Dr. Cam Simmons - 3,140 grafts

[Joered78]

Hang in there Megatron. Yes, it looks rough right now but Dr. Simmons seems to be on it and you just gotta have faith in it all. Good luck man, I'm looking forward to seeing it all clear up and you grow an awesome new hairline!

[azn_guy]

Megatron, keep fighting through it, I expect things to get better soon

 

I also have prone to acne even at my current age. I'm currently on a daily dose of minocycline due to acne. Prior to my HT, I made it clear to Dr. Cooley (my HT surgeon) about my medical history.

 

What you are experiencing is something I personally was worried about.

 

One thing for sure is these Doctors know what they're doing Good Luck! You'll hopefully be clear in no time

[Raphael84]

Commendations to Dr Simmons for the lengthy and thorough post. Megatron, yoour good Doc seems to be on top of things and I wish you an improved condition over the coming weeks. Keep us updated.

This kind of situation is the perfect example(unfortunately for Megatron), why an experienced and accountable Dr is such an important asset to the whole hair transplant process!

[Megatron]

**Update - 2 Months**

 

The acne is actually improving (check out Week 7 pics if you don't believe me! LOL). I was taking Minocycline twice a day for two weeks to help prevent pimples which cleared up my face, chest and back completely. I haven't had a new pimple in those areas since. But, the acne in my recipient area has continued. It seems an unavoidable side effect for those that are prone to acne, albeit I've definitely had a worse case than most.

 

The good news is that the surface infections I had seem to be gone. Dr. Simmons sent a sample to the lab and discovered I had two different types of bacteria cultures. One was common and treated by Cephalexin (pill 2x per day for 17 days) and Bactroban (ointment 3x per day for 14 days). The other type of bacteria was a surprise. It's most commonly contracted in hot tubs, but I've not used one in years. I can only guess I picked it up in my mixed martial arts gym as staff and other skin infections are very common there. I've been taking Ciprofloxacin (pill 2x per day for 10 days) for that.

 

While cosmetically unappealing, Dr. Simmons tells me it should not impact growth or my ultimate result. I do have some sparse growth in areas that previously had no hair. I guess that's better than nothing at all, but still way too early to be hopeful or worry.

Edited May 13, 2010 by Megatron

[Nicky]

Hey Megatron!

 

2nd month looks great!

 

dont worry...looks like your in great hands with Dr. Simmons..

 

keep us updated ok!!!

[azn_guy]

looking good megatron

 

Right after your HT, were you not already on Cephalexin? When I had my HT, my HT doctor asked me to take Cephalexin the first 10 days to prevent bacteria.

 

But compared to Week 7 photos, your month 2 photos are looking good Lets see how your 3 month post-op looks

[Megatron]

azn_guy

 

No, I don't think I used any acne or bacteria preventative medications post op. I remember just pain killers and sleeping aids, but I could be wrong.

 

Dr. Simmons explained that he normally won't try to protect against acne immediately post op. The logic is that acne is impossible to predict, antibiotics aren't good for you and it ultimately shouldn't impact the final result. That said, now that we know I'm prone to CRAZY ACNE, we'll use it immediately after my next HT (assuming I have another one for my top scalp, temples and/or crown). I agree with that approach and honestly couldn't care less about my infection & acne so long as it doesn't impact my result.

 

Crunch time is coming up for us azn_guy! I think the best HT results usually start to see signs of growth in their 3 month pics. I know, I know, everyone's different and no one should get too worked up this early in the game. But, I can't help but point out that's what I've observed in the hundreds of blogs out there.

 

I'm excited and anxious about what's on the horizon for us. Can you relate or are you just chillin' about the whole thing?

[markymark]

What is meant by "stick-in-place"?

 

MarkyMark

[azn_guy]

Originally posted by Megatron:

azn_guy

 

No, I don't think I used any acne or bacteria preventative medications post op. I remember just pain killers and sleeping aids, but I could be wrong.

 

Dr. Simmons explained that he normally won't try to protect against acne immediately post op. The logic is that acne is impossible to predict, antibiotics aren't good for you and it ultimately shouldn't impact the final result. That said, now that we know I'm prone to CRAZY ACNE, we'll use it immediately after my next HT (assuming I have another one for my top scalp, temples and/or crown). I agree with that approach and honestly couldn't care less about my infection & acne so long as it doesn't impact my result.

 

Crunch time is coming up for us azn_guy! I think the best HT results usually start to see signs of growth in their 3 month pics. I know, I know, everyone's different and no one should get too worked up this early in the game. But, I can't help but point out that's what I've observed in the hundreds of blogs out there.

 

I'm excited and anxious about what's on the horizon for us. Can you relate or are you just chillin' about the whole thing?

 

Interesting, I guess it's really up to the HT doctor. Dr. Cooley by default puts his patients on cephalexin because he doesn't want to risk infection so I guess it was more of a proactive measure.

 

I did point out to him that I am prone to acne so I'm sure he took that into consideration. But based on his pre-op instructions, I think this antibiotic is a default drug for him including valium and a few others.

 

Yes! I think this is our month to start seeing some growth. While this is not a set in stone scenario. I like generalities so hopefully we'll see good things happen this month.

 

As far as being anxious versus being laid back. I look at my hairline every day dissecting it

I am very anxious and excited

[Cam Simmons MD ABHRS]

markymark

 

Stick-and-place is a technique where an incision is made then immediately filled with a graft. Many doctors make all the incisions first then fill them with grafts later. Both techniques work very well and there are pros and cons for each technique. You can search stick-and-place for more info.

 

azn_guy

 

Pre-operative and post-operative antibiotics, like Cephalexin, are used by some doctors to prevent immediate infections. They don't prevent pimples that sometimes form a month later.

 

We don't know why some people form pimples about 1 month after their hair transplant but presume it is in part due to ingrowing of new hairs. It may also be from a reaction to exposed keratin (hair protein) under the skin from incomplete exogen (shedding) of the transplanted hairs, buried or damaged hair. I have found that people who have had acne elsewhere have a higher risk of getting 1 month post-op pimples. Every hair transplant doctor will get a few patients who get a lot of pimples but Megatron has had the toughest time of any of my patients.

 

Pimples on the face come from increased sebum production, blocked pores, infection, then inflammation. This could also happen on the scalp.

 

I believe that patients who are prone to acne or had a number of pimples 1 month after a previous hair transplant get fewer pimples a second time if they start Minocin at the time of their second surgery. This is only anecdotal and not scientific evidence because the patient numbers are too small. Minocin is used commonly for teenagers with acne and has anti-inflammatory and anti-infective properties. It is more useful to suppress the formation of new pimples than to get rid of old ones.

 

I believe that Megatron got pimples first. The skin barruer was then broken and he got a secondary skin infection called Impetigo. Hindsight is 20/20. If I knew then what I know now for Megatron, I would have started Minocin on or before his hair transplant to suppress the initial pimples. However, Minocin can cause GI irritation and makes someone more sensitive to the sun so I try to use medications only when they are needed. I don't believe that Cephalexin taken in the first 10 days after his hair transplant would have prevented Megatron's pimples or his secondary infection. The Pseudomonas likely came later but neither Cephalexin nor Minocin work against it.

 

On the positive side, Megatron looked much better when I saw him last. I will be following him closely until he has complete resolution. I still expect him to have good hair growth but, as for all hair transplant patients, we have to wait a full year to judge the final results.

[Sparky]

do you stick and place on all procedures? and does this add time to the surgery, or does it work out the same. I had a bit of stick and place (only about 10-15) on my last procedure as there were a few grafts left over with nowhere for them to be put.

[Cam Simmons MD ABHRS]

Sparky

 

I don't want to hijack Megatron's thread so I will answer briefly. I pre-make the incisions for the initial hairline but we use stick-and-place for the majority of the transplant. It may be faster to shave the head and do all pre-made incisions but we are confident of our results with this method and our patients have more hair for camouflage afterward. A typical 3000 graft session will start at 7:30 am and we will finish somewhere between 5:30 and 7:00 pm.

[vincehair]

How soon after this HT did you start using Rogaine Foam again? jus wondering

[Megatron]

**Update - 3 Months**

 

It's not been an easy 3 months, but I believe my best hair days are in front of me now. I've been seeing a tiny improvement each passing day since about the 2.5 month mark. I still have a long way to go before I can call my HT a success, but I I'm where I hoped / expected to be at the 3 month mark.

 

There's definitely growth happening as you can see in these pics versus my 2 month pics. The hairs you can see in the recipient area where hair did not previously exist probably sprouted around the 5 week mark I'm guessing, but are only now visible in my pictures as they've thickened & lengthened over the past 1.5 months. This must be the case because these news hairs are about 1/2 inch long and they say that hair grows at about 1/2 inch per month. Therefore, I must have had growth, albeit very modest, just over the 1 month mark.

Another thing I noticed was that the areas in which the transplanted hairs shed faster (i.e., mostly on the left side) seemed to be where I experienced earlier growth. However, the right side also experienced more acne which could have slowed the growth there. While I think I see the most growth in the front, followed by my left side and then my right side I think it's all pretty even and still way too early to judge final results.

 

The acne remains even though I'm taking Minocin 2x per day. I've always been prone to severe acne so I'm not surprised or too alarmed by this. The infection seems to have be eliminated thanks to Dr. Simmons' diligent care & attention. I definitely experienced a significant amount of shockloss in my front forelock area which sucks and which I think was exacerbated by the anti-bacterial ointment I used for 3+ weeks. Oh well, hopefully they all come back along with a lot of new friends.

 

In summary, it's been a rough road mainly due to my acne/infection issues, but I'm pleased with my 3 month progress and I continue to be cautiously optimistic about my final outcome.

[Anouar]

Well Megatron you certaintly look better. When you first posted pics of those zits they looked pretty scary. I even questioned if you get decent growth. I wish you well and alot of growth

[azn_guy]

Looking good Mega, As far as the acne goes, everything is starting to really looking up for you. What I can say is that it's pretty amazing to see so much sprouting, in addition to finely thin hair. I personally havent encountered your positive results at month 3. One thing I notice is when a hair does sprout, it's pretty thick in diameter.

[Tsakalos]

is this shockloss in the recipient area ? u had lotd of hair there and i dont see them now, good luck in the following months

[Megatron]

is this shockloss in the recipient area ? u had lotd of hair there and i dont see them now, good luck in the following months

 

I had a lot of shockloss in my mid-forelock. The hairs you see along my hairline in the 3month pic are all new. The HT lowered my hairline almost an inch. I'll have to post some pre-op pics with my hair combed back for a better comparison.

[jmg544]

Those are some intense photos you've shared with us. I'm glad that the infections are behind you (fingers cross) and that it will not affect/hinder the success of your HT experience. I'm looking forward to month 4. I wish you the best.

[Fingers Crossed]

Everything is looking great Megatron. The acne has cleared up considerably! You have a lot of growth for being only 3 months past surgery. I look forward to seeing your 4 month updates as well.

[Megatron]

4 Month pics are up...here's what I wrote on my blog:

 

 

I believe things are progressing well for me at the 4 month mark. There is substantially more hair than the 3 month pics, albeit very fine and thin (to be expected at this early phase). All the hairs you see along the hairine are new. Check out my Day 0 pics to see what my natural hairline looked like (i.e, I did not shave for my surgery).

 

The donor scar seems to have healed well and Dr. Simmons tells me it hasn't stretched. As you can see, the redness is almost completely gone which was a pleasant surprise when I took these pics. The color must have faded recently because it still looked pink when I checked it a few weeks ago. My wife actually had a hard time finding the scar today which was also nice to hear.

 

That said, the champagne is still on ice. I need the density to continue to improve and the hair to thicken before I call my HT a success. I still have lots of acne in the recipient area even though I've been taking Minocin twice a day for 2 months now. But, that's ok because I'm guessing new growth will probably cease when I stop seeing acne. I do believe they are directly related in my case.

[azn_guy]

Mega,

 

Just taking a look at your 2nd and 3rd month, I can easily notice you've had really good growth in month 4. I can just imagine once the hair matures and thickens, boy oh boy, it'll look good.

 

Just comparing the HT Donor Scar to mine, yours seems to have healed very well, it's difficult to locate.

 

Good luck on the 5th month, I anticipate good things in month 5

[Megatron]

***5 month blog update***

 

Steady improvement since about 2.5 months. It's certainly gotten more thick and a little more dense than 4 months. I'm showing my hair in the harshest of conditions to be consistent w/ prior pics (wet, combed back and under bright light). I'm so glad I did this blog, because there's really no other way to really see the changes than to document it month-to-month.

 

The great thing is I really don't have to think about my hair much anymore. Wind, water, bright lights...who cares. While it's still very see through in some conditions, I'm confident that it looks 100% natural. That's a very, very good thing and something I haven't truly felt for perhaps 15 years (i.e, since I was 19).

 

That said, I would obviously like to continue to see the density improve. I don't

need the final result to be very dense as that wouldn't blend with the rest of my head. What I do want and hope for is to be able to properly style my hair and for it to not be too see through unless under the worst of conditions.

 

I still have some acne in the recipient area, but it isn't a major concern because I feel like that's par for the course for me. There are a couple of areas right above the hairline in the temples that seem a little less dense than the rest of the area. I'm not sure if it's solely due to the fact that my hair changes direction there (Dr. Simmons' team told me about this in my surgery) or if it's truly a lower yield in these areas. I'm keeping a close eye on this.

 

Thinking back to my pre-op days I think my hopes and expectations going into a HT were slightly different. I hoped to have a great looking head of hair but, deep down my more realistic expectations was for there to at least be a noticeable cosmetic improvement. At 5 months, I am pretty confident that I will achieve my expectations and I continue to hope for a great looking (albeit, mature looking) head of hair. I think I'm on track, but only time will tell.

[TakingThePlunge]

Megatron,

 

I think your brushed forward/dry pic looks great at 5 months! You still have a lot of new growth and maturation to come so I'm confident you'll achieve your goals.

 

Happy growing!

[azn_guy]

I was wondering why I haven't seen you on these boards in a while,

 

Looks very good. The Donor Scar Information is really helpful too, knowing that a lot of hairs are growing out of it now.

 

Keep up the post Mega, look forward to Month 6