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This is a thread documenting my recent 2612 graft FUE procedure with Dr. Rahal.

 

I'm a NW3A in his late twenties/early thirties who has battled hair loss over the past few years. I've done the big three more or less consistently over the past few years and finally bit the bullet on doing a procedure after some bad experiences at work and with women that convinced me beyond a shadow of a doubt how important having hair really is. After doing some research last year I finally settled for Rahal.

 

The Procedure

 

As the thread says, I did a 2612 FUE procedure, which yielded a total of 5336 hairs. The total graft count was as follows:

 

  • 1 unit: 547
  • 2 unit: 1426
  • 3 unit: 619
  • 4 unit: 20

His head nurse technician Mike did all the extractions with a motorized extraction tool. Rahal did the incisions, and finally implanting was carried out by Mike and another experienced technician (6-7 years of experience). Two additional staff members assisted. The procedure lasted for 12 hours from 06:00 until 18:00. During the extractions I bled a bit more than usual, otherwise the procedure went smoothly.

 

The clinic as most of you know does multiple procedures; another FUE procedure was going on the same day, for crown work. I stayed awake for the majority of the procedure and opted not to watch a movie as I wanted the staff to remain focused while they were working on me. My impression during the procedure was that they took their work seriously. I have some minor observations that I'll share based on the final outcome, but nothing serious.

 

Worth noting here is that they were using a tool that had been introduced during the past 2.5-3 months, called an "implanter". This is essentially a plastic tube that reduces damage to the graft during implantation and allows for denser packs. According to the doctor this is part of a major shift across the industry. Apparently Lorenzo, Bernstein, Erdogan and other famous docs are already using this, though since adoption is somewhat recent only Erdogan has final results on file.

 

During my consultation I became quite concerned about this as it introduced an additional element of uncertainty to the process. However, the doctor stressed to me that Erdogan's results had been amazing and that the introduction of the implanters would reduce risk rather than increase it.

 

Pre-op/Post-op and Patient Experience

As detailed by many others over the years here, this is a clinic that takes patient care and post-operative follow-up very seriously. A lot of thought has been put into the "journey" that you take from showing the first interest to submitting the final follow-up photos. I won't spend too much time on this here, just state for the record that I have had a uniformly positive experience throughout. I really like the staff and they have come across in a sympathetic manner in all the interactions I've had with them.

 

The doctor himself is a good man. He has rock solid ethics. While there I met a NW3 patient who to my semi-trained eye would seem like a good candidate, but was ultimately turned down. For this patient there was a risk of donor depletion, and his final pattern of loss would make the transplanted hairline seem odd if the loss progressed. Another, younger patient was turned down during my time there as well, due to his loss being too minor.

 

Some reviews I saw characterized him as seeming "rushed", however I have had the complete opposite impression. He has been very generous with his time to address my various concerns and my myriad of different questions about post-op care and the procedure itself. Personality-wise he does have a bit of swagger to him, however in a way that I associate with high performers from work. Full marks for him and his team in this respect.

 

My concerns

The industry is "caveat emptor", and I take some blame for poor research in selecting my surgeon. My intention with choosing Dr. Rahal was to derisk my procedure, which I thought I had done by going for a clinic with a good reputation online. I did not want to go to Turkey, and had been somewhat underwhelmed by the results of the euro surgeons that were available in a reasonable timeframe. Rahal is routinely mentioned in top #3 lists across the internet and I also spoke with a former patient of his that I trust, and got his assurances that a large FUE session would not be a problem. I dodged most of the obvious bullets, like ARTAS, newbie techs, dense packed Armani hairlines, cheapo third-world surgeons and fallen greats.

 

However, I overlooked the negative experiences of forum member Sean (which I believe was due to a combination of physiology and inexperienced staff members working on him during his initial procedure) and SugarHighs (combination of factors but probably physiology seeing as the hairs grew and then shed), and some of the other rather subpar FUE results floating around here.

 

Ignoring the fact that Sean's procedure was back in 2011, most of the results you can find are rather old and there isn't really a plethora of recent complete hairline FUE results similar to what I was going for. Some of the patient results posted here evidence poor growth, though there is clearly a trend of better performance over the years. Mike told me that they generally don't get poor growth, time will tell but he seemed confident when he said it. I should mention that the most recent results you can find here, those of zx_toth and ftbpicks, both had very good growth and final results.

 

I guess I've attached some new meaning to "doing your research". It really means going the extra mile; scouring the web for results and first-hand accounts, and compiling everything into a timeline. Contact former patients that stopped updating. Get everything in writing before you go in, like how many techs will be working on you, what tools will be used and the doctor's involvement in the surgery. No matter how this procedure turns out, I'll be much more careful with my next one, that's for sure.

 

The road ahead:

The way I see it, I'm taking one for the team here, essentially. If the results turn out great then that should help assuage anyone who's apprehensive about doing a larger FUE procedure with this doctor. As I said, the patient experience is top notch and I'd recommend anyone that can handle a FUT scar to go with Rahal.

 

Attached are some pre-op, post-op day 1, and day 11 pictures. I'll get some higher res pictures soon so I'll upload those as soon as possible. However, having browsed a few of these threads over the years I know most people don't care too much about the post-op pictures, the final results are what matter. I'm committing to semi-regular updates until the 12 month mark.

 

Other recent FUE patients of Dr. Rahal are welcome to post here, especially those that are far enough out from the procedure to see how it turned out.

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Edited by David - Moderator

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Very detailed and honest review of your experience and apprehensions.

Hope it works out for you in all respects including yield and growth and looking forward to the updates.

 

I won't go into detail but agree with what you posted about this doc and FUE, you also did dodge major bullets by passing on Artas, Armani etc. so it should work out well.


go dense or go home

 

Unbiased advice and opinions based on 25 plus years of researching and actual experience with hair loss, hair restoration via both FUT & FUE, SMP, scalp issues including scalp eczema & seborrheic dermatitis and many others

 

HSRP10's favorite FUT surgeons: *Dr. Konior, *Dr Hasson, Dr. Rahal

HSRP10's favorite FUE surgeons: *Dr. Konior, *Dr. Bisanga, Dr. Erdogan, Dr. Couto

(*indicates actual experience with doctor)

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The bottom line is....I glad you feel like the transplant procedure was successful. I'm sure you will look great in 5-6 months. I am curious regarding the implanters. It seems you're describing implanter pins for insertion of grafts. Implanter pins were used on me more than 2 years ago by Dr. Vories. Also, 12 hours is a long time for 2,600 grafts. I'm sure you were quite tired after the procedure. I'm sure your doctor wasn't tired if technicians extracted and implanted all the grafts. I've had two surgeries and Dr. Vories extracted every graft (with minimal transection rates) and inserted every graft (artistry) and has been using implanter pins for quite some time. Also, you would expect to be in the chair for around 7-8 hours for 2,600 grafts. That said, I'm sure you're procedure was successful and you have a lot to look forward to. Keep us posted in the future with your results. Thanks for such a comprehensive summary of your surgery.


I am an online representative for Carolina Hair Surgery & Dr. Mike Vories (Recommended on the Hair Transplant Network).

View John's before/after photos and videos:  http://www.MyFUEhairtransplant.com

You can email me at johncasper99@gmail.com

I am not a medical professional and my opinions should not be taken as medical advice.

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Very detailed and honest review of your experience and apprehensions.

Hope it works out for you in all respects including yield and growth and looking forward to the updates.

 

I won't go into detail but agree with what you posted about this doc and FUE, you also did dodge major bullets by passing on Artas, Armani etc. so it should work out well.

I had a chat with the doc today and it really helped clarify some outstanding issues for me. The final results will speak for themselves, but I'm at least less concerned about the outcome now. For one they're using a semi-sharp punch and not the SAFE system anymore.

 

Will keep you posted.

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Looking good so far, hope you're lucky with the shock loss. Rooting (pun not intended) for ya!

Thanks. I have to stress that this clinic really sets the gold standard for post-operative care and follow-up. They've more or less been in constant touch with me since the operation and seeing how they've dealt with their patients throughout the years there is a consistent theme of honest dealing and fairness.

 

Attached are some higher res pictures in daylight of the recipient area, day 20 post-op. Apologies for the gross factor. The grafts have started to shed but a lot of them still cling on.

1.thumb.jpg.0996cda6d5a69442a6e294cc1d1718db.jpg

2.thumb.jpg.c790a2003c848f31e9dbcba648c46081.jpg

3.thumb.jpg.dcb4cc9fee7b08ec3130cc5732a7f78c.jpg

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Thanks. I have to stress that this clinic really sets the gold standard for post-operative care and follow-up. They've more or less been in constant touch with me since the operation and seeing how they've dealt with their patients throughout the years there is a consistent theme of honest dealing and fairness.

 

Attached are some higher res pictures in daylight of the recipient area, day 20 post-op. Apologies for the gross factor. The grafts have started to shed but a lot of them still cling on.

 

Szotz, great write up. How's the shedding going?


3185 FUT with Dr. Rahal on 2/17/16

http://www.hairrestorationnetwork.com/eve/182611-fut-3185-dr-rahal-day-after-pics.html

 

1204 FUT with Dr. Rahal on 3/27/17

http://www.hairrestorationnetwork.com/eve/186586-round-2-rahal-1204-fut-frontal-third-same-area.html

 

---> total of 4389 grafts to my frontal third via FUT

---> 1mg finasteride daily since 1999:)

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Is that you zircon? Saw that on the thread list so I guess you changed you ID earlier. Apology if I got it wrong. If not then I'm quite familiar with your stories on HLT :)

 

You are currently a NW 3A by hairline. However, judging by the second (side), fifth(top) and last (back) pic you seem to be heading to a NW 5. Are you 100% maintaining on finasteride? What's your thought on future loss, especially considering you just had an initial FUE (instead of FUT) with a fairly low hairline? I'm curious about your thinking because I'm in a similar situation.

 

Thanks for posting and wish you great results.

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Szotz,

 

Congratulations on your recent her transplant with Dr. Rahal. I understand how you feel in particular because you have not seen as many grown out FUE results as you would like before taking the plunge. However, I have full confidence in Dr. Rahal and know him to be very ethical and top-notch. Thoughts, I'm sure you will feel confident about your results when I grow up.

 

I look forward to following your progress and watching your new hairspray out.

 

Best wishes,

 

Bill


I am the managing publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and this Hair Loss Forum. I am also a 4 time hair transplant patient. View my patient hair loss website to view my entire hair restoration journey with photos.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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Checking in for a four month update here. I've decided to leave pics to the PMs as a precautionary measure, so send me a message if you want to see the actual results.

 

I have good news and bad news, essentially. Good news is the hairline design looks quite natural. Bad news is growth is currently quite limited and nothing like the results posted by zx_toth and ftbpicks at their respective four month marks. Some of the implanted hairs never stopped growing and have formed a sparse frame for the hairline. In addition, there are a handful of new sprouts that have come out, mainly in the forelock. New growth in the temples is extremely limited, I can count the current stubble hairs on one hand.

 

I don't know exactly how this will turn out, and it is still quite early, relatively speaking. So I'm giving it another two months before making a final verdict.

 

I've been in touch with the clinic about this and they have reassured me that Dr. Rahal stands by his work and I will also say that I trust them to resolve the situation to my satisfaction if things do not improve.

Edited by Szotz_257

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Hi Szotz, how is the healing? Particularly in your donor and recipient areas? Any redness still? Hope things improve for you in the months ahead. Wish you the best.

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Healing in donor has been very good actually. I had no shock loss and it looks really dense still. Redness in the recipient area has all but subsided.

 

With regards to improvement over the coming months, I don't really have high hopes. Any improvement is likely to be minor, from things like the hair growing longer. Good transplant outcomes on virgin scalp usually have significant growth materializing by month 4. Like a poster said in another thread, you can usually tell which cases are disappointments/knockouts by this time. I haven't seen any knockout cases where a ton of growth suddenly materialized in month 5 or 6. You never know though.

Edited by Szotz_257

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honest and great write up, I think everyone's experience is different, mine with Rahal was excellent to the point I did 2 FUE procedures with him for a total of 3500 grafts and not only was it successful but life changing for me. I hope you achieve a successful result, that is what you're looking for, and best of luck healing and growing!

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I am really happy that you do not have any donor issue or redness. I hear what you are saying, virgin scalp and it should kick in. Still hoping for the best and maybe next month may change something.

 

If not, approach things carefully and let the area heal if you plan on doing anything else.

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4 month, 3 weeks update: not much happening and this looks like it's going to be a disappointing result. The growth is very uneven in the hairline - drawing a line tracing the outermost hairs in the shape of the design, you can see huge blank spaces and areas where there has been zero growth. It's somewhat similar to jbl's result though not as bad.

 

A thing to note was that the doctor ordered his staff to go slow on me as he perceived me as anxious to undergo surgery. While I appreciate the sentiment, the small staff that was implanting meant that this increased the length of the operation to twelve hours and significantly increased time out of body for the grafts. I believe this may have contributed to the poor yield of the procedure. At this point it looks like I'm getting around 20-40% growth in total, maybe less.

 

Still processing the decision and the outcome ATM but obviously I'm quite disappointed.

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I saw a result posted by Dr Feller where there was basically no growth until the eighth month which continued until around month 16 with a great final result. A pain in the ass perhaps, hair sooner rather than later would be nice but you can't deduce anything at all at this point. Take a chill pill.

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4 month, 3 weeks update: not much happening and this looks like it's going to be a disappointing result. The growth is very uneven in the hairline - drawing a line tracing the outermost hairs in the shape of the design, you can see huge blank spaces and areas where there has been zero growth. It's somewhat similar to jbl's result though not as bad.

 

A thing to note was that the doctor ordered his staff to go slow on me as he perceived me as anxious to undergo surgery. While I appreciate the sentiment, the small staff that was implanting meant that this increased the length of the operation to twelve hours and significantly increased time out of body for the grafts. I believe this may have contributed to the poor yield of the procedure. At this point it looks like I'm getting around 20-40% growth in total, maybe less.

 

Still processing the decision and the outcome ATM but obviously I'm quite disappointed.

 

Sorry to hear that. Basically, you are at 5 months. If you feel 20-40 % growth in total/less, then i really hope you have some more growth this month to help turn things around. You do make a point on out of body times, http://www.hairrestorationnetwork.com/eve/167711-hair-graft-survival-out-body.html . Keep a good record of your monthly pics and right now all you can do is keep an eye on it. Some docs make you wait 12 months or more to before they say they can judge your result. I wish you the best.

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I think it's fair to wait out the 12-month period. There is a chance that things just happen to drag on a bit longer in my case and that the result will improve by a lot over the next months. It would honestly surprise me though. I don't want to be the guy who's at seven months with shit growth going "maybe I'm just a slow grower??", I prefer to be realistic.

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Hey bud, how is everything?

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