Disappointed and not sure what to do next...

[Pulpedfiction1]

Hello.. I've been an avid reader of this board for awhile, but this is my first post.

 

I should probably begin with the background info. I'm a mid 30's male from the northeastern US. I first noticed thinning in the front at about age 25. It got progressively worse but wasn't a detrimental life issue until I hit 30. Of course I didn't take the proactive approach and get on finasteride early. So by the time 30 came around, things were getting out of control. I was well on my way to the dreaded 'horseshoe' head, as even the crown was rapidly receding (althought not nearly the rate of the hairline and further back)

 

I began using Finasteride and Minoxidil. Didn't see any appreciable results so I foolishly

stopped and just buzzed my hair short (and I'm not one of the lucky few who can pull off that look)

 

I finally decided to take the plunge in 2012. Based on extensive research, I sought out Dr MIke Beehner, who not only has excellent reviews but is also within driving distance of me. His plan called for two 1700 graft procedures and to get back on Finasteride (which has done a nice job on the crown and really has seemed to stop or at least slow down the loss). i had the first procedure that spring. The procedure mostly resulted in significant hairline improvement, but gave me little coverage beyond that. Moreover the procedure seems to have resulted in permanent shock loss above the ears (more pronounced on the right side). When I tried buzzing my hair down to a #3, the scar in the back did not show at all but the scar on the sides were not only visible but also had a couple of empty patches. When the hair is half an inch or longer it isn't quite an empty patch but there's a very noticeable thin area on the siides. When I asked Dr B about this, he said that filling in the patches with some grafts during the 2nd procedure would be the solution .

 

Feeling somewhat discouraged with only a very mild improvement from my first procedure, the reality that another procedure of equal size would not be sufficient began to set in, I decided to shoot for the hair-transplant moon and book a procedure with Dr Wong. I did the online consult and Mike Ferko got in touch with me. As I had expected, it would take about 3000 grafts to fill things in. While this would be rather expensive and I'd have to travel quite the distanced, I have the luxury of summers off.. And besides who needs a new car when a full head of hair or close to it is only a plane ride away ?

 

I arrived in Vancouver this week and had my consult yesterday. Dr Wong felt my laxity was 'average' and donor density somewhat below that. Nevertheless he promised hed do his best and I left confident that we'd come reasonably close to the goal.

 

My procedure was scheduled for this morning. After taking a Valium and getting the front buzzed down, Dr Wong began to get me positioned to harvest the strip. The awful news followed.. not only was my scalp tight and the donor density somewhat low but he decided that the sides were so thin that he could not take the strip from them. We'd only be able to get 500 or so grafts and excise the scar. Needless to say I'm absolutely devestated. He recommended doing the laxity exercises for several months... And then perhaps we could get 1000 singles.

 

I'm absolutely beside myself right now. I've invested so much emotionally into this procedure

ending this very dark period of my life.. and now it seems no matter how much money I'm willing to spend or how far I'm willing to travel, I'm just going to have to accept the fact that ill never have a decent head of hair again.

 

I realize that I can't do anything about my donor density (which is surprisingly low to me considering how coarse my hair is). I'm willing to spend the time doing the laxity exercises if they'll get me anywhere near where I need to be. However what I don't understand is how the sides could be so thin. Isn't this area basically immune from the effects of DHT? Prior to my first HT I could buzz my hair all the way down to a #1 and not notice any thin spots whatsoever. Is it possible that these were damaged from the first strip?

 

Any thoughts on my situation would be most appreciated. I can try to post the photos that I originally sent for my H&W consult if that helps. Thanks for reading

Edited July 7, 2013 by Pulpedfiction1

[SADbutTRUE]

welcome to the forums, hang in there, without pics its hard for any one to give advice on how to procede further, get on meds, not sure if your still on them, and theres always fue, beard hair, and temp smp, with these and concelars you can improve your situation, try to stay positive ,maybe you can get 2000 grafts with fue and 500 beard hair, its a thought, that's close to 3000 grafts that the docs are recommending, add concelaear and you have something to work with,, good luck in your research,

[tacolinowest]

thats really ruff, im very curious to see what your donor looks like, iv never heard of something like this be4

[Levrais]

I agree with SadbutTrue. Have you talked to any clinics that do fue?

[Pulpedfiction1]

Thanks for all the quick replies. Yeah, I'm totally heartbroken right now...while I knew my donor density was somewhat below average, I had never anticipated THIS.

 

Sorry to not have been more clear--I am on meds. I have been taking a quarter of a Finasteride pill 3x per week, for the past 15 months. It has significantly improved the crown and has stabilized the frontal loss (at least in my perception it has),

 

I'd love to get some photos up...but at the moment my frontal scalp is shaved (talk about adding insult to injury!) When I speak with Mike on Monday I'll hopefully get the photos that I had originally sent to H&W.

 

Dr. Wong provided me with a letter detailing my issues(which I will show to my original surgeon). It reads "(Me) was prepped for surgery today and on examination of the scalp laxity it was determined that we can only obtain 400-500 follicular units along with a scar revision. (Me) was hoping to achieve 3000 follicular units but the problem is that the hair bearing strip can only be 12-14 cm in length as the sides are too thin to harvest. If (me) can stretch his scalp with the scalp exercises in the future we may be able to obtain up to 1000 follicular units. Because of (me) very limited hair supply it would be best to reserve this hair for future use to camouflage the existing graftsif his native hair thins out in the frontal region. (me) does not have enough donor hair to achieve his desired density as this would require 3000-3500 follicular units."

 

Again--my sides were NOT thin prior to my 1st HT!

 

I've thought about the FUE route; but am concerned about the cost (double?) and the limitations in session sizes.

[SADbutTRUE]

im also surprised that your graft total is under is under 3000 grafts, 1700 with 1st surgery and the possible 500 grafts from dr wong, together that's 2200 grafts, I never seen a case with some one with that low of donor .the only thing I can think of is that maybe your 1st surgery the tension was to tight , resulting in perment schockloss in donor,maybe the patient reps can have a better explation for this, but that's the only thing I can think of, pictures will help , meds can slow down hairloss and a fue session may be the ticket to get you where you need to be.good luck , stay positive and never give up.

[Blake Bloxham]

Hi Pulped,

 

Sorry to hear about this. While permanent shock loss, especially in the temporal/parietal scalp, is rare, it's not totally unheard of. It's also difficult to say whether or not the first procedure actually caused thinning in the donor region. I too think some images would help, and look forward to reviewing these when you get a chance. Have you discussed this issue with Dr. Beehner at all?

 

Also, Follicular Unit Extraction (FUE) may be an option, but I think it would be helpful to undergo multiple consultations to determine if you're truly a candidate. What's more, I think it's very important to proceed - if you are a candidate - very cautiously and only with a trusted, screened FUE surgeon.

 

I hope this helps! Look forward to the images.

[hairshopeing]

Look into fue with the Turkish doctors mate, cheap and very good fue, some utilise body hair if needed and have flight and accommodation packages available!! I'm sorry to hear about your situation but I'm sure something can be done by one of these guys!!! Good luck and I hope it works out for you pal!!

[Spanker]

Terrible news man. I'd love to see some pics, especially of your donor if you have any. Hope it works out and you find the right solution. I am surprised he did not find this stuff out during the in-person consult.

[Cant decide]

Far be it for me to start any sort of contraversy on here but both Drs. Beehner and Wong should have some explaining to do. If your donor was so bad that you were essentially maxed out at 2200 grafts (maybe 3200) someone should have noticed this during your consults and should have turned you away; Especially Dr. Beehner. However, I don't know what conversations you had with these docs so I am not saying they are totally at fault just yet. If they are reading this, I strongly suggest they chime in because this does look bad on them IMO.

[Spanker]

Far be it for me to start any sort of contraversy on here but both Drs. Beehner and Wong should have some explaining to do. If your donor was so bad that you were essentially maxed out at 2200 grafts (maybe 3200) someone should have noticed this during your consults and should have turned you away; Especially Dr. Beehner. However, I don't know what conversations you had with these docs so I am not saying they are totally at fault just yet. If they are reading this, I strongly suggest they chime in because this does look bad on them IMO.

 

CD, I agree that this should have been expressed.The first procedure was in 2012 so it is not like his donor should have changed that much in that time. Also, the way I read it, Dr. Wong had an in-person consult before the surgery, so this should not have been a surprise. Like you said, there could have been more to the story and like I said, I do like Dr. Wong's work, but I would like to know the full story being this one.

 

Some pt's are dead set on having a procedure even if they are not the best candidate. For that reason, if a patient insists that he will have surgery, I feel that they are in the best hands with a top doc, so I am not a big fan of turning away educated patients. For this reason, I am not knocking the Drs, but the rest of the story would be nice to know.

[rev3]

hey pulp

 

since your donor was fine pre-surgery, sounds like you've had shock loss of your donor reserves from the trauma

 

your last procedure was only in 2012, these follicles might have a chance of returning in time

 

do the exercises

up the propecia to one tab a day

up the minox 2x day

and set a date in 2014 to re-evaluate

 

be consistent in treatment

 

this all might be temporary

[Pulpedfiction1]

Thanks for all the great input.

 

To address the last few posts....yes, this is the entire story! I am infinitely grateful for the plethora of wisdom on this board, and feel no need to hold back.

 

During my initial consult with Dr Beehner in early 2012 (3 months prior to my first HT), he stated that I had very solid characteristics due to my coarse, dark hair. I dont particularly recall any comments about the region where the strip is taken; but his original treatment plan called for ~3400 grafts (over two sessions)--so that alone would indicate that he wasn't particularly concerned about being able to take good strips.

 

I'm just as surprised as all of you about Dr. Wong not fully seeing my issues until the day of surgery (after my entire recipient area had been shaved ) During my pre-op consult the previous day, he did express doubt about being able to reach our goal (3000 grafts) due to a somewhat tight scalp. We discussed placing grafts in the thinning areas on the sides of my head; but the sides were not mentioned as a potential road block to completing a decent harvesting.

 

Rev3: The consensus on Finasteride seems to be that a dosage as high as you mention would be of no additional benefit (and would likely result in increased side-effects). Am I wrong here? Not using Minoxodil because, according to Beehner, its pretty much useless. Not to mention that it can be a pain to apply (even the foam can be messy). Agreed on the scalp exercises--I've been rather lax in doing them due to varying schools of thought in regard to their efficacy; but if Wong believes in them as much as he seems to per our conversations, I'm sold.

 

Finally, I'm not resigned to putting this off for another year. This has held me back long enough, and I want my self-esteem back NOW. Some guys are okay with MPB; I am not.

We're all vane to a degree whether we're willing to admit it or not. Morever, I'm in my mid-30's and single again after getting out of a long-term relationship. I need to be able to put myself out there again. Due to my profession (teaching), I have the luxury of being able to get this done over the summer. I had everything planned out perfectly--procedure with Wong at the beginning of my vacation, and the remaining 7 weeks or so to heal up quite well before the next school year.

 

I'm about as low as can be at the moment--the entire front of my head is shaved, as well as most of the donor area, yet without those precious grafts. I'll be forced to wear a hat for the better part of the next month, with absolutely nothing to show for it. However, I'm not going to just accept this. I will be getting in touch with Dr. Beehner ASAP. I want answers. Hell, I'm even willing to drive/fly/walk to the end of the earth to get a consult with SOMEONE who can give me answers and a way out of this mess.

 

I hope to posts photos--particularly of the donor area--by Monday. Thanks for all the concern and letting me vent

[Pulpedfiction1]

Dr. Wong suspects that I may have been thinning in the donor region (behind the ears) prior to my first HT.

 

If this is true, I certainly did not notice it at all. I had been buzzing my hair down as low as a #2, and never could see any signs of thinning on the sides. After my first HT, if my hair is buzzed to a #4 or even a #5, the thinning/shock loss is very noticeable. In fact, there's a particular area on each side where there's a bald patch if I go with a #4 or lower.

 

I've always been under the impression that this area was pretty much immune to the effects of DHT and totally outside the domain of typical MPB.

 

 

 

 

 

Hi Pulped,

 

Sorry to hear about this. While permanent shock loss, especially in the temporal/parietal scalp, is rare, it's not totally unheard of. It's also difficult to say whether or not the first procedure actually caused thinning in the donor region. I too think some images would help, and look forward to reviewing these when you get a chance. Have you discussed this issue with Dr. Beehner at all?

 

Also, Follicular Unit Extraction (FUE) may be an option, but I think it would be helpful to undergo multiple consultations to determine if you're truly a candidate. What's more, I think it's very important to proceed - if you are a candidate - very cautiously and only with a trusted, screened FUE surgeon.

 

I hope this helps! Look forward to the images.

[greatjob]

Did your scar stretch on the sides? That's the only reason I can see as to why you wouldn't be able to get more than 500 grafts and only from the back, and would make sense why Dr. Wong wouldn't be fully aware of the situation until you were shaved down. I do agree this is very unusual to have such a low graft count available from your donor, and would definitely like to hear from the doctors.

[Spanker]

Did your scar stretch on the sides? That's the only reason I can see as to why you wouldn't be able to get more than 500 grafts and only from the back, and would make sense why Dr. Wong wouldn't be fully aware of the situation until you were shaved down. I do agree this is very unusual to have such a low graft count available from your donor, and would definitely like to hear from the doctors.

 

Well this is one of my questions. Shouldn't your donor be able to be effectively evaluated when not shaven? Mine was evaluated with long hair.

 

Are strips normally pulled from behind the ears? Isn't that the point the incision goes up?

 

Each patient is different. I've never heard of transplanting hair in the donor area except for temple points.

[Pulpedfiction1]

Photos are finally here!

 

I found software that can recover deleted images from a memory card, so I can share my consult photos. I've included several that highlight the loss around the sides, as well as photos of the donor in the back and a few of the front.

 

I've created an album on my profile. I'm also attaching a couple to this post.

 

I'd greatly appreciate it if you'd check them out.

[agenteye]

Pulpedfiction-

 

I just had a look at your photos in your album. I'm really sorry that you received bad news after you got your hopes up with a restoration. It's gotta be frustrating. With that said, I don't think your hair looks bad at all. You have a nice shaped head, so you should be able to just keep it short......you pull the look off well. As others have said, I think you should possibly look into some FUE surgeons and see what they have to say. That may certainly be an option for you. As CD and Spanker mentioned, it would be great if Dr. Wong and Dr. Beehner chimed in, so the members of our community had some more information pertaining to this particular case!!

 

Best,

 

Mike

[Pulpedfiction1]

Agent,

 

Thank you for the feedback.

 

I agree that it doesn't look awful. The results from my first procedure (1700 grafts) did improve things along the hairline and helped to provide a semi-respectable view from the front (as long as I keep it clipped at a #4 or possibly a #5).

 

However, my journey is nowhere near complete. This has affected my self-image to such a degree where status quo is just not acceptable. I now find myself in my mid-30's ,single again, and without the confidence to put myself out there and go for what I really want in life. No, it's not all about the females....its more about with people in general. My self-image has very much affected me professionally, and has kept me from pursuing opportunities that I would have jumped at 5 years ago. I'm a high school teacher..so you can probably imagine some of the comments I've heard throughout the years (although these have diminished since my first HT).

 

By the way, I took a quick peek at your photos with Dr. Rahal--very impressive. You must be thrilled.

[hairshopeing]

Your donor does look patchy and I can't understand why?? But your overall hair looks pretty good!!! I havnt heard of anyone doing this but I can't see why you couldn't use fue and then if your donor looks moth eaten as they put it, use smp in your donor region?? I'd never consider it at my hairline or top of my head but I think to fill in the back it might be an option as no one really looks at someone's donor area like they do a hairline, even obsessive s like us all on here!!! Hope it all turns out positive for you mate!!

[KO]

Preop?

[Pulpedfiction1]

Preop?

 

Yeah, those would be helpful

 

Unfortunately, I don't have any....as I haven't exactly been seeking out cameras the past five years or so.

 

However, I am going to do my best to get my pre-op photos from Dr. Beehner's office. I requested them several months ago, but their scanner was broken at the time.

[jfables]

" I'm just going to have to accept the fact that ill never have a decent head of hair again. "

 

Jeez man. When I'm done with my procedures I still won't have what you got right now. Enjoy it while you got it and be happy you still have so much hair in your 30s.

 

I think your donor is naturally thinning from mpb. It does happen there too. Too much FUE will make it look even thinner but that's maybe your only surgical option.

[Nick153452]

I agree, your hair looks pretty good right now..... Count your blessing, because you could be in one of our cases with a limited donor supply and advanced hair loss at 24 years old.... I would kill for your hair

[KO]

FUE could be good, and you could focus on one area and buzz down. I think Bisanga could help u.