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win200

Dr. Gabel 10/30/18 - 1,132 Grafts via FUT - Third Procedure (Age 36)

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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.

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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 :/

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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

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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.  

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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.

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Your hair looks amazing, thanks for sharing your experience- HTsoon


I do not provide medical advice, recommendations, all responses are my opinion.

Melvin- Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @htrestoration FacebookPintrest, Linkedin and YouTube.

 

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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?

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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.

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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?

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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.

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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.

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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.

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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.

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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

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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.

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2 hours ago, Spanker said:

You have nice hair. 

Thanks!  Just trying to make it ever-so-slightly nicer.

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