Worried my procedure failed.

[Crown1000]

I am currently entering month 8 of a 1,100 FUT surgery for a crown procedure. At this point there is no new growth, I took tons of before pics and have been taking photos monthly. I went to a respected doctor and am meticulous about my after care. I use rogain foam 2 times a day, take biotin as well as Saw Palmento. I do not take Propecia due to side effects. I am beyond disappointed at this point in the journey. I do not want to throw the doctor under the bus as I respect his work. Though that may change if nothing grows as the cost was large and the time spent and effort was difficult. Please advise? I am not new to the hair tranplants as this is not a first procedure. I have seen most forums state that most hair should be showing up or at least beginning to thicken by month 8. 

Edited February 2, 2022 by Crown1000

[Berba11]

Without photos there's not much anyone can do for you. Can you upload some before photos, photos of the work (ideally the ones the clinic took) and some monthly progress photos including recent ones so we can see where you started, what was done and how things have developed? Cheers

[Crown1000]

Will do. Thanks, hope you can give me some feedback. 

[ciaus]

1100 is not that large of a procedure, especially for the crown, but you should be seeing some growth by now. 

Saw Palmetto is an extremely weak DHT inhibitor compared to Propecia/Finasteride. Not worth taking really. And as long as you eat a decent diet you don't need to take Biotin supplements. And it doesn't inhibit DHT at all. 

If you're continuing to lose existing hair because of DHT that could explain why your crown area doesn't appear to be gaining hair. Especially if you still have a decent amount of existing hair, which I assume you do since you are getting a procedure so relatively small.

Before/ after/ current pics will help.

[HappyMan2021]

Month 8 is more than enough time to judge. Amazing late-bloomers do exist....but these are the exception, not the rule. I am sorry but if you are unhappy with the result now I don't think this will change. 

19 minutes ago, Crown1000 said:

I do not want to throw the doctor under the bus as I respect his work.

you can certainly respect the doctor as a human and medical professional, but there is no reason to respect his work if you are unhappy with it. 

[Melvin- Admin]

What did you hair look like before?

[AlexMeister21]

I feel like you should have a good idea of how the procedure is going to turn out by month 8 and it does look like the density is just not there. 1,100 grafts seems low for that crown coverage though. You should speak with your surgeon.

[HappyMan2021]

I will say grafts in the crown can take much longer to develop than the front due to less blood supply, but even so by Month 8 you should be able to tell somewhat of the end-result. 

I agree 1000 grafts is less than what's needed for full-coverage. I would imagine 2500 total would have been more appropriate. 

Did you doctor specifically tell you beforehand what the end-result would look like? Perhaps he truly did just intend for an improvement but not perfection. 

Can you share how old you are? Many doctors are hesitant to 100% fill-in the crown for younger guys because there is so much time left for the crown to recede. 

Naming the doctor and clinic would be helpful as well. 

Thanks. 

[Gatsby]

You stated that this is not your first procedure. How long ago was your previous procedure? Have you considered trying topical finasteride? Do you have a pre and immediate post photo of your surgery in the crown? It would be great if we could see where those grafts were placed.

[Crown1000]

Thanks for the feedback guys. I don't have those photos on my phone but can grab them from my wife when she is home. I am 43 years old. I wasn't aware there is such a thing as topical finasteride? Is that more potent than rogain? I had a small procedure at 36 for only 500 grafts for the crown as well. I don't want to name the doc and such until the entire year plays out. I figure that is at least fair. I certainly wasn't expecting full coverage but did expect some growth. 

[ciaus]

 

1 hour ago, Crown1000 said:

Thanks for the feedback guys. I don't have those photos on my phone but can grab them from my wife when she is home. I am 43 years old. I wasn't aware there is such a thing as topical finasteride? Is that more potent than rogain? I had a small procedure at 36 for only 500 grafts for the crown as well. I don't want to name the doc and such until the entire year plays out. I figure that is at least fair. I certainly wasn't expecting full coverage but did expect some growth. 

 

The time order of your pictures is not clear. Numbered them below to help clarify. What's the order?

 

Edited February 3, 2022 by ciaus

[Gokuhairline]

you have to name the dr....its about helping others as well.

[ciaus]

I received your private message about the time order of the pictures. Posting an updated layout below based on that for everyone to see and be able to comment. You'd already healed pretty well by the time the #2 pic was taken so I can't really tell where he put the grafts. Did the doctor take any pictures right after the procedure they can email you? Again 1500 is a relatively small procedure anywhere on the head, particularly in the crown area. Because of the way hair is angled and layered in the crown area it takes more grafts to get good coverage compared with other parts of your head. 

In your original post you say that you still see no new growth. But looking at #3 compared to the others, at 8 months you do appear to have somewhat better, though still inadequate, coverage. What was your goal with this procedure? To just thicken the crown a bit or fully restore it? Any chance the doctor wasn't clear on your expectations?

 

 

 

[Rahal Hair Transplant]

Ciaus,

I totally understand your concerns. Based on the photos in your last post however, it looks like you did experience growth. I’m not suggesting that its ideal by far however, 1100 grafts in such a large  balding area (especially an area such as the crown that is considered the black hole because it takes a large number of grafts to make any real difference) is not going to produce a significant cosmetic improvement.  It’s simply not. Now, I don’t know who your surgeon was but based on the photos, it doesn’t really look like the grafts were placed in a natural whorl pattern which is how hair grows in the crown naturally and this might be part of the problem.

I suggest speaking to your surgeon about your concerns and seeing what they say. You still have several months left to experience the final result however, I wouldn’t expect to see a significant cosmetic difference given how much hair loss you’re experiencing in the crown.

best wishes,

Rahal Hair Transplant 

[AB2000]

My understanding is that growth in the crown is slow going compared to other parts of the head.  As in, it might take the 12 month mark before they begin sprouting in a significant amount.  You are on month eight.

As RHT mentioned above, 1.1k grafts are not very much for such an area, either.  Patients can sink a lot of donor hair into the crown before getting appreciable results.  That's why in some cases it's best not to bother.

[LaserCaps]

A few things to consider.  Hair in the front grows forward at an angle.  The hair in the mid-scalp grows the same way and provides the shingling effect.  In the crown, however, we all share the whirl.  It is the weakest point for everyone.  Hair grown from the point outwards.  (There is no shingling as there is no hair coming into the area).  Let me give you an example,

Draw a dot on a piece of paper.  Draw a cross intersecting that point.  Imagine that's the result of a procedure in the crown.  Now, put your finger on the dot and turn the paper, (rotate a bit either up or down). Draw another cross.  Continue doing this several times.  It would take a ton of lines, (procedures), to achieve any type of density.  We refer to this area as a sphere.  It can eat a lot of grafts.  Considering the donor is limited, if you use all your grafts in the crown, you will not have enough to address the front if that ever became necessary.  At that point you'll be asking "why did you put all the grafts in the crown? Now I have nothing to cover the front - which is what others see when they interact with you. 

A much better plan is to get on as many modalities as you can and give them a year.  It does take that time period to confirm what exactly they'll accomplish.  If you are happy with what you have in the front, and the meds are helping you with retention, it is then prudent to start adding some density in that area.  But you could consider something else.

We refer to the horizontal part of the head as the front and top.  You can go back as far as you can horizontally on the pattern to minimize the size of the crown.  If the doctor works in a circular fashion, the area will still look natural. Even if the pattern expands, (and you dip into the donor), you would still be OK.  Something to consider.