Partial Shave FUE - 2340 Grafts - Dr Manish Mittal, London - 10/01/23

[Speoj]

Hey all, 

After thinking about getting a hair transplant for a few years, this week I finally got it done! I'm 29, starting receding when I was 16, I've been using minoxidil for 5 years and finasteride for 2 years. I did see some positive results with both, but it only helped to curb the diffuse thinning that started to set in when I was 24, they did help with thickness but didn't do much to improve my hairline. I tried derma rolling on the hairline for about a year but after seeing no results I stopped and started to think more about getting a HT.

I wanted to go for a partial shave FUE to address hairline recession, as mentioned in a previous post I have always styled my hair to cover my hairline, so wanted to go partial shaven to continue to cover the hairline through the ugly duckling phase. Over last summer and autumn I had consultations and conversations with a bunch of different surgeons and clinics. I was looking at going abroad for it initially, I liked the idea of going to either Cyprus or Belgium, waiting it out in a hotel for post op and coming back once the scabs were off. But whilst I was still weighing up my options in a consultation with Dr Manish Mittal (Dr Mani) he asked about how I respond to anaesthetic which led to me talking to him about my unilateral renal agenesis - I was born with one kidney, the other didn't develop, it's hereditary, and is usually passed down the male side of the family. For all terms and purposes I am 'healthy' but it does mean that my tolerance to things like alcohol and recreational drugs are lower that other peoples. And a few years ago from stress and overworking I had a scare where the one kidney had the symptoms of it failing and I had to get to hospital quick for them to do checks and put me on a drip until it flushed the kidney out. The A&E doctor at the time said that if I hadn't had gotten to them when I did it might have been more serious, that in future a similar episode might mean dialysis. So when it came to picking a surgeon for the HT, I then decided it would be best if I stayed in the UK so that if I did have a reaction to the anaesthetic, that at least I could get to a hospital quick where I could explain what was happening faster than if I was abroad. 

I was chatting to some of Mani's patients on Reddit who were happy with their decision and from what I saw, I liked his hairline designs and he seemed to have a good track record with cases similar to mine - hairline restoration work and less full coverage diffuse thinning. I also liked that he only sees one patient a day, that he does the punches for the extractions to keep on top of donor management and does all of the incisions himself. So I pulled the trigger and we set a date. 

In terms of wait time I think it is around 3-6 months. In the consultation in August he said realistically we'd be looking at February, but chatting to Rus his co-ordinator we managed to set a date in January which was my preference, being after Christmas when there's not much going on and was the most convenient time to take time off work. Before they would take me on as a patient though I had to get bloods done that showed kidney function, Mani said that if it came back as normal function he'd go ahead, but would have to decline if kidney function came back as abnormal. Did the tests, came back fine, and we were all set. And in terms of pricing, I was quoted between 2200-2400 grafts at £3 a graft. Which would include PRP and a 12 month supply of finasteride. 

Chatting to Dr Mittal's co-ordinator, Rus in the run up to the consultation just put me at ease, like chatting to an old friend. I didn't get that kind of rapport chatting to other co-ordinators. And in the run up to the op and now post op, the communication has been great, quick responses over email, knows his stuff and sometimes it can even be difficult to get off the phone, we always seem to have a lot to talk about, which is the opposite of what I experienced chatting to other co-ordinators. So yeah, shout out to Russel. 

On the day of the op I got to the clinic for 9am, I was nervous as anything, it was tipping it down and when it rains in London everything grinds to a halt. I was late, but so was Dr Mittal. The receptionist requested paperwork that I had sent over weeks ago. I resent it, she couldn't open it to print it off, I offered to resend it as a PDF but in the end completed parts of the paperwork by hand. Not a great start but understandable, just a miscommunication. If I had known they needed the paperwork printed off I could have printed it at home to save them time on the day.

But by 9:45 that was all dealt with and we designed the hairline. It's something that was discussed at length at the consultation, so we were quickly on the same page about my goals etc. Since my teens I have always had a windows peak hairline, that then receded, it would would have been unnatural and very noticeable if I opted for a straight hairline, instead I wanted to stay conservative, to have a mature hairline still just with less regression. Mani reaffirmed that the recession was quite deep so he'd shave back the hairline to reinforce and blend the native with the transplanted grafts.

I was concerned about the pain and how I would respond to the aesthetic, I was chatting to people days before on this and other forums who'd already had work done at different places who said the pain can be pretty bad so I felt like I was ready for the worst pain I'd ever felt. But when the anaesthetic was injected in it didn't feel that different to giving blood or donating plasma, just in your head. After 5 minutes or so, once it had set in I didn't really feel anything after that. Still in the room, still aware of what was happening and chatting still, just didn't feel any pain. At any point when I could start to feel something I would say so and Mani would inject more anaesthetic, which was a mix of lidocaine and adrenaline. 

Mani used a motorised 0.85 punch to do the extractions, as one tech, Salma used a clicker to keep on top of the graft count whilst another tech, Edene, was at a microscope dividing the grafts into singles, doubles and multis. Dr Mittal said I had one of the best donors he'd seen in a while, with that majority of extracted grafts being multis; mostly triples, quads and even some fives. They had to split some of the multis up to make more singles. It felt a lot like being at the dentist, I couldn't feel the extractions but I could hear the sound of it if that makes sense. 

Singles: 413
Doubles: 725 
Multis: 1119

After the extractions we broke for lunch, and after Mani did the incisions at the recipient area. He used a 1mm blade for the singles at the front of the hairline, they find that the singles just slot straight in that way, and then switched to a 1.25mm blade for the rest. He said for the quads and fives he nearly went up to a bigger blade but was reluctant because he wanted to keep trauma and scaring to a minimum. The anaesthetic meant that I didn't feel pain whilst he was doing the incisions, and Salma was back on the clicker keeping count of how many incisions he was up to whilst Edene continued organising the grafts. Mani created irregularities along the hairline to create a more natural look which we chatted about whilst he did them. Once the incisions were done and Dr Mittal was happy with the density for dense packing the grafts, they used a blue dye to more easily identify the incisions for implanting the grafts. Salma and Edene then implanted the grafts into the incisions, they started with singles in the hairline then worked back and I was free to watch some movies on Netflix. Once the majority of the grafts were in, Mani asked the techs to leave 30 or so singles until the end and he implanted these himself, creating additional irregularities along the hairline with the last remaining grafts. Every step of the way I got the impression that they take their time with everything, with an attitude of it's done when it's done which I admired. We were all finished at 7pm, they rinsed my hair, took the photos attached below and put a bandage over the donor area. 

Mani then went over the after care procedure with me again, gave me a post op care goodie bag with baby shampoo, saline solution spray, a weeks worth of Clarithromycin, airplane pillow and some gauze pads. As mentioned in a previous post, some of this I had already picked up but it was very much appreciated. We then chatted on the sofas in the reception area until my partner arrived and he waited for us to get a taxi. 

All in all a great experience, apologies for the essay, I'll be updating as the journey continues... 

[HappyMan2021]

Image files are broken. 

[JohnCasper]

Thanks for the narrative!  Well documented.  Can't open the attachments however.

[Speoj]

On 1/14/2023 at 7:47 PM, HappyMan2021 said:

Image files are broken. 

 

On 1/16/2023 at 10:24 PM, JohnCasper said:

Thanks for the narrative!  Well documented.  Can't open the attachments however.

Thanks for letting me know chaps, not sure why the attachments aren't working. @Melvin- Moderator is this something you can help with?

Would be great to get the photos working so I can post an update 

[A_4_Archan]

Yeh not able to open files

[JohnCasper]

Great narrative, try to find a way to show us the pictures.  Looking forward to seeing them.

[Rafael Manelli]

The pictures load fine for me, the grafts look densely packed. You should expect a great result 

[mavigo]

Images are broken for me too.

[Speoj]

Sorry about the image files not loading for some of you, I'll post the post op pictures in this comment and hope they show up. I can't seem to revise/edit the post itself to try and re-upload them, think we might need mod assistance to do that. @Melvin- Moderator are you able to help? 

Here's the pre op and op photos again. 

[Speoj]

The scabs finally all came off at day 12, I still had some dryness at the recipient area so at day 14 I started to dab the hairline with aloe vera gel so it didn't get too itchy. Donor scabs were off by day 10, but still some redness and still pretty itchy. I started using aloe vera gel on the donor area after the scabs were off because it started to look a bit red from my scratching it because it was pretty itchy.

Here's photos from Day 14 post op. With the scabs off and going the non-shaven route I've been able to style my hair as usual to cover it 

[Speoj]

I'm now at 1 month post op.

The shedding started at around Week 3, I was pretty gutted about it starting so early as it was just before I went to visit family for the first time since the op (had a family bereavement, also why I haven't updated this in a while), everyone wanted to see it up close and they were all very supportive but it was a shame the ugly duckling phase started days before. I showed them all the Day 14 pictures and explained the shedding was part of the process.

I don't think these Day 30 pictures do justice to how red it looks lol. It looks sore but it feels fine, a lot less itchy than it has been, but now it's starting to shed it just looks quite pinky red underneath. The donor has been pretty itchy, from about Week 3 onwards I've been dabbing CeraVe moisturising lotion on the donor which helps with itchyness far more than aloe vera gel does. And the aloe vera clumps up when it dries in to shiny flakey glue like clumps. There has been some thinning at the crown which wasn't there before the op, it might be because I was off minoxidil for 14 days before then another 14 days after the op, so might have lost some ground on the crown or it might be a bit of shock loss. I've started minoxidil again at the crown, midsection and hairline so hoping it will speed things up.

Just the waiting game now, looking forward to it growing out but preparing myself for more shedding to come. Here's the Day 30 photos.

[Melvin- Admin]

Following closely happy growing 🙏

[JohnCasper]

Pictures look great!  Looking good!  Keep us posted with results down the road a bit.

[londonboy9030]

HI @Speoj : I m considering going to Dr. Mani for a consultation - my hair is kinda similar to yours (though I m Asian, but my Norwood level is quite the same).

Can I ask if you had to be placed on a wait list for surgery ? And how long did your donor take to grow back out to a decent level to cover the work that was done ? THanks !

[mydadisbald]

4 hours ago, londonboy9030 said:

HI @Speoj : I m considering going to Dr. Mani for a consultation - my hair is kinda similar to yours (though I m Asian, but my Norwood level is quite the same).

Can I ask if you had to be placed on a wait list for surgery ? And how long did your donor take to grow back out to a decent level to cover the work that was done ? THanks !

I had a consultation with Dr Mani at the beginning of Feb, and have booked in with him in late September. He advised he doesn't take many bookings over Summer, and his busiest period is the end of the year November/December. When enquiring about September, a few dates had already been taken. 

[londonboy9030]

1 minute ago, mydadisbald said:

I had a consultation with Dr Mani at the beginning of Feb, and have booked in with him in late September. He advised he doesn't take many bookings over Summer, and his busiest period is the end of the year November/December. When enquiring about September, a few dates had already been taken. 

Thanks ! Did you book September because there was no availability from now until then ?

[mydadisbald]

Just now, londonboy9030 said:

Thanks ! Did you book September because there was no availability from now until then ?

No, I booked September as it's after Summer and I'm typically out and about less. It was the time that suited me best, where I felt as though it wouldn't be noticed as much.

I believe Dr Mani is upping his prices from £3 a graft to £3.50 as of June (I think this was the date, don't hold me to it). If you secure a booking before this date, pay deposit etc. then you'll be locked into his current prices. This was not used in a way to pressure me into booking any sooner, but more of a heads up. I was told to go away and think about it as much as I liked. So just something else to bear in mind! 

[mydadisbald]

@Speoj Have you had any issues with it being a partial shave? What made you choose partial shave?

Dr Mani advised he prefers full shave as there's less risk of clients accidentally knocking grafts out in the early stages (when touching their hair), as well reducing risk of infection (greasy hair touching grafts etc.). I'm wondering what I should do when it comes to it. 

[londonboy9030]

Thanks ! I am having the in person with Dr Mani next week, so hopefully can secure the current pricing.

Just out of curiousity, did you see any free slot for the Easter period (April/May) time ? :-)

[Spring15]

Nice clean work. Any reason you chose not to shave your head? I felt it more tidier to have it shaved off

[Speoj]

On 2/9/2023 at 3:25 PM, Melvin- Moderator said:

Following closely happy growing 🙏

Thanks Melvin! 
 

On 2/12/2023 at 2:20 PM, JohnCasper said:

Pictures look great!  Looking good!  Keep us posted with results down the road a bit.

Thanks John, yes will do! 

[Speoj]

On 2/18/2023 at 10:01 AM, londonboy9030 said:

HI @Speoj : I m considering going to Dr. Mani for a consultation - my hair is kinda similar to yours (though I m Asian, but my Norwood level is quite the same).

Can I ask if you had to be placed on a wait list for surgery ? And how long did your donor take to grow back out to a decent level to cover the work that was done ? THanks !

Awesome, have you booked the consultation yet? I think it depends on when you wanted it done. For me personally I knew I could plan a gap in work in January (I'm freelance, the start of the year is always slow, social wise most my mates are usually burnt out in January after christmas so not a lot happens lol). I had my consultation in August last year and they were able to find a date for me in Jan. If you have a date in mind the sooner you can have a consultation and book the better I guess in terms of getting the date you want.

I started socialising from the 2 weeks mark so from around then for me I'd say. Can see in the 2 week photos above the donor was a little pink if you look closely but no scabs and just looked like I had a short back and sides. Saw family at 3 weeks and they said at that point you couldn't tell, donor had grown back so it was completely covered. 

[Speoj]

On 2/18/2023 at 2:42 PM, mydadisbald said:

@Speoj Have you had any issues with it being a partial shave? What made you choose partial shave?

Dr Mani advised he prefers full shave as there's less risk of clients accidentally knocking grafts out in the early stages (when touching their hair), as well reducing risk of infection (greasy hair touching grafts etc.). I'm wondering what I should do when it comes to it. 

I didn't have any issues with going partial shave and I'm really glad I did. I did quite a bit of research in the years running up to the HT, knew the risks and in the consultations I specifically said I wanted to go partial shave. 

On the day of surgery I pushed for it still and acknowledged in some cases it wouldn't be advisable. There's the risk of infection and native hair getting stuck in scabs and dislodging them. If you have any miniaturisation / thinning elsewhere then if you go full shave additional grafts can be places there, but if you go partial shave that's not an option. So for me if I had a thinning behind the forelock then partial shave wouldn't have been an option. 

But in my opinion, for my case, I felt the benefits mentioned in the original post far out weighed the risks. The only people who know I've had work done are the people I've told, and that works for me. 

 

[londonboy9030]

15 minutes ago, Speoj said:

Awesome, have you booked the consultation yet? I think it depends on when you wanted it done. For me personally I knew I could plan a gap in work in January (I'm freelance, the start of the year is always slow, social wise most my mates are usually burnt out in January after christmas so not a lot happens lol). I had my consultation in August last year and they were able to find a date for me in Jan. If you have a date in mind the sooner you can have a consultation and book the better I guess in terms of getting the date you want.

I started socialising from the 2 weeks mark so from around then for me I'd say. Can see in the 2 week photos above the donor was a little pink if you look closely but no scabs and just looked like I had a short back and sides. Saw family at 3 weeks and they said at that point you couldn't tell, donor had grown back so it was completely covered. 

Yeah i have had, Dr Mani is probably one of the most chilled person (not just a doctor) that i ve ever met actually.

 

i think i ll book it in for Easter, as i can get a 2-3 weeks period of leave and working from home. Ppl probably will know i had a hair transplant (coz i m going the full shaven route), but i m back office in a bank so dont think that would be too much of a problem

[Speoj]

30 minutes ago, londonboy9030 said:

Yeah i have had, Dr Mani is probably one of the most chilled person (not just a doctor) that i ve ever met actually.

 

i think i ll book it in for Easter, as i can get a 2-3 weeks period of leave and working from home. Ppl probably will know i had a hair transplant (coz i m going the full shaven route), but i m back office in a bank so dont think that would be too much of a problem

Glad to hear the consultation went well mate! Yeah for sure, I felt pretty at ease with Mani at the consultation, and it's one of the reasons I went with him. And on the day his demeanour definitely made me less nervous. 

Sounds like a good plan mate. I think do as much reading as you can about post op care. I did a post on here about a post op shopping list on my profile, here's the link. Russ will send an information pack so you'll know what to expect and you'll get a goody back with the stuff you'll need but always good to go to a pharmacy beforehand to get some essentials. I also filled the fridge with loads of quick easy food to make and pot noodles etc. I spent my recovery playing playstation lol. 

Edited February 25, 2023 by Speoj
Added a link to previous post