Doing another operation within 2 years of first.

[tacale]

HI all. 

Wanted to ask for advice on how to proceed. I had an operation 16 months ago and would like to go and do another one, but want to be sure I'm making the right decision and not rushing in. 

My (33 years old) case is a little different to most. Prior to my first OP  I was about a NW 5 and in a position where i needed around 4000 - 5000 grafts for a good result (pic from before the Op)

 

However, I was unsure with all the travel restrictions at the time so decided to go for a local doctor who would only do around 2500  (in the end closer to 2000) who was available without too big a waiting list.  My logic was rather than wait and keep researching for the right doctor to do the whole operation, which knowing myself could have taken a long time to decide, I'd just pull the trigger  get at least some of the work done, look better and potentially be able to do more down the line.  

Well here we are now. 

I am quite happy with the result I got, considering I had almost no hair on the front 2 years ago and didn't use many grafts. I no longer look mostly bald and if there isn't a light right above me it looks like I do have hair. 

However, my hair is still obviously very thin, its pretty much just the 2000 grafts that cover the entire front where there was almost nothing. When I cut it short it looks like I have none but of course at longer lengths the illusion works as intended (eg below)

 

So getting more done would be desirable and I would like to get one in the fall/ winter. Perhaps another 2000 to cover some gaps 

The reason I am unsure though is because I have tried Fin a few times and had sideeffects, despite pushing through for months thinking theyd go away.  So I realize that unfortunately I won't be able to rely on a DHT blocker for the next 20 years like most transplant patients do. 

Therefore I would be limited to hair transplants as my sole way of combatting hairloss moving forward. My fear is that if I rush in to get another 2000 grafts done, I'm left very thin for the future as DHT perhaps continues to erode my hairline.

So should I be more conservative and wait a few years for a top up - be happy with what I have now, or is there no risk to getting the grafts I should have in the beginning (say 2000 for 4000 total) and then in 7 years deal with whatever the situation is?

 

[A_4_Archan]

@tacale it depends on your hairloss progression whether it is stable/slow or you are loosing ground quickly...if it is not that stable than you have to think twice before going for it...and if it is stable/slow than you can think abt it..if you are happy with the current situation and can manage it than you can delay your HT to be on safe side and if its concerning you too much and you wanna go for a HT than small session would be better so that you have grafts in your bank for future loss ....your transplanted hairs won't probably fall off as they are less prone to dht though some may get miniaturized with time....you may try some non surgical therapies which can help you with this ....i hope this helps you ..best of luck ..

[Rahal Hair Transplant]

@tacale,

I can certainly understand your position and why you chose to undergo a hair transplant locally considering all the travel restrictions although obviously, most including me would have advised you to look into all of the travel regulations because traveling was still possible.

That said, based on the photo I’m seeing it looks like that your result is decent for the number of grafts you received. Of course I’m only seeing one photo of one angle and I suspect it’s very thin looking when you view the result from the top down.   That doesn’t mean the result isn’t good, it just means that you need more graphs in order to provide you with the coverage and density you want and need.  

All that to say I’m not really clear on what your question is. Whether or not to proceed with a second heart transplant now or in another couple of years, what do you see as being the big difference?

In my opinion, if you are willing and able to travel and pay to undergo a larger hair transplant procedure with a surgeon you are highly impressed with with a proven track record of producing outstanding results, then I don’t really see the purpose of waiting a couple more years since you’ve already started down the surgical hair restoration route. Also, 16 months is long enough to wait between procedures if that’s your concern.

if your concern is that you don’t have the money yet to pay for the best so to speak, then I would suggest waiting until you can.

Obviously you could continue going to the surgeon you’ve initially selected who seems to have done a decent job on you from what I can tell. But if you’re looking for larger sessions and this particular surgeon limits session sizes as a general rule rather than strictly based on your situation, then you may want to look into surgeons who don’t create those types of general limits.

if you are interested in an information session with Dr. Rahal Who has an outstanding reputation on this community and amongst his patients and peers, feel free to send me a private message and I’ll be happy to set this up for you. The session would be online and there’s no obligation. But it might give you a frame of reference and what you can expect moving forward if you do proceed with surgery now versus later in the hands of an outstanding surgeon. 

I hope this helps.

Rahal Hair Transplant 

 

[Rahal Hair Transplant]

I just want to add one more quick note.  If you are still losing hair and you are not currently taking non-surgical solutions such as finasteride or minoxidil, you may want to speak to a doctor about that possibility.  Surgical hair restoration is great at restoring hair to bald and thinning areas but it does nothing to stop the progression of genetic hair loss.  Also keep in mind that non-surgical solutions work a lot better when existing hair still exists. It’s not likely going to bring back hair in completely bald areas. So it’s always better to use on surgical treatments as early in your hair loss as possible.

Best wishes,

Rahal Hair Transplant

[Bhumik Shah MD]

It seems to me that you understand the limitations of hair restoration surgery very well. The question you want answered really depends on what your donor area looks like. If you are not going to take finasteride, erring on the side of being conservative is never a bad idea.

[tacale]

Thank you for the advice both of you. 

On 7/18/2023 at 2:46 PM, Rahal Hair Transplant said:

@tacale, 

All that to say I’m not really clear on what your question is. Whether or not to proceed with a second heart transplant now or in another couple of years, what do you see as being the big difference?

In my opinion, if you are willing and able to travel and pay to undergo a larger hair transplant procedure with a surgeon you are highly impressed with with a proven track record of producing outstanding results, then I don’t really see the purpose of waiting a couple more years since you’ve already started down the surgical hair restoration route. Also, 16 months is long enough to wait between procedures if that’s your concern.

if your concern is that you don’t have the money yet to pay for the best so to speak, then I would suggest waiting until you can.

Obviously you could continue going to the surgeon you’ve initially selected who seems to have done a decent job on you from what I can tell. But if you’re looking for larger sessions and this particular surgeon limits session sizes as a general rule rather than strictly based on your situation, then you may want to look into surgeons who don’t create those types of general limits.

if you are interested in an information session with Dr. Rahal Who has an outstanding reputation on this community and amongst his patients and peers, feel free to send me a private message and I’ll be happy to set this up for you. The session would be online and there’s no obligation. But it might give you a frame of reference and what you can expect moving forward if you do proceed with surgery now versus later in the hands of an outstanding surgeon. 

I hope this helps.

Rahal Hair Transplant 

 

My question is basically- what to those on this site who probably know a lot more than me or have had or seen similar experiences, see as the potential cons of doing an operation 2 straight years.

I don't see a big disadvantage to doing it now rather than in a few years but wanted to check if there's something I am overlooking. 

You say I may consider larger sessions, but if I already have had 2300 or so and now go for a large session say 4000 wouldn't that leave me with nothing left for the future?

I'm hoping 2000-2500 will be enough to add some good density leaving me with a little bit potentially to still work with in the future if necessary. 

[Bucky O Hair]

5 hours ago, tacale said:

Thank you for the advice both of you. 

My question is basically- what to those on this site who probably know a lot more than me or have had or seen similar experiences, see as the potential cons of doing an operation 2 straight years.

I don't see a big disadvantage to doing it now rather than in a few years but wanted to check if there's something I am overlooking. 

You say I may consider larger sessions, but if I already have had 2300 or so and now go for a large session say 4000 wouldn't that leave me with nothing left for the future?

I'm hoping 2000-2500 will be enough to add some good density leaving me with a little bit potentially to still work with in the future if necessary. 

Lots of people do surgeries in two straight years.  

I think it's moreso about making sure you don't deplete the donor, and that you have enough hairs there for a sizable second HT (but this is best determined by your surgeon).

The only disadvantage would be if you end up transplanting a bunch of hairs that are likely to fall out in the future anyway. 

 

[tacale]

8 hours ago, Bucky O Hair said:

Lots of people do surgeries in two straight years.  

I think it's moreso about making sure you don't deplete the donor, and that you have enough hairs there for a sizable second HT (but this is best determined by your surgeon).

The only disadvantage would be if you end up transplanting a bunch of hairs that are likely to fall out in the future anyway. 

 

What do you mean by hairs that are likely to fall out in the future anyway? Mean ones close to balding areas which are probably next to fall out? Or just if someone has aggresive balding all hairs are expected to fall out at some point?

[Bucky O Hair]

I mean, hairs from your donor that may end up falling out in the future.

The hairs on the sides and back of your head that are in the safe zone are "resistant" to hair loss, but they are not guaranteed to remain forever.  Granted, it may take a very long time for them to fall out, but even transplanted hairs should eventually thin out over time.