Senior Member win200 Posted November 6, 2018 Senior Member Share Posted November 6, 2018 Hi, all. I haven’t posted here much since my last procedure in 2015, but happy to share an update with everyone about my latest surgery. As background, I had my first transplant with Dr. Robert Niedbalski in June 2012. I was a NW 2-3, and he transplanted 1,450 grafts via strip to form a lower, but still recessed, hairline. I wanted a flat hairline, so I had a subsequent procedure with Dr. Rahal in October 2015, when he transplanted 2,200 grafts, again via strip. The hairline design was great, but the right side grew in a little sparse. Nothing awful, and I could’ve gone without addressing it, but I wanted to go back to the well for a fuller hairline. I just turned 36, BTW. I've been on Avodart and Propecia for six years and essentially no longer lose hair--my loss is fully halted. I use Rogaine but discontinued before surgery per instructions. Links to thread about my earlier procedures are here: https://www.hairtransplantnetwork.com/blog/home-page.asp?WebID=2858 So, last week I drove from Seattle down to Portland for a third procedure--this time with Steve Gable. I’ve known Dr. Gabel for about five years and have really looked forward to working with him. He’s a precise, thoughtful guy, and I knew he’d be a great choice to refine my results. I left Seattle at 3am to check in at Dr. G’s clinic at 6:30. His clinic just moved to a brand-new facility, and it’s gorgeous--two ORs, a lovely lobby, and overall just a great, clean, attractive space. We sat down and discussed hairline approach, and agreed that we weren’t going to lower the hairline. I didn’t need it, and lowering it even a few millimeters would mean that I’d need to get in again to spruce up the density, and I wanted to be done. (My hair is still very dense and I want the hairline to match, so I don’t want to get stuck in a loop of chasing density in an ever-lower hairline.) We agreed 1,000 more grafts across the hairline--and concentrated in the right side--would do the trick. The procedure was very smooth. Strip excision took about 30-45 minutes and I didn’t feel any pain. Dr. G excised part of my prior scar, which ran from just inside left ear to above my right ear. He didn’t need to run all the way from end-to-end on the scar. He closed the strip with staples, which I hadn’t had before; he thought they’d do a better job at holding the tension and has had good luck with them recently. Once the wound was closed, he did the incisions--nothing eventful, and nothing painful. I didn’t bother to watch TV, but just spent the time chatting with Dr. G and his techs. If you haven’t met him, he’s a really personable, chatty guy, which was engaging during surgery. I had a Valium before surgery but didn’t feel it much, which was fine; I’m not the anxious type and was perfectly relaxed during surgery. I seemed more comfortable than my previous surgeries, but that’s probably due in part to the fact that it was fewer grafts so the sit was shorter. When we got to placing grafts, I’d estimate that Dr. G placed about 50%. He places grafts in all his procedures, and I was his only patient that day, so there wasn’t any need for him to pop out and attend to someone else. If you haven’t gone through a transplant before, it’s really disconcerting when you feel like a surgeon disengages from the procedure once the incisions are made and just turns everything over to the techs. Dr. G was omnipresent and was in the room for virtually the whole procedure. That’s not the norm. Of my three procedures, this was the smoothest and easiest. That’s no knock on Niedbalski or Rahal, but a huge compliment to Dr. G and his staff. The post-op materials were first-rate and included a calendar specialized for my surgery date so I didn’t have to count post-surgery days. That’s a nice touch that I hadn’t seen before. The recipient area was also very clean--virtually no blood or scabbing. They carefully washed it the next day and showed me how to shampoo. Great post-op hand-holding all the way, and Dr. G responded to an email same-day later in the week. Pictures are below, and obviously there’s not much to report in terms of growth. My scabs are falling off, but the recipient area is hardly noticeable because although it was shaved, I’m combing my hair forward. Hard to cover up the staples, but they’ll be out in another week. I’m definitely experiencing a lot of tightness in my donor area given that it’s been excised three times, so I’m trying especially hard to keep my head tipped back to keep tension off the scar. I’m a little concerned about a widened scar given that it’s my third strip, but I’ll keep everyone posted as that progresses. Please fire away with questions/comments; I’ll be checking in every day. Thanks! When reviewing pics, please keep in mind that the after pictures are both immediately post-op and then the next day; my hair is wet in both. Remember that the transplanted area contained both native hair AND previously transplanted hair, so the density will be much, much higher than the number of grafts you can see. Link to comment Share on other sites More sharing options...
Senior Member bman3082 Posted November 6, 2018 Senior Member Share Posted November 6, 2018 hey fellow rahal patient, just wondering why u didn't go back to him? ur troublesome growth has me worried since i am only 3 months in Link to comment Share on other sites More sharing options...
Senior Member Speegs Posted November 6, 2018 Senior Member Share Posted November 6, 2018 Gabel did touch up work on me after unsatisfying results from another doctor, he's pretty adept at tweaking the work of surgeons that didn't get the best result before him. Hair loss patient and transplant veteran. Once a Norwood 3A. Received 2,700 grafts with coalition doctor on 8/13/2010 Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011 Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016 Link to comment Share on other sites More sharing options...
Senior Member bman3082 Posted November 6, 2018 Senior Member Share Posted November 6, 2018 ahhh so worried after seeing the old thread since I went with Rahal! Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 6, 2018 Author Senior Member Share Posted November 6, 2018 58 minutes ago, literalno said: hey fellow rahal patient, just wondering why u didn't go back to him? ur troublesome growth has me worried since i am only 3 months in Hey, I wouldn't worry! The issue wasn't actually poor growth; immediately after the surgery with Rahal, I noticed that the grafts on that right side looked a little more spaced out. I think they all grew, just that they weren't as densely packed as they could have been. Rahal had to create a totally new hairline in a really big space, and the design was great. When you're creating a new hairline over a lot of forehead like that, sometimes it takes a couple passes to really punch up the density. Rahal is a great surgeon and I'm happy with his work. I've just wanted to work with Dr. G for a long time and was confident he would do well here. No knock on Rahal at all and you made a great choice; both of these docs are in the top five worldwide, in my opinion. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 6, 2018 Author Senior Member Share Posted November 6, 2018 21 minutes ago, Speegs said: Gabel did touch up work on me after unsatisfying results from another doctor, he's pretty adept at tweaking the work of surgeons that didn't get the best result before him. He's a great surgeon, and an incredibly nice guy. He'd given me periodic input and advice for five year prior to my surgery with him, all with no guarantee of me coming to him for work. He just cares a lot about the industry. 1 Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted November 6, 2018 Administrators Share Posted November 6, 2018 Your hair looks amazing, thanks for sharing your experience- HTsoon I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Senior Member jcs87 Posted November 6, 2018 Senior Member Share Posted November 6, 2018 already looked pretty dense in the pre-op photos. should be a knockout once it grows in. so how many grafts total in frontal third at this point? Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 6, 2018 Author Senior Member Share Posted November 6, 2018 2 minutes ago, jcs87 said: already looked pretty dense in the pre-op photos. should be a knockout once it grows in. so how many grafts total in frontal third at this point? 1,450 from Niedbalski, 2,200 from Rahal, 1,150 from Gabel (all rounding), so 4,800 total. So with thick native hair behind it, it's going to look great. It helped that between my first transplant at 29 to my third at 36, I really haven't had any additional loss; it's easier to go aggressive once you've aged a bit and have established that your loss will stabilize. 1 Link to comment Share on other sites More sharing options...
Senior Member jcs87 Posted November 6, 2018 Senior Member Share Posted November 6, 2018 11 minutes ago, win200 said: 1,450 from Niedbalski, 2,200 from Rahal, 1,150 from Gabel (all rounding), so 4,800 total. So with thick native hair behind it, it's going to look great. It helped that between my first transplant at 29 to my third at 36, I really haven't had any additional loss; it's easier to go aggressive once you've aged a bit and have established that your loss will stabilize. I meant to ask you, what's your regimen with the dutasteride/finasteride? Any increase in sides or other issues with the Dut? Link to comment Share on other sites More sharing options...
Senior Member bman3082 Posted November 6, 2018 Senior Member Share Posted November 6, 2018 26 minutes ago, win200 said: Hey, I wouldn't worry! The issue wasn't actually poor growth; immediately after the surgery with Rahal, I noticed that the grafts on that right side looked a little more spaced out. I think they all grew, just that they weren't as densely packed as they could have been. Rahal had to create a totally new hairline in a really big space, and the design was great. When you're creating a new hairline over a lot of forehead like that, sometimes it takes a couple passes to really punch up the density. Rahal is a great surgeon and I'm happy with his work. I've just wanted to work with Dr. G for a long time and was confident he would do well here. No knock on Rahal at all and you made a great choice; both of these docs are in the top five worldwide, in my opinion. It's just odd to me that he would space them out during a dense packing session at all? Do you have any clear post of photos to see the work? I also noticed i had shedding of the hairs really early on, like in the first week, so that's really kind of thrown me off since i've never really been able to see or appreciate what the full result could be. Link to comment Share on other sites More sharing options...
Potier Posted November 6, 2018 Share Posted November 6, 2018 (edited) C Edited November 7, 2018 by Potier Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 7, 2018 Author Senior Member Share Posted November 7, 2018 On 11/5/2018 at 8:02 PM, jcs87 said: I meant to ask you, what's your regimen with the dutasteride/finasteride? Any increase in sides or other issues with the Dut? I take .5mg/day Avodart and 1mg/day fin. I have mild sides--slightly reduced erection strength--but tolerate it just fine. I'd rather have a full head of hair and somewhat less-rigid boners. I don't even give it a second thought. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 7, 2018 Author Senior Member Share Posted November 7, 2018 On 11/5/2018 at 8:04 PM, literalno said: It's just odd to me that he would space them out during a dense packing session at all? Do you have any clear post of photos to see the work? I also noticed i had shedding of the hairs really early on, like in the first week, so that's really kind of thrown me off since i've never really been able to see or appreciate what the full result could be. All of my photos are in the thread on my procedure with Rahal. I can't speak as to why the grafts weren't more densely packed. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 8, 2018 Author Senior Member Share Posted November 8, 2018 Small update--the tension in the closure is easing a bit as the tumescing goes down. Feeling better about that part; it's just natural that your risk of a wide scar goes up when you're on your third strip, so it's good to feel things loosening up a bit. Link to comment Share on other sites More sharing options...
Senior Member Speegs Posted November 8, 2018 Senior Member Share Posted November 8, 2018 3 hours ago, win200 said: Small update--the tension in the closure is easing a bit as the tumescing goes down. Feeling better about that part; it's just natural that your risk of a wide scar goes up when you're on your third strip, so it's good to feel things loosening up a bit. You'll be fine, you're in good hands. I had three FUT as well, including two with Dr. Gabel. Hair loss patient and transplant veteran. Once a Norwood 3A. Received 2,700 grafts with coalition doctor on 8/13/2010 Received 2,380 grafts with Dr. Steven Gabel on 9/30/2011 Received 1,820 grafts with Dr. Steven Gabel on 7/28/2016 Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 14, 2018 Author Senior Member Share Posted November 14, 2018 Just an update--at 15 days, nothing momentous to report. The scabs were gone at about eight days and now the transplanted hair are starting to fall out. Staples came out at 12 days and the donor feels much better; regaining some elasticity so I'm less concerned about a stretched scar. I think the staples staying in increased sensitivity in the scar and created some "pull" in the rear scalp, and probably prevented the tumescence from going down a little. I'll add some pics in a week or two, but there won't be anything exciting to see for a couple months. Thankfully, having gone through this twice before means I'm pretty chill about the process and just have my mind on other things with the growth takes hold. I was a basketcase during recovery from my first transplant because I had no idea what to expect. Link to comment Share on other sites More sharing options...
Senior Member Spanker Posted November 14, 2018 Senior Member Share Posted November 14, 2018 You have nice hair. I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians. View Dr. Konior's Website View Spanker's Website I am not a medical professional and my opinions should not be taken as medical advice. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted November 15, 2018 Author Senior Member Share Posted November 15, 2018 2 hours ago, Spanker said: You have nice hair. Thanks! Just trying to make it ever-so-slightly nicer. Link to comment Share on other sites More sharing options...
Regular Member ItHasToLookNatural Posted July 14, 2019 Regular Member Share Posted July 14, 2019 How is it looking? Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted July 16, 2019 Administrators Share Posted July 16, 2019 @win200 I’d love to see some updates as well hope you’re doing good. I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Moderators Al - Moderator Posted July 17, 2019 Moderators Share Posted July 17, 2019 It looks great, but using 4700+ grafts just for the hairline isn't the smartest thing. Some people have no sense of donor management. What happens if you lose more hair behind the hairline? I know someone who had a full head of hair into his 40's who is now a NW 6 in his 50's. You never know when of if a high rate of hair loss will hit you. Al Forum Moderator (formerly BeHappy) I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here. Link to comment Share on other sites More sharing options...
PeloDinero Posted July 17, 2019 Share Posted July 17, 2019 12 hours ago, BeHappy said: It looks great, but using 4700+ grafts just for the hairline isn't the smartest thing. Some people have no sense of donor management. What happens if you lose more hair behind the hairline? I know someone who had a full head of hair into his 40's who is now a NW 6 in his 50's. You never know when of if a high rate of hair loss will hit you. This dude is fine. Look at his hair caliber and quality. He has nothing to worry about especially being on meds. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted July 17, 2019 Author Senior Member Share Posted July 17, 2019 Shoot, sorry for leaving this dormant for so long! Been a super busy eight months and it's easy to forget when everything is going well. The procedure has grown in extremely well; tough to see in pictures because it only thickened the existing hairline and didn't change anything beyond that, but it's much thicker and the weak spots in the corners have been resolved. I'll post some better pics soon; this is just what I had on my phone. Link to comment Share on other sites More sharing options...
Senior Member win200 Posted July 17, 2019 Author Senior Member Share Posted July 17, 2019 3 hours ago, PeloDinero said: This dude is fine. Look at his hair caliber and quality. He has nothing to worry about especially being on meds. Thanks. I think your response is the correct one; there's always a risk, but: It's been over seven years since my first transplant (at 29), and there is no sign of the work not holding up or shedding behind the transplant. I've been on Avodart and minoxidil consistently and respond well to both. I still have grafts in the tank. There is no sign of miniaturized hair behind the hairline. If you comb through, you just see thick hair. Could be something I'm not seeing, but the hair caliber looks good and the hair behind the grafts isn't becoming thin, either in terms of the shafts themselves or the spacing of follicles. Link to comment Share on other sites More sharing options...
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