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

[akuma]

Right temple= 1 hair graft=50, 2-hairs graft=200 area roughly 12 cm2=23 grafts/cm2

 

Left temple= 1 hair graft=50, 2-hairs graft=160 , area roughly 9 cm2=23 grafts/cm2

 

Frontal scalp 15 cm2 not count thinning inside 1 hair=109 grafts,2 hair 442 grafts, 3-hair 187 grafts, 4 hair 92 grafts = 830 grafts

92 of 4 hair grafts were placed further inside ,therefore roughly almost 50 grafts/cm.

 

 

Even though the temples are just 23 CM2, it looks wayyy thicker than my frontal scalp which is around 50CM2. I understand that for the temples the hairs are laying flat against the skin so hence the overall thicker, darker effect.

 

But I've held my scalp hair down as well to fairly compare with the temples, its still no where near my temple result. This all can be seen in the pictures.

 

My aftercare after the surgery was very good. I dont drink alcohol, no smoking, and eat very healthy diet. And I did not let direct sunlight on the scalp for weeks.

 

I dont know what to do now. I dont know if this is fixable or not.

[Sean]

Akuma, you may be in a regular seasonal shed. That does happen sometimes.

 

Thanks for posting pics. I think your doc will take care of you. I do see that density issue you were talking about better by seeing the newer pics. Your temples do seem on point and good from what I am seeing.

 

I know it's hard but don't stress yourself over it too much. You may need another touchup in the front if you don't see any improvement in the time frame you have been given. Most people do get full results at the 12 month mark, then some do have improvement but from what I have seen it's not like a huge improvement after that time frame. I do hope you see a positive change in the next few months. Someone posted this in my thread,

 

3 months - 10%

4 months - 25%

5 months - 40%

6 months - 60%

7 months - 70%

8 months - 75%

9 months - 80%

10 months - 90%

11 months - 95%

12 months - 98%

18 months - 100%

 

 

 

RodG, I think you are right about the whole 40-50 cm density issue. I really think it comes down to hair texture/hair caliber in conjunction with density cm2 planted. Some may need 40-50, while some may need more if they have thinner hairs for the illusion of density. With very thick hairs, it is very hard to dense pack as well.

[akuma]

Akuma, you may be in a regular seasonal shed. That does happen sometimes.

 

Thanks for posting pics. I think your doc will take care of you. I do see that density issue you were talking about better by seeing the newer pics. Your temples do seem on point and good from what I am seeing.

 

I know it's hard but don't stress yourself over it too much. You may need another touchup in the front if you don't see any improvement in the time frame you have been given. Most people do get full results at the 12 month mark, then some do have improvement but from what I have seen it's not like a huge improvement after that time frame. I do hope you see a positive change in the next few months. Someone posted this in my thread,

 

3 months - 10%

4 months - 25%

5 months - 40%

6 months - 60%

7 months - 70%

8 months - 75%

9 months - 80%

10 months - 90%

11 months - 95%

12 months - 98%

18 months - 100%

 

 

 

RodG, I think you are right about the whole 40-50 cm density issue. I really think it comes down to hair texture/hair caliber in conjunction with density cm2 planted. Some may need 40-50, while some may need more if they have thinner hairs for the illusion of density. With very thick hairs, it is very hard to dense pack as well.

 

thanks for the reply mate. Seasonal shed? whats that?

 

From what i know, the hairs stay in anagen (growth phase) for 2 years. Why would recently grown hairs fall back out again? its well within 2 years right now.

 

My hair is thick, so if the transplanted scalp hairs just become full terminal hairs, the final result will be very very good. I do have realistic expectations.

 

I even lifted up my temple hairs to see what it could look like (temples are at 23 cm2), even if i get that hair diameter thickness at my scalp area, its acceptable.

[Sean]

Akuma, I was referring to this:

http://www.hairrestorationnetwork.com/eve/136742-%22seasonal-shedding%22-aware-3.html

 

I can see that your hair is thick. You definitely do have realistic expectations. Let's see how it matures in the next month. I hope it gets better for you.

[Spanker]

I don't feel that you will get much better IMO. It is a little sparse and I can definately see your area of concern. You may want to talk to Dr. Path and see what he thinks.

 

I don't like it when clinics say to wait 18 months, especially for somone in your case.

 

There is clearly not semetrical growth in that area.

[Bill - Seemiller]

Guys,

 

I know people don't like when physicians ask their patients to wait a full 18 months, but there is a good reason for it. Physicians aren't just brushing or blowing off their patients. In fact, there are scientific studies that show increased growth rates between 12 and 24 months and this is even more true for slow growers.

 

Akuma,

 

I know it's not easy but Dr. Pathomvanich has asked you to wait a full 18 months before evaluating the final result.

However, even after a year and a half, while you may have more thickening, you will not achieve a great deal of density remotely close to what you had before any signs of hair loss. I trust you are aware of this right? Honestly, you've had a minimal number of grafts transplanted in the front and while you may see more growth, you may require another hair transplant in order to achieve the density you desire, assuming you understand that no hair transplant will restore a "full" head of hair.

 

Also, according to Dr. Pathomvanich, even though fewer grafts were transplanted at the temple, it lays flat against your scalp. This overlapping effect creates a greater illusion of density compared to the top that's angled at 45 degrees. Furthermore, the transplanted area in the hairline is much greater than the temple areas and thus, the grafts may not have been packed as closely together.

 

That said, in the event the result doesn't turn out as expected at that time, I trust that Dr. Pathomvanich will work with you to meet your goals. In the meantime, I encourage you to hang tight, wait it out and try your best to be positive.

 

Best wishes,

 

Bill

[Spanker]

Guys,

 

I know people don't like when physicians ask their patients to wait a full 18 months, but there is a good reason for it. Physicians aren't just brushing or blowing off their patients. In fact, there are scientific studies that show increased growth rates between 12 and 24 months and this is even more true for slow growers.

 

Akuma,

 

I know it's not easy but Dr. Pathomvanich has asked you to wait a full 18 months before evaluating the final result.

However, even after a year and a half, while you may have more thickening, you will not achieve a great deal of density remotely close to what you had before any signs of hair loss. I trust you are aware of this right? Honestly, you've had a minimal number of grafts transplanted in the front and while you may see more growth, you may require another hair transplant in order to achieve the density you desire, assuming you understand that no hair transplant will restore a "full" head of hair.

 

Also, according to Dr. Pathomvanich, even though fewer grafts were transplanted at the temple, it lays flat against your scalp. This overlapping effect creates a greater illusion of density compared to the top that's angled at 45 degrees. Furthermore, the transplanted area in the hairline is much greater than the temple areas and thus, the grafts may not have been packed as closely together.

 

That said, in the event the result doesn't turn out as expected at that time, I trust that Dr. Pathomvanich will work with you to meet your goals. In the meantime, I encourage you to hang tight, wait it out and try your best to be positive.

 

Best wishes,

 

Bill

 

Bill,

 

Do you have a source for these studies? I really would like to see these. I can't help but feel the 18 month thing is a little too long to see actual cosmetic change, but I may be wrong.

 

I also agree that he had a small amount of grafts placed for the area covered and would not expect it to look too dense, but would have expected it to be symmetrical growth.

[akuma]

Bill,

 

Do you have a source for these studies? I really would like to see these. I can't help but feel the 18 month thing is a little too long to see actual cosmetic change, but I may be wrong.

 

I also agree that he had a small amount of grafts placed for the area covered and would not expect it to look too dense, but would have expected it to be symmetrical growth.

 

Yea the growth is not symmetrical at the moment.

 

Bill, please look at my post number 27. I got that information from Dr Pat.

 

 

-------------------------------------------------------------------------

Right temple= 1 hair graft=50, 2-hairs graft=200 area roughly 12 cm2=23 grafts/cm2

 

Left temple= 1 hair graft=50, 2-hairs graft=160 , area roughly 9 cm2=23 grafts/cm2

 

Frontal scalp 15 cm2 not count thinning inside 1 hair=109 grafts,2 hair 442 grafts, 3-hair 187 grafts, 4 hair 92 grafts = 830 grafts

92 of 4 hair grafts were placed further inside ,therefore roughly almost 50 grafts/cm.

 

-------------------------------------------------------------------------

 

23 cm2 on temples compared to around 50 cm2 on the frontal scalp.

 

 

However, even after a year and a half, while you may have more thickening, you will not achieve a great deal of density remotely close to what you had before any signs of hair loss. I trust you are aware of this right? Honestly, you've had a minimal number of grafts transplanted in the front and while you may see more growth, you may require another hair transplant in order to achieve the density you desire, assuming you understand that no hair transplant will restore a "full" head of hair.

 

Also, according to Dr. Pathomvanich, even though fewer grafts were transplanted at the temple, it lays flat against your scalp. This overlapping effect creates a greater illusion of density compared to the top that's angled at 45 degrees. Furthermore, the transplanted area in the hairline is much greater than the temple areas and thus, the grafts may not have been packed as closely together.

 

 

 

Yes I am aware that i will not get the density of my native hair. I already mentioned that in my previous posts.

 

The transplanted area is greater at the scalp, but so is the number of grafts transplanted. Plus the scalp was transplanted at around 50 CM2 (hence packed together closely). And the temples at 23 CM2. Temples are at roughly half density.

 

I understand that the temples lay flat and hence look darker and denser. But I even lifted the temple hairs up and saw that it still looks better than my top scalp area.

 

Fully matured hairs can be seen along the temple line. My diameter shaft of a hair is thick. And that is just 1 hair grafts along the temples. It still gives a good cosmetic result. That kinda individual shaft thickness is very sparse on my top scalp hairline.

 

Plus I layed my top scalp hair flat in my pictures to fairly compare with the temples (since temples lay flat too), yet we can fairly see that the scalp is lagging far behind.

 

I even cut a hair from the scalp hairline and the temples. Look at post number 24. You can see the short, light hair from the scalp hairline. And the long thick one from the temples.

 

I believe its fair to atleast get the hair shafts to thicken to terminal hairs. That on its own would give a good result.

Edited April 14, 2012 by akuma

[RCWest]

Akuma, did you or have you ever tried Minoxidil after surgery? I know it's a shot in the dark, but it could possibly bring some hairs out of dormancy.

[Duckie]

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

 

 

Hey Akuma - could I check w you how much you paid for your HT with Dr Path?? I'd just been to his clinic and I was quoted quite a hefty sum for 2400 grafts!!

[akuma]

Akuma, did you or have you ever tried Minoxidil after surgery? I know it's a shot in the dark, but it could possibly bring some hairs out of dormancy.

 

no i haven't tried minoxidil or propecia.

 

Hey Akuma - could I check w you how much you paid for your HT with Dr Path?? I'd just been to his clinic and I was quoted quite a hefty sum for 2400 grafts!!

 

I think it was 85 baht per graft.

 

My hair is improving I think, but i am not sure because it is soo slow. Maybe it not even improving at all. Hard to tell. I think something went wrong in my hair transplant case.

 

In the worst case scenario that my grafts dont grow in, what are my options?

[Duckie]

no i haven't tried minoxidil or propecia.

 

 

 

I think it was 85 baht per graft.

 

My hair is improving I think, but i am not sure because it is soo slow. Maybe it not even improving at all. Hard to tell. I think something went wrong in my hair transplant case.

 

In the worst case scenario that my grafts dont grow in, what are my options?

 

Dear Aukuma - thank you for replying to quickly! Yes, I think Dr Oravan quoted me 85 baht per graft too >.< Though she quoted me a higher price for eyebrow transplant...I'm wonder if I could write to her to ask for a discount? It really doesn't make sense to charge me a different price for eyebrows...

 

I think the Path's website promises that you could go back to him if your grafts don't grow in. I don't know what's the legal aspect of holding him account to his website promise though. That's the problem with medical tourism! Let me know and I hope you're doing better!

[akuma]

Dear Aukuma - thank you for replying to quickly! Yes, I think Dr Oravan quoted me 85 baht per graft too >.< Though she quoted me a higher price for eyebrow transplant...I'm wonder if I could write to her to ask for a discount? It really doesn't make sense to charge me a different price for eyebrows...

 

I think the Path's website promises that you could go back to him if your grafts don't grow in. I don't know what's the legal aspect of holding him account to his website promise though. That's the problem with medical tourism! Let me know and I hope you're doing better!

 

Yea I remember being charged more for eyebrow transplant. I think this is because its a more delicate procedure and takes longer to do.

 

Their website says..

 

DHT Clinic

 

"However if there is no growth which has never happened in our practice you may return for surgery free of charge. "

 

Would I get a free surgery if I dont get a reasonable result?

[HARIRI]

Yeah, I think you should ask him for a free surgery if that's what its mentioned in his website UNLESS there is a small lettered terms and conditions for this offer but still I think you will be told wait 18 months :-)

[akuma]

Yeah, I think you should ask him for a free surgery if that's what its mentioned in his website UNLESS there is a small lettered terms and conditions for this offer but still I think you will be told wait 18 months :-)

 

Yea I am waiting the full 18 months though. Just cant help thinking what went wrong though.

 

Was so happy with my result at the temples. You can see how dark my hair is. This even gives me a strong temple result when compared to lighter coloured hair individuals. Was so excited waiting for the scalp result to come in.

 

I thought maybe the scalp hair are growing out at a slower rate (cm per week). But I snipped a baby hair all the way short, and saw that it grew out at a normal rate. It wasn't slow.

 

I think somehow the growth and sleeping phase of the hair has got messed up.

 

The scalp hairs had slept for heaps longer before it even began to grow in.

 

But all this guessing on what went wrong wont help...

 

I want to upload a recent picture but I think i'll wait. 5 more months till I hit the 18 months mark.

[akuma]

hey guys. Today is 1 year, and 2 months and I'm afraid it hasnt improved much.

 

I've attached some pictures.

 

Again, I held the frontal hairs down to compare fairly to the temples, there is a big difference. The frontal has not matured up much at all. I dont think there is going to be any maturing from now on.

 

There are still hairs that are thin and wiggly. Looks like they are struggling to grow or something. All the thickened hairs are stiff and straight.

 

 

I guess this is my final result for my frontal scalp. I cant comb the hair back because the hairline isn't even and has some gaps.

 

 

Comments?

[Duckie]

hey guys. Today is 1 year, and 2 months and I'm afraid it hasnt improved much.

 

I've attached some pictures.

 

Again, I held the frontal hairs down to compare fairly to the temples, there is a big difference. The frontal has not matured up much at all. I dont think there is going to be any maturing from now on.

 

There are still hairs that are thin and wiggly. Looks like they are struggling to grow or something. All the thickened hairs are stiff and straight.

 

 

I guess this is my final result for my frontal scalp. I cant comb the hair back because the hairline isn't even and has some gaps.

 

 

Comments?

 

i'm so sorry you're going through this akuma. have you checked back with the doc?

[HARIRI]

Check out Dr. Radha, she is good. Ask RodG, he used to be Dr. Path patient and then went to her for extra density. Honestly Im not a believer of 18 months stuff. One year should be crystal clear. Good luck Akuma.

[strypp]

do you have any before pics of the hairline and the temples?

 

were the new grafts implanted into completely bald areas or into thinning areas?

 

the temple points look really good. were they moved in as well?

[TomCruise]

Akuma, You have been very diligent with posting all the photos and waiting the alloted time. I hope you find the solutions you are looking for!

[akuma]

do you have any before pics of the hairline and the temples?

 

were the new grafts implanted into completely bald areas or into thinning areas?

 

the temple points look really good. were they moved in as well?

 

 

The frontal scalp was transplanted into bald areas, but also deeper into my native hair as well (just incase).

 

yes my temples were moved forward. Am very happy with the temples.

[akuma]

do you have any before pics of the hairline and the temples?

 

 

 

Here are some picture. 3 days after surgery. Grafts were inserted into my native hair as well, and hence some of my native hair was shaved down.

[akuma]

do you have any before pics of the hairline and the temples?

 

 

Here are some pictures 22 days after surgery.

[akuma]

do you have any before pics of the hairline and the temples?

 

 

Here is a picture before transplant. As you can see, I had a zig zag hairline before.

 

The blue line is roughly where I transplanted.

[Sean]

Akuma, your temples do look great. I do understand your concern with the hairline. I do commend you for trying to be really patient with this process the way you have. It's not easy because you are constantly just waiting for hope to have more growth the way you assumed it would be. Will the 18 month growth timeline you were given produce a substantial increase to your areas of concern? I honestly am not too sure. Who knows though? There could be a possibility in that possible 2% change. 14 months have passed, 4 more to go. Try not to stress too much about it until that time target but continue to post your photos. There are quite a few members of the community reviewing your photos and rooting for you.