Dr.Rahal 4000 graft FUT is booked DEC 2016

[wantingmore]

Hi guys just wanted to start a new thread to start documenting my HT journey. I've learned so much from this site and I'm grateful for finding it and the users for its supportive environment. I hope that me documenting my journey will in return help someone else and as well help me to gauge how its going and get feedback from the community. I will do my best to keep this up to date and document it and how i feel about the whole thing the good and (small ) potential bad, hopefully all good!

 

Quick bit about myself which I did post in a different thread titled "newbie....."

I'm 35 years old Caucasian with light/moderate skin tone and dark brown hair. I have been called a norwood 3-4 and started losing my hair about 12-13 years ago. Started in the front corners and receded pretty quickly then forelock also receded back all this in about 2.5-3 years to point it was pretty noticeable friends making large forehead jokes when i used to be the guy with the biggest head of hair going!. Then stabilized around age 27 or so for a few years I think in part to laser comb therapy which surprisingly did have positive effects for me. Once it receded back far enough all the thin hair was gone I was left with decent density in front just a higher up hairline so still workeable and styleable. Then around 31-32 it started up again thinning further in the frontal 3rd then in the last 3 years or so crown started and crown got a good sized hole in it pretty quickly in the last couple years. frontal now is pretty thin and corners bare but I can still comb forward in essence and cover everything reasonably well. I apologize if this is 100% congruent with my original timelines in previous thread as I'm going on memory and of course never recorded any of this (who wants to monitor and stress more over it!).

I tried propecia a few times over the last 10 years or so and never used it for more than 60 days as the sides were brutal for me last tried it 3 years ago. Also tried rogaine spray and the regular stuff for about a couple months 3 years ago but had brutal shedding which may have been due to over using it and drying out the hair.

 

So I have an appointment booked with Dr.Rahal for next week! for around 4k grafts in frontal third and mid scalp. Depending on the density I go with based on their online consultations they are thinking zones 1-4 at 50Fucm2 or zones 1-5 at 45Fucm2 with more of it going to full frontal rebuild as i still have some good/decent midscalp hair. I'm a bit concerned with the 45Fucm2 based on what I read on here that 50 sounds to be better as i dont want a thin look in the front (already have that!) but have decided I will let the good Doc give me his opinion of this once he sees in person as I've also realized the Fucm2 is not all about numbers but also hair caliber color etc.

I'm also concerned about shockloss as I do have some decent mid scalp hair that when comb right can cover mid and front without seeing through for the most part so don't want to lose it but it is thinning as well. I will post some pre op as well as post next weekend once I have a chance to relax. Wish me luck thanks guys!

[TakingThePlunge]

You're in good hands! I think you have the right attitude. Let Dr. Rahal give you his professional opinion about density. He's got a great track record of producing impressive results.

 

Looking forward to your future updates. Best of luck!

[Ernie]

Hi guys just wanted to start a new thread to start documenting my HT journey. I've learned so much from this site and I'm grateful for finding it and the users for its supportive environment. I hope that me documenting my journey will in return help someone else and as well help me to gauge how its going and get feedback from the community. I will do my best to keep this up to date and document it and how i feel about the whole thing the good and (small ) potential bad, hopefully all good!

 

Quick bit about myself which I did post in a different thread titled "newbie....."

I'm 35 years old Caucasian with light/moderate skin tone and dark brown hair. I have been called a norwood 3-4 and started losing my hair about 12-13 years ago. Started in the front corners and receded pretty quickly then forelock also receded back all this in about 2.5-3 years to point it was pretty noticeable friends making large forehead jokes when i used to be the guy with the biggest head of hair going!. Then stabilized around age 27 or so for a few years I think in part to laser comb therapy which surprisingly did have positive effects for me. Once it receded back far enough all the thin hair was gone I was left with decent density in front just a higher up hairline so still workeable and styleable. Then around 31-32 it started up again thinning further in the frontal 3rd then in the last 3 years or so crown started and crown got a good sized hole in it pretty quickly in the last couple years. frontal now is pretty thin and corners bare but I can still comb forward in essence and cover everything reasonably well. I apologize if this is 100% congruent with my original timelines in previous thread as I'm going on memory and of course never recorded any of this (who wants to monitor and stress more over it!).

I tried propecia a few times over the last 10 years or so and never used it for more than 60 days as the sides were brutal for me last tried it 3 years ago. Also tried rogaine spray and the regular stuff for about a couple months 3 years ago but had brutal shedding which may have been due to over using it and drying out the hair.

 

So I have an appointment booked with Dr.Rahal for next week! for around 4k grafts in frontal third and mid scalp. Depending on the density I go with based on their online consultations they are thinking zones 1-4 at 50Fucm2 or zones 1-5 at 45Fucm2 with more of it going to full frontal rebuild as i still have some good/decent midscalp hair. I'm a bit concerned with the 45Fucm2 based on what I read on here that 50 sounds to be better as i dont want a thin look in the front (already have that!) but have decided I will let the good Doc give me his opinion of this once he sees in person as I've also realized the Fucm2 is not all about numbers but also hair caliber color etc.

I'm also concerned about shockloss as I do have some decent mid scalp hair that when comb right can cover mid and front without seeing through for the most part so don't want to lose it but it is thinning as well. I will post some pre op as well as post next weekend once I have a chance to relax. Wish me luck thanks guys!

 

Good luck buddy!! You're in good hands. I would/will go back to Dr. Rahal in a heartbeat when/if I ever need a second HT

[wantingmore]

Right on thanks guys much appreciated!

[wantingmore]

Hi guys quick update I met with Dr.Rahal in person today he had a look over everything and has revised the original plan of doing a 4k Fut in zones 1-4 or 1-5 potentially. I guess my donor hair is a bit finer than they thought it was based on the pics, just slightly below average, My mid scalp hair there is more hair there than they thought there was (i suspected might happen as my pics did show in bad light to show through and hair was moved around to show the thinness as it is reasonably thick and covered) & said it is pretty risky to do the mid scalp to far in based on shockloss, as well as maybe not as good of donor supply amount as originally anticipated.

 

So the new plan was to just do the front hairline zones 1-3 ? ish but only with around 2100 grafts at 50FuCm2 and leave the rest of mid and donor for future loss and procedures. I'm cool with not doing into the mid scalp as much as shockloss was one of my bigger concerns and I can make whats there cover just fine.

 

The hairline is drawn in & surgery is in the am I'm going to ask for couple minor tweaks to hairline tomorrow morning to round out the temple closures a bit more & maybe lower it 0.25-0.4cm ? Little bit of adjustment period mentally with a fairly big change in game plan which I'm ok with the only thing I'm concerned with at this point is 2100 grafts with finer hair than i thought i had seems a bit on the light side for good density based on Ernie your case, seems like I will be treating a somewhat similar area as yours. So I think I should just run this by him at least again in the am to see if bumping it up a bit more even to closer to 2500 would be a better result. (maybe can't lower hairline design as that might just eat up the extra grafts right there if he can go up to 2500). Not sure if anyone will see this before I leave in the am but any comments appreciated thanks guys!

[Ernie]

In my opinion a lower graft number procedure (even with a great doctor) is a better experience. 2500 FUT is sooooo much less traumatic on your head. I'm super excited for you man. I remember telling Dr. Rahal to "just jam as much hair as you can into my frontal third", lol.

 

His plan for me was 2500, but we ended up with 3185 :-)

[hsrp10]

Good luck on your upcoming surgery man!

Agreed lower overall graft count is better for the patient and I personally believe helps with achieving better graft survival and ultimately better final results. Less overall trauma to the scalp and the grafts are out of the body shorter amount of time.

 

I just will add that if you have fine hair as we discussed before, try to go as high as the doctor can perform and as high as your donor will allow (future donor management included) especially in zones 1-2.

As close to 60 grafts/cm2 you can get in zone 1 the more you will reduce the chance of your hairline looking see-through in harsh lighting from my personal experience.

I know Dr. Rahal is capable of this as per Ernie's case, so I don't think it is a stretch for him.

 

I took a few pics in different lighting to show what I mean. There is a small area on my left side middle frontal third where the density is maybe 45 hairs/cm2 or lower (you can see in last bottom photo). This area is mostly all transplanted hair and looks ok in normal lightning and also when I let my hair grow longer. But I've been progressively cutting it shorter and shorter and the last bottom photo shows the reality of fine hair transplants if the density is not on the higher side. (*I will delete the photo after you view it as not to derail your thread)

 

Anyway good luck with surgery and looking forward to your updates.

Edited December 16, 2016 by hsrp10

[wantingmore]

Thanks Ernie & Hsrp! Hsrp I had a look at your pics and see what you mean on the left side being a tad see through it seems like overall it looks really good and I'm assuming it doesn't bug you to much ?

So my surgery seems to have went well I did ask Dr. Rahal to round out my temple closures a bit in the am which he happily did quickly (had to initial that form making the change). I asked him about lowering it 0.25-0.5cm and he didn't think it was a good idea so i went with the good docs suggestion and left that alone.

 

My natural original hairline before any loss was one of a widows peak and then kind of arched up in a fairly symmetrical rounded manner to the temples. Mom said when i was born doctor commented i had a receding hairline at birth! Seems I was doomed from the beginning Lol. So I did want to replicate mother nature as much as possible with the drawn hairline.

Dr.Rahal did note that typically he wouldn't come down quite that much for the widows peak with that shape. I had noted last night viewing his website and seeing a lot of the drawn hairlines being essentially half moon like from temple to temple arching down slightly in middle that once they grew in the after pictures showed more shape to end result than what i thought they would based on the purple marker drawings. So with that in back of my mind this morning when he noted he typically wouldn't come down quite that much I did ask right away if he seen any issues with it, if he suggested changing it or was uncomfortable with or thought it might not look quite right once done and he said No, so I went with my gut & we went ahead with it.

 

Final result we ended up with just a tad over 2600 grafts think they said 2620 but I'll confirm tomorrow he said it went really well and both him and the techs said everything looks really good which is nice to hear. The cleaned me up she asked if i wanted to see it got to admit I was scared to look. I didn't get a great look at the density to form opinion but I'm hoping that being yesterday he said 2100 grafts for the area was going to be around 50Fucm2 that the extra 500 grafts should up that number ? My gut reaction was that I really liked the design shape so thats good. The donor scar they commented looks really good from what I could tell it seemed to look good I know its stitched up but can't help but feel like the sucker could blow wide open which obviously won't happen. I guess that's all for now will post some pics soon as I have them thanks again guys much appreciated!

[hsrp10]

Congrats on the surgery being successfully over!

looking forward to the post op pics when you have a chance.

 

and I'm assuming it doesn't bug you to much ?

Actually the perfectionist part in me makes it bug me a lot at times lol, but the point I wanted to get across was it's something quite subtle and also difficult and risky to correct later on so wanted to make sure you get it right the first time around, that was one of my miscalculations earlier.

 

How long are you staying there for the post-op btw?

[wantingmore]

Hi guys so I got the graft update final count goes as follows

 

1 unit grafts 475

2 unit grafts 1581

3 unit grafts 509

4 unit grafts 39

 

total grafts 2604

total hair 5320

size of donor area 21.65cm2

 

So I'll have to ask again on monday about the grafts per cm as on the original in person meeting they said it was a 50cm area we would be doing, when i asked in person after the count the after care gal (not sure if I'm supposed to add names on here but she has been awesome) had said it worked out to 52 Fucm2 but 21.65cm2 is only 43cm surface area i think ? I'm not great at math so maybe I'm missing something or maybe when i asked she had calculated it on the original area we discussed but it was smaller once completed ? I'll double check unless one of you guys knows the math it it all sounds right ? So I think the lowest case scenario is 52Fucm2 but might be higher also with my native hair (hopefully that sticks around) should be a good Fucm2 I believe ? Dr.Rahal and everyone that has looked at it has said it looks really good and will be good result which is comforting to hear.

 

I went yesterday to get my cleaning done at 930am i hadn't eaten anything which was a mistake and had taken the antibiotic & earlier in the night couple T3's. Once i got in the room was warm in there i got super nauseated sweats vibrating body and brutal sick feeling followed by cold shakes and feeling dizzy horrible all around. The team & Dr.Rahal were unbelievably on top of it getting some sugars in me OJ & Granola bars I ended up having to post up in one of the rooms for about 3-3.5 hours before I could get up without being dizzy the whole time Dr.Rahal and all the staff showing world class compassion, care and expertise I can't say enough positive things about him & all the staff it seemed like I was the only person in there even though I know they had other stuff to do it didn't seem like it. I can see now how scary this process would be if you went somewhere that had sub par care and service or had a doctor that was cocky or ego based it would not be a good experience. Having someone with a calm humble caring demeanour like Dr.Rahal and all his staff is crucial in my opinion and can't say enough good things about it.

 

So I went back today got another cleaning done again told again everything looks really good I had some swelling in the right side of my face which they said doesn't happen to everyone but is normal try to stay at a 45 as much as possible since I've got back to the hotel my other side of my face has swollen huge it doesn't hurt just feels like pressure but looks really bad my head is .5x times bigger than normal looking like an elf from LOTR or stewy from family guy egg head lol. Below is a pic taken yesterday which would be one day post op sorry not the greatest pic bit hard to see the hairs but let me know any comments and thoughts. I tried to get a pic of donor scar but was tough with my hair in the way and was still a bit bloody last night so I'll try to get some donor ones tonight. Thanks again!

[Ernie]

Surgery - easy part (congrats!)

 

Waiting game - the tough part (think 4 months, as most Rahal FUT guys start to look good by then)

 

I will say the work looks pristine and very refined

[baldlivesmatter]

Looks like clean work. Happy growing!

[wantingmore]

Currently at 9 days post op the last 2-2.5 days have started to get skin drying out and starting flake and crust it seems like there might be a couple areas where it looks like its fresh skin and there is no hair in it although i havent seen any of the flaking actually come off yet so hoping that isn't just where there is no hair follicle, hoping maybe the hair already fell out with an unnoticeable flake that fell off. Haven't had any bleeding so don't have any reasons to think there is any graft problems although its a bit of a scary time with everything flaking and starting to fall its hard to tell what is what.

Attached is the some pictures of the scabs you kind kind of see the bare skin area slightly although the picture quality is not the best.

The clinic is going to send me their pictures in the next 1-2 weeks once loaded on their system so I will update and back date the pictures to have some better quality pictures as well as some pictures of the donor area. Any comments on the scabbing ?? Normal ?

[wantingmore]

few more scab pictures

[robc]

Hi WM,

 

everything looks normal to me, It took about 2.5 weeks for most of my scabbing to go away. I wouldn't worry about the small areas where there are no scabs. I had those also, will look normal once the final hair grows in.

Just hurry up and wait for you now. Happy growing

[mav23100gunther]

Great write-up mate. Reminds me of my procedure with Rahal just as his time last year. Everything looks great, and it's looking like another killer result from the hairline king.

[wantingmore]

Little update today is day 12 post op had my sutures removed today by a nurse at the hospital didn't really hurt at all but do have some numbness still in the donor area which might have helped with that. She said everything looks good but I did have couple areas where it did have some very minor amounts of blood to me it looks pretty rough visually but when i got home i cleaned the area and had very minor blood spot on the clothe. I'll post a couple pics see what you guys think. I did email Dr.Rahal office tonight just to send the pictures in to see what they think if its normal or not (assumed would hear back tomorrow) despite the fact it was way past business hours and the after care ladies I emailed were technically off for xmas till tomorrow (auto email response said) She did still email back tonight, again just a testament to the clinic and everyone that works there world class no doubt.

One clarification on my numbers from before that I had got confused on so it was the donor area that was 21.65cm2 not the recipient area. The recipient area was 50cm2 so in total worked out to 52Fucm2 on average but Dr.Rahal said the first 2cm were packed denser with the single hair grafts so that FuCm was higher there than 52.

The recipient area was pretty itchy for the last 3-4 days and scabbed up most of the scabs are still there but have released from the skin and seem to still just be stuck on there by the hair. So I haven't touched them just let them fall off naturally couple more days till I can touch the recipient area.

One notable thing is I never ever get headaches and I've had headaches everyday since a few days after the surgery when I wake up in the morning its pretty noticeable and seems to fade as the day goes on i haven't been taking anything for it just want to see what naturally happens. I think there is still a small bit of swelling in my forehead so that likely the cause I would assume. Thanks again for reading below is the donor pictures.

[hsrp10]

Hey man congrats on making it through the hardest part.

The recipient area was 50cm2 so in total worked out to 52Fucm2 on average but Dr.Rahal said the first 2cm were packed denser with the single hair grafts so that FuCm was higher there than 52.

 

Also sounds like you'll have an awesome dense result when it grows in.

Did you take Tylenol for the headaches?

 

Next tough part is the ugly ducking phase after the new hairs shed, but in about 10 weeks you should start to see small gradual changes.

[wantingmore]

Hi guys so got back my photos from the clinic which are better quality than mine so I'll add all those below. Few things to note figured out that the headaches were allergic reaction to the keflex which was the antibiotic medication also had full scale reaction after the last pill upper body rash, killer headache, disoriented, yellow skin, slight respiratory shortness of breath i read up on online and it said if you have any of these reactions to Keflex seek immediate medical attention so I went to the hospital waited 3.5 hours met the doc told him what i had been taking and that these were all the top serious side effects of this medication and he said nope you have the flu go home...Thanks doc!! went home took couple days but the headaches went away and started to feel normal. Also to note I'm sure it normal from the seriousness of the surgery but man have I been mentally tired most of the time. I typically play a fair bit of poker and I can't even think at all at the table hopefully that ends soon!

 

As of today which is 24 days post op all scabs are gone the hairs are starting to grow I have been using the Rogaine since day 15 as per Dr.Rahal instructions slight burning from it and minor redness so they have suggested i stop taking for a few weeks let skin heal bit more and try it again. The donor area is completely concealed by my hair you can't see the scar although if you move the hair you can see it, of course its still red but I'm wearing a hat cause of the recipient area is short little hairs and right behind it is long so looks goofy. Recipient hair I haven't lost any yet, that I can tell of they seem to be growing out some of them are longer than others, some are barely poking out through skin. Doesn't seem to be any signs of shock loss at all so far anywhere. Below is the clinic photos before and right after/ over the week that i was there. I'll post some current pics next week at the 30 day mark.

[steven2801]

why did you choose fut over fue?

[wantingmore]

Hi Guys sorry I haven't kept this updated like I said that I would for the first few months there wasn't much to report and I was just doing my best not to think about it so i stayed off of here.

Quick catch up I had a decent amount of little in grown hairs in the 7-9 week range, my scar was concealable by the 6-7 week mark with longer hair & I was able to comb over and conceal everything in small doses by the 6 week mark with super long hair that I would have never wore that long before but which was nice although I've been wearing a hat 95% of the time.

Up to current time I'm at 4 months & 2 days the pics attached are from 1 day before 4 months so 4 months. At the 3 month mark I started to see 2-4 hairs poke through but since then I have had literally nothing else happen. There is no growth and the 2-4 hairs that did poke through haven't grown in length at all in the last month just stayed the same. I'm definitely starting to think or realize there is a decent chance this might not turn out the way I had hoped or that I'll even see anything from it at all. I know that 4 months is early but to see basically no growth whatsoever at this point can't be a good sign.

So couple questions for you guys 1. can anyone reference someone that also had no growth at 4 months that ended up with a good result ? Some positive reassurance would be nice at this point. It seems like the "slow growers" never get the premium results that they quicker growers get. Also could some of the Vets chime in about whether a guy should be worried at this point or not or if it is still early. Being that the literally 2-4 hairs out of the 2600 grafts put in haven't grown since popping through it seems hard to believe that even in 2 months I will be happy being that even more hairs popping through in the next month couldn't have too much visual impact at the theoretical length they would be at in 2 months and that most people are seeing some type of results at 6 months that I might not see anything. Below is a bunch of pictures all the hair in the donor area is native hair that I had before so when looking at the pics keep in mind you can't see a single transplanted hair in the pictures. As far as shockloss it is a bit hard to say but I would say I've lost somewhere in the 30% range I think some of those hairs are there and are thinner now so hopefully they make full recovery and just maybe the worst case will be that I look the same as before in awhile, if the surgery is a complete failure. Sorry not trying to be dramatic just its looking like I might be one of the poor results cases hopefully I'm wrong and I'll try to stay positive. I appreciate any feedback positive or negative the honest truth is what I would be happy to hear good or bad thanks. I did wet the hair in some of the pics so that you could see better as dry I can comb it over decently.

[wantingmore]

sorry it didnt load first time

[wantingmore]

if someone wants to let me know how to post the pics right side up would be awesome thanks!

[hsrp10]

https://iphonephotographyschool.com/iphone-photos-upside-down/

[wantingmore]

Thanks!