I'm getting FUE with Dr Path in Thailand.

[JobSmith]

Scheduled date for operation: 4/26, 2016.

Estimate from photos: 1200 FUE grafts.

Cost: 130 THB (today $3.70) per graft. (Required deposit: $1000.)

 

I'm Norwood 2 or 3, where the temples receded in my late 20s. I'm now 53.

There's also some thinning in the middle front, the "widow's peak" between the receding temples.

 

At first I considered surgery in Medellin, Colombia, a city that I like, and a country known for plastic surgery. However, there are next to zero reviews.

 

Thanks to commenters here on HRN, I decided to not be too cheap, and go with a well-reviewed doctor. I picked Dr Path, as the price is still decent, I like how you visit the clinic post-op for daily schampoo and inspection, and I'd like to convalesce in Thailand. So instead of paying $2000 in Colombia, It'll now be about $4300 in Thailand, and a longer flight.

 

I wired the full amount to keep things simple. My bank, Schwab, required me to visit a branch office, since this is my first wire transfer. Future wires I can do with a phone call. The fee is $25. The amount goes out in USD. Dr Path's bank (bangkokbank.com) then converts to THB, and their website shows that the conversion spread is +/- 1%, which is pretty low.

Edited April 7, 2016 by JobSmith

[JobSmith]

I arrived five days early to acclimatize and feel really relaxed. I'm hanging out at a hotel pool on the top floor. Tomorrow I'll have the consultation. The day after I'll have the hair transplant.

 

Meanwhile, I got instruction from the clinic. No blood thinners, like aspirin, for a week before. No alcohol or tobacco for 24 hours before. No coffee or tea on surgery day. No T-shirt on surgery day, nor for a few days afterwards (so as not to rub against the fresh grafts when taking it on and off). Do shampoo with "antiseptic shampoo or scrub" night before and morning of surgery (they can supply the shampoo). Bring loose hat to wear post-op. No hair dye for a month afterwards.

[TakingThePlunge]

Job,

 

I wish yopu the best of luck. You're in great hands with Dr. Path. Please let us know how the procedure gores for you. I look forward to your continued updates.

Edited April 28, 2016 by David - Moderator

[esrec]

Good Luck!

[JobSmith]

April 25: consultation in person.

The initial estimate from photos was 1200 grafts to fill in receding temples, another 800 to lower the hairline.

In person, Dr Oravan (Dr Path's sister) noted that there was some more thinning than the photos showed, and she drew various options. I have a triangular head (wide top, pointy chin) and so leaving "widow's peaks" is less attractive. I greedily opted for 2675 grafts.

 

This now gets expensive for FUE at $10300, while FUT is $7300 and both doctors recommended FUT for the savings. I have a loose scalp. I will have a scar, but I never plan to get a crew cut. There will be some more pain for a few days.

 

Surgery is in a few hours. I hope I'm thinking straight here.

Edited April 26, 2016 by JobSmith

[Sean]

Do you have any preop pics you can post now before any surgery. It will definitely help you document. Do you know what design and placement would be like? Do you know, if you do FUE, what punch sizes will be used? What is the extraction pattern going to be like, scatterred or in a conxentrated zone? Have you met any patients there or seen pics of fue results? Do you know the density cm2 to be planted in recipient zone? Will any work be done in and around native hairs? Who will be doing most of the surgery? Will you have any work on temple areas? Just wondering.

 

Regardless of what you personally decide, FUT or FUE, please do document in detail here and other areas. Do what you feel comfy with. Take pics and keep full track of your progress. I really wish you the best.

[plotholes]

I know that Dr Path have been doing FUT for many years, didn't realize he also offers FUE. Was this because its only offered recently or just simply less advertised in the past?

[JobSmith]

(I will post pre-op pictures in a bit.)

 

April 26: the operation. I arrived a little before 13:00 to relax and cool down. Superfriendly staff. Puie at the front desk is a sweetheart.

 

I paid the excess. Because it had been less than 24 hours, there wasn't time to wire (cheapest), so I had to use a credit card. Dr Path charges 3% for card use, and my card charges another 3%. On the other hand, the excess number of grafts were about 5% lower on the bill, so nothing to fret about.

 

I got another antiseptic shampoo by a nurse, because I had walked 1 km in the heat and sweated.

 

Then Dr Path (they pronounce it as the American name "Pat") redrew the hairline from yesterday. It seemed slightly off so I asked for Dr Oravan to double check the widow's peak, and we made a minor adjustment until I felt happy. This is not like trying on a new dress shirt! It's my hairline for the next 40 years we're deciding on!

 

I was given antibiotics (to keep taking for 3 days) and valium, so that I'd doze off during the procedure. I felt very relaxed. The strip extraction was pain free. In the recipient area they had to inject anesthetic in multiple locations -- apparently there are many more nerves to numb than for example in the jaw when you get dental work. One spot hadn't been numbed and it stung a lot when they poked holes for the grafts. I complained, got a little more anesthetic, and then I was fine.

 

Every 5-10 minutes I asked some question, until Dr Path asked if I was not sleeping. Um. No. So he gave me something "similar but stronger than valium" and then I finally dozed off.

 

I was sent home with a care bag. The pain from the strip scar was not super-intense, but enough to keep me from sleeping. My slow brain finally realized that I could take a pain killer from the care bag. I chose the "strong" one: 400 mg ibuprofen, which is what I usually take for the occasional back ache. I also set my alarm to wake up every 2 hours and spray some fridge-cold ATP onto my forehead -- I believe this is to minimize the swelling to spread.

 

Now it's the morning after -- 12 hours since surgery ended. I feel okay. Some tightness at the strip scar. I get to drink coffee! Whether I'm happy with the results will take 6-12 months, possibly 18. I'll add more updates here.

[Harebrained]

Looking forward to seeing your results as you grow. How involved was Dr. Path in your overall procedure including the planting? Good luck.....Happy growing!

[Bill - Seemiller]

Dr. Pathomvanich is an outstanding surgeon. I am pleased to hear that you selected one of the best and I trust you will be very please with your experience and results when they all grow in. I look forward to hearing all about your experience and seeing your photos each month documenting your progress.

 

Best wishes,

 

Bill

[JobSmith]

Thanks for all the well-wishes.

 

Harebrained, Dr Path did the cutting of the FUT strip from the donor area. He also did the hole punching of the recipient area. As for the actual planting of the grafts, I don't know, because I had fallen asleep by then. The removal of follicles from the strip I believe is done by a team of technicians.

 

April 27: day after surgery. It was a relaxed day. I keep spraying the grafts with ATP solutions every two hours, day and night. I visited Dr Path's clinic to get shampooed by a nurse, and also to learn how to do it myself -- buy baby shampoo, create lather between my two hands, then apply by gently patting (not rubbing), using cooler-than-lukewarm water. I'll be wearing a headband for a few more days to avoid any swelling to spread. When showering, I need to remove it very gently: no pulling sideways, but lift straight out from where it touches grafts (the sideburn area near ears). I feel a slight burning pain from the donor scar, nothing from the recipient area. Before sleep, I take the "stronger" pain killer (400 mg ibuprofen), while after breakfast I take the "weaker" pain killer (2x250 or 2x500 mg tylenol).

[Rawkerboi]

Nice detailed experience!!

How's your sleep now? Is it uncomfortable to sleep with scar or you use neck pillows?

Kindly post some pics.

[JobSmith]

Rawkerboi, I take 400 mg ibuprofen before going to sleep, and then it doesn't bother me at all. I sleep with my head on a pillow, either on my back or sideways with pressure on my jaw and cheek, not temples.

 

April 29: post-op day 3. I went in for a check-up. Dr Path said I was healing well, and that I have below-average swelling in the recipient area, though I should expect to wear the headband for another day or two -- it keeps the swelling from propagating down the forehead, which would look unsightly (even if temporary).

 

I have my own pseudoscientific theory on why I'm doing well. For several years I have been eating an "anti-inflammatory" diet: no sugar (including no cookies, buns, ice cream, soda...) and no processed food. Instead lots of fruits and veggies and some meat. I think this makes my body less reactive to trauma or physical irritation.

 

I got another shampoo by a nurse who blow dries my hair with cool air. It felt good. Dr Path asked me to chat with another patient, already in his surgery smock, who was quite nervous about pain -- I seem to have calmed him down.

 

Here's a triptych of me where Dr Path has drawn my new hairline before surgery.

Edited May 1, 2016 by JobSmith

[xdcs]

Hi JobSmith. Wow what a small world! I had a surgery with Dr. Path on the same day. I guess he goes between patients. I had 2500 grafts FUT. Be careful with the ATP solution. I left it out for 4 hours at room temperature by accident and had to buy another bottle for 450 thb. I took my headband off today, as like yourself the swelling is minor. Any scabbing yet?

 

Edit: Interesting how you talk of a widow's peak. I let Dr. Path give me a peak... to be honest I wasn't really thinking about the hairline too much and just trusted his opinion. He says it gives the illusion of a lower hair line. Though at this point I'm a little afraid of it as it looks a bit triangular post-op, but Dr. Path says not to worry it will look more natural in time. I apparently have the features for it. I hope he is right!

 

Edit 2: I've uploaded three photos of my procedure for comparison, one before surgery, one immediately after surgery, and one from today (4 days after surgery). Note that they are taken from different angles. My hair is unusually long as I intend to comb it forward... I have to give public talks and don't want people to be drawn to the procedure.

Edited April 30, 2016 by xdcs

[JobSmith]

Xdcs, that's great! And you're probably the reason I was bumped from 9am to 1pm. Apparently Dr Path typically does either one or two patients per day.

 

I miswrote about the widow's peak. I actually got some grafts in the center to give the illusion of an even lower hairline, as you also point out. What I meant to write was that for me it's important to really fill in the temples, not leave a sharp corner. So we rounded off the corners, as you can see in my triptych photo above.

 

Yesterday, I skipped the hairband for half day, but at night I slept with it on, as there it still a hint of swelling, but this morning I took it off. Should the swelling seem to increase, I'll put on the hairband again.

 

Yesterday I also took the skytrain to the megamallopolis at Siam station. A bunch of malls, mostly airconditioned, are connected via walkways. So cool. I'm not much of a shopper, but I'm getting cabin fever in my hotel room. I booked to stay here until post-op day 8, so that Dr Path will be the one to remove my stitches, and just in case there are complications. None so far.

 

Below is a photo of Dr Path holding the Golden Follicle award.

[xdcs]

Hi JobSmith,

 

Yes I hope that the widow's peak doesn't end up as sharp as it looks in the transplant day 1. Like yourself, for me it was important to fill in the hair loss at the temples. In fact, Dr. Pat went far behind the hairline to add density in the back as well so it looks good when parted.

 

Do your stitches still hurt/itch/feel tight? I can't wait to get them out on day 10.

 

There's a lot to do in Bangkok. I think air conditioned malls are good if you have cabin fever, as you want to avoid sweating. I've been cooped up inside rather bored for the last 6 days as well.

 

The skytrain is an excellent way to get around. They opened up a brand new mall recently called Emquartier near the Phrom Phong station, it's really neat and worth checking out. Most of these malls have really luxurious movie theatres too, for the price of a movie ticket in your home country, you could get what feels like a first class airline seat.

 

Oh yeah, and get a massage. :-) And if you do end up near Soi Cowboy you can always go see a ping pong show. Ha. hahahaha.

[JobSmith]

Xdcs, it was fun to meet up in person! Lunch and drinks. Talk hair, life, love and music -- all that is important.

 

Today, Day 8, I saw Dr Path for the last time. I went in to have the stitches removed. (The main ones -- others are biodegrable and dissolve in 3-6 weeks.) All looked good. I was told to soak my scabs in olive oil for a few hours (or overnight) and then shampoo and rub gently. So I did. Boy it was nice to finally rub and comb (gently) again, instead of patting! I'm not sure how many scabs actually came off. Dr Path said it sometimes takes two or three rounds. The skin should look almost normal after the scabs are gone.

 

The risk of shock loss appears to be about 25%, either in the donor area (especially at the ends of the FUT scar) or in the recipient area, just next to the grafts, or where blended with thinning hair. It'd grow back though.

 

Then, Dr Path said, it'll be fun to see the hair grow. No kidding!

 

Tomorrow, Day 9, is a holiday here, so the clinic is closed. I leave very early the morning of Day 10. Long flight. Back to normalcy.

[xdcs]

It was nice to meet you in person too JobSmith. We had a fun night out on the town! Took me a couple days to recover. Have a safe flight home!

 

Good to know about the stitches. It must be a relief to get the permanent ones out. I see Dr. Path tomorrow to get mine out. They have been itching like crazy and the corners of the scar still kind of hurt when touched, which is hard to avoid when lying on a pillow.

 

As long as the wait will be, it's nice to think of waiting for hair to grow... rather than trying to keep it from falling out. Hope we both get good results. If there are any important updates, I'll post them here.

[JobSmith]

It's been four weeks. I haven't had any problems. No pain. No shock loss that I can see.

 

Curiously, many of the transplanted hairs haven't fallen out yet, which I expected by now (Dr Path said 2-4 weeks). Nor have they grown. Does this delay the new fresh hairs to start to grow?

 

Scalp sensations are interesting. No itch, no pain. But the FUT donor area feels tight when I bow my head forward. When I apply pressure to the donor scar, and especially its ends, they have a tender feel. Recipient areas sometimes feel like I'm wearing a headband, or like sunglasses pushed up to rest toward my crown. When I press on the recipient areas they have that numb feel as when getting surgery under analgesia.

[JobSmith]

At 3 months, my receded temples still looked bald and shiny, except that the 5-10% of hairs that hadn't fallen out by now had grown at least an inch. This looked a bit funny, but I mostly covered it up, and no one said anything.

 

Shortly afterwards, a fuzz started to grow in the receded areas, giving them a "four-o'clock shadow" - a darkened appearance similar to people who need to shave twice daily. This also looked a bit funny, almost as if I had dyed my skin, but it was nice to clearly see where the new hairline would be.

 

Now at just over 4.5 months, I've got close to an inch of new hair. It's starting to look good. The face in the mirror looks a lot more youthful. It's still a bit weird in that the old good hair, 3 inch in length, sits on top of the new hair. It doesn't yet feel like a "nice thick head of hair" but the solid hairline looks so much better than the fading no-man's-land of yesterday.

 

Projection: as the 2000 new hairs grow out to 2-3 inches (2-4 months), I should be able to style in ways long out of reach.

[Vainism]

Hey good luck man! wish you all the best with the growing phase!

In regards to your operation, how much of the process was Path exactly apart of?

[JobSmith]

Vainism, see post #11 earlier in this thread.

Edited September 23, 2016 by JobSmith

[JobSmith]

I just got a haircut that now fully shows my new hair. The barber said there were parts he didn't touch, because they still need to grow a bit longer.

 

I'm trying to attach a photo. Compare to my pre-op pics (page 2, post #13).