Sugar Goes to Ottawa - My 2822 FUE with Dr. Rahal

[SugarHighs]

Hi Everyone,

 

I traveled to Ottawa, Canada on January 6th for a FUE procedure with Dr Rahal. I am going to try to post a very thorough write-up of the experience, and will be, uh, borrowing forum member Sean's template as I was impressed with his detail-oriented organization and posts.

 

 

 

Initial Research, Choice, and Booking For FUE

 

 

 

Experience: I have been following hair restoration doctors since ~2005 when I was 32 years old, on forums similar to this. I was not really sure I wanted to do anything then, but then took a greater interest in 2008/09, when I began following a few doctors more closely. I had an online consultation with Hasson and Wong in early 2009, however after learning that they do not perform FUE, I lost interest.

 

In summer of last year, I began to get serious in my search for an FUE doctor and began viewing cases and talking to patients online. I would estimate that I viewed several hundred restoration cases (both Strip and FUE) and spoke with about a dozen patients online. In mid-October I had an online consultation with Dr Rahal's people and Dr. Feller's people, as well as one or two others. Representatives from both clinics were quick to get back to me, were very professional, and did not attempt to really pitch me anything, rather came back with a recommendation as I asked.

 

Dr. Feller's people recommended around 2000 grafts for me, and recommended strip surgery - for two reasons. First he stated that Dr. Feller could not do FUE for me "...due to the number (of grafts) required and doesn't do back to back days." And they also recommended strip due to my hair characteristic.

 

I admire Dr. Feller for his principles. He could have easily told me that he would do FUE for me, over two sessions, and quoted an expensive price for me, as we all know FUE costs more than strip surgery. There was no way I was getting strip surgery however, so I chose to go my way.

 

Dr Rahal's people, during my online consult, suggested that I would be a "strong" candidate for FUE and recommended 2800 grafts, and quoted a price for both FUE and strip.

 

Due to my budget for the procedure, I asked if we could lower the number of grafts slightly, without impacting my goals very much - and we ultimately settled on the number of 2500 grafts, with the option to agree to more once I arrived. (For whatever reason, the cost of 2500 grafts ended up being slightly higher per graft than the cost of 2800, but at this point I had reached my decision, and I didn't really want to quibble over what was ultimately a few dollars.)

 

 

 

 

Payment Information

 

 

 

 

I won't belabor this point too much, please see Sean's FUE thread for more details, as he summarized it as well as anyone can...but I do want to throw in my two cents.

 

I ended up paying though a wire transfer from Chase bank to Dr. Rahal's bank about two weeks before my procedure. I think it took about 3 business days to go through. I had the option of paying in Canadian or US money, and I decided to pay in CAD and I will say that I pretty much got my ass kicked on the exchange rate. I think USD was trading at about $1 US = $1.01.5 CAD that day, but instead I ended up getting something like $1 US = 99.5 cents CAD. Yes, you read that right - I paid MORE in US currency than the total number of dollars in CAD - although only slightly more.

 

If I had to do it over, I would have paid it on my Citi credit card, which actually had much better rate when I used it in Canada, even with the foreign transaction rate percentage included. I did not have a high enough limit on that card to pay for the entire procedure, but I could have put half the cost on card, paid that balance off, then put the remainder on it.

 

The moral - avoid bank transfers if you can, unless you can get a competitive rate

 

 

 

 

My Arrival

 

 

 

Experience: I flew from California, to DC, to Ottawa, as there are no direct flights from anywhere in California to Ottawa for whatever reason. I left a day early in case there was a weather issue, and took my work laptop so I could work as needed a few days after my procedure. The Ottawa airport is small and well laid out and it was very easy to get my bag, go through customs and get a cab to Foxbar. The cab driver even accepted American money (as does the drug store across the street from Dr. Rahal's office.)

 

Consent forms: About 8 million implied consent forms to fill out. In summary - you understand that hair transplants have varied results, and any disputes you might later have must be settled in Ontario.

 

Design/Meeting:

 

I walked to the clinic (3-4 mins walk from Foxbar) and met Dr. Rahal around 4:30pm on the day before my procedure. One of the first people I saw when I arrived was Mike the head nurse and it was nice to see him. He has a very nice manner with people and has of way of making you feel comfortable. Mike smiled at me when he saw me, and it made me feel good about being there. After a short while I met Dr Rahal, who was also very nice, and we talked about what I wanted to do. I showed him a few photos, of both people I know and of work he's previously done. Dr Rahal took some measurements and did an initial design, and mentioned that he would want to do the final measurements and design in the morning.

 

I asked Dr. Rahal about a million and a half questions and we discussed some details like the fact that for a small % of people FUE extraction is problematic (I think he said 5%) and that if I was one of those people I would have to decide whether to stop, or whether to consider a strip procedure at that time. He said that he didn't anticipate that for me after feeling the donor area. I guess he can get an idea about this from touch. I noticed Dr. Rahal has a good sense of humor outside the operating room, and I remember him saying one or two things that made me laugh although the details at the moment escape me. I also met Chad my patient advisor at this time, and I was happy to meet him after talking many times on the phone.

 

 

Future: Dr Rahal estimates that I would lose more hair in the future through the top-center region, but that I would likely never lose it all. He said this was based on my age and current hair / characteristics.

 

 

 

Pre-Op On FUE Session Day

 

 

 

Before Procedure: As discussed, Dr. Rahal did much more thorough measurements and drew a bunch of rectangles on my forehead and head, taking into consideration my needs. Basically, I said I wanted to be modestly aggressive, but not foolishly aggressive. Dr. Rahal came up with 51 cm2 area to implant and mentioned what my varying densities would be based on 2500 grafts. He mentioned around 60 cm2 at the hairline, although I pushed for 65. Dr Rahal said that no 60 is good, and that it is even more dense than his own native hair. This made me content, because Dr Rahal has a full head of hair as far as I can see. We agreed that he would try to get more than 2500 grafts, but that a) I would have to pay for them, and b) we couldn't go for too many more, because 2500 is a lot and we do not want to risk donor shock loss and the other things that go along with taking too many grafts from a donor area my size.

 

Procedure FUE Day 1: Got my gown on, took some pictures, and then went in the procedure room. At some point I was given a valium-like sedative but I don't remember what time exactly.

 

 

 

FUE Procedure on Friday, January 6th

 

 

 

Duration: Estimated procedure time from 7:50AM to 7:20PM

 

Experience: We began with some shots to numb the donor area, and these are not very fun. Imagine being stung by a bee, except in your head, and about 10-15 times more painful.

 

After that, Dr Rahal and Mike alternated taking turns doing my FUE extractions. I remember sort of feeling the punch (no pain), and then the pause as the follicles were taken out. The sensation sort of reminded me of if you stuck the tip of a mechanical pencil into a watermelon. A few times I had to have additional numbing shots and a few times I felt a bit of discomfort. The main discomfort was from being face down and my face squashing into the pillow. I am a fairly densely muscular person and believe my upper body weight contributed to that. So for a bit, my sinus areas were in pain from the pressure. The clinic made sure I was comfortable though, moving the pillow 7-8 times for me to ensure my comfort. A few times I groaned from the discomfort of the extraction procedure, and Dr Rahal pretty much told me I needed to suck it up. He was a lot more diplomatic than that with his words, but I got the message.

 

After the extraction process, which I felt like took an eternity, it was time to have a quick drink (Gatorade not Whiskey) and then move on to making my incisions. This was by far the least comfortable part of the process, although there was no pain, it was all psychological. I was given the nerve shots, which hurt like a bitch, but only for a second, and then Dr Rahal began the incisions. For some perspective, I will not even let women run their fingers through my hair or touch the front of my hair where my hairline is. So to have someone, even someone I trusted implicitly with the job, cutting little holes in the front of my head, made me extremely uncomfortable. I definitely breathed a little more heavily here, but I reminded myself that I was here for a reason and Dr Rahal is great and knows what he is doing, so to just deal with it. It helped that the clinic played very soothing music during the extractions/incisions. Whatever Dr. Rahal has on his iPod, it is good stuff.

 

The last part of the procedure was the implanting. I didn't really understand what was happening at this point, but probably because my mind was in a fog from the events of the day. A hair restoration is definitely a surreal experience. So I picked out a couple movies to watch, and then relaxed for the long implanting process. The movies were good, but in retrospect I would have just asked for continued music, because at that time I just needed to relax, not to get engaged in the movies. In any event, after 4-5 hours we were done. Dr Rahal and Mike let me know we had gotten 2822 grafts, and the technicians had let me know that I had a lot of "3s" and that my donor hair was very thick, so that made me happy.

 

 

Dr. Rahal's Staff

 

 

 

Experience: What more can be said about Dr. Rahal's people? Everyone in Ottawa is great. Dr Rahal is really easy to talk to, yet is completely focused and on task when in the procedure room. Everyone knows what they are supposed to be doing. Mike is the freaking man. He answered all my questions in detail and really made me feel comfortable at all times we were working together. He just has that innate quality that you can not teach. Chad my patient advisor has been great, too, and has promptly answered all my questions. Everyone else there was great, too. The only drawback I can think of is that I have not received my pre and post op photos yet in email, even though I have asked for them a few times. I left Ottawa on 1/12 and still don't have them yet.

 

 

Conclusion

 

Overall I was very happy with my time in Ottawa. I am a little tired of writing now, but later I will post more about my post-op days in Canada, about Foxbar, the food in Canada, and my first month post op with current photos added to my blog.

 

Thanks,

Sugar

 

 

 

Edited February 1, 2012 by SugarHighs

[SugarHighs]

I posted some photos that I took with my iPad on 2 days post op.

 

Rest assured I do not look like this at the moment, now 26 days post op.

 

I have shed many of my grafts, and grown about 1/2 inch of my original native hair, but still have the visible sign of my new hairline because of some hairs and the difference in color. More photos to come.

[Capelli11]

Congrats and welcome to the club!!! The hard part is over and now the ugly duckling mode comes next but soon enough you will have your hair back! Keep us posted!!!

[NEWHAIRPLEASE]

Great write up...even if you did plagiarize!! Ha...good luck!! we can all track one another!!

[TakingThePlunge]

Sugar,

 

Congratulations on your recent FUE with Dr. Rahal and thank you for taking the time to provide such a detailed account. I checked out your photos ans the hairline looks great. I'm looking forward to following your progress.

 

Happy growing!

[SugarHighs]

Thanks, guys. I will be putting up some threads with 1-2-3 week updates.

[PatientlyWaiting46]

SugarHighs I flew in from California from San Francisco to Toronto to Ottawa. I received 3744 grafts from Dr. Rahal to the frontal third on 1/17/12. I actually ran into NEWHAIRPLEASE when we were both getting follow ups. I am 16 days post-op and my grafts are ready to come out as well. Very nice write-up you picked a great surgeon and should turn some awesome results when it is all done. All of us on this thread with the exception of TakingthePlunge are within a months timeframe from surgery with Dr. Rahal so we can definitely keep up with each others results.

[NEWHAIRPLEASE]

Parientlywaiting

I actually got the black eyes the day after I saw you. I looked like I had gone 10

Rounds with Tyson!!!

[Sean]

Sugerhighs, just read your write up. Thanks for taking your time to do that and help others. Can't wait to read more in the upcoming days.

[orlhair1]

Congrats!.....Looking forward to following your progress.....I am sure you will have a great result.

[SugarHighs]

SugarHighs I flew in from California from San Francisco to Toronto to Ottawa. I received 3744 grafts from Dr. Rahal to the frontal third on 1/17/12. I actually ran into NEWHAIRPLEASE when we were both getting follow ups. I am 16 days post-op and my grafts are ready to come out as well. Very nice write-up you picked a great surgeon and should turn some awesome results when it is all done. All of us on this thread with the exception of TakingthePlunge are within a months timeframe from surgery with Dr. Rahal so we can definitely keep up with each others results.

 

Hey Patiently,

 

That is funny, I also live in SF, although I flew out of a different airport. How funny would it be if we actually know each other.

 

So yeah I am really happy for the group here. Quite a few of us have gone into Dr Rahal in the last six months, so we can kind of keep track of each other over the next six months to year.

 

Have you put up and pictures or story?

 

Thanks,

Sugar

[SugarHighs]

Sugerhighs, just read your write up. Thanks for taking your time to do that and help others. Can't wait to read more in the upcoming days.

 

Thanks Sean, and thanks for letting me plagiarize your first entry. You can't sue because I'm poor from having had the procedure - haha!

 

Looking forward to your 5 month updates, and I will be posting my 1 month tomorrow.

[SugarHighs]

Congrats!.....Looking forward to following your progress.....I am sure you will have a great result.

 

Thanks orlhair1, I am really looking forward to it!

[SugarHighs]

I followed the clinic's instructions to the letter for the first 14 days post-op requirements. Using Vitamin E Oil for 7 days (actually 8) and then discontinuing that. I sprayed the grafts and donor area with a spray bottle of distilled water mixed with the shampoo I was given, washed the donor area with gauze pads, and then used distilled water in its own spray bottle to clear the shampoo from the grafted area. As instructed I did not touch the grafted area for 2 weeks, and actually carried on the two week routine for about 17-18 days because I did not feel my crusts were ready to fall.

 

Then I began the next set of instructions, which stated that I gently shower and let the water drip down on the grafts and gently massage to remove the scabs. I was extremely gentle about this, and it may have taken 3-4 days/showers to remove all the scabs. I barely used the pressure of my fingertips and massaged the grafts. Never used any pressure to try to lift the grafts nor did I use my finger nails (don't have any.)

[SugarHighs]

My recipient area was very sensitive for a while, especially at the right side of my hair line (my new hair line.)

 

Day 21 I began Minoxidil because I finally felt the sensitivity had gone away enough to allow it.

 

I was more heavily grafted on the right side, and I believe I received more numbing sedative there during my operation. Coincidentally, I have noticed when applying Minoxidil, that the feeling is beginning to return to the left side of my grafted area/scalp more quickly than it is returning to the right side of my scalp. I still have a bit more numbness on the right side in the grafted area.

[garmax]

Since you are located in the SF area I was wondering if you considered any HT doctors in the San Francisco/Bay area; ie Dr Rosanelli. What sold you on selecdting Dr Rahal?

[SugarHighs]

Since you are located in the SF area I was wondering if you considered any HT doctors in the San Francisco/Bay area; ie Dr Rosanelli. What sold you on selecdting Dr Rahal?

 

I did not consider any doctors in the SF Bay Area because in following forums such as these and researching doctors for over 7 years, I did not hear of a local surgeon developing an outstanding reputation.

 

I was really only interested in doctors who have developed an outstanding reputation over a period of years, and I didn't really care where they were located.

 

This is not to suggest that Dr Rosanelli isn't an excellent surgeon, he well may be, but I have never heard of him until now. That said, it certainly would have been convenient - I could have walked/taken the bus to and from his clinic, or a $5 cab ride.

 

Rather than several hundred dollars for the flight and having the buffoons at United Airlines lose my bag for 48hours.

Edited February 7, 2012 by SugarHighs

[England]

A few times I groaned from the discomfort of the extraction procedure, and Dr Rahal pretty much told me I needed to suck it up.

 

 

Can I ask, what discomfort was this? Was this discomfort from your body position and being face down, or was it discomfort due to pain in the back of your head where the extractions were taking place?

 

Oh, and I'm looking forward to your updates, and congratulations on what will hopefully be a very successful HT.

[SugarHighs]

I am talking about general discomfort. I was not strictly speaking of pain, because I'd received the numbness shots, but I was aware of the sensation of the punch going into the back of my head and it made me psychologically uncomfortable.

 

Also, I felt some significant pain and discomfort in my face and sinus area from the pressure of laying down with my face in the pillow. This would probably not affect most guys as much, however I am heavily muscular in my upper body/shoulders, and the angle put an undue amount of stress on my face. The clinic moved the pillow and adjusted the angle as much a they could to accommodate for my comfort.

 

Thanks for the well-wishes!

[SugarHighs]

6 week photos. Minoxidil seems to be working.

 

Before and after haircut.

[SugarHighs]

After haircut to a #1 guard (approx. 1/8 inch.) Note that there is no visible recipient area issue at this point.

[SugarHighs]

More photos.

[NEWHAIRPLEASE]

Looks great!!

[SugarHighs]

Looks great!!

 

Thanks NH!

[SugarHighs]

Close ups