2800 FUE with Dr. Lupanzula

[menosmolas]

Hello everyone,

 

I'm 38, loosing hairline since forever, stable with medication (Finasterida, basically) till 6-8 months ago when I have experienced a very dramatic loss in the scalp, specially the third front.

 

I've just undergo the HT. Due to the gratitude I feel to this forum, I will share my results here if for the interest of anyone. Briefly, two days ago I had the first physical visitation with the doctor (I'd never recommend to have the first visitation just before the transplant itself, but it went like this for me; in any case, note that the doctor was totally available via skype before that day). The hair check confirmed I had a quite thin one (about 50u), and moreover, bad quality at the end of the back and sides. On the other hand, the density of the rest of the donor seems quite good (80 in the sides and 90-95 in the back), with a decent ratio of hairs per follicle. The doctor roughly estimated a low range of 6000 follicles available.

 

The doctor proposed a conservative hairline which I actually changed to an even more conservative one. I guess that we 're always on time to lower the hairline, and my capillary future does not look bright, better save donor.

 

Therefore, the next day, I had 1600 follicules tranplanted in the third front (taken from the back) and the second day we made the hairline with 1200 follicules more (basically from the sides). Doctor made the extraction and the incisions himself, the grafts were placed by his technicians, Overall, 2800 FUE (average of 2.2 hairs per follicle) in two sessions, accounting for about 15 hours between both.

 

The plan is to continue with finasteride, and when healed of the transplant, try a finasteride version in gel that the doctor proposed me. And durasteride as backup.

 

I attach the day 0 photos. I will update later as approppriate.

 

Best of the lucks to everyone!

Edited October 21, 2016 by menosmolas

[gillenator]

Awesome Meno!...nothing wrong with being conservative my friend. And a decent size procedure considering where the grafts were placed.

 

I think you're going to like the final result and please let us know how the topical finasteride works out and if there are any side effects from it.

 

Hey...you got it done...now the fun begins...waiting for the regrowth and transformation!

 

Congrats Meno and thanks for sharing your case with us!...

[wibbles180]

Really looking forward to watching this result develop !! I think this is the first patient review for dr lupanzula on this site ?? Please keep us regularly updated as I am seriously considering dr lupanzula for my first surgery ! His work looks outstanding , so glad he's started posting on this site

[menosmolas]

Sure thing, I will do it. Thanks everyone for the feedback!

[hsrp10]

Looking very good ! Congrats

The competition in Brussels is getting hotter, which is good news for all of us as consumers.

[TakingThePlunge]

Looks fantastic! Keep us posted on the outcome.

[menosmolas]

Ey fellas,

 

one quick 1week - update. Anything remarkable to share so far: itchiness of the donor area, some swelling of the forehead and couple of bruises on the eyes. Not really a big thing, what was a bit more annoying was the first four nights, I barely sleep since I was afraid of scratching my head. But again, nothing remarkable besides my anxiety when wondering how everything will look next months.

 

I just made my first wash (betadine) + massage to the recipient area (the preceding days I was just applying the betadine solution and then wash it gently with water). With the today's wash I get to soften the stuff that formed there (I think it is some kind of dead skin cells??). I get to remove some of these things by doing a gentle brushing with the tips of my fingers. Some hairs fall too, but I guess it's normal; in any case, I stopped after a while, and I will do a second round tomorrow. What appear behind these crusts are some tiny hairs (not sure which one may be my original ones and which the transplanted guys), and quite a red scalp (more than it appears in the photo). It seems quite clear that I will need a cap or similar to hide everything when I will come back to my normal life, five days from now.

 

Hope it helps (and comments welcome!)

have a good weekend

[gillenator]

The work looks very clean Meno...and the itching is very normal from healing.

 

The hair that comes off with the crusts is definitely graft hair and expected.

 

I think you're going to be very happy with the results...

[wibbles180]

Yea all looks good at this early stage , really looking forward to watching this develop

[menosmolas]

Thanks for your comments., folks.

 

Today (8th day) I put a bit more of energies in cleaning the scabs, and I thought I could upload a photo showing the results, in case someone is interested in having a close follow-up, since I removed all of them.

 

Everything looks good to me, I lost some hairs during the washing, but there is plenty of guys there; difficult to say which ones are originals and which ones are the transplanted. I'm not sure neither if the concept of graft survival applies already to what I can see now, but I assume that this refers to what it's going to grow in the future. It's such a pity that they have to fall!

 

As a comment, note that the scalp is more red that it seems in the photo. Is not striking but 100% noticeable, which can be a info of interest for those wondering about the possibility of the procedure being unnoticeable at this stage. The donor area also looks good, but also red and depleted in hair, so also noticeable.

 

Have everyone a nice weekend!

[pkipling]

Commenting to say congrats - and so that I get email notifications to follow this thread. The work looks great and there will be even more excitement leading up to your wedding day now....

[menosmolas]

thanks pkipling!

 

by the way, I have been reading random threads in hairloss forums these days (I'm off of the job and basically hidden in my house till tomorrow), which can be indeed dangerous and as a result I have a question.

 

As I commented in my first threads, I had a huge hair loss during last 6 months, which has been the cause to decide to undergo the HT. During last year, I have been probably a bit indulgent with my Finasteride intake, due to several logisitc reasons. It's difficult to say to which extent, since I have been taking the med for so many years (12? 15?) that i do not really follow the track of the days i take it or not (which is a minority, do not misunderstand me!). I do not feel that I had significant 'lower' intake than other casual periods in the past, except maybe during 2 months (june-july of this year) that I was travelling a lot and maybe aprox. half of the times I was not taking the pill.

 

So here is my question: it is my understanding that when you stop Fin, at some point the testos->DHT comes back and then your hair just react to that, 'normally'. But I also read that the thing can hit stronger under this circumstance, in the sense that the hair loss is not 'normal' but can be significantly heavier. I read somewhere that this can be related to the fact that the cells have created more DHT receptors to 'compensate' the lack of it, so when the DHT is there again, there is more 'reaction' (larger hair loss). I do not see much sense to that, because I do not know why the hair cells have to 'generate' more DHT receptors, if this product is not needed for the hair cells to undergo any important biological task --as far as i know--.

 

What do you think about it? This can be an explanation for such a severe hair loss in a small amount of time ? And if so, there is some possibility that re-starting religiously the finasteride can help to recover some of that?

 

Maybe i should post this thread in another post. If so, I will do it, and sorry for spamming here. However, both issues are quite related, since I have been adviced by my HT doctor to add finasteride gel to the finasteride pill, and at some point reduce --i guess-- the later. I've really lost ground in my top scalp and crown, also during these 6 months, and if I do not stabilize that, my HT will look a bit sad even if successful in no time.

 

Thanks to everyone again!

[KO]

^It seems that when you get off finasteride, patients experience accelerated hairloss until they go back to sort of a baseline. It is as if the follicles realize they need to jump.

[gillenator]

That's because finasteride is no longer in the bloodstream to effectively inhibit DHT to the hair follicles and as a result, the follicles begin retreating to the resting telogen phase, shed the hair, and the thinning resumes.

[menosmolas]

@ko, thanks for the response. But there is some reason for that? I read about the cell hairs expressing more ARs when deprived from DHT, but I did not find any solid evidence.

 

@gillenator, thanks for your response too. But note that the point is not that the hairloss starts again 'as expected' when the hair faces the DHT, but that it may happen that such hairloss is more aggressive 'than normal' (for instance, and to put an example that may be not true, because there are a larger amount of ARs in the cell created by the cell during DHT depravation, and when this hormone comes back, the effect is larger) . Or you meant that when DHT is off, then there is a shed effect, and the hair will grow again (although the thining will be back then at the 'normal DHT rate') ? (sorry if i'm missing your point!)

[milo12]

Hello gillenator,

 

Do you feel that once someone stops taking finasteride then starts applying it again say 8 months later that it would be more difficult to regrow the same hair?

[gillenator]

That probably will vary between individuals Milo. I think the younger guys have a better chance of experiencing some regrowth from finasteride if they start early.

 

I think for most guys, they experience good efficiency but not very much new growth that was lost in the past.

 

Have not heard much about guys who stopped taking it, and then resumed it within 12 months and experienced some regrowth.

[menosmolas]

Small 15days update with some photos. The ones at the left are with artificial light, the ones in the right are with natural one. It's hard to reflect the reality with the camera I'm using, but as a summary: (a) donor area is a bit red and with the 'holes'; noticeable but basically it looks that some small irritation is going on; (b) similar in the recipient area: there is some redness that is fading little by little, noticeable but that also looks as some 'normal' irritation (at least now that there is the transplanted hair in the area); © maybe i lost some transplanted hair (by the way, tomorrow I will do my first shampoo), but of course I'm expecting a much more severe shading in the near future.

 

on the other hand, in around one week i should start the topic fin (in combination with the 1mg oral, during about 3 months). I realized that the concnetration of the topic fin the clinics provide me is 2.5%, and I'm supposed to use 1ml. If I'm not wrong, this means 25mg applied to the scalp?? Likely I'm missing some point, I would appreciate any feedback about that. In any case, I will probably begin a new thread to ask about that issue, since I have no doubts that although it's topic it will reach the bloodstream, and this seems a huge amount of product.

 

Good luck to everyone,

[gillenator]

That's a tough one to evaluate since the topical product is relatively new and few guys using it...certainly hope it works well for you....

 

Please keep us in the loop.

[menosmolas]

Hi everyone,

 

1month update:

 

I attach three photos, one with dry hair (up) and the other with wet hair (bottom left), both with artificial light, and the last one with natural light (bottom right) Probably not the most pro photos, but I hope they are good enough to give you an idea.

 

I guess that I'm suffering the shedding, but it's quite progressive and I would not be able to say how much of the transplanted/original hair of the area is still holding. In any case, the hair there has quite a sad looking, since besides the density, what it is more obvious is that it is growing heterogeneously (i.e. different sizes) and at quite a lower pace that the rest (so the one in the rest of the scalp is larger). Since I'm still in my 30-days mark, I assume that it will keep falling, although I heard that it does not need to fall the 100% (any feedback here would be appreciated!)

 

No big things to mention except: one, that I had a very bad itching in my donor area and I needed to go to the pharmacy; a corticoid gel helped a lot, and now it's much better (I did not check it out with the clinics since it was weekend and it was quite bad). And second, I'm using only the oral finasteride; I did not receive yet the data from the clnic (they told me they are waiting for the pharmacy) that they claim demonstrates that the use of the topic one does not expose the body to too much product but that it is equivalent to the 1mg oral Finasterida dosage.

 

Let me know if someone needs some extra info!

best

[jaswalraj1]

Looking very good ! Congrats

[gillenator]

meno,

 

What you are experiencing with the loss of some of the grafts is perfectly normal. It appears based on the photos that you still have retained roughly 50-60% of the grafts. Over time, they will shed as well. But keep positive my friend as the end result is going to look very good!...:cool:

 

And the itching is also normal from the healing...the topical steroid should be fine but probably a good idea to touch bases with your doctor so he knows you are applying it.

 

Lastly, it will take time 9-12 months before you will know how efficient the topical finasteride is working for you. I for one am very interested in knowing how you respond to it and wish you all the best with it.

 

Nice update meno and happy growing to you....

[pkipling]

Thanks for the update and I'm happy to see that you seem to be right on track. The first several months (after the shed waiting on the hair to grow) is the hardest part of the process, so just know that what you're experiencing is completely normal. Some guys are lucky and have a decent amount of growth by the 4th month, but don't be alarmed if you don't see significant results several months later than that.

[menosmolas]

Thanks for the answer guys,

 

indeed I was well-informed of the shedding, I was just wondering if I would be lucky enough to do not loss the 100% of the transplanted hairs, since I heard that not always have to happen. Today it's 5 weeks mark and the situation is quite the same, quite a lot of the transplanted hair is still there (although looking a bit sad and not growing well) and I would say that I start to have some tiny hairs just popping up now (although they could be my native ones that were still holding in the transplanted area)

 

I guess that there will be a point where the shedding will happen massively and suddenly. I will update when something more meaningful happens. On the other hand, I did not take the decision of what to do with the topical finasterida, my side effects with the pill are borderline of being a big problem, so that is stressing me a bit, I will procastinate the decision till after Christmas.

 

best to everyone!

[gillenator]

The shedding of grafts can occur as early as 2 weeks post-op right up to 8 weeks.

 

The good thing is that the regrowth is roughly 3-4 months post-op so the best is yet to come!

 

Hang in there as your transition is right on the horizon....:cool: