"Cant decide" Round 2 With Dr. Rahal

[Cant decide]

Well, I have finally booked by second procedure with Dr. Rahal for August 2013. I am going in March for my consult and to discuss the game plan with Dr. Rahal. I have been on Proscar and Rogain foam since a few months before my first procedure in October of 2010 and it seems that I have basically stabilized my hairloss so I feel the time is right for my second (And last!!) procedure. I could have rushed into a second a year or two ago but I wanted to make sure I had a handle on my rate of loss and where I am potentially headed. Based on discussions I have had with Dr. Rahal back when I had my first procedure on what I need, want, and what my donor is capable of, what I want to do is 3500 grafts in the following locations:

 

Most grafts placed in the following locations:

 

1. Each side of the crown so as to make my side profiles solid.

2. Work back into the crown overlapping just a bit from the midscalp where Dr. Rahal left off the first time.

3. Lower density at the remaining top crown circle (whater is left of the crown after the sides and top of crown are addressed with good density.

I am thinking 3000-3100 grafts to accomplish this.

 

Remaining Grafts:

 

1. VERY minor temple corner work. Not ncessarily to bring the temples corners forward but rather to make them denser in their current location so as to expand my styling options.

2. Whatever grafts are left over, add just a bit more density into my center hairline and possible lowering the center of the hairline very very slightly.

 

I am thinking 400-500 grafts at most to accomplish this.

 

As you can tell, I have been giving this alot of thought . Of course, this is my educated idea of what should be done and what I want to do but of course, when I talk to Dr. Rahal, he may have other ideas and of course he needs to confirm if I can get more/less from my donor this time around. He said 3000 would not be an issue for me the second time around but that was 2.5 years ago and I want to see if he will be able to squeeze in 500 more . He thinks I have about 5000 total left with FUT alone.

 

For me, it is very important to make sure I hit the sides and top of the crown with very good density even if that means that the center crown is left somewhat thin. This will ensure my side profiles look good. My crown loss is such that I may be able to just put 3000 evenly distributed into it and get decent density overall but it is so important that my side profiles are solid and the back top of my head is solid that I am willing to put extra grafts in these locations and give up some density in the center crown. All to often, I see thin/bald crowns transplanted with even density throughout and while they certainly look better, the thinning diameter was not reduced. Instead, my approach would close the crown diameter with better density even if it means a thinner top center is left (Relatively small area).

 

Thanks to all for your kind words over the last couple of years. Of course, I will continue to update my web page as well to document my progress.

 

Here is the link to my HT expierience from my first HT

 

http://www.hairrestorationnetwork.com/eve/160548-5000-grafts-dr-rahal-pics.html

Edited January 9, 2013 by Cant decide

[TommyLucchese]

Just read through your previous thread.

 

Your results are amazing, I'm so happy for you! Rahal is exceptional.

 

Good luck for round 2, sounds like a plan!

[Spanker]

Awesome man. Congrats! Got any crown pics?

[Davis91]

Can't Decide: totally agree with your strategy. I am looking for the same. Can you share any before/after crown pics and current crown pics?

[TommyLucchese]

Agreed, also quite curious to see your crown .... would you be so kind? Interested to see the "lateral" section you had done?

[chrisdav]

Congrats Cant decide.

 

Your hair looks really good currently.

[NEWHAIRPLEASE]

Great...that will be close to 9000 grafts total....good luck!!! Your hair will look great!

[chrisdav]

I actually forgot how far you have come Cantdecide.

 

Great transformation and the second session will take you to another level

[Cant decide]

Thanks guys. I will post crown pics when Dr. Rahal takes them during my consultation.

 

Any other thoughts on my proposed approach?

[hairthere]

CD, sounds like a solid approach. If I could go back in time I would have a) started with Dr.Feller and b) planned my hair restoration the same way, addressing front to back. Lucky for you to begin the process with such a great surgeon! Looking forward to seeing your crown work.

[NEWHAIRPLEASE]

CD, sounds like a solid approach. If I could go back in time I would have a) started with Dr.Feller and b) planned my hair restoration the same way, addressing front to back. Lucky for you to begin the process with such a great surgeon! Looking forward to seeing your crown work.

 

Hairthere

Not to steal cane decide thread, but do you have any current updates? How's your hair doing. I would love to see some photos. I think I'm getting the hair greed bug!!!

 

Can't decide,

Good luck and tell Dr Rahal I said thanks and hi. Also, tell that hot girl that works up front I said hi!!!! Lol

[hairthere]

NHP, Good to hear from you my man! I will update with pics soon as I am approaching the 1 year mark Feb.2.

 

CD, after giving your approach some more thought, I would recommend possibly concentrating all grafts in your crown and perhaps hitting those temples corners with FUE if it's just 400-500 grafts. The reason being, the crown takes up a whole lot of grafts. I addressed my crown the same time I did my hairline/frontal areas, and in hindsight this was a mistake. I ended up with the "island effect" because my loss progressed so quickly. So I had to hit the area again in a later session. As others have stated, some crown pics would certainly help.

[Cant decide]

Thanks Hairthere and NHP!!

 

Hairthere - When you say you were left with an "Island effect", I assume you mean the crown dropped further and left gaps between the transplanted hair and native hair? Would you suggest that I have Dr. Rahal really go as low as possible on the crown borders to address any thinning in order to "Stay ahead" of the potential crown expantion? This was my thought and why I would rather spend the grafts on the borders than in the center.

 

I am pretty confident that my bottom crown will not drop further but the crown sides are vulnerable although Proscar has stabilized it.

[hairz]

I will be there in March also!

[Cant decide]

Thanks Spex. I decided to try and stop overthinking this and leave it up to Dr. Rahal

I will see what he says mext month when I consult with him in person.

[Raphael84]

CD,

All the best in your upcoming consult. What date are you with the Dr? Its great that you have solid ideas of how you would like your next HT to go! You have come a long way!

[Cant decide]

Thanks Raphael. All the best to you as well. I will see the doc at the end of March.

[hairz]

Thanks guys. I will post crown pics when Dr. Rahal takes them during my consultation.

 

Any other thoughts on my proposed approach?

 

 

Cant decide, Nice to of met you. How did the consultation go?

[Cant decide]

I wanted to let you guys know how my consultation with Dr. Rahal went in March in preparation for my second procedure in August.

 

I arrived and when Dr. Rahal called me in, he took one look at me and said "Wow you look like a completely different person, so much younger". That was nice to hear. He examined my hair and agreed that the yield, angulation, and density was very good. He took a look at my scar and could not find it at first. I think he was even amazed at how small it was. He said it was 1 mm or less almost everywhere. This was also great to hear. My laxity was good even though I had not really started exercises very much at that point and he told me to keep doing the exercises even though laxity was good to make it even better.

 

On the down side, I did lose a little more hair in my crown over the last 2.5- 3 years since my first surgery. Not too much and I am sure without the meds, I would have lost more. By now, I am a NW VI and Dr. Rahal does not think I will hit a VII so my hope and our expectation is that by now I have lost enough hair to just about complete my pattern so between that fact and the meds, any further loss after my second procedure should be relatively minimal and will not have a significant effect on my overall look.

 

Dr. Rahal said we will shoot for between 3500-4000 grafts to cover the crown and do some very minor temple corner blunting. He said there should be no issues hitting this number.

 

If we hit 4000, that will put me at 9229 total and he stated that after that I should still have about 2000 left for any future procedures if I so choose although I really want this to be my last.

 

So as you can see, I was cursed with a NW VI pattern but blessed with a great donor supply and a good hair to graft ratio (2.29)

 

I am not going to post pics of my crown now as they just bum me out at this point . I certainly will post pre/post op pics and progress when the time comes.

[Cant decide]

Also, if anyone will be at the guest house around Aug 6th, let me know. We will me "In the trenches" together

[TakingThePlunge]

Congrats and good luck! I'll be watching your latest journey with interest.

[garmax]

Congratulations, and all the best to you on your upcoming procedure. You are one lucky dude with that above average donor density....i'm very envious. I'm looking forward to follow your final procedure as I will also need a 2nd procedure to take care of my crown.

[greatjob]

Also, if anyone will be at the guest house around Aug 6th, let me know. We will me "In the trenches" together

 

Good luck man!! I'm happy for you, I think this last one might be the end of your journey. I wish I was getting my procedure done while you were there, if I remember right you are a chemistry guy, I'm working on my PhD in molecular biology and biophysics and would love to be in the house with another science nerd, lol. Good luck brotha you already look great and after this one you are going to be a HT poster child!!

[Cant decide]

Thanks guys for the well wishes.

 

Greatjob - Yes I am a chemist but now I work as a VP for a small pharma company. It would have been nice to connect at the guest house. When is your procedure? Good luck with yours as well.

[hairthere]

This procedure will be a cakewalk for you my man.....best of luck!