3000 FUE with Hair Dr Arshad and 1056 FUE Top up.

[Hemingway]

I have had my first transplant with the Hair Dr in January 2021. I was very impressed by previous results and good reputation. My aim was to fill in minor hairline and temple hair loss and advance a bit on my natural hairline which I feel is unreasonably high and I have always wanted it lowered. I first noticed minor hair loss in early 2017 or so and I have been on finasteride for 4-5 years now which halted the issue. Dr Arshad and Sommiya discussed with me how low a hairline would be realistic and I was quite happy with the placement of things.. The first transplant took a long time and I think I was at the clinic from around 7am to 9pm. The technicians seemed to have had some trouble putting my grafts in as they seemed to pop out but other than that nothing seemed to go wrong at all.

Unfortunately like several results posted around 2021 my result was quite poor. I am not sure how much of the hair grew; I would probably estimate it at 35-40%, perhaps less. The temples had a bit more growth, but the front and centre-left and centre-right areas had quite poor yield with some small areas of zero yield. I have experienced most new hair growth from month 4-6 in terms of new hair and some after that but not nearly as much. I have not really had any real benefit from it; under any harsh light it mostly bare.

These are my results at 12 months; I could only upload these highly cropped due to HD file size.




I've spoken to Sommiya at 10-11 months and we agreed to book in for a second transplantation; which is free of charge. I've had this on the 1st of February 2022. I was concerned I might need up to 1500 grafts but Dr Arshad only took 1056, vast majority he said were multigrafts for density and only some singles. We've discussed some reasons as to why things may have failed and Dr Arshad felt inflammation may be a problem as I had some prolonged redness in my recipient.

As previously, I took two weeks off work and all exercise. No bumps to the head and stayed out of the any strong wind and rain. I did have have a small amount of spontaneous bleeding both times, first time on the left temple and this time on the right. No apparent graft dislocation though.

Some differences from the first FUE;

• I've used Nizoral shampoo and topical minoxidil in donor/recipient three months prior.
• Dr Arshad did both incisions and extractions; previously Dr Hamza did extractions.
• It took a lot less time and we skipped lunch and went straight to implantation; it was done by 14:00 or so.
• Implantation itself went quite quickly as well and there seemed to be no issues with putting grafts in
• PRP given on day for recipient
• Dr Arshad also gave me 6% minoxidil and topical finasteride spray to use from 1 month onwards, which he feels should be better than the Kirkland I've been using
• Spraying every 30 minutes instead of 2 hours; I went through a lot of saline!
• Continuing to take supplements including biotin and saw palmetto; not too certain these help but I don't mind trying them as the cost is minor

Immediately post op

Day 7 after the first wash; scabs came out nicely

After about 10 days I have began to shed a lot up until 3 weeks and then it stopped. Interestingly I've noticed new hairs growing already which has not happened before. Particularly centre-right region and and some new hairs spread out places where I am sure I've had nothing growing before. It may well be the PRP and minoxidil is doing its job.

So far I am feeling optimistic given the early growth. I will update things on a monthly basis or so.

 

[Bigmac]

Hello Hemingway.
I remember your first postings on here where the advice given was to wait because of your young age. You were 23 then, and have had your first HT aged 24 which is considered young. 3000 grafts for your first surgery should have produced a better result than what you have posted in your first post.
You say that you had less than 40% growth and this may have been due to inflammation that was noted in your pro-longed post-op redness. What advice were you given about the pro-longed redness? What precautions or advice has been given this time around to reduce the risk it doesn’t happen again?
Do you have your graft breakdown from this second surgery?
4000 grafts is a lot of your donor used up at 24. Hopefully, the meds work in slowing your loss down to a trickle.
Do you know how many centimetres your hairline was lowered?

 

[Hemingway]

Hi Bigmac

Slight error with my age; I put 23 and I was 24. 25 at first transplant, 26 this time.

Regarding redness, Dr Arshad and Sommiya said keto shampoo for this. Also been advised to use aloe vera cream. Subjectively I've found the redness to fade quicker this time so far.

My hairline measured at the front was lowered just about 2cm. I had a chat with Sommiya today and also agreed to try oral minoxidil on top of the topical spray. If I tolerate the oral minoxidil well I'd consider taking it for lifetime just like finasteride.

My donor is quite above average which allowed me to do this; although I am aware of future implications if too much is taken and my hair loss progresses. I do not have a graft breakdown; I believe less than 100 singles.

 

[Philw]

I always hate it when u have a hair transplant stick to the rules of meds than after u had a transplant that u not happy with then being told to chuck topical meds etc on your scalp
Just confuses everything cos u aint got a clue whats working and whats not
Should always be meds to start off first before any transplant then if u need a transplant go for a mature softer hairline
Whenever i see people who want there hairline more forward it never seem to work as much

 

[Bigmac]

Do you have any pre and post-op pictures from your first surgery? Some showing the hairline design.
Thanks for the correction on your age.
Without seeing pictures from the first surgery it’s impossible to give any opinion on it. We can only go by your estimate that less than 40% grew which is very low yield. If I take 40% that would mean 1200 grafts grew out of 3000 leaving 1800 that did not survive and this number has been replaced with 1056 which is a shortfall of 744 grafts that was originally agreed to give you the desired result. This is a guesstimate on your 40% yield. Did the clinic not provide a figure/percentage of what they believed grew?
I do hope all these grafts survive this time round and you see benefits from the extra meds.
All the best.

 

[Hemingway]

I did not get an estimate of yield. The areas where I had transplantation were essentially hairless except for some areas into the temples where there was some recession. Essentially what you're looking at is where there was no hair before.

I am now at two months




Continuing to see a small amount of new hair which is encouraging. I would lie if I said I did not check at least twice a day for new hairs. Oral minoxidil in combination with the topical seems okay as well. Of course it's hard to say which hairs are old and which are new this time. But the couple small areas of no yield do have some new hairs. For comparison, this was two months the first time around.

Given how things were last time, I'll probably know if this is going to succeed at six months.

 

[Bigmac]

It’s good that you are noticing some new hairs popping through. Hopefully they all grow this time and give the result you want.
I looked back at your other thread. I`m glad you and the dr went for the higher hairline. Picture below. The pink was too low and straight.

 

[Hemingway]

Hi guys; now back at 3 months; click thumbnails for full images.

Hair is continuing to sprout a fair bit. No major changes as of yet but comparing to the 12 month zoomed in photos it certainly seems to be filling out a bit. Feeling reasonably optimistic, time will tell.

Not much more to add other than than that. Still taking oral minoxidil which is fine. I will ask the clinic if I could use it permanently and best place to source it.

 

[Baldingman23]

Looks like it’s coming on nicely and starting to fill in

 

[Hemingway]

I am now back at 4 months. I've had some progression, not as much as I'd have hoped for since last month. The left side seems to have caught up the right and maybe even slightly better.

The centre remains the worst with quite significant gaps. It has not progressed as much but I can see there are tiny hairs in the gaps, where as there were not any at 3 months. At the moment I am somewhat nervous with this, trying not to focus on it too much. I feel there is a chance I might need a third pass unless there is a whole lot more of new growth. Despite improvements it's still nowhere near an acceptable result but it is early.

Last time, 4-6 months where there I thought there was most improvements and I expect that really 6-7 months will give me an indication if I will need a third transplant.

 

[Baldingman23]

I think it’s filling in nicely, you are still very early days. I don’t think you have anything to worry about

 

[Follicly_challenged]

Good improvement between month 3 and 4, if that continues you’ll be pretty happy I’d say! The difference I had between 3 and 6 months was massive. Keep the faith (And follow guidance from the clinic)!

 

[Bigmac]

It is filling in more from the last update. Seeing small hairs in the gaps is a positive that new growth is pushing through. At 4 months you still have a long way to go.
Thanks for the update.

 

[Hemingway]

Good morning,

Thank you for the encouragement, I do appreciate it.

I'm now at 5 months. Two sets of photos, one in a stronger light and soft room light.





The progress seems to be somewhat limited at 5 months especially with the heavy minoxidil treatment. The gaps at front especially haven't really began to fill in. It seems like the progress from last two months has slowed. The yield generally seems to be relatively better but it doesn't really approach an acceptable level.

In truth I wonder if I made a mistake in going back. Unless next month increases my growth significantly I don't see how this can look good or even passable. It's not a done deal at 5-6 months but realistically almost every successful case I've ever seen online has had much more than this at the same stage.
Do let me know what you think.

 

[Baldingman23]

Strong forward facing light will always show up imperfections

I think it’s hard to judge at 5 months because you are not even halfway there. My first surgery most of my growth came at the 8-9 month mark, this time round it seems to be growing a bit faster. I know you here it all the time but give it till 12 months before you make a proper decision.

 

[Bobbins]

Strong forward facing light will always show up imperfections

I think it’s hard to judge at 5 months because you are not even halfway there. My first surgery most of my growth came at the 8-9 month mark, this time round it seems to be growing a bit faster. I know you here it all the time but give it till 12 months before you make a proper decision.

I agree. I think you we’re pretty slow with the 8-9 month growth spurt. My unscientific marker for my own hair is that if there are still significant gaps at 8 months I’ll start to get worried.

Edited to say; it’s dammed hard not to get worried through. Despite the above, i still look for weak points now at short of 5 months while my other half just laughs at me and tells me I’m ridiculous

 

[Hemingway]

Back at 6 months guys.

I don't really know what to say. Still major gaps, completely see through hair generally. No real significant progress from last month. I wasn't expecting a miracle but I didn't expect it would be this bad. I don't really know how to cope with this. I did not expect for my second transplant to fail.

 

[Baldingman23]

6 months is still early days @Hemingway.

 

[Bigmac]

Most patients see a noticeable difference in months 7-8-9 with some continuing to experience more growth after these months. While I understand you being anxious, you`re only at 6 months which is too early to make any decision.
If you can, try not to stress about it. Keep in contact with the clinic and hopefully, you’ll experience some nice growth in the coming months.

 

[Hemingway]

Morning all,

Thanks for the reassurance in any case although at this stage I don't have much with the current situation. 7 months today and I wouldn't say there is much change. Left side has improved a little but overall it's staying the same in my opinion.




I also have a link to my donor; 7 months after a total of 4000 grafts. Let me know what you think; I hope it has not been overly depleted at this stage.

https://imgur.com/a/h1CORxo