Recent FUE with Dr Ron Shapiro . Prior FUT patient .

[mikeyhwk]

any chance you could post a preop pic unshaven, like how it looked styled preop if you have one?

[fortune11]

any chance you could post a preop pic unshaven, like how it looked styled preop if you have one?

 

These are two pics right before the HT in December 2016

[fortune11]

Another pre op photo from the top view

 

Here you can see the thinning areas in the frontal third and midscalp that I wanted to fill in with the new FUE transplant , to provide more support to the hairline .

[Melvin- Admin]

What does your hair look like now? The pre op pics look like you needed no work done especially to the side channels, could it be you had permanent shock loss? In fairness you didn't get a whole lot of grafts, if you had significant loss of native hair I don't think the grafts transplanted would be enough to warrant a good cosmetic difference. What has Dr. Joe said about this result? Did he warn you prior to surgery the risk? I'm considering getting my side channels strengthened as you can see a bit of a gap like you, but now I'm thinking it may not be worth it, I use toppik to conceal those spots and it looks perfect. Thanks for posting this thread great information.

[Bill - Seemiller]

Unless I am missing something, your hair looks great. Are the photos you posted above showing your results? If so, what are you unhappy about? Maybe if you show a before and after picture right next to each other that would help?

 

Best wishes,

 

Bill

[Melvin- Admin]

Unless I am missing something, your hair looks great. Are the photos you posted above showing your results? If so, what are you unhappy about? Maybe if you show a before and after picture right next to each other that would help?

 

Best wishes,

 

Bill

 

Post #24 is his most recent pictures and post #27 and 28 is what he looked like prior to surgery, IMO he didn't really need another surgery, now it appears perhaps shock loss occurred, not sure but I would like to see if things have improved in the last month.

[fortune11]

HT soon you are correct -- post 24 is 10 months post op and 27 and 28 is the day I walked into surgery .

 

On the question that did I even need surgery ? --- Like I said in a different thread, pictures can be a bit deceiving . Outdoors and especially under direct sunlight , the side channels would become visible and I also wanted to create more fullness behind the hairlines to get more styling freedom. Lastly I also wanted to fill in the big scar on the right side side that had developed after FUT #3 in early 2015.

 

Right now, as you can see I look worse than before the FUE surgery. There was considerable shock loss right after some of which has gradually recovered , but I am hoping rest is not permanent

 

One factor that Dr Ron and I discussed two weeks ago was maybe switching from oral to topical finasteride could have been a factor, To rule that out as a possibility, I have switched back to 1mg propecia every other day.

 

Right now, you may say I was better off before surgery and why did I bother (except for the scar). Well, I have great faith in Dr Ron's work (HT #1 and HT #3 were a success) . I want to wait for 6 more months, continue taking oral propecia and then decide whether it was a success or failure.

 

One thing that is obvious to me from the small sample size of one (my own experience) - growth after FUE has been much, much slower than the growth bounceback after prior FUTs. I don't care how many studies people (and FUE fanatics) throw in my face, this is just a fact I am living with right now .

 

To be clear - this is not a " complain " or being " unhappy " . I am just documenting my experience , as it happens, with changes and swings in either direction, for every one else to see and draw their own conclusions. I am assuming people on this board would rather have access to my complete thought process than me going radio silent for 1.5 years . I have learnt a lot from this forum over last 15 years reading other people's experiences and hope I am doing my part by sharing (or oversharing as the case may be).

[Melvin- Admin]

HT soon you are correct -- post 24 is 10 months post op and 27 and 28 is the day I walked into surgery .

 

On the question that did I even need surgery ? --- Like I said in a different thread, pictures can be a bit deceiving . Outdoors and especially under direct sunlight , the side channels would become visible and I also wanted to create more fullness behind the hairlines to get more styling freedom. Lastly I also wanted to fill in the big scar on the right side side that had developed after FUT #3 in early 2015.

 

Right now, as you can see I look worse than before the FUE surgery. There was considerable shock loss right after some of which has gradually recovered , but I am hoping rest is not permanent

 

One factor that Dr Ron and I discussed two weeks ago was maybe switching from oral to topical finasteride could have been a factor, To rule that out as a possibility, I have switched back to 1mg propecia every other day.

 

Right now, you may say I was better off before surgery and why did I bother (except for the scar). Well, I have great faith in Dr Ron's work (HT #1 and HT #3 were a success) . I want to wait for 6 more months, continue taking oral propecia and then decide whether it was a success or failure.

 

One thing that is obvious to me from the small sample size of one (my own experience) - growth after FUE has been much, much slower than the growth bounceback after prior FUTs. I don't care how many studies people (and FUE fanatics) throw in my face, this is just a fact I am living with right now .

 

To be clear - this is not a " complain " or being " unhappy " . I am just documenting my experience , as it happens, with changes and swings in either direction, for every one else to see and draw their own conclusions. I am assuming people on this board would rather have access to my complete thought process than me going radio silent for 1.5 years . I have learnt a lot from this forum over last 15 years reading other people's experiences and hope I am doing my part by sharing (or oversharing as the case may be).

 

I know what you're saying about the side channels and pictures, I would say my hair is pretty close to yours in terms of pattern, I also have a thin spot in the hairline transitional zone, my side channels are also weak, I currently use clever styling and toppik to fix it, honestly with the toppik I forget about it, I used to be against concealer until I actually tried it man has it been a blessing for me. I was right about to pull the trigger, coincidentally I had talked to Dr. Josephitis as well about doing a small FUE for the side channels, so that I could have more styling freedom. After reading this thread I think I'm going to hold off, after three successful transplants my thinking was why not just finish it off, but seeing as my donor is now limited I'll have to make sure my next move is a careful one. This thread has helped me a lot man thanks that's why we post our results. I hope things improve for you, even if they don't you're not in a bad position considering where'd you be with no surgery, you mustn't forget about that.

[mikeyhwk]

thank you for sharing your pre op pic fortune, I was curious to see if part of the problem was that you were transplanting into an area that already had a fair amount of coverage and that does seem to be the case. That is always the risk, I know when I wanted to do crown initially Dr Bisanga told me to leave it fearing the net result would be break even due to loss that implanting in between some minaturized hairs and area that was thinning (im diffuse as well) would lead to. I do hope that Dr Shapiro is correct and you will find growth in time. It is interesting to see how the multiple procedures take a toll and leads to slower growth. Did you notice this trend prior this surgery, did you find your last fut procedure a little slower to grow than your first procedure as well? I agree with ht, you seem to still be in a favorable position overall while this hasnt been an ideal post op ride, its not over, please keep updating. Best of luck!

 

While im at it, do you believe the topical fin was a set back because you had initially gone the oral route, do you tend to believe that if somebody was on topical throughout and not ever gotten serious with oral fin that theyd not have had your experience? i guess you'll know more about fins effect with a little more time back on the oral but I got a friend who has switched to the topical after some time on the oral and im wondering if hes better off switching back

[fortune11]

Thanks HTsoon. I am hopeful too. The one thing I will re emphasize is Dr Ron is the ultimate professional and he has shown great degree of personal interest and support for my case. Since he made the incisions himself I am hoping it is not a case of permanent shock loss from inserting new hair into existing transplanted hair and should grow back eventually.

 

mikehwk - re: topical fin., a lot depends on the absorption into the scalp and maybe mine has been so jaded now after 4 HTs that penetration is not as effective , who knows , I am obviously not an expert on this subject. But the fact also remains that I was NOT on propecia after HT#1 and HT#2 and in fact did not start propecia until after HT#3 in Jan 2015. The only way I will know if topical versus oral is the cause is that if my hair comes back fuller as it was before say in the next few months. So this is something definitely worth monitoring.

[Pete-from-Farjo]

Interesting thread. Sorry your latest ht hasn't given you the result you hoped for (yet). Did you get any growth at all in the scar?

[Bald36]

I just read this entire thread and I'm really sorry for your situation. My worry is that you're taking accutane and what it might do to your hair. I was told by more than one HT doctor that accutane can cause thinning and prevent new grafts from growing. Did you speak with the clinic about this? I'm also suspicious of your switch back to oral fin. Fin doesn't always regrow hair and in many cases once it is gone it is gone for good so if you don't have regrowth it doesn't really mean that topical didn't cause the problem.

 

Since you've had so many grafts I wonder if the micro scarring can inhibit absorption of any topical solutions. I hope this works out for you. You should stick with what works and don't experiment.

[fortune11]

Interesting thread. Sorry your latest ht hasn't given you the result you hoped for (yet). Did you get any growth at all in the scar?

 

Thanks Pete-from-Farjo . Hair implanted into scar hair did grow- closer inspection the scar is a bit visible at #5 but it is meaningful improvement from before. Given many of the hairs were from the beard they feel a bit uneven, curly and coarse to the touch I will try to post some pictures tomorrow.

[fortune11]

I just read this entire thread and I'm really sorry for your situation. My worry is that you're taking accutane and what it might do to your hair. I was told by more than one HT doctor that accutane can cause thinning and prevent new grafts from growing. Did you speak with the clinic about this? I'm also suspicious of your switch back to oral fin. Fin doesn't always regrow hair and in many cases once it is gone it is gone for good so if you don't have regrowth it doesn't really mean that topical didn't cause the problem.

 

Since you've had so many grafts I wonder if the micro scarring can inhibit absorption of any topical solutions. I hope this works out for you. You should stick with what works and don't experiment.

 

Accutane is serious stuff and I am aware since I took it back in my early 20s (and I thought I was done with it forever ). I have never seen so many warnings on a medication as I have for accurate. I was also asked to sign some sort of generic pledge and my information is in a database for monitoring . Plus regular blood tests needed to monitor liver ! But yes, Dr Ron is aware of accutane. He didn't seem to think it would be a problem with the hair growth per se (there are other side effects of course).

 

ALL -- If you have a prior acne condition from your youth and are thinking about using hair from beard - please be very very careful and give it a serious second thought. I would have never gone through with sourcing beard hair had I foreseen this acne breakout that has become a scourge in my life now , esp given in middle age and my client facing profession.

 

 

And I agree w you on the micro scarring - I have no idea whether this is a factor or not with the absorption as I only have my personal experience to go by and it didn't work for me . I have also asked Dr Ron whether introducing a different type of hair (beard) which is not native to the scalp has any effect on the more "native type " (if you can call it that) hair that was there before from the previous FUT transplants from original donor,

 

On your last advice . I agree -- Don't change what works .

[fortune11]

Thanks Pete-from-Farjo . Hair implanted into scar hair did grow- closer inspection the scar is a bit visible at #5 but it is meaningful improvement from before. Given many of the hairs were from the beard they feel a bit uneven, curly and coarse to the touch I will try to post some pictures tomorrow.

 

Here are some photos at #5 cut where you can see the scar but it is a bit faint and only if you know what you are looking for -- so yes, the FUE into scar was effective .

 

The third pic also shows a bit of the side channel thinning that I wanted to fix -- no improvement there yet

[fortune11]

Here are some post op pictures at the one year mark. these are after a fresh shampoo , with no product or concealers in the hair, taken with my iPhone .

 

All in all, you may recall me mentioning that I had faith in Dr Ron and was willing to be patient , and as you can see from the pics , it turned out to be quite good, even though it took a bit longer this time around. a factor may have been this being the 4th hair transplant.

 

I know I had posted several issues with my progress after HT so let me address these points one by one

 

1. Shock loss - has completely recovered by now as you can see the hair looks fuller and thicker

2. The big scar is now barely visible at #4 . I am very satisfied with this result

3. The frontal third where I wanted more support behind the hairline has filled in nicely - so that is objective achieved

 

4. The side channels and the top of the crown where I have marked with a red are still developing I think . I am going to wait some more to see how these look in a few months from now

 

5. Beard area Acne -- you may recall I was taking accutane for this. It Is effective , but absolutely a horrible medication as far as side effects go ( propecia has nothing on this !) . I stopped it after a month of usage. The acne is still there but a lot less than what it was at the peak of the problem and looks to be gradually improving .

 

6. One interesting observation is that the hair is a bit more curly now as part of it is coming from the beard area singles. but the placement is so amazing that you cannot tell which is beard hair and which is scalp donor hair - it is this mastery of placement that I think is unique to Dr Ron, in my opinion - making your donor hair give more bang for the buck , so to say.

 

Also I want to emphasize that Dr Ron continued following up with me throughout the year and took a keen interest in every aspect of the case from the medication I was taking for the acne to my dosage of propecia to video chatting with me to understand what the problem areas on the transplanted scalp were. Very happy with the post op care.

 

I will post again as results continue to develop but happy to take any questions

[mikeyhwk]

I'm happy to see the result coming around fortune. Your hair is looking better and better. Your side channels do look stronger as well but just a year in I could see them needing further time, as the crown is usually around 18 months to full maturation, side channels on a 4th op must be a similar time frame. Definite improvement on the channels still tho. Scar isn't noticeable and happy to hear Dr Shapiros looking after you so well. Thank you for the update

[fortune11]

thanks mikeyhwk.

 

Below is another picture, this time of the hairline . And here is where I want to make an important point for anyone undertaking this journey -- especially if you are heading to a NW6 or NW 7 , a position I am in now . Pretty much all the hair you see on top is transplanted hair

 

Very critical to have a solid foundation to build upon. That hairline is from 2004 and still looks natural. I was lucky that I went to Dr Shapiro for my first HT and he designed a hair line knowing well where I was headed.

 

Some one else who might have been more aggressive in order to appease a patient ( I was younger and in a different mindset back then) may have given me a low or aggressive hairline and then left me scrambling afterwards to keep chasing it . And having gone through 4 hair transplants now, I can tell you it gets more and more difficult to get good coverage as time goes on, especially if you have black hair on pale or olive complexioned skin (as opposed to blond hair on pale skin.

 

I changed my hair stylist recently and the new one when I told her all the hair on top was transplanted, could not believe it . her jaw dropped . This result is as natural as anyone or I could hope for . She also had a hard time locating the scar from previous FUT.

 

This is also why HT is as much an art as science . It is more than just getting a whole bunch of grafts and jamming them into the scalp. Having a skilled surgeon who knows how to place each and every follicle to create that irregular , natural look with enough randomness thrown in to create an illusion of denser than it actually should be , helps a lot. I spent some time trying to figure out if I could tell which hair in the frontal third was from beard FUE and which hair was from scalp donor region and I could not .

 

The last leg left for me now is the back of the crown. I will revisit that later maybe next year. But I am now done with the top of the scalp and hoping to maintain it as long as I can with meds like propeica and rogaine.

[Melvin- Admin]

Glad things turned around for you, the front looks incredible, I mean the crown isn’t that and, if you use toppik you’ll be 100% good.

[fortune11]

thanks for the compliment htsoon

 

I have used toppik and various toppik like concealers but every time I have tried them , I have eventually quit. something just doesn't feel right w them and when I travel it becomes a real hassle to maintain the same regimen

[sadhairlossman]

thanks for the compliment htsoon

 

I have used toppik and various toppik like concealers but every time I have tried them , I have eventually quit. something just doesn't feel right w them and when I travel it becomes a real hassle to maintain the same regimen

 

Hey Fortune,

 

What is Dr Ron Shapiro's take on beard hair? Do you think the beard hair survived? were they spread out or concentrated in an area? Also, do you plan on using body hair if needed?

[fortune11]

Hey Fortune,

 

What is Dr Ron Shapiro's take on beard hair? Do you think the beard hair survived? were they spread out or concentrated in an area? Also, do you plan on using body hair if needed?

 

Bear d hair was used across , especially on the scar . I think it did a good job concealing the wide scar .

 

My biggest problem was w acne that started after the HT was over -- all over the beard area . I have detailed that experience in my other posts

 

this was the single biggest post op complication - which made me take all sorts of anti biotics and even accutane.

 

For me it is a strict no no going forward for beard / body hair - mainly because of this reason.

 

But if you are asking whether beard hair eventually grew and did its job, yes it did. the tradeoff with the acne side effect for me is not worth it going forward

 

but maybe you are not pre disposed to acne as I am so it wouldnt be a problem for you

[wazaam]

Fantastic result. The hairline and front look terrific. This is as natural of a result as you will find.

 

Did you notice much of a texture difference with the BHT that was used compared to scalp hair?

 

 

Best of luck if you decide to finish off the crown in the future.

[bald67]

Hi -

 

As some of you may recall, I have posted prior experiences of my FUTs (2004-Shapiro, 2011-Ziering and 2015-Shapiro). I am basically a diffuse NW6 and have tried to keep pace with my hair loss using HTs into existing hair. While I have used Rogaine almost forever , I did not start using Propecia until 16 months ago (after HT#3) .

 

My scalp laxity during FUT #3 was not great and while I was happy with the grafted result, it did leave a prominent scar on the right hand side (see pic below pre op).

 

Having been " stripped out" , the goal with this HT was to use FUE to

 

1) fill in the gaps in the frontal third (as a consequence of somewhat inadequate result from HT#2) 2) fill in the side alleys and importantly 3) fill in the scar, esp on the right side -- I must say here that I did try SMP into the scar with rather unsatisfactory results (done elsewhere, not at SMG) so this time wanted to use actual hair into the scar to get that coverage

 

We used about 1200 hair from the scalp and ~ 300 from beard, 1500 total. The instrument used by Dr Josephitis (who did all the extractions) was a hybrid punch (motorized). Dr Ron Shapiro made all the incisions. I will not go into procedural details since people are already well aware of the high quality SMG process. There is a video attached below that you can look at for the extractions

 

My donor area was completely shaved for the procedure and now at 10 days post op it has grown nicely to be able to conceal the procedure enough . The only problem I am facing is the shaved areas in the recipient scalp (alleys and frontal third) are taking their time growing back (the original hair , not the new grafts) and I am experimenting with some concealers now to figure out how to make it look reasonable. I am also taking some MSM and applying a liberal dose of Rogaine but so far it doesn't seem to be helping.

 

Let me know if anyone has any questions etc. Overall I am excited and looking forward to seeing the new transplants grow whenever they do , but I am well used to the long and painful wait , having been through it three times before !

 

The pics below are pre op (shaved down) and also during the procedure . I will post the 10+ day post op separately.

 

send you a PM!