My FUE With Dr. Rahal 3000+ Grafts (Large Procedure)

[Sean]

Spanker, Zen, thanks for your feedback. I appreciate it fellas.

 

Spanker, honestly, some a person can get caught off guard with. I know I am not on 12 month yet but it is getting hard emotionally as I am looking for that luscious dense solid standalone frontal zone, which I do not have yet based on recipient specs/pre-op targets. Right now, some people say it may have to do with things not being fully even yet, the growth, and sparsity that seems to be evident. People have suggested a lot of things and various tips to try to work around it for the time being. It really means an enormous amount to me and I just want to be worry/stress free at the conclusion of the 12 month mark. The doc did tell me in early May it will continue to grow/thick/mature etc in early May. In the end, I wish it turns out to be a prime FUE example of a solid high density restoration that helps everyone who needs similar work.

 

Zen, will do bud. Thanks for the boost to stay positive. Man, I tell ya, it gets tough, especially when you sacrifice a lot. For some people, employment is hampered, the process itself isn't completely a piece of cake, it takes some serious dough (well to me it was), and lots of post op care and commitment. If you have a job, then your vacation days are used for the healing. You are using your own resources by moving them one place to the other on your scalp and those resources are precious. But you do all of that to get the one key thing everyone wants, hair, and to style it your way flexibly. So, bottom line is you just want everything to go smooth. For the past couple of months, I have received various comments in person, forums it's mixed, privately something else. However, I have been waiting patiently as the process takes 12 months but it isn't all that easy. Could there still be a drastic difference at 12 months? Most give mixed views. I try not to be overly stressed out about it, but I think any other person would be after such an investment. Some people pay 5K, 10K, 15K, for a one day hit, I think stress is increased if you are well over the $16k+ mark lol. Anyway, after taking part in a war zone while in the service, you really try to look towards the positive and stress free things in life, in my case, wanting to create the new me with a look/style I was robbed of years ago due to hairloss. I even put some media etc related and other interviews on hold due to it. So, I want to enjoy the new me with no one looking at my head in an in depth conversation, no one making thinning or receding comments, and no one saying a damn thing to me in person or anywhere about it after all this. Patience is important and I remind myself because there are a lot of large gatherings I need to go to in the future too, such as weddings, and I want to be able to walk with my head up under any condition any light with no worries you know. The waiting is honestly a pain.

[Sean]

Hey Sean.....hope all is well. Where did you land on using propecia? I am seriously thinking about stopping. I have not had noticeable side effects since the first few months when I experienced some mild discomfort on occasion. However, I am just concerned about the drug since every report of recent is quite negative on it. It makes me wonder what other impact it has on our overall health in the long run.

 

 

Orlhair, hope your doing outstanding. About propecia, it's a tough call. I can see what you mean and there are concerns but will stopping it cause a lot of harm? I don't know. Hair-wise, what if things go downhill? David the moderator hasn't reported anything after stopping. You should send him a message to ask him if he noticed anything new. I think he stopped quite a while ago.

 

I just don't want my hair to be taken away from me when stopping. Concern is what if it goes against your transplant? At the same time, I can understand you since the side effect being a serious one might be more important then that. You shouldn't have any discomfort like that. Did you talk to Dr. Shapiro about it? Before you even stop, ask to see if you taper it down or stop immediately. Some say don't do it right away, some say taper it, some say don't stop at all. I really don't know what to tell you at this point and I don't want to give you any wrong info about that. I can understand your worries though as I am just kind of debating the "brain fog" type issue. It's bothersome, but I don't know how to pinpoint it by being certain that's the cause. Are you on any saw palmetto or etc along with finasteride? The one thing that alarms me is that a lot of folks have an increased side effect issue when they take finasteride and saw palmetto combined. I just know this because I spoke with a doctor of mine at the Veterans clinic, and they have patients that use it, other medications, along with finasteride. Then again, the guys are really taking 5mg a day vs 1mg of what we take for hair. The recent report of the drug has everyone concerned and it being fairly new for hair loss, it is something to think about. It's not like something that was used as long as penicillin or something. Some people found out of sides years later. So, it's important to monitor this. Keep me updated though pal, I'd like to know how things go.

[wb280]

hi buddy, actually ur growth seems to be in line with the timeline u set. I know its tough to just wait but there is nothing much u can do now. I think u look great at your age buddy, if thats of any consolation I would kill to have your current hair line when i was your age Whatever it is, take pride that u made the best decision at that point of time and look forward, not backwards

cheers mate!

[orlhair1]

Sean, things are good with me, thanks. I did have a fair amount of thickening and maturity from months 9-12. However, it is subtle and I don't think that I had more hairs grow in, or at least if I did, it probably was not much. So I do think that it does get better over the last part of the first year. That said, I do think you result is really nice. HT rarely produce the perfect result, but when you compare where you started to where you are now, it is quite a transformation. That is the perspective that I have with my surgery. People like us who have had a HT and done so much research notice a lot more than the average person ever would. So be patient and I think you will continue to see some improvement, but I do agree that it is not likely that there will be dramatic change.

 

On the fin issue, short periods of groin discomfort are a relatively common side effect, which I did have for a few days a couple of times at about the 5 or 6 month mark of being on the drug. Others on the forum have reported the same thing. Since then, I have not had any sides. When I saw Dr. Shapiro at the 6 month mark, he recommended that I keep using it and suggested that if I had any sides that I could consider a lower frequency (every other day or 3 times per week), which is effective for a lot of people and many times will eliminate the sides. It is such a tough call. I don't like taking it because of the knowns and the unknowns, but I do want to hang on to my native hair as long as possible to either delay or avoid needing additional work done. I go back and forth, but for now I am still on it.

[zenmunk]

Sean,

 

wb280 is on the money. You do look great, and you've made good progress. Perhaps not what you were expecting so far, but far from a failure. Try to take some pleasure in that despite the less-than-sensitive critiques of others.

 

That said, I completely understand where you're coming from regarding all of the sacrifices and investment you've made to achieve your goal and worrying that it may not happen with one procedure. Those are natural and justified feelings.

 

One of the hardest things to do in life is to let go of the worry and stress regarding things we simply cannot control. It's a challenge everyday, but we really don't have a choice but to meet that challenge head-on. This is one of those things. You picked one of the best docs in the world, and you followed post-procedure instructions to the tee. What else can you do? My advice is to keep working hard on accepting what you cannot currently change, and give it the full 12 months. If you're not satisfied at that time, then talk to Dr. Rahal about your options. He seems like a stand-up guy, and I'm sure you'll be able to find a workable solution.

 

As always, best of luck.

 

z

 

P.S. Regarding finasteride use, I'd suggest to anyone who has been on it for while and experiencing sides to lower the dose first before stopping. Experiment to find the lowest dose which preserves your hair. Try 0.5 mg per day for a few months. That reduces fin intake from 7mg per week to 3.5mg per week. See how that goes regarding hair preservation and reducing sides. If your hair is holding, but sides are still plaguing you, then try 0.5 mg M, W, F, Sun; that'll take it down to 2mg per week. Some people try 1mg M, W, F. There are lots of regimens to explore. It's worth it to experiment before completely discontinuing the meds. You may just be able to find a dosage that works for you. The other advantage to that approach is if you ultimately end up stopping, then you've followed a sort of tappering-off regimen which some have recommended as a good way to stop.

 

If you stop completely, odds are you will lose your hair. Of course, some people who are not genetically predisposed to advanced MPB take fin. as as a preventive. So, in their cases, the fin. wasn't really doing a whole lot to help them preserve their hair. They didn't really need it much or at all, but they didn't know that, and that's the point. Can you be sure you're one of them? I know I can't.

 

Unfortunately, we can't go by how others experience the drug. Even though David the moderator hasn't reported anything after stopping, doesn't mean you won't. Also, it's not easy to measure hair loss unless you experience a massive shed. Often, it's an insidious process. So, you may think you're doing OK after you stop, but you are actually losing hair, and eventually you will notice it.

 

Just my $0.02. To each his own.

[Sean]

10 Month Update

 

Photos taken yesterday 7/17/2012. I haven't cut my hair since my last haircut to see how things look when grown out a little bit more. The hair is DRY in all of them. I'll take more photos later or when I get a cut soon. I really want to show the donor area as well. Thanks for the feedback everyone.

 

You can expand these photos as well to their original size by clicking the bar above each photo.

Edited July 20, 2012 by Sean

[Sean]

More 10 Month Photos

 

Taken yesterday 7/17/2012

 

 

As always, thank you everyone for the feedback.

Edited July 20, 2012 by Sean

[aim4hair]

Hey Sean,

I hope by the 12th month you will get the result you desire.

 

One question though, if you did not get full growth and you not really satisfied with the result, would dr. Rahal do a touch up session for free ?

[zenmunk]

Sean,

 

Thanks for the photo update! I think the photo which best illustrates what concerns you is post #286, 3rd photo from the top. It's not bad by any means, but I do agree your concerns are justified. If it doesn't improve by month 12, given the amount of grafts you had implanted, then I'm sorry to say you'll definitely have a legitimate gripe, and hopefully Dr. Rahal will make good on it. Obviously, I'm no expert. Just my opinion. Of course, you'd have to try to determine if you've lost any native hair during the past 10 months despite finasteride use.

 

That said, your hair in its present condition is nothing to be embarrassed about. It still looks better than the majority of the guys on this site (myself included).

 

z

[Spanker]

Sean,

 

I went back and looked at your immediate post ops and I have to say it looks like this surgery didn't work out for you. I know it has not been 12 months yet, but the final result is not looking too good. It seems that the places that are thin that had grafts placed, which was not a huge are to begin with.

 

I still think that Dr. Rahal is one of the best. Although he can't give you the grafts that were lost back to you, I hope that he does the right thing and gives it another shot, if that is what you decide.

 

Like is has been said already though, you had a nice head of hair to begin with, and even pre-op, had nice hair.

[orlhair1]

Sean, I agree with the other posts. You will probably see some thickening and maturing of the transplanted hairs, but I doubt you will see substantially more hairs grow in at this point. I agree with Zenmunk and Spanker that your hair looks good and natural overall....but I know you are not where you wanted to be with the areas you addressesd in your surgery which is what is disappointing for you.

[HARIRI]

Bro Sean, with all of my respect to Dr. Rahal as the best strip surgeon alive IMO. I do think his Mega session FUE on you didn't yield well. It doesn't look at all a 3000 grafts job as I don't see any real difference between the Pre-op and one year post op. Look at my case as you can see the big change I had with ONLY 2500 grafts. In your case, your hairline was much better than me but you consumed much more grafts. You were promised a hairline of 60% or more but I can see its around 40%. I think this FUE session didn't work out well with you because of three reasons:-

 

1) The 3000+ grafts session was done in one day "usually it should be done in two days"

2) A motorized tool was used for the extraction "lower graft survival rate"

3) Maybe Dr.Rahal didn't extract all of these 3000 grafts himself.

 

I think you really deserve a free FUE session of at least 1500 grafts for the first 2 cm of your hairline but make sure this time to ask them to be done manually by Dr. Rahal only. I know you feel somehow depressed with all the life-saving money spent but I'm sure that Dr. Rahal is kind and decent enough to compensate you with some touch ups. You really need to resolve your hairline, Hairline is the most important element that need to be taken care of, even future medications could solve other thinning areas but the hairline remains the HT baby.

 

I hope Matt J can give you an official reply on your thread as you are one of the most popular thread in this forum with 37,363 views and 290 replies.

Edited July 20, 2012 by HARIRI

[wb280]

Sean, i couldn't agree more with orlhair. You do have very good hair but thats not a fair comment. Its like 20 yrs down the road i would be thrilled to have whatever hair i have now. Having said that, it does look like there wasnt' that much of a 'wow! what a transformation! ' kind of result.

 

I know people always say that the thickening and maturing would continue till as late as 18mths after HT but at least for me, it did not happen. Hence i really cannot force myself to say something for the sake of saying it.

 

As for factors which might affect ( which Hariri wrote ), well, we will nvr know but i goto agree with him that for a 3k ish FUE procedure, i do notice that its always done in 2 days rather than 1 but i cannot label that as a reason. Anyway, like me, u will in the end get tired of speculating on the reasons and look fwd as to how to get the mane u wanted. Its tough bro, i feel for u, i have been in that same scenario albeit with much worse results and hair line

[headbangerguy]

Hey Sean, sorry that you're not happy with the result so far. Definitely below the standard that we know Dr Rahal has set the bar for hairline/FUE results. Majority of his patients chose him because of the awesome hairline that we are accustomed to see. And you don't have it so far.

 

Still rooting for you to get it after few more months but those who got great results already had great results by 6 months or so. I always think of youngandy (Hair Restoration Journal for youngandy - 6 months update), who at 3 months was already awesome, as Dr Rahal's standard for FUE/hairline although it's unfair to compare due to a number of variables involved. I still envy his results though.

 

Goodluck brother.

Edited July 19, 2012 by headbangerguy
tiny

[headbangerguy]

Hey brother Hariri,

 

The only thing unusual for Sean is the large amount of FUE.

 

The last 2 reasons are I think standards for every FUE with Dr Rahal.

 

But I'm also interested to see what's the head-to-head study between the motorized tool and the non-motorized method.

 

 

 

1) The 3000+ grafts session was done in one day "usually it should be done in two days"

2) A motorized tool was used for the extraction "lower graft survival rate"

3) Maybe Dr.Rahal didn't extract all of these 3000 grafts himself.

 

 

[chrisdav]

You have still got a couple of months yet til 12 months so I would wait until then Sean.

 

There is still room for more thickening and maturing but regarding growth I don't think there will be much more growth as Orlhair said.

 

It was a larger session(3000) on one day and things may have been different in hindsight if it was spread over two days etc but you cannot do anything about that now so you just need to review it at 12 months and form a plan of action with Dr Rahal to hopefully achieve the result you want.

 

I have said this countless times that every excellent surgeon will have unhappy patients, it's normal and there has been a lot of discussion over large sessions of this kind.

 

I would wait until 12 months then review the situation with MattJ and Dr Rahal as they are both top professionals.

[orlhair1]

I think it is difficult to know the reasons why it worked out like it did. With all due respect to Hariri, I don't think any of us are really qualified to know. There are many highly respected surgeons who use the same motorized punch and achieve great consistent results. Even in Hariri's case which was strip, he did not get the yield/density he was hoping for, although his result looks really good to me. I think this just illustrates that HT is not an exact science. We all get very excited and blown away by the "wow" results that are posted, but they are "wow" because they are not the average HT result, even with top surgeons. Sean, worst case scenario, you can have a small touch up procedure and you will be fine long term. I know it is not what you wanted to do, but it really is not that unusual. Try not to stress over it...you will be all good my friend.

[SugarHighs]

I think it is difficult to know the reasons why it worked out like it did. With all due respect to Hariri, I don't think any of us are really qualified to know. There are many highly respected surgeons who use the same motorized punch and achieve great consistent results. Even in Hariri's case which was strip, he did not get the yield/density he was hoping for, although his result looks really good to me. I think this just illustrates that HT is not an exact science. We all get very excited and blown away by the "wow" results that are posted, but they are "wow" because they are not the average HT result, even with top surgeons. Sean, worst case scenario, you can have a small touch up procedure and you will be fine long term. I know it is not what you wanted to do, but it really is not that unusual. Try not to stress over it...you will be all good my friend.

 

I had a very similar procedure to Sean - 2800+ FUE grafts in one sitting, with Dr Rahal, mototrized FUE tool, and Dr Rahal did not extract all the grafts himself. And I've also had issues with losing grafts at the recipient area.

 

I agree we shouldn't speculate too much, but at the same time I think it only makes sense we should consider the factors in common.

[orlhair1]

That does make sense SugarHighs. I forgot that your procedure was also an FUE.

[Davis91]

SugarHighs

 

When you say losing grafts do you mean the grafts never grew or do you mean they grew and then fell out after (sometimes happens but is rare).

 

Thanks

[Davis91]

OrlHair1

 

Hair transplants are not an exact science but there is scientific studies on graft survival at 20, 30, 40 grafts per CM and above, with decreasing viability of grafts the more you dense pack (Dr. Bernstein has a nice summary of this on his website). I know this has been discussed (perhaps on this thread?), most HT veterans on this site are aware of these studies and indeed with better methods it is getting easier to dense pack.

 

On the other hand, with FUE, GIANT one day FUE sessions, motorized tool use and having techs take out some of the grafts--well, there aren't a lot of studies on how these factors might or might not affect a dense pack.

 

Sean, as people say, in any event you are not far off, it looks good and you are in better shape than most people. This matters little when you feel bad about it...but you should have options going forward still left to you.

 

Thanks

[SugarHighs]

SugarHighs

 

When you say losing grafts do you mean the grafts never grew or do you mean they grew and then fell out after (sometimes happens but is rare).

 

Thanks

 

In my opinion, based on the empirical evidence, both things are the case. I have not had this independently looked at by a professional yet, though, so I won't say it's the case with absolute certainty.

[orlhair1]

OrlHair1

 

Hair transplants are not an exact science but there is scientific studies on graft survival at 20, 30, 40 grafts per CM and above, with decreasing viability of grafts the more you dense pack (Dr. Bernstein has a nice summary of this on his website). I know this has been discussed (perhaps on this thread?), most HT veterans on this site are aware of these studies and indeed with better methods it is getting easier to dense pack.

 

On the other hand, with FUE, GIANT one day FUE sessions, motorized tool use and having techs take out some of the grafts--well, there aren't a lot of studies on how these factors might or might not affect a dense pack.

 

Sean, as people say, in any event you are not far off, it looks good and you are in better shape than most people. This matters little when you feel bad about it...but you should have options going forward still left to you.

 

Thanks

 

I agree and have read those studies about decreasing viability go grafts as density gets higher after a certain point.

[Capelli11]

Sean,

 

I haven't been on in a while and haven't really read too many of your posts recently. I just read some of them...keep your head up buddy...it takes some time to fully grow out. As others have said, your hair appeared to be originally really nice and I can see how you wanted the 3k to make it a slam dunk. Pictures are tough to get the full view and feel of someone's hair so with that said, it is tough to full get what is going on with your hair currently. Believe me, I totally understand the pain and suffering that goes along with a HT...def the money but also the time involved in caring for your head like a new born baby...taking the propecia, applying rogaine twice a day which is a huge pain and babying your hair. You went to the best surgeon out there and I am sure he will help you if he can going forward. I think your hair looks good buddy...so just hang in there and please keep us all posted!

[Sean]

Wb280, Zenmunk, Aim4hair, Spanker, Orlhair, Hariri, Headbangerguy, Chrisdav, Sugarhighs, Davis91, MPBsucks4545, Capelli, all you private guys and the rest who have given me feedback/asked questions......

 

Fellas, I want to let you all know that I have read each and every one of your responses and feedback. I absolutely appreciate your feedback and have throughout the process. As I said before, it is always welcome. You may also talk about anything relating to it, aspects of the FUE procedure in general and so forth, it's more than welcome. Throughout this process I have gotten to know some of you and commented on your threads I came across. I have spoken to lots of you personally viewing my thread and actively commenting as well as what seems like overwhelming amounts of folks interested in the fue experience in particular. I try my best to reply to you all as soon as I can because I really want to help sufferers since I know this feeling all too well. I don't have to but I know the feeling of hairloss so it makes me want to. Well, I am approaching 11 months and then 12 month mark. I will keep everyone updated. Obviously, the process isnt easy and I gotta take a little breather though. This is my first experience and obviously due to so many factors, I feel it more than anything. At this point, I need to try to keep my head up as much as I can as it is very important for me right now. I went to a top notch surgeon with class so I know I am good. It's the process that does get the best of most of us. I will update my thread again in a few days. About 3-4 of you viewing told me you want to see me in person and want to see things up close and inspect my donor. Let's wait for conclusion of full 12 months and you guys are more than welcome to meet with me still just remind me at the end of August. Once I promise or say I will do something, I honor and keep my word and do it under any circumstance. So, the meetup will happen and is set in stone. Thank you all for following my progress. Much appreciated everyone.