3808 FUT on Norwood VI with Dr. Wong today 12/4/17

[zaxter]

Here's a couple of selfies until I can have a friend do some better quality pics. Growth has been fast enough that my colleagues can't help but to notice, and I'm getting nothing but compliments. Most importantly, I very happy with how it's coming along. Better pics to follow.

[Melvin- Admin]

Wow impressive growth Zax, your hair is growing like wildfire.

[zaxter]

After more than 5 months, my scalp is still showing some redness, especially along the hairline where the follicles were planted at the highest density. With my hair growing in, at least it's not very noticeable. Next update will be in mid-June.

[zaxter]

Here's a pic taken on 12/4/17 at H&W, and one taken on 5/13/18.

[zaxter]

Not the best photos, but taking selfies of my scalp isn't the easiest thing to do. After my next haircut, I'll have a photographer friend take some sharper pics outside. I'm 7+ months post-op, and my friends and colleagues who I told about my HT can't believe the difference. Every now and then I run into someone who I haven't seen in a while. Some can't put their finger on why I look different, while others immediately notice that it's the hair. I kept my balding head buzzed at about 1/8" to 1/4" length for a long time, some people who I see regularly say "oh you let your hair grow out".

And to think that I almost backed-out a month before the procedure because I was concerned that my hair was too fine, my density was too low, and the extent of my hair loss was too great for a HT to make a worthwhile difference. 

Better pics to come.

[n00b]

My mind's blown. That's an amazing transformation for 3800 grafts!

[Melvin- Admin]

Fantastic results, thanks for updating us with your progress. 

Warmest regards- Melvin 

 

[hockeyman]

Holy s##t!!  You look unreal.  Congratulations on your result thus far and you're not done yet.  Dr. Wong seems to really do excellent work on fine-haired individuals.  There was another one of his cases posted here just in the last few days.  I have a couple of questions if you don't mind:

1)  Are you still free of side effects from the finasteride and do you feel like it's doing much for you?

2)  You mentioned that you had been concerned that your donor region was low density.  I thought it looked good in your photos. What did Dr. Wong say about it?

Thanks.

 

 

 

[zaxter]

Thank you for your comments Melvin, n00b, and hockeyman.

Hockeyman, your question about my density has prompted me to tell a little about my journey. The initial pics I sent through H&W's online consult page prompted his rep to contact me saying something to the extent that they weren't sure that my density could yield enough grafts to make me a candidate for a HT. I wish I could find those pics, but to give an idea, I posted a pic below taken post-HT, to show you how my density looks with short hair in natural sunlight. I think the pic makes me look like a diffuse thinner, and not a good candidate for a HT. I then let my hair grow a little and sent his rep a video showing a comb running through my donor areas. The video made them feel much more optimistic, and his rep relayed that I appear to be a good candidate, and 4000-4500 grafts could be possible. Honestly, I felt like the video made my density look greater than it really is. I then went to an in-person consult with another coalition surgeon I was considering. He described me as (and rightfully so) a tough case, with fine hair, average to below average density, and a lot of area to cover. He also estimated that a 1.6cm wide strip would yield 2400-2600 grafts, which he would transplant from my hairline to maybe just a little behind my frontal zone. He also told me his honest opinion that Dr. Wong would most likely get more grafts because he goes wider with strips, but at the risk of a more apparent scar. Well you'll see below, that his statement was not accurate.

I went ahead and scheduled the HT with H&W, and then had growing concerns about my density. A month before surgery date, I shaved my hair really short and had a photographer friend take high resolution pics of my donor areas with a cm2 tool against my scalp so I could do a follicle count. What really concerned me was that I was counting as few as 50 follicles per cm2 in the area on the sides of my head. I sent the pics to Dr. Wong and scheduled a phone consult. Based on the pics, he rated my density at a 4 on a scale of 1-10. He also said with good laxity, 3500+ follicles could be possible. My minimum goal was 4000 grafts, and initially I was hoping for up to 5000. Even though that didn't leave me feeling terribly optimistic, I felt like I was in good hands with Dr. Wong. Never less, those thoughts of "what if he only gets like 2500-3000 grafts" would creep in. 

I met with Dr. Wong on surgery day and he examined my laxity and density. He really liked the laxity above my ears, and felt the back had average laxity. I don't quite remember what he said about my density, but I know he wanted to be particularly careful about strip width, since a wider scar could show through the hair on sides of my head where my density was lower. 

Now to the cutting. The first surgeon I saw said that he spends about 30 minutes excising the strip. Well, Dr. Wong spent every bit of 90 minutes removing that strip. Even though he ended up cutting it the same width (1.6cm) that the first surgeon said he would excise, he yielded way more grafts. He was very careful about finding that balance between maximizing grafts with as wide of a strip that was possible, without risking an apparent scar that could show in the low density areas above my ears. I'm sure the care he took in cutting minimized graft transection, allowing him to get more grafts than some other surgeons may have yielded from a strip that size. 

So, if my math is right, a 28.6cm long x 1.6cm wide strip yielding 3808 grafts gives me an average donor density of 83 follicles cm2, putting me at the lower end of average density.

Dr. Wong's strategy included a conservative hairline that we both agreed on, and planting the hairline and frontal at 50-60 grafts/cm2. The remaining grafts mostly went into the mid scalp, and he did a little bit of work around the crown. He said he went as low as 10 grafts cm2 in the mid scalp, which initially concerned me. Obviously, his strategy worked, creating the illusion of density, and a dramatic transformation with just 3808 grafts on a very bald head. 

In searching this board (and the whole web) in the months leading to my procedure, I was hard pressed to find much material showing what 3k-4k grafts can do on an advanced Norwood VI head. So I now hope that others in my position may learn and gain from my experience.

Edited July 18, 2018 by zaxter
typo

[zaxter]

And to answer your question about Fin, I'm still taking 1mg/day. Although I don't feel any side effects, I did gain 20 lbs over the first few months. Whether that was caused by the med, or just my poor eating habits over the winter, I really don't know. Over the past 5 weeks I've been on a strict keto diet, which helped me to shed nearly all of that weight gain.

Whether fin is helping or not is really hard to say. Most of what little native hair that remained in my balding zone was miniaturized, so maybe it thickened those up a bit, adding to the transformation. Also, I'm not noticing any hair loss. I sometimes do hair pull tests, just like a dermatologist did on my head in my early 30's to look for hair loss, and I'm not seeing any hair coming out. My plan is to stay on fin long-term.

[hockeyman]

Zaxter

Thanks for that detailed explanation regarding your donor density. That's a great writeup and very informative.  I bet you never dreamt that Dr. Wong could get almost 4000 grafts in your procedure with another 2000 left in the bank for another Fut if you so choose.  For a guy that was worried he might only have 2500 grafts that's pretty sweet!  Also, once you're all stripped out you could probably get a few more via Fue if you wanted to.  At any rate, I'm glad that things have turned out so well for you.  I just cannot get over that scar ..... or lack thereof.  

 

 

[hockeyman]

Just saw your reply regarding the finasteride.  Thanks for answering that as well.

[jjsrader]

Good writeup for newer members to read & compare w/other doctor's they are considering.   Shows you what a truly meticulous and excellent doctor says and does before/during a transplant to get the best possible results for his patient.

Taking everything into consideration - details/details.  Nice.

Edited July 18, 2018 by jjsrader

[TrixGlendevon]

Great result and great scar! I wish Dr. Wong was in Europe.

[zaxter]

Here's my 9 month photos that I sent H&W last week. One thing my photographer friend couldn't do was catch a pic of the scar...which of course is a good thing. I'm getting used to having hair again!

[PeloDinero]

Unbelievable result. Completely natural and undetectable even at only 9 months and to the trained eye. Congratulations. You must be estatic. 

[Hairs1]

great result. You get what you pay for applies here.

[lukeyb1687]

Wow! This is a huge difference! You must be over the moon! Congratulations and the scar is basically unnoticeable! 

[Melvin- Admin]

Fantastic results, thank you for updating us with your progress, any plans to work on the crown?

[True]

I must say that your result looks very impressive.

The hairline seems perfect.

Your result speaks volumes about the skill, experience and artistry of your surgeon and his staff.

I still can't believe the hairline.

Really nice work.

Edited September 26, 2018 by True

[zaxter]

Thank you for your comments! True, one of the things that I think contributes to the naturalness of the hairline is that Dr. Wong planted it just behind where I still had some stray native hairs that remained in the tuft area.

The scar is just barely noticeable above my ears right after I get a haircut, especially in the sunlight. Perhaps I'll try getting a scar pic right after my next trip to the barber.

Melvin, I know Dr. Wong is especially a wizard when it comes to doing crown work, but at age 51, I think I'm ok with things just as they are. Having the hairline, frontal, and mid-scalp has made a remarkable change in my appearance, so yes, PeloDinero and lukeyb, I am ecstatic and totally over the moon about it!

If not for this board, I probably wouldn't have considered going through with a HT, or known about the differences between doctors, so I'm very grateful. I'll continue updating through the one year mark.

[Rappy]

Absolutely wonderful and almost unreal. 

[Wicky]

I think more then enough people have said this, but wow this is unreal...

[Qneedhair]

Looks really good, do you plan to do anything with the crown?  Does having gray hair help with the disguise of the scar you speak of?  Seems like dark haired individuals tend to be more noticeable IMO.  

The suture was a trychophytic closure right? 

[hockeyman]

Hi Zaxter

Was wondering how you're doing and if you have any current pictures to share.  I followed your case from the beginning and consider your transformation to be one for the hall of fame. In fact, your case and a handful of others are what finally convinced me to book an in-person consult with Dr. Wong next week ......... it only took 12 years of research lol. I have two questions:

1) What led you to consult with and ultimately choose Dr. Wong as opposed to Dr. Hasson?

2) Do you have any plans to address your crown?

Thanks