Response From Doctor

[Time to do something]

I am going in for my second HT in January which will be 6 1/2 months after the first one. There was some concern that I might be going back too soon. Because of that I posed that question to my doctor and here is his response.

 

Let me deal with your questions, which are very relevant.

I would not be doing your procedure in 6 months if you only have 80% of your

hairs growing out. That was never my intention. The reality is, for some

patients, by 4 months. 80% to as much as 95% of the hairs are growing out,

meaning that by 6 months, we could expect that close to, if not all, 100% of

the hairs would be growing. Anything less than that would be an indication

for holding off on a second procedure for another 2 to 3 months, or even

more.

So, by no means would I ever consider compromising your long term results.

However, every experienced surgeon knows that, around 30% of patients (or at

least from my 15 years of experience) display 95% plus growth by 6 months.

Now by saying growth, these hairs may be just coming to the surface, but

they do show were they are, making it quite possible to avoid damaging them.

Now obviously, if we determine that, come early January, that you are not

one of those 30%, then by all means I would absolutely recommend holding off

for a few months.

[Time to do something]

I am going in for my second HT in January which will be 6 1/2 months after the first one. There was some concern that I might be going back too soon. Because of that I posed that question to my doctor and here is his response.

 

Let me deal with your questions, which are very relevant.

I would not be doing your procedure in 6 months if you only have 80% of your

hairs growing out. That was never my intention. The reality is, for some

patients, by 4 months. 80% to as much as 95% of the hairs are growing out,

meaning that by 6 months, we could expect that close to, if not all, 100% of

the hairs would be growing. Anything less than that would be an indication

for holding off on a second procedure for another 2 to 3 months, or even

more.

So, by no means would I ever consider compromising your long term results.

However, every experienced surgeon knows that, around 30% of patients (or at

least from my 15 years of experience) display 95% plus growth by 6 months.

Now by saying growth, these hairs may be just coming to the surface, but

they do show were they are, making it quite possible to avoid damaging them.

Now obviously, if we determine that, come early January, that you are not

one of those 30%, then by all means I would absolutely recommend holding off

for a few months.

[MORE_HAIR]

Hey TTDS,

 

What do gather from your docs response ??

 

More_hair

[Time to do something]

I'm behind him. I don't beleive he could be one of the top HT surgeons in the world and give out any advice that could compromise his reputation. He has been doing this for many years and is very good at what he does. So I'm putting my faith in him and just relaxing.

[Bill - Seemiller]

TTDS,

 

Your doctor is correct.

 

I personally have reservations however, of going for a second hair transplant too early especially if hair is being transplanted in the same area as existing hair.

 

In my opinion, going for a hair transplant too early does not give the scalp enough time to restore normal elasticity. That means a lesser amount of grafts can be excised the second time around. Scalp exercises are only encouraged 6 months after the first hair transplant anyway which ultimately suggests that the donor area can be a bit sensitive before that point. Personally, my donor laxity started to really increase dramatically after about 8 months from each hair transplant surgery.

 

Secondly, regrarding the recipient area, new hair growth can occur up to 12-18 months though in the latter months, new hair growth will be minimal. Due to the projected new hair growth, it is possible that some will be transected before they actually grow. Additionally, it may be more difficult to determine the proper direction of a hair if that hair has only started to grow.

 

Therefore, personally speaking, I wouldn't consider a second hair transplant any sooner than 8-10 months depending on your circumstances.

 

Your doctor obviously recognizes that each case must be taken individually. I just wanted to add my general opinion.

 

Obviously, the donor issues are different when talking about FUE - however, the recipient area concept is the same.

 

Bill

[Guest wanthairs]

I agree with Bill...and I also respect what Epstien has to say too. I decided to wait at least 12months before even booking my next proceduree for the above described reasons. I want to have about 4 months of scalp exercises in and want to see my slow growing finished results from HT 1....

[Time to do something]

Now I am more confused than ever. I can't imagine Dr. Epstein doing anything to risk a bad outcome and his reputation and it isn't like he is hurting for business. However, I also respect your opinions since you have been through all of this before and have done your research. I suppose I could compromise and do the second procedure the end of March which will make almost nine months. I have a week of vacation I am carrying over that I must use by then or I'll lose it so maybe that makes sense.

[Bill - Seemiller]

TTDS,

 

There is nothing that we said that contradicts what Dr. Epstein has told you.

 

I believe he will make a decision on your behalf that is in your best interest.

 

He states that only 30% of hair transplant patients have 95% hair growth (new hair growth at the very least above the surface) by the 6th month. That means that most do not fit this category. He is simply stating that if you are in the 30%, hair transplantation might be an option earlier for you than others.

 

But, there is no downside in waiting at least 8-10 months to get surgery other than you just have to wait.

 

Bill

[Time to do something]

Dr. Epstein is ready to do the second procedure in six months if certain criteria is met. I was under the impression that you felt the procedure shouldn't be done in six months under any circumstances from your reply below.

 

"I personally have reservations however, of going for a second hair transplant too early especially if hair is being transplanted in the same area as existing hair. In my opinion, going for a hair transplant too early does not give the scalp enough time to restore normal elasticity. That means a lesser amount of grafts can be excised the second time around. Scalp exercises are only encouraged 6 months after the first hair transplant anyway which ultimately suggests that the donor area can be a bit sensitive before that point. Personally, my donor laxity started to really increase dramatically after about 8 months from each hair transplant surgery.

 

Secondly, regarding the recipient area, new hair growth can occur up to 12-18 months though in the latter months, new hair growth will be minimal. Due to the projected new hair growth, it is possible that some will be transected before they actually grow. Additionally, it may be more difficult to determine the proper direction of a hair if that hair has only started to grow.

 

Therefore, personally speaking, I wouldn't consider a second hair transplant any sooner than 8-10 months depending on your circumstances."

 

 

I have no doubt that Dr. Epstein will do the right thing. I'm pretty sure I'm not in that 30% category because I am at 4 1/2 months now and have a sprinkling of hair certainly nothing cosmetically acceptable so I'm sure A LOT is still to come. I guess the bottom line is one size doesn't fit all and each individual has their own unique situation. Since Dr. Epstein is one of the highly rated coalition doctors on this site I'll just let him decide after looking at me in January if I'm ready or not and go with his decision. Just bear with us guys that are going through this for the first time. We don't know what to expect. I'm sure in a year I'll look back at others on this forum asking these kind of questions and remember I was there at one time.

[hoose]

I know that in my procedure I looked dramatically differant from the 6 month compared to the 1 year mark--more density, maturity etc...also my donor area was quite sensitive when styling etc. for at least 6 months; I would recommend waiting till at least 1 year post-op; in the big picture waiting another 6 months is a small amount of time, and the benefits such as excising more grafts due to scalp laxity returning back to normal etc. will be worth the wait--IMO

[NervousNelly]

I don't want to confuse you but I personally would wait also. I will ditto Bills response and also add that from a cosmetic point of view, don't you want to see what everything looks like and then you can determine what plan of attack you want? You might choose to add a little here and a little there--you get the picture.

[Bill - Seemiller]

TTDS,

 

You are correct on my statement.

 

I personally would be reluctant to get a hair transplant procedure done as early as 6 months because I personally feel that the donor area could use more time to heal to regain proper laxity. Additionally, I feel that waiting to ensure that most of the transplanted hair has grown in is best - but certainly Dr. Epstein will be able to make a proper evaluation of your donor laxity and hair growth yield at 6 months during an in person consultation. He will not steer you wrong.

 

It is just my preference to wait a little longer, minimum of 8 to 10 months for me.

 

Bill

[Time to do something]

Yeah, that makes sense. I wonder if the doctor has a way of knowing what the final result of his work will look like at six months? If not I'm not sure why I'd be going back that soon. I sent him a photo at the four month mark and it is clear that I have a long way to go so I doubt I'm going to be in that 30% mentioned that has 100% results in six months.

[the B spot]

I believe 10 months is the earliest to re-transplant an area, by 10months everthing should have begun growth, and should be visible under magnification.

 

I believe 6 months is fine for those choosing to transplant into a different area (ie--- they did the frontal zone, and are transplanting the crown)

 

I don't have to agree with Dr. Epstein on this particular matter, but I know he is a good doctor and would not do anything to harm his patients, so if he feels this is acceptable and you the patient feel it is ok, then your in great hands. He knows you, knows what he did during your first hair transplant, etc....

 

Again, you may go in and he tells you to wait a few months longer.

 

Much of what we as HT vets believe in is just good, old-fashioned patience and research. So don't be alarmed when you get a couple of differing opinions-- because we all have our personal outlook on the process.... just make sure you consider all options and avenues.

 

Take Care and Happy Turkey Day!

Jason

[wylie]

Sounds like you want to get this proceedure done as it coincides with available time off from work, which it totally understandable.

 

You and your doctor should decide if he can determine another session can be done when you get to the 6 month mark, and if in his opinion sufficient growth has resulted and he knows where he can go with this procedure than you can go for it.

 

It may be optimal to wait for 8-10 months (and for some that may be even be necessary) but not everyones hair grows the same. You might be ready at 6 months. Your doctor will know best on that.

[Bill - Seemiller]

B Spot is correct. There are varying opinions and we don't all have to agree. I trust Dr. Epstein has your best interest at heart and won't do you wrong.

 

As you can see, my opinion differs from B Spot also because I personally believe that allowing the donor area more time to increase laxity is optimal. But donor laxity can be tested prior to undergoing a second hair transplant - so Dr. Epstein can make a proper determination.

 

Happy Thanksgiving!

 

Bill