HT with Dr. Ken Siporin in Beverly Hills

[HK500]

First of all many thanks to all the posters and Pat for this forum. I found out about this "hidden gem" (Pat's words) thanks to Pat's dedication in taking regular field trips to observe and report on known and established clinics as well as being open minded to investigate yet unknown HT surgeons.

I am probably the first member of the forum to have had an HT by Dr. Siporin. I considered my decision very carefully and after lots of research, reading, posting and learning, I decided I did not need to go to the best-known and proven Coalition surgeons. My case is straightforward and I only required a fairly small graft count, I could not justify the time and expense to travel out of State in my situation. I consulted with five HT surgeons/clinics before making this decision, this gave me a good perspective on the differences of opinion and techniques and allowed me to make a rational decision. Pat's report after he visited Dr. Siporin's clinic was right on and I can now attest to this first hair (I mean hand).

 

I followed the pre-op instructions, no caffeine, no alcohol, no tobacco, and no vitamins/supplements containing blood-thinning substances, scalp stretching exercises, etc ...

 

HT DAY

I was nervous the night before and even more when I got there, I had decided to drive myself to the clinic and back, my blood pressure was high so I was told to take three 5mg Valiums which did the trick in about 30 minutes. We reviewed the details one more time, mostly high-density work using ultra refined techniques to reach in excess of 40 FU/cm2. The frontal hairline and some selected areas behind the hairline closer to the mid scalp area were to be reinforced along with light temporal peaks improvements, no crown work. We agreed on the donor area location based on several pre existing criteria. The three technicians were friendly and had obvious experience, Ismael was the one giving me all the shots and I know why now, he has the touch and I almost could not feel them, Yami and Raquel did most of the donor strip trimming into the FU's and most of the FU placement into the recipient sites, their light touch reflected great experience and skill.

The goal was to transplant 1200 + FU, the donor area was given local anesthesia by Ismael, very gently, then Dr. Siporin excised the donor strip (1 cm wide by 16 cm long) and closed it in double layer and using the trichophytic technique.

While Yami and Raquel got busy trimming the grafts, Ismael started to give me the local shots for my recipient areas, he also did a nice job although it was more uncomfortable due to the fact that the recipient surface area is much larger than the donor area and has many more nerve endings. Then Dr. Siporin started making his recipient site slits, starting with the temporal peaks areas he used 0.65mm blades, then 0.75mm blades for the frontal hairline density and 1.0 mm blades for the multiple hairs FU's behind the hairline in the mid scalp area. We harvested 1,305 FU's of which 500 were single hair FU's, I do not have a breakdown for the multiples but I was told they all were twos and threes.

Because we focused on the density in the frontal hairline where the nerve network is denser I needed several local anesthesia touch ups throughout the session, some were a little uncomfortable but not a big deal. Everyone was in a relaxed and unhurried mood and Dr. Siporin made sure all took the necessary amount of time to insure the best graft placement.

Yami and Raquel started with the most delicate area, the temporal peaks where they placed single FU's, this took a while given the very small incisions, then they moved up to the hairline and a little behind, Ismael helped more toward the end in the placement of the larger multiple FU's in the mid scalp area.

I was then cleaned and cleared to go after being given my post op instructions. I did not need any bandages, the surgery was barely noticeable, and I just put on a loose baseball cap and drove myself home. After I got home I could feel a bit of tingling on the frontal hairline, I ate a light afternoon snack and the pain went away, I realized I had not eaten since the very early morning breakfast, the food seemed to help process the anesthetics better through my system. I will mention to Dr. Siporin that it might be a good idea to give the patient a 10 minute break at some point to eat a snack. I had no pain and no tightness in the donor area whatsoever, I never even took one Tylenol much less the stronger painkillers I had because I never needed any. I slept the first night with my head elevated on two layers of pillows, not needing a single Tylenol.

 

NEXT DAY

I looked at my donor scar in the mirror the next day, I could not believe how straight and thin it is, a world of difference with my scar from my first HT which yielded 42% less FU's, different surgeons, different skills ...

There was no staining at all on my pillow case the next morning from either the donor or recipient areas, now that's what I call Ultra Refined ... After my first HT I had noticeable staining mainly from the donor area, the recipient area was also bandaged and draining slightly. I took a lukewarm bath, soaking my head in the water for ten minutes, I shampooed my hair very gently with Head and Shoulders, no rubbing just light patting, nice feeling to have clean hair. More than half of the scabs went away and the pinkish skin tone was also greatly reduced. I noticed a slight swelling on the forehead in spite of my use of frozen gel packs, so to stay ahead of the situation, right away I took the prescription of generic methylprednisolone bar pack, the swelling came down after about six hours, on the next day it was 90% gone. I suspected I would be prone to this swelling of the forehead because it happened on my first HT and I have thin blood, a "bleeder" as they like to refer to my type.

 

SECOND DAY

I took another lukewarm bath on the second day, shampooing the same way, the scabs are almost all gone and so is the pink color, the photos of the second day were taken right after my bath and they look way more red than in reality. After reading the many posts recommending wet graphcyte soaks and the others recommending dry healing I decided on a combined approach, we'll see.

I wear my hair medium to long and I let it fall over my forehead to hide the recipient sites better, the morning after the HT, as I was wiping my hair to the side (because it bugs me to feel it close to my eyes as I am not used to this) I accidentally snagged a fresh implant with my fingers, it was right on the edge of very front line and I noticed some light bleeding, it felt like a bee sting for a minute, I then realized I had dislodged it and it was stuck to a strand of hair, I pushed it back into it's hole with tweezers, it stopped the bleeding, later I noticed it came out again, this time I put it in deeper, we'll see if it survives. I am under the impression that most transplants are pretty well "glued in" after a couple of days, I must have snagged this one just right because it hurt a little.

Now I have to heal and wait, I am hoping we achieved the density I was looking for, so far everything seems very positive and I will be updating this thread and my pictures regularly.

I have the pictures taken during my donor strip excision but I decided to not post them, if interested you can PM me.

 

The second set of pics was taken almost 2 days later, most of the scabs are gone and the skin color is becoming less red, on the pictures the reds are much deeper than in reality.

 

7 DAYS UPDATE

Dr. Siporin took out the stitches one week later, no pain, all looks good.

 

2 WEEKS UPDATE

It is now two weeks since the HT, the scalp skin has been back to it's normal color for several days now, most of the new hair is still in place, and no shock loss yet, I hope it lasts. The donor area is not sore, no tightness, I have been able to sleep on either side of my head for about three days now.

 

3 WEEKS UPDATE

Some of the grafts have fallen out, almost half are gone in the hairline and on the temple points that I can see. I can still feel and see most of the others still holding on slightly deeper beyond the hairline and in the midscalp. The graft I pulled out by accident and put back in the hairline seems to still be here, I think ...

90% of the donor area scabs are gone, no pain, I am starting to get this weird sensation of the nerve fibers reconnecting in different areas around the scar.

 

One Month Update

The closure is healing nicely , I still feel some thicker scar tissue or maybe it's residual scabbing but I have no tightness or pain whatsoever.

In the recipient areas along the exposed hairline and temple points I would say that more than 80% of the hairs from the new grafts are gone. A little deeper and in the mid scalp area I can feel the hairs from the new grafts still holding on and I am guesstimating that close to 50% remain.

I have started to see some hairshock loss around the third week, it seems most of the hair falling out is very thin (miniaturized) and mostly grey, I am loosing very few thick dark hairs. My recipient area seems thinner than before the HT, and besides the shock loss I think that there might be still some light swelling expanding the scalp and resulting in more surface to cover thus contributing to the appearance of less density.

I have to be patient and hope that I experience some regrowth around the third month or so.

 

Update of 10/13/07

FYI This update is also in my Weblog

I just went for my first post op visit since the HT which took place at the end of January 2007 (except for removing the stitches). I had some shock loss for about 3 to 4 months then it slowed down. I was concerned but I could only be patient and ride it out. I can see that I am far from seeing full growth, still lacking density in most of the areas. I am sure the shock loss did not help and that's why I will probably be a late bloomer on this second HT.

Dr. Siporin agreed and gave me some perspective, this time around I'll probably have to wait 12 to 18 months before I see the full growth, in spite of having taken Finasteride for the past few years I was showing some degree of hair miniaturization on the top of the head before the HT so the shock loss was not a huge surprise but still a bummer...

So, I will have to be patient about another 10 months before I can reevaluate my final outcome, I am not complaining though, you can see from the pics what we are talking about, the temple refinements actually developed very nicely and the scar is just great.

I asked about switching from Finasteride to Dutasteride and Dr. Siporin convinced me to stay with Finasteride daily and to do the Laser twice a week for 6 weeks. I did my first laser session in his office, he does not have yet the latest hi potency laser, only an older model for now, I did 15 minutes and 24 hours later I felt a pimple coming up in a slow growth area, I had not felt that in a few weeks or more... Coincidence?? Who knows? I'll keep doing the Laser in office knowing it can't hurt and maybe help a little, I know some other clinics like using it as a complement to the HT. Maybe I should have started sooner??? I'll keep you posted after the 6 weeks go by.

Look at the 3 new pictures taken mid October 07, they show growth but density is still a work in progress.

 

 

 

[the B spot]

Thanks HK for sharing your experience with us!!!!!

 

I remember reading Pat's information and thinking that we would probably never see anyone actually get a HT with this guy.

 

I am glad you are happy and the work looks real clean.

 

I do want to make sure that I am reading your post correctly where you state that you were transplanted up to or over 40 fu's cm/2, because with your hair not being shaved it is difficult to see.

 

Anyway, I will be watching your progress with a high level of interest as it is always nice to a get a "first impression" of a new HT Doc from a fellow member and someone we trust.

 

Speedy Healing and Happy Growing my friend!!!!!

J

[HK500]

Thank you for your encouraging words B spot. My first HT gave me around 15 FU/cm2 and I was looking to get over 40FU/cm2 in the same recipient areas with this second pass. I will have to wait about a year before I can attest of the real results but the thing I noticed most until now is the huge difference between a surgeon using Ultra Refined techniques and the older techniques. My healing has been much faster so far and a much smaller impact on my body in general, all this with close to twice as many grafts.

[Bill - Seemiller]

HK500,

 

Congratulations on your HT bro. I always follow with great interest HT procedures and progress with those who post regularly on this forum. You've been a great asset, helper, and friend on this forum, so I thank you for that.

 

Looking at your before pics, I must admit, from my perspective, I would have been satisfied if I had that much hair . But we are all in different places with our needs and wants right? The HT looks clean, though I agree with B...it's difficult to see behind all that native hair! Hopefully you will experience no shockloss of any native hair.

 

The one picture showing the temple placements on the left side does appear, however, that there might be an unnatural gap between your natural and transplanted hair. It might just be the picture, but it looks like the doc placed some grafts in the temple area and then left a space behind it before your natural hair? Correct me if I'm wrong, but based on the picture, that's what I'm seeing.

 

As B Spot said, I'll be following this also with great interest, partly because I'm here to cheer you on as your fellow friend and also, it will be nice to see first hand work done by Dr. Siporin, since I've never seen work done by him before.

 

Keep us posted bro.

 

Bill

[HK500]

Thanks Bill for the nice words. You are very observant, I also find a bit of a gap on the left temple. I remember the Dr told me the day of the HT that he would fill any temple area for free later if it ended up showing separation from the rest of the hair, I did not make anything of it then but now the left side is a bit of a question mark. For now I trust his judgement and I'll have to wait and see what happens. I am now at 2 weeks and I will post pictures at one month.

[hairbank]

HK-

 

Hey, congrats to you, my friend. I don't know if you shared that you were going in but if so, I missed it. Looks like things went very nicely for you.

 

I kind of noticed the slight temple gap Bill mentioned but I'm with you, trust the Doc and go from there. Nice of him to offer to take care of it for free if there was separation later.

 

The work really looks good and it appears you had nice closure in the donor area. Grow quick and heal well! Ditto Bill's comments............thanks for your contributions on HTN. I look forward to following your progress.

[NervousNelly]

HK500,

 

The work does look great. It should help to make a considerable change to the hairline. Glad to see that you are happy with your decision to go with doc Siporin. It shows us that we have to have faith in what Pat is saying. Look forward to following your progress.

[Pat - Community Publisher]

HK500,

 

Thanks for sharing your experience is such excellent detail. You have contributed a great deal to this community so it's great to see you get top flight results.

 

Although I must agree that upon looking at your photos I was also struck by the seperation between the transplanted hair and your hair in your temporal points. I would have thought that Dr. Siporin would have allocated more grafts to this area rather than placing them into the central areas. I'm going to ask him about this.

 

Your experience and the photos you present are very much like what I saw and experienced when I saw him perform surgery (see my report at http://www.hairrestorationnetwork.com/eve/showthread.php?t=143210). The work if very refined and the donor closure is excellent.

 

I think in time with more first hand reports like this Dr. Siporin should be given serious consideration for membership in the Coalition.

 

I look forward to seeing your progress.

 

Best wishes for great growth. Pat

[HK500]

Thanks for asking Ken about this one area Pat, please let me know what you hear either way.

[HK500]

Guys please read my recent update in my album and in the web log (text only no new pictures, I did not think they would show much change but I could post some, let me know) and feel free to chime in, especially about the exposed areas losing more of the new hair???

The shock loss of miniaturized hair is pretty normal, right? Do I get them back? How long? It is about 3 months when you start seeing some activity and then at six months for another spurt, correct?

Am I crazy to think that there is still some light swelling of the scalp in the recipient area contributing to give the appearance of less density because the same amount of hair covers a slightly expanded scalp?

I think I already know some of the answers but it would be nice if you would confirm or let me know otherwise.

[the B spot]

HK--- everyone is a bit different and our bodies react in various ways to surgery.

 

I think it is a reasonable expectation to notice a thinner look after your HT, especially if you are experiencing a bit of shockloss.

 

Another thing to consider is that the small implanted grafts do lend a considerable amount of density in the 2-3 weeks post-op.

 

It just might be that because they are falling out, along with some shockoss, you feel you look thinner.

 

Let me tell you from experience that your probably staring at your hair more than ever and over-analyzing every cm of transplanted scalp!!!!!

 

This is normal!!!!!!!

 

You have to relax and put it out of your mind. There is nothing you or anyone else can do at this point but wait.

 

Someone asked me if the surgery was the most difficult part of all of this--- I say no.

 

The toughest part is dropping 5-10K and sitting on your arse for 3 months waiting for hair to sprout!!!!!

 

Anyway, having no experience with your Doc, I cannot comment on the level of trauma your scalp endured. My slight swelling and post-op redness dissipated rapidly. Others take time and perhaps you are one of those guys who take a bit longer to get things back in proper order.

 

I think your fine and at this stage of the game, relax, have a beer (BTW, I can wire you 5 bucks so it's on me, if you like!), and just focus on other things.

 

Happy Healing Bro'

J

 

PM me if you like.

[HK500]

Thanks Bspot, I'll agree that my anxiety is getting on my nerves and I'll tend to over analyse all the details. So far I have healed better than average and I have no complaints, I'll try to wait patiently until month 3 when I hope to see a spurt.

It's so funny .... I can advise newbies in such a cool and collected way but when it comes to my own situation I seem to lose this perspective in judgement and everything seems confused .... That's why my buddies call me for the best advice on dealing with girlfriends situations but I can't seem to apply the same principles with a clear mind when I am faced with a GF dilemma ... I guess our emotions get the better of us.

[hairbank]

Hey HK,

 

Hang in there, my friend! If I remember correctly, this point for me (around the 3-4 week mark) was tough because most of the grafts had shed and I was looking pretty sparse on top.

 

Everyone's different with shock loss. IMO, most shocked hair returns, however, if it is MPB hair that was close to being gone it may not........kind of an unknown. Personally, my shocked hair from HT#2 came back at the 2 month and 1 week mark (yes, I was counting the days/minutes/seconds, then...!).

 

Growth timing again is a huge variable. I had some very early growth around 6-7 weeks, but nothing really noticable util around 3 months............then it was pretty slow and gradual. I do believe crownwork is slower than most, since yours was temple/frontal 1/3 maybe you'll start a little quicker???

 

I wouldn't think you have any swelling left after a couple of weeks but who knows. Did you have much swelling in general?

 

Try to stop looking in the mirror..................do something to get your mind off it if possible. For evidence of growth, try to meticulously document your progress with pics.............set the camera on a base for stability and try to take the same angles/positions each month under the same lighting conditions so you can see what's going on?

 

Chin up, pal!

[HK500]

Thanks Hairbank, I have to dwell on other stuff I know.

[Bill - Seemiller]

HK500,

 

I know what you mean my friend. You have all the head knowledge...which believe it or not...IS helping you. Imagine how anxious you'd be if you didn't know what to expect? . Everyone experiences anxiety and handles it differently. Just try to remember what you know and use this forum as a support for you. I think if you look at my pictures, especially my 2nd surgery, you'll see I experienced a LOT of shockloss and I felt awful about it. I experienced all kinds of doubts "would it grow back?" "did I make a mistake?" etc. My wife got to hear ALL about my anxieties. You'll even see some of my posts if you read through all 1 billion of them that I expressed my disappointment and concern on this forum. It's all part of being human man. Head knowledge helps, but it doesn't mean that we don't experience doubts. Hang in there buddy. We're here if you need us.

 

Bill

[HK500]

Thanks Bill, It's funny but I think I was a bit less anxious after my 1st. HT when I had not found this forum yet and knew so little about everything. I must be over analyzing every detail now. Thank you all for your support, I know all will be fine.

[Guest Kenneth Siporin]

I must apologize to all have had questions regarding this HT. I am new to the network, and a Technophobe, so I am just learning the system. Rest assured, I am a much better surgeon than I am a computer techy. In any event, there were many questions regarding them temporal hair line in this nice patient, and I wanted to share some very important points with everybody. First, it is important to realize that photographs can be very deceiving. I am not suggesting that photographs are not important to examine, because they are, but it is important to understand the limitations of photography, and that they do not tell the entire truth. Photographs can give the impression of much greater density than is actually achieved. In this particular case, I did put about 150 fu's in each temporal peak, in a dense packing, and as I approached his native hair, I feathered the density back in the areas where I could possibly do more damagae than good. I did however place grafts back in the hairline, but the feathered density does not show up very well on the photographs. Especially in the temporal area where I am using only one hair grafts. I would never abrubtly stop grafts in a straight line, and I am sorry that people perceived that as the case. I look forward to posting the follow up photos to prove my point, and I look forward to participating on the network on a more consistent basis. I enjoy

what I do , and I enjoy the interactions with patients, who have the same fears, emotions and concerns that I had, and still do have. Anybody can e mail me at kdsiporin@aol.com, and I would be glad to respond to you.

Thanks, and good luck guys,

Ken Siporin, M.D., F.A.C.S.

[Guest Kenneth Siporin]

Thanks HK500 for sharing with everybody your experience. I must admit, I have been very lax about getting involved with the network, as after long days in the o.r., finding the extra time to go on line can be difficult, but I am going to make a real effort to participate more in this very meaningful and informative forum. Thanks to Pat and all of you who contribute, and I hope to be a source of infomation and inspiration for many of you.

Take care,

Ken Siporin,M.D.

[Pat - Community Publisher]

Dr. Siporin,

 

Thank you for your explanation. Upon looking at the photos in enlarged view I can see what you mean.

 

We all look forward to seeing more of you on this forum. I know that you will find that our forum members really appreciate feedback, advice and photos posted by leading physicians.

 

I'm confident that as people see more of your results and hear from more of your patients that they will come to better understand why you are recommended on our community. I expect that in time you will develop a strong and proven reputation for ultra refined results and will then be invited to become a member of the Coalition of Indepdent Hair Restoration Physicians.

 

Best regards, Pat

[the B spot]

VERY refreshing response by Dr. Siporin.

 

I am very glad that a trusted member of this community HK500 was able to display his work and Dr. Siporin was able to come on here and offer an very nice explanation of his methodology and thought process.

 

Given the hoity-toity nature of ANYTHING So. Cal, (as displayed by McAndrews), I personally find it refreshing to read the down to earth style Dr. Siporin displays.

 

Of course, I hope to see an influx of clear before, during and post-op pics of patients suffering from variant degrees of baldness.

 

That will be nice as well.

 

Thanks Dr and Thanks Pat!!!!!

 

Take Care,

[HK500]

Hello gang, it's been a while I know but I finally just updated my album and my weblog. I welcome your comments.

[NervousNelly]

Hk500

 

Good to have you back my friend. I guess I have to be honest and say that it is challenging to see the difference between pre and post results. Sometimes pics don't give the true idea of things especially someone that has a lot of native hair. I can comment on the naturalness of the hairline and how clean it is but it is very challenging to see a cosmetic difference in the density of things with the photos provided. We would need several photos in the same position and lighting as the pre photos.

 

Sorry bud but I couldnt bs just because I think you are a good guy. In this case I would just have to go with what you tell us and trust your judgement. Possibly you could demonstrate some other photos and we can go from there. The temple refinement and the scar though are definitely super. He did a great job and I'm sure that they are up to the standards you expected.

 

NN

[HK500]

Hi NN,

Thank you and it's nice to see you here too. Yes, I know, these pics don't show much of a difference, at least I did not use a flash but I need to take close ups. I will do this in the next few days and post another update. In general I do not think this HT has yet yielded enough to make a noticeable difference but I am so biased that I can't even tell any more. You guys will tell me after I post better pics.

[notgoing2gobald]

HK,

 

Ive seen your photos while researching this site in the past. Honestly, even in the pre ht#1 photo it appears that you have ALOT of hair. I think part of this is due to the styling and length of the hair. But, regardless you DO have ALOT of hair now too! It looks great. You look like one of those guys who if I saw in public somewhere I would say to myself: how did that lucky bastard keep so much hair!?!? It looks great, but it is hard to tell by those photos how much loss you had before, I think in part because your hair was so long too so that its hard to tell. Either way looks good.

[HK500]

Thank you NotGoing,

I have been wearing my hair longer to hide the HT and I have kept it fairly long since and that makes it harder to detect much difference. I will take some better pics soon and post them.