Regular Member asiako Posted August 22, 2021 Regular Member Share Posted August 22, 2021 (edited) I have my first HT surgery booked in three weeks, and plan on documenting everything in this thread. I've had diffuse thinning since 25. Being on Fin/Min/Stemoxydine/Alfatradiol and Microneedling has improved overall density over the past two years or so. I plan to continue various treatments with an 'overall density' goal, but I would like to focus on my hairline in this first operation. Video of diffuse thinning here (wet hair, strongest overhead lighting): https://imgur.com/a/u6AVaao I'm concentrating on the 'mid forelock' area and aiming for a dense hairline that I can push back with confidence. My biggest worries are shock loss (since I'd like the diffuse hairline filled in) and a natural placement that matches the current direction of my hairs. Next up: the pre-operation session! Dry, Left Side: Dry, Right Side Dry, Pulled Back: Wet hair, mid brightness Wet hair, max brightness Wet hair, overhead lamp Edited August 22, 2021 by asiako Link to comment Share on other sites More sharing options...
Senior Member JDEE0 Posted August 22, 2021 Senior Member Share Posted August 22, 2021 1500 grafts should be a good number to give you a nice strong hair line whilst not going too far back into your existing hair, and Rahal is a good Dr, so I'm sure you'll be happy. As a side note though, although yes it is clear you probably do indeed have some fairly minor thinning throughout the whole top when your hair is wet and under a harsh artificial light, I think it will look great in pretty much every other scenario once your results come in. Unless you're wetting your hair and combing through it under a harsh artificial light, I honestly doubt anyone would ever think your hair is thinning once your new hairline comes in. Even at the pool or beach with wet hair in normal sunlight, with your hair slicked back and a nice strong hairline on display, I don't think the partially visible scalp up top will register in the vast majority of peoples minds as baldness. I would probably just see how the results of my surgery went, and then once results were in (and I was happy with them) I would just keep on with the meds and hold off on any more transplants until they were needed, which will probably be a decent amount of time. 2 Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted August 22, 2021 Senior Member Share Posted August 22, 2021 Dr Rahal is definitely a good choice 👍🏽 1500 grafts should certainly address then areas we can see in your pics. Look forward to seeing your results develop 🙏 1 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted August 23, 2021 Author Regular Member Share Posted August 23, 2021 Thanks both! JDEE0 - totally agree. I figured I should show the 'worst case scenario' to get a real handle on things. If I do progressively diffuse (which I will try my best to avoid) I may have a thicker hairline than anywhere else. What I'm not ready to do quite yet is use those precious grafts all over my scalp. I agree that it won't be very noticeable, even when swimming -- if I get that frontal density. We shall see! Link to comment Share on other sites More sharing options...
Senior Member TorontoMan Posted August 23, 2021 Senior Member Share Posted August 23, 2021 Good conservative approach. Best of luck 1 Link to comment Share on other sites More sharing options...
Senior Member JDEE0 Posted August 23, 2021 Senior Member Share Posted August 23, 2021 Sounds like a good plan to me - just stick with the fin (which it sounds like you've been on for the past 2 years only from your post) and going by the most recent clinical data (and overall life-time data in general) you should be able to hold on to what you have with no issues well into your fifties - most likely 60's even in my opinion - and possibly beyond. Maybe the rest of your days, who knows. If the time ever comes that you need more grafts to address the areas behind your hairline, your donor looks decent judging by the sides of your head and I'm sure you will likely have another 5000-ish grafts or so available left over for the future after only 1500 extractions. You're in a good position, so I say go for it without any hesitations! 1 Link to comment Share on other sites More sharing options...
Regular Member Mark Wolfer Posted August 23, 2021 Regular Member Share Posted August 23, 2021 You have a good head of hair pre-op, you're on the meds and you've given them two years to do what they can do. You've picked a great surgeon and a smart plan. You clearly are a man who has done his homework, I look forward to seeing your results, best wishes on the upcoming surgery. 1 Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted August 26, 2021 Administrators Share Posted August 26, 2021 In my opinion, you should hold off. You don’t have much hair loss at all. You’re better off waiting until your hair loss progresses or try to maintain with meds. Just my opinion, but Rahal is an excellent choice. 1 I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing 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: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Regular Member asiako Posted August 27, 2021 Author Regular Member Share Posted August 27, 2021 (edited) 8 hours ago, Melvin- Moderator said: In my opinion, you should hold off. You don’t have much hair loss at all. You’re better off waiting until your hair loss progresses or try to maintain with meds. Just my opinion, but Rahal is an excellent choice. Thanks for the honest feedback! The truth is my hairline has been like this for almost twenty years. I lost density over the last 5 years, and medication brought much of it back. I'd like to just fill in my hairline-- even if it's fewer than 1500 grafts in the end. The initial consultation was 1000 grafts, so let's see how the pre-op appointment ends up! Edited August 27, 2021 by asiako Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted August 27, 2021 Senior Member Share Posted August 27, 2021 7 hours ago, asiako said: Thanks for the honest feedback! The truth is my hairline has been like this for almost twenty years on the hairline. I lost overall density over the last 5 years, and medication brought much of it back. I'd like to just fill in my hairline-- even if it's fewer than 1500 grafts in the end. The initial consultation was 1000 grafts, so let's see how the pre-op appointment ends up! Yup anywhere between 1000 - 1500 is going to really reinforce your hairline, definitely worth doing IMO. 1 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted September 7, 2021 Author Regular Member Share Posted September 7, 2021 (edited) Completed my initial consultation with Dr Rahal today and I think it went well! He and Sarah touched on all my questions pretty much immediately.. donor density, shock loss, etc. My donor shaft thickness is at '48' (50 being average thickness). Could be thicker, but enough to use for this operation. Fin and min did bring back my overall density + some growth on the hairline,...but he said much of it could be gone due to shock loss-- and if some do make it, hey even better! But he wanted to accommodate so we didn't rely on that. He did quote 1500 initially and increased to 1800 grafts for that 50g/cm density. I had a feeling this might be the case. My hairline is eroded and doesn't really have a shape. The lack of density goes quite far back as you can see in today's photos. He broke it down into four regions where the highest graft count will be up front. He also adjusted the hairline against my uneven skull bones I think the unevenness will help with a natural appearance. I asked if he could use nape hairs at the very front for a softer transition, but he said they tend to die out. But they do aim for the finer hairs lower in the donor area. Edited September 7, 2021 by asiako Link to comment Share on other sites More sharing options...
Regular Member asiako Posted September 10, 2021 Author Regular Member Share Posted September 10, 2021 Post surgery update! Day 0/1/2: Everything went well and the staff made me feel really comfortable. Dr Rahal is very 'to the point', but I like that.. I don't want to feel I'm being sold something, and he offered his suggestions that didn't always result in a higher cost-- which is awesome. The only hitch was that I have scalp eczema. It used to be very bad, and has left scars. That made the numbing injections ineffective, and they had to inject me a LOT. The actual needles were not painful for me, but when you can feel the graft removal... yikes! I should have said something earlier, but they picked up on my wincing. In the end I felt nothing. I think I had more swelling that is typical (at least from what I've seen -Day 1 photo below) but it looks like it went down a lot this morning. I just have a ton of itching, and may try out allergy meds as they suggested. Link to comment Share on other sites More sharing options...
Senior Member Britanium Posted September 10, 2021 Senior Member Share Posted September 10, 2021 Really refined work. That is a very good density that’s been implanted. This is definitely one to follow 👌 1 Link to comment Share on other sites More sharing options...
Senior Member stephcurry30 Posted September 13, 2021 Senior Member Share Posted September 13, 2021 nICE. gOOD LUCK ON THE HEALING PROCESS 1 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted September 25, 2021 Author Regular Member Share Posted September 25, 2021 Two week check-in! I asked about my total grafts available. It was suggested I could have one procedure with 2000 more grafts, and a final with 1000 (before over-harvesting, I think) Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted September 25, 2021 Administrators Share Posted September 25, 2021 This has the makings of another @TorontoMan 2 I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing 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: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Senior Member Curious25 Posted September 25, 2021 Senior Member Share Posted September 25, 2021 11 hours ago, asiako said: . It was suggested I could have one procedure with 2000 more grafts, and a final with 1000 (before over-harvesting, I think) So only 4800 total donor capacity? This seems a very conservative number - unless you’ve already had previous procedures that I’ve failed to pick up on? Nice hairline design by the way, will look forward to seeing how you are in 6 months time 😊 1 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted September 25, 2021 Author Regular Member Share Posted September 25, 2021 2 minutes ago, Curious25 said: So only 4800 total donor capacity? This seems a very conservative number - unless you’ve already had previous procedures that I’ve failed to pick up on? Nice hairline design by the way, will look forward to seeing how you are in 6 months time 😊 Correct! The estimate is 4800 total including this current operation. I was hoping for 7000 tbh. I also noticed with this op that I had more singles/doubles vs. triple/quad grafts than the average I've seen... so I'll have to be conservative going forward. Link to comment Share on other sites More sharing options...
Senior Member Curious25 Posted September 25, 2021 Senior Member Share Posted September 25, 2021 (edited) I’m sure different doctors will give you different opinions - eg in Canada, where you are . . Dr Hasson has shown to be quite a bit more confidently aggressive in his extraction patterns, and is often found to extract from outside a typical NW6 safe zone if he feels confident a patient is unlikely to progress to that level - without knowing your age, but given your limited level of hairloss at what I presume to be over the age of 27, going off the maths from your initial post, you could be one of the ‘safe bets’ in his eyes. What were your pre donor densities? And do you have a decent beard? I’m a big believer that even average donors can yield upwards of 6-8k these days, with the advances in skill level and understanding from FUE surgeons, combine that with a few k beard grafts, and most will live a comfortable full headed life. Check out @Zoomster story for instance - he was turned away from an average at best UK surgeon as not being a candidate a few years ago . . he went to a more skilled and advanced clinic, and has since had over 11k grafts implanted 😂 Edited September 25, 2021 by Curious25 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted September 25, 2021 Author Regular Member Share Posted September 25, 2021 (edited) 45 minutes ago, Curious25 said: I’m sure different doctors will give you different opinions - eg in Canada, where you are . . Dr Hasson has shown to be quite a bit more confidently aggressive in his extraction patterns, and is often found to extract from outside a typical NW6 safe zone if he feels confident a patient is unlikely to progress to that level - without knowing your age, but given your limited level of hairloss at what I presume to be over the age of 27, going off the maths from your initial post, you could be one of the ‘safe bets’ in his eyes. Makes sense! I do think Dr Rahal was being conservative, given my profile. I appreciate that because.. it's easier for a surgeon to aim high and increase profits, right? But we all know the patient will call the shots at the end of the day (within safety measures). I'm 44, but there was some 'later in life' hair loss on my maternal side. I think I've already surpassed that (more hair than expected!) but my plan is to maintain for the next 4 or so years. If things are holding, I will look at another procedure-- possibly with a more aggressive donor plan. I also haven't been on fin/min all that long, so I'm hoping they will remain effective for a while yet. I'm not sure about the per/cm density of my donor area, but was informed my shaft density is 48 (average). I would definitely consider beard grafts for my crown, now that I've defined my hairline for the future. @Zoomster's results are hugely impressive! I would also consider SMP on my donor area, if it allowed for 7-8k grafts. Edited September 25, 2021 by asiako Link to comment Share on other sites More sharing options...
Senior Member Curious25 Posted September 25, 2021 Senior Member Share Posted September 25, 2021 If you are 44, then I would be fairly confident in assuming hair loss is going to be of little concern to you - your pre transplant loss for a man aged 44 was very minimal. Good for you! 1 Link to comment Share on other sites More sharing options...
Senior Member TorontoMan Posted September 25, 2021 Senior Member Share Posted September 25, 2021 Oh I didnt realize you were 44 years old, you def look younger than that. If thats the case you're in a great position, post work looks clean, strap in for the ride. 1 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted November 7, 2021 Author Regular Member Share Posted November 7, 2021 Looks like I didn't post a 1-month update! (2 months as of today, following..) 6 weeks, and then 8 weeks --> Overhead, 2 months --> Link to comment Share on other sites More sharing options...
Senior Member stephcurry30 Posted November 7, 2021 Senior Member Share Posted November 7, 2021 you are now past the ugly duckling stage. Congrats. Happy growing! 1 Link to comment Share on other sites More sharing options...
Regular Member asiako Posted December 17, 2021 Author Regular Member Share Posted December 17, 2021 Three months-ish update! Starting to see some growth of fine hair where there was none before. Pretty happy with progress so far and hope it continues. Link to comment Share on other sites More sharing options...
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