FUE With Dr. Nader on July 12th-13th, 2022 | 3,200-4,000 Grafts | 30M American.

[Trichotrophy]

After nearly a year on this site, I'm almost ready to finally contribute. Two weeks from now, I'll pool in my experiences with Dr. Nader—a doctor I wouldn't be adamant on if I didn't spend most of my prior usership lurking.

What you're most interested in reading are the experiences- and outcome-to-be, and I'll be even more eager to share that when they materialize. All I can detail for now is the lead-up: what's bringing this 30-year-old Wisconsinite to Mexico for his first hair transplant?

Backstory: before the journey

I've acknowledged—but never accepted—my likelihood of male-pattern baldness since my teenagehood. Every patrilineal ancestor I knew went as bald as a cue ball before they could even comb grey hair, and I've known since I knew anything about genetics that it was in my cards.

It became undeniable one chastening day in high school, when I consciously noticed diffuse thinning and even a few bald patchlets. Nothing that's macroscopically discernible to others, but I saw it plainly enough in front of a downlit mirror. I tried chalking up my scalp's visibility to my inch-long-hair, and it might've washed at the time if it weren't for my brother's similar-lengthed yet shaggy hair. He was fortunate enough to inherit movie-star-hair genes from my mother's side of the family, whereas I was forced to acknowledge I had my dad's alopecic DNA.

How did I cope with it? I blotted it out. Just as a teenager doesn't actively imagine ever becoming a middle-ager, I didn't brood over baldness; it was too far away (as regrettably inevitable as it seemed), and I thought I'd embrace it by the time it came—or, more encouragingly, that there'd be some magic-bullet treatment for it in the once-distant future. The future typically isn't even close to what we envision, especially when you're a naively uninformed teenager.

I coped too well for too long, and it came back to bite me. By the time I was independent enough—both legally and financially—to seek proper treatment, I had locked away my hair-loss dread in a mental back-burner. Oh, I wasn't oblivious to my hair loss; I just willingly didn't fret about it enough to actually resolve towards combatting it. I just wallowed in limbo, and it naturally worsened over time.,

By age 21, the light limned my entire scalp; and by 24, I had a mildly but noticeably bald crown. I even had some panicky bouts about this progression. Fast-forward to 27 years of age, and it's bad enough for any able-sighted person to notice.

I needed someone like one of my eventual hairdressers to call out the elephant in the room. Most family, friends, and acquaintances were too polite to comment on it, and some even tried disabusing me of it when I remarked on it. My barber wasn't impolite by any means, but she considered it her duty to give her honest, if hurtful, hairstyle recommendations. And I'm increasingly thankful she gave it that day in 2019.

"It looks good for thinning hair," she said about my buzzcut. "I saw you looking at [your thinning hair]. It's noticeable with long hair because it looks all split."

I hadn't gone a day without thinking about my hair loss since.

Starting my hair restoration

Better late than never, as the adage goes. At age 28, I made my first overt admission to MPB by seeking a finasteride prescription.

The final impetus was during the 2020 lockdown, when there was a moratorium on all inessential services like hair salons. I was unable to follow my barber's buzzcut advice, but I was mindful enough about the rest of her words—that my hair was noticeably thin when grown out. Oh God, that was truer than ever after several more months of balding.

I did my research on all hair-restoration options, which unfortunately didn't include the panacea I fancifully hoped for as a teenager. I started with finasteride in April of 2020 and ultimately expanded it into a synthesis of other medications, supplements, and shampoos.

The entire eventual regimen?

The results?

Yep. I had a heartening progress report on Reddit about that. I was bordered on shaving territory during my nadir, and I only had mild crown balding at the peak of my regrowth.

I've come a long way, indeed. Yet, I still have a long way to go.

Opting for a hair transplant

Why get a hair transplant with such results? Several Redditors, who DMed me for updates in response to my progress report, asked me that after I disclosed my FUE plans. They told me they'd be thrilled to have that density, and I believe them; I initially felt that way myself, and maybe I would've been right to end the journey there. Like all achievements, however, the gratification wears out, and you often start desiring more.

Am I getting greedy? I wouldn't deny it, though I'd ultimately never take the plunge if there wasn't much more to my rationale; I've deliberated it for months and decided it's in my best interest for the following reasons:

1. Reshed periods

Most, if not everyone, here is familiar with the dread shed—a period of homeostatic hair-fall after starting finasteride and/or minoxidil, a necessary step towards thicker regrowth. I've experienced that as well—and repeatedly so in what I call reshedding.

It's because of these resheds that my last progress report might misreflect my current hair. For every few months I relish that density, I undergo another few where I'm barely above baseline. It impossibly regressed as if I dropped my regimen cold-turkey, despite taking all my medications religiously. I even considered seeing an endocrinologist to see if my body was no longer metabolizing the medications for whatever reason.

The first reshed is what prompted me to research hair-transplant surgeons—a project I once happily shelved—and, in turn, join this board: I wasn't sure how much, if any considerable amount, would regrow; as such, I started envisioning an FUE as a contingency plan.

Thankfully it has regrown since, but the vicious cycle has continued. These regressions—however temporary—have all been traumatic enough that I've had to steel myself just to walk past a mirror; I even bought hair fibers as a stopgap for that.

A hair transplant might not stop these autumnlike sheds, but it will improve my baseline; that could make the difference between hair-fiber usage, or comfortably waiting out the resheds.

2. Great but incomplete results

I've come a long way, but not all the way. I've achieved as much as I could've realistically hoped for with my regimen. It densified all my existing hair regions, but it didn't restore my lost ones.

After over a year on the regimen, I safely concluded it wouldn't lower my mildly receded hairline or fill in my crown. I knew deep down even back then I'd have to go under the knife for that, and now I'm finally willing to.

I consider it my penance for letting myself lose so much hair.

3. Disproportionate amount of donor hair

It's common knowledge that hair on our sides—the horseshoe-shaped occipitotemporal region—is naturally denser than that on the top of our head, hence it's used as donor hair. That disparity is still too pronounced in my case, to the point where I must keep my donor areas at least half an inch shorter than my dome's hair.

Rather than shaving or trimming my sides incessantly—which I consider a waste of hair follicles—I'd rather have them transplanted to the top of my head, which is where coverage is needed the most.

In short, I want not just thicker but better-looking hair, and a more even distribution of them is the best answer.

4. Promising maintenance

Ironically, I want a hair transplant in part because my medications have worked so well.

This procedure prudently wasn't my first option, but I always considered it in the back of my head. At the time, however, I wasn't even mentally ready to take plunge; in fact, I found it more likely I'd end up shaving than seeking surgical treatment. The jury was out on whether or not it'd ever become a serious option, and the trial was finasteride's efficacy—whether or not it'd simply halt my hair loss. If it didn't, I'd resign myself to shaving, and you wouldn't see me anywhere on this board.

Now that I know it's successfully stabilizing my balding, I'm much more bullish about this operation. I'd never invest in it if it could only stave off baldness for a few years, not the decade(s) I can realistically expect now.

5. The economies of medical trips

I once joked to others that if I won the lottery, I'd invest into a hair transplant. I seriously thought it was that expensive; it might have been before Dr. Rassman pioneered the FUE technique, but I was ignorant to the procedure's modern efficiency for the same reason I let myself lose so much hair: I didn't even bother to do a smattering of hair-loss research until two years ago.

It still costs a pretty penny, but when doing it in non-American countries? It wouldn't cost much more than a family vacation to Disney World—something many parents manage to save up for because they want it as badly as I want a headful of hair.

Not that I've ever had much wanderlust—quite the contrary, as I've never traveled outside of my country—but medical tourism is too advantageous to forego in my case. Not only does it save me oodles of money; it also expedites the procedure by about year, as waitlists are typically that long for all the local top-end surgeons I've consulted here (e.g., Dr. Konior). If I'm going to have to emplane to meet an earlier-available doctor, I might as well go outside of the country where it's cheaper.

Choosing Dr. Nader

Thankfully I did my due diligence, or I would've wound up at a hit-and-miss hair-mill. I've changed my decision at least a dozen of times as I've refined my parameters for the surgeon hunt, which were one as simplistic as finding cheap surgeons on a once-over Google search. Thanks to this board, I have a keener eye for all the red flags.

I initially vetted Turkey (considered the mecca of hair-transplant clinics), but I ultimately narrowed it down to intracontinental countries for convenience of proximity. Canada certainly has top-end surgeons like H&W, but it'd be counterproductive in that the medical trip wouldn't save me money. Mexico, on the other hand, is nearly as cost-effective as Turkey, and it doesn't entail any extracontinental plane ride.

Using the keyword "Mexico," the search engine brought me to several verified Mexican clinics, most promisingly Dr. Nader's. I researched and consulted him, and now I'm less than two weeks away from meeting him.

What sold me on Luis Nader in the end? I don't mean to recommend him for everyone, and I'm sorry if I sound like I'm shilling; I'm only trying to explain why I consider him my best option and to help exemplify what to look for in your ideal surgeon.

All the right credentials

He's a member of all the recommended hair-restoration societies, such as the ABHRS and ISHRS. I know those memberships in themselves aren't as valuable as actual empirical evidence of their work, but I still used that (or a lack thereof) to decide whether or not to consider Dr. Nader in earnest.

Unimpeachable track record of results

I have yet to find a negative review for him, and I've scoured all hair-loss boards I know—including here and relevant subreddits like Tressless and HairTransplants. No patient I read was dissatisfied with their final results.

Not to suggest his work is infallible; I'm sure there are some disappointing cases, as there are with every surgeon. But he must be doing something right if I didn't find them among the dozens of verified patients I researched.

The pricing scale

The more grafts he uses, the cheaper the total cost is. The options range from 1,000 grafts for ~$4,000 ($4/graft) to 4,000 grafts for $7,400 (a shade under $2/graft).

Because he projects I'll need 3,500-3,800 grafts based on the virtual consultation, it's about as cost-effective as I could expect from any reputable surgeon.

Proper dedication to his patients 

Thanks to this board, I thought to ask about the nitty-gritty about his operation. Knowing what to ask entails knowing common mispractices, which I learned of from here.

For starters, who does most of the surgical work: the doctor, or undertrained technicians? Encouragingly, Dr. Nader answered that he does all the extractions and incisions himself, and his staff only performs clerical tasks (e.g., recording the amount of grafts). It's for that reason, he told me, he only fields one patient a day.

That satisfied my two biggest questions. Unlike the more expedient surgeons, Nader doesn't sell out safer practices for a more profitable rate of patients; he takes as much time as needed to properly focus on each patient, and he doesn't delegate delicate work to unqualified nurses.

I don't pretend to know all the red flags, and I'd imagine more knowledgeable users would've asked more. But I'm confident enough about his clinic to conclude it's not just another hair mill that this board warns us about.

His ethicality

From his self-description on his website and reported interactions with verified patients, I've divined that he genuinely cares about his craft.

He's not just monetarily motivated; he has an intrinsic interest in hair restoration. Having undergone the procedure himself, he can empathize and sympathize with us about hair loss—and that assuredly lends more diligence into his work. He seems to sincerely care about even more about our outcomes than his profits and reputation, and the latter two take care of themselves as such.

——————————————————————————————————————————————————————————————————————

My only major complaint so far is how long it can take for his staff to reply to emails, which seems to be a common experience. Nonresponses to my questions have sometimes gone on for as long as a month, and I would've been discouraged if I hadn't already read other patient reviews: by others' accounts, their office is inundated with thousands of daily emails.

They still ultimately responded to me and satisfactorily answered all my questions, so it'll be a nonissue when it's all said and done. Plus, I'm getting timelier responses now that I'm actually texting Dr. Nader.

My FUE plan

As I told Nader, my hair-restoration goals in order of precedence are:

1. Densifying my mid-scalp further

2. Lowering my hairline

3. Filling in my crown

You may or may not agree with those priorities looking at my current hair density and pattern.

 

It shows a markedly receded hairline (especially from the side angle) and a bald(ing) crown. The mid-scalp density doesn't look so bad, but remember (or, if you haven't yet read it, be advised) my reshed periods (one of which I believe is incubating now) will inevitably take it its toll. I don't expect it to look this good at the time of the appointment; I'm just hoping I won't have regressed to near-baseline levels by then so he can allocate more grafts to my hairline.

During the in-person consultations, he'll determine exactly how many grafts I need. I tentatively broadened my range in the title to 3,200-4,000 in the title because I won't know the exact range; Nader's actual estimation is 3,500-3,800 grafts (judging from photos of my baseline density), but it can wildly vary depending on the aforementioned reshed and the actual trichometry he performs. I'm planning on using 4,000 grafts, and I'm hoping he'll be able to use enough of those to acceptably lower my hairline; if not, I'll probably seek a second transplant just for that purpose, provided I'll have enough donor grafts left.

Preview: the next leg of my journey

Now that I've paid for my flight, I've finalized all the traveling arrangements. I'm set to deplane in McAllen on July 11th and shuttle to my hotel downtown. The doctor himself—in lieu of the usual cabman, who's currently on medical leave—will drive me to and from the clinic on July 12th and 13th, as well as back to the airport on the 14th for my departure home.

I'm naturally anxious about the procedure (as we typically are about unknowable futures). Not that I'm chiefly concerned about the doctor himself, of course; I'm as confident about him as I can be about any surgeon. It's more so my end of the work: the recovery may be even more crucial than the operation itself, and much of it will hinge on my lifestyle. I'll have to sojourn out of my comfort zone as I carefully minimize contact with my scalp will be, which affects how I sleep, bathe, exercise, and even what shirts to wear.

Only time will tell how it all shakes out, but I'm not going to shy away from this medical trip. Ever since I started pushing thirty, I started appreciating how short life is, and I consequently ran out of excuses to delay undertakings like these.

I'm sure this novella-sized thread has more details than you're interested in—especially while the procedure has yet to happen—but hopefully it helps shed light on Dr. Nader and explains where I'm coming from. If nothing else, writing my concerns has helped allay them in ways my internal monologue never would've, whether anyone reads this thoroughly or not.

If you have any other, uncovered questions, feel free to ask ITT. 🙂

Edited June 30, 2022 by Trichotrophy

[MazAB]

Great plan, and very impressed by both your research and daily hair regimen. Best of luck in your transformation!

Follow my Journey with Eugenix and Dr Arika Bansal!

[Trichotrophy]

The big day is almost here. I just checked into Cambria Hotel McAllen Convention Center.

Dr. Nader will cab me to his clinic in Reynosa from here at 7:30 AM tomorrow morning. Whether or not I manage any sleep before then is anyone's guess, but I have comfortable lodging for the night—however sleeplessly or restfully I'll spend it. Not that I expect here, or anywhere, to feel comfortable after the impending procedure.

One last unshaven overhead shot of my scalp.

Unfortunately, a bit of noticeable shedding since I took the OP's photos weeks ago. But I've hopefully nursed enough density that I won't need much more than 3,000 grafts for my desired coverage; I'll find out definitively one way or another during the in-person consultation.

This medical trip feels surreal now. It's actually happening! Intellectually, I've known for many months this would happen, but it didn't dawn on me emotionally until I actually made the travel. On that same level, I'm sure this procedure will be more comfortable than I've expected—but nothing I didn't sign up for. Beautification is painful.

Edited July 12, 2022 by Trichotrophy

[Trichotrophy]

I was improbably well-rested for today's sitting. Instead of turning in early (as I thought I might need to), I'll chronicle in today's journey while it's still fresh in my head.

I'm sure many of you will find some of these details superfluous, so feel free to skim through to find whatever headers and photos pique your interest. The information overload is more to help marshal my thoughts and memories, though I'm hoping someone—especially another prospective patient contemplating Nader—will find the detailed experiences informative; after all, most of them are answers I sought out myself when researching him, and I'd imagine I haven't been the only one searching for them.

The drive

After helping myself to Cambria's voucher-redeemed breakfast, the renowned doctor picked me up at roughly 7:30. It felt outre to finally meet an online-met person—this one a famous doctor—in the real world (outside of online dating); it's a quotidian experience for the overbusy doctor, however, who has patients virtually every day.

We made small talk during the drive, more about our personal lives and families than about the impending procedure. A bit of rapport-building we wouldn't have had as much time for if the usual cabman—currently on medical leave while recovering from the stroke—took me.

I left the USA for the first time in my 30-year-old life as we crossed the border into Mexico, descrying Trump's WIP wall along the way. I didn't have to present my passport to enter; that was only necessary for my post-op return to the States. I saw a procession of pedestrians on the sidewalk entering the USA for their jobs; I'd imagine they're smartly leveraging their USD income for Mexican commodities and services, like I'm doing for my hair transplant. I also learned a smattering of more Spanish seeing every sign unilungually written in that language, and I learned even more (at least common working orders) by osmosis of Nader's dialogue with his staff.

Reynosa looked about as slummy as I expected, but sight was thankfully the extent of my experience; it was a door-to-door transportation wherein I only had to exit the car for Dr. Nader's clinic. Once inside, I was about as comfortable as I could be anywhere else.

Just not yet comfortable enough for the operation.

The consultation: finalizing the plan

After furnishing all the paperwork Brenda requested upon arrival, I entered Dr. Nader's office. We conferred about probably the most important preliminary step: designing and gridding the intended coverage.

And that banished one of my biggest concerns: would he deem it safe to use enough grafts to lower my hairline? It seems acceptably low and natural-looking examining the hairline design, and he's perfectly willing to allocate ~1,300 of my donor grafts for it. I can finally dream of having an aesthetic hairline.

The rest of the estimated grafts (approximately 2,500) are intended to densify my mid-scalp and crown, the latter of which I forgot to take a rearward shot for at the clinic. Not that it's necessary if you're looking at my previous selfies, with my unmistakably bald(ing) vertex.

I had no qualms about the layout; it was only a matter of their implementation and my recovery.

Extractions

This point demarcated planning from doing. At this stage, I was no longer limited to fantasizing the procedure, its good, bad, and ugly; I finally started actually experiencing.

Dr. Nader and his technicians escorted me to his examination room at around 9:15, where he instructed me to lie prone on the patient bench. From there he could optimally harvest out grafts from the donor bank on the back of my head.

As is generally the case for my medical and dental procedures, it was much less painful than expected. Not entirely comfortable, but perfectly bearable. The only pain I had to withstand was a barrage of anesthetic injections on the donor area. On a scale of 1-10, I'd grade the pain as 1-2 (varying depending on the region's sensitivity), so none were particularly hurtful—just that they were numerous.

Once the doctor exhaustively anesthetized my donor bank, he started the actual extractions. The physical contact was about as ignorable as my clothes on my skin; I only heard screwdriver- and scissor-like sounds. If they weren't so close to my ears, you could've convinced me I wasn't the object of it for all I felt.

The only unpleasant aspect was continuously lying facedown on the bench, which I'm not used to. However, Nader was always willing to pause whenever I felt the need to readjust my posture.

This step took about two hours, during which his nurses stored all the extracted grafts into a safe solution. Then they cleaned off the donor site before bandaging it. That all wasn't so bad, as we often tell our kids after their dental appointments.

Intermission and implantations

At around midday, he seated me in the procedural room where he'd perform the actual transplant. While he went out to carefully count my graft-and-follicle count, he allowed me a lunch break. Nothing like the clinic's famous tacos!

I also had my choice of various Netflix movies; I chose Whiplash. By the time I got immersed in the movie (I missed J.K. Simmons' schtick!), Dr. Nader was ready to perform the implantations. He injected another score of anesthetics on my scalp, this time on the recipient sites: the crown, upper-mid-scalp region, and a tuft on my hairline (will explain this aberration below). He made the incisions steadily while his technicians aided him by providing donor grafts, microscopically illuminating my scalp, spraying a saline solution for routine cleaning, and jotting down the report; Nader himself did all the delicate surgical work, and I wouldn't have felt confident otherwise.

This process went on for another 2-3 hours, though I couldn't have felt much comfortable during it. I was reclined in the patient's seat with a neck pillow watching Netflix movies for all of it; I could have even fallen asleep if it were later at night. I only needed him to intermit for my bathroom breaks, or I wouldn't have minded sitting like a statue the entire time.

With all grafts implanted, they cleaned my scalp and unbandaged my donor area.

Day 1 was officially in the books for all practical purposes.

Reports, reviews, and instructions

Nader then escorted me back to his office, sharing this follicular-unit report with me:

UF 1: 144
UF 2: 701
UF 3: 928
UF 4: 143
Total grafts: 1,916

I had an inordinate amount of 3-hair grafts (928). Assuming a successful survival rate, the 1,916-graft yield undermeasures the expected coverage for that reason: I'll get more coverage overall because of more transplanted follicles.

Due to how tricky my crown's cowlick is, Nader decided to use most of my 3- and 4-hair grafts on the vertex and upper-mid scalp regions. The relatively scarce amount of 1-hair grafts were used on an isolated patch of my hairline because he wants to earmark most of such UFs for it: if he were to use too many multi-hair grafts on my hairline, it would look pluggy.

As the report detailed, he compartmentalized the intended coverage in five zones:

Zone 0: Hairline

Zone 1: Lower-mid scalp

Zone 2: Center-middle scalp

Zone 3: Upper-middle scalp

Zone 4: Crown

Today, he distributed the vast majority of the 1,916 grafts to zones 3 and 4, which is prudent since I won't damage them by lying facedown on the extraction bench again tomorrow. During the second sitting, he'll focus on the zones I want the most: hairline coverage in addition to the rest of my mid-scalp region. I try not to count my eggs before they hatch, but if my hairline successfully yields most of those grafts? I'll reach a whole new level of preening and narcissism a year from now.

Return home and night recovery

After the report, Nader doled out antibiotic, anti-inflammatory, and painkilling medications, a saline spray, and post-OP instructions for the way out. Also a shampoo that's off-limits until Fridays; the saline spray is my closest substitute for now, which I just used midway through this writing.

Because of a visa technicality, the doctor himself couldn't drive me back home; he had to hire a surrogate cabman instead. Another nice fellow, but not ably conversational because of our interlingual barrier (now I'm motivated to learn at least rudimentary Spanish).

We left around 4:00 PM and had overcongested traffic to contend with. Not just the rush-hour surge but also on the bridge back to America, which is never a seamless drive on weekday evenings: that's where I had to present my passport for the first time in addition to explaining my travel purpose. I didn't get back until around 5:00 PM.

Now I'm back in the hotel, writing another novella and ordering dinner. Also nursing all my newly transplanted grafts:

It's not nearly as painful as it looks, but I'm not going to be sleeping like a baby tonight—especially following my post-OP instructions. Paranoid about dislodging my grafts, I'll be following all post-OP instructions regularly—including proper sleeping postures. There's unfortunately no recliner in my hotel room as there was in the clinic, so I can only make do with my neck pillow and try to find a semi-Fowler's position wherever I sleep. I might have to return to the clinic underrested, if not completely sleepless, but I'd rather lose sleep than jeopardize the grafts in any way.

An assortment of medications to take tonight. Cefalver (antibiotics), Mavidol (analgesics), Alin (Anti-inflammatory). And melatonin (for my fighting chance of sleep)—no shortage of it.

Edited July 13, 2022 by Trichotrophy

[Trichotrophy]

I just concluded my second and final session. Dr. Nader implanted all 3,902 of the intended grafts; now the onus is on me for their in-vivo maintenance. It'll take months to properly secure the transplanted grafts; however, these first-two days of successfully conducted procedures and recovery may be at least half the battle for their survival.

I'll keep today's report brief. Partly because I'm tired (fitful night in my new sleeping position), and mainly because most of it was just the same routine detailed yesterday.

The only notable difference is that today, as I previously mentioned, was roadmapped to fill in my lower-mid-scalp region and hairline.

Hopefully you'll find that well-designed as I do. Between my genetic widow's peak and cowlick, I've been cursed with an uneven-looking hairline for most of my life.

Below are the respective and combined UF reports for each session.

Session 1 (7/12)

UF 1: 144
UF 2: 701
UF 3: 928
UF 4: 143
Total grafts: 1,916

 

Session 2 (7/13)

UF 1: 172
UF 2: 691
UF 3: 907
UF 4: 216
Total grafts: 1,986

Combined

UF 1: 316
UF 2: 1,392
UF 3: 1,835
UF 4: 359
Total grafts: 3,902

Per Nader, the total transection rate was under 1%—all of them being partials.

Only the future will tell the actual graft yield; like every natural hair-restoration method, it takes time and patience for the full results. But the present can conclude it's been a great experience at his clinic, and the past can attest to the doctor's track record. I'm hoping to add another success story for him; otherwise, mine would be the first disappointing outcome on this board that I know of, and God forbid that. It wouldn't surprise me if he cracks HRN's recommendations list within the next year at the rate of satisfied patients he's had here.

I also must thank this board once again for not only providing verified glowing reviews of him but also educating me on my surgeon hunt. With all I've learned from here, I feel incredibly naive for even bothering to consult the several quack surgeons and hair mills in Turkey that I did. I was once tempted by their too-good-to-be-true prices; now that I'm a year older and more informed, I wouldn't even let them perform a HT on me gratis. Money is always recoverable; donor hair isn't.

I'll continually post updates as it unfolds. As you all know, I'm not due for actual regrowth any month soon, but I'll post all the inchoate stages of recovery in the weeks to come—from the skin-cleaning to the shock-loss shed to the ugly-duckling phase. I'll also always be around if you have any further questions regarding the procedure.

[E39]

Looking good! Congrats on your procedure!

[JoselitoElGallo]

Congratulations amigo! Everything looks great.

 

It is amazing how dutasteride change the color of hair to Charcoal. 

By the way I love you described your personal journey and experience.

keep us updated with the improvement 

 

Best wishes!

Edited July 16, 2022 by JoselitoElGallo

[Trichotrophy]

Three days post-OP

I shampooed my hair for the first time since the procedure; my only hair-washing before then has been via application of the H2Ocean saline spray. I poured water on my scalp with a cup—avoiding direct pressure from the shower-heads—and gently rubbed in a baby shampoo provided by Nader's office, rewashing my foamed scalp with the container for five minutes afterwards.

It's still scabby and bloodily crusty—as it's bound to remain for several-plus more days—but it's much clearer now than it was in the wake of the operation.

 

 

I wish I had taken more all-encompassing pre-OP pictures of my once-bald crown, because that's where nearly half of the grafts were transplanted. Its baldness was probably discernible enough from the previous overhead shots, however, and you can tell an abundance of grafts were needed on it in the above-embedded pictures.

There's still a long-haul road to recovery ahead of me, but I'm immensely relieved I made it through these first-few crucial days intact. Words fail to describe how paranoid I was about dislodging grafts during that timespan, when they were at their most fragile; I even strictly wore button-down shirts to avoid grazing my scalp when changing. They won't be wholly secure for another 7-11 days, but it's practically impossible to accidentally dislodge them at this stage.

I'll continue shampooing in this fashion every morning and applying the saline spray every half hour until it's fully unscabbed, by which point I'll post my next update here. I'm expecting to experience incipient shock loss by then.

[Trichotrophy]

9 days

I've completed arguably the most crucial stretch of recovery. The graft anchorage is as good as a done deal at this point, and I no longer need my follow-up medications.

Most of the scabbing has cleared; the only visible sign that I've had surgery is my scalp's erythema, which'll take weeks longer to fully fade.

My only concern (possibly an overreactive one) is my hairline's density: I'm wondering if the 1,300 grafts allotted to it will be enough. As it is, it seems a bit sparse compared to my native hair despite that I haven't experienced significant shock loss yet, and I'm worried the possible deficit might look obtrusive when it's all said and done. I'm curious about others' honest thoughts, good or bad.

Otherwise, I'm loving the design itself. Nader is a masterful hairline artist. Whether or not I get acceptable density is another issue, and only time will tell that. It's laughably early to draw such conclusions at this time, however, and I can always get a dense-packing touch-up if ultimately needed.

[E39]

Looking good 

[Spacedcherry]

How long did it take you to hear back from dr.Nader when you first submitted your request?

[Trichotrophy]

On 7/24/2022 at 1:15 PM, Spacedcherry said:

How long did it take you to hear back from dr.Nader when you first submitted your request?

Within a few days, I believe. I don't have a point of reference to know precisely how long it took since I don't remember (nor have a record of) when I submitted my consultation form; I just vaguely remember receiving it in a timely fashion, which I must have since I thanked them for it in my email response. 😆 I'm assuming you used the website's form yourself rather than directly emailing them.

I've only had protracted response times for some of the follow-up emails. Typically for no longer than 3-5 days, but once taking as long as four weeks (because my email was filtered as spam, per Brenda).

I wouldn't be discouraged if it's still responseless; their clinic gets a deluge of emails everyday, and many get unattended because they prioritize whichever patient is presently undergoing an appointment (which seems to be almost every day). If they still haven't emailed you after a few days, it might be worth calling them regardingly.

 

[GoliGoliGoli]

Can you breakdown exactly how many grafts went into each zone? Or just how many went into the greater crown region vs how many went into the hairline?

 

Thanks

[Trichotrophy]

3 hours ago, GoliGoliGoli said:

Can you breakdown exactly how many grafts went into each zone? Or just how many went into the greater crown region vs how many went into the hairline?

 

Thanks

If I'm remembering and reading Nader's postop report correctly, he did approximately 1,300 grafts for the hairline, 1,000 for the entire mid-scalp area, and the rest (roughly 1,500-1,600) for the crown. I'd have to ask Nader for clarification on the exact amounts (I only remember the hairline amount for certain), but those are assuredly dependable ballparks for the rest.

The most were definitely used for the crown, and that includes many of the 3- and 4-follicle grafts. I realistically only want to restore my crown to 70% density, so that should be enough. I just hope the hairline and midscalp will be dense enough when it's all said and done.

 

[GoliGoliGoli]

16 hours ago, Trichotrophy said:

If I'm remembering and reading Nader's postop report correctly, he did approximately 1,300 grafts for the hairline, 1,000 for the entire mid-scalp area, and the rest (roughly 1,500-1,600) for the crown. I'd have to ask Nader for clarification on the exact amounts (I only remember the hairline amount for certain), but those are assuredly dependable ballparks for the rest.

The most were definitely used for the crown, and that includes many of the 3- and 4-follicle grafts. I realistically only want to restore my crown to 70% density, so that should be enough. I just hope the hairline and midscalp will be dense enough when it's all said and done.

 

Thanks, and you said the pictures you posted earlier don't do full justice to how bald the crown was? 

[Trichotrophy]

11 hours ago, GoliGoliGoli said:

Thanks, and you said the pictures you posted earlier don't do full justice to how bald the crown was? 

Correct. Below are the best extant preop crown photos I have.

Both have suboptimal lighting and vantage points; however, they provide the best coverage I have.

I don't expect my transplant results to completely fill in that vertex, but it should be transformative enough to change that from bald(ing) to diffusely thinned at worst. 🙏

[Trichotrophy]

1 month

For just a few weeks in my life, I had an aesthetic hairline. That was in the wake of my operation before my bout of shock loss.

On the third post-OP week, the transplanted regions started shedding like a tree in autumn. There's only a sparsity of donor hair left on my dome, and now it's mainly only my scalp's redness that's demarcating my new, lowered hairline.

I'm below baseline now because I've shed many native hairs in addition to the transplanted ones, both due to shock loss and because my periodic reshed, I believe, coincided with this operation. Diffuse thinners like myself are especially liable to native shock loss, though I know it's typically only temporary—especially since most of the follicles weren't advancedly miniaturized thanks to finasteride/dutasteride.

The persistent redness isn't that concerning at the moment; I figured it'd last longer than usual because of my fair-complected scalp. Just some microlesions (e.g., the hairline pimple you might notice), but I understand those are also normal and short-lived.

It'll take at least a few more months for my breakthrough to start, of course, but I'll still update this once-monthly—if only to show levels of the ugly-duckling phase. Hopefully this is the last time I'll foreseeably resort to hair fibers!

Edited August 12, 2022 by Trichotrophy

[Trichotrophy]

2 months

The ugly-duckling phase is in full effect, as expected. My overall density is probably the sparsest it's ever been since the first dread shed on my regimen back in 2020; this I chalk up to continued shock loss coinciding with another one of my reshed cycles.

I'm not panicking about my long-term results for obvious reasons: we all go through this fittingly named phase at this juncture of recovery. But for the here and now, I'm about as self-conscious about my hair as ever. I thankfully have abundant leftovers of Toppik hair fibers to temporize with, though I'd prefer to just buzz/shave it once the scalp acne clears up.

On the flipside, the donor area seems to be recovering nicely overall, especially on the back. Could just be the ingrowth covering up the patches more so than the regrowth, though I'm happy in that respect either way; at worst, it already renders the illusion of full density (the most realistic hair-restoration goal), and much more regrowth is in the pipeline anyway.

The redness has mostly faded as well. This is despite a first-degree sunburn two weeks ago; I got complacent and neglected to wear a hat out in the sun. I'm not worried about that compromising the graft-survival rate, though—only for how it might've stunted the skin-healing process, in addition to all the other, obvious sunburn concerns.

It might take longer to get back to pre-OP baseline—much less outstep it—than usual because of my ongoing reshed, so I wouldn't be surprised if I'm a late bloomer. Still, I'm going to keep scrutinizing my hairline—my salient point of reference—for peeking regrowth, which I expect starting next month.

[Gatsby]

You're at the worst point in terms of the ugly duck. But your donor has certainly bounced back at only 8 weeks post op. Thanks for sharing @Trichotrophy and I look forward to following your journey.

[mrmane85]

Donor looks great

[John1991]

Good write up.  I think you'll end up looking good - although I actually think your hairline was solid prior.  I laughed out loud when you said the surgery was your penance for waiting too long.  You look young for 28.

Edited September 17, 2022 by John1991

[Trichotrophy]

3 months

I can't believe it's been that long.

I'm still in the ugly-duckling phase; make no mistake about that. I am, however, hopefully out of the Ninth Circle by now.

The shedding has finally stabilized for the most part. My native hair has slowly but noticeably recovered, and it shouldn't be much longer before it's back to pre-OP baseline at this rate. My donor bank looks as good as undepleted already.

 

 

Yes, I know I'm overdue for a haircut; that's even more painfully obvious now that I've seen my nape again. I was hoping for my folliculitis to clear up by now, and no such luck (as you'll see in the closeup hairline shots below). I can and should still get it buzzed—just not as short as I'd like yet.

My transplanted follicles are slowly emerging. Last month, my lowered hairline region only had an interspersion of hairs that never shed post-OP; now, they're visibly sprouting all over. Sparsely but unmistakably so.

 

Obviously, it's harder to do clear closeups on my crown, but I know there's incipient regrowth there as well; every time I run my fingers through them, I can feel thick new strands peeking.

Nowhere near satisfactory density overall yet, of course, but I can't reasonably be discouraged by the progress this early on. Anxious to see if I start breaking through during these oft-decisive months.

[GoliGoliGoli]

Curious why you went will full shave as opposed to partial shave? Did you discuss the pros and cons of each with Nader? Thanks!

Edited October 13, 2022 by GoliGoliGoli

[Trichotrophy]

7 hours ago, GoliGoliGoli said:

Curious why you went will full shave as opposed to partial shave? Did you discuss the pros and cons of each with Nader? Thanks!

We didn’t really discuss it at all; he just asked for my consent to shave my scalp pre-OP. It seemed like a no-brainer to me.

It’s my understanding that partial shaving is typically only feasible if the sole hair-restoration goal is to lower the hairline. If the surgeon has to operate on diffusely thinned regions (such as the middle of my scalp), then they’ll all but invariably require full shaving so they don’t have to navigate through a thicket of hair to make precise implants.

The obvious con of full shaving is that it’s a temporary aesthetic setback, but isn’t the operation itself always one on some level? The ugly-duckling phase is so-named because of that; I might as well embrace it completely.

Nonetheless, he does seem to offer it for some advanced diffuse thinners like this patient. I would’ve declined either way, however, since I personally don’t mind temporarily shaving—especially if it facilitates the operation.

Edited October 13, 2022 by Trichotrophy

[Dboozer]

Glad to see you're responding well.