(Doctor Damkerng Pathomvanich) Transplanted scalp area growing slower than temples?

[akuma]

My temples have grown in and thickened fully around 6 months after surgery. But my scalp transplanted area rested for many months and only started to grow at around 8 months and is still thickening ( its been 1 year now). There is still new hairs sprouting and thickening. Its a slower process than the temples.

 

I got my surgery done in Thailand with Dr Pat.

 

Has this happened to anyone? Is it cause scalp hair grow slower than sides of the head side since its the highest point in the body (hence less blood flow)? which translates into slower growth?

 

The scalp was more densely packed than the temples, I read somewhere that densely packed areas have less blood flow. So maybe this is why the slowed growth?

 

2 months after my surgery, all the transplant scalp hair had fallen out. But around 50% of my temple hairs stayed. Basically scalp hair fell out sooner and is taking longer to grow back. Temples didn't fall out as quickly, but grew back quickly and thickened quickly. Scalp hair seems to have had a longer "no growth sleeep time", whereas temples had less sleep time. Is this all due to blood flow? or something else?

 

Please let me know whats going on.

 

Thanks

Edited February 28, 2012 by akuma

[akuma]

anyone please?

[TakingThePlunge]

akuma,

 

Since you are at the one year mark already and you feel that there are still new hairs sprouting and thickening, you may fall under the category of slow grower.

 

I would say that you may need to wait a ful 18 months before assessing your final results. Have you mentioned your concerns to Dr. Pathomvanich?

[Sean]

Akuma, do you happen to have photos to show the area?

 

At the one year mark, things should have been evened out by now? I know some people grow slow but I don't know how much of a difference those extra months would make in terms of density. There may be little growth, but not too much I think. That's from what I have seen on the forums. It depends on how much of a difference there is at this point I guess.

 

I am at 6 months right now, and my left side of my head is thicker then my right in all aspects and it looks different. I guess growth occurs unevenly first few months, but I am hoping it will even out by the year mark.

 

I also got temple work done too, and right now at my 6 month mark, my left side temples are thicker then my right too.

Edited March 3, 2012 by Sean

[TakingThePlunge]

Yes, photos would really help us judge where you are now in relation to where you started.

 

Growth does does occur unevenly for most patients but I agree that there is not likely to be significant growth from this point forward. However, as you have stated that you feel there is still regular improvement happening, I would definitely wait until your transplant has fully matured before evaluating your growth.

 

I do recommend discussing your concerns with Dr. Pathomvanich if you have not already.

[akuma]

hey guys. i've attached the pics i took on 19th december 2011. My surgery was on 8th march 2011. So the pics are 9 months later. The last picture is taken in bright light.

 

Yes, photos would really help us judge where you are now in relation to where you started.

 

Growth does does occur unevenly for most patients but I agree that there is not likely to be significant growth from this point forward. However, as you have stated that you feel there is still regular improvement happening, I would definitely wait until your transplant has fully matured before evaluating your growth.

 

I do recommend discussing your concerns with Dr. Pathomvanich if you have not already.

 

That is what Dr Pat assistants have said. To wait around 18 months after surgery for full result.

 

I cant help but get worried though. That is why I wanted some other opinions on this. Looking at the pictures you can see my left and right temporal peaks have matured fully. They had fully matured 6 months after surgery. They match my native hair greatly and is dark and dense now.

 

But the top scalp area as marked by the line in the picture, started to grow in later and is still maturing. You can see that the frontal area where i got it transplanted doesn't yet come anywhere close to my native hair. Less grafts have grown in at this point and more grafts are still starting to grow.

 

My frontal area definitely has slower growth. Can anyone tell me why though?

 

My frontal area was transplanted with 50 grafts per cm2. I read somewhere that dense areas have less blood flow. Is this what causing slow growth? Or is it because the front scalp is the highest point in the body and hence naturally has less blood flow.

 

Please advise

[akuma]

i wet my hair and combed it back to show the results more clearly.

[Bill - Seemiller]

Akuma,

 

Thanks for presenting your questions and concerns about growth on our forum. In order for us to provide you with a better idea of where you're at, I'd also suggest providing us with more detail about your surgery and post before pictures. For starters, how many grafts did you receive on your scalp? In another topic, I see that you expressed similar concerns. You also mentioned that you had some eyebrow work done. How many grafts did you receive in the temple areas? What about your eyebrows?

 

Based on the pictures you provided above, your temples and hairline look pretty good already. However, without before pictures, it's impossible for anyone to make an assessment and give you an idea about growth. Moreover, posting pictures of wet hair is not optimal since wet hair always appears thinner as hair tends to clump together.

 

I know you're a bit worried, but some additional growth and thickening can occur between 12 and 18 months, albeit for most people, growth that occurs during this time is minimal but for slow growers, it can be a noticeable change.

 

In the meantime, I strongly recommend presenting some before pictures and current dry hair pictures so we can get a better idea of the kind of growth you've experienced. I also suggest providing us with a graft count breakdown of how many grafts you received in the hairline, temples and eyebrows. After all, there's a chance that you may have experienced more growth than you think.

 

Best wishes,

 

Bill

[akuma]

Akuma,

 

Thanks for presenting your questions and concerns about growth on our forum. In order for us to provide you with a better idea of where you're at, I'd also suggest providing us with more detail about your surgery and post before pictures. For starters, how many grafts did you receive on your scalp? In another topic, I see that you expressed similar concerns. You also mentioned that you had some eyebrow work done. How many grafts did you receive in the temple areas? What about your eyebrows?

 

Based on the pictures you provided above, your temples and hairline look pretty good already. However, without before pictures, it's impossible for anyone to make an assessment and give you an idea about growth. Moreover, posting pictures of wet hair is not optimal since wet hair always appears thinner as hair tends to clump together.

 

I know you're a bit worried, but some additional growth and thickening can occur between 12 and 18 months, albeit for most people, growth that occurs during this time is minimal but for slow growers, it can be a noticeable change.

 

In the meantime, I strongly recommend presenting some before pictures and current dry hair pictures so we can get a better idea of the kind of growth you've experienced. I also suggest providing us with a graft count breakdown of how many grafts you received in the hairline, temples and eyebrows. After all, there's a chance that you may have experienced more growth than you think.

 

Best wishes,

 

Bill

 

The eyebrows had grown in and thickened within 6-7 months after transplant.

 

I received around 800 FU on the frontal scalp. And roughly 200-300 on each temporal peak sides.

 

The temporal areas that got transplanted are shown by the yellow line i drew.

 

My temporal peaks were always not strong. This is something I had since I can remember. From age 12 even. I inherited it from my mum. So I just transplanted there to better frame the face.

 

My growth is definitely not what it should be. This is because I can clearly see that my temporal peaks have fully matured and i can see individual thick hairs now.

 

Whereas on my frontal scalp, there are some hairs that have thickened up, but there is STILL many others that are wispy and thin. And there are also new hairs coming up that are only 3-4 mm long and is very thin.

 

The area on my frontal scalp that got transplanted can be seen with the line i drew. Everything behind that line is my native hair. It clearly shows that the transplanted hair isn't as thick as it should be. Many wispy hairs cant even be seen in the picture.

 

I definitely know and can see that its not as thick as my temporal peaks or even my eyebrow hair. The question I have is, has there been a case like this where their temporal peaks grew faster than their scalp hair?

 

and did the scalp hair eventually thicken up fully?

[RodG]

Hi,

 

My understanding of hair transplant procedures is that 50 grafts per cm is about 50% of your normal hair density. You can never have the density that you had before you started losing your hair and when you wet your hair it is always going to be a bit thin looking.

 

I would suggest that you take Bill's advice and provide some better photographs and details of your hair transplant. I had a procedure with DHT Clinic in 2010 and they are very good to deal with. I'm sure that they can help with any enquiries that you make.

 

Good luck

 

Rod

[Sean]

hey guys. i've attached the pics i took on 19th december 2011. My surgery was on 8th march 2011. So the pics are 9 months later. The last picture is taken in bright light.

 

 

 

That is what Dr Pat assistants have said. To wait around 18 months after surgery for full result.

 

I cant help but get worried though. That is why I wanted some other opinions on this. Looking at the pictures you can see my left and right temporal peaks have matured fully. They had fully matured 6 months after surgery. They match my native hair greatly and is dark and dense now.

 

But the top scalp area as marked by the line in the picture, started to grow in later and is still maturing. You can see that the frontal area where i got it transplanted doesn't yet come anywhere close to my native hair. Less grafts have grown in at this point and more grafts are still starting to grow.

 

My frontal area definitely has slower growth. Can anyone tell me why though?

 

My frontal area was transplanted with 50 grafts per cm2. I read somewhere that dense areas have less blood flow. Is this what causing slow growth? Or is it because the front scalp is the highest point in the body and hence naturally has less blood flow.

 

Please advise

 

I saw your photos, yes it seems like your temples have matured. However, you say that too much density may cause blood flow issues? I don't know about that. I had 65cm density transplanted on my frontal hairline by Dr. Rahal. I would consider that densely packed. However, like I said I am only 6 months out and I am still thin in some areas vs others.

 

Could it be delayed growth? I am not quite sure. But if you are still growing grafts, then the area may fill in, but I don't think it would be a massive filling. Is your hair wet in the pictures as well or do you have any product like gel on?

That may also make a difference in the appearance of the hairline.

[akuma]

Hi,

 

My understanding of hair transplant procedures is that 50 grafts per cm is about 50% of your normal hair density. You can never have the density that you had before you started losing your hair and when you wet your hair it is always going to be a bit thin looking.

 

I would suggest that you take Bill's advice and provide some better photographs and details of your hair transplant. I had a procedure with DHT Clinic in 2010 and they are very good to deal with. I'm sure that they can help with any enquiries that you make.

 

Good luck

 

Rod

 

Yes but the frontal scalp definitely hasn't thickened up.

 

 

I saw your photos, yes it seems like your temples have matured. However, you say that too much density may cause blood flow issues? I don't know about that. I had 65cm density transplanted on my frontal hairline by Dr. Rahal. I would consider that densely packed. However, like I said I am only 6 months out and I am still thin in some areas vs others.

 

Could it be delayed growth? I am not quite sure. But if you are still growing grafts, then the area may fill in, but I don't think it would be a massive filling. Is your hair wet in the pictures as well or do you have any product like gel on?

That may also make a difference in the appearance of the hairline.

 

so you got 65 follicular units per cm 2? That is quite dense.

 

Yes my hair is wet without any product like gel.

 

Even if I get my scalp to the level my temples are, I'll be happy. Because it will blend in very well. Any the moment it does not blend in with the native hair at all.

 

But from what Dr pat assistants have told me, My temples weren't packed as densely as my scalp. So my scalp area should provide better results than my temples for sure.

 

It has to fill in massively because if this is the final result it is very disappointing to say the least.

[Bill - Seemiller]

Akuma,

 

I appreciate you answering my question, but again, I ask that you provide better photographs of your hair when your scalp is dry and more pictures of your scalp before surgery. While you may have had more hair transplanted on your scalp, it's a much bigger area to fill than your temples. Thus, I'm not so sure how much more density/growth you'll achieve since we don't have any clear pictures or photos to compare them to. Honestly however, even with wet hair, your hair looks quite thick which is more than most hair transplant patients can say with less density. Your hairline even looks thicker than mine.

 

That said, if you are seeing some thinner, wispier looking hairs, these could either be natural hairs that are in the process of miniaturizing due to male pattern baldness or new transplanted hairs that have not yet thickened and matured. If it's the former, these hairs will eventually shrink, thin out, shorten and disappear. If it's the latter, these hairs will thicken, darken, grow and mature.

 

I agree with Dr. Pathomvanich that you should wait a full 18 months before determining the success rate of growth from your hair transplant. In the meantime however, let's see the photos I asked for as the photos you've presented really don't tell us much about your hair transplant.

 

Thanks,

 

Bill

[Dr. Damkerng Pathomvanich]

My record indicated that he had receding mid-frontal and temporal hairline with thinning eyebrow. His hair is coarse, with density at 80%. He underwent strip FUT on March 9, 2011.

830 grafts were transplanted at the mid-front of the scalp, 460 grafts at both temples, 224 grafts at both eyebrows, 56 grafts at the beard.

 

I haven't seen his post-op photos since surgery and would like to compare from his pre-op photos before further discussion. He was informed that it would take 12-18 months to see the final results of the hair transplant.

 

The frontal scalp hairs usually fall off first 3-6 weeks after surgery and grow back in about 3-4 months. For unknown reasons, the majority of eyebrow and temple hair transplants continue to grow without shedding. We transplanted the temples in a flat angle so the density appears greater as a shingle effect since the hairs lay down flat covering the scalp even with less number of grafts. However, the angle of the transplanted hairs at the frontal part of the scalp were made at 45 degrees so that the hairs when combed up, make the scalp visible. He should send me the post-op photos taken the same way as the pre-op photos so that I can compare and discuss his concerns.

[akuma]

thanks for the reply Dr Pat. I have full confidence in your work.

 

I have sent pictures to the clinic. I was told to wait 18 months for full result. I am doing that, its just that the worrying got me to post on this website. Just to get more opinions.

[akuma]

I'll post pics in this thread when I reach 18 months for final result.

[akuma]

I've attached the pictures as you requested Bill.

 

Here i've attached pictures of me before surgery. Age 25.

 

I do not use any medication.

 

Just wanted to have better temples and lower the frontal hair line a little (had high hairline since birth). But wanted to keep as much donor hair left as possible. Hence the smaller surgery.

 

The "more forward" temples better frames my face. I am loving the temples.

 

Just the top scalp....

 

The dates show on the picture. Surgery date was 9th March.

 

1.jpg and 2.jpg were before surgery.

 

The blue arrow points to areas you can see that are thin. You can even see some baby hairs (transplanted ones) along the new hair line.

 

I can practically see through the transplanted scalp hairs. I drew arrows to show the transplanted area.

 

The yellow arrows point to thickened hairs. You can see it clearly that its DARK and thicker than the rest. Its become the thickness like my temples. I hope the other areas get as thick as this, would be very happy.

 

Would love your comments guys.

[akuma]

it may look like my hairline was brought down alot. It wasn't. My native hairline was shaved to transplant there as well.

 

I wanted a straighter V hairline instead of the zig zag one i had.

[Bill - Seemiller]

akuma,

 

Thanks for posting some new photos however, your hair is still very wet. Why aren't you posting photos of your hair when it's dry like members of this community asked? Again, wet hair will always look thinner as the hair clumps together and doesn't provide an accurate representation of your hair or hairline. Thus, I ask that you present photos of your scalp showing dry hair so we can get a better idea what your hair really looks like.

 

That said, even wet, the growth you see so far appears to look like the postoperative design which is good. As to the density, I expect you'll see some additional growth over the next several months, although it's debatable as to how much.

 

I strongly suggest at this point that you:

 

1. Contact Dr. Pathomvanich privately to discuss your concerns and send him the photos he asked for so he can provide his professional input

 

2. Take and present pictures of your hairline on this forum when your hair is dry.

 

Best wishes,

 

Bill

[akuma]

Here are the dry hair pictures. There were taken today. 1 Year and 2 weeks after surgery.

 

I am holding my scalp hair flat so it can be fairly compared to my temples. Can definitely see that the temples hair (base) is thicker than the hairline. But the yellow arrow areas have hairs that have thickened up. So I am hoping the rest of the hairline becomes like that. In the pictures you can see that the right side of the scalp has thickened up more than the left.

 

I even cut a single hair from my temples and one from the hair line to compare.

 

The long thick one is from temples. And the short thin one is from the hairline.

 

The hairline one has a very tapered tip, so its recently grown. If you look closely at the hairline, you can see mini hairs still sprouting.

 

I'm trying to stay positive and hope the rest of the hairline gets thicker.

 

Comments guys?

[RodG]

Hi,

 

It does appear that u don't have full density in your hairline. Can you take another photo without your hand on your head because it doesn't help with the illusion of density. I'm nt totally convinced that in general 40 - 50 grafts per cm gives a thick hairline IMO. It depends on the calibre of hair that a person has whether it looks full.

 

The clinic is good to deal with and I would discuss any concerns that you have with them.

 

Regards rod

[Bill - Seemiller]

Akuma,

 

Thanks for presenting photos of the hairline showing dry hair. I do agree that you should probably achieve more density from your results than I'm seeing in your recent photos. Hopefully you'll see some new growth and thickening over the next 6 months. However, I trust that Dr. Pathomvanich will stand behind you and help you meet your goals in the event you don't achieve optimal growth.

 

Have you contacted Dr. Pathomvanich privately as he suggested in a previous post yet? If not, I suggest you consult with him and send him the photos so he can provide you with his professional input

 

Best wishes,

 

Bill

[akuma]

Here is the picture I forgot to add in the last post.

 

The long thick one is from temples. And the short thin one is from the hairline.

 

The hairline one has a very tapered tip, so its recently grown.

 

I am just wondering what is causing the delayed growth.

[akuma]

the thickening is veryyy slow and I feel that I wont get the density that I should get. It has been 1 year and 1 month now.

 

I just dont know what could have gone wrong, My temples, eyebrow, and beard all grew in fine. Dont know what is causing the slow thin growth on the frontal scalp. The next 5 months are a anxious wait.

[akuma]

i actually think that either the thickening has stopped or that some of the hairline hairs have fallen out. Its like the hair is struggling to grow and then falls out. Has there been any other cases of this?