Dr Ron Shapiro --- Recent FUT (my HT #3)

[fortune11]

Hi All --

 

Some of you who have seen me post here before may recall I have been though 2 FUTs in the past - first with Dr Ron Shapiro (~1,600 FUT , 2004) and then with Dr Ziering (~2,200 FUT, 2011). This was HT #3 two days ago. Made the trip from Southern California to Minneapolis, mother nature was kind enough to me this time around wrt weather and everything went smooth travel wise.

 

I am a diffuse thinner NW5+ to an eventual 6 type . While the first two HTs were focused on the frontal tuft and the frontal third which gave me a decent optical frame from the front and sides , I thought it was time to add some bulk to the mid scalp area. I am leaving my crown alone for now (I figure it is age-appropriate for me and does not detract from the frontal view anyways).

 

The biggest issues I faced were -- 1) limited donor supply (I was told 1500-2000 max by a number of doctors) 2) lack of decent scalp laxity.

 

Why FUT over FUE --- I did debate this for a while , but in the end decided that given 1) my comfort level with FUT was already very high and I already have a scar anyways 2) I don't intend to shave my head down ever as it is not a good look for me given my facial built 3) needing to take as little time off work as possible and not wanting to shave the back of my head for an FUE . FUE remains the last / future option if I need some touch up work down the road and have the luxury of taking more than a few days off work.

 

Dr Shapiro spent a good deal of time with me the morning of the surgery discussing strategy. One suggestion I liked of his was trying to comb my hair back instead of forward and down like I used to (caesar style) . Combing back adds bulk to the mid scalp area especially as the transplanted hair have more thickness and shine compared to my native hair. I was also concerned about the tendency of my scar to stretch on the right side and he planned on taking that into account as well.

 

I won't go into the details of the surgery itself as people already know how well run and immaculate this setup at Shapiro Medical Group is. One improvement that I liked over my prior experience here in 2004 is that when they inject your scalp with numbing meds, they also use a vibrating instrument that "confuses" the nerves and reduces the pain significantly. Dr Ron also used Vitrase solution during excision of the donor area.

 

Given the tight scalp, the strip width was no more than 1.1 cm . However , Dr Ron did manage to take the scar high on either side to get a total of 29+ cm of length. Final # of grafts were -- 1921 FUs comprised of --- 1's- 781, 2's - 845, 3's - 289 and a few 4's = 3,362 total hairs . This was certainly towards the high end of my expectations.

 

Upon my request, Dr Ron used sutures but also added a few staples for good measure overnight. The next morning , he removed the staples , leaving a few on the right side where the scar has been prone to stretching historically (during FUTs #1 and #2) . I will get the sutures and the remaining staples removed in a couple of weeks.

 

Overall, Dr Ron , Janna and the entire surgical staff made the experience as easy on the mind and body as is humanely possible (no surgery is ever "pleasant" obviously) and my day went by quickly despite being in the surgical chair for a good 8+ hours. I will keep you posted on the progress. Here are a few pictures posted below.

 

Today is Day #2 post op and the healing process is going on faster than what I expected during HT#1 and #2 in the past , maybe I am just more used to it by now !

 

Wish me luck guys Also, happy to take any questions if anyone has queries.

[MusoInOz]

Really cheering for you mate I remember your original posts back in 2011.

 

Best of luck, you are in great hands.

[Pete-from-Farjo]

Congratulations, that should make a noticeable improvement.

 

All the best with it.

[fortune11]

Thanks guys. For reference , I am also attaching an "after" picture from my HT with Dr Ron from back in 2004. As you can see , my hair loss has only progressed since ( I am on rogaine but no meds) but the initial HT was so well placed that the first transplant has withstood the test of time.

 

This is precisely what makes hair transplantation an "art " -- regardless of fancy-named robots , or whatever new scientific techniques come up for hair extraction tomorrow. As ultimately long term satisfaction depends on how well the transplanted hair can be styled and withstand the test of time and further hair loss.

 

Seeing my own case over the last 11 years, Dr Ron truly distinguishes himself as a visionary in that regard, at least from my perspective.

[fortune11]

Here are a few pictures , apologize for the poor lighting but hope it gives a general sense. The first one has the best view of where most of the the grafts were placed (mid scalp area) .

 

I am not using any concealers here when taking these pics. However, when I go back to work (post op day 7, after a one week down time), I plan to use the "in-fill" powder around the left scar area which you can see is slightly more noticeable.

[Gram]

Congrats on your procedure. I am in a similar situation. What is "in fill powder?"

[fortune11]

This is kind of like derm-match . basically a powder that can be used to blend in scalp with existing hair around it . Dr Ron gave it to me post-op after the first shampoo wash. You can probably find it on amazon . The way it worked best for me was to wet the sponge applicator first with a little bit of water and then dab it on the powder before using it on the hair. Hope this helps.

[fortune11]

I got my sutures removed yesterday at Dr Craig Ziering's clinic (he is a good friend of Dr Ron, and he also did my prior HT , #2 ) . This was day 13 post op.

 

There was some mild inflammation in one small section of the donor area and I was prescribed anti biotics and told to apply Bacitricin ointment on the scar . Dr Ziering and his surgical staff were extremely gracious and took great interest in me , it was as if I had undergone surgery there itself.

 

Regarding concealment from co workers -- everything has worked out well so far in terms of people not commenting (and like I said before it is a tough crowd) although I am pretty sure anyone who went through a strip procedure themselves can figure it out if they look hard enough. I do think I will need to buzz my hair down to a more uniform cut to avoid the "bowl haircut " look on the back and sides.

 

The "fill-in" powder has helped with concealment, but given the sutures are out and the area is still somewhat tender and reddish , I am giving the concealer a break and will take a chance without it tomorrow . See how that goes.

 

The recipient site is generally fine but there are the occasional pimples here and there.

 

I will say this though -- healing for this HT#3 is not as fast as what I experienced for #1 (2004) and #2 (2011) . Maybe it is the fact that I am older now (touching 40), maybe the scalp is too tight after 2 HTs . Dr Ron Shapiro was able to extract a decent number of grafts from a very thin (but long) strip so I am hopeful that it will turn out well.

 

I will try to post some more pictures in a few days.

[fortune11]

Here are some pictures Day 20 post op . I had a follow up appointment at the local Dr Ziering clinic to check on the donor scar and the issues I had mentioned in my prior posts have been remedied .

 

The donor scar is healing alright, width about 2mm right now but that is including all the mild redness etc., I am hoping it will thin down further as it did with previous 2 HTs.

 

Grafted hair has started shedding - if I had to guess, would say 1/3 of them are gone. But some have continued to grow in length . This part is very similar to what I went through during HT#1 and HT#2 .

 

I guess now all one can do now is wait ... and wait ... this should turn out well going by what has happened so far and my prior HT experiences. WIth the mid scalp covered I can then focus my attention towards the back of the crown where the below should help ...

 

PS -- I also plan to give propecia another shot this time around (I had side effects more than 10 years ago which made me discontinue after a few weeks of use back then) . Per Dr Ron's recommendation, planning on just one pill twice a week and gradually upping the dose if things seem normal. Will keep you guys posted on how that goes as well.

[Loki]

I had my procedure recently done as well with Dr Ron... I had my staples removed day 9... I went in at a local cosmetic clinic for a consult so they could evaluate and they said the wound was healing fast and they did the removal at the consult... The local dr was amazed I had the procedure just 9 days prior... I wonder if the Spray (Lipo ATP) on the recipient runs down and accelerates healing of the donor... I could feel it running down my head... First 24 hours I sprayed every 30 minutes (on recip)....

[fortune11]

I had my procedure recently done as well with Dr Ron... I had my staples removed day 9... I went in at a local cosmetic clinic for a consult so they could evaluate and they said the wound was healing fast and they did the removal at the consult... The local dr was amazed I had the procedure just 9 days prior... I wonder if the Spray (Lipo ATP) on the recipient runs down and accelerates healing of the donor... I could feel it running down my head... First 24 hours I sprayed every 30 minutes (on recip)....

 

ATP was very good with keeping my grafted area clean and scab free but not sure if it helped the donor site at all. In fact the donor area used to get irritated whenever the solution would trickle down to it from the sprayed grafted area.

 

I am glad your healing process was that fast. MIne was similar back in 04 when I went through my first, but different (slower) healing this time around with #3 . Was this your first FUT ?

[Loki]

This is my 3rd but spaced over 16 years... 1200 grafts 16 years ago, 1500 8 years ago and 3200+ 2 weeks ago....

[Garageland]

Good luck to you Loki, wishing you all the best for a great result.

 

And the best of Fortune to you Fortune11. Sure you will have a great result.

Edited February 18, 2015 by Garageland

[Loki]

Good luck to you Loki, wishing you all the best for a great result.

 

 

Thank you Garageland!!! Sitting in that chair all day is a walk in the park compared to the wait time!!!

[Garageland]

Yes agreed and you know more than others having been through it twice before. It will be interesting to know how you find the wait time after having been through it twice before.

 

Patients that had bad experiences the first time around can find it even more stressful whilst patients who had experienced good growth and were happy first time generally find it much easier. Just generalizing of course as everyone is different.

[fortune11]

Patients that had bad experiences the first time around can find it even more stressful whilst patients who had experienced good growth and were happy first time generally find it much easier. Just generalizing of course as everyone is different.

 

Thanks Garageland. Count me as one who had a good experience , but am still anxious to see some growth : ) It never gets easier . But I am very hopeful that it will be a great outcome , just like the ones before !

[fortune11]

Here are a few picture after getting my hair cut (scissors only, but equivalent to #4 to #5 ) . The scar area is somewhat visible without concealers as you can see in the pics below (all pics taken without concealers) , but i use fill-in powder to cover up the left side where it seems more prominent .

 

As expected, most of the grafts have shed by now . I have also started taking propecia for the last 2 weeks now and hoping that the little bit of shock loss that has happened near the donor region and the mid scalp area can reverse itself in a few months .

 

The donor has taken longer to heal this time around (FUT #3) as I mentioned before . Dr Ron and Janna have been extremely helpful in terms of post op monitoring and follow up . If my previous two surgeries are any guide, I am hoping the scar follows a similar path and becomes less prominent in the months to come. Also, once the transplanted hair starts growing , I will have more styling options that will enable me to grow my hair longer for better concealment.

[2youngforthis]

Any new current updates after this ht

[fortune11]

I am 10 days away from 6 months post op for this procedure , thought I would update the group on the progress.

 

One pic is outdoor lighting (bright sun) , another is under an indoor floodlight. Generally I am seeing some growth , but still think fairly early. Lot of the new hair are fine and baby like, sticking out here and there so hard to style and keep organized , I do use some conditioner (non thickening) to help with that .

 

Recall my 1921 FUT grafts were concentrated on the midscalp, nothing on the core area of the crown. For context i am a NW 5-6 diffuse thinner , prior HTs #1 and #2 were focused on the hairline and portion of the midscalp. From the hair texture of what is remaining on my head , I can tell you that nearly all of what you see is transplanted hair on top.

 

The length in the back is #5 , enough to keep most of the scar concealed , although there is still some shock loss behind the right ear that I haven't recovered yet . There is also a ~ 3 cm length scar portion on the right where the scar is a little wider (5+mm) than the rest of it , but at this length , it is somewhat concealed . I am going to give it the full year to see how it heals further .

 

Also posting some pre op and immediate post op next .

[fortune11]

These are pre op (first) , during surgery (second) and day 3 post op (third and fourth) to give you context .

[fortune11]

There are a few other angles - all in outdoor lighting , all 6 months post op.

[TakingThePlunge]

Impressive changes in only 6 months!

[fortune11]

Thanks David. I am also on propecia now for 5 months going , so thinking thats also having an impact , perhaps on the margin .

[Janna]

Thanks Fortune for updating your progress. It looks like you're able to notice some growth. I'm sure the next 6-8 months will bring noticeable more. Thanks again!

[Garageland]

Wow! Looking great Fortune at 6 months. Really happy for you. Great work by Dr Shapiro.