Regular Member BlueSteel Posted July 13, 2012 Regular Member Share Posted July 13, 2012 June July 2012 Hi there, I wanted to document Dr. Bijan Feriduni's repair of my prior hair transplant. I have learned so much from reading the forums for the last year. I wanted to say thank you for all the wonderful information that has been presented and contribute to our online community through a picture based write up on my experience with Dr. Feriduni. My patient history: -1998: age 18 - started to notice norwood 6 diffuse pattern, very similar to my father and maternal grandfather -1999: age 19 - started finasteride use over age 19-27. I was a good responder over the diffuse nw6 area. The hair regrew a little and was maintained at ~35-40% of original density -2005: age 25 - I had a hair translpant with Dr. Armani in Toronto, strip of 3000 grafts to the frontal zone; the cosmetic result was acceptable but I was a little surprised by how little area was covered and the questionable graft yield. The main concern was scar stretching, whitening, and hypertrophy / keloid formation. However, I kept my hair longer to cover the scar and was happy with the result. The hair behind the transplant was 35% of original density from propecia use. -2007: age 27 - scar revision with Dr. Rahal. The results improved the scar width but I still had stretching over the ears, whitening, and possible keloid formation; I feel Dr. Rahal did his best and I was satisfied. I could cut my hair with guard #7 and not show scar. -2008: age 28 - finasteride side effects began with a progressive decrease in sex drive, decreased penile skin sensitivity, and lack of early morning erections / nocturnal penile tumescense (negative postage stamp test). Thus after another 6 months of this I quit the drug. -2009: age 29 - my side effects decreased after stopping finasteride. After 1 year I regained my libido, penile skin sensitivity, and early morning erections / nocturnal penile tumescence (positive postage stamp test). I sense DHT affects me greatly and as I approached 30 my normal testosterone levels dropped and the propecia effects became clinically evident. Everyone has their own experience and I hope no one else has these side effects. -2009: age 29 - after stopping finasteride the diffuse hair in nw6 pattern thinned from 35% of original thickness/density to ~5% as it is currently -2009 to 2012: age 29-32 my hair had very poor aesthetics with a frontal ht and ~5% density behind, i didn't have time to do anything about it because I was in residency/fellowship till 2011, i am a surgical subspecialist and was very busy. I also wanted to wait 3 years to let all the propecia / finasteride wear off and hope that my male pattern baldness would stabilize as it had with the men in our family by age 30. In short I am a complicated patient with many issues including: "further hairloss after transplant" "scar stretch" "scar hypertorophy" "keloid formation" and "propecia finasteride side effects". In addition to this I have "moderate scalp laxity" and "poor to moderate donor density" The few things I have in my favor include: low contrast between skin and scalp (brown and black respectively), financial stability, slightly coarse hair with average thickness, and I am also slightly above normal stature at 5'11" With so many risk factors and prior complications, this makes things very difficult for my hair transplant surgeon so I knew I could not make a rushed or emotional decision as I had in my first procedure past. I took from August of 2011 to April of 2012 to research and narrow things down to a short list of surgeons. My decision to go with Dr. Feriduni was based on several factors. Which I will comment on in the next post. Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 (edited) Pre Op Eval: 7-4-12 - July 4th During the pre op evaluation on July 4th 2012, Dr. Feriduni and I spoke for almost over an hour. I asked a litany of questions and to be quite honest, although I am a surgeon and on the surface may appear confident; I was extremely nervous due to being in another country, jet lag, and the anxiety associated with any surgery. Dr. Feriduni did a great job of helping me feel calm and I sincerely feel he was acting in my best interests. He took exact measurements of many parameters of my hair. He measured the exact donor area size, recipient size, checked laxity, measured the micrometer thickness of each donor follicle, and many other things including the use of a very cool mask like device that checks your temple points are properly placed. This device looked like a cross between a transparent protracter and a mardi gras feathered mask. He also used a surgical wax marking pencil to draw in the exact boundaries of where he wanted to place grafts. In summary, he was extremely thorough. He told me that I had poor donor density, and I could likely have a total of 2000 FUE at maximum. I wanted a minimum of 3000 grafts for the whole process of having a HT to be worth it (time off/healing/recovery etc). So we decided on a strip/fue combo. Dr. Feriduni was able to harvest about 2000 strip (without excessive scar tension) and about 1000 FUE. I was glad we could do both, it gave me one more opportunity at getting a better strip scar and also if I had poor scarring from FUE, I only had 1000 rather than having 3000 punctate scars on the back of my head. As I write this now at 11 days post op, the FUE site is totally healed with no signs of surgery or decreased density. Over all the preop experience was both thorough and calming. Edited July 17, 2012 by BlueSteel add more information Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 (edited) Intraoperative Pics - planning In the morning I was greeted by Dr. Feriduni and staff. They were 110% professional and made me feel very calm. Getting my head shaved was a novel experience and I realized how different I look without any hair. Looking at the pictures now I realize how bad the keloidal scarring was. Unfortunately this is how I heal and I highly doubt much can be done about it. Dr. Feriduni had mentioned cortisone injections into the scar which I may try here in the US if I can find a dermatologist amenable to it. Edited July 17, 2012 by BlueSteel Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 (edited) Intraoperative - incisions and grafting Overall I don't remember much of the operation, this is due to the amnestic effects of versed (midazolam) which is a commonly used sedative in surgery. What I do remember was that other than the anesthetic injections there was almost no pain. It should be noted that you will feel "pressure" just not pain. This is actually reassuring to me but I can imagine that for some patients it can be disconcerting if they were expecting a total lack of sensation. I slept most of the procedure, when I woke they did show me the grafts (all 3000+), it was fascinating. Edited July 17, 2012 by BlueSteel Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 (edited) Post Operative Day #1 - bandages removed I slept fairly well and only needed a moderate amount of painkillers. Getting the bandages removed and being able to see how far the grafting had gone back really excited me. Dr. Feriduni really covered a lot of ground. For the next few days I came in for washes. Having the aftercare done professionally is really nice. It takes a lot of the stress out of the whole process and his staff was extremely professional. Dr. Feriduni saw me each day, even if it was just for a moment to make sure the aftercare was done perfectly. Although I trust his staff 100% I really appreciated the time and effort he put into perfecting his art. On Saturday he also came in and did a quick check & wash for us, the fact that he is willing to come in on Saturdays shows his dedication. Cristian was really helpful and made my mom and I really feel at home, always helping us arrange transportation, informing us where we were in the patient flow and making some amazing macchiatos when we had to wait. Edited July 17, 2012 by BlueSteel Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 (edited) Up and about Hasselt,over the next few days it was beautiful. With the surgical cap on and a fedora over top, no one noticed. The healing progressed. If you are staying at the Radisson Blu and want to get your friends back home gifts, I would suggest some Belgian chocolates. Leonidas is literally right behind the hotel. Nieuhaus is a little further away but its beautiful walk. I told all my friends I was going to Belgium but never told them it was for anything more than tourism. When I returned with chocolates no one asked too many details about the trip, they were too busy consuming these amazing delicacies. When people asked what all I did I just responded, "it was so relaxing I just hung out in this beautiful little town in the country side, ate great food, relaxed, and totally decompressed... it was a restorative process" Also, when staying at the RadBlu I would definitely suggest a higher level floor facing towards the West. This gives city and sunset views which are beautiful. It also prevents claustrophobia / cabin fever which can definitely occur. The food at the RadBlu is not bad per se, just not necessarily good, breakfast will get monotonous. I really enjoyed exploring the city for short sessions while recovering. There are literally hundreds of restaurants and bakeries to get high quality fare. Carrefour is a grocery store behind the RadBlu, go there to stock up on food / water / etc. Loading my iPad with movies/tv shows was definitely nice because the RadBlu has good internet bandwidth but the TV and on demand services are lacking. Also you can't get streaming such as NetFlix or Amazon on Demand there due to licensing restrictions. One other thing the TV is approximately only 19" so I used the laptop when my Mom and I both wanted to watch a movie. Edited July 17, 2012 by BlueSteel Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 Post op day 6 & 7 Dr Feriduni and his team did an excellent job of removing the scabs. Later, I put on an addidas headband to get ready for my return to the Arizona. The headband is really wonderful, it covers the strip site and exposes the grafted hair so everything looks fairly normal. This is nice as I prepare for the airport. In addition to this it also prevents the staples from moving and irritating the incision site when I lay down. Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 The headband shown here. I also realize from Dr. Feriduni's shavedown for FUE that I look good with extremely short hair. Hopefully the scarring is non keloidal and I can get FUE / SMP into the scar in the future. Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 13, 2012 Author Regular Member Share Posted July 13, 2012 I will write more about my experience later, but right now I need to pack. Thank you to everyone online who has posted their experiences. It has made my journey much easier and more relaxed. Link to comment Share on other sites More sharing options...
Senior Member chrisdav Posted July 13, 2012 Senior Member Share Posted July 13, 2012 Congratulations Bluesteel on your recent surgery. You picked an excellent surgeon and keep us posted with your progress. 2 poor unsatisfactory hair transplants performed in the UK. Based on vast research and meeting patients, I travelled to see Dr Feller in New York to get repaired. Link to comment Share on other sites More sharing options...
Senior Member irishsailor Posted July 16, 2012 Senior Member Share Posted July 16, 2012 Great write up. Congrats on yr latest procedure you cetainly picked one of the best. I hope you get the results you deserve Hair Transplant Dr Feller Oct 2011 Hair Transplant Dr Lorenzo June 2014 Link to comment Share on other sites More sharing options...
Senior Member alix Posted July 16, 2012 Senior Member Share Posted July 16, 2012 great write up and pictures..I'm interested in Strip+FUE combo method.I knew Bisanga performs them in Belgium but didn't know Feriduni performs them too.I think in cases were scalp is a bit tight and doesn't allow harvesting necessary number of grafts in one go,Combo method is the better option than waiting one more year for another strip. Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 17, 2012 Author Regular Member Share Posted July 17, 2012 (edited) great write up and pictures..I'm interested in Strip+FUE combo method.I knew Bisanga performs them in Belgium but didn't know Feriduni performs them too.I think in cases were scalp is a bit tight and doesn't allow harvesting necessary number of grafts in one go,Combo method is the better option than waiting one more year for another strip. I was glad we were able to do the combo. Imagine if you only had the laxity for 2000 strip and only had the density for 2000 FUE. That was my situation. It would be hard to go through a procedure for only 2000 grafts. I also think it would be interesting to see if some patients who could harvest ~4000 via strip and 3000 FUE would be able to get 7000 grafts in one 3 day period (day1: strip 4000/ day 2: fue 1500/ day3: fue 1500). Although it might be a little pricey it would be an amazing opportunity to do a lot in one pass and could restore most NW5s. Of course you would have to see if this was something Dr. Feriduni felt was appropriate. Edited July 17, 2012 by BlueSteel Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted July 17, 2012 Author Regular Member Share Posted July 17, 2012 Great write up. Congrats on yr latest procedure you cetainly picked one of the best.I hope you get the results you deserve Thank you, I really appreciate your kind words... especially as I realize my new grafts will shed in the next 10 days or so! I saw your thread also, looks amazing! You still have more maturation which has to feel great because you already have achieved excellent cosmesis. Link to comment Share on other sites More sharing options...
Senior Member Mickey85 Posted July 18, 2012 Senior Member Share Posted July 18, 2012 I wish you all the best with this procedure, you sure have been through a lot. The only 2 threads you will ever need: Revamped Advantages/Disadvantages of FUE. Myths dispelled. Educate yourself Everything FUE. Manual, motorized, ARTAS, NeoGraft, physician details and more Link to comment Share on other sites More sharing options...
Regular Member BlueSteel Posted August 2, 2012 Author Regular Member Share Posted August 2, 2012 Wow, only 5 to 10% of the grafts have shed at maximum... post op month #1.... a significant portion look like they are growing. As odd as this sounds I kinda want them to fall out so that I can "know they are cycling". Some look "lifeless" many look "growing" but its tough to distinguish trees in a forest. What are your guys thoughts? Am I one of the lucky 2-3% who retain most of their grafts or just a "late shedder" Link to comment Share on other sites More sharing options...
Senior Member Mickey85 Posted October 1, 2012 Senior Member Share Posted October 1, 2012 Any updates champ? The only 2 threads you will ever need: Revamped Advantages/Disadvantages of FUE. Myths dispelled. Educate yourself Everything FUE. Manual, motorized, ARTAS, NeoGraft, physician details and more Link to comment Share on other sites More sharing options...
Senior Member hairshopeing Posted October 4, 2012 Senior Member Share Posted October 4, 2012 Any updates after such a well detailed experience??? Link to comment Share on other sites More sharing options...
Senior Member Mickey85 Posted November 5, 2012 Senior Member Share Posted November 5, 2012 Any updates on how the scar healed champ? The only 2 threads you will ever need: Revamped Advantages/Disadvantages of FUE. Myths dispelled. Educate yourself Everything FUE. Manual, motorized, ARTAS, NeoGraft, physician details and more Link to comment Share on other sites More sharing options...
Senior Member alix Posted January 26, 2013 Senior Member Share Posted January 26, 2013 any updates? Link to comment Share on other sites More sharing options...
Senior Member tacolinowest Posted January 26, 2013 Senior Member Share Posted January 26, 2013 great wright up how is everything Link to comment Share on other sites More sharing options...
Senior Member MAGNUMpi Posted January 27, 2013 Senior Member Share Posted January 27, 2013 would love to see new pictures. hope all is well. Link to comment Share on other sites More sharing options...
Senior Member socates123 Posted April 15, 2013 Senior Member Share Posted April 15, 2013 I'm curious, hope all is well Link to comment Share on other sites More sharing options...
Regular Member sevnblak Posted June 16, 2013 Regular Member Share Posted June 16, 2013 Are you happy with your results?? Any updates?? Link to comment Share on other sites More sharing options...
Senior Member stinger99 Posted June 16, 2013 Senior Member Share Posted June 16, 2013 an update would be great Link to comment Share on other sites More sharing options...
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