~2200 Graft FUT with Carlos Wesley, NYC, 7/21/21 2nd Surgery 539 grafts, 7/14/22

[JoeMan]

Have you spoken with the Dr lately? 

[washingtondc]

11 minutes ago, JoeMan said:

 

Well it hasn't been a year yet but I would expect a quality Dr to fix this if at 1 year it still shows little to no progress. Still some time but not much longer and you'll have your answer. He should stand behind his work though. 

Hopefully... I'm not made out of donor grafts either though lol, that's a truly finite resource... And I can't do another FUT because this strip was already too wide to heal normally... And I'll be destroyed if shaving my head is a requirement to fix things...

To the second question, I hadn't talked with him in months, figuring any response was likely to be "you need to wait for 12 months and things will be great" (or that sort of sentiment, which does often hold true), but when I realized yesterday there was virtually no change from months 6 to 7 that I could see, I did email the office.

Edited March 10, 2022 by washingtondc

[JoeMan]

Nothing wrong with staying in touch and expressing you're disappointed. Really by month 10 I think you'll know for sure. Yes the hairs might not be mature by then by I don't think new hair is likely to sprout either. 

[JoeMan]

On 8/5/2021 at 4:34 AM, Dr. Carlos Wesley said:

When you sign on with a team, you sign up for a result.  It's our commitment to get him there even if it takes an extra step. 

This is from your Dr. I'd assume he will still ask you to wait but it's a pretty strong statement. 

[hairbackpls1]

On 3/11/2022 at 2:32 AM, washingtondc said:

Hopefully... I'm not made out of donor grafts either though lol, that's a truly finite resource... And I can't do another FUT because this strip was already too wide to heal normally... And I'll be destroyed if shaving my head is a requirement to fix things...

To the second question, I hadn't talked with him in months, figuring any response was likely to be "you need to wait for 12 months and things will be great" (or that sort of sentiment, which does often hold true), but when I realized yesterday there was virtually no change from months 6 to 7 that I could see, I did email the office.

any follow ups? curious how the Dr. handled your email

[SeanT1]

In the same boat as you, at 7 months my hair seems thin, it looks similar to yours actually.
Going to follow your progress.
Feel free to check out mine for reference.
Everyone keeps saying that the hairs will thicken so let's have faith!

[Rolo]

Hi  i wonder how your 8 month results look?   I am at 5 weeks with same dr and also concerned about low coverage although its way too early to tell.  I also undergoing some shock loss 

[Rolo]

I am 7 weeks now and believe i have the same issue as here, from the beginning i didn't feel the front was filled in enough.  However, it is way too early to complain and i can do nothing but wait it out.   I would like to see more photos, if there has been a change, please post updated photos, will be encouraging.

[washingtondc]

I wanted to pop in to update (no photos this time but will post soon).

Things have improved marginally since my last photos (mostly maybe I think just due to hairs getting longer and creating increased shadow on the scalp?) but not in a crazy-significant way or anything. In some lighting, I'm incredibly happy with how I look, but in many environments, like being at work or even just in stores or that sort of thing, I realize what things actually look like. I become aware of when a light source is overhead and futilely try to move to somewhere where it's not overhead, haha.

I have a follow-up procedure scheduled for July to repair the scarred area in the back and to add a bit of density to the front. I'm optimistic that this second one is going to put things in a place that earns a huge thumbs up.

[Hairdom]

Looking forward to your update

[Melvin- Admin]

Look forward to seeing your progress and updates. 

[Vann]

I am a little late to this... but you have light contrast so youll probably going to get hit by the lights early on. But once you hit your full year. I think youll have a great result. When you get the density packed in youll definitely be happy to put everything you went through earlier behind you.

Best of luck to you. Hope your mental health is getting back, stay strong with the previous breakup that can definitely escalate things. Most of all just look forward to the updates to see yourself from 'month x' to 'month x'... to present

[washingtondc]

Updating again as I'm now beyond 11 months, just a few weeks away from a year. Unfortunately, as I was kind of suspecting, those last photos I had posted at month 6/7 were pretty much it in terms of growth. Here are a few pictures from just now.

This is in soft, diffused light coming from above, but not very close, or even directly overhead or anything. Very standard lighting for life.

I wish I could say this is what I had fully envisioned for one year haha. It seemed kind of clear immediately following the surgery that the hairline density was going to wind up as sort of a see-through/awkward strip compared to my existing hair. I appreciate the people who didn't just bat away my assessment with "you don't know what you're talking about, wait for a year" and who were actually honest and straight with me.

That said, in low light conditions and at night, it looks very good. I'm just not nocturnal haha. My hairline is obviously a little lower than it was, which was the goal; it just looks... strange in a lot of very common environments.

The good news is that Dr. Wesley is doing a touch-up procedure to repair the scar from my original donor and to add density to the front. I will have to shave portions of the hair I've been growing for three-plus years to do it (it's a long-hair FUE since all my scalp laxity was used up in the first procedure), which I was really, really hoping to not have to do, but I just don't have any other options at this point. I'm hoping he can at least distribute the shaved patches so they're as numerous and small as possible to minimize the size of bald spots on the back of my head.

The procedure is July 14th. I was really hoping to not have to do this whole process of healing and hiding more than once, but maybe I should just be grateful that it's possible at all. Things can't always go the way you'd choose.

I'm thoroughly optimistic that this second procedure is going to add density to a good level and result in an appearance that's natural both now and down the road. I have faith in Dr. Wesley and expect that I'll be over the moon this time next year.

Im not sure what protocol is, should I just continue this thread for the second procedure? Or should I start a new one? Thanks again to this community for your knowledge and guidance.

Edited June 30, 2022 by washingtondc

[Vann]

2 minutes ago, washingtondc said:

Updating again as I'm now beyond 11 months, just a few weeks away from a year. Unfortunately, as I was kind of suspecting, those last photos I had posted at month 6/7 were pretty much it in terms of growth. Here are a few pictures from just now.

This is in soft, diffused light coming from above, but not very close, or even directly overhead or anything. Very standard lighting for life.

I wish I could say this is what I had fully envisioned for one year haha. It seemed kind of clear immediately following the surgery that the hairline density was going to wind up as sort of a see-through/awkward strip compared to my existing hair. I appreciate the people who didn't just bat away my assessment with "you don't know what you're talking about, wait for a year" and who were actually honest and straight with me.

That said, in low light conditions and at night, it looks very good. I'm just not nocturnal haha. My hairline is obviously a little lower than it was, which was the goal; it just looks... strange in a lot of very common environments.

The good news is that Dr. Wesley is doing a touch-up procedure to repair the scar from my original donor and to add density to the front. I will have to shave portions of the hair I've been growing for three-plus years to do it (it's a long-hair FUE since all my scalp laxity was used up in the first procedure), which I was really, really hoping to not have to do, but I just don't have any other options at this point. I'm hoping he can at least distribute the shaved patches so they're as numerous and small as possible to minimize the size of bald spots on the back of my head.

The procedure is July 14th. I was really hoping to not have to do this whole process of healing and hiding more than once, but maybe I should just be grateful that it's possible at all. Things can't always go the way you'd choose.

I'm thoroughly optimistic that this second procedure is going to add density to a good level and result in an appearance that's natural both now and down the road. I have faith in Dr. Wesley and expect that I'll be over the moon this time next year.

Im not sure what protocol is, should I just continue this thread for the second procedure? Or should I start a new one? Thanks again to this community for you knowledge and guidance.

Hey man thanks for the update. Long hair FUE would almost be as similar to normal FUE just that if your hair doesn’t shed you’ll still have that look. But I’m guessing you won’t have to do a full shave if that’s what you meant?

also if you have beard grafts Ive been seeing people ‘regrow’ their donor that way instead of adding scalp back into the donor. I wish you best in the upcoming 2 weeks to follow and hope you truly get some awesome results! I’m glad you’re getting a touch up (free hopefully).

[washingtondc]

40 minutes ago, Vann said:

Hey man thanks for the update. Long hair FUE would almost be as similar to normal FUE just that if your hair doesn’t shed you’ll still have that look. But I’m guessing you won’t have to do a full shave if that’s what you meant?

also if you have beard grafts Ive been seeing people ‘regrow’ their donor that way instead of adding scalp back into the donor. I wish you best in the upcoming 2 weeks to follow and hope you truly get some awesome results! I’m glad you’re getting a touch up (free hopefully).

Thanks. Yes, the way Dr. Wesley initially described it to me, he'll have to shave a number of spots the size of a finger/thumb, and the grafts will come from there. I sent an email a while back asking if he could do a greater number of smaller spots to limit the total impact, and the office responded in a way that made it seem like he was on board with that plan. Since my hair is long, I don't think they'll be visible or anything, but it's obviously going to affect the actual volume of hair and is the sort of thing where the back/sides won't return to a more natural situation compared to everything else until at least like... mid 2024 or 2025 or something.

Also, to make sure this one-year result is totally represented, I'll also add some photos soon of what it looks like in lower-light situations. As I mentioned, in low lighting, I am happy with how it looks. There are just a few too many common environments right now where it looks strange. Also contributing right now is the fact that these one-year grafts are at a very awkward length compared to the rest of the hair and stick up crazily all over the place, which obviously time should help with.

Edit:

In a room with the lights off:

 

Inside of my car, in the bottom level of a parking garage:

Edited June 30, 2022 by washingtondc

[Vann]

1 hour ago, washingtondc said:

Thanks. Yes, the way Dr. Wesley initially described it to me, he'll have to shave a number of spots the size of a finger/thumb, and the grafts will come from there. I sent an email a while back asking if he could do a greater number of smaller spots to limit the total impact, and the office responded in a way that made it seem like he was on board with that plan. Since my hair is long, I don't think they'll be visible or anything, but it's obviously going to affect the actual volume of hair and is the sort of thing where the back/sides won't return to a more natural situation compared to everything else until at least like... mid 2024 or 2025 or something.

Also, to make sure this one-year result is totally represented, I'll also add some photos soon of what it looks like in lower-light situations. As I mentioned, in low lighting, I am happy with how it looks. There are just a few too many common environments right now where it looks strange. Also contributing right now is the fact that these one-year grafts are at a very awkward length compared to the rest of the hair and stick up crazily all over the place, which obviously time should help with.

Edit:

In a room with the lights off:

 

Inside of my car, in the bottom level of a parking garage:

I agree with your statement. You also should take into consideration that you have light contrast and you had hair implanted in an area where there was no hair at the front. With the added density to that area I think you’ll get more coverage that you should’ve got maybe the first time around. But since you have your hair long that could also be an issue since the lengths don’t match up right away. I am very excited for you man. I know it’s a bummer but remember it’s better to add more then having to remove.

[jjsrader]

I'm surprised you wear your hair at such length as you will continue to lose hair and are relatively young.  Considering how fine your hair is combined with deep recession in the temples & frontal hair loss - in my opinion it exacerbates the 'thinning' look of someone with long hair & visually the 'dis-connect' between the zones of thinning/transplant hair vs more healthy normal density sides & back.

The reason I bring it up is I have grown out my hair long at times (after many transplants) & it took 100% perfect styling & lighting at a length of about 20 inches & then I had to hope everything would 'hold.'

I surveyed a bunch of random people asking them long hair vs short hair & nearly all said short hair improved my overall appearance & made the contrast of my frontal hairline/frontal hairline 'zone' less of an issue w/my surrounding hair.

That was disappointing because I like long hair but finally gave up the ghost. 

Edited June 30, 2022 by jjsrader

[Vann]

18 minutes ago, jjsrader said:

I'm surprised you wear your hair at such length as you will continue to lose hair and are relatively young.  Considering how fine your hair is combined with deep recession in the temples & frontal hair loss - in my opinion it exacerbates the 'thinning' look of someone with long hair & visually the 'dis-connect' between the zones of thinning/transplant hair vs more healthy normal density sides & back.

The reason I bring it up is I have grown out my hair long at times (after many transplants) & it took 100% perfect styling & lighting at a length of about 20 inches & then I had to hope everything would 'hold.'

I surveyed a bunch of random people asking them long hair vs short hair & nearly all said short hair improved my overall appearance & made the contrast of my frontal hairline/frontal hairline 'zone' less of an issue w/my surrounding hair.

That was disappointing because I like long hair but finally gave up the ghost. 

I can relate to this but fortunately my hair is on the curly end so it looks better long. 

For me it was extremely hard to swallow letting go and accepting my hair loss was happening… especially early on. But, once I did it’s honestly so effing refreshing to not have to think twice about it. I usually recommend people to shave their head and see what they look like. Whether bad/good it’s something we must accept at some point. For me I wish I accepted that earlier. 
 

however, OP also mentioned he has been growing his hair out that way for some time so it could be that it’s something he is just naturally accustomed to. 

[Melvin- Admin]

I’m sorry to hear you’re not happy, but happy to see Dr. Wesley is doing a touch-up. I believe with your fine hair caliber a second procedure for density may have been inevitable. Please continue your journey on this thread. Look forward to your updates. 

[washingtondc]

4 hours ago, Melvin- Moderator said:

I’m sorry to hear you’re not happy, but happy to see Dr. Wesley is doing a touch-up. I believe with your fine hair caliber a second procedure for density may have been inevitable. Please continue your journey on this thread. Look forward to your updates. 

Haha if you were thinking a second procedure was maybe inevitable based off of caliber in pictures, it would have been nice to hear that back when I was initially expressing concern about the density. Honesty/transparency lead to credibility; the opposite, not so much. Just some purely friendly unsolicited advice.

Also, I wouldn't fully say I'm not happy. It's an improvement in many ways. It just looks wonky in a lot of situations and to me isn't quite on the level of the appearance of most of the post-op photos I've seen from the office.

Regardless, I'm trying to just be positive about the fact that this is possible at all (whether it needs to be done once or twice), and I'm thoroughly optimistic that the second pass is going to leave things great.

Edit: I wanted to leave one other thing that I think is worth noting. I think it looks slightly better in person/viewed with eyes than it does in photos. It seems like the camera/software accentuates the gaps in photos beyond how they actually appear to the human eye. If I compare a photo I've just taken to the mirror, what's in the mirror looks better to me. So in truth I'd say it looks slightly better than the photos indicate, just figured that was worth tossing out there.

Edited July 1, 2022 by washingtondc

[Rolo]

Hi I am female and now at 4.5 months and operated by Wesley and believe I have same situated; my concern was always center front hairline and temple areas.  The temples have or are seeming to grow it nicely but the front center seems a bit like yours; I actually had expressed concern at the time that they didn't do enough grafts in that area.  I had 1800 grafts.  My hair is otherwise thick and coarse.   I really hope I don't require a second procedure, not sure I would do it at my age, but although it does seem better and I am not so obsessed as before about it, I suppose I had expected more results in that area.  Hopefully it is too soon but lets see.

When is your next operation?

[BigMike27]

washingtondc, let us know how things went since your proc was yesterday i believe?

You had 2,200 grafts i believe so maybe another 800 or so in the initial procedure might have given additional thickness?  Just looking for some experienced folks to chime in - although Melvin I just re read your post talking about his fine hair making a second procedure almost inevitable. 

Is this a common issue for this Dr.? His work looks really good in other cases i have seen. 

Wishing you all the best WashDC! 

Thanks!

Edited July 16, 2022 by BigMike27

[John1991]

It's a hard sell to say that two procedures were "inevitable" for this guy.  He didn't have that much loss, fine hair or not.  There are plenty of examples of guys with more loss than that that have good density after one go around.  That said, like "BigMike27" said, another 700-800 grafts should accomplish the goal.  It's really crappy you have to go through the hiding and waiting again, but at least you weren't butchered and at least now the second procedure has been done and you're going to be getting closer day by day to the result you should've gotten the first time.  Wishing you the best bro!

Edited July 16, 2022 by John1991

[washingtondc]

Hi all, thanks for the positivity.

My round two procedure was two days ago, and went pretty well. I wanted to update with final pre-op photos before I get into where things are now. These are from the night before the second procedure.

 

 

 

That's in bathroom lighting.
 

The initial reason for this second procedure was to repair the gapped portion of scar that was unable to be sutured back together normally after the first (FUT) procedure. That area has been healing over the course of the year and essentially just looks like a widened portion of the scar now, like this:

 

 

Zoomed out shot for better scale. It's not too big, but still a somewhat significant gap in terms of a spot with no hair growing (to the right edge of this picture):

 

So the idea for this second procedure was to fill this gap area in the back with grafts, and also add density to the front to eliminate the areas from the first procedure that are see-through to the scalp. All of my scalp laxity was used up in the first procedure, so that meant that this one had to be a long-hair FUE. That entails shaving some spots on the back/sides of the head to harvest grafts from, filling the circular portion of the existing scar with grafts, covering those grafts with a special glue to make sure they stay in place, and then using the remaining grafts to address the density in the front.

This procedure itself was shorter and easier. I got there at noon, had a lower level of sedation than the previous one, and it took about 4 hours in total. Procedure itself was quite easy and close to painless. Photos of the portion of scalp that had to be shaved to harvest grafts:

It's tough to have to shave spots into ~3 years of growth like this, but it's the only way to do this second procedure to touch things up. Many surgeons require the entire head shaved, which is why I went with Dr. Wesley in the first place, because that's not a requirement at his office. The patches are situated in spots that make it so they aren't visible unless the hair is moved around. Shaving that much out definitely reduced the total volume of hair coming off of my head in a not-insignificant way, and it will be probably 2 years or so from now until those portions are back to looking relatively close to how they were, but this was my only course of action. Needing a second procedure and having no more scalp laxity left this as the only way forward. It will be slightly strange for a year probably, and then less noticeable to me for the second year, and then gradually back to how it was, hopefully. The whole idea here is improving things for the long term, and I'm totally confident I'll feel it was the right decision a few years down the road.

The total number of grafts harvested was 539, overwhelmingly doubles:

Singles - 31

Doubles - 474

Triples - 34

That comes out to 1081 total hairs by my math. Dr. Wesley mentioned that the scar gap portion had healed a little better over this past year than he had hoped, meaning it was smaller in size than he was thinking it would be, and would require fewer grafts to repair. I forget offhand how many exactly were needed to repair the scar portion, I think it was 65-85 but will try to get the exact number. This left the remainder (450-475) to be used to address the front density. They were placed primarily in an arch shape in the region where my hairline had been lowered in the initial procedure, just behind the hairline to hopefully fill in that swath of lesser density. It's kind of hard to see the graft placement because they all went into areas of existing hair, but these are photos from the day after the procedure:

A plus to having all the grafts placed where there's already hair is that the scabbing/redness is better hidden, but I'll also highlight the fact that the scabbing is really very minimal in general, those photos look pretty amazing to me for being literally the day after the procedure. I'd bet I'll be able to be out in public with absolutely no one the wiser as soon as I hit about 10 days in when I'm able to fully wash all of my hair normally, the scabbing is so minimal and it seems like many of the grafts even have no scab at all.

I came home yesterday after my morning-after follow-up to remove bandages and check on things. After my initial procedure last year, my hair had been a little bit tangled and knotted in a few places, and it took some work and some trimming some knots out to fix, which was understandable as my hair is long and can tangle easily. This time, it was far worse. Like, not just knots, somehow so tangled near the bottom that it formed essentially a solid mass. I'm still trying to envision how it even would have happened to the extent that it did, it took hours with multiple people with conditioner/oils/tools/scissors to try to fix it at all, and in the end, most had to be cut off. I'm grateful that it's even possible to do an HT procedure with long hair, but it was a little demoralizing to have to chop off even more hair on top of what was actually necessary.

In terms of the density in the front, it's hard to tell as always at this early stage, but it looks far better to me with these added grafts. I definitely don't have the same sense of "This looks significantly less dense than the pre-existing hair behind it" like I did after the first go-round. The stubs are kind of acting like SMP at the moment before they fall out, making the overall scalp seem darker, and I'm quite optimistic that once they grow back and longer they'll be at a density that looks natural and full. I logged in today to see a couple people estimating I'd need 7-800 grafts to correctly fill in the front; in reality I added 450-475, so I'm hoping and trusting there's a reason you guys have whatever job you actually have and aren't experts or HT surgeons and what I have is enough, lol.

Final set of pictures from this morning, two days post-op, after my first (very careful) soak/wash:

 

Crazy how little scabbing there is. I'll update this periodically, though since all of the hair is going to be growing in places where there's already hair, I have a feeling the results are going to be a little harder to see on a gradual basis as they would if the hair was growing in unoccupied space. It will probably just get gradually darker/fuller looking, I'd think. 

[BigMike27]

Great update WDC! Looks really good to me, and as you mentioned, Wesley doesn't require the recipient area to be shaved so this should blend in nicely (and a lot sooner) for you.  Any comments from him about the front and density from the first procedure?   Think this is going to look really good in a few months time!