Jump to content

Mixed Feelings after First HT (FUT)


Recommended Posts

Posted (edited)
2 hours ago, SLA said:

My very amateur guess is 500-1000 more grafts in that area would make a huge difference.

Honestly, I tend to disagree. For me 2500+ Grafts are required. Maybe less (1500?) if the focus is really only the frontal 1/3 and midscalp is avoided. Therefore, I recommend to research very carefully, and visit at least 1-2 additional clinics in addition to the discussion with your current clinic. There are not much bullets left. 

Visit clinics which does mega session FUT like H&W and Hattingen.

Visit clinics which excel in BHT. 

Visit clinics who doe FUT/FUE combination...IMO you need to think also about donor homogenization to get a decent result. 

Edited by Gasthoerer
  • Like 2
  • Thanks 1
Link to comment
Share on other sites

I’m afraid it’s going to take a lot more than 500-1000 grafts to bring this upto a satisfactory result. 
 

IMO you’re looking at least another 1500 in the hairline and frontal 1/3 alone to bulk this area out and create an illusion of fullness. 
 

Like has already been aforementioned, large amount of real estate to be covered, with fine calibre hair is never an easy fight - which is why I think it is important for us to have answers from the Dr about what his strategy was for this case, and why he executed your surgery in this way. 
 

Hopefully you have >2000 grafts available from your beard, and some decent chest donor would also be a great help. If you can squeeze out another 4000 grafts from your scalp donor via both FUT and FUE, combined with some BHT and SMP, I think you’l be in a much better place, and close to obtaining your original goals. 
 

I agree, consult with a variety of surgeons and clinics that are renowned for mega sessions such as H&W and Hattingen - Eugenix, Mwamba, and Bisanga are all great options for using BHT . . And there are a few users who are pretty shit hot for advice when it comes to SMP, more specifically SMP for density, is what you need to focus on. 
 

In regards to your original Dr, it’s worth hearing his two cents, and overall analysis on your case - FWIW I think his response to you on here was pretty out of order as it came across as a post purely focused on self preservation, flipping it on the head as though he was the victim here at the expense of you and other posters trying to ‘scorn’ his reputation - which if you read back through the thread, was absolutely not, and has not been the case. 

I don’t know much about his work, as I’ve never seen a patient posted thread of his on here (not that I’ve looked), the only thing I can recall is a recent video where he advised against restoring temple points, which is an area of surgery I’d fully expect a world class doctor to be capable of doing. 

  • Like 6
  • Thanks 1
Link to comment
Share on other sites

3 hours ago, elicochin said:

@Gatsby, as I can see from your profile/postings you have a good understanding and experience with SMP. In my case even if I do another HT down the road to fix the current HT shortcomings, I still need to find a temporary solution to bridge the time-gap so that I can go out without a hat/cap. One of the options I am considering is to go back to my old shaved/trimmed look with the help of some SMP touch-ups. While SMP on the donor scar is an easier decision, SMP touch-ups on other areas is hard to decide because SMP may not be as temporary as advertised, based on some cases I have seen here. I would love to hear your thoughts.

SMP would not be a good solution for this. Even though it begins to fade over several years it will still stay with you. More importantly you would have to wait at a ‘minimum’ of a year between surgeries for any scar to heal (preferably longer). Scars are unstable in the healing process and SMP in the scar can change color or migrate as the scar heals. 

  • Like 3
Link to comment
Share on other sites

I hear you @Gasthoererand @Curious25about needing more grafts than 500-1000.

It is interesting seeing the wide variation in the amount of grafts surgeons use to recreate certain areas.

 am reflecting on the many examples I have seen on this forum in which the front and midscalp were successfully recreated with 3200-4000 grafts.

Some of these include @Wandererind , @juanjs84(he had 5150, however I think 1,500 went toward the crown), @Siyork89 , @MrClean58 , @paddyirishman

I know that there are a lot of factors at play in results including head size, hair caliber, scalp/hair color contrast. I am not sure why the OPs results with ~3,000 look not close to the examples above. You might say that hair quality and caliber played a role, however, I am not so sure as paddyirishman had very fine hair as well. 

Perhaps the others were FUE in which they were able to cherry pick grafts with more hair?

 

 

  • Like 1
Link to comment
Share on other sites

hi, as we talk about number of grafts, each and every clinic i had a consultation with, prior told me that i would be needing around 4800 to 5500 grafts.i was doubtful and surprised when eugenix told me that 4000 grafts would be sufficient! maybe it depends on the surgeon and how they create a hairline! mine was 4072 with 468 going to temples alone!

 

  • Like 4
Link to comment
Share on other sites

 

49 minutes ago, Wandererind said:

hi, as we talk about number of grafts, each and every clinic i had a consultation with, prior told me that i would be needing around 4800 to 5500 grafts.i was doubtful and surprised when eugenix told me that 4000 grafts would be sufficient! maybe it depends on the surgeon and how they create a hairline! mine was 4072 with 468 going to temples alone!

 

Graft estimates are just a general guide to say how much a clinic thinks you need to create sufficient density based on the area needing coverage. But what it can sometimes fail to take into account are individual hair characteristics (thin or thick, straight wavy or curly) and the average number of hairs per graft.

So a patient with thick wavy hair and lots of multiple hair grafts is going to need far less grafts than someone with thin straight hair and mostly singles if they were to cover the exact same area. The specific placement of these individual grafts then is how a surgeon is able to create an "illusion of density" - and obviously some docs are just better at this than others. This is perhaps why you can get such varying estimates. 

This is why its so important to get a consultation in person first where you can be properly evaluated with your expectations moderated. A good clinic will take all these individual variables into account and reliably determine how many grafts are necessary for you to meet your goals (or even tell if youre a suitable candidate in the first place). 

  • Like 5
Link to comment
Share on other sites

  • Administrators

I have spoken to Dr. Lindsey on your case, he did mention saying you would certainly need a second procedure for adding density and coverage. I believe he should be contacting you. Please do keep me updated. 

  • Like 1

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.

 

Link to comment
Share on other sites

     You had a lot of real estate to cover and were always going to need more then 1 surgery to reach your goal. Don’t beat yourself up you’ll still get there. You’ve been given good advice by some of the guys here. The only thing I’ll add is you need to grow your hair out to get coverage! You’re not doing yourself any favors shaving it down at nine months post op when the grafts are still maturing and exposing your scar which healed really good by the way. 

  • Like 2
Link to comment
Share on other sites

On 5/3/2021 at 12:24 PM, Melvin-Moderator said:

I have spoken to Dr. Lindsey on your case, he did mention saying you would certainly need a second procedure for adding density and coverage. I believe he should be contacting you. Please do keep me updated. 

Thank you for your continued support @Melvin-Moderator. I think I met the objectives of starting this thread; I have been given some great advice here. I am grateful for that.

Just to be clear, a second surgery was always part of my plan all along, but it wasn't targeted for the same recipient area though. My plan was to establish a mature hairline and fill the frontal-scalp through an FUT first, and then move on to the back of the scalp with a second FUE surgery. I always knew that the crown was not going to be addressed with my Norwood scale and I was fine with it.

My grievance is mostly on not densely packing the recipient area and needing another surgery to add density, risking damage to the recently transplanted hair, shock-loss and other usual complications. I see many people (even with my Norwood scale) on this forum achieving decent density with just one surgery, and that put them on the driver seat in terms of options. And of course, there are few cases ending up with the prospect of multiple surgeries on the same recipient area to fix the shortcomings of the previous surgery. Unfortunately I am in the latter group and that's a bummer.

Link to comment
Share on other sites

  • Administrators
11 minutes ago, elicochin said:

Thank you for your continued support @Melvin-Moderator. I think I met the objectives of starting this thread; I have been given some great advice here. I am grateful for that.

Just to be clear, a second surgery was always part of my plan all along, but it wasn't targeted for the same recipient area though. My plan was to establish a mature hairline and fill the frontal-scalp through an FUT first, and then move on to the back of the scalp with a second FUE surgery. I always knew that the crown was not going to be addressed with my Norwood scale and I was fine with it.

My grievance is mostly on not densely packing the recipient area and needing another surgery to add density, risking damage to the recently transplanted hair, shock-loss and other usual complications. I see many people (even with my Norwood scale) on this forum achieving decent density with just one surgery, and that put them on the driver seat in terms of options. And of course, there are few cases ending up with the prospect of multiple surgeries on the same recipient area to fix the shortcomings of the previous surgery. Unfortunately I am in the latter group and that's a bummer.

I certainly understand your grievances. Hopefully you can find an amicable solution with Dr. Lindsey, keep the line of communication open. Please let me know if you have any issues. We’re always here to help.

  • Like 1

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.

 

Link to comment
Share on other sites

Posted (edited)

I think it looks ok, but you just need 2 or 3 more surgeries.  What you have had to be spread out otherwise it would have looked pretty silly compressed into the front quarter/third of your head.

You could:

Get Lindsey to continue with the plan, and place another ~2500; or consider H&W to max out the FUT and do some FUE at the same time.  More costly, but might get you where you want to be quicker.

Edited by 1978matt
  • Like 1

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

Link to comment
Share on other sites

Imo on price and graft numbers this patient should consider a clinic like Eugenix who are competent with body hair work. Depending on laxity Hasson/Wong would be my other main consideration.  

If the goal is simply filling the current transplanted area I still wouldn't even consider 2500 grafts viable. To fill that full NW6 area that was a job for 8k+ grafts, even with the crown completely bare this case should have been 5000 grafts to begin with. To add to that, the growth was mediocre, pretty clear from the post-ops that not everything grew. Not terrible and likely straightforward to repair for the right clinic.

Personally, I just think the clinic chosen was the wrong one for this specific case. Anyone with that level of baldness should be looking to the obvious contenders like HnW, Eugenix, ASMED etc. 

For OP, I wouldn't be too concerned about risk of shock loss or damaging grafts etc with a second procedure, its a very normal process for people to undergo multiple surgeries. For your case it would be very much expected no matter the approach.

I wouldn't risk the same mistake of ultra-conservative graft numbers for a second surgery.  You're basically completely bald beyond a few thousand transplanted grafts and there's no reason to be conservative when the goal is to fill that area to the highest degree possible. That area is huge and takes a lot of grafts, there's no getting around that. That doesn't mean it has to be 4-5000 grafts, but the reality is that the best result is going to be from those kinds of graft numbers. Whatever a clinic like HnW would deem to be the maximum number of grafts that can safely be taken I would advocate for. 

  • Like 2
Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...