Feller repair - 7 month update

[hair2stay]

Some of you had been following my case, and I apologize for the lack of updates. I have been holding out for the best, but my patience is being put to test. You can all be the judge of these photos. Personally, I feel that the cosmetic improvement is minimal at this time, though I know I still have a ways to go. The old grafts prior to surgery have grown to styling length and there is some noticeable growth of newly transplanted hairs.

 

 

 

[hair2stay]

http://www.hairrestorationnetwork.com/eve/showthread.php?t=147822

 

Follow above link to find previos gallery and realted threads

 

H2

[NervousNelly]

For me to give an honest opinion of the situation is there anyway that you can provide similar side by side photos of before and after. So far it does appear like minimal growth but at 7 months believe it or not it is still early.

[PLEASE GROW PLEASE]

What NN said is so true .ITS NOT OVER!

Im a classic repair case example. I didnt see hardly any growth until 6 months and even then it was minimal .

Im at 8 months now and things are looking SO much better,with new hairs seeming to sprout everyday.

I starting using a combination of Retin a and the foam in month 5. Dont know if that was the reason Ive had this big growth spurt or was just a slowgrower but it sure didnt hurt.

[nobuzz4me]

H2stay

 

You are very fortunate to have such thick hair, you will turmn out fine.

[hair2stay]

NN, sure I can add some photos. Did you follow the link to my previous gallery? There you will get a great glimpse of before Feller surgery. The only difference in the two sets, is my hair was still wet in the 2nd set. I'll re-shoot photos with more dry hair and lift it up with a comb just as I did in the first gallery.

 

FYI, I have been applying 5% rogaine 2x daily before and after surgery once the healing was underway and ready to receive the applications.

 

H2

[max1010]

Hi H2,

 

It looks like you may very good results. Like the other posters said it's at the 7 month mark, more improvement is still to come.

 

You are fortunate to have such thick hair.

 

BTW, I sent you a PM.

[Dr. Alan Feller]

Hair2stay,

I understand your furstration and I know how difficult it is to wait for your hair to grow. I don't minimize how much you are bothered as your post makes it pretty clear, but perhaps I can make you feel a bit better by simply putting together a few of the photos you put up side by side.

 

For those out there who don't know much about your case, hair2stay had 5 surgeries prior to visiting me for repair work. His donor area was pretty well tapped out and was loaded down with scar tissue. Fortunately, he still had some good hair on the sides of his scalp which gave us enough to produce 1500 follicular units. It would have been nice to have more, but this is what he had to work with.

Most of his old work was of the plug variety and while the cosmetic result from afar was actually pretty impressive, his hair had the classic "corn row" look when the hair was pulled back. He also had a ridge of scarring from confluence of scar right on and behind the hairline.

From the photos I think you are doing quite well. I see that you are concerned about the gap of scar between the first row of plugs and the second, but like I said on the day of your procedure, that's probably the last area that will grow. I never rely solely on scar tissue to execute a repair when I don't have to and that's why I cut down your first row of plugs on the hairline and filled in as many gaps as I could there because that was the most important area to fill if you were going to pull your hair back.

As the other posters wrote, you are only at 7 months and still have a way to go, especially because you had so much surgery prior to visiting me.

 

Click the links to view some side by side photos that may help to make you feel a bit better. Stay in touch, and remember, you can always call the office and voice ANY concerns about your growth and perhaps I have something to tell you that may make the wait a little easier.

 

http://www.fellermedicaldata.com/images/hair2stay/beforeafter1.jpg

http://www.fellermedicaldata.com/images/hair2stay/beforeafter2.jpg

http://www.fellermedicaldata.com/images/hair2stay/beforeafter3.jpg

http://www.fellermedicaldata.com/images/hair2stay/beforeafter4.jpg

http://www.fellermedicaldata.com/images/hair2stay/beforeafter5.jpg

http://www.fellermedicaldata.com/images/hair2stay/beforeafter6.jpg

[hairthere]

Hair2stay, those side-by-side comparisons show a HUGE improvement, imo. you should be psyched! your hair looks awesome and you still have plenty of growth left ahead of you...

[hair2stay]

Thank you all for your responses. I do realize that there is a positive improvement in my case. However the hiarline still has much to be desired at this juncture, particularly the left side. I will continue to wait this out and withhold judgement. However there is one thing, Dr Feller in your reply that greatly concerns me.

 

"His donor area was pretty well tapped out and was loaded down with scar tissue. Fortunately, he still had some good hair on the sides of his scalp which gave us enough to produce 1500 follicular units. It would have been nice to have more, but this is what he had to work with."

 

At no time did you state that you wanted to do anything more than 1500 grafts, nor did you ever state to me before, during or after the surgery that 1500 grafts was not enough to achieve the desired results. Based on your comment here, one could infer that you are implying that more than 1500 grafts is necessary to reach a desired end, and that you feel the donor supply is depleted. I find this contradictory to our consultation.

[Dr. Alan Feller]

Yes, I see what you mean. It can be read that way. My bad.

 

I would NOT have tried to place more grafts in your recipient area (whether it would have been easy or not) because of the scarring from the prior plugs.

 

Keep growing and thickening and if you get the chance I'd like to see the growth for myself after the New Year if you find yourself in town.

 

Grow well.

 

Dr. F

[hair2stay]

Thanks Doc,

 

Just want to be clear on this. The left side of my head was virgin and had no prior surgeries. In consultation, as I recall, you felt that donor hair would not be a problem looking ahead into future years. After seeing things up close in surgery, has your staqnce changed?

 

Can you please elaborate on the logic in not loading up the area in front of the hairline in this past surgery? I would think bloodflow would be a non issue in this area because there were no previous grafts placed there.

 

Thank you,

 

H2

[Dr. Alan Feller]

You had no surgery on your left side? There is a wall of scar tissue running right through it.

Give me a call at the office tomorrow after 11:30am or I'll call you and we'll get on the same page. Typing takes too long and I'm not catching your concerns clearly.

[spoon]

Originally posted by Dr. Alan Feller:

You had no surgery on your left side? There is a wall of scar tissue running right through it.

Give me a call at the office tomorrow after 11:30am or I'll call you and we'll get on the same page. Typing takes too long and I'm not catching your concerns clearly.

Maybe he meant the left side of his DONOR was virgin? That's my interpretation.

[Bill - Seemiller]

hair2stay,

 

I do agree that your hair has improved since your surgery with Dr. Feller though admittedly, when your hair is styled back, the hairline isn't "perfect". But then again, perfection is not something that is often achievable, especially for repair work.

 

As others have stated however, 7 months is still too early to make a final evaluation of your surgery - so try to hang in there and wait until at least 12 months to make a proper evaluation of your surgery.

 

I see that Dr. Feller has already engaged you in discussion on this thread which is great. I trust that Dr. Feller will continue to take good care of you in this situation.

 

Please keep us posted.

 

Bill

[John_in_NC]

is there an after surgery shot so we can see where the 1500 grafts were placed?

[Dr. Alan Feller]

Immediate post op photos of Hair2stay. Any hair in his old plugs were shaved to the skin with a straight razor. All visible hair on the hairline are solely transplants:

 

http://www.fellermedicaldata.com/images/hair2stay/8.jpg

http://www.fellermedicaldata.com/images/hair2stay/9.jpg

http://www.fellermedicaldata.com/images/hair2stay/10.jpg

http://www.fellermedicaldata.com/images/hair2stay/11.jpg

[Bill - Seemiller]

Thanks Dr. Feller for posting some additional before/after photos. Sometimes doing a side by side comparison is the only way to show just how far a patient has come.

 

hair2stay,

 

Looking at the above before/after pictures posted by Dr. Feller, it is evident that there has indeed already been a significant cosmetic improvement. And at 7 months you are still early so you can expect to see additional hair growth and maturation of the transplanted hairs.

 

You may not receive a "perfect" hairline with this surgery - but from what I see so far, it is a definite improvement.

 

Bill

[hair2stay]

I agree, improvement is noticeable. Hairline is what I draw into question and what will be watched for improved growth as we move forward. A natural hairline has been what I have been after from day one, and that my friends I have made explicitly clear to every doctor I have ever visited. Why we have trouble getting to that point I can not answer??? That is why I am trying to understand better why Dr Feller did not work more in front of the existing hairline. I still am unclear on this...

 

Sorry if I was unclear on the previous post, the DONOR area was virgin on the left side of my head prior to the most recent surgery, NOT the recipient.

 

Dr Feller has been most professional in the handling of this case and his contributions to this thread. I don't think there is any other Dr where one would see this sort of interaction. I have not yet had the opportunity to have a conversation with him, though did leave a message, and will again try.

 

Thank you all for your contributions to this thread.

 

H2

[..]

Would plug distribution been the better option in this case !?

[Bill - Seemiller]

hair2stay,

 

It is cleary from your previous work that your hairline was far from natural, but one thing you have to understand is that correcting poor work is not nearly as cut and dry as you would like it to be. A high level of scar tissue from previous work sometimes can lessen growth yield and the work of camoflauging the old plugs certainly has and will continue to soften the hairline. But if you are looking for perfection, your expectations are simply too high. The good news is however, there is significant improvement and in the event that it doesn't turn out exactly as you would like, you can probably go for a second pass to further refine it.

 

Please keep us posted on your progres.

 

Bill

[balody]

im having trouble understanding this case,but going back through the history i think ive got it now.

as i understand it hair2stay wasnt happy with his previous surgeries and asked dr feller to drop the hairline to cover old work.right so far?dr feller then said he would be better served filling in amoungst the old work and now h2s is saying he is not happy with the yeild and his old hairline is still on show?am i still on the same page?

h2s have you any pics before any surgery ?what norwood was you?i personally think your hair looks good,the only time it looks pluggy is when your pulling it up with the comb and that is surely the effect of the teeth on the comb.or have i got it all arse about face?

[Dr. Alan Feller]

Balody,

You are dead on. I couldn't have summerized it better.

If you click on the links in the first page you will see I put his before photos next to his recent 7 month after photos. The first few are with his hair wet in the after photos, the last one or two are with the hair dry. Excellent photography and he kept the angles almost exactly the same from before to after.

 

I opted not to remove the plugs because, as Bill noted, it would have caused even more trouble. Plugs that size don't get removed without a fight, and he would have been left with yet even MORE scar. To me, the right thing to do was to fill in the gaps between the plugs on the hairline and behind. This would build the "foundation" that he needed. IF this does not satisfy him then, as noted by Bill, he would do one more round just in front with pure singles in a super dense pack. Had I started out by doing the front it would not have helped because of the space behind.

 

H2 has been through the ringer and I don't blame him if his patience has worn thin. I'd feel the same way if I had 5 prior surgeries with his amount of hair and didn't reach my goal. The problem is there was no real continuity of care from procedure to procedure AND the techniques used on him were ancient. He's lucky he looked as good as he did. What saved him was that nice silky hair he has. Had he had a course thicker hair he would have been in some real trouble.

 

It's been a long dark tunnel for him, but rays of daylight are beginnig to shine through and he should be able to put this all behind him.

[balody]

thanks for that dr f.

[hair2stay]

I'm with you guys and I really appreciate what direction this thread has taken. This is the best explanation of Dr Feller's reasoning yet and I am thankful for that.

 

Though, in light of this, never was there discussion of a second round in front of the hairline as being a part of the treatment plan, and had there been, my decision process may have been different. I anticipated that this could be done in conjunction with what took place, I felt I got that out of the consultation as well, yet it was not until day of surgery where it became evident the doctor was headed in the direction as detailed in the previous post.

 

At the point, I had no choice but to trust in the good doctor. A precarious place to be, I had second thoughts at that moment, and had I not had the time constraints facing me with the scheduling of this last surgery I may have walked. Instead throughout the surgery I continually expressed my desire to not see the old plugs in the hairline, and I was reassured that our goals were the same.

 

Now I will wait this out further, but can you all undertstand my frustration a bit better? It's not the poor quality of the old work that is frustrating me, it is the promises made with regard to the new work that has left me wanting more.

 

Perhaps my expectations were high going into this last surgery, presuming that one surgery could do the trick. Perhaps a better reality check was in order going into this? I think this again demonstrates the importance that doctors must err to the side of deflating patients' expectactions and be as blunt as possible.

 

H2