the redness has faded, but this little hairless "path" remains; the left side scar is barley detectable, so no pics necessary. I'm sure the doc used a trichophytic closure all the way around as he did on the first two procedures, but why is the scar healing not uniform? Prior to staple removal (see below) Is there any reason the hair would not grow back through the scar line as they did successfully on the first two procedures? I cannot find the first two scars no matter how hard I look. That's really the bottom line here. Here are some 60-day post-op scar pics from the first procedure which are now undetectable: (see HT #1 pics below).

As you can see, the scar is still healing as its obviously red. The hair indentation follows exactly along the line of the scar. It is very hard to tell looking backwards in a mirror, but it looks like the hair right above the scar stops and a different layer of hair begins right below it.

3 mos. post-op now.

This is what I'm talking about... I do recall them shaving my hair before doing the excision, so maybe it's from that and I just have to let it grow back?

Posted previously regarding my 3rd HT graft survival: http://www.hairrestorationnetwork.com/eve/165185-delayed-no-growth-possible-multiple-hair-transplants.html#post2298975 I am now 3 mos. post-op and concerned whether this depressed "band" from the strip scar will eventually lessen. It looks like I was wearing a tight hat. Never had this on my first two procedures. Could this be like some kind of shock loss? My doc has always done the tricophytic closure. Anyone else experience this?

One good thing thus far (2 mos. post-op); I suffered no apparent shock loss that i did on procedure #2.

The difference is that you've had a series of small sessions, whereas mine were all megasessions with dense packing. I trust my doc all the way through, but it's still a concern. I, too, exercise regularly, eat clean, and take a ton of supps, but you never know with so many grafts whether there will be enough blood supply intact to supply multiple procedures in addition to native hairs. That's my concern.

I take so many supps it isn't funny. But my main concern is whether the grafts for my 3rd HT will grow out as well as in my previous procedures.

We all know that blood supply is critical to graft survival. But the questions still unanswered are what parameters are needed in the hair transplant surgery to insure that this supply is adequate? I read that a common rate for graft survival is in the 90-95% range. I wonder how much that may decrease with each successive procedure, hence, the cause for my concern. I read further that as the number of hair grafts placed per unit area (density) rises, so does the risk of vascular compromise (decreased blood flow to the area caused by injury to the scalp) and this may result in sub-optimal graft growth. So, what is ultimately critical for the patient is not how many grafts were transplanted, but how many actually grow. Poor or retarded growth is not an all-or-none phenomena and sub-optimal growth is literally impossible to detect. If too many grafts are done at one time, some feel the hair growth is reduced due to crowding of the grafts and lower blood supply. Does anyone know of any research that shows that blood flow to the grafts could be compromised or growth delayed with multiple procedures as compared to the first procedure? Can multiple procedures really outstrip the blood supply necessary to insure maximum growth? Did those of you with multiple procedures see any stubble of erupting hair coming in between your hairs after 3-4 mos.? For example, Bill, the Managing Publisher, has had 4 procedures. The reason I ask is that I don't recall seeing a stubble on my 2nd procedure and am concerned as whether I will see any for my 3rd. It was easy to see on my first procedure; the surgical advantages of transplanting into virgin scalp being the original blood supply is intact. You can see my results and procedure stats here: http://www.hairrestorationnetwork.com/eve/164911-cant-find-incisions-grafts.html I see this subject has been touched on before: http://www.hairrestorationnetwork.com/eve/158395-growth-time-slow-growth.html http://www.hairrestorationnetwork.com/eve/158428-multiple-procedures-poor-growth.html

Joseph Williams, M.D. He's a coalition member.

Whatever it takes to get the job done and done right.

You guys asked for it, now you got tons of pics! Sorry they're out of order, but if you put the arrow on the pic, it identifies the date. It took nearly 2 1/2 years to finally decide that HT #2 wasn't going to cut it; between getting sick and tired of boatloads of Toppix and Couvre getting on pillows, towels, etc. (embarrassing to say the least), I definitely needed more density. Unfortunately, I have no pics for HT #2, only the first and latest. On a side note (no pun intended), my sides right above my ears experienced a weird loss and became thinner over time as you will see in the HT#3 folder pics, appearing like a depressed area. My doc didn't know what to make of this, although it did seem to accelerate after HT#2. We don't know if the cause is from the prior surgeries, the scar, or something else, however, strangely, the loss was not linear below the entire scar line except for above the ears. You would think if it had to do with the scar it would run below the entire length. To remedy this, my doc conservatively transplanted 120 and 130 grafts on each side. He felt going more than this might produce too much thickness above the ears and look even more odd than it does now. How the sides will turn out is my biggest concern. He also dipped all the grafts in the ACell mixture. It will be interesting to see if anything different comes about this time, although it does seem that the healing is taking place faster this time as compared to the last two. My swelling was practically non-existent also (I took only 1 prednisone prior to the day of surgery). One little thing I did this time around was go in for a shorter haircut (not crew cut) the day before the surgery. I did this so the doc and his staff could see exactly where the least density was and to emphasize the loss on the sides. Everyone felt this helped a lot. Might not be a bad idea for others to employ that in future HTs. I'm hoping that by now, and being age 52, I have pretty much "bottomed out" on losing any more native hairs in the affected loss zones and I will have the density I desire so that any use of concealers will be minimal, if at all! For follow-up maintenance, I have been using the iGrow laser for the last several months and will continue to use it in place of oral anti-androgens. HT 1 PHOTO ALBUM pictures by CS2006 - Photobucket HT 3 PHOTO ALBUM pictures by CS2006 - Photobucket

1st procedure - 2006: 3571 grafts - 31cmx2cm strip 2nd procedure - 2009: 2743 grafts - 33x1.25cm strip 3rd procedure - 2012: 3521 grafts - 32 x 2.0cm strip Yes, I had good density of native hairs in my donor area.

Not in one procedure of course!

Not in one procedure of course!

Yep, he uses custom cut micro blades for super dense packing. I'm like, what happened to the grafts, did he really transplant them, lol! Not only are the incisions invisible to my eyes, but so is his scar work. I could never find the scars to my first two procedures and the third one is becoming less visible daily. 9835 grafts total thus far. Hopefully, this will be my final! Also noticed that this time, I have far less shock loss, probably because most of the hair is previously transplanted and less sensitive I'm thinking.