Transplant Experiences

[mayer]

I thought I would pass on my experiences with the transplant process for the benefit of those considering it. I'll point out the good and the bad so you can see what you are in for.

 

I'm a 41 y/o male and had my first procedure at age 32 and have had a total of 3 with the last one being 4 years ago. The total cost was about $12,000 and was accomplished by a good HT / dermatologist whom I have no problems recommending.

 

Before getting into the details of the surgery and the results let me give some history. When I was younger my parents had prepared me for the possibility that I would most likely be bald. Perhaps not totally but that it was a distinct possibility. My barber was telling me I would probably have the hair profile of someone like Jack Nicholson who receded rapidly but kept reasonable amounts on the sides and back.

 

In any case it didn't bother me that much until I started losing lots of hair around 27 and all my friends were pointing it out. I had considered the HT route but first went to a dermatologist in my area who put me on the rogaine regimen and while that helped it didn't do much to stop hairline recession. After about a year and half he showed me some videos of his HT clients and suggested that as a course of treatment. I was skeptical though after talking to some of his patients and seeing their results it looked pretty good so I elected to move forward with it.

 

The first HT was pretty impressive as I still had a fair amount of hair on my head so the transplants were in an around existing hair which made the hair look quite full within a very short period. I didn't experience much of the fallout that people report. After about 9 months I went back for the second round and things were like before and the results were very good and the surgeon suggested that we wait for the third one since I was happy with the results.

 

I will admit that this was a great feeling. The look was phenomenal and no one noticed anything ! I felt much better about things. So for about 4 more years I was very happy with the way things were going. However I did start to lose some more hair on top (the non transplanted hair) at which point we had the third HT session which covered that up quite nicely. I must point out that this third session was the only time I experienced any real pain. The scar area that they use to get donor hair was always tender and when they went in this time it hurt considerably so they supplemented the medication. And ever since it still remains tender (not acutely so but its not comfortable to apply pressure).

 

Now This is where things became a bit frustrating. The HT surgeon had placed me on Propecia to retain the existing , non transplanted hair since it was a candidate for loss (obviously the transplanted hair would remain) though at some point around 38 I started to rapdily lose the rest of my hair (the remaining "natural" hair) which left some thinning areas that exposed larger sections of transplanted hair which had those small "bumps" that sometimes accompany the transplanted hair. As all hair loss is gradual it took some time for this to become more apparent but after another year there were sections that looked (to me) like obvious transplants. I can't say that other people noticed but I did get some comments from some relatives about the "bumps" on my head. They were especially obvious in the office environment with the over head lighting which is where I spend most of my time. I told a relative that it was dermatitis and that seemed to satisfy her curiousity.

 

So I went back to the HT surgeon who told me that this sometimes happens and he prescribed some lotion to diminish the unevenness in these areas and while it worked in some areas it didn't address all the areas. Of course he did suggest that I consider another HT session but at this point I'm not sure that that is what I want to do. I look okay in general and

for me its fine to look like I'm losing my hair and its not like I want to look like one of those guys with a straight across hair line. But

I guess the real blow came not long ago when I was at a bar hanging with some people playing pool and later in the evening one of the people in the group came up and said "have you had a hair transplant ?". It shocked me a bit because

no one had ever asked that. I just said something evasive like "what do you think ?" and he just laughed and didn't say anything else.

I thought about it and it was the strong over head light above the pool table that made obvious some of the areas of which I was speaking. Evidently this person discussed with some others in the group because next week at work one of the women in the group came to talk to me about something and she was definitely checking out my hairline. Its like what people do when they suspect that anyone has had any type of enhancement (breast augmentation, lip, and I guess now HT).

 

Still. At that point it hit home that as good as these surgeries are there is a point where you will always need "Another session" to keep it looking optimal. Now obviously people have a greater awareness of HT surgeries than they did 8 years ago. Now they have lots of TV commercials about it and its the ads in the sports section and they even have worked HT talk into some sitcoms (Sex And The City) so people are more educated on it.

 

The bottom line is that after dropping 12 Gs on this who would want to have someone be able to spot it ? No one. Of course its not everyone that even notices it and it really hasn't impacted my social life but its still very frustrating when you go out of your way to get a good HT surgeon and things still need to be dealt with like every 4 or 5 years as your natural hair continues to fall out in stages. I'm still weighing my options but I'm not really looking forward to another surgery. In any case don't take this as a recommendation for you to not puruse HT. I'm happy I did it for the most part though I never thought I would still be dealing with these same issues or issues relating to the tell-tale signs of the transplant. I do admit that sometimes I wished that I had done nothing. You know just let it occur and not worry about whether or not women liked it. On the other hand it did provide me with undeniable results (And still does) just that over time those results aren't going to be permanent and will require some supplemental action.

 

I also want to add what might be obvious but bears repeating. Having a transplant does not stop or diminish the loss rate of your existing hair which will continue to fall out unless you are using propecia, rogaine or some combination thereof. The propecia didn't work so well for me as I still experinced loss though if you do commit to a course of HT treatments then protect your invesement by using the propecia to try to keep what you have which will make the transplants look much more natural. See the HT surgeon fills in and around your existing hair which means that once that hair falls out you might, depending on denisty, see thinning areas which is why multiple sessions are typically required.

 

I suppose none of this is an issue if you commence with HTs at a time when you are mostly bald. In situations like this the surgeon can design and recreate your hairline albeit at a much greater expense.

 

One last thing. Do your homework and take your time to find the right doctor. This cannot be over emphasized enough. You will be developing a relationship with this person and it is essential that you have some confidence that he is respected for his ability and will not be leaving town on you because if he does then you will have to start over with someone else or go to where he or she is. Relative to those Bosley commercials I don't know how I feel about that.

I suppose if you could get access to Bosley himself then it might be okay but don't accept someone who has been doing it for just a year or two. Note. Myself I would never consider the Bosley chain

[mayer]

I thought I would pass on my experiences with the transplant process for the benefit of those considering it. I'll point out the good and the bad so you can see what you are in for.

 

I'm a 41 y/o male and had my first procedure at age 32 and have had a total of 3 with the last one being 4 years ago. The total cost was about $12,000 and was accomplished by a good HT / dermatologist whom I have no problems recommending.

 

Before getting into the details of the surgery and the results let me give some history. When I was younger my parents had prepared me for the possibility that I would most likely be bald. Perhaps not totally but that it was a distinct possibility. My barber was telling me I would probably have the hair profile of someone like Jack Nicholson who receded rapidly but kept reasonable amounts on the sides and back.

 

In any case it didn't bother me that much until I started losing lots of hair around 27 and all my friends were pointing it out. I had considered the HT route but first went to a dermatologist in my area who put me on the rogaine regimen and while that helped it didn't do much to stop hairline recession. After about a year and half he showed me some videos of his HT clients and suggested that as a course of treatment. I was skeptical though after talking to some of his patients and seeing their results it looked pretty good so I elected to move forward with it.

 

The first HT was pretty impressive as I still had a fair amount of hair on my head so the transplants were in an around existing hair which made the hair look quite full within a very short period. I didn't experience much of the fallout that people report. After about 9 months I went back for the second round and things were like before and the results were very good and the surgeon suggested that we wait for the third one since I was happy with the results.

 

I will admit that this was a great feeling. The look was phenomenal and no one noticed anything ! I felt much better about things. So for about 4 more years I was very happy with the way things were going. However I did start to lose some more hair on top (the non transplanted hair) at which point we had the third HT session which covered that up quite nicely. I must point out that this third session was the only time I experienced any real pain. The scar area that they use to get donor hair was always tender and when they went in this time it hurt considerably so they supplemented the medication. And ever since it still remains tender (not acutely so but its not comfortable to apply pressure).

 

Now This is where things became a bit frustrating. The HT surgeon had placed me on Propecia to retain the existing , non transplanted hair since it was a candidate for loss (obviously the transplanted hair would remain) though at some point around 38 I started to rapdily lose the rest of my hair (the remaining "natural" hair) which left some thinning areas that exposed larger sections of transplanted hair which had those small "bumps" that sometimes accompany the transplanted hair. As all hair loss is gradual it took some time for this to become more apparent but after another year there were sections that looked (to me) like obvious transplants. I can't say that other people noticed but I did get some comments from some relatives about the "bumps" on my head. They were especially obvious in the office environment with the over head lighting which is where I spend most of my time. I told a relative that it was dermatitis and that seemed to satisfy her curiousity.

 

So I went back to the HT surgeon who told me that this sometimes happens and he prescribed some lotion to diminish the unevenness in these areas and while it worked in some areas it didn't address all the areas. Of course he did suggest that I consider another HT session but at this point I'm not sure that that is what I want to do. I look okay in general and

for me its fine to look like I'm losing my hair and its not like I want to look like one of those guys with a straight across hair line. But

I guess the real blow came not long ago when I was at a bar hanging with some people playing pool and later in the evening one of the people in the group came up and said "have you had a hair transplant ?". It shocked me a bit because

no one had ever asked that. I just said something evasive like "what do you think ?" and he just laughed and didn't say anything else.

I thought about it and it was the strong over head light above the pool table that made obvious some of the areas of which I was speaking. Evidently this person discussed with some others in the group because next week at work one of the women in the group came to talk to me about something and she was definitely checking out my hairline. Its like what people do when they suspect that anyone has had any type of enhancement (breast augmentation, lip, and I guess now HT).

 

Still. At that point it hit home that as good as these surgeries are there is a point where you will always need "Another session" to keep it looking optimal. Now obviously people have a greater awareness of HT surgeries than they did 8 years ago. Now they have lots of TV commercials about it and its the ads in the sports section and they even have worked HT talk into some sitcoms (Sex And The City) so people are more educated on it.

 

The bottom line is that after dropping 12 Gs on this who would want to have someone be able to spot it ? No one. Of course its not everyone that even notices it and it really hasn't impacted my social life but its still very frustrating when you go out of your way to get a good HT surgeon and things still need to be dealt with like every 4 or 5 years as your natural hair continues to fall out in stages. I'm still weighing my options but I'm not really looking forward to another surgery. In any case don't take this as a recommendation for you to not puruse HT. I'm happy I did it for the most part though I never thought I would still be dealing with these same issues or issues relating to the tell-tale signs of the transplant. I do admit that sometimes I wished that I had done nothing. You know just let it occur and not worry about whether or not women liked it. On the other hand it did provide me with undeniable results (And still does) just that over time those results aren't going to be permanent and will require some supplemental action.

 

I also want to add what might be obvious but bears repeating. Having a transplant does not stop or diminish the loss rate of your existing hair which will continue to fall out unless you are using propecia, rogaine or some combination thereof. The propecia didn't work so well for me as I still experinced loss though if you do commit to a course of HT treatments then protect your invesement by using the propecia to try to keep what you have which will make the transplants look much more natural. See the HT surgeon fills in and around your existing hair which means that once that hair falls out you might, depending on denisty, see thinning areas which is why multiple sessions are typically required.

 

I suppose none of this is an issue if you commence with HTs at a time when you are mostly bald. In situations like this the surgeon can design and recreate your hairline albeit at a much greater expense.

 

One last thing. Do your homework and take your time to find the right doctor. This cannot be over emphasized enough. You will be developing a relationship with this person and it is essential that you have some confidence that he is respected for his ability and will not be leaving town on you because if he does then you will have to start over with someone else or go to where he or she is. Relative to those Bosley commercials I don't know how I feel about that.

I suppose if you could get access to Bosley himself then it might be okay but don't accept someone who has been doing it for just a year or two. Note. Myself I would never consider the Bosley chain

[zerro]

Good post! I had/do have those same concerns but decided to bite the bullet anyway a couple of months ago. I guess, I decided to cross that when it comes around. Although, I'm considering another to get that great result, I'll probably wait until the first matures.

 

I'm sure you'll get many responses on this topic.

[GuitarPlayer]

Mayer,

 

Who was your doctor? I'm assuming this was not a follicular unit transplant as you started nine years ago. Was it micro and minigrafts? Many doctors on this website would be able to disguise your older grafts by using follicular units.

 

GuitarPlayer

[arfy]

Good thread. A lot of serious issues in this one.

 

This undercores how problems with your hair transplants are not always noticeable until years later. Hair loss is progressive so it is important that your transplant can stand on it's own, if it has to. It underscores the absolute necessity of using only ultra-refined Follicular Unit grafts, which look the most natural compared to "mixed grafts" (Minigrafts). Minigrafts look "grafty" and are the likely culprit for the bumpy effect (cobblestoning) too.

 

I can also relate to the feeling when more surgery is necessary, but you just don't want to have to endure any more surgery.

 

Even older techniques can be satisfying when the patient has retained a lot of his "original" hair. The more original hair you can keep, the better it will conceal your transplant.

 

Mayer, if you do decide on more surgery you can probably find a better doctor than the one you've been using (and NOT Dr Bosley!!!!! Do not go to Bosley).

[mayer]

Actually I neglected to make a distinction that is important.

The "bumps" to which I referred aren't the "grafty" look that characterized the older "corn row" style of HT surgery. Not at all. As you know the surgeon must make incisions to accomplish the work and there are a number of factors which influence healing of those areas. Some people do in fact form minute amounts of scar tissue as a result which is the situation in my case. Mind you its not obvious in natural lighting even in a close up view though it can be with bright overhead lighting. Even then the average person might in fact not notice a thing

though I think that someone with HT experience would. It might at least make them go "hmmmmmm"

 

As has been mentioned there have been significant refinements in the granularity of these techniques in the past two years which would and could minimize scarring or scalp surface irregularities so I'll definitely keep that in mind. My primary point in mentioning the problems I had was to illustrate that we are talking about surgery and cuts and healing so there are a number of unexpected things that can occur during this process. When we are eager to have our hair back we don't always think of these things.

 

Finnally my surgeon Edmund Griffin in Atlanta (Atlanta is regionally close)is actually on the recommended list here and is very well respected for his abilities. He did mention a process (not surgical) that could smooth out the bumps so I might move in that direction before considering another HT session.

 

It is definitely true that the more so called "natural" hair you have going into the HT process the better off you will be BUT to protect the investment one must try to use conventional methods (Rogaine , Propecia) in attempt to retain it.

[zerro]

its still very frustrating when you go out of your way to get a good HT surgeon and things still need to be dealt with like every 4 or 5 years as your natural hair continues to fall out in stages. I'm still weighing my options but I'm not really looking forward to another surgery.

 

Huh... I thought this was the main part of you comment and that it warranted a lot of feedback. I guess people will avoid or ignore this situation hoping propecia, rogaine helps keep a status quo or that a miracle develops in the short future.

 

Believe me my concern about life-long maintenance was the last thing (worry) I held onto to the very end. I took a leap of faith that continued maintenance would be at a minimum. Likely, it is just the beginning, and I often wonder that people who are in the beginning stages of balding or are extremely aggressive in the early stages are setting themselves up with a lot of heartache and pain. But on the other hand, being bald is a devastating blow too, perhaps worse! I guess this is a personal dilemma for the ages and each works out our own demons.

[kg007]

Great post Mayer,

 

Your story is very helpful. I think lot of people who had HTs 7-9 years ago have similar problems. HT has improved dramatically over the last few years.

 

I think this is a great story for a young guy like me and many others on this forum. I don't know if you call this being aggresive or not, but I had my first HT last year to cover the crown ~ 1500 grafts, and I am 24 years old. I have been on propecia for over 4 years now and it seems to be working well. and Now I plan on going in for 2nd procedure to add more density on top/front (already decent existing coverage) ~ lot of top docs have shown interested working on me. Initially I was going to get it done this year, but now I am going wait until early next year, by the time I'll be 25.

 

Yeha lot of guys are being aggresive at young age, but as Zerro mentioned being bald at very young age is very devastating as well. It sucks to be losing hair in your college days.

 

I think I understand what you mean by 'bumps'. I think I am really starting understand the difference between the small grafts and big grafts. Now I prefer to have more small grafts (single, and two hair FUs), then having less big grafts (3 hair FUs or more). Yes it would be more expesive, but it can't get any more natural than having single hairs popping out of your head + the faster healing and less scaring.

 

Thanks Mayer,

 

KG

[thinkingaboutit]

This is an excellent thread. Thanks to mayer for beginning the discussion with such an eloquent post.

 

As I am scheduled to undergo a first HT on 10/17, I think I am beginning to get cold feet. The surgeon I have selected is considered one of the best but I wonder if I really have done enough research.

 

I was aware of the potential of pitting with the older methods but I was not aware the it was still an issue with the current follicular unit technique. Is it a common problem still?

 

Also. I know that hair will continue to thin, but once again with the current all follicular unit technique performed by a quality surgeon, I did not feel that additional surgeries will be required for maintenance. Is it naive to think that 1 surgery would suffice, even if natural hair continues to thin? I mean, will it look peculiar if the transplanted hair stands alone. ( I am scheduled for 2000 grafts in the temporal recesses and front 3rd of scalp.

[mayer]

Originally posted by thinkingaboutit

 

I was aware of the potential of pitting with the older methods but I was not aware the it was still an issue with the current follicular unit technique. Is it a common problem still?

 

 

 

Well each of us has a differenet physiology in terms of healing and how much scarring might occur in response to incisions. So this can be a variable that influences the outcome of your HT. FUs do appear to be the way to go these days and even in cases where I have some surface irregularities due to scar tissue this can be handled with micro-dermabrasion. Again some of us are more sensitive to incisions or more correctly how our body forms scar tissue and how much. Ask your surgeron about what he anticipates in this area. Also ask his opinion about what you might need in terms of future sessions. Be honest and if he is ethical he will be also.

 

I do point out that I was/am pleased with the results of mine. I'm pointing out some things that are not so great about the process which might help people to make a decision or at least bring up with their surgeon prior to process. I'm sure each person here who has had a HT can tell you about at least one thing that they didn't expect to have happen.

 

Typically we judge the success of a given HT session on the basis of how much resulting coverage we get and how well it integrates into our existing look. Obviously the more consistent it is with our current growth patterns , the more undetectable it will be and for many people this is as important as the quantity of hair. I'm in the entertainment/music industry as a performer so I'm under the lights a great deal

(both on stage and in a record company office) and its very important for me to have a consistent look and have confidence that its holding up well.

 

I held on to my "natural" hair for quite a while before it disappeared though it took years for this to occur and each time it did there were areas that could use some "coverup". If a person has lost most of his or her hair then the initial HT sessions can be planned around a blank slate so to speak. If you have a substantial amount of hair despite obvious recession then you can approach this process as a gradual project.

 

The good news is that you can get some impressive results with just one or two HT sessions. The "bad" news (if you want to look at it like that) is that when your "natural" hair continues to fall out in stages then you might need a "tune-up" to keep pace with the loss.

Of course you can use things like procecia to slow this process and if it works for you its a great investment though it doesn't work for everyone (as in my case). Thankfully most hair loss is gradual so if you stay on top of it (no pun intended) then the transition periods can be smoother. Just make sure you budget for these "Tune-ups" as HT surgery doesn't appear to be going down in price as time goes by.

 

And I would agree that being bald during your college years is indeed a legitimate concern and while guys with shaved heads appear to be everywhere its always nice to have the option to grow it back. It is some consolation to know that there are women who like the bald look or the receding look but again it does suck when you know that a woman won't go out with you because you are bald. But lets put this into perspective. Enhancing your look is a great thing to do. Women do it all the time and society not only supports it they openly discuss it. Guys, we don't talk in public about these things too often and like to keep this info private but that doesn't mean we can't deal straightforwardly with these issues and benefit from surgical technology available to us today.

[zerro]

thinkingaboutit and others... I'm not being negative about attacking the ol' eight ball before you're a a 5+ like me. I would have preferred to do this much earlier in life but I had other financial committments (my family) that I had to deal with.

 

I'm just saying, it would be foolish to think that you will only need one Ht. As the years progress, and the thinning continues, you'll want another and another. Heck most of us are considering our second or even third Ht before we do our first.

 

I'm just saying, that unfortunately, as good as propecia is and the doctors are... it can't totally stop natural recession, and being aggressive in the early stages... like replacing temples and side burns is an over kill in my opinion. We can't all expect to look like Howie Long or Pres. Reagan nor do we want to. Keep in mind... that 18 yr old hair line you're after, although it looks good now, does not cut it and will perhaps be more obvious looking as a Ht when you're forty or older than if you maybe went a little more conservative.

 

There is no real answer, and each of us make our own decisions. Most of the pics I have seen on this site are incredible... my hats off to you (not really, my Ht hasn't grown in yet) but it seems, and I'm trying to be totally nuetral here, some are a little hair greedy early and not considering the long-term.

 

Believe me, I've lived through it; it's miserable, but a natural look to me, is a great looking receeding hair line with plenty of donar area to spare. We'll probably need it.

 

I just don't know. This is a great thread because this topic was the very last self-arguement that I held onto not to get an Ht. Money is no longer the issue, it is the stages in between where you feel you need to get another that concerns me. I know, no one needs to get an Ht, but if a previous is obvious, they should probably get one.

 

For me, it was a tough decision... and young people who are trying to hang onto their youthful hair line , it's an easy sale. Be careful and consider the long-term investment one has to make.

[Pat - Community Publisher]

Excellent Topic. As they say "hair loss is progressive" and there is no "cure".

 

I did my first surgery about 8 years ago with Dr. Ron Shapiro. At that time my big "mega" session was 1,400 grafts.

 

Today I know that if I was a virgin patient with Dr. Shapiro I would have gotten a session of about 2,500 to 3,000 grafts that would have been placed in smaller incisions that were more carefully orientated. Some times I almost get "hair envy" :-)

 

But I certainly have no regrets for jumping in when I did. I believe that if you were also starting today with Dr. Griffin rather than almost 9 years ago you would also get a more refined procedure with Dr. Griffin - who has really embraced the continous evolutions in surgical techniques over the past ten years.

 

The ultra refined hair transplantation that Dr. Shapiro, Dr. Griffin and other members of the Coalition provide incorporates the refinements and evolutions made in the last five years in particular. While these refinements are more evolutionary than revolutionary, they are significant as your scenario and mine illustrate.

 

Mayer, you may want to consider using some Prothik or Toppic in your hair to minimize the contrast, while increasing the overall fullness of your hair. You may also want to consider using Dutasteride rather than Propecia. Some people find that Dutasteride works better for them than Propecia. Of course, Propecia is widely prescribed because many physicians get incentives from Merck, the makers of Propecia, to prescribe and sell it.

[zeroaffinity]

Great post. I wanted to chime in because I had a HT done with Dr. Griffin in late April 2008. It was the first of what will hopefully only be two HTs. Mayer echoed some of the concerns I had at the time (and continue to have), but I do think the procedures Dr. Griffin uses now are somehow different (or maybe I healed differently) because I haven't noticed any bumps or other unusual features. My understanding was that he would use 1s for hairline and work back into denser areas with 2s and 3s. I can see evidence of that if I take a pic of my scalp, but I think the effect is a natural one - not at all conspicuous. The point of that is to reinforce my theory that I think there are probably more advanced techniques in play today than 6-10 years ago. There are no doubt physiological differences between me and Mayer, too. I'm just a layman, but it sounds like a hard trick to pin down the cause of some of these things. You have to be cognizant of all the variables and try to optimize all of them.

 

Anyway, thanks for bringing up such great points, Mayer. I hope everyone that reads this thread and who is considering an HT will be better prepared with questions for their prospective surgeons. If this forum teaches us anything, it's that there are a lot of variables to consider: patient type, doctor quality, technology used, medications, and probably a few more I'm not thinking of. Good luck to everyone.

[Bill - Seemiller]

zeroaffinity,

 

Congratulations on your recent hair transplant with the experienced Dr. Griffin.

 

Keep in mind the posts on this thread are over 3 years old. I do encourage you however, to start your own thread to share your experience and photos. You can do this by going to the "Hair Restoration Results Posted by Patients" forum and clicking "New" and then "Photo Album". You can also create a hair loss weblog to chart your progress with photos and then link it back to your forum signature. For detailed instructions on creating a free hair loss weblog and linking it to your forum signature, click here.

 

Best wishes,

 

Bill