had surgery with dr h. rahal at the age of 20

[Rambler]

I think it's a huge improvement from where you started. Congratulations. Possibly even just one more large session might give you pretty even full density.

[azza786]

hi guyz,

 

thanks for the kind words. i do understand that i will not get super thick as of now and accept that fact. there has been an improvement for sure but my only cause for concern is of the fact that right now, it seems my hairline is receding. in real life, you can see right through my hairline from each angle and straight on which is rather annoying as it gives the balding look. from the top, thats where you can see the difference. honestly speaking, i wouldnt have mided a thicker hairline and a not so thick top of head but its the other way round at the moment. people say i should wait a full 12 months, but my question is that i have been waiting for a full 10.5 months to see an improvement in the hairline and was expecting one where it would not be as see through as it is now, what hope do i have in the next 1.5 months? any comments on that

[azza786]

hi guyz,

 

hope all is growing well! i have updated my blog with the penultimate month before assesment at 11 months..please take a look.

 

thanks

[richie48]

azza

i have followed your progress since your first post , at first you seemed to be alot of time to grow in and had some concerns over shockloss , from your pics i think you did suffer alot of shockloss over your scalp and in later pics you can see your hairline growing in better .

 

It is good to see that finally after 11 month you have gained a excellent overall cosmetic improvement , your hair , certainly when combed forward is a world away from you before shots , i think you may be a little hard on yourself because i see a deffinate improvement to your hairline and over the top of your head ,i even showed my girlfriend , who by no means is an expert but i feel she offers clarity in certain circumstances because she lacks our often over critical eye , her opinion was simply wow !

 

This is how the public will see you as a young lad without any clear signs of any hairloss , a that my friend is a world away from your post op pics .

 

good luck az and remember , we , as hair transplant patients are often very critical and in some ways almost over educated to the point of obsession .

 

Dr Rahal in a very good surgeon and you have had a really good overall improvement , i look forward to your next update

 

richie

[azza786]

thanks for the reply richie,

 

this is a reply to u and others who may think that im disappointed.

 

the fact is, i am not. i acknoeldge that there is a good change but i set out to redefine my hairline more than the rest and according to what i see, im not there yet. it is much stronger and there is the shpae of a hairline, but its extremely thin for 11 months. anhow, i am hoping for the best to come over the next couple o months and see what happens.

 

thanks

 

azza

[azza786]

well well well...i have made it..the 1 year landmark.

 

taking everyones advice to wait this long to make full analysis..i shall do that today.

 

over the course of the 1 year i have indeed learnt that this is perhaps the most toughest 1 year i have had yet. been full of ups and downs...emotional rollercoaster.

 

i will now briefly look at the positive and negative aspects of my 3608 FUT procedure i had this time last year.

 

postives:

 

the coverage has improved. not too good, not too bad. there is minor minor improvement in the temples. and i guess what i have transpanted should last me for most of my life.

 

negatives:

 

i must say that the area that was the main priority of the whole procedure...the hairline has honestly not been good. there are still gaps and it is the hairline area that has been the culprit. i am sure had this turned out well, the rest would have been nicely complemented and overall results will be one of better satisfaction.

 

when i went into the procedure, i knew i was not goin to get a low hairline or a highly dense one. the aim was to have enough so atleast i can comb the hair back. at the moment, i dont stand a chance without a concealer. infact i dont stand a chance at all because, the area behind the hairline does not have enough hair for me to pull of that look

 

i still have some stubbles in the hairline that i felt at around 4-5 months. im not sure what is going there. either they have frozen or growing below snails- pace

 

 

 

i know that the results will keep improving till 18 months but in all honesty my concern is that if i have had the same problem throughout the 12 months, then its highly unlikely that anything dramatic will happen over the next 6 months. at most thickening of the current hairs that grew.

 

in my opinion, the only thing i would like to readdress of now is just the frontal area i.e. hairline and about 4-5 cms behind it. obviously i would like it to look natural rather than completly dense. as long as the hairline is not too see through, i will be happy. so from my research and knowledge i have gained over the past few years, i would predict around 1500-1600 grafts.

 

i shall be updating hopfully at the 14 month and 18 month mark. so i will be back.

 

thanks for everything. and i shall stick on this forum to give my own inputs where possible.

 

az!

[dakota3]

azza,

 

While I can definatly see where you're coming from as far as it being a bit thin in the front, I have to say to me it looks that overall it's a dramatic improvement! You propably still have a ton of donar hair left. It appears that you had a great deal of real estate covered during your first procedure, now you should concentrate on filling in the front! BTW would you go back to Dr. Rahal?

[NW5a]

Generally i like Rahal?‚??s results, but this one is definetly the worst one, i have seen.

 

Many grafts did not grow or the allocation was terrible

 

What say Rahal to you ?

[azza786]

well like a good doctor would, dr rahal is willing to correct the procedure at his cost should he feel that the results are not up to standard.

 

this does mean that he takes his work with caution which is a good thing. lets see what he has to say. i have sent him the pics, jus waiting for the reply.

[NW5a]

I think so, too. He will do all, that u will be happy. But perhaps u lost many valuable grafts :-(

 

Good luck

[Bill - Seemiller]

Azza,

 

Thanks for posting your one year update.

 

You have certainly come a long way especially when you compare your before and after photos. Considering the number of grafts you received (3600) over a large bald area, you have some nice coverage.

 

I do agree however, that the hair in the front looks a little thin directly behind the hairline. It is difficult to tell from the immediately postoperative photos alone how much density you should be expecting. Given however, that you only had 3600 grafts over the entire pretty bald scalp, the density in the front may be as expected.

 

Have you talked to Dr. Rahal about this? What has he said about it? I sent him an email to inform him of this thread so that he may offer his input on this case. Azza, please contact Dr. Rahal to give him any necessary permissions to discuss your case openly online.

 

Thanks,

 

Bill

[azza786]

Bill- thanks for that...i will do...

[PLEASE GROW PLEASE]

This is not a total failure but far from the results we are use to. Handling it any other way besides a free surgery would be VERY disappointing. Its funny how we forget about all the great results and NEVER forget the poor ones. Im confident Dr Rahal will do whats right.

These forums have boosted his workload but it can also destroy it just as quick

[azza786]

HT55- you may have a point to an extent but if you observe, the trend of young patients i.e between 20-25 getting transplants today is getting common.

 

despite my results not being the best, i do not have to regret that i went to a botch surgeon. everyone knows of dr rahals talent so that is reassuring. i am sure he will get back to me with a plan of action of what to do now.

 

actually i am thin in front. i say this because me being the subject can say that there has been improvement everywhere the procedure was done but the hairline. why, i dont know. i do have hair where i didnt before on the frontal part but it is too thin. i feel i just need a minor touch up.

 

i will say this again that like many young patients who want an ultra thick hairline and coverage, i just want something that gives me an appropriate result where i can atleast style my hair in more than 2-3 ways. so my guess is between 1500-1700 grafts on the hairline.

 

doctor rahal did a procedure on a 22 year old who was about a norwood 4 using over 2400 with good results.

 

PGP- im sure something positive will happen

[Rahal Hair Transplant]

I am posting a response to this thread as requested under adrian's account (as i don't have my own at this point)

 

Azza786 and I have been in constant communication through out the post op period. He has been kind in enough to provide us with ongoing updates.

 

As I have communicated to azza786 at an earlier time, that a no cost procedure, can be done upon further examination and with mutual agreement. So we will stand behind the work and will support azza786 through out this process. I know he knows and understands this already.

 

Treating younger patients with potential large recipient areas is always a challenge, not from a technical, but rather from the planning point of view. And this case is no exception.

 

Prior to surgery a thorough discussion had taken place with azza786 detailing out the benefits and the long-term consequences of surgery. We had certainly discussed the need for further medical and surgical treatment.

 

However, the main challenge with azza786, besides age, was the treatment area at 85+ cm and the grafts we can get from the donor, 3608 grafts (754 singles, 2464 doubles, 390 triples). This gave an average density of 42% density. This density is below what can provide an illusion of fullness, which is now the case. Had we been able to get 1000 extra grafts or the area was somewhat smaller and with proper hairstyling, then azza would be a happier man.

 

Also, due to azza786's age, we debated, at length whether to go for more frontal density and less back coverage or to maximize coverage and less front loading. We ended up agreeing that a more conservative route in coverage and not frontal loading. This approach, although dilutes the density, is a safer way when future hair loss is bound to happen.

Had we done more front loading and ignored the top/back, a short term gain, will still necessitate further future surgery.

 

I had already discussed with azza786 future surgery and adding density to areas that are lacking and improving overall coverage..

 

Dr H. Rahal

[azza786]

HT55- ye you may be right of changes between 12-18 months. ye i did say 1500 grafts for hairline area. well, as for the whole coverage again, i doubt any ethical doctor will allow that. that way, i will perhaps use up all my grafts not allowing for future surgerys based on what may happen. i know for sure what loss pattern i am (or was) heading for but despite that i want to take this route slowly and smoothly rather than aggressively. everyone knows that the biggest obstacle that has come in between me is just my age so this needs to be taken with caution. had i been in the same state at the age of say 30+ i probably would have been the one of the most suitable candidates regardless of any factor for surgery.

 

anyhow, i will discuss the situation with doctor rahal

 

doctor rahal- can you reply to my email please so that we can discuss further?

 

thanks

[hairthere]

ht55, i have to disagree with you. i think it's unethical to perform surgery on someone that young if their loss isn't that bad or if their nw pattern isn't established. but azza's thinning was quite bad and it was pretty clear what his pattern was.

[Bill - Seemiller]

Dear forum members,

 

I have full faith in Dr. Rahal's ability and know and believe he has in mind what is best for the patient.

 

Hair transplant surgery is not an exact science, but as I stated in "Am I Too Young for a Hair Transplant", in my opinion, cases can be made with younger patients having surgery given certain conditions.

 

As hairthere pointed out, it would be more detrimental to do larger densely packed sessions on younger patients with minimal hair loss.

 

As. Dr. Rahal said above, in taking into consideration future baldness, they opted for coverage over density instead of front loading (a lot of dense packing in the frontal core). This patient should have plenty of donor hair in reserve for subsequent procedures in the most likely event of further loss. It's all about the long term plan.

 

Azza, I trust that Dr. Rahal will work with you to make sure your satisfied as long as your expectations remain realistic. You have a good head on your shoulders. Keep us posted on your long term plan.

 

Best wishes,

 

Bill

[NW5a]

I am a big fan of Dr.Rahals work, but this time he did not a good job. We saw many men with high nw pattern, who get around 4k grafts only in the frontal third or frontal half. The docs leave the crown alone. So their faces are framed and all said, that it looks amazing.

 

In this case, it the strategy was a failure to put all grafts over the whole area. It looks now, like an old woman with thinning hair.

 

I think, he needs much more than 1500 grafts to get a good appearane from front and to restore the hairline and zone2-3.

 

A good example is the member clock who get 4k grafts only in the frontal half or look my case. I get the same amount of grafts and less hair, but the appearance is better, cause all grafts went in the front.

 

Good luck azza and i hope, that there will be coming many hairs the next month, perhaps u are a slow grower :-)

[azza786]

let me make one thing clear,

 

firstly, the crown wasnt touched just the frontal 70%.

 

secondly, as we went for coverage no more than 2000 grafts were placed in the frontal region.

 

if i am to go one more time with approximately 1500-1700 grafts, then this would be a total of over 3500 grafts in the front so i think it will and should make a substantial difference.

 

i will hang in there though however so there is plenty to come!!

[PLEASE GROW PLEASE]

Things will be sooooo much better with another session. Hang in there . This is one reason I could never call a transplant a cure. With another decent size strip and the advancement of fue you could very well eventually have a final result that youll be really happy with. Even without the fue another strip can work wonders

[Byehair]

Has anyone ever thought that Azza might be fighting a losing battle?

To have that much loss at such a young age, I would assume there was more loss while the new hair was growing in. It's a no brainer, the guy needs more work, but I doubt he will ever have a thick mane. But for NW5A to say he looks like an old woman with thinning hair seems a bit far fetched. His case and Azza's case were much different. NW5's balding pattern was much more localized to the front 1/2 of the scalp.

 

Dr. Rahal is a top notch doc, I should know since I have met with him 3 different times.

Once in San Diego and twice at his office in Ottawa. His patient care is outstanding.

[azza786]

byehair- you may have a point about losing more hair while the new one is coming. BUT I would like to emphasise that as you saw from my pre op pics, i pretty much lost all i had (which wasnt much) so even despite, i dont think it would have made such a difference had i lost more at this stage.

 

as for the losing battle? can you elaborate

 

if we think about it, the hairloss pattern that i had was pretty much what i was going to have as it is based on genetics family history. for instance i was a NW5. that does not mean that i would most definately b NW6 or 7 quite soon as the only NW7 is my grandad who is in his 80's. The rest are more or less NW5 or 6.

 

Also, if we also consider that many patients here including those who have had remarkable results have also experienced hairloss (maybe not as extensive as me)as early as i did have not all ended at NW 6 or 7.

 

Therefore, I feel despite i am not going to get that thick mane but i can certainly and hopefully with the state-of-art technology nowadays can atleast pull off 50% of the density i had when i was 14-15.

 

As long as i have styling options at hand, I am happy! First priority is to get a good illusion and something that looks good.

 

Yes dr rahal indeed is a good surgeon with whom i am aiming to meet up again soon hopefully!

[PLEASE GROW PLEASE]

He is fighting a battle but one that doesnt necesarily have to result in total defeat. At the very a least truce can be obtained in the end with the right choices.

Possibly more growth to come ,plus a well thought out plan for the second surgery can get him back on track. It may may require a 3rd with strip or fue but there is plenty of light at the end of the tunnel

[Byehair]

Azza

 

By a losing battle I was referring to the continued loss while the new hair was growing.

I mean no disrespect to you. I think you had decent coverage for the amount of grafts and large placement area. It seems from Dr. Rahal's repsonse that you both knew this would be a 2 step process for you.

I am amused when I see some Armani patients getting that many grafts in a half inch hairline.

I also felt like NW5a's comments were a bit harsh, but we all have our opinions.

 

How have your friends and family responded?