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6 MONTH results: should I be worried


Ittiaz1

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6 month update Dr Bruno Ferreira. Portugal. 3459 grafts. Cost was €8,500 euro. Dr did all extractions and implantation himself. Diffused hair loss, hair type characterised as thick by the Dr.

 

Let me know what you think? 


 

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Everyone who has had a bad HT experience understands your concerns and frustrations, and while Im not trying to dismiss any of them it might help to focus on some of the positives;

- You are only 6 months and there is far more time to assess things. Realistically these are just the beginning stages of growth and its still far too early to judge - its really around month 9 -10 when all the transplanted hair has penetrated the surface and begins to thicken and mature. here is a link; 

Some guys are just slow growers as well. Try and take a break from looking in the mirror and focus on something else. take photos in the same lighting conditions then check again in a month. if you are overly concerned/self conscious about the density of the hairline concealers like dermatch of toppik would work pretty effectively given your pre-existing hair. 

- you have a doctor that responds to your emails, acknowledges your concerns and is offering to fix things. I tell you this from personal experience but finding a doc who does one of these things let alone all of them is RARE. Realistically clinics cant guarantee growth or anything like that, and it's you as the patient that takes on all the risks .. so the support youre getting from your doctor is the best it can possibly be.

- Ferriera has a reputation for great donor management and the extraction patters/size from the post-op pics look top notch. As long as you have a viable donor you have options. It also looks like you have a good beard, so again you have options. 

If you can put aside the time and money spent its not like you are disfigured or anything (i.e. your pre-op state is not dissimilar to your current state), and even you yourself admit you still have more time for growth. Give yourself a few more months before judging things and then assess how you want to proceed. Should the results not improve It might be good to get a 2nd opinion.

Other than that all I (or anyone else) can do is wish that your results improve as your transplanted hair goes through its various hair cycles and matures. 

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29 minutes ago, qui bono said:

- You are only 6 months and there is far more time to assess things. Realistically these are just the beginning stages of growth and its still far too early to judge - its really around month 9 -10 when all the transplanted hair has penetrated the surface and begins to thicken and mature. here is a link; 

The rule of thumb, if I remember correct, is that by the six month mark 50% of the grafts should have grown out, and at nine months 90%.

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yeah for the average patient at 6 months its about 50-60% have popped through. But this doesnt necessarily include the hair itself being noticeable at any length or very thick (as its still immature). By 9 months around 90% of the hairs should have grown through the surface and the results should be easier to assess.

Give it a few more months I think. 

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Realistically I think its unlikely that the growth will ever be a home run if this is the situation at six months, however its definitely possible it can improve reasonably substantially over the next three months or so. 

As Bono said,  the responses from Ferriera are well above average for patient aftercare, and the fact that he is he supporting of potentially remedying the situation at twelve months if still not satisfied is as close to as good as you will get anywhere in the industry. 

"One thing I will do if after 10 months my hair transplant has failed ( and yes i am jumping the gun here) is to find out why it failed otherwise it would bug me forever."

One can safely say you will never, and should try to find out why a transplant failed, because no one in the world will be able to tell you (unless its related to some rare physiological condition). No other surgeon is likely to be able to even get a rough idea either. Any surgeon or any person who can claims exact reasons in a case like this lying or being misleading. If it fails you have to move on and the best option in your case would likely be to have Ferreira attempt to remedy through a touch-up. 

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Everyone understands your frustration, but it is too early to jump to conclusions, and to defame your Dr. in the title is a not the most tactful thing. He is the one that is offering to follow you up at his expense, should the growth be poor in a few months.  

What is your hair loss and medication history before/after the surgery? Would be nice with a balanced write-up so we can follow your progress and support you. 

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2 hours ago, j1mmy said:

Everyone understands your frustration, but it is too early to jump to conclusions, and to defame your Dr. in the title is a not the most tactful thing. He is the one that is offering to follow you up at his expense, should the growth be poor in a few months.  

What is your hair loss and medication history before/after the surgery? Would be nice with a balanced write-up so we can follow your progress and support you. 

I am.nit defaming the doctor. I'm telling it as it is. 6 months post of with Dr Ferreira and my results are disappointing. Yes he is offering a no cost touch up but to be honest  I don't know about that. Would I go back somewhere I already been and wasn't happy? I don't know

Propecia for over 10 years.

Minoxidil  for over 10 years.

No health issues 

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4 hours ago, JayLDD said:

Realistically I think its unlikely that the growth will ever be a home run if this is the situation at six months, however its definitely possible it can improve reasonably substantially over the next three months or so. 

As Bono said,  the responses from Ferriera are well above average for patient aftercare, and the fact that he is he supporting of potentially remedying the situation at twelve months if still not satisfied is as close to as good as you will get anywhere in the industry. 

"One thing I will do if after 10 months my hair transplant has failed ( and yes i am jumping the gun here) is to find out why it failed otherwise it would bug me forever."

One can safely say you will never, and should try to find out why a transplant failed, because no one in the world will be able to tell you (unless its related to some rare physiological condition). No other surgeon is likely to be able to even get a rough idea either. Any surgeon or any person who can claims exact reasons in a case like this lying or being misleading. If it fails you have to move on and the best option in your case would likely be to have Ferreira attempt to remedy through a touch-up. 

Thanks for the reply. It definitely doesn't look a home run and to be honest I can't see it getting better. Again, as I mentioned to someone else, would I go back somewhere which hasn't left me happy the first time? I don't know.  

And yes his responses so show he cares.

If this does fail then I would like to know why. It would bug me all the time, not knowing why. Paying alot of money to suffer a failure,  I don't know anyone else but I would like to know the reason why 

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5 hours ago, qui bono said:

yeah for the average patient at 6 months its about 50-60% have popped through. But this doesnt necessarily include the hair itself being noticeable at any length or very thick (as its still immature). By 9 months around 90% of the hairs should have grown through the surface and the results should be easier to assess.

Give it a few more months I think. 

What about the short stubble hairs that have popped up to surface but just sit there and do not grow ?

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14 minutes ago, Ittiaz1 said:

I am.nit defaming the doctor. I'm telling it as it is. 6 months post of with Dr Ferreira and my results are disappointing. Yes he is offering a no cost touch up but to be honest  I don't know about that. Would I go back somewhere I already been and wasn't happy? I don't know

When is it ever a good idea to go back to the same doctor for a no cost repair?  Donor hair is finite.

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5 minutes ago, AB2000 said:

When is it ever a good idea to go back to the same doctor for a no cost repair?  Donor hair is finite.

And also I need to take into account fitting into a slot with the dr. getting time off work, recovery time, and months of patience. I don't know if I can do all that again. It gets very emotional and depressing  for me. To be truly honest, when I lool in the mirror,  I really wish I didn't ever bother with it in the first place.

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18 minutes ago, Ittiaz1 said:

What about the short stubble hairs that have popped up to surface but just sit there and do not grow ?

This has actually been a phenomenon that I have came across on various threads over the years . . I can’t think of, or remember any off the top of my head . . Maybe @Melvin-Moderator can help point you in the right direction to these threads when he logs on. 
 

I can’t remember the doctors answers for this occurring either I’m afraid, however I have definitely read about it before. 
 

FWIW . . Although disappointing at 6 months, I wouldn’t be as hasty to call it a write off just yet, you could just be 1-2 months behind average growth . . Your frontal third appears to have quite a few immature hairs that still need to grow and strengthen. Wait it out, and keep in contact with your doctor. It’s certainly a positive he is being very communicative with you, and is pledging to stand by his work. 

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23 minutes ago, Ittiaz1 said:

Thanks for the reply. It definitely doesn't look a home run and to be honest I can't see it getting better. Again, as I mentioned to someone else, would I go back somewhere which hasn't left me happy the first time? I don't know.  

And yes his responses so show he cares.

If this does fail then I would like to know why. It would bug me all the time, not knowing why. Paying alot of money to suffer a failure,  I don't know anyone else but I would like to know the reason why 

There's no means to find out why unless you have some kind of specific physiological condition. Other surgeons who didn't take part in the surgery would almost certainly be lying if they try to give you specific reasons. The surgeon who conducted the surgery to begin with might have theories as they're the one that conducted it but even they are unlikely to have anything close to concrete answers.

Its worth taking it out of your head completely because there's no means of getting concrete answers here. I understand in an ideal world that you would know, but that's not reality.

 

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It looks ok to me and no need to panic at this stage.

The extractions look like he had no problems obtaining the grafts: nicely spread out and small punch.

One side appears to be lagging.  I had that around months 5-6.

All you can do is wait until 12-15 months.  Saying you only have 4 months to go is false.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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15 minutes ago, AB2000 said:

When is it ever a good idea to go back to the same doctor for a no cost repair?  Donor hair is finite.

If he or others have the money to go to a surgeon that uses stick and place as well as being more meticulously hands on in general like Konior or Keser for example, then absolutely I'd recommend going elsewhere. In reality unless he has the money to do this its probably the best option to go back with Ferreira. I don't consider Ferreira at the absolute top end for hair transplant surgeons, but he's no clown. I would give him the benefit of the doubt.

Also has been said, I think he's likely to get some further improvement that leaves a position where a touch-up will achieve a good result. 

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Even if a doctor has a superb process, there are still risks / variables that the outcome may not be as expected. All a quality process can do is minimise the probability of a bad outcome. 

Regardless of that, you are only at 6 months. As other have pointed out, there's a lot of opportunity for further growth / development. 

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We understand your concern. But do not loose hope yet. I know it is easy to say, and I did not follow my own advice, when my own (crown) surgery was behind. I did barely cross baseline (look at the timeline yourself) at month 6 and really panicked. Now, I am really happy and feedback is very positive. 

My comments/advice is:

a) At some more pics to give a proper time line (month to month)

b) Some of the hair diameters seems still thin, this is a sign for further maturation later on

c) comparing you before an after, you might still suffer from some shockloss which is about to recover

d) If you go for another surgery/touch-up go in small steps. 300-400 FU focussing on small areas. Lower risk, high reward in your case.

 

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2 hours ago, JayLDD said:

If he or others have the money to go to a surgeon that uses stick and place

Dr. Ferreira does perform manual punch, as well as motorized extraction. Not sure about stick and place implantation, though. 

I see why the OP is frustrated. I would also expect more "results" at this point. But really, it is only 6 months. Being a couple months behind the average growth cycle is nothing to be worried about. Truth is, there's nothing to do but wait. I would hold off on judgement until month 9. At which point, consult with Ferreira to discuss next steps. 

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@Ittiaz1 I am sorry to hear you are going through this. I can only imagine the frustration you must be feeling, you have my sympathies and I hope things turn around. 

I have a few points:

For the surface area covered, it doesn't seem like 3400+ grafts were used. This may be tedious, but with the additional pictures you have that are zoomed in and high resolution, could you do a manual count and see if indeed that is the amount that was applied?

Additionally, the transplantation was done around native hair, which is always tricker. Do you suppose that the combination of shock loss, plus native hair competing with donor hair for blood supply, may have compromised your yield? Perhaps this is something to ask Dr. Ferreira in a follow up e-mail. 

Also, for how long did you discontinue minoxidil before surgery, and when did you start using it again?

If you want to pm me any other details in addition to sharing them here publicly, I will be happy to talk to you more. 

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@Ittiaz1

Here’s the problem “disappointing 6 months results” virtually everyone is disappointed at 6 months. It takes a full year to see growth.  Always keep your surgeon informed, from my experience Dr. Ferreira seems like a genuine person. I’m sure he would like to be in the loop of your feelings.

Unfortunately, the only thing we can do is stay patient and wait for the results to fully manifest. Please pm me your name and surgery date, I’ll try and reach out to Dr. Ferreira. 
 

Please watch this video

 

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

My Hair Transplant Journey

Melvin- Associate 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 Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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Just now, Melvin-Moderator said:

@Ittiaz1

Here’s the problem “disappointing 6 months results” virtually everyone is disappointed at 6 months. It takes a full year to see growth.  Always keep your surgeon informed, from my experience Dr. Ferreira seems like a genuine person. I’m sure he would like to be in the loop of your feelings.

Unfortunately, the only thing we can do is stay patient and wait for the results to fully manifest. Please pm me your name and surgery date, I’ll try and reach out to Dr. Ferreira. 
 

Please watch this video

 

 

1 minute ago, Melvin-Moderator said:

@Ittiaz1

Here’s the problem “disappointing 6 months results” virtually everyone is disappointed at 6 months. It takes a full year to see growth.  Always keep your surgeon informed, from my experience Dr. Ferreira seems like a genuine person. I’m sure he would like to be in the loop of your feelings.

Unfortunately, the only thing we can do is stay patient and wait for the results to fully manifest. Please pm me your name and surgery date, I’ll try and reach out to Dr. Ferreira. 
 

Please watch this video

 

I have already reached out to him thanks. He will check with me month by month. I'm just disappointed with how it looks. Surely that must have been more growth. And the question about the stubble hair is really worrying me.

But thanks for your help. As I have said, I have reached out to him already and he is good with his replies.

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1 minute ago, Ittiaz1 said:

 

I have already reached out to him thanks. He will check with me month by month. I'm just disappointed with how it looks. Surely that must have been more growth. And the question about the stubble hair is really worrying me.

But thanks for your help. As I have said, I have reached out to him already and he is good with his replies.

Did you watch the video? It’s important to understand that not everyone grows at the same rate. There’s two very good examples there. 

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

My Hair Transplant Journey

Melvin- Associate 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 Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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7 minutes ago, asterix0 said:

@Ittiaz1 I am sorry to hear you are going through this. I can only imagine the frustration you must be feeling, you have my sympathies and I hope things turn around. 

I have a few points:

For the surface area covered, it doesn't seem like 3400+ grafts were used. This may be tedious, but with the additional pictures you have that are zoomed in and high resolution, could you do a manual count and see if indeed that is the amount that was applied?

Additionally, the transplantation was done around native hair, which is always tricker. Do you suppose that the combination of shock loss, plus native hair competing with donor hair for blood supply, may have compromised your yield? Perhaps this is something to ask Dr. Ferreira in a follow up e-mail. 

Also, for how long did you discontinue minoxidil before surgery, and when did you start using it again?

If you want to pm me any other details in addition to sharing them here publicly, I will be happy to talk to you more. 

Hello mate. Thanks for your advise. I had crown done too so maybe overall it is 3400+ 

I will definitely ask him about the compromised yield die to competing for blood supply.

Stupid question but how do I PM on here ? 

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Just now, Melvin-Moderator said:

Did you watch the video? It’s important to understand that not everyone grows at the same rate. There’s two very good examples there. 

I will watch that video, but when true Dr who has done your procedure also states that should have been more at this stage, for me, it is worrying.

Thanks Melvin, I will watch the video.

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  • Ittiaz1 changed the title to 6 MONTH results: should I be worried

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