Why did my transplant fail? I don’t get it and it just has been really tough to make sense of.

[ITA]

1 hour ago, Bucky O Hair said:

La mia ipotesi è che i tuoi innesti siano stati probabilmente recisi al momento dell'estrazione, o che siano rimasti fuori dal tuo corpo troppo a lungo prima di essere impiantati nuovamente.

Hanno menzionato qualcosa di unico nel tuo caso?
I tuoi follicoli erano più grandi del normale? Hai avuto un sanguinamento maggiore del solito?

È stata una buona decisione non accettare una procedura gratuita dalla stessa clinica.  

Potrebbero aver avuto un nuovo tecnico che lavorava sulla tua testa che non aveva l'esperienza... o forse i tuoi follicoli erano più difficili da rimuovere, ma non si sono adattati o adattati al tuo caso.

Se hai i soldi, valuterei sicuramente Zarev o Munib.  
 

The assumptions that you are making, particularly that of the inexperienced technician, may occur in the hair grinders, the OP said it was operated on by a surgeon with a good reputation here. Many of us think he went to H&W, which until recently were among the best in the world, but I don’t think they made mistakes like the ones you mentioned, maybe the only mistake was to estimate 3000 grafts for a degree of baldness like this.

[Hair-here]

4 hours ago, Bucky O Hair said:

My guess is that your grafts were probably transected upon extraction, or they stayed outside your body too long before being implanted again.

Did they mention anything unique about your case?
Were your follicles larger than normal?  Did you experience more than usual bleeding?

Good call on not accepting a free procedure from the same clinic.  

They may have had a new technician working on your head who didn't have the expertise...or maybe your follicles were more challenging to remove, but they didn't adjust or adapt for your case.

If you have the money, I'd definitely look into Zarev or Munib.  
 

To answer your question, I had no inkling that this was anything but a standard surgery- no unusual bleeding, no mention of anything from anyone that this was anything but standard.  It was my first surgery, but everything about it seemed pretty normal.

If it all grew in like in my after-surgery photo, I think I would have been happy enough since that’s basically the look I was expecting- a buzzed down frontal third with moderate density. We spoke at length about my expectations so this was not the doctor mis-estimating.  3000 grafts was the most any of the docs I consulted with were quoting me (due to my donor I assume) so I went in knowing 3000 grafts on an advanced NW wouldn’t go very far, but since I was buzzing it down anyway, my goals were realistic in just creating a hairline and gaining some frontal 1/3rd coverage to help connect the horseshoe. 

Edited April 17 by Hair-here

[Bucky O Hair]

4 hours ago, ITA said:

The assumptions that you are making, particularly that of the inexperienced technician, may occur in the hair grinders, the OP said it was operated on by a surgeon with a good reputation here. Many of us think he went to H&W, which until recently were among the best in the world, but I don’t think they made mistakes like the ones you mentioned, maybe the only mistake was to estimate 3000 grafts for a degree of baldness like this.

You are making an assumption too, that the ones with good reputations cannot make these same mistakes.  They do.

There are a lot of big name clinics who have diminished over the years.  I'm noticing more frequent bad reviews here and there from some of these former top clinics, which was impossible years ago.

Things change.  There are new doctors that bring new tools, techniques, and ideas.  The industry changes for the better, and some of these clinics (who choose not to change and evolve) will be left behind.  

[ScottishGuy21]

You were slick bald as you say so 3000 grafts was never going to be enough. But if you discussed this with your surgeon and the plan was to simply add some hair then fair enough.

 If I’m honest though I’m not sure why your surgeon has opted for a scatter gun approach if your wish was to get frontal coverage to frame your face. With 3000 grafts you could have solely focused on the frontal third and achieved a dense result.

How is your donor holding up now? As previously suggested another small tester procedure may be a good idea to gauge if your scalp is ok.

I’d also consult with a few other surgeons to see what they think / suggest too. Although there’s some very knowledgable people on here and it’s great you are using this as a tool you can’t beat the input of a few surgeons with 1000s of cases behind them. Theyll be able to advise better what could have happened in the first procedure.

 

 

[Hair-here]

4 hours ago, ScottishGuy21 said:

You were slick bald as you say so 3000 grafts was never going to be enough. But if you discussed this with your surgeon and the plan was to simply add some hair then fair enough.

 If I’m honest though I’m not sure why your surgeon has opted for a scatter gun approach if your wish was to get frontal coverage to frame your face. With 3000 grafts you could have solely focused on the frontal third and achieved a dense result.

How is your donor holding up now? As previously suggested another small tester procedure may be a good idea to gauge if your scalp is ok.

I’d also consult with a few other surgeons to see what they think / suggest too. Although there’s some very knowledgable people on here and it’s great you are using this as a tool you can’t beat the input of a few surgeons with 1000s of cases behind them. Theyll be able to advise better what could have happened in the first procedure.

 

 

Based on my post-op photo, do you think if it had all grown it would have been decent?  It seems like you rarely see photos of buzzed down transplants a couple years later since most guys wear it long to give more coverage, so it’s hard to know what actually survives from the original implanted density.
 

Had I known about the high NW expert docs before my surgery, I probably would have gone with one of them because they could have gotten many more grafts which was what I really needed. But a few years ago when I was researching, I guess I just hadn’t read enough consistently good things about any of them to include them in my search.  But researching now, they seem to be the commonly agreed 3 docs for a situation like mine.  

[jjsrader]

Looks like you have a big head - alot of real estate to cover.  Probably need another 3K in the frontal 40% of your scalp to get enough 'aesthetic coverage' - assuming you don't have some scalp issue that is giving you a lower-than average yield.

If you have fine/straight hair when grown out you will need more grafts and proper hair length to give you enough visual coverage to frame your face properly. 

Edited April 18 by jjsrader

[Melvin- Admin]

To be fair, this looks like 3,000 grafts on this large area. 

 

There are some patches that look like subpar growth. But its not a total failure. I think the problem is there wasn’t enough grafts placed in this area. 

I had a podcast with Dr. Pittella, he talked about a case that looked relatively minor in comparison to your case and he required over 6k grafts. I think you probably need at least 10,000 grafts. 
 

I think this might give you a better idea of what’s necessary.

 

[Hair-here]

Ok interesting feedback.

So maybe the yield wasn’t great but not quite as bad as thought?  Maybe the bigger issue is density and it should have been concentrated in a smaller area, more focused on the front 1/4th instead of 1/3rd?  

In retrospect, I don’t think I had a good sense of what the end density would be like and for sure wasn’t expecting this. I think I trusted the doctor that surgery would bring me from slick bald to “naturally balding with hairline”. And I was OK with that, I knew 3000 grafts was never going to get me anything near a full head of hair.  The balding dad with hairline look seemed better than bald horseshoe dad. I  just wanted the results to look somewhat natural whatever they were.

Buzzed it looks patchy. Any longer and it doesn’t really accomplish any real coverage and I look like the guy who has some odd scraps of hair left and should just shave his head already.

Ive been buzzing the implanted area at 0 guard to keep it slightly longer and skin shaving the sides and it looks kind of OK for a couple days.

And yes I do have a big head, so definitely some real estate to cover.

Has anyone done anything like scalp biopsy or testing for this purpose? What exactly would they be looking for or testing for? 

 

Edited April 19 by Hair-here