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Dr. Maras at HDC Clinic - FUE 3773 Grafts - April 5th & 6th 2021

P

Parasol

member
Hi everyone! My name is Ryan and I'm 37 from the USA. My topic may be a little bit different than most. Perhaps we can view it as a cautionary tale (hopefully one with a redemption arc!
:)
)! I had two pretty successful FUT procedures with Dr. Scott Boden in Connecticut back in 2009 and 2010, totaling approximately 3,750 grafts. Although the very frontal hairline and the left side of my hairline near the temple weren't as dense as I had hoped (Dr. Boden and I agreed I could use a few hundred more grafts), the result was all in all pretty life changing.

So of course I took it for granted, stopped taking Finasteride because I had somehow convinced myself my frontal half was mostly transplanted hair anyway, and lost so much hair over the last decade it even shocks me looking back at my post-op photos.

2009 before any surgery (my hair was pretty long then and we went with no-shave both times so these are the best photos I have)

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2011 final result, taken at my 1 year follow up after my second FUT procedure


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It's pretty crazy how quickly after these photos were taken how aggressively I lost more hair! I never looked at these photos until recently or took new ones to compare. As time went on, stopping Finasteride about a year or two after surgery, and taking no other preventative measures, it just thinned out more and more until I realized about a year ago, wow, I'm basically bald again!

Right as COVID started about a year ago, I decided to get back on Finasteride and started Rogaine foam, and began researching clinics again. This time I knew I wanted FUE, so I could get some grafts put into my strip scar, which had stretched quite a bit, while we were at it. Originally, I was thinking of going to Dr. Boden for a third pass, but when I discovered he uses ARTAS for his FUE procedures (something I decided I wasn't comfortable doing), I hit the forums here pretty hard, looking for the best in the business in frontal half scalp work and hairlines.

After getting some consults, I decided on Dr. Maras at HDC in Cyprus, and had surgery last Monday and Tuesday.

Pre-op

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Hairline and area design

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Graft breakdown


3773 grafts (approximately 300 placed in strip scar)

834 singles

1599 doubles

1340 triples (HDC didn't say whether I had larger graft units, and if so, whether they were included in this number)

2.134 hairs per graft (based on my math)

After two days of surgery

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Firstly, I want to thank my advisor @Doron Harati rep . For the last several months, no matter the time of day, no matter how ridiculous the question, he has been there for me no matter what. Regardless of how this result turns out, Doron is phenomenal and is clearly in this business because he cares about people. It feels really good to know I'll have his support through this.

I also want to thank the entire community here, for helping and comforting me along this journey. You may remember me from here:

Stretched FUT scar. Looking for advice on what to do next | Hair loss Forum - Hair Transplant forums (hairlossexperiences.com)

I also need to say....wow. The recovery has been much worse than my last two procedures. I absolutely feel 10 years older. Currently, I'm 8 days post op, and already managed to bang my head and lose a graft, and get prescribed an anti-biotic due to some poor scab healing. It's also a real pain trying to sleep when you can't sleep on your scalp grafts or your FUT scar grafts.

For those curious, right now I'm taking 1mg of Finasteride daily (and have been for roughly the last year), some collagen and plant based protein powder daily (along with eating really well and exercising regularly...though the clinic wants me to wait a month to start working out again), and just ordered some MSM tablets to hopefully help speed up the growth. I'm also currently debating on whether or not I want to begin Rogaine foam again. I'm reading different things recently on whether it's a good thing to use or not, and am a bit torn on it at the moment. The clinic wants me to wait 4 weeks to apply it again if I chose to do so, so I have some time to decide.

Anyway, I do hope to continue to document my journey here. I'd love to get some feedback on how I'm healing in my upcoming posts, and how the growth is going once it starts.
 
P

Parasol

member
When I said above that I didn’t think I was healing all that well, here’s what I was talking about.

Below are some photos from day 5, where you can see some scabbing along the temples and a bruised area in the center.


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That bruised area became this, today which is day 8, which I’m now on antibiotics for.


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I guess I’m also a bit worried about the front center hairline density (the first few rows right where and above the zig-zags are). I know this is a long process so I’m not trying to be paranoid. And I also appreciate @Bigmac 's reassurance that this is probably normal, that the grafts probably washed away due to the clinic's pretty immediate post-op hair washes, and that everything is ok. I'm just looking for other opinions on it. In my immediate post op pics, the hairline looks super densely packed. But looking at it now, and even 3 days or 5 days post-op like I posted above, it looks like most of that hair is gone and I'm not sure if it's supposed to be or not this early on.
 
Bigmac

Bigmac

Administrator
Staff member
Hi Ryan, I`m pleased the forum has been useful in your research and the support it offers. It`s good to see you made it back home safely although probably a bit tired due to all the travel. The work looks clean and refined, well until you knocked your head. Losing the graft and the knock should not affect the end result. I`ve seen many patients whose recipient areas don`t look as though they have the number of grafts transplanted due to the area being so clean and tidy. In my opinion, the grafts have already begun to shed and the healing process is well underway due to the hair washing aftercare you received. I think this transplant and the reintroduction of Finasteride will give you a great result. It`s just a shame you stopped the Finasteride after your first two HT`s.

It`s good to hear @Doron Harati rep has been very supportive leading up to this 3rd and hopefully, final surgery. I think it`s wise to take the clinic's advice and wait 4 weeks before trying Minoxidil again if you do decide to. This will allow your scalp to heal and lessen the chance of irritation.

So, be rest assured everything looks good and quite normal at this stage.

I`m looking forward to following this new journey.

All the best.
Bm.
 
Kevboy

Kevboy

Valued member
Hey Parasol been following your stretched fut thread with a vested interest. What a nightmare you had with your flight cancelled and long layovers but you made it. When I look at your hair after the 2 transplants it looks really thick and then when you started to go thin again it looks like you lost native and some transplanted grafts.
Do you think this happened because of donor hairs that were killed off by DHT? If it was, it goes to show those donor hairs are not guaranteed to last which makes it even more important to be on Finasteride. It looks like you were heading towards a nw4 plus on your before surgery pictures with HDC. I wonder where your hair loss would be if you never had a transplant or took Finasteride.
HDC results they post always look clean with no blood, just like yours. I bet this will turn out great. I`ll be following your progress on here from now on and good luck with the Finasteride, it`s worked wonders for me.
 
P

Parasol

member
@Kevboy Hey man, thanks for your support in my FUT scar thread and making your way over to this one!

I’m in sort of a unique position, where I can show you exactly how I’d look if I never had surgery or took any medication. I have an identical twin!
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So as you can see, our temples are completely gone, and the hairline is receded and thin all the way back to the crown (our crowns are thinning slightly too, but really only noticeably from the whirl forward).

Whether or not what you see on my head is 3,750ish grafts or not is hard to say. I had a decent amount of natural hair 10 years ago so it’s tough to pinpoint if I lost transplanted hair, or just didn’t get full yield, or if this is what 3,750 looks like when all the hair around it has fallen out.

But I agree it’s definitely possible I lost some transplanted hair, which is why it’s very important to me this time around to do everything I can to maintain the hair I have left.
 
P

Parasol

member
Hi everyone! I just wanted to post a quick10 day update.

I’m feeling quite a bit anxious about this wound/scab/whatever you want to call it. As the hair is starting to grow, I can see now this area has virtually no hair at all. Maybe 25% compared to the areas around it.

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I’m sort of concerned even if I do get good yield, this area will end up being bald.

The clinic and I have been in constant contact. I’m a few days into some prescribed antibiotics, and sending photos over for review daily.

At some point I’m guessing we’re going to have to get this thing off. They haven’t said anything about that yet though (the instructions are to just gently pat the area when I wash for now).

On the plus side, I’m feeling a lot better. Most of the pain has subsided and last night I finally slept in a bed again, with an actual pillow. Laying down and everything. It was awesome.
:)


The donor seems to be healing pretty well too. At least to me. I can already tell getting these grafts put into my scar was a good decision. The clinic did say that anything around an 80% yield should be considered a success due to graft survival rates in scar tissue, so hopefully we can get that and down the road I can have a slightly shorter haircut than I used to have (couldn’t really go below a 6-7 guard due to the scar being visible).
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Bigmac

Bigmac

Administrator
Staff member
Hi Ryan.
Everything looks to be healing well at ten days post op, well except for the scab where you knocked your head. I would keep the scab moist by spraying or gently dabbing with water. This will help soften it and encourage it to fall off naturally. The grafts should be fine that are underneath. I recall seeing a patient on here who posted a similar larger scab than yours and everything turned out fine. I can`t remember which user it was though.
Your donor FUT scar will look good once those grafts have grown. Having the option to cut your hair shorter will be nice.
The area where you knocked your head looks ok to me, no missing density, just the scalp showing whiter, no redness, unlike the surrounding area.
It`s good to hear the clinic is keeping track of your progress. I know how worrying it can be post op but I definitely think everything will be ok.

Sleeping normally again and minimal pain is a big plus for you. A good night's sleep really helps the body and your well-being.

Keep on doing what you`re doing regarding post op and try not to stress.
 
Kevboy

Kevboy

Valued member
That’s unreal that you have a twin who never bothered having anything done. We can see how you would have looked if you never had anything done with Dr Boden.
I think this one will restore your locks to their former glory.
 
P

Parasol

member
Has the scab fell off?
It has. Thanks for asking. It would be good to post an update on my scab, in the event this happens to someone in the future and they come here to see if it’s happened before.

It fell off a few days ago, and took a bunch of hairs with it! They didn’t seem to have any roots attached (it looked just like normal shedding), so I’m hopeful the grafts are still anchored and will grow there again eventually. Time will tell.

Here’s a shot from today, 15 days post-op.

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I do still feel like I look different than most people do at this stage of recovery. From the scab, to the hairline density, to the odd rows of course clumped multi-grafts throughout, but I do believe in HDC and Dr. Maras so all I can do now is wait and trust in the process.

Shedding seems to have started as well. When I touch my head I see hairs in my fingers. This is gonna be quite the journey.
 
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T

Techno1

member
The hairs around the area of bruising and the now dispatched scab look darker in color. I wonder if that's something to do with the body putting more energy into repairing the area and increasing the blood flow.
The groupings could be the larger grafts that will add the density. I think everything looks quite well with the healing process and I wouldn't stress out about it.
 
P

Parasol

member
The hairs around the area of bruising and the now dispatched scab look darker in color. I wonder if that's something to do with the body putting more energy into repairing the area and increasing the blood flow.
The groupings could be the larger grafts that will add the density. I think everything looks quite well with the healing process and I wouldn't stress out about it.
That’s an interesting observation! I hadn’t thought of that.

I know you can’t see it in the photos, but those “tracks” of thick hairs going towards and through my left temple are also on areas that scabbed a little bit as well. The skin still feels rough and pitted in these places.

Hopefully as I heal, and shed and time passes, it’ll all even out and take on a more natural appearance.
 
Bigmac

Bigmac

Administrator
Staff member
Hi Ryan, good to see the scab has finally fallen off. The grafts underneath the area will be securely in place. There`s still some bruising but that should not impact the growth. At 15 days you`ve retained quite a bit of the transplanted grafts, maybe they will continue to grow. This is why you have an appearance of clumps. Some hairs will have shed, making those that are still there stand out more with being somewhat isolated.

I reckon everything will turn out fine. How is your donor looking now?
 
P

Parasol

member
Hi Ryan, good to see the scab has finally fallen off. The grafts underneath the area will be securely in place. There`s still some bruising but that should not impact the growth. At 15 days you`ve retained quite a bit of the transplanted grafts, maybe they will continue to grow. This is why you have an appearance of clumps. Some hairs will have shed, making those that are still there stand out more with being somewhat isolated.

I reckon everything will turn out fine. How is your donor looking now?
Thanks for the reassurances. It’s always great to have your feedback.

I think my donor is looking ok. Still a bit thin and red, and the grafts in the scar are similarly thicker than the surrounding hair (perhaps some shock loss below the scar as well), but all in all I’d say I’m pleased with how it’s been healing. Hopefully my hair grows long enough to cover the scar before the scar grafts fall out (very doubtful but a guy can dream! :) )!

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Bigmac

Bigmac

Administrator
Staff member
Hi Ryan.
Your donor looks ok. As you say, a little thin and red until it recovers. Maybe some Biotin or MSM might help with faster growth in the donor.
When I had my sutures removed from one of my FUT procedures I used DermMatch to camouflage it, it worked well.
The hairs do look thicker in the scar. This may be they selected thicker calibre hairs to provide more density and coverage.
 
P

Parasol

member
Thanks @Bigmac . I am currently taking 1000 mg of MSM daily. I’ve heard up to 3000 mg’s is good post transplant, so perhaps I could up it a bit.

I tried Biotin as well for about 4-5 days post op, but every single day I was waking up with horrible acne on my chin and near my mouth. Looked it up online and saw Biotin can cause breakouts in people, so figured I’d give it a rest. Since I’ve stopped the Biotin the acne has stopped, but I really can’t be sure if that’s what caused it or not.

Thanks for the tip on the dermatch. I’ve definitely considered concealers and fibers to get through the ugly duckling phase. I’ll keep it in mind. If I lose the hairs in the scar soon-ish, it will look really bad at this length. Fairly certain HDC forbids stuff like this for 30 days (I’ll have to double check) so hopefully I don’t shed those hairs until then.
 
Bigmac

Bigmac

Administrator
Staff member
Hopefully, the MSM higher dosage will help with faster growth. It probably was the Biotin causing Acne with it clearing up after you ceased its use.
Yes, the DermMatch worked well but do double check with the clinic on their policy for using products post op. There are similar products to DermMatch that women use, its root touch ups and most beauty counters, pharmacies stock them. With some luck, those hairs will hang in there.
 
T

Techno1

member
That’s an interesting observation! I hadn’t thought of that.

I know you can’t see it in the photos, but those “tracks” of thick hairs going towards and through my left temple are also on areas that scabbed a little bit as well. The skin still feels rough and pitted in these places.

Hopefully as I heal, and shed and time passes, it’ll all even out and take on a more natural appearance.

I doubt you will have any issues once your scalp heals.
 
P

Parasol

member
4 Week Update

Who’s the ugliest duckling that ever lived???


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^^^ This guy.

Over the last 10 days or so, I’ve shed virtually all of my transplanted hair. Though it’s pretty clear to me too that most of my previously transplanted and natural hair has been shocked out as well. Wow, I knew enough to expect these things but man, this is gonna be quite the journey!

As you can see, the scab has fallen off, but what concerns me is not only the indent in my scalp the scab left behind (which is pretty big!) but all the other pits and craters and indents. My whole scalp looks so much like scar tissue to me, it’s actually very difficult to take a clear picture because my scalp is now very shiny.

I’m a bit concerned about the condition of my skin. Do you guys see what I’m talking about? For instance, along my left temple, you can see a bunch of indent lines where some other smaller crusts had formed in the days just after my surgery. I’m a bit worried even if hair does eventually want to grow, it won’t be able to because in my entire transplant area, all the skin just looks and feels off.

Do I have anything to be worried about with the way I’m healing?

I guess on the upside, my current state has motivated me to begin using Rogaine foam again. I had up until today to decide and the choice wasn’t a hard one.


EDIT: I just want to clarify that I may have used the term “pitting” incorrectly. I didn’t realize this was a very technical term in regards to transplants, and looking at images of it, I don’t think this is what’s happening to me.

My concern is the bumpiness and indents and the overall skin texture of my transplanted area.
 
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