Two transplants with Dr. Rahal. Hair thinning terribly. Patchy spots

[Mike Flaherty]

Hello everyone,

Mike Flaherty is not my real name.

My first transplant with Dr. Rahal was nine years ago in 2010. I had another one performed two years later in 2012 to lower my temple points and add some hair to the sides of my head. All in all, I believe it was around 5000-5500 grafts transplanted over those two sessions.

My hair still felt rather thin and wispy but with meds and thickening products I managed and for a few years was pleased with it. This year my hair has started thinning something fierce - especially on the sides which now appear almost bare. I've developed bare patches on top as well, which were always there but this year they have gotten extremely sparse. By the end of the day, my hair feels extremely thin and almost greasy to touch and I can feel these bare patches. I'm seeing a lot more long hairs fall out in the sink when I wash my hair. I switched to organic shampoo two months ago but that might have made shedding (if that's what this is) worse.

My bareness on the sides (right side especially) has now exposed my scar from my procedure years ago. After these two very expensive procedures ($20,000 which I'm still paying off) I'm very disappointed in the quality of my hair's overall thinness, patchy spots and continuing loss. I know I've put on an amount of weight the last few years but I can't see that factoring into my hair loss.

I did consult with Rahal this past spring who suggested another procedure - at an additional $7000. I'm amazed at the incredible thick hairlines and work I see from other Rahal patients but mine was not one of them. Pretty much at a loss (pardon the pun) right now regarding this situation.

 

 

Edited October 27, 2019 by Mike Flaherty

[champybaby]

Why are your sides thinning? The top looks good. 

[John Doe]

That doesn’t look too bad. A bit thin on top but nothing near 1500-2000 more grafts (given the $7000 price) what about pics before your HTs?

Edited October 26, 2019 by John Doe

[John Doe]

Also, consider seeing other doctors?

[Melvin- Admin]

I agree the top looks good. The sides look a little thin. Looks like maybe you cut your hair too short for the strip scar. 

[Mike Flaherty]

16 hours ago, champybaby said:

Why are your sides thinning? The top looks good. 

I have no idea. Seems to have thinned  monstrously this year. The top is "good" but not a great result. Not near the caliber of thickness I've been seeing from Rahal since my surgeries which would be fine except for my bare patches - I've been able to work over them but this year they have really gotten more visible. I'm happy I'm not bald which I was very close to being when I first met Dr. Rahal (he told me that himself when I first met him) and I've managed on Fin and thickening products but these bare patches have gotten to be very prominent now. The thought of paying another $7000 to a clinic that should have covered this area the first two times is concerning to me. There are real problems I'm having with my hair that possibly the camera can't pick up. I'm not one to make false claims at all (I showed and discussed my concerns to a Rahal rep this past April as I've said) and I'm a journalist who writes for a Canada-wide read magazine so accuracy in truth-telling is paramount to us.

 

 

Edited October 27, 2019 by Mike Flaherty

[John Doe]

I’d look into other clinics if I were you. I see them covering touch ups or things that haven’t grown within a year or two but you’re pretty far out from your surgeries

[Mike Flaherty]

9 minutes ago, John Doe said:

I’d look into other clinics if I were you. I see them covering touch ups or things that haven’t grown within a year or two but you’re pretty far out from your surgeries

Possibly. I did give it the full two years to achieve maximum results and then I went to journalism college for three years and couldn't just fit the time in for another procedure. I live on the east end of Canada so Rahal seemed to be the ideal place for me.

[John Doe]

On 10/26/2019 at 10:03 PM, Mike Flaherty said:

Possibly. I did give it the full two years to achieve maximum results and then I went to journalism college for three years and couldn't just fit the time in for another procedure. I live on the east end of Canada so Rahal seemed to be the ideal place for me.

I had a surgery of 2740 grafts with Rahal in May. Hoping patchy areas fill in after 6 months.

Edited October 28, 2019 by John Doe

[Mike Flaherty]

6 hours ago, Melvin-Moderator said:

I agree the top looks good. The sides look a little thin. Looks like maybe you cut your hair too short for the strip scar. 

It's not a terrible outcome but far from great. My hair actually grew very fast after my first procedure in early June, 2010 and there was enough visible growth by October to start dating. I really responded fast to growth. I still needed the aid of thickening creams though (still do) as it's thin, flyaway hair (still is). 

Yes, I did just have a cut and the stylist did remark on the scar showing through. That's about close to the density I now have on my sides. It doesn't get a whole lot thicker than this unfortunately.

Edited October 27, 2019 by Mike Flaherty

[Mike Flaherty]

1 hour ago, John Doe said:

I had a surgery of 2740 grafts with Rahal in May and I’m in a place where I’m gonna need certain issues resolved where hairs weren’t placed or placed poorly. Gonna give them the chance to make it right. I’m giving it the 12 months to be fair to Rahal but I’m 99.9% sure this will not magically fix itself. Sucks Ill have to make another 8 hour drive one way and time off work so I feel your pain

That's not good to hear. Giving it the full 12 months sounds fair. You should see even more growth by Christmas and after (seeing the new growth come in is so awesome!) and it will take that long before near maximum results but  bare patches are a letdown. I know it was nine years ago but I do recall Dr. Rahal doing most of the work on my first procedure but the second one two years later was mainly done by - I believe his name was Mike (younger technician) and the female technicians who were all really very nice. Dr. Rahal was very present though and did the initial important steps. The first procedure went by smooth as caramel but during the second one, there was trouble getting the strip extracted. It took some effort so I'm not keen on another strip procedure at all which I feel could case some permanent major damage. Now that I'm graduated and working in the field of reporting I am more aware of how my bare patches have progressed (I see them on video - ugh). I hated to make a public post but didn't know what else to do.

Edited October 27, 2019 by Mike Flaherty

[Mike Flaherty]

7 hours ago, John Doe said:

That doesn’t look too bad. A bit thin on top but nothing near 1500-2000 more grafts (given the $7000 price) what about pics before your HTs?

I don't have any pre-op photos but I'm sure the clinic has them.

[Mike Flaherty]

Slightly higher quality pics.

[Sean]

As mentioned by others, I can understand the patches and understand your concerns.  Have you tried any concealers on camera to see how they come out.  They may help.  If you go in for another procedure, you have to be careful as thicker grafts in already scarred tissue can result in more shockloss or damage if done wrong.  I can see the strip scar on one side more then the other at the same haircut length? You may be able to get that filled.  Your donor seems medium caliber so id expect it to fill up front well.  How did the area look before surgery?

thats the one thing i looked forward to with the restoration, having a front facing job requires a lot of eyes at the face including scalp.  If it doesnt go as per the goals it can create numerous issues and your left chasing ways to get out of the situation with very confusing options.  Currently trying to figure all of it out myself.  Journalist that writes for a magazine?-thats pretty cool.  Wish you the best.

 

 

[Melvin- Admin]

You’ve been given great advice by Sean. You really don’t need another procedure IMHO. A little concealer goes a long way.

[Mike Flaherty]

Concealers didn't really work for me. I tried one - it was Marc Anthony thickening fibers and it made a mess of everything. As you can see my bare patches extend to half the top area of my scalp. I don't feel concealers can make up for that. It's the amount of money I paid out only to have bare areas that's concerning to me.

Dr. Rahal (or someone from his clinic) has messaged me. I've been on assignment yesterday and today but should hopefully be able to discuss my concerns with him tomorrow.

Edited October 29, 2019 by Mike Flaherty

[Abi28]

Your situation is really not that bad man, your hair on top looks very good, you can add more density with another procedure, plus you can fix the patchiness in your donor via FUE it only requires a few hundred grafts, you are going to be fine.

[Melvin- Admin]

On 10/29/2019 at 7:31 AM, Mike Flaherty said:

Concealers didn't really work for me. I tried one - it was Marc Anthony thickening fibers and it made a mess of everything. As you can see my bare patches extend to half the top area of my scalp. I don't feel concealers can make up for that. It's the amount of money I paid out only to have bare areas that's concerning to me.

Dr. Rahal (or someone from his clinic) has messaged me. I've been on assignment yesterday and today but should hopefully be able to discuss my concerns with him tomorrow.

Honestly, I don't see anything to be alarmed by, you are spreading your hairline, so you should expect to see some scalp. 

[Mike Flaherty]

I thought I'd update this post and sadly things have gotten much worse. I'm on month 11 of daily Finasteride per doctor's instruction and I fear it's shredded my hair. I have more patchiness/sparseness and I'm thinning greatly on top now along with my crown. My hair has no density at all and I can even see how it's flattened from my shadow when I'm outside. I haven't grown anything on the side and the hair I have just sticks out as there's thin patches of hair but not enough for it to "catch" onto other hair if that makes sense. To maintain even a little bit of volume I have to shampoo twice a day at least. My hair is extremely very thin (practically pre-transplant thin), soft and you can even see light through it. Over $20,000 spent and my hair feels worse than before my transplants. Unless I spend close to another $7000 for a third procedure there's nothing to be done. I know those of you reading this wish to see photos and I will have them posted here within a few days. I'll send them to the doctor's clinic first. It seems all my procedures bought me wasn't a lifetime of hair but only seven-eight years. 

Edited June 16, 2021 by Mike Flaherty

[champybaby]

On 10/29/2019 at 10:31 AM, Mike Flaherty said:

Concealers didn't really work for me. I tried one - it was Marc Anthony thickening fibers and it made a mess of everything. As you can see my bare patches extend to half the top area of my scalp. I don't feel concealers can make up for that. It's the amount of money I paid out only to have bare areas that's concerning to me.

Dr. Rahal (or someone from his clinic) has messaged me. I've been on assignment yesterday and today but should hopefully be able to discuss my concerns with him tomorrow.

Never heard of Marc Anthony concealer. XFusion is amazing when used correctly (watch a video, dont use a lot). Also something like Tint Brand which is super fast to apply would work well.

Though I get it. If it's really bothering you then go ahead and get the surgery. I can see something like that bugging me. Just make sure you go to a top tier doc. And be prepared for the possibility of having a second procedure several years later .. EDIT: And be prepared to take fin. It's a must, imo.

Edited June 16, 2021 by champybaby

[Melvin- Admin]

Can you post updated pictures? Last pictures are from two years ago.

[Britanium]

Be interested to see the pics in a few days. Thanks for the update 🙏

Edited June 16, 2021 by JohnAC71

[Mycroft]

I am actually unclear whether any of the photos thus far represent the peak strength of your transplant results. The way I've read it all photos here reflect your hair after the additional thinning you described in the original post. Is that correct?

It's hard to comment on the original result without being sure of what I'm looking at, but I agree with others that it doesn't look terrible, but I also see why you're frustrated with it. 

You said you're 11 months on Finasteride, but in the original post you referenced a previous thickening with meds. Was that Minoxidil or did you have a previous stint with Finasteride?

[aaron1234]

Would love to see updated pics before I comment.  People need to remember that hair loss continues even after multiple transplants.  Very few if any of us who got HT's in our 20's or 30's realized our final pattern before getting into the chair.  Just because you look good 12 months out doesn't mean things will stay that way.  

Edited June 16, 2021 by aaron1234

[Mike Flaherty]

8 hours ago, Mycroft said:

I am actually unclear whether any of the photos thus far represent the peak strength of your transplant results. The way I've read it all photos here reflect your hair after the additional thinning you described in the original post. Is that correct?

It's hard to comment on the original result without being sure of what I'm looking at, but I agree with others that it doesn't look terrible, but I also see why you're frustrated with it. 

You said you're 11 months on Finasteride, but in the original post you referenced a previous thickening with meds. Was that Minoxidil or did you have a previous stint with Finasteride?

I'm trying to explain as best as I can and as I mentioned in a previous comment  I did have a video conference with a Rahal rep and showed them my thinning concerns. I can't say my results were ever on the "full" or "thick" side, hence the need for a second procedure just two years after my first. There's no doubt my hair has thinned considerably since then, naturally though I'm half convinced shock loss was a factor as the point end of the strip is as thin as it's ever been. I did continue to use Fin for some time, left it and restarted last July - pretty much on it an entire year again now. Speaking with the doctor in Sept. he  advised me thickening and growth would happen in time but it's just the opposite. Hairs are falling out on my laptop, on the edge of my sink and my scalp is extremely itchy. Between my patchy spots on the sides, back, and top of my head my transplanted hair is weak, thin, brittle, and difficult to comb or style. Perhaps my expectations were high but this is incredibly frustrating to me as meds (Fin not minoxidil) aren't working, what hair I have looks  and feels terrible and I'm gaining more sparse thin patches.  I understand It's difficult to visualize without photos and determine what is actually going on. If I was reading this from another member I'd want to see them too. It's difficult as I live alone and just can't get the angles right, I will be posting some. 

 

Edited June 17, 2021 by Mike Flaherty