1800 Grafts with Dr Paul Shapiro

[multiplier]

This past Wednesday, I had another surgery with Shapiro Medical in Minneapolis. I wanted to give some impressions of the last surgery, this one, and the future.

 

In Jan 2011, I had gone off off Propecia due to what I perceived as side effects. When I got surgery with Dr Shapiro in Oct 2011, he said we'd try to shoot for 2000+ grafts, but we only yielded 1400. He said that due to the previous MHR scar, the donor area was suboptimal, but he'd refined scar so the next yield should be better.

 

For most of the year afterward, I stayed off of Propecia, and unfortunately I believe this just led to more hair loss. Thankfully, I have worked through a divorce and very tough period in my life and my libido seems to have mostly come back, so I'm back on the meds. But was there any gain from the surgery, or did I break even? Hard to say.

 

Anyway, I had another surgery with SMG this week and Dr Shapiro again said we'd shoot for 2000 more grafts. In the end, we got 1800. When I asked why, Dr Paul said the donor area had become taxed, tight, and the density was poor. Going forward, he recommended I stay on the meds, see where I am in 2-3 years, and re-evaluate. He said FUE would probably be the best bet and it would actually yield more hairs than another strip. Around 1000-2000 he quoted? But again, the predictions keep falling short. He also mentioned considering micropigmentation at some point in the future which also requires maintenance and sounds to me like a last resort.

 

At this rate, things are beginning to feel pretty abstract and discouraging. I can't say I ever had delusions about being an ideal candidate with dense reserves of donor hair. But at the same time, in my 3-4 meetings with reps from Shapiro, I was told my donor was Average at worst and that we'd get multiple sessions of 2000+ grafts. As time went on and surgeries were done and those numbers did not materialize, the more the reps began characterizing my donor as Poor, not Average.

 

On the plus side, I have 3200 grafts that I didn't have 2 years ago. But what if I become resistant to finasteride? Or what if I get re-married and, at some point, need to explain to my wife that not only have I had 3 of these surgeries, I may need more in order to not look freakish?

 

Has anyone in my position taxed their strip to the point where they've switched to FUE to help "finish" the job, so to speak? I don't mean to sound alarmed right now. But I'd be lying to say this is where I thought I'd be after starting this journey 10 years ago.

Edited January 20, 2013 by multiplier

[multiplier]

I would like to add, though, that using staples in the donor area has been much less painful than last time we used sutures. No trouble sleeping or shifting at all. And as usual, the SMG staff was very professional and accommodating.

[tacolinowest]

most people that are destined to be norwood 5-6 wont have a full head of hair, but as long as you have a hairline and some mid scalp coverage you should be happy, its a privilege that we have this technology now we can cheat nature, i mean at least thats how i look at it,, i think what you have now looks pretty good,, maybe one more session of fue and bam, ur not a bald guy

[Spanker]

Did the say why they did not concentrated the top of your head? Seems like it was concentrated on the hairline again.

[multiplier]

I think that might be a bit of an illusion. Most of the work was done at mid-scalp, I just have a high hairline and am tilting my head a lot in that photo.

[SADbutTRUE]

im pulin for you, i wish you great growth and a great scar, stress can do a number on your body, going through a divorce is very rough. ,it could be a reason for some hair falling out, last summer my dad took ill ,and i was very stressed out, lost 50 pounds ,, and hair was shedding like crazy for three months , and i my hairloss was very stable for 4 years. dads fine now, and hair stop shedding around sept, the amount of grafts you got should give you some decent coverage in the front half, and you always have concelar to aid if needed,your donor looks good im suprised you diddnt hit the 2000 mark, 1800 grafts is close though, maybe its the fact your donor is tight thats why the mark wasnt hit, was vitrase used , ive read that they use it at times to increase the laxity of the skin and that enables more grafts to be taken out, you still have donor avalible, hopefully you wouldnt need it, thanks for sharing , once again im pullin for ya.

[calgaryhairguy]

It also doesn't hurt to get another opinion. In all my research both here and elsewhere I have sometime noticed people getting different answers from different doctors. Like anything in life it sometimes is a good idea to see what other professionals think. Best of luck!

[aaron1234]

Dr Shapiro again said we'd shoot for 2000 more grafts. In the end, we got 1800. When I asked why, Dr Paul said the donor area had become taxed, tight, and the density was poor. Going forward, he recommended I stay on the meds, see where I am in 2-3 years, and re-evaluate. He said FUE would probably be the best bet and it would actually yield more hairs than another strip. Around 1000-2000 he quoted? But again, the predictions keep falling short. He also mentioned considering micropigmentation at some point in the future which also requires maintenance and sounds to me like a last resort.

 

I imagine that in the evaluation of patients scalp laxity there is a little bit of guesswork. Meaning, you're not entirely sure how the donor area will act until it's opened. Quick question, did you do scalp exercises before this procedure?

 

As for micropigmentation; it is in the infancy stages. But I can see the value of it for patients who have tapped out their donor. I know you use some concealer, so the temporary inking may be a great compliment to your transplants once they grow out. Keep an open mind. I'm definitely considering it in the near future.

 

At this rate, things are beginning to feel pretty abstract and discouraging.

 

Hang tight my friend! Think positive! You know the next three months will be tough. Theoretically, most of the permanently shock-proned hairs would have been lost in the last surgery. Definitely stay on the meds. I felt that after my second procedure with SMG that things improved drastically... and I was pretty darn happy with the first one.

 

Has anyone in my position taxed their strip to the point where they've switched to FUE to help "finish" the job, so to speak?

 

I'm not there yet but I'm definitely planning on it.

 

It's been a tough couple of years for you. You deserve a wonderful result and I hope you get it! Keep us all posted.

[aaron1234]

I would like to add, though, that using staples in the donor area has been much less painful than last time we used sutures.

 

Yes! This was the case for me as well. I used sutures for the first surgery and had a very difficult time with them. The staples felt much better.

[SADbutTRUE]

im suprised that at under 4000 grafts ur taped out, maybe its the tighness of the scalp is the reason for the low graft count, because you dont want a streched scar, you deserve a good result, and i hope you get it,