Dr. Maras at HDC Clinic - FUE 3773 Grafts - April 5th & 6th 2021

[Parasol]

Hi everyone! My name is Ryan and I'm 37 from the USA. My topic may be a little bit different than most. Perhaps we can view it as a cautionary tale (hopefully one with a redemption arc!  )! I had two pretty successful FUT procedures with Dr. Scott Boden in Connecticut back in 2009 and 2010, totaling approximately 3,750 grafts. Although the very frontal hairline and the left side of my hairline near the temple weren't as dense as I had hoped (Dr. Boden and I agreed I could use a few hundred more grafts), the result was all in all pretty life changing.

So of course I took it for granted, stopped taking Finasteride because I had somehow convinced myself my frontal half was mostly transplanted hair anyway, and lost so much hair over the last decade it even shocks me looking back at my post-op photos. 

2009 before any surgery (my hair was pretty long then and we went with no-shave both times so these are the best photos I have) 

2011 final result, taken at my 1 year follow up after my second FUT procedure

It's pretty crazy how quickly after these photos were taken how aggressively I lost more hair! I never looked at these photos until recently or took new ones to compare. As time went on, stopping Finasteride about a year or two after surgery, and taking no other preventative measures, it just thinned out more and more until I realized about a year ago, wow, I'm basically bald again! 

Right as COVID started about a year ago, I decided to get back on Finasteride and started Rogaine foam, and began researching clinics again. This time I knew I wanted FUE, so I could get some grafts put into my strip scar, which had stretched quite a bit, while we were at it. Originally, I was thinking of going to Dr. Boden for a third pass, but when I discovered he uses ARTAS for his FUE procedures (something I decided I wasn't comfortable doing), I hit the forums here pretty hard, looking for the best in the business in frontal half scalp work and hairlines. 

After getting some consults, I decided on Dr. Maras at HDC in Cyprus, and had surgery last Monday and Tuesday.

Pre-op

 

Hairline and area design

 

Graft breakdown

3773 grafts (approximately 300 placed in strip scar)

834 singles

1599 doubles

1340 triples (HDC didn't say whether I had larger graft units, and if so, whether they were included in this number)

2.134 hairs per graft (based on my math)

After two days of surgery

Firstly, I want to thank my advisor @Doron Harati . For the last several months, no matter the time of day, no matter how ridiculous the question, he has been there for me no matter what. Regardless of how this result turns out, Doron is phenomenal and is clearly in this business because he cares about people. It feels really good to know I'll have his support through this. 

I also need to say....wow. The recovery has been much worse than my last two procedures. I absolutely feel 10 years older. Currently, I'm 8 days post op, and already managed to bang my head and lose a graft, and get prescribed an anti-biotic due to some poor scab healing. It's also a real pain trying to sleep when you can't sleep on your scalp grafts or your FUT scar grafts.

For those curious, right now I'm taking 1mg of Finasteride daily (and have been for roughly the last year), some collagen and plant based protein powder daily (along with eating really well and exercising regularly...though the clinic wants me to wait a month to start working out again), and just ordered some MSM tablets to hopefully help speed up the growth. I'm also currently debating on whether or not I want to begin Rogaine foam again. I'm reading different things recently on whether it's a good thing to use or not, and am a bit torn on it at the moment. The clinic wants me to wait 4 weeks to apply it again if I chose to do so, so I have some time to decide.

Anyway, I do hope to document my journey here. I'd love to get some feedback on how I'm healing in my upcoming posts, and how the growth is going once it starts.  

Edited April 14, 2021 by Parasol

[asterix0]

I think minoxidil can only help your grafts, so if you can deal with the annoyance of applying the topical then I believe it is worth it.

Do you think you lost transplanted hair after quitting finasteride back in 2011? From your recent pictures it is hard to tell because you had quite a lot of native hair as well.

[Parasol]

40 minutes ago, asterix0 said:

I think minoxidil can only help your grafts, so if you can deal with the annoyance of applying the topical then I believe it is worth it.

Do you think you lost transplanted hair after quitting finasteride back in 2011? From your recent pictures it is hard to tell because you had quite a lot of native hair as well.

I have an identical twin brother that’s never had any surgeries, or taken any hair loss medication of any kind. So I’m sort of in a unique position to be able to answer that. Our hair loss accelerated remarkably over the last few years unfortunately. It’s hard to say whether what’s left is 3,750 grafts worth though. 
 

Here’s what I would look like without any work done.

So basically, no temple hair at all, and very very thin from the receded hairline back to the crown (which is starting to thin on both of us from the whirl forward).

Yeah, my plan all along was to restart Minoxidil after I was allowed to. I really want that early growth and to do everything I can to keep what I have for the long haul this time. But HDC doesn’t seem care for it all that much, and I know researching, other clinics (such as H&W) don’t care for it either.

I’ve been looking into this a bit, trying to get opinions on it from experts, and I keep reading how the downsides outweigh the upsides (in some people’s opinion). Kind of unsure at the moment.

 

Edited April 14, 2021 by Parasol

[Melvin- Admin]

Thank you for this amazing write-up. I look forward to seeing your progress, happy growing🙌🏼

[asterix0]

Minoxidil will keep your hair in anagen phase for longer, and thicken existing hair as well. Many clinics do advocate its use, as well as finasteride. However, one must stay committed to it, which is a pain to do, especially when traveling, when you are busy with many other things, etc.

[Parasol]

When I said above that I didn’t think I was healing all that well, here’s what I was talking about.

Below are some photos from day 5, where you can see some scabbing along the temples and a bruised area in the center.

That bruised area became this, today which is day 8, which I’m now on antibiotics for.

I’m guess I’m also a bit worried about the front center hairline density (the first few rows right where and above the zig-zags are). I know this is a long process so I’m not trying to be paranoid. It’s just, in my immediate post op pics, the hairline looks super densely packed. But looking at it now, and even 3 days or 5 days post-op like I posted above, it looks like most of that hair is gone.

HDC does begin washing the scabs with their fingers two days post-op, so maybe it washed away and the grafts are still secure and it will grow back? 

Edited April 14, 2021 by Parasol

[Parasol]

27 minutes ago, Melvin-Moderator said:

Thank you for this amazing write-up. I look forward to seeing your progress, happy growing🙌🏼

Thanks, Melvin! And thanks to you and @DrTBarghouthi for all the help behind the scenes too!

[Curious25]

Congratulations on your third procedure. The work looks clean, and I have seen some nice work coming from your chosen clinic. 
 

I will reiterate @asterix0’s impression, it does look as though some transplanted hair was either lost, or the original yield wasn’t quite as high as the impression the 2011 post op photos gave - perhaps due to the higher amount of native hairs you still had. 
 

Did they provide you with any estimates of remaining graft count, after totalling around 7.5k grafts used up now, and where they projected your final pattern to end up?     

[follically challenged]

44 minutes ago, Parasol said:

I have an identical twin brother that’s never had any surgeries, or taken any hair loss medication of any kind

Fascinating. I would have thought he'd be in the same boat with you as to trying to do something about it...

So I'm really curious as to why he never bothered with the battle... Are you both quite different in personality? I presume he obviously knows about your surgeries and regime right?

Another reason i thought he'd join you in procedures etc, aside from the near-identical genetics, is the fact that....surely it must annoy him somewhat often hearing 'So...why do you look older than your twin brother?' 😅

[Helios]

Great write up Parasol and well done choosing HDC. I strongly believe you made the best possible choice. Wish you the best of luck with your results and keep us updated.  

[Britanium]

Excellent choice of clinic/Dr ! Really nice clean and refined work as we have come to expect 👌look forward to following your latest journey 🙏

[Parasol]

48 minutes ago, Curious25 said:

Congratulations on your third procedure. The work looks clean, and I have seen some nice work coming from your chosen clinic. 
 

I will reiterate @asterix0’s impression, it does look as though some transplanted hair was either lost, or the original yield wasn’t quite as high as the impression the 2011 post op photos gave - perhaps due to the higher amount of native hairs you still had. 
 

Did they provide you with any estimates of remaining graft count, after totalling around 7.5k grafts used up now, and where they projected your final pattern to end up?     

I think it’s definitely possible I lost transplanted hair too. Although I wish I had come to the realization sooner, this is why I want to do whatever it takes to treat my hair loss and ensure this procedure turns out well.

I even quit drinking and smoking cigarettes for this (I do use an e-cig occasionally but not nearly as much as I did when I smoked).

I’m not sure on my final norwood or the exact number of grafts left in reserve. All I can say is, they said my donor is “amazing” and other than the scar, my donor is “like a virgin scalp” and there’s no limitations to having at least one more surgery if needed.

Edited April 14, 2021 by Parasol

[Parasol]

17 minutes ago, follically challenged said:

Fascinating. I would have thought he'd be in the same boat with you as to trying to do something about it...

So I'm really curious as to why he never bothered with the battle... Are you both quite different in personality? I presume he obviously knows about your surgeries and regime right?

Another reason i thought he'd join you in procedures etc, aside from the near-identical genetics, is the fact that....surely it must annoy him somewhat often hearing 'So...why do you look older than your twin brother?' 😅

Haha yes we are very different. He’s much more shy. Though he’s also married to a beautiful woman inside and out and he has a great job and big-ass house and an awesome baby, so I guess he’s found fulfillment in other, more important ways.

He’s one of the few people that know about my surgeries actually. This is one of the reasons why I’m sheltering in place right now, taking a month off work, because I don’t want to have to tell the whole world about my shaved strip scar.

Right after my full result from my last surgery, my brother did say that it was becoming really obvious I had much more hair than him and that someday he would consider it. But that was a long time ago and short lived really. Within a couple years I had lost a lot of the ground I covered, so I think it’s hard for someone to want something when the result at the moment isn’t exactly great.

[Parasol]

21 minutes ago, Helios said:

Great write up Parasol and well done choosing HDC. I strongly believe you made the best possible choice. Wish you the best of luck with your results and keep us updated.  

Thanks @Helios ! Your result was one of the several that put HDC in my top-tier choices. If mine can come out even close to what you have, I’d be so happy.

Congratulations on yours. Your hair looks incredible.

[Parasol]

20 minutes ago, JohnAC71 said:

Excellent choice of clinic/Dr ! Really nice clean and refined work as we have come to expect 👌look forward to following your latest journey 🙏

Thanks, John! After lurking here for so long, and reading tons and tons of threads, I just want to say you are a big help and a positive force around these parts.

I look forward to getting your opinion on my progress as the months pass.

[Britanium]

7 minutes ago, Parasol said:

Thanks, John! After lurking here for so long, and reading tons and tons of threads, I just want to say you are a big help and a positive force around these parts.

I look forward to getting your opinion on my progress as the months pass.

That’s very kind of you to say that ! It’s very much appreciated. 🙏

[Doron Harati]

@Parasolthanks!

I am sure you'll be happy with the final result, always here for you

[Britanium]

2 minutes ago, Doron Harati said:

@Parasolthanks!

I am sure you'll be happy with the final result, always here for you

Good to see a clinics support 👏

[DrTBarghouthi]

3 hours ago, Parasol said:

Thanks, Melvin! And thanks to you and @DrTBarghouthi for all the help behind the scenes too!

Wishing you all the best in your journey! Looking forward to following your progress. 

[Parasol]

Hi everyone! I just wanted to post a quick 10 day update.

I’m feeling quite a bit anxious about this wound/scab/whatever you want to call it. As the hair is starting to grow, I can see now this area has virtually no hair at all. Maybe 25% compared to the areas around it.

I’m sort of concerned even if I do get good yield, this area will end up being bald.

The clinic and I have been in constant contact. I’m a few days into some prescribed antibiotics, and sending photos over for review daily.

At some point I’m guessing we’re going to have to get this thing off. They haven’t said anything about that yet though (the instructions are to just gently pat the area when I wash for now).

I’m also unsure what’s going on with the very frontal hairline, and why the front right just below the scab is so thin (seemed pretty densely packed in the post-op photos to me. Maybe those hairs already washed away?). 

On the plus side, I’m feeling a lot better. Most of the pain has subsided and last night I finally slept in a bed again, with an actual pillow. Laying down and everything. It was awesome.  

The donor seems to be healing pretty well too. At least to me. I can already tell getting these grafts put into my scar was a good decision. The clinic did say that anything around an 80% yield should be considered a success due to graft survival rates in scar tissue, so hopefully we can get that and down the road I can have a slightly shorter haircut than I used to have (couldn’t really go below a 6-7 guard due to the scar being visible).

 

Edited April 16, 2021 by Parasol

[Helios]

At ten days post the donor area is looking very good indeed. I wouldn’t worry about some areas looking less dense than others as it’s normal to panic that some areas are thinner than others. I went through this myself on both surgeries and was panicking about some areas but turned out fine. 

the scab is located to only one area so I would simply keep contact with the clinic and follow instructions. Keep us updated. 

Edited April 16, 2021 by Helios

[Melvin- Admin]

Have you tried to conditioner? Is it still bleeding? Or is it that you haven’t cleaned it?

[DrTBarghouthi]

You can attempt to keep the scab moist. This is now acting like a natural dressing. Once skin under it heals it will just peel off. Keep the doctor informed with the progress as his input is important ofcourse. Best of luck with your continued recovery. 

[Parasol]

1 hour ago, Melvin-Moderator said:

Have you tried to conditioner? Is it still bleeding? Or is it that you haven’t cleaned it?

This area was bothering me even back when I was in Cyprus under HDC’s direct care. Above I posted a photo when I was 5 days post op, still in Cyprus, and it was yellow, bruised and slightly scabbed.

I think when I got home and took over washing myself, it just wasn’t ready to be washed like the rest of my scalp and got worse.

Fairly certain if the scab was to come off right this moment, it would take a chunk of my scalp with it (gross).

So, regarding washes, this area has been washed twice every day since two days after surgery. It’s just in hindsight I think both the clinic and myself were just too rough with it too early. Yesterday it started bleeding again after my morning wash, so the clinic asked me to stop washing it with my fingers in a circular motion and to just pat it down with shampoo for now.

I haven’t asked if soaking it with conditioner is ok but I will if they ask me to start trying to remove it.

25 minutes ago, DrTBarghouthi said:

You can attempt to keep the scab moist. This is now acting like a natural dressing. Once skin under it heals it will just peel off. Keep the doctor informed with the progress as his input is important ofcourse. Best of luck with your continued recovery. 

The clinic just messaged me saying they want me to start spraying it often throughout the day to keep it most between washes. Sounds like you and them are on the same page.

I appreciate the feedback, guys. It helps put me at ease.

Edited April 16, 2021 by Parasol

[Parasol]

@Helios Thanks for the reassurance on the hairline density stuff. It’s good to know this is normal and all part of the process. 

Having done no-shave with my last two surgeries this is the first time I’ve gotten to see the progress up close and had the chance to over analyze it.