Dr. David Josephitis (SMG) | 2,309 grafts | 35 years old | Dec. 20 / 21, 2022

[needmyhairback]

I understand your frustration, but don't worry, I see it is getting better each month. I think next month update we will see a big improvement.

[Balding Bad]

15 hours ago, Gatsby said:

Honestly I had new growth kicking in all the way up to 12 months. It’s the tortoise not the hare that wins. Everything about hair transplants is patience. 👍

Gatsby, always good to hear from you, man! And you're absolutely right...that's the right mindset to have! It can just be difficult to maintain, as I'm sure you're aware. Slow and steady, slow and steady... lol

[Balding Bad]

2 hours ago, needmyhairback said:

I understand your frustration, but don't worry, I see it is getting better each month. I think next month update we will see a big improvement.

Hope you're right! Hopefully month 6 we'll be seeing something amazing! 😎

[Spring15]

Slow grower it looks like, much more improvement to come

[needmyhairback]

Looking forward to your update 😀 

[Balding Bad]

JUNE 19, 2023 UPDATE (180 DAYS POST-OP [6 MONTHS])

Today's update is a special one because we are officially at the 6 month mark, the halfway point, 180 days and counting!

 

Before I get into it, I want to preface that the below statements are MY opinions and feelings in THIS VERY MOMENT. I want this thread to be as authentic and transparent as possible. Also, for the sake of being as thorough as possible with this month's update, I've decided to include 4 batches of photos:

 

1.) wet hair

2.) wet hair - dimmer lighting

3.) dry hair

4.) dry hair - dimmer lighting

 

So this is a pivotal milestone in the HT journey because, at this point, there's been ample time and growth for a solid baseline to have visually formed...or that's the hope at least. Half a year has gone by and the question at the forefront is: Am I better off today than where I initially was back in December 2022? And, secondly, is a hair transplant supposed to actually provide coverage/density or is it supposed to only provide an illusion of coverage/density?

 

Well, in regards to my first question, it's not exactly a clear cut answer and, in fact, I think it ultimately depends on a combination of several factors and considerations: 1.) angle 2.) lighting 3.) hairstyle 4.) condition of hair (wet or dry)

 

At first glance, when perusing the initial photos below, one might be inclined to conclude I've turned the corner and the "results" are looking great and the hair is finally filling in. I'd be inclined to agree, however once you begin to examine the hair with those 4 aforementioned factors in mind then the results (illusion) begins to fall apart astoundingly fast...

 

According to the "What to Expect After Surgery" literature provided by SMG:

What to expect at 5-6 months following surgery
A significant change usually occurs between the 5th and 6th month. By the 6th month, about 80% of the hairs should have penetrated the skin. However, only about 50-60 percent of the final visual aesthetic effect has been achieved. Between the 6th and 7th month is the best time to schedule your follow up appointment to evaluate the progression.

 

If my transplanted grafts are at 80% penetration and let's assume the final visual aesthetic is at 50% then that means I'm in trouble because the current 6 month results are seriously a huge letdown in my opinion. Moreover, my brother, who is not knowledgeable with the HT process, inadvertently asked me a confidence-killing question: when's your hair going to start growing? That just goes to demonstrate how poorly it's growing.

 

if I had to summarize my results thus far, it'd be: underwhelming, sparse, pluggy. Obviously there's still 6 months remaining before I can fully assess the results, but as of now, where it currently stands, I'm not inclined to believe it will visually improve in a significant way. There's just a concerning lack of density that I doubt will fill in adequately within the remaining time frame.

 

The frontal hairline is especially weak. Comparing photos from my day 1 procedure, it appears that my frontal hairline received enough incisions to build up a decent looking hairline, but the end result of my 6 month journey thus far seems to suggest otherwise...or I suppose it's possible the grafts just didn't take? I dunno...

 

At this point, my confidence is very low that the density will fill out to a passable natural look and it's beginning to dawn on me that I will likely need a second procedure. I'm not one to be a pessimist, rather I'm just a realist, and the results as they currently stand offer no indication that it'll improve substantially. Obviously I'd love to be proven wrong, but this is just my honest assessment. I hope there's a scenario where I look back in 6 months and laugh off my concerns, but I guess only time will tell...

 

Anyways, moving forward, I will begin ranking my monthly results. For my 6 month results, I will rate it at 3 out of 10.

 

On a side note, my Fin side effects have finally fully subsided and I am planning on starting 0.5 mg twice a week beginning in July...

 

Disclaimer: my last haircut was back on 4/16/23, so it's been over 2 months since my last haircut, the longest I've ever gone without one.

 

WET HAIR

Edited June 20, 2023 by Balding Bad

[Balding Bad]

WET HAIR - DIMMER LIGHTING

Edited June 20, 2023 by Balding Bad

[Balding Bad]

DRY HAIR

Edited June 20, 2023 by Balding Bad

[Balding Bad]

DRY HAIR - DIMMER LIGHTING

Edited June 20, 2023 by Balding Bad

[mister_25]

I understand your frustrations and sentiments very well, our situations are pretty much identical and I think your feelings/assessment is extremely honest and comes from a place of education and reason.

I have seen growth similar to yours at the 6/7 month mark make a massive turn around, but these are uncommon.

I don't think 2300 grafts for the area covered was going to give you a solid wall of hair, but it should be better than this, at least that means that it didn't do as big of a dent in donor reserves. Have you been in contact with the clinic? And if you are what are they saying about where you are at this point in time?

 

Edited June 20, 2023 by mister_25

[Spring15]

More time needed but you possibly might need a second transplant for desired density

[Balding Bad]

8 hours ago, mister_25 said:

I understand your frustrations and sentiments very well, our situations are pretty much identical and I think your feelings/assessment is extremely honest and comes from a place of education and reason.

I have seen growth similar to yours at the 6/7 month mark make a massive turn around, but these are uncommon.

I don't think 2300 grafts for the area covered was going to give you a solid wall of hair, but it should be better than this, at least that means that it didn't do as big of a dent in donor reserves. Have you been in contact with the clinic? And if you are what are they saying about where you are at this point in time?

 

Thanks for chiming in @mister_25. I've been following your thread and find it quite serendipitous that we're in the exact same situation with subpar results having gone to acclaimed, world-renowned clinics. We are brothers united by our unfortunate circumstance! lol

I was never expecting a "wall of hair," but I definitely expected it to look much better than how it currently is. And when you consider I still had some minor but decent coverage of native hairs, it should have turned out better visually. I've gone from heavily but stablized thinning to marginally moderate thinning. Is that a win? No, I don't think anyone undergoes a HT procedure with the goal of marginal improvement.

I feel like only a miracle can turn this around because I'm not seeing or feeling any new hairs sprout up either. So what has grown is pretty much it.

I haven't hit up SMG about my current status. I will do that once I hit the 7 month mark, but at this point, I've actually kinda lost confidence in the clinic as a whole, so not sure I would return to them for a "repair" or a 2nd procedure...

[Balding Bad]

7 hours ago, Spring15 said:

More time needed but you possibly might need a second transplant for desired density

I agree, more time needed, but in terms of a second transplant? Not necessarily. Maybe I'm naive here, but given my hair loss is primarily confined to the frontal third, I believe a single procedure could have yielded much better results. Perhaps not a wall of hair, but it could have produced denser, fuller looking results.

In fact, all the clinics I consulted at, the general consensus and average in terms of graft was in the 2,500-3000 range. So I think with the 2,300 I received, the results should have been much better than this.

Edited June 20, 2023 by Balding Bad

[needmyhairback]

I think you do look better than before the surgery. But I also expect a much better result given the reputation of the clinic and the number of grafts you got. I understand your frustration when you have done your research and went to one of the best clinic in the world and still get a subpar result. Hopefully you are a slow grower and we will see more growth soon.

[baldfighter]

Interesting story. Your grafts shed quite early, did you notice any growth before shedding? 

[ALittelTeal]

I’m probably as critical as anyone for cases like these given that my experience with FUE had even less results at the 18 month mark and I’m considering Shapiro should I opt for a second pass. That being said, I feel like I am seeing some solid growth between Months 5 and 6? I’m open to people telling me otherwise, but I would be incrementally optimistic after seeing the progression over the last month. I say this as someone who last month thought that your growth was in fact disappointing. Regardless, I’m sorry that you have had to wait as long as you have and still wrestle with the frustration and doubt of a potentially poor outcome.

[Balding Bad]

7 hours ago, needmyhairback said:

I think you do look better than before the surgery. But I also expect a much better result given the reputation of the clinic and the number of grafts you got. I understand your frustration when you have done your research and went to one of the best clinic in the world and still get a subpar result. Hopefully you are a slow grower and we will see more growth soon.

Yes, comparatively speaking my pending results now are better than before surgery, but the results of the procedure should be able to stand on its own accord without the need for comparison. In fact, comparison should only be utilized in order to emphasize the dramatic turnaround...which, sadly, I don't believe this will be.

And yes, I agree. The results should be much better given SMG's reputation. And there's still technically 6 months left on the table. Could I be a slow grower? At this point, I sure as hell hope so!

[Balding Bad]

6 hours ago, baldfighter said:

Interesting story. Your grafts shed quite early, did you notice any growth before shedding? 

If memory serves me correctly, I believe I may have had some minor growth before shedding, but I think the timeframe for when I started shedding was more or less on par for the course.

[Balding Bad]

3 hours ago, ALittelTeal said:

I’m probably as critical as anyone for cases like these given that my experience with FUE had even less results at the 18 month mark and I’m considering Shapiro should I opt for a second pass. That being said, I feel like I am seeing some solid growth between Months 5 and 6? I’m open to people telling me otherwise, but I would be incrementally optimistic after seeing the progression over the last month. I say this as someone who last month thought that your growth was in fact disappointing. Regardless, I’m sorry that you have had to wait as long as you have and still wrestle with the frustration and doubt of a potentially poor outcome.

Appreciate your input on the matter and sorry to hear about your less than stellar results at the 18 month mark. May I ask where your first procedure was? And what is making you consider SMG for your second procedure?

Also appreciate the brutal honesty about my results at 5 months. I was struggling and underwhelmed with what I was seeing then as well. Glad to hear you think my month 5 to 6 as "solid growth." Hopefully that translates to even more growth down the line, but, man, this certainly has been a psychological/mental struggle for sure...

[needmyhairback]

22 hours ago, Balding Bad said:

Looks like you still have many baby hairs. When they mature it will look better.

[Balding Bad]

52 minutes ago, needmyhairback said:

Looks like you still have many baby hairs. When they mature it will look better.

Tick tock. Fingers crossed. 🤞

Although, it's also entirely possible those "baby hairs" are just my native ones that are just naturally thin and wispy and on their last legs. 🤷🏻‍♂️ But if they are transplanted ones growing, then yeah, I hope they thicken up.

Edited June 21, 2023 by Balding Bad

[mister_25]

3 hours ago, Balding Bad said:

If memory serves me correctly, I believe I may have had some minor growth before shedding, but I think the timeframe for when I started shedding was more or less on par for the course.

Growth before shedding is simply the hair shaft working its way out of the scalp.

[baldfighter]

36 minutes ago, mister_25 said:

Growth before shedding is simply the hair shaft working its way out of the scalp.

That’s interesting. How did you come to that conclusion?

[mister_25]

5 minutes ago, baldfighter said:

That’s interesting. How did you come to that conclusion?

I asked that question on a previous thread which I didnt receive a answer. I asked my surgeon and he told me that.

Edited June 21, 2023 by mister_25
accidently posted early.

[stephcurry30]

OP Why did your surgeon make the incisions the day before? This makes no sense to me. 

 

I remember reading a Patient of Dr Bhloxman not too long ago who made pre made slits the same day and the Dr mentioned that the slits closed up extremely fast and the grafts might have not survived because of it.

 

I have bene on this forum for 7+ years and have yet to see a single surgeon who has done this? What's the purpose of this? Is this the possibility as to why your surgery didn't succeed?