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

[digi23]

7 minutes ago, Mike Flaherty said:

This one is probably slightly better quality as it's not zoomed. 

Based on this photo I see absolutely no difference compared to 2019 photos.

The question you had about 1500 grafts if it would add density, yes it would add density, even 500 grafts would add density if you are asking about adding it behind the hairline. If you are asking 1500 grafts to your whole top part including front, mid scalp and crown then it would be a big area to cover.

The risk of shock loss is also there, you could potentially trade your hair you have now for new transplanted hairs because of shock loss, so if you want to take the gamble then do it.

Edited October 4, 2021 by digi23

[Curious25]

It all depends on where you started from. If You were a NW5 in 2010, and this is what you look like now after 5000 grafts in 2021, I’d say you are doing just fine. Without having seen your crown etc, from the pics I can see small top up of 1000-1500 grafts  likely get you to a much happier place. 

[JDEE0]

This is one of those threads where it's essentially impossible for anyone to give any insight or even tell what's going on.

OP, I understand something has probably changed for the worse at least somewhat in the last few years regarding your hair (which prompted you to post this thread in the first place), but upon seeing your pics after all you wrote, I was expecting a lot worse.

We really need to see what you looked like before your HT's and the condition of things/what you looked like after each one you had in order to compare to now. Ideally with similar style pics in order to compare accurately. Currently, all we have is you taking selfies in harsh downlight pretty much with no real baseline to know what the difference is. 

You're also saying meds have ravaged your hair and made it a lot worse, again, can't you post some pics in the same conditions as you did initially in this thread in October 2019? You at least have some baseline pics already here for this in the thread, and by doing so a comparison can be made and people can advise how real of an issue this is. 

I honestly suspect that your hair just continued thinning out over the course of the decade in which you let nature take its course (not on any meds). Around the time you initially posted this thread was probably just the time that the scale was tipped and you visually began to notice the loss, as far as the fin causing things to be much worse, it really makes no sense to me and although I have read numerous other accounts of this happening online, I've never really been convinced much that it's true. I'm not suggesting you're lying though, I just don't see the huge difference in your pics that you describe as having taken place in the last few years. Maybe it's more a mental thing or just a result of the natural loss before getting on fin?

Again, some direct comparison photos to your ones from October '19 could help more.

[track_rat]

I didn’t read every post but did skim your text and observed the photos. I think things look great to be honest. Those bathroom overhead lights that shine directly overhead are horrible indicators of how we actually look lol.

 

I also am not seeing a difference from now vs 2019 photos.

 

How do your sides look now? Looks like you grew them out a bit. 

[Mike Flaherty]

This photo actually makes my hair appear thicker than it is. I honestly believe it's getting worse by the week. 

The hair on the sides of my head have ceased growing. 

The hair around my crown will not grow to any length.

I've developed bare patches on my right front, left front where I part my hair, the area on the right side of my head near the top of of strip scar.

The hair on the front of my scalp which was always the thickest area has now become thin, wispy flyway hair that is unable to bind to any hair towards the side.

Temple recession and even slight frontal thinning/recession.

Something detrimental is occurring and my hair is regressing to pre-transplant levels to the time when I first met Dr. Rahal and he told me the hair I had wasn't going to last "much longer."

Most of these issues have occurred within the last year.

So, basically I'm freaking out.  

Edited October 10, 2021 by Mike Flaherty

[digi23]

10 hours ago, Mike Flaherty said:

This photo actually makes my hair appear thicker than it is. I honestly believe it's getting worse by the week. 

The hair on the sides of my head have ceased growing. 

The hair around my crown will not grow to any length.

I've developed bare patches on my right front, left front where I part my hair, the area on the right side of my head near the top of of strip scar.

The hair on the front of my scalp which was always the thickest area has now become thin, wispy flyway hair that is unable to bind to any hair towards the side.

Temple recession and even slight frontal thinning/recession.

Something detrimental is occurring and my hair is regressing to pre-transplant levels to the time when I first met Dr. Rahal and he told me the hair I had wasn't going to last "much longer."

Most of these issues have occurred within the last year.

So, basically I'm freaking out.  

I get it that you freak out, and I see what you are writing, but you are posting photos which basically tell us the opposite so its abit difficult for anyone to understand.

If you want us to be able to try to help you out you need to send better photos which confirms all these points.

Edited October 10, 2021 by digi23

[mcr7777]

If you have itchy scalp - you should definitely check that you don't have Lichen planopilaris -an autoimmune condition. This is what I have - it causes an itchy scalp with hair loss - which can be patchy or sometimes diffuse or other times in a vertical strip down the centre of the head. 

 

People with LPP are often misdiagnosed as MBP.  For this reason, you should find a derm specialising in hair loss - not a general derm - and not  just a HT doctor- as they often will miss LPP/not be very aware of it.  If you think you might have LPP i'd suggest trying to find a derm that knows about scarring alpoecia.  It's not uncommon for people with LPP to also have some MBP which seems to confuse doctors.   

I'd recommend trying to find what is causing the thinning and itchiness before doing another transplant.   Meds might help to stabilise your hair - but LPP meds are oten different than MBP mesd.  So important to find out what is going on if you've lost a lot of hair very quickly.  The itching and quick thinning makes me suspicious of LPP - but you need to see a dermatologist to figure out what's wrong rather than a HT doctor.

 

 

Edited October 11, 2021 by mcr7777

[Mike Flaherty]

On 10/10/2021 at 1:59 PM, digi23 said:

I get it that you freak out, and I see what you are writing, but you are posting photos which basically tell us the opposite so its abit difficult for anyone to understand.

If you want us to be able to try to help you out you need to send better photos which confirms all these points.

I understand. I am trying to get photos taken to adequately depict my situation. Complaining about it on these boards is not going to determine the cause or options I have. I have however decided to see the Dr. in person next month. I can't wait any longer. Until he sees this in person we're all at a loss (no pun intended). I'll be in touch with the clinic to arrange a time tomorrow.

Edited October 13, 2021 by Mike Flaherty

[Mike Flaherty]

Okay, I finally managed to take some photos. This is where my hair is at now. I didn't even realize my crown was thinning so harshly. It's all very thin hair with nothing near the temples to bind what hair I have onto. This is basically the state of my hair just before first transplant. 

Edited October 13, 2021 by Mike Flaherty

[JDEE0]

I honestly see no noticeable difference here from your photos uploaded with the initial post in October 2019, and even with your hair in a completely messy frizzed up state, I don't think it looks particularly weak at all. I would argue it may even look better here than those previous pics, but comparisons between two different sets of pictures in different conditions are hard.

Considering that you emphasised the fin has considerably worsened your hair since those pics were taken, (ravaged it even, as you put it), and I can see no signs of this, it casts a shadow of doubt over the rest of what you say in my mind...

I'm not saying you're purposely making it up, I just think this a mostly psychological thing and maybe you've developed some sort of image issues recently. I'm also not saying that no thinning has happened and you've completely made it up, I think that you've definitely continued to lose hair over the period of a decade as you didn't use fin during this time (and clearly had/have a lot of native hair left to lose), the result of which you have only just noticed recently due to the cumulative effect of hair loss. It's hard to suggest how much continued loss there's been as we have no pics from 10 years ago, but it doesn't seem like its possible to be a vastly huge amount judging by your current state - looks to be lightly diffused in it's nature or progression - and you're still looking fairly dense up top with no real or obvious recession etc.

Upon noticing this cumulative loss, I think you've just become hyper-aware and are now worrying to the point it's unhealthy/has triggered some sort of episode in you.... you say you've developed bald patches all over, that it won't grow past a certain length in areas, is at 50 percent of the density it was recently etc.... and I just don't see it. As I say, I think that you continued to lose hair due to being unmedicated for 10 years straight and you noticed it when you reached a 'tipping point' visually speaking a couple years back when you wrote this post. From here, it seems the fin has kept it in a similar state judging by the photos.

I'm sure you will disagree, and I'm not you so I could certainly be wrong, I'm just going by everything I've seen and read so far and I feel my assessment is accurate going off that alone.

Edited October 13, 2021 by JDEE0

[track_rat]

You’ve got a head of hair brother.

[Mike Flaherty]

The "completely messy frizzed up state" is how it mostly is now. 20 minutes after washing, drying, styling this is the state it reverts to. I wanted the emphasis the overall thinness.

One from 2016. The hairline is pretty even with some decent thickness at the temples and the front, 

Looking at the photos I posted today, how much coverage will 1500 grafts give me? Guess I\m looking at the front and temple areas again. That crown thinning is alarming though. I've never experienced crown loss until the past six months.

Edited October 14, 2021 by Mike Flaherty

[Mike Flaherty]

A few more of my current situation. 

[JDEE0]

6 hours ago, Mike Flaherty said:

The "completely messy frizzed up state" is how it mostly is now. 20 minutes after washing, drying, styling this is the state it reverts to. I wanted the emphasis the overall thinness.

One from 2016. The hairline is pretty even with some decent thickness at the temples and the front, 

Looking at the photos I posted today, how much coverage will 1500 grafts give me? Guess I\m looking at the front and temple areas again. That crown thinning is alarming though. I've never experienced crown loss until the past six months.

I understand you my friend, and I can see that your hair was stronger here too, but yeah I'm very sure this is just a case of continued loss of native hair over the years. Similar to how people say oh I only started losing my hair at 30, 35 or whatever age when this is not the case at all; it's just when they noticed it for the first time. It had been happening slowly in the background since puberty began and their body was saturated with androgens. In your case, it's just built up in the same way slowly until you've noticed it recently, unfortunately. 

Good news is that the fin should now keep you in a steady state for a long time, and your hair as is really isn't bad at all. You can revert back or close to your previous state shown in 2016 without much issue in my opinion. I think maybe a few thousand grafts in the right doctors hands, spread out across the frontal third/half and you'll be good to go. 

This guy was worse off than you by a fair bit I would say, here's how he looked with over 2.5k from De Freitas in Spain:  https://www.hairrestorationnetwork.com/topic/61325-dr-rafael-de-freitas-2759-grafts-6049-hairs-fue/?tab=comments#comment-607476

Just make sure the doctor you choose is comfortable doing this type of work and is confident in your particular case as it can sometimes leave you worse than before implanting between so much native hair due to permanent shock loss.

 

[aaron1234]

Hair is looking good, just a few weak spots which can easily be addressed with another procedure.

[Curious25]

What did you look like in 2010 before you had any procedures? 

You're coming across as pretty erratic - another small procedure would bring you up to a standard I presume you want to be at. 

[TorontoMan]

Sorry I'm a bit confused by this post. At what point did you start taking finasteride? And what were you on the NW scale before you started taking fin and before you had your surgeries?

[sharkman]

I had a pretty bad experience with DR Rahal, so I'm not surprised.

 

[fitwhynot]

On 10/15/2021 at 5:20 PM, sharkman said:

I had a pretty bad experience with DR Rahal, so I'm not surprised.

 

Care to elaborate on the details?

[sharkman]

On 10/25/2021 at 2:26 PM, fitwhynot said:

Care to elaborate on the details?

Sure I came in slightly bald, I came out a bit less bald after 3000 graphs. Dr Rahal was perfectly satisfied with his work, not willing to admit how unimpressive was the performance. It was also extremely painful. I feel he is a very good marketer

[mcr7777]

On 10/13/2021 at 7:30 PM, Mike Flaherty said:

Okay, I finally managed to take some photos. This is where my hair is at now. I didn't even realize my crown was thinning so harshly. It's all very thin hair with nothing near the temples to bind what hair I have onto. This is basically the state of my hair just before first transplant. 

Do you have any

 

On 10/10/2021 at 6:42 AM, Mike Flaherty said:

This photo actually makes my hair appear thicker than it is. I honestly believe it's getting worse by the week. 

The hair on the sides of my head have ceased growing. 

The hair around my crown will not grow to any length.

I've developed bare patches on my right front, left front where I part my hair, the area on the right side of my head near the top of of strip scar.

The hair on the front of my scalp which was always the thickest area has now become thin, wispy flyway hair that is unable to bind to any hair towards the side.

Temple recession and even slight frontal thinning/recession.

Something detrimental is occurring and my hair is regressing to pre-transplant levels to the time when I first met Dr. Rahal and he told me the hair I had wasn't going to last "much longer."

Most of these issues have occurred within the last year.

So, basically I'm freaking out.  

Do you have any burning/tenderness sensations on the scalp?  

[stephcurry30]

Any update on this? Sounds like Op lost a lot of native hair from not using finasteride. 

[mxm56]

Good luck mate