Transplant w/ Dr. James Deyarman- 6 month update

[userdefined]

6 MONTH PICS ARE PHOTOS 19-31

 

Restoring a lost frontal hairline due to Traction Alopecia. Transplant was completed by Dr. James DeYarman of La Jolla, CA 12-11-2006

[Bill - Seemiller]

Userdefined,

 

Post op pictures look great! Congratulations on your procedure. How many grafts did you get?

 

Bill

[userdefined]

Originally posted by Bill:

Userdefined,

 

Post op pictures look great! Congratulations on your procedure. How many grafts did you get?

 

Bill

 

 

2088 Grafts total, all in 1's and 2's. I wrote a post on it in the surgeon reviews section for your viewing pleasure.

 

Hey btw how do I get the jazzy signature thing you got goin on there, where it gives the break down of how many grafts you got and by who?

[GrowPlease]

Whats up Userdefined,

 

The hair you do have pre-HT looks really thick.

 

Do you mind me asking how much hair traction you experienced to loose a significant amount of hair?

 

GP

[userdefined]

well i'm not sure exactly how i would quantify how much traction i experienced, but basically the whole graft site you see in the pics was pulled out from my head over the course of years and years and years. somewhere probably in the range of 5-10 years of nearly constant pulling.

 

btw although i do have hair on the rest of my head, its more long than thick. remember, when you have long hair it fills in a bunch of the thinning areas. lemme know if you have any other questions.

[NervousNelly]

There is no question about the quality of the work as things look awesome. I guess I wonder though about how low the hairline is as you mentioned that your hair is actually somewhat thinning(although it doesn't at all look it in photos). How old are you userdefined?? Is there at all a history of baldness in family?

[Pat - Community Publisher]

Thanks again for sharing your ongoing saga in detail. Congratulations on your surgery.

 

It will be very interesting to see what kind of density you achieve in 8 to 12 months. Given that your existing hair behind your hairline and temporal points on the side is very thick I would not expect your transplanted hair to match this density.

 

Did Dr. DeYarman suggest that you will need a second session to achieve sufficient density to blend your hairline and sides into your existing hair?

 

I really hope that you will stay involved with our community and post updates. Note - Userdefined's post detailing his surgical research and experience is at http://hair-restoration-info.com/eve/forums?a=tpc&s=569...601062682#2601062682

 

Best wishes for great new growth, Pat

[hairbank]

userdefined -

 

The quality of work looks solid though I also question whether or not you will be able to match your native hairs density as it looks pretty thick.

 

I'm curious about your hairline placement............it seems very low with really no widows peak whatsoever. At your age, was there a reason Dr. Deyarman chose this for you? Did he state whether you showed any other signs of MPB?

 

Best of luck to you with the healing and growth process.

[userdefined]

In response to your questions:

 

Pat- I received 50 grafts/cm in the transplanted area. According to Dr. DeYarman in my initial consult with him, he said I might want another transplant in this area down the line. I asked him whether this would be because it would be noticeably less thick, and he responded by saying not necessarily, just that many guys grow on to the idea of having transplants, and are not satisfied with a single transplant. Based off the research I've done, assuming I have 100grafts/cm in non-transplanted areas, I would hope that 50/cm would be enough to mask the fact that I had a transplant altogether. However, if I lose more hair on the rest of my head, perhaps it will make it blend a bit more since I'd be getting closer to having only 50 grafts/cm. Interesting concept, although completely counterintuitive to this forum, huh?

 

Nervous Nelly - I am 21 years old, and if there is any history of MPB in my family, I don't think its anything significant (i.e. Norwood 6,7). Although I must admit that I can't say for sure. B/c most of my extended family practices Sikhism, a religion where one is traditionally not allowed to cut their hair (and usually turbans are worn), whenever I see my family people usually have their heads covered anyway.

 

Hairbank- I'm actually surprised to hear that you think the hairline is low. I voiced my concern to Dr. DeYarman about having an extremely low hairline for the fact that way down the line (20, 40, even 60 years down) it may look extremely weird to have a boyish hairline. He took this into account and worked this into his product.

As far as MPB goes, apparently I do have some, which I was not expecting to hear. Using his microscopic hair follicle viewer camera thing (aka the m.h.f.v.c.t), he pointed out minaturizing hairs in both the top and donor area. He recommended I start Propecia and/or Proscar, perhaps even Rogaine foam immediately. I haven't done much research into any of this though, and I think I will wait on this until I see exactly how the frontal hairline comes in.

 

Thanks to all for the questions. -ud

[the B spot]

I think after seeing the post-op photos and looking at them full-size, I have a couple of comments.

 

1st--- I really dislike the idea of a 21 year old doing a HT. I understand in this instance that extenuating circumstances played a role in the decision to proceed (Traction Alopecia), but the age, truly bothers me. Regardless of what ANYONE thinks, it is categorically impossible to forecast future hairloss, and at 21, it is virtually impossible to assess balding patterns.

 

2nd-- While I feel that the transplant was justifyable, I do not understand replacing the temple points and the temples themselves back to the original state. They will certainly not be the same density as the existing hair, and a better than average chance exists for hairloss behind the transplanted areas.

Remember, everything we pull forward, takes away from the back.

 

3rd-- The highest density appears to exist in the temple region and on the side of the head, not in the actual hairline itself. I can see Dr. DeYarman's little purple boxes in the hairline and they are only slightly filled and nothing went into the existing hair.

 

 

I cannot understand why it was necessary to frame UD's face this way.

 

If a transplant could not fill in the thin areas without looking weird, then it should not have been done.

 

I think the work itself will look good when it grows out, but I guess I do not agree with rounding the temples off on this kid, nor replacing his temple points back to their original state.

 

I would welcome some form of rebuttal on this topic, because to my knowledge this is exactly the same type of work Armani is known for and subsequently hammered online for.

 

Regardless of the fact that his density will be only 50 fu cm/2, the PLACEMENT of the hairline is not going to go away.

 

I could be wrong though........ it happens all the time.

 

Gentlemen, your thoughts.......

 

ps.. the tip of the frontal hairline is fine and is not too low, IMO. I am referring only to the temples and points.

[NervousNelly]

Userdefined,

I want you to know that we are pointing things out because we want everyone to be educated on the topic, including the many doctors that frequent this forum. In your particular case, there is some justification for the HT and I think that with your very thick hair (from what it appears) you will have a natural look and everything will work out ok.

Several of us (myself included who had a HT at 22) don't believe that doctors should be performing HT on young men because there is absolutely no way to predict future hairloss.

If a young individual is given a very low hairline because the doc believes that the person won't have much future loss , this is absolutely crazy. Anything can happen.

In your particular case:

1. I have concerns of density matching existing hair.

2. I believe that the hairline is too low. I know that B spot thinks the center is OK but I would have to disagree. If you were 40 my opinion would be the same as his.

3. You are too young. I don't think he should have taken the case. I think that you looked fine prior and you should have been told to wait to see what natural progression will take place.

 

That being said, I would like to see a response from Dr. Deyarmen.

[userdefined]

Although this discussion concerns me (seeing as how I feel like a guinea pig), I want you to know that I really do appreciate hearing both sides of the matter from anyone who is interested.

 

That said, I have sent an email to Dr. DeYarman inviting him to participate in this discussion. Let's see if he responds.

 

B-spot- One of the biggest concerns I had going into surgery was whether Dr. DeYarman would blend the grafts to the areas where I have some but scarce hair, e.g. the frontal hairline at center, and the RT sideburn just in front of my RT ear. Looking at the pics I can see the purple boxes you speak of showing that there is a small gap between where the grafts end and the existing hair begins. Of course we really won't know how natural the look will be for some time, but this would also be something I would like to address w/ Dr. DeYarman.

 

B-Spot and Nervous Nelly- regarding my age, i agree that 21 is young, but I'm not sure how young TOO young is..A couple of years ago when I had my first consultation w/ Bosley in Beverley Hills, they gave me a consultation but said 21 was the minimum age that they would allow someone to have a transplant, the reason being that "by that time your hairline will have matured and we will have an idea of how to proceed." Also, given that my main problem was traction alopecia rather than progressive hairloss, I assumed that my case was a bit different. As far as I know, traction is the pulling out of hairs due to constant tension; it is not progressive. If this is so, then redrawing my hairline would only be a problem if the hair directly behind it showed evidence of significant loss, which it doesn't seem to.

[NervousNelly]

Userdefined,

I'm glad to see that you are open to forum discussion and I'm sure that it is not easy when it pertains to your particular case.

Major concern: Yes, although NOW most, if not all of your hairloss is due to traction, we are concerned for you that one day you might start to lose hair due to male pattern baldness. If this is to happen and you have a significant amount of future loss, we think that possibly Dr. DeYarman might have misjudged things and gone too low with your hairline. It is always a guessing game on a young patient and I personally always believe to either wait until the patient is older or err on being conservative. That being said, I am also making these determinations just from your age and pictures, possibly the doc has good justification from his years of experience and his personal examination.

I think that it is very good quality work from a technical point of view but just question the artistic and ethical side of it.

[the B spot]

I would like to thank Userdefined for his levelheaded maturity in response to our comments. It is very refreshing, to be honest.

 

Nervous-- If you look at Post Op 3, you can see that the "tip" of the hairline is located right where the forehead curves into the scalp, which is generally thought to be an acceptable hairline placement, not too high or too low. I think the rounded temples give the impression that the overall hairline is too low, but to me it is not. It's OK if we disagree, because the point is moot, due to the temples and temple points. The shape of UD's hairline should have a wide, dense forelock and then some temple recession. The reason the temple points have to be so youthfully defined is because the corners of the hairline have been lowered to much.

 

In any event, I think we ALL can agree that UD is too young for this type of transplant. The traction alopecia areas could have been strengthened without compromising this young mans future.

 

Sorry if this is an unpopular opinion or viewpoint, but it is truly how I feel.

[John_in_NC]

good luck, but I have to say that you're much braver than me. I have plenty of hair to make the temples like that (judging by my age, family history and donor) yet I would not do it.

 

Given the texture, placement and density of the side hair I don't think a doctor can make them undetectable, especially that low. Mayeb one day they will but for now, I haven't seen any "undetectable" one. Plus the temple hair is thinner IMO.

 

Of course, as others have pointed it out, you have another issue: you are have drawn the line in the sand, for the rest of your life your hairline will there. Problems arise when the hair behind is lost to MPB.

[NervousNelly]

B Spot,

I read your post and further studied the photos and I can see your point about how the temples give impression of hairline being very low. I like your statement about hairline being strengthened-- I fully agree with you. I guess my main point as is yours is that he is too young for this type of HT because of possible future variables and if the surgery is done I would like to see them be very conservative. They can always come back years later and lower things if desired and donor allows.

[hairbank]

Userdefined-

 

As has been mentioned already, thank you for your levelheaded response to our posts. Ultimately we mean to help but I think at times we may suffer from "analysis paralysis".

 

I digress to my earlier post about your hairline. I believe I jumped the gun in saying that it was too low. I do believe it is still pretty low for a person who could have substantial loss in the future....who knows. The reason it looked low to me was due to the temple closure. It's hard to understand why the surgeon seems to have chosen to replicate your original hairline..................it's not commonplace especially for someone at your age who is experiencing any miniturization and signs of further loss in the future.

 

I do hope that Dr. DeYarman will take the time to respond. I would really like to get a better understanding of his reasoning with respect to the temple reconstruction. I'm getting older but never too old to learn!!

[NervousNelly]

While surfing this site late last night, I did notice that Dr. DeYarman was online here but still no post. Hopefully he'll share his insight on the surgery as it is always nice to get their input.

[userdefined]

Well, I have done my best to refrain from my own biases, but I have to say, I still disagree with some of you that said my new hairline was placed too low. I think I should be clear and distinguish the forelock from the temple area, as B spot did. When I talk about hairline, I suppose I'm actually talking about the forelock (the horizontal part of the hairline on the forehead). After the start of this dicussion I must admit that I have been scrutinizing people's hairlines (including people on TV) even more than I originally was, to a point where they wonder why I'm staring at them. From most of what I can see in those that have lush hair, the forelock sits pretty much directly where mine is. Of course many have it higher up for the mature look, but from what I can see it is very common to have the forelock this low, even in older adulthood. Regarding the temples, I can't really say much because I saw some both older and younger people with temples, and some of both groups with no temples. I guess can't say I agree with your opinions completely, I can't say that I disagree fully either.

 

Also, I am still questioning why Dr. DeYarman did not blend the grafts into my existing hair, esp. at the center of the forelock. While the hair on the RT side of my head and on the temples will be layered over one another, with short hair the forelock hairs will be pointed vertically, and thus with little of the layering effect. Looking at the current stage of the hairline in the mirror, I hope what doesn't end up happening is a row of hair at the front, followed by a gap, followed by hair on the rest of my head. I know that many of you are concerned with me having this down the line, but due to the nature of the graft placing, am I going to see this even in just a few months when my hair begins growing in?

 

Taking in your concerns, I think I'm going to start a regimen of Proscar/Propecia sometime soon, after I research it a bit. I know this should go in the 'Drugs' part of the forum, but does anyone know of a low-priced option for either off the top of their bald/fabio-like heads?

 

Regarding the suture area, at 6 days post op should the area still be hurting? I've followed Dr. DeYarman's order of putting on Bacytracin (just a stronger Neosporin) on the site once a day. Sometimes there's just pressure on the area as if its being pulled, sometimes there is some acute pain. There isn't any blood present so I don't think they ripped open, so maybe its an infection. Does anyone have any suggestions as to how to numb the pain (beyond Vicodin and the meds, which I've already finished)?

 

 

Also, at this point my transplant area is still covered in scabs. This is kind of an odd question, but does anyone know how many hairs generally go in the area of one scab? Given that I received grafts in all 1 and 2 hair units, it seems logical to think that one/two hairs = one scab. Is that right? I highly doubt that there are 2088 scabs on my head (I suppoosedly received 2088 grafts), and I can't really imagine as many hairs as there are scabs being able to produce a natural looking head of hair. As much I analyze and break down others' pics and comments, the fact that one day a guy can have a scabby bald head and the next he can have a full head of hair still seems like..well, magic.

 

 

Originally posted by NervousNelly:

While surfing this site late last night, I did notice that Dr. DeYarman was online here but still no post. Hopefully he'll share his insight on the surgery as it is always nice to get their input.

 

Nelly, thanks for the heads up on Dr. DeYarman cruising this site. I sent him the email, so its good to know that he got it and he's at least taking a look. I also really hope he posts to this site so we can all find out what's going on from the man himself.

 

I've already scheduled to have my sutures taken out this Friday Dec. 22nd (btw please see the above paragraph about the suture area - it hurts like a b*tch). ASSUMING HE DOESN'T POST HERE IN THE MEAN TIME, PLEASE POST ANY QUESTIONS THAT YOU HAVE FOR DR. DEYARMAN HERE. I'LL MAKE A LIST OF THEM ALONG WITH MY OWN AND DO MY BEST TO SEE THAT HE ANSWERS THEM ALL. thanks.

[userdefined]

btw, i'll try to post up some more pics in a day or two.

[NervousNelly]

Userdefined,

If you look at most of our posts, you'll see that we all state that you can't predict the future. That works both ways. We can't predict what the future holds for your hair situation. Dr.Deyarman is a highly trained specialists that is recommended on this site. He examined you and used his several years of insight and knowledge to make a determination of what he believes is best for you. I'm quite certain that there is good reason for his decisions. We are HT amateurs that are giving you our feedback based on very little in terms of your history and without a physical evaluation of your hair and scalp. Possibly some of our thought of just strenthening your hairline might be doing you an injustice if infact you can pull off the lower hairline. Right now you need to put faith in his expertise. Although my opinion was exactly my honest initial thoughts, I'm sorry that we have now got you concerned. Hopefully Dr. Deyarman will post his thoughts.

[Bill - Seemiller]

userdefined (and everyone else),

 

I took a second look at the after photos and can see why people are expressing concerns about hairline and temple placement. If it were me, I think I would have opted for the widows peak to be exactly as the doctor placed it but then had it up a little further toward the left and right sides. Additionally, I don't think I would have wanted the temples out that far. Were your temples out that far originally? I know everyone's hair looks a little different and maybe I'm having trouble visualizing it...but it almost looks like they were bridged out too far, more than they would have been originally. I could be wrong, however.

 

I'm sorry that you feel a little alarmed...we don't intend to alarm you of course...but we are expressing concern over something that MAY or MAY NOT be a problem. It's hard to tell at this point how it will look grown out regarding density and placement. As Pat stated, you might need a second HT to get the density the way you want it to blend in with your existing hair.

 

Additionally, as the voices of reason state...21 is one of those ages where it is risky to get a densely packed thicker and lower hairline. It's a simple concern of how much hair (if any) you will lose in the future. This is why I always believe IF someone very young is going to get an HT, to start conservatively. However, what's done is done at this point and you can only move forward from here. My best advice is get on Finasteride now to try to prevent future loss.

 

Sorry again for the alarm, but we are only trying to help.

 

Bill

[userdefined]

new 3 1/2 month photos posted in the gallery for all to see. wish i knew how to post them here... enjoy.

[hairbank]

User-

 

Thanks for posting the updates. It's a little difficult to see anything growing in the pics.............has it started to come in yet? Hang in there, the first several months is the toughest part!

[Bill - Seemiller]

user,

 

Thanks for the update. 3.5 months is just the beginning. Try to be patient and don't expect results overnight...these things take time

 

Bill