Dr. Wong - 4,332 FUT in 5/2005 (31 yo), 2,107 FUE in 7/2023 (49 yo), NW6, Blonde Hair, On and Off Medicine between surgeries

[hongkongfue]

Hi guys, first post here.  As title states, I had a pretty large gap in time between surgeries.  Wanted to share my story incase it helps others with similar characteristics.  Thank you for others who have shared their stories and insight.  Like many others I started losing my hair at an early age.  Since my teens I have had a receding hairline that just progressed to more hair loss over time. I just remember being 17 and getting grief and saying I'm not worried about it, there will be a cure by the time I am 40 for sure, ha.  Well didn't quite work out that way.   I figured I would try to include pictures from the first surgery to help give a total picture.  My hair is fine and blonde, but now with more gray and brown mixing in.  

Firstly I can't say enough positive things about Dr. Wong and team. Honestly being 18 years since the first one I don't recall all the ins and outs, but had no issues with the experience and was more than happy with my result. I was never going to chase density either then or now, just not enough hair and to much real estate.  Prior to the first surgery I was not on any medicine.  The first surgery was May 2005, FUT with 4,332 graphs.  I decided on Dr. Wong originally because of the amazing results they were putting out.  Probably not much to really worth saying about one so long ago other than the numbers and satisfaction, which for me both were good. With light hair and hair skin I think it really helps with how things look for me. 

After the first surgery I did start taking 1/4 Proscar tablets and continued on them for several years, for whatever reason I just faded out from taking it, maybe because at the time I was getting them from Canada, got busy with life, don't really know.  That is one regret I do have. As everybody says, you should definitely stay on it if you can, especially if high loss like myself.  I did use minox foam for the last several years, but stopped Dec 22 at the clinic's recommendation.  I did experience quite a bit of shedding along with starting 1mg Finasteride at the same time. So I was back on the Fin 6 months before the second surgery, and certainly plan to stay on it or replace with topical Dut which at the surgery Dr. Wong recommended to use.  I don't really have any side effects of the oral fin, so I will have to read up more on it, but I will definitely stay on whatever I need to. 

When I started thinking about getting a second surgery I knew I had lost a ton of non-transplanted hair over the last 18 years, but honestly it didn't really bother me to much so my goal was if my hair could look fairly close to how it looks 18 years from now and with that I know I needed to supplement what was lost so that is when I found this website and started reading. I think back in 2005 it was a different site that there were a lot of H&W results being posted.  I don't remember exactly back then if even FUE was around much, I feel like it was just starting, so I had to read up a lot about it.  After seeing Dr. Wong was still practicing and doing both, I felt no reason to really talk to any other doctor. If it worked the first time, why chance it so I reached out to their office in December 2022 for the consult.   After the usual back and forth consult stuff, Dr. Wong said he could target 2000-2500 units. Since I already had the scar and I don't cut my sides and back less than a no. 5 I didn't see any reason to get the FUE so we planned for FUT and told to start .  I think when I had mine in 2005 the trichophytic closure wasn't being used yet as I did not get it, so I thought I would aim for that.  To me the scar wasn't to bad since I had not plans to go short, and in the back it was pretty think, with a little stretching in a few parts on the side.  At that time of my consult I got the only available opening in 2023 which was in July so I the waiting game and scalp stretching started.  The clinic took care of all the hotel arrangements and I turned it in to a week stay with some days before and after so we could explore the city and area more. 

Fast forward to July I went to the clinic the afternoon before surgery day for the in person consult.  Told Dr. Wong I had never gone 18 years between doctor appointments with the same doctor before. ha. 

We discussed what I was looking for, which was no lowering of the hairline, just make the best use of the graphs for coverage, to plan for the future.  After the scalp exam he said that my laxity on the sides was good, but the back not so much, which honestly I had a feeling he was going to say that even though I had 6 months of stretching.  He said we could proceed with the FUT but that probably 1,800 max units and could not use the trichophytic closure as there wasn't enough laxity. I appreciated his candor as I was really wanting to aim for 2,000 units. He said that if I wanted to do FUE instead he felt confident he could get to 2,000.  So that is the direction we set off in. Which in retrospect I am glad it worked out that way as I felt like things healed up quicker and not having to rock 50 staples in my head for 2 weeks was nice!   We also discussed if I wanted any units in the scar, but he was honest and said it would eat up atleast 300 graphs. The day of surgery we talked about it some more and agreed since it wasn't bothering me, I don't wear my hair short and have limited resources, the plan was just to use around 100 to break up the scar in the wider part on the side so I think he put around 115 in to the scar in those 2 areas.  Dr. Wong also said that the transplant hairs have held up very well and at this point up top in the transplanted zone 95% of the hairs left are probably the transplanted ones, so that shows you the progression of loss. 

The only unexpected thing was that I needed to dye my hair for the FUE due to the light color of my hair,  so went back to a procedure room and they shaved off all my head and proceeding to color it, they had to use a couple different ones to get it dark enough. Honestly it was kind of shocking, I had gone for never having a complete hair shave (last time was only the top area) to shaved and colored!  The only thing was we didn't get any before pictures before it was shaved, probably because we were doing things the day before surgery. 

I know it was only little stubble that was colored, but not sure how long it will take to lose the color which I am probably as anxious as that as anything so I can get back to "normal" as soon as possible, I am happy to just get back to my baseline hair length and color and wait the 12 months for the new hair to do it's thing.  If anybody else had to color the shaved head and has any insight on that I would appreciate it. 

Day of surgery arrived at 6:15 am, hair wash, catch up with Dr. Wong,  another final hair shave and pictures and they started.  The hardest part was probably being face down until we broke around 1:30 or 2 for lunch.  For the most part it was painless, you felt some stings here and there but they were very quick to administer more numbing agent.  For my my crown felt more sensitive.  But everything is tolerable, again for me, the hardest part was sitting face down, or really more so when had to turn head to side. I was certainly ready flip over by the time we got there, but the goal was to get everything face down done at that time, so the tech did the extractions,  Dr. Wong did the incisions in the crown and scar and the techs did the implants in those area and then we broke for lunch. I believe they Dr. Wong did 340 graphs in the crown. So between that and the scar, it left around 1,657 for the rest.  The day finished up probably 5:30-6, so it was a long day.  Dr. Wong was in and out several times and I was more than happy with the level of his involvement and the techs.  You can't say enough about the techs, I get that a lot of people wish the docs did it all, but like I said the techs did great the fist round, so many of them have been there for so long they are very experienced at what they do and are just so in sync with Dr. Wong. 

Just picked up some Subway by the hotel for dinner since was long day. Next morning when back to to the clinic for a wash and check.  Tech took care of that and met with Dr. Wong and he was happy with how things looked. After that, went about my day just wearing the hat they give you which at nameless, solid back, it nicer than the H&W branded hat from last round! Same thing the next day.  Since my scalp is prone to pimples they recommended I wash 2x a day and did not need to return the 3rd post op day, so we just explored more until left on the red eye back to the states.  Swelling wasn't to bad, I tried to massage my forehead as much as I could. I definitely swelled up less this time, but it was half the graphs. 

Sent pictures back to the clinic on day 4 and day 7 with prompt feedback.   Up until day 7 I slept on the travel pillow and it was ditched after that and I slept much better.  Day 8 came around and I was able to take the long shower and use a wash cloth to scrub off the scabs, after that I felt fairly normal other than short and colored hair in places.  Anyways, that is pretty much it.  

I know I will not win any density awards and a lot of people would probably not be satisfied, but I have to play the long game here and with fair hair, light skin and my hair style it works and I can carry it off and feel good about it.  So that is kind of it, if anybody has any questions, happy to help. 

Here is a pic from when I was probably 14 or 15 so you can see the high hairline., circa 1988-1989. 

 

I know pictures from a surgery 18 years ago are probably not needed, but figured would help the story. 

May 2005

 

 

 

 

 

 

 

 

 

 

 

Surgery day from May 2005

 

 

 

 

Scar 5 months after surgery.

 

These next ones are 22 months after the 2005 surgery. I have a lot of pictures over the first year but figured fast forward to the end.  If I had only been able to maintain! 

 

 

 

 

 

 

 

Some at home pre photos over the last year few years. I know not a lot of good ones, but just helping to paint the picture. 

 

Pictures for initial consult. There were also videos sent in. 

 

 

 

My wife took these right before it was shaved. 

 

 

Day 1 (assuming surgery is day 0)

 

Day 2

Day 3

Day 3

Day 4

 

Day 5

Day 6

 

Day 7

 

Day 8 - Scab free day!!

 

Day 10

 

That takes it to where I am today. I have gotten pretty used to the short hair now. I wanted to also add to what has been echoed by others, even at the airport coming back when I didn't wear a hat  a lot since I was inside, nobody looked at me weird or anything else.  So don't worry about that. and now that my head is cleaned and the initial surgery redness gone I am comfortable to go out without the hat (aside from wearing it if going to be in sun) even with the FUT scar since at this point to most people I would just look like every other thinning hair shaved hair guy. 

Thanks

 

 

 

 

 

 

Edited July 16, 2023 by hongkongfue
fixing pictures

[davidn]

Looks Like great Work! Happy healing.

[HairEnthusiast101]

Did you lose some transplanted hair? For not being trichophytic closure that is sure a good scar. Something about Hw always having good scars 

[GoliGoliGoli]

2 hours ago, HairEnthusiast101 said:

Did you lose some transplanted hair? For not being trichophytic closure that is sure a good scar. Something about Hw always having good scars 

I was wondering the same thing from looking at the pictures. Always hard to tell in photos if it was transplanted hair that was lost or hair around it, but it does seem that some of the 2005 hairs were lost. 

[hongkongfue]

Hard to say since I lost so much non transplanted hairs over the years.  I wouldn’t rule it out but since it’s been 18 years that’s a lot of time. I didn’t specifically ask Dr. Wong if it looked like that. He just said it looks like it held up very well and when I asked him how much non transplanted hairs were still in the transplanted areas he said what was left was prob 95% transplanted hairs at this point in those areas.  That was just conversational number during consult. .  I feel pretty good that if I did lose any I lost so much non transplanted hairs the difference is minimal for loss of any transplanted hairs.  Like you said hard to tell from photos and I’ve never dwelled to much on it when looking at things in the mirror over time. 

[mrmajified]

Missing the one month update!!!

[Melvin- Admin]

Fascinating story, one id like to highlight! It definitely seems that some of the transplanted hair thinned. Not a lot, but it did thin. For those who ask what an HT without meds looks like long term. This is best case scenario IMO. 
 

What was the biggest difference from your FUT to FUE? Why did you opt for FUE?

[hongkongfue]

 

Here are 30 day update photos taken August 6.

. 

 

 

[hongkongfue]

Here are day 53 update photos taken August 29. Not much to report other than I really need to shave my neck hairs! ha. Feels strange to have now gone 2 months with no haircut. Since so many of my hairs are either blonde  it is hard to capture them in the photos at a short length, but at this point I am just waiting for my old hair to grow back to the prior length which I will be happy for but I have to say shorter hair has been nice for the summer.  I seem to have had more pimples in the donor area than receipt area but between the 2 there are usually several at any given time. 

 

al. 

[hongkongfue]

On 8/28/2023 at 1:41 PM, Melvin- Moderator said:

Fascinating story, one id like to highlight! It definitely seems that some of the transplanted hair thinned. Not a lot, but it did thin. For those who ask what an HT without meds looks like long term. This is best case scenario IMO. 
 

What was the biggest difference from your FUT to FUE? Why did you opt for FUE?

I feel like the recovery has been a lot easier with the FUE than strip, but with the 18 year gap it's honestly hard to recall how it truly was then, I know I was a lot more nervous the first round.  I feel like my redness faded quicker this time also, but it probably helped I had half the grafts this time compared to the FUT so less trauma to scalp. I think back then I was slathering emu oil every day since that is what was popular at the time. This go round I have not put anything at Dr. Wong's recommendation.  I also got back on foam minox after the FUT, but again following Dr. Wong's advise I discontinued usage after the consult 7 months before surgery and have not gone back on it, which I have to say I do felt like a lost a lot of hairs or atleast had a big shed when I stopped.  

 

As for why FUE over FUT this time, after the scalp exam he said that my laxity on the sides was good, but the back not so much, which honestly I had a feeling he was going to say that even though I had 6 months of stretching.  He said we could proceed with the FUT but that probably 1,800 max units and could not use the trichophytic closure as there wasn't enough laxity ( he was not using that closure technique when I had the FUT). I appreciated his candor as I was really wanting to aim for 2,000 units. He said that if I wanted to do FUE instead he felt confident he could get to 2,000.  So that is the direction we set off in. Which in retrospect I am glad it worked out that way as I felt like things healed up quicker and not having to rock 50 staples in my head for 2 weeks was nice!   The other thing I was not expecting was shaving my hair in full the day before surgery since last time with FUT they just shaved the parts working on. But I am glad to have shaved the whole head this time, it looked a lot more normal. Also this time they had to use 2 boxes of black hair dye the day of consult since I had so many gray hairs on the sides and back.  Guess no my hair is a full on hodge podge of gray, blonde and dark colors. 

[hongkongfue]

2 month update. Not much to report as expected. Getting first hair cut tomorrow just to clean things up a bit.  Inside and outside photos. 

[jjalay]

40 minutes ago, hongkongfue said:

2 month update. Not much to report as expected. Getting first hair cut tomorrow just to clean things up a bit.  Inside and outside photos. 

Donor looks great, now its the waiting game!

[hongkongfue]

4 month and 2 days update.  Have had a few haircuts now. Hair length is growing out. Pimples have died down. Happy with things. Again my goal was coverage as density is not in my cards. But having light hair and skin I think it helps.  Pictures from inside bathroom lights and outside.   Only thing I may have changed in retrospect is spending 100 graphs on the scar when I don’t traditionally wear my hair that short on the sides  but later if I ever decided to get another procedure to fill in the scar it jump starts that and also breaks up the scar some with how Dr. Wong did it put some on either side to break up one long scar.  

 

Edited November 9, 2023 by hongkongfue
Photo edit

[Gatsby]

@hongkongfue with your blond hair and fair skin that FUT scar is imperceptible. Early days at four months. Happy growing and thanks for sharing your updates. 👌

[Melvin- Admin]

Looking right on track 👌

[Needhelpwithscar]

@hongkongfue I was wondering how your scar looks right after your have put fue into it ? would you mind showing your scar and if the grafts are growing in it? I need some guidance on the scar and your help will be much appreciated. Thank you.

[hongkongfue]

@Needhelpwithscar I have some pics above that are from day 1 and the next few days they show the graphs in the scar. It’s only 50 on each side of the scar to break it up some.  I’ve posted any pics I have. 
 

I haven’t tried to get any close ups of the scar recently since I’m just coming up on 5 months and waiting for more growth to start overall.  I’ll try to see if can get some with next update. 
 

sorry you’ve had any issues with your scar. I’ve been very happy with mine and I don’t wear my hair lower than a guard 5 so it’s not that short anyways. 

[Needhelpwithscar]

@hongkongfuethanks, would like to see how well those grafts are growing in the scar. I’ll wait for your next update.

[hongkongfue]

Sorry I missed the 5 month update. Here is the 6 month update. It’s also been one year since I started back on Fin and a year since having stopped Minoxidil. Things are progressing about as expected.  The top is pretty much back to my normal length.  Tried to get a few pictures of the graphs in the scar for @Needhelpwithscar   You can definitely see some graphs growing through already. Inside and outside photos. 
 

 

[Needhelpwithscar]

@hongkongfue thank you for sharing your updates, happy for your progress so far.  I hope you will have a great final results. For the fue into the scar, yeah I do can see there are some grafts growing in the scar. How do you feel about the survive rate of the grafts in the scar ? I remember in your earlier post that you place 100 grafts, now there is maybe at most 20-30 grafts growing it seems. Do you think more will be growing out later? Did the doctor mention the survival rate of the grafts in the scar?

[hongkongfue]

Hi, I don’t know about the survival rate. Yeah it was only 50 on each side. And to be fair it was very hard to get a picture with longer hair and certainly the view wasn’t like for like on the full grafted area and full photographed area for comparison.  Regardless at 6 months things aren’t final by any stretch. Maybe at the year mark after a fresh haircut I can do some better photos with more accurate comparison.   No Dr. Wong didn’t mention survival rate. But I didn’t ask. I’d assume though if it was anticipated to be any lower than the rest of the scalp he’d have said something and told me don’t waste the graphs.  But honestly the scar was of little concern to me going in or now. As you can see with my hair length at a no. 5 guard along with my skin tone and hair color it’s a non issue. Atleast in my eyes.  You should reach out to Dr. Wong to discuss any particulars on scar grafting.  Sorry I don’t know more particulars.  Hope that helps. 

[Needhelpwithscar]

@hongkongfue you have helped a lot. I am considering grafting in my scar in the future but I’m concerned about the possible low survival rates mentioned by others. I’ll keep up with your next updates. Hope your results will keep getting better and better in the next few months.

[josha]

Wow looks great

[Gatsby]

@hongkongfue these are excellent results for 6 months and as I said prior that strip scar is pencil thin. You could always have SMP for it but personally I wouldn't bother. Thanks for sharing and I look forward to further up dates! All the best! 👌

[hongkongfue]

Hi guys, 8 month update. Sorry missed a few months. Still very happy with things. It was rainy day today so couldn’t get outside shots.  This is about 3 weeks out from my last haircut. Still using no. 5 guard on the sides.  Thanks!