4355 Grafts FUE / Dr. Laorwong Absolute Clinic / 06.07.2023

[Sele]

I (42M) had my hair transplant done with Dr. Laorwong and his assistants in Bangkok at Absolute Clinic on July 6th. Its been 3 months and 7 days (14 weeks) post surgery when I finally  took my time to make this post.

The total Grafts of 4355 were done in one session.

• Single Grafts: 928
• Double Grafts: 2106
• Tripple Grafts: 1329
• Should be from my calculations 9103 hairs (or more if quadruple grafts were used as well)

I went to the surgery pretty uninformed. Dr. Laorwong recommended doing only the front part half of my head but I asked him to do all the head. So they did some grafts on the crown as well. Not sure how many but I think just a few. If I had to guess, maybe 200-300. Unfortunately I never received my pre and post surgery photos, the Doctor took. So I can only post a few of the bad quality pre surgery photos I have.

Donor area:

Top view:

Front view:

Just a quick story about my hair loss. I started noticing hair loss around the age of 21, after the removal of my tonsils under general anesthetic. I dont know what happened there but basically the days after the surgery I started losing hundreds of hairs daily. At some point it slowed down but kept going. With 24 I started taking 1.25mg finasteride daily and noticed horrible side effects but kept going. I could only get 40-50% erections during sex. I was extremely depressed and had chronic fatigue. I developed social anxiety and histamine intolerance. A year later I stopped finasteride. But unfortunately I never fully recovered. To this day I have most of the symptoms. Anxiety, depression, fatigue, low libido. Erections are okish. On the positive side, post finasteride  syndrome slowed down my hair loss dramatically. To the point where I was able to hide my diffuse thinning with hair fibers until early 2023.

My hair in 2018 with fibers:

My hair with fibers in early May 2023:

Until 2018 I didnt know post finasteride syndrome exists. I always knew instinctually that finasteride messed me up. But I thought an FDA approved drug cant do permanent damage. Until I started research in 2018. After finding out that PFS is really a thing, I started doing different treatments. From DHEA, Pregnenolone, Testosterone Replacement Therapy. My testosterone and DHT were sky high naturally but the Testosterone just didnt do its job in my body. I stopped TRT and did a PCT. Then tried HCG. Nothing helped.

Labs 13 years post finasteride before any treatment:

After nothing helped with PFS, I gave TRT another try in August 2022. I had my hands on Testosterone Enanthate (The first try was Sustanone) and this time it didnt work for low libido and other issues but I gained some muscles without even working out. In around April I started taking Primobolan (DHT) injectins more regularly. Every 2 days. But low doses. About 10mg every 2 days. Thats when my hair loss started to get out of hands. Pretty much within 2 months I lost an insane amount of hairs so I was not able to hide it with fibers anymore. It did help with libido though. But I stopped Primibolan fully because it gave me very bad problems with my prostate (like so many, I got prostatitis after stopping finasteride).

Sorry for this boring story but I wanted to explain why I went to do a hair transplant and was pretty uninformed. Luckily I chose a very good doctor, after doing my research. I am living in Bangkok. So I chose the Absolute Clinic and Dr. Laorwong as my surgeon.

As for the surgery, everything went pretty smooth. The doctor took some pictures, shaved my head, gave me some pills and within a few minutes I was so knocked out that I barely can remember anything. I just made a note on my phone "injections painful" and then fell asleep. Woke up for having lunch (chicken with rice, very delicious). Then the grafts got placed and I was knocked out again. I think I woke up 1 hour before the surgery ended. That was the part that felt it will never end. After getting a sandwich, I went home with the BTS and pretty much immediately fell asleep again. Slept probably 10-12 hours like a baby. Next day was the first wash, a LLLT treatment and then I headed to the shopping mall Icon Siam. The next 4 days were the same.

I received a PRP and so called Stem Cell treatment during the surgery.

here are some post transplant pictures:

Day after transplant:

2nd day after transplant:

13 days post surgery:

Shedding phase was brutal: It started around day 15 after the transplant. Within 10 days I would say 80% of the transplanted hairs were gone. I also had severe shock loss everywhere. Even the untouched stripe between donor and recipient area had bad shock loss.

Start of shedding with lots of L-shaped hairs:

1 month post surgery:

Donor after 1 month:

2 months post surgery:

3 months:

Some small growth:

First hair cut skin fade:

I dont know where my transplant is heading to. If I had lots of grafts dying or not. Because my scalp was extremely red and inflamed. Around week 5 or 6 I went to the clinic and the doctor gave me a topical antibiotic cream. Within 2 weeks the inflammation got better. But as I said, I have no idea if that inflammation killed some grafts or not. But I think the inflammation started around week 3. So normally the grafts were safe already. I made the mistake to use rosemary and peppermint oil mixed with jojoba oil (3% and 3%). I think that made my scalp inflamed. I stopped after a week but it was red as hell already. So, not the fault of the clinic.

Visited the doctor yesterday. He said looks good for 3 months. As Melvin always says, I trust the process. Sorry if these are too many pictures. I easily took 500+ pictures and a few videos in the last 3 months 

Edit: I want to add, I like the hairline design. It fits my face and I think replicates my natural hairline. I never had a V shape. It was round, just like now after the HT.

Edited October 13, 2023 by Sele
Added content.

[Hairwolf]

Good report! I am a Dr Laorwong patient (1 week behind you) also and my scalp was also very red  several weeks after surgery, but I thought that was normal. Hopefully it won’t influence things too much. Living in BKK is a big advantage as you can check in with the Dr with any concerns.
 

I am 3 months post op now and the redness started to subside about 2 weeks ago. Do you have any pics of the hairs that were pulled out? 

It seems that generally if you are susceptible to hair loss you should avoid TRT. Nevertheless the hairline is  looking good and is shaping up well. Keep updating!
 

 

 

Edited October 14, 2023 by streethawk

[Gatsby]

You’ve gone to an excellent surgeon @Sele. For three months your growth looks excellent. 👌

[Spring15]

Should turn out great 

[Sele]

On 10/14/2023 at 10:01 AM, streethawk said:

Good report! I am a Dr Laorwong patient (1 week behind you) also and my scalp was also very red  several weeks after surgery, but I thought that was normal. Hopefully it won’t influence things too much. Living in BKK is a big advantage as you can check in with the Dr with any concerns.
 

I am 3 months post op now and the redness started to subside about 2 weeks ago. Do you have any pics of the hairs that were pulled out? 

It seems that generally if you are susceptible to hair loss you should avoid TRT. Nevertheless the hairline is  looking good and is shaping up well. Keep updating!
 

 

 

Thank you. No I dont have pictures from pulled out hairs. But on month 1 picture you can see quite a few thick but short hairs that didnt grow or shed. Those were all death grafts. If that is what you mean by pulled out hairs?

I know about TRT but the fine line between having no libido but having hair or having no hair but libido is pretty thin. Try to catch the sweet spot. If I had a choice I would chose full libido pre finasteride levels and instead going bald and then doing a hair system.

Your hair looks quite good for the 3 months mark. You have thick donor hair. I think your result will look great.

On 10/14/2023 at 11:52 AM, Gatsby said:

You’ve gone to an excellent surgeon @Sele. For three months your growth looks excellent. 👌

Thank you mate. I´ve followed your progress quietly and its absolutely impressive what you and your surgeons achieved. Its like 2 different persons. Gives me hope in case of further progression. And I see your rocking it in South East Asia as well. Im living here in Bangkok for almost a year now.

[A_4_Archan]

@Sele

You have gone to an excellent surgeon..generally at 3 months people are at baseline and growth atarts to kick in after 4 months....so the game begins now...Happy growing and keep updating brother.will follow your journey closely.

[Sele]

8 hours ago, A_4_Archan said:

@Sele

You have gone to an excellent surgeon..generally at 3 months people are at baseline and growth atarts to kick in after 4 months....so the game begins now...Happy growing and keep updating brother.will follow your journey closely.

Thank you brother. I have been following your progress and your gains are impressive. The medication surely does wonders for you as well. I wish I would not react this bad to medication. 

[Hairwolf]

20 hours ago, Sele said:

 

20 hours ago, Sele said:

If I had a choice I would chose full libido pre finasteride levels and instead going bald and then doing a hair system.

Wow, that’s radical man. Tough choice for any man to make, but there’s no doubt in your mind.

 

20 hours ago, Sele said:

Thank you. No I dont have pictures from pulled out hairs. But on month 1 picture you can see quite a few thick but short hairs that didnt grow or she

On another thread you said that you went back to the Dr to have some grafts pulled out and they slipped out very easily?  The grafts just didn’t take?

 

20 hours ago, Sele said:

Your hair looks quite good for the 3 months mark. You have thick donor hair. I think your result will look grea

Thanks! Touch wood and all that for a good final result. Funny thing was I was told my donor was weak, according to pictures and an in-person consultation years ago. Said I lacked sufficient donor for a transplant. My hair was quite wavy pre MPB. Meds may have helped a bit, but not 100% sure.

[Spring15]

Missed your experience with Finasteride, I had similar issues with erections but after one month - I stopped and function returned near to normal except it takes longer for round 2

Have you tried any sort of Viagra? 

[Gatsby]

4 hours ago, Spring15 said:

Missed your experience with Finasteride, I had similar issues with erections but after one month - I stopped and function returned near to normal except it takes longer for round 2

Have you tried any sort of Viagra? 

You can go round two? 😳🥺🤣

[Spring15]

11 minutes ago, Gatsby said:

You can go round two? 😳🥺🤣

Hah that was after I stopped fin which was over 10 years ago in my early 20s. Sometimes but now in my 30s one seems to be more the standard 😄 

[Sele]

On 10/16/2023 at 8:50 PM, streethawk said:

 

Wow, that’s radical man. Tough choice for any man to make, but there’s no doubt in your mind.

 

On another thread you said that you went back to the Dr to have some grafts pulled out and they slipped out very easily?  The grafts just didn’t take?

 

Thanks! Touch wood and all that for a good final result. Funny thing was I was told my donor was weak, according to pictures and an in-person consultation years ago. Said I lacked sufficient donor for a transplant. My hair was quite wavy pre MPB. Meds may have helped a bit, but not 100% sure.

Yes, thats right. I went to Dr. Laorwong about the 6th week and told him about those hairs that didnt grow nor shed. He pulled out quite a few. If I had to guess, maybe 50? And at home I pulled out another 10. I assume those were grafts that didnt take. Because normally they should easily shed/fall out. I have marked a few I assume didnt take. I just hope it weren't too many. I read that the survival rate is usually 90%. So if 4000 grafts survived, I am very happy. Just hope its not more.

 

[Sele]

10 hours ago, Spring15 said:

Missed your experience with Finasteride, I had similar issues with erections but after one month - I stopped and function returned near to normal except it takes longer for round 2

Have you tried any sort of Viagra? 

It was 18 years ago. I just remember I was extremely suicidal after stopping it. I was considering driving against a tree with the car. Had severe CFS. I couldn't go to public places and meeting people without being drunk, due to anxiety. Was sweating waterfalls under my arms, even though I was not hot. Complete lack of libido. Back then I was 25 and had a super hot 21yo Russian girlfriend. We only met on weekends due to long distance and it was so terrible with the lack of libido, I just wanted to sleep. I developed MCAS/Histamine Intolerance and all my body was itching like hell. And the worst was this extreme brain fog. I couldn't follow the school lessons anymore. Low libido, itching, anxiety, cfs, brain fog, still have most of if. Luckily erections are ok. People without fin symptoms say PFS is just in your head. But I didn't know back then that PFS exists, so how can it be in my head. I never made the connection of all these symptoms with finasteride until 2018.

Also anything slightly anti androgenic like Zinc (5ar inhibitor) or B-Vitamins bring me back to pfs hell. Had it just 2 months ago. Took 50mg zinc for 2 weeks and my dick was completely numb for 4 weeks. As if you wear a diaper over your dick. Zero morning wood etc. So, unfortunately, I wont take Fin nor Minoxidil nor anything else that interrupts androgens. I know Minox doesnt, but I see couple people got PFS symptoms from Minox on Forums.

If this HT is successful, I will do a 2nd one covering the rest of the progressing hair loss. Dr. Laorwong said I have about 2K grafts left. But I honestly dont care about my donor area and if it has low density. If he can get out 4-5k grafts more, I am happy to do an SMP for density of the donor and recipient are. But lets wait this one out first and hope grafts survived 

[Sele]

Today received the pictures from the clinic. I am shocked how far my hair loss was gone on the front. So much hair loss in just 3 months. In May I was able to cover the front with fibers. Also this very HQ picture from after the procedure shows each graft very detailed. 

 

Edited October 17, 2023 by Sele

[Coffee_bean]

6 hours ago, Sele said:

Yes, thats right. I went to Dr. Laorwong about the 6th week and told him about those hairs that didnt grow nor shed. He pulled out quite a few. If I had to guess, maybe 50? And at home I pulled out another 10. I assume those were grafts that didnt take. Because normally they should easily shed/fall out. I have marked a few I assume didnt take. I just hope it weren't too many. I read that the survival rate is usually 90%. So if 4000 grafts survived, I am very happy. Just hope its not more.

 

Anyone know how common this is for grafts to just not take like this? I’m coming up on 3 weeks post op and definitely have a few grafts that look like this. 

[Hairwolf]

17 hours ago, Sele said:

Yes, thats right. I went to Dr. Laorwong about the 6th week and told him about those hairs that didnt grow nor shed. He pulled out quite a few. If I had to guess, maybe 50? And at home I pulled out another 10. I assume those were grafts that didnt take. Because normally they should easily shed/fall out. I have marked a few I assume didnt take. I just hope it weren't too many. I read that the survival rate is usually 90%. So if 4000 grafts survived, I am very happy. Just hope its not more.

 

Good high magnification pic thanks, although I am having difficulty determining how these hairs are grafts that didn’t grow versus new hair growing. How did you decide they were grafts that weren’t going to grow? From touch or from how they looked?

[TEXAN35]

You will continue to see these budding hair follicles for few more months, and it is a good sign. If they were lost, they would have already gone out of the scalp.

Sometimes it just takes time for these grafts to pick up the growth speed. This is the reason people see incremental gains for like 8-9 months and not all growth in 4-5 months.

[Sele]

5 hours ago, streethawk said:

Good high magnification pic thanks, although I am having difficulty determining how these hairs are grafts that didn’t grow versus new hair growing. How did you decide they were grafts that weren’t going to grow? From touch or from how they looked?

To be honest, I dont know. I assumed. Because they came out without any resistance. I always describe it as if you take out a straw from an empty glas. But maybe there still was a intact graft behind and it just didnt push out the hair during shedding. Only time will tell.

21 minutes ago, TEXAN35 said:

You will continue to see these budding hair follicles for few more months, and it is a good sign. If they were lost, they would have already gone out of the scalp.

Sometimes it just takes time for these grafts to pick up the growth speed. This is the reason people see incremental gains for like 8-9 months and not all growth in 4-5 months.

Yes its quite possible they still survived. I start to see lots of tiny hairs popping out now. Maybe they really survived and I am too negative about everything.

I just took this picture and I see tons of these tiny hairs popping. Feels like a small garden where you see the first growth 

[disTressedHairline]

On 10/17/2023 at 12:50 PM, Sele said:

It was 18 years ago. I just remember I was extremely suicidal after stopping it. I was considering driving against a tree with the car. Had severe CFS. I couldn't go to public places and meeting people without being drunk, due to anxiety. Was sweating waterfalls under my arms, even though I was not hot. Complete lack of libido. Back then I was 25 and had a super hot 21yo Russian girlfriend. We only met on weekends due to long distance and it was so terrible with the lack of libido, I just wanted to sleep. I developed MCAS/Histamine Intolerance and all my body was itching like hell. And the worst was this extreme brain fog. I couldn't follow the school lessons anymore. Low libido, itching, anxiety, cfs, brain fog, still have most of if. Luckily erections are ok. People without fin symptoms say PFS is just in your head. But I didn't know back then that PFS exists, so how can it be in my head. I never made the connection of all these symptoms with finasteride until 2018.

Also anything slightly anti androgenic like Zinc (5ar inhibitor) or B-Vitamins bring me back to pfs hell. Had it just 2 months ago. Took 50mg zinc for 2 weeks and my dick was completely numb for 4 weeks. As if you wear a diaper over your dick. Zero morning wood etc. So, unfortunately, I wont take Fin nor Minoxidil nor anything else that interrupts androgens. I know Minox doesnt, but I see couple people got PFS symptoms from Minox on Forums.

If this HT is successful, I will do a 2nd one covering the rest of the progressing hair loss. Dr. Laorwong said I have about 2K grafts left. But I honestly dont care about my donor area and if it has low density. If he can get out 4-5k grafts more, I am happy to do an SMP for density of the donor and recipient are. But lets wait this one out first and hope grafts survived 

That sounds absolutely horrible, I'm sorry that you have had to deal with this but I really respect you for persevering through it. 

I'm not a doctor - but it looks like your hormones are at the right levels, its just your receptors were somehow "turned off" so your body can't use that testosterone floating around. I could be completely wrong though - I don't have any medical training. 

Curious, have you ever talked to a doctor about trying daily low-dose tadalafil (Cialis)? There is extremely limited research that have shown it to increase androgen receptors - granted this was in in vitro cells, not on a normal person and the study was limited. 

Again, I'm not a doctor and I'm sorry if this is against any rules on this forum, I just feel for you in your situation and trying to throw out any ideas that you might explore with a qualified medical professional (not some random HRN lurker like me). Sounds like you have tried many things, and I'm shocked TRT didn't work. 

[Coffee_bean]

3 hours ago, Sele said:

To be honest, I dont know. I assumed. Because they came out without any resistance. I always describe it as if you take out a straw from an empty glas. But maybe there still was a intact graft behind and it just didnt push out the hair during shedding. Only time will tell.

Yes its quite possible they still survived. I start to see lots of tiny hairs popping out now. Maybe they really survived and I am too negative about everything.

I just took this picture and I see tons of these tiny hairs popping. Feels like a small garden where you see the first growth 

Actually, was it just hairs themselves you and him pulled out? Or actual, FUE grafts that were pulled from your scalp? 

[Sele]

On 10/19/2023 at 3:40 AM, disTressedHairline said:

That sounds absolutely horrible, I'm sorry that you have had to deal with this but I really respect you for persevering through it. 

I'm not a doctor - but it looks like your hormones are at the right levels, its just your receptors were somehow "turned off" so your body can't use that testosterone floating around. I could be completely wrong though - I don't have any medical training. 

Curious, have you ever talked to a doctor about trying daily low-dose tadalafil (Cialis)? There is extremely limited research that have shown it to increase androgen receptors - granted this was in in vitro cells, not on a normal person and the study was limited. 

Again, I'm not a doctor and I'm sorry if this is against any rules on this forum, I just feel for you in your situation and trying to throw out any ideas that you might explore with a qualified medical professional (not some random HRN lurker like me). Sounds like you have tried many things, and I'm shocked TRT didn't work. 

Exactly, I think the receptors do not do what they are supposed to do. Some say the receptors are oversensitive to androgens. As I mentioned, my current Total T is between 1500 and 1800 ng/dl. Thats double or even tripple the normal T levels. Free T is 3x higher than norm. Yet I dont feel anything different in terms of libido, confidence, aggression etc. But there are tons of people like me with pfs who didnt had any benefits from TRT. But if the receptors are really oversensitive, TRT would have a negative effect.

I indeed tried low dose Cialis. I tried 5mg every day and dropped that to 2.5mg every day after a week or so. Cialis was one of the things that helped with libido in the beginning. Just as Black Maca extract or Rhodiola did. Even TRT did help in the first 4 weeks. But, as with Finasteride, it seems I am a one in a million case with bad luck when it comes to Cialis. After about 2 weeks on Cialis I noticed vision problems on my right eye. In the center of my eye I felt like I was going blind. I lost about 50% of my vision. Couldnt make the connection to Cialis at first. But luckily around week 4 I did some research and found that Cialis can cause vision problems for some people. I immediately stopped and within 2 weeks the vision turned back to normal. Guess I was lucky. If I would have taken it longer, who knows what would have happened. Yet people on Reddit, just as with Finasteride, dont believe that Cialis can do this.

23 hours ago, Coffee_bean said:

Actually, was it just hairs themselves you and him pulled out? Or actual, FUE grafts that were pulled from your scalp? 

Yes, it was hairs without a root/shaft. The hairs looked like cutted hairs. So just a hair with nothing under it.

[disTressedHairline]

4 hours ago, Sele said:

Exactly, I think the receptors do not do what they are supposed to do. Some say the receptors are oversensitive to androgens. As I mentioned, my current Total T is between 1500 and 1800 ng/dl. Thats double or even tripple the normal T levels. Free T is 3x higher than norm. Yet I dont feel anything different in terms of libido, confidence, aggression etc. But there are tons of people like me with pfs who didnt had any benefits from TRT. But if the receptors are really oversensitive, TRT would have a negative effect.

I indeed tried low dose Cialis. I tried 5mg every day and dropped that to 2.5mg every day after a week or so. Cialis was one of the things that helped with libido in the beginning. Just as Black Maca extract or Rhodiola did. Even TRT did help in the first 4 weeks. But, as with Finasteride, it seems I am a one in a million case with bad luck when it comes to Cialis. After about 2 weeks on Cialis I noticed vision problems on my right eye. In the center of my eye I felt like I was going blind. I lost about 50% of my vision. Couldnt make the connection to Cialis at first. But luckily around week 4 I did some research and found that Cialis can cause vision problems for some people. I immediately stopped and within 2 weeks the vision turned back to normal. Guess I was lucky. If I would have taken it longer, who knows what would have happened. Yet people on Reddit, just as with Finasteride, dont believe that Cialis can do this.

Yes, it was hairs without a root/shaft. The hairs looked like cutted hairs. So just a hair with nothing under it.

Yeah, Tadalafil (Cialis) and Sildenafil (Viagra) can absolutely cause vision problems, it's a known side, unfortunately. Glad that was fixed when you stopped. 

[Sele]

It’s crazy what a difference one week made. Looking in the mirror daily, I didn’t see any improvement. But on these pictures it’s clear. First one is October 15th and 2nd one October 22th. Both taken with the flashlight of the phone.

 

Edited October 24, 2023 by Sele

[hairman4321]

wow, thats good growth! scalp is looking at lot less red too, or maybe its just the flash. hoping you have a good result dude!

[Sele]

1 hour ago, hairman4321 said:

wow, thats good growth! scalp is looking at lot less red too, or maybe its just the flash. hoping you have a good result dude!

Thanks mate. I keep checking on the date of the first photo and wondering if this improvement is really possible in just a week. But the date of the photo doesn’t lie.