Repair advice [Pics included]

[eze]

@HappyMan2021 @Gatsby @gillenator @Berba11

Posted a thread a while ago but now I added a pic to hopefully get some advice from experienced members. I had 1700 grafts and as you guys can see the hairs stick up like antennas. I am kind of torn between:

1. Remove only the frontal part of the transplanted region (a few hundred grafts at the very front) then implant correctly angled hairs to camouflage it

2. Remove every transplanted hair before implanting new hairs. 

Any input is much appreciated. 

https://imgur.com/a/OgICVsW

Edited January 25 by eze

[Berba11]

The issue with only taking out the first couple of rows is that you're only really getting 300-500 grafts out. That's fine if the hair immediately behind that is flatter, but if it sticks up as much as the first few rows then you'll have a similar problem. Ideally you'd just remove as much of the offending grafts as possible (you won't get all of them) so that everything blends when new grafts are added.

The answer probably sits somewhere in between option A and option B in all likelihood. Ideally you need to seek some in-person consultations with excellent repair doctors, but at the very least get some emails fired off with good quality pictures for an initial assessment.

[Maorizio]

You gonna need multiple repairs to remove all of them, I think it’s best to go to top surgeon to perform a camouflage transplant and try to work with it.

Which hairmill did this?

Edited January 25 by Maorizio

[Dr. Glenn Charles]

It would help if we could see the actual height of the hairline or distance from hairline to eye brows. If you have grafts removed that area would need to heal properly before transplanting news hairs into that area. Consider removing first few rows of grafts and then just thinning down area behind hairline using partial removals or alternating removals. Then at later date having additional grafts added in proper angle and direction.

[eze]

15 minutes ago, Dr. Glenn Charles said:

It would help if we could see the actual height of the hairline or distance from hairline to eye brows. If you have grafts removed that area would need to heal properly before transplanting news hairs into that area. Consider removing first few rows of grafts and then just thinning down area behind hairline using partial removals or alternating removals. Then at later date having additional grafts added in proper angle and direction.

Its 5-5.5cm, which looks quite low. So I will probably get electrolysis to move it up at least 5mm before rebuilding. 

And thank you for the alternating removal suggestions, I will look into that. 

[Dr. Glenn Charles]

Also keep in mind that graft removal can cause some micro scarring below the surface which can effect the survival rate of new grafts placed into that area. 

[eze]

3 minutes ago, Dr. Glenn Charles said:

Also keep in mind that graft removal can cause some micro scarring below the surface which can effect the survival rate of new grafts placed into that area. 

Is this mostly the case with FUE punchouts or will electrolysis result in the same thing? And to what extent does it reduce survival rate?

Would you recommend going less dense on the repair procedure to ensure a higher survival rate? 

[HappyMan2021]

1 hour ago, eze said:

@HappyMan2021 @Gatsby @gillenator @Berba11

Posted a thread a while ago but now I added a pic to hopefully get some advice from experienced members. I had 1700 grafts and as you guys can see the hairs stick up like antennas. I am kind of torn between:

1. Remove only the frontal part of the transplanted region (a few hundred grafts at the very front) then implant correctly angled hairs to camouflage it

2. Remove every transplanted hair before implanting new hairs. 

Any input is much appreciated. 

https://imgur.com/a/OgICVsW

can you post more pics? 1 picture is not enough to understand the complexity of a repair case

also, in your current pic, have you pushed your hair back in the picture, or its placement is how it naturally rests? I will admit it does look very badly angled if the hair naturally sits up like that and you have not forcefully styled it to look like that. 

Camoflage is baloney it doesn't work. 

I know it sucks feeling like you need to regress and take 2 steps backwards, but I recommend killing off all the bad grafts as much as humanly possible, so when you do have repair surgeries they will primarily be implantation with just a bit of extraction. 

Perhaps look into laser therapy as well. I am not an expert in electrolysis vs laser. But I think the differences with laser is it is harder to kill the grafts in 1 go, but simultaneously you can really "carpet bomb" mass areas, whereas electrolysis is killing grafts 1 by 1. 

With electrolysis I think you can kill like 50-100 grafts every session, and you can do it 1x a month. I am not sure of the cadence with laser

The cold hard truth is - while I think you can get a good end result- this WILL be a multi-year journey for you. There is unfortunately no shortcut or easy path. I predict a a handful of electrolysis or laser sessions, followed by a minimum of 2 surgeries. 

Also I wouldn't get worried about electrolysis causing micro-scarring. While that is true - extracting the grafts via surgery is way more damaging and traumatic for your skin. SO the less damaging route is electrolysis

Additionally, as you talk with doctors and do consultations, be skeptical of doctors who tell you not to do electrolysis (MANY MANY doctors I personally have talked to have been against electrolysis)

By doing electrolysis, there is alot less work for the doctor to do and therefore alot less money for them. So they have a financial incentive to tell you not to do electrolysis. 

For bad angles, electrolysis (or laser) are really the best option, in conjunction with surgery. 

Lastly, can you please describe your donor? How many grafts do you have left in your donor? It is super important to know this, ask your previous doctor if you are unsure.

I will say that while I do think alot of doctors are financially motivated to scare bad angle patients away from electrolysis, there is legitimate concern and a big risk of doing electrolysis if you have a limited donor. 

If you do not have the donor supply to kill off anywhere from hundreds up to 1700 grafts, then save yourself the time and remove electrolysis as an option for you. 

In the interim - if it helps you to cope - I recommend using gel or another holding product as that will (temporarily) control these bad angles. 

Edited January 25 by HappyMan2021

[eze]

19 minutes ago, HappyMan2021 said:

can you post more pics? 1 picture is not enough to understand the complexity of a repair case

also, in your current pic, have you pushed your hair back in the picture, or its placement is how it naturally rests? I will admit it does look very badly angled if the hair naturally sits up like that and you have not forcefully styled it to look like that. 

Camoflage is baloney it doesn't work. 

I know it sucks feeling like you need to regress and take 2 steps backwards, but I recommend killing off all the bad grafts as much as humanly possible, so when you do have repair surgeries they will primarily be implantation with just a bit of extraction. 

Perhaps look into laser therapy as well. I am not an expert in electrolysis vs laser. But I think the differences with laser is it is harder to kill the grafts in 1 go, but simultaneously you can really "carpet bomb" mass areas, whereas electrolysis is killing grafts 1 by 1. 

With electrolysis I think you can kill like 50-100 grafts every session, and you can do it 1x a month. I am not sure of the cadence with laser

The cold hard truth is - while I think you can get a good end result- this WILL be a multi-year journey for you. There is unfortunately no shortcut or easy path. I predict a a handful of electrolysis or laser sessions, followed by a minimum of 2 surgeries. 

Also I wouldn't get worried about electrolysis causing micro-scarring. While that is true - extracting the grafts via surgery is way more damaging and traumatic for your skin. SO the less damaging route is electrolysis

Additionally, as you talk with doctors and do consultations, be skeptical of doctors who tell you not to do electrolysis (MANY MANY doctors I personally have talked to have been against electrolysis)

By doing electrolysis, there is alot less work for the doctor to do and therefore alot less money for them. So they have a financial incentive to tell you not to do electrolysis. 

For bad angles, electrolysis (or laser) are really the best option, in conjunction with surgery. 

Lastly, can you please describe your donor? How many grafts do you have left in your donor? It is super important to know this, ask your previous doctor if you are unsure.

I will say that while I do think alot of doctors are financially motivated to scare bad angle patients away from electrolysis, there is legitimate concern and a big risk of doing electrolysis if you have a limited donor. 

If you do not have the donor supply to kill off anywhere from hundreds up to 1700 grafts, then save yourself the time and remove electrolysis as an option for you. 

In the interim - if it helps you to cope - I recommend using gel or another holding product as that will (temporarily) control these bad angles. 

Thank you again for your reply, you are an absolute angel. 

I added 2 more pictures in the original link. https://imgur.com/a/OgICVsW 

It actually does look that bad when I don't comb it forward or sideways. It looks ok with gel tbh. 

And my donor is quite a bit above average. The back of my head is quite large in proportion compared to the front. 

I will remove it with electrolysis before consulting any doctor.

I will also be on dutasteride for life so chances are my natural hair will not reach NW 5-6? (what are your thoughts on this statement?)

Also, verteporfin will be out so I can at least get a few thousand grafts from that. 

[HappyMan2021]

46 minutes ago, eze said:

will remove it with electrolysis before consulting any doctor

I think it would be beneficial to begin the consulting process earlier rather than later. No harm. 

But yes in my experience some doctors really will strongly debate you if you mention electrolysis, and for all i know reject you as a candidate 

Perhaps lead with the question "what do you think about electrolysis...". If they react negatively then just keep all the electrolysis on the downlow. If they are positive then share more

But yes, you can do successfully do electrolysis prior to consultations if you want

48 minutes ago, eze said:

will also be on dutasteride for life so chances are my natural hair will not reach NW 5-6? (what are your thoughts on this statement?)

Everyone is different...but as long as you only have a minor genetic propensity for MPB (like NW3) + dutasteride, you likely should be fine

[HappyMan2021]

@eze i also recommend you strongly demand a refund from the surgeon. If not, name and shame them on this forum (which you actually should do anyway to help out the community and potential new patients)

You were undeniably botched and there is no excuse at all for this type of result

Alot of ht doctors are shady and for all i know you wont get a refund....but you really have nothing to lose by asking them. 

Being respectful, kind, discreet to a doctor who was so negligent with you is not being fair to yourself

There is NO valid excuse for bad angles other than surgeon incompetence and/or outright carelessness

[baddecisions]

Do not go for electrolisis without having consulted some doctors. That would be something you may regret.

 

[baddecisions]

In this forum you can find guys that got their missangled/multi/thicker grafts punched out, some cases involving a few hundred and other involving more than 1 thousand. Similar cases can be found in other regional forums. Invest time and resources in doing extensive research. All the best. 

[gillenator]

Listen my friend, start with obtaining multiple opinions from reputable repair surgeons before making any decisions…it’s going to involve a number of methods and techniques to remove some of the badly mis-angled grafts and re-implantation…a huge factor to contend with is your wide contrast of hair and complexion color…this is why the imperfections appear to be more noticeable.

[Tougoire]

Definintely go the very best surgeon you can find. There is help out there; I know, I've been there.