Looking for advice on attempting a third FUE procedure. First two were unsuccessful.

[Zxcv7890]

I’m 35, male, NW2.5, have been on Finasteride successfully for 10yrs with little to no loss of native hairs. 
 

Had my first FUE procedure ~2018, 600 grafts, all in the temples. I went with a surgeon with no reputation who I didn’t meet until the day off. I was eager and naive. I had immediate concerns about density and the hairline itself directly post-op. Although I wouldn’t say the grafts were unsuccessful. It had no density and left me with a very unnatural look.

Second procedure in 2020 I went with a very reputable surgeon in NYC. Very highly spoken of and recommended on this board. Surgeon was up front that because my first transplant went so badly I’d likely still need a third to get the desired density. Had an excellent experience with the 800 FUE procedure. Left the building ecstatic at the immediate post-op density. Followed the post-op procedures to the letter, but the results 18 months out were poor. Limited graft acceptance and density on one temple, almost no graft acceptance, zero density on the other. 
 

Met with the surgeon, we both agreed the results were less than the expected. He offered to correct the temple that failed with 200 grafts free of charge and said if I wanted to perform the third procedure (an additional 400 grafts on top of the 200; total distribution as 500 in the failed temple, 100 in the other) we could do it at the same time.

My dilemma is although I’ve only been to two surgeons, both failed. The second procedure, although unsuccessful, I’m still confident of the surgeons expertise. So, I’m questioning my candidacy. 
 

I want a third procedure because my hair loss has become a significant confidence issue, but I’m worried I’m walking into the same result. Essentially it may be me and either I’m not a good candidate in general, or I’m just not a good recipient of the surgeons approach. 
 

Has anyone else had an initial less than expected result with a good surgeon and stuck with it for success? Or is it insane to try this with the same office again?

[SuperC]

Please share the clinic names. Also, posting some photos would be helpful.

[Rawkerboi]

You need to share some images, for a proper feedback & please share the name of clinic or doctor why you want to keep it secret? 

[mr_peanutbutter]

id suggest to check if you have lichen planopilaris, frontal fibrosing alopecia (ffa) or some other issue which could cause issue with growth

[Doron Harati]

We need to see photos including the punch and incision jobs.

Making expectations is very personal, I prefer usually to present the candidate what MINIMUM can be done, than have a "happy suprise" with the result.

There's also possibly you had aggressive hairloss after each HT which can make the result less impressive, it's very hard to share opinion with some photos.

[Zxcv7890]

Clinic was True & Dorin. Photos marked with ‘B’ are before, ‘A’ for after. I’ll try to obtain immediate post-op photos. I can’t find those I took myself. For expectations, what I was hoping for is a semblance of a hairline to fill in the corners; definitely not native density, but the density I have is so low I have to keep it covered. Appreciate the advice, thank you.

[Rc14]

I wonder if perhaps True and Dorin are not that great anymore. I can’t see any new hairs growing at all on one side, and the other side has crazy shock loss, and very little hair growing, and I’m almost 12 weeks out. 

I got 1200 grafts…I’m extremely nervous right now. 

can I ask some questions about your surgery with Dorin? Did you retain your transplanted hair for a while after the surgery? But then once they fell out, they just never grew back in?

Edited August 14, 2023 by Rc14

[Zxcv7890]

15 hours ago, Rc14 said:

I wonder if perhaps True and Dorin are not that great anymore. I can’t see any new hairs growing at all on one side, and the other side has crazy shock loss, and very little hair growing, and I’m almost 12 weeks out. 

I got 1200 grafts…I’m extremely nervous right now. 

can I ask some questions about your surgery with Dorin? Did you retain your transplanted hair for a while after the surgery? But then once they fell out, they just never grew back in?

Hard to remember exactly how long I retained the transplanted hair but it was a few weeks; but yes they pretty much never grew back in. Strangely, I remember them growing a bit before shedding.

I would try not to worry about it too much at this point. I’ve been to two surgeons and both transplants didn’t just fail but had a near nothing survival rate. Could be the surgeons but there’s also a chance I’m just not a good candidate or have some underlying condition. 

Also the angles may be tough to see and I cut my hair a bit different but although I had some shock loss from both surgeries in the months after, my native hairs did grow back. 

I know that feeling but just remember my case is bit of an exception. Bad results highlight pretty easily but the office does have a good track record. Don’t stress about it, the numbers are on your side. Hoping for good results for you.

[Rc14]

Lol, the same thing with me. They grew a bit, and now, completely gone. 
 

I’m not completely sure you should be this sure about Dorin. In the past few years, there have been a decent amount of bad results(like 3). 
 

True, there’s a sampling bias, but I think there’s a disproportionate amount of grafts not surviving for Dorin vs other doctors I think.

 

actually, look at the google reviews. Many people are echoing what you’re saying — friendly staff, but poor graft survival.

Edited August 14, 2023 by Rc14