M36 | Dr. Bruno Pinto | 1716 grafts | 17 May 2022

[Gatsby]

@Harry Bosch for under four months your results are looking excellent. Being on oral minoxidil will go a long way. All the best!

[Harry Bosch]

On 7/20/2022 at 9:20 PM, Harry Bosch said:

Alright fam. Moral support time.

This is my update at 2 months (9 weeks).  I think I’ve shed or outright lost native hair since my last update at 7.5 weeks.

Understand that this is the absolute nadir in the ugly duckling phase, and I’ll stay here for at least another month.  You have to go backwards to go forwards.  Hopefully the experts and veterans have some positive feedback.

Attached are multiple pictures from multiple angles during dusk.  Good lighting but not super intense.  I also added one comparative picture from the pre-op / post-shave that clarifies my conclusion that some shock loss (or native AA progression) has occurred.

 

Here is my update at 4 months.

Meds:

Finasteride = 1.25mg/day

Oral Minoxidil = 5mg/day

 

Overall, there has been a slight improvement.  I was of course hoping to be as far along as Pinto patients @JDEE0 and @Falconary at the same stage in their timelines, but alas we aren’t there.  The hairline is not yet resembling the homogenous (admittedly aggressive) surgical design of Dr. Pinto.  At minimum, I’d like to see those two large gaps in the frontal forelock start to fill in a bit.

Interestingly, I have that two-face Dr. Jekyl / Mr. Hyde dynamic going.  One side has healthier denser hair; the other side (with the greys) remains substantially weaker and translucent under harsher light.  I fear that the fibrosis area that Dr. Pinto discovered might continue to be a wasteland and perhaps we should have done a scalp biopsy to evaluate if there was an underlying medical problem.  Optimistically, perhaps this area is simply destined to come along slower — but by now I’d like to see evidence that it was improving.

Every patient timeline is different and hopefully months 4 and 5 bring about positive cosmetic change.  I feel that I look worse now than I did pre-surgery.  That might be temporary, or it might be indicative of a looming sub-par result.  Like I said, at this point we are just looking for signs that growth is approximating the design.  Hopefully soon.  

 

[Vann]

it can definitely be a mental game when it coems to waiting. I recommend staying strong and waiting for results more so than letting the worrisome thoughts take over. Theres nothing you can do other than let time pass. Dont stress over anything because its already done. 

Whether there was a wasteland or not, it definitely will take time to say whether or not you remember this current feeling once everything kicks in. 

[Harry Bosch]

5 minutes ago, Vann said:

it can definitely be a mental game when it coems to waiting. I recommend staying strong and waiting for results more so than letting the worrisome thoughts take over. Theres nothing you can do other than let time pass. Dont stress over anything because its already done. 

Whether there was a wasteland or not, it definitely will take time to say whether or not you remember this current feeling once everything kicks in. 

100%

I think part of me, understandably, is wishcasting that some of the more educated transplant experts here might be seeing promising signs that I’m missing, or perhaps too biased to see - not uncommon to judge ourselves in less favorable light than objective observers 

[Tiger2050]

I looked worse than I did pre-surgery up until the 6.5 month mark. Very similar case to yours, about a 1000 grafts to improve density in the hairline and slight lowering. I know it’s hard but try not to think about your hair until the 6 month mark. I was driving myself crazy and just buzzed it off around 5 months post surgery and stopped obsessively checking my hair.

[Harry Bosch]

A few more pics of dry hair in outdoor light.

Really hoping that weaker side begins to improve — that was the primary goal of the surgery, to be able to move away from the combover look.  Looking underneath the hood, it’s still awfully concave with some thin wispy hairs existing non-homogeneously.

My expectation was that those front line singles would grow in first and approximate the aesthetic hairline that the surgeon designed.  And then they’d thicken over time as the doubles behind it all grew in.  Was this a wrong assumption ?  Is it feasible I’ll experience new hairs growing into those corners to create the temple closure we wanted?

@therambler @rambo man@Falconary @JDEE0

[BDK081522]

My experience has been that hairs in the immediate front of the hairline have always come in thicker and actually softened around the 6-7 month mark. Could just be my physiology but the hairline always looked less dense and more natural after some 6 months. 

[Harry Bosch]

40 minutes ago, BDK081522 said:

My experience has been that hairs in the immediate front of the hairline have always come in thicker and actually softened around the 6-7 month mark. Could just be my physiology but the hairline always looked less dense and more natural after some 6 months. 

I see.  It’s easy to be misled by testimonials on here that feature faster growers.  Really what I need to hear right now (and believe) is that my current progress and hairline presentation is not predictive of the outcome 

[BDK081522]

You're only at 4 months. The most impressive growth (visual change) typically occurs between month 4-6. You're just entering the noticeable growth phase so I would say that yes what you see right now is not indicative of your final result. Patience is one of the hardest aspects of hair restoration surgery. 

[rambo man]

I was thinking this looked good. To make sure though I went back and looked at your pre op and straight after op photos. I was right I does look good.

the temple points look great in fact they have worked nicely. 
 

your hairline is there. These hairs shed and then only grow back around 3 months so they have probably only just poked out a month ago they look as they should for now and shall get better for you. You need to remember when looking at other peoples that you had very limited grafts and area than what others do. When other people have 3000 grafts then it’s easy to see growth early on and it look much better than it did a few weeks earlier. With yours you won’t see much yourself it shall just gradually get better and better

Your hair is good mate

[FITA]

18 hours ago, Harry Bosch said:

A few more pics of dry hair in outdoor light.

Really hoping that weaker side begins to improve — that was the primary goal of the surgery, to be able to move away from the combover look.  Looking underneath the hood, it’s still awfully concave with some thin wispy hairs existing non-homogeneously.

My expectation was that those front line singles would grow in first and approximate the aesthetic hairline that the surgeon designed.  And then they’d thicken over time as the doubles behind it all grew in.  Was this a wrong assumption ?  Is it feasible I’ll experience new hairs growing into those corners to create the temple closure we wanted?

@therambler @rambo man@Falconary @JDEE0

I’ve just been through your thread and I personally think your results are looking great so far. I think 99% of people on this forum would kill to have even had your pre-op hair, but I definitely see a difference already with the new hairline and temples. I definitely think you’re in a good place for 4 months. By 6 months you’ll be spot on.

How much does Pinto charge per graft? He’s definitely on my radar now, if I can get on this of course..

[Harry Bosch]

4 hours ago, FITA said:

I’ve just been through your thread and I personally think your results are looking great so far. I think 99% of people on this forum would kill to have even had your pre-op hair, but I definitely see a difference already with the new hairline and temples. I definitely think you’re in a good place for 4 months. By 6 months you’ll be spot on.

How much does Pinto charge per graft? He’s definitely on my radar now, if I can get on this of course..

Thanks for the input.  I hope you are right!

At the time of my surgery, he was about $3 euros per graft.

And I agree I’m in a better position than most and was trying to qualify my observations as more curiosity than panic.  No one wants to invest time and money without seeing the desired improvement, and that fibrosis region he discovered has been the looming complication in my mind.  I also still have slight smooth bumps underneath the implanted area on the hairline.  
 

So many variables that determine the outcome, and I enjoy sharing with the group for education, conversation, and of course (selfishly) peace of mind !

[Falconary]

I think it looks really good so far, in about 1-2 month you should notice great progress. I also have one week side, my left side is a bit weaker, but I'm the only one noticing it and it basically because we are much more critical of our own progress and look through everything in great detail. But honestly my first reaction of your new pictures were "wow it looks really good and natural". Look forward to see your progress further on. 

[Harry Bosch]

51 minutes ago, Falconary said:

I think it looks really good so far, in about 1-2 month you should notice great progress. I also have one week side, my left side is a bit weaker, but I'm the only one noticing it and it basically because we are much more critical of our own progress and look through everything in great detail. But honestly my first reaction of your new pictures were "wow it looks really good and natural". Look forward to see your progress further on. 

Thanks brother.

And I think most of us have some weak point.  On my weaker side my hope is to go from this to this:

 

 

[Hairy Henderson]

I like the sharp temple point design.

[Alex94gasp]

I'm still waiting for my turn with Dr. Pinto. Hopping that I can have the appointment in the beginning of next year 

[Iceee222]

On 5/26/2022 at 6:38 AM, JPCF said:

yeah, I know, but I just decided with Dr.Pinto, and when you put something in your mind is hard to take it back. Plus, I'm portuguese and I live in Portugal so I thought it would be easier to go with Pinto or Ferreira, but Ferreira is out of the equation budget wise.

How much more per graft is Ferreira than the other two?

[Hairy Henderson]

23 hours ago, Alex94gasp said:

I'm still waiting for my turn with Dr. Pinto. Hopping that I can have the appointment in the beginning of next year 

What’s the waiting time?

[Harry Bosch]

On 9/21/2022 at 11:02 AM, Calihome1 said:

I like the sharp temple point design.

Hey thank you.  My weaker temple has grown in pretty well.  That, along with my pristine donor, gives me hope a more aesthetic change is coming for my weaker areas on the hairline 

[Alex94gasp]

On 9/22/2022 at 8:17 PM, Calihome1 said:

What’s the waiting time?

8 months

[LatinBald]

On 9/20/2022 at 1:43 PM, Harry Bosch said:

A few more pics of dry hair in outdoor light.

Really hoping that weaker side begins to improve — that was the primary goal of the surgery, to be able to move away from the combover look.  Looking underneath the hood, it’s still awfully concave with some thin wispy hairs existing non-homogeneously.

My expectation was that those front line singles would grow in first and approximate the aesthetic hairline that the surgeon designed.  And then they’d thicken over time as the doubles behind it all grew in.  Was this a wrong assumption ?  Is it feasible I’ll experience new hairs growing into those corners to create the temple closure we wanted?

@therambler @rambo man@Falconary @JDEE0

It look perfect in only 4-5 months (really 1.5 month of evolution).

The best is yet to come in the next 6-8 months.

I envy you.

[Falconary]

Hey man, how is it going?

[Jayson1361]

Updates?? 

[Dillpickle123]

Interesting I too have a grey patch, mine was examined and determined to be a vitiligo patch my skin there is pinker and the hair shafts there are grey and thinner they out 200 grafts in my patch maybe it grows who knows 

[Harry Bosch]

6 Month Update

Hey gang.

Attached some pics at 6 months.  Outdoor lighting, post-shower, damp hair *
 

(*hairline looks a lot better and homogenous when moist; dehydration- which is common with my wavy hair type - makes everything look more sparse)

Overall hard to complain.  My goals were aggressive, and in that sense it’s been a positive change but I’ve got a few weak points.  My thick hair type + loss pattern demanded a lot of density in the recipient area.  Cosmetically, it looks good and responds well to some mild, strategic fiber application (not pictured).

Downstream I will consider a touch-up.  I haven’t yet grown evenly everywhere, notably those two small gaps in my frontal forelock.  And I’m sure I’ll lose some thickness in the front to gradual MPB progression - my left side (stronger side, historically) does look like it’s become a bit more concave than a I prefer.  But these are small critiques, and not worth addressing for some time - hate to endure another shave/ugly duckling. Of course we all become hyper critical and greedy once we’ve taken the HT leap.

Speaking of shave, I know my case was unique with that peninsula of 200 grants that Dr. P implanted into a region affected (we think) by fibrosis.  I can’t really determine how that has grown or impacted the outcome, and I suppose I couldn’t know unless we shaved down again.

I do have a small smooth bump in each temporal region.  Initially we figured this was natural swelling from the dense pack, but Dr. P’s prediction that it will resolve in time has not proved true.  He did assure me it wouldn’t impact the final outcome.  Had anyone else experienced this long-term subtle inflammation (?) in the recipient?

Protocol

1.25mg Fin/day

5 mg Oral Min / day

Nizoral 1% 2-3x / week 

No topicals since the operation.  Had previously used topical Min for a decade, and RU for about a year.  Reluctant to return to the latter given its gray market status, anecdotal evidence,  and complete lack of safety information.

Interested in Pyralitamide.  I’m in that age pocket where TRT is a real option with much-needed physical benefits, but obviously hair safety is important to me. A legit, tested topical AA would be a great adjunct.  I did not respond well to oral Dut (in two limited samples) and hesitate to try the topical, endure a shed, and be able to confidently source it long-term.

Feedback welcome.

Pics below:
 

 

 

Edited November 25, 2022 by Harry Bosch