Mr T's 11 month update after 3rd HT with Dr Feller

[Bigmac]

I just dont like staples, imo sutures with a two later closure is the better option.

As for another strip for you, its hard to tell from your pictures, plus i`m no doctor so cant really say.

Your doctor said you could get another strip so you most likely can, have you forwarded your pictures to him to get his opinion on your present situation.If so what did he recomend for your worst part of the scar.

Bm.

 

[Mr T]

no spoken to Dr Feller, kind of annoyed with him to be honest, it's been nearly a year and he still can't send me my pics from my last ht, yet he can post results of others who had theirs done 6 months ago...
saw Dr Lindsey when he was in London, he said fue, but at the time, I was only 5 months into my HT no.3 and he said it was hard to decide what to do...
I'm sure Spex is reading this post, hopefully he can help
)

 

[Mr T]

another strip of 1-1500 grafts, which wud be ideal if i were to have revision done also...

 

[Bigmac]

Another 1500 would be great if you can get that amount and have a revision done at the same time, as for your pictures maybe give the clinic a call and ask the admin to send them as the doc may be busy or try his uk consultant who should be able to get them for you.

You say you`ve been on Proscar since 2006, do you feel its working for you as you said earlier you think you only have HT hair left and your crown is dipping a little at the back.

 

[Mr T]

dont know if working, possibly, as back in 2007, my crown was dipping also, no change since...

 

[janna]

mars wrote:

Plus no matter how much fue you put into the scar it will still be visable when short,you will never realisticaly be able to match it to native density around the scar.

Last point im going to make on this topic is worst case scenario is after revision the scar strethches back and your back to square one but at least you have tried and you cannot have regret,no way will the likes of rahal or shapiro or h&w make a scar worse well at least 99.9% of the time.

I agree with Mars on the what to do with the scar. With limited scalp donor supply, most patients want those hairs for the top of the head not so much for the scars, especially with the degree of loss Mr. T has. Nothing is guaranteed of course but since your scars are big, it's seems worthwhile to at least take a chance on producing smaller scars. Planting into scar tissue come with it's own challenges. The tissue is very white, which separates it from normal skin tissue. It's as if you need twice as much hairs to cover but can only plant at 1/2 of what you want due to limited blood supply. You'll have to plan for at least two sessions of fue into scar tissue alone to achieve a noticeable difference.

As for how much to do on front 1/2 and crown goes down to how much donor is available. I'm afraid you'll have to contend with a low density crown as it looks doubtful that with either strip or fue that you have enough donor to achieve natural looking density throughout your head. I would advise you to take care of the frontal 1/2 and plan on using Dermatch, Nanogen or Toppiks for crown.

I saw that you are waiting for your pictures for almost a year. How many times have you contacted Dr. Feller's clinic for them? If a clinic doesn't respond to you within a week or two at the most, then you need to contact them again. Sometimes, things fall through the cracks.

If we had a patient who ended up with bad scars, we'd do their scar revision for free and take care of any lower than expected yield issues. Don't you think it's worthwhile to double check with Dr. Feller to at least get his opinion?

 

[ejj]

Hi Mr T

I have looked at your photos again , it defo looks like shockloss in the majority of the area i cant tell re laxity but i dont think any Dr would excise that area in one go , more like 2 or 3 in reality , im aware revision is cheaper generally ,however 2 or 3 FUE procedures ( possibly less ) into it should box it off ,minus the risk of stretchback , just a thought .

all the best

ejj

 

[Mr T]

Janna



My aim is to have density on the front and midddle, as my hairs are thick and black, i feel this is possible now that I have a fair amount of hair there now...

Beard hair I would test on the crown and if successful will have small session of beard hair at a time... not expecting full coverage of the crown, but enough so not to make concealers a pain to use...

Could you pass my situation on to the Docs at Shapiro and let me know what they advise please?



Kind Regards

 

[janna]

Hi Mr. T,

Thanks for your patience. I had to wait until Dr. Ron was able to break from surgery today.

First and foremost, he thought it best to be seen by a doctor for an in-person evaluation. There are many factors that need to be considered and only through a live consult will you be able to devise a good plan of action.

Since he doesn't have that luxary and going strictly by your pictures, he'd advise you to get the donor scar taken care first. Depending on just how wide the scar is, it could take one or two revisions. As I mentioned above regarding limited donor supply, he also thought it worthwhile to at least try to minimize your scar with a revision. He would not advise you to harvest donor at the same time - only excise out the scar or else you may end up with a stretched scar again. Having said that, he mentioned that you could try to harvest donor at the same time if you are not worried about the scar and the laxity was good in the donor region. So a great deal of what to do next depends on what bothers you the most and what you'd like to achieve. Once the revision (s) are done - then you could go FUE or strip depending on laxity.

He also didn't think beard hair only in the crown area would look natural enough. He'd advise mixing it with scalp hair so that it doesn't stand out. This depends on how coarse your beard hairs are once grown out in the crown. Your plan of doing real small "test" sessions is a good one for the crown.

 

[baldasabadger10]

[align=left]Hi there Mr T,

I'm a little confused and am having some trouble understanding your current situation so please excuse my thickness.

Please let me explain why i am baffled. I have been a lurker on this site and on Stophairlossnow for years, therefore i have followed your progress for a long time now and have read many of your posts before over the years.

The reason I'm stumped is because i read your original thread on this site before and am now left wondering what happened to the hair that was put into the crown?

Did none at all grow?. I hope you don't find me rude but your post op crown pictures look worse than your pre op crown pictures in my opinion.

Sorry if i sound thick but i am confused as hell.


http://www.hairlossexperiences.com/view_topic.php?id=358&forum_id=3&jump_to=3499#p3499

I too would also love to see your post op pictures from your past Dr. I would contact his UK rep if in your shoes.

Regards.
[/align]

 

[Ryth]

Hey Mr. T.

Let me give you my opinion since I'm in a similar situation and just had a scar repair.

I had a bunch of other strip surgeries back in the mid 2000s that left me with a nasty scar from ear to ear due to the doctor not taking out high enough and another doc taking from the same area and making it worse. I also had a certain doc in NO VA try to repair it and he didn't do much to it (IMO he made it worse).

I just had surgery with Dr. Ron back in October just last month and we are doing a 2 part repair. Sides (from ear to back side on each side) in 1 surgery and the back middle in other. The scar is a tad smaller then yours but in parts is 1/2 wide and goes ear to ear.

Using this as an example (line being scar)

Ear <------------------------------------------------------------> Ear

First surgery I just did was taking out the scar from the sides (like below)...leaving just the back middle for the second repair.

Ear < Remove Remove ----------------------- Remove Remove > Ear

Dr. Ron and I both decided (and from my experience with ear to ear stitches), that it is better to take it out in 2 pieces because you aren't putting tension across the whole back and sides. I strongly suggest during a scar repair in 2 parts or even 3.

It's been a month now and I can tell you the following.

1. IMO, staples are the way to go. I just had my first staples ever with Dr. Ron and my lord I cannot believe at the 1 month mark how GOOD my scar looks. I know scars can widen later but right now, there is no widening, no redness, no nothing....but I think there is another reason for that...which is....

2. Dr. Ron used 2 things on me. #1 One was a substance called Vitrase which he used to help with the scar revision. Janna can explain it what it does but from my understanding it helps with making the repair less tight. #2 He also used ACell in the closure and I swear on my life, my scar at even 1 week looked like it was almost fully healed and more like a scar from 6 months out, not 1 week. After 1 month, all that is red is some of the staple holes and a minor faint redness in the super skinny scar line.

Dr Ron and I decided to leave the staples in longer also. We left all of them in for 14 days and took half out at the 14 day mark. Then we left them in for another 7 days and took the rest out on the 21st day. I think in scar repairs you have to leave them in longer. He said I could have taken them out at 14 but told me if I could deal with them for 21 days, then to keep them in. I think it made a big difference because I don't have ANY tightness and I feel the rest of the scalp stretched and not the scar during those 21 days. I can also tell you that I like staples better. I never itched at all with them and barely knew they were there after the 5th day.

I also feel that stitches cause shock loss and stretching from experience. Having the experience now of multiple stitch closures (tri and all) and now staples, I would NEVER go back to stitches. That's just my opinion.

I would avoid Feller. I got a bad vibe from talking to him.

Go see Dr. Ron and Im sure he can help you. Im going back in Feb/March to have my middle back part of the scar removed..and Im chomping at the bit because again, I cannot stress enough HOW GOOD of a job Dr. Ron did..and yes it's only 1 month, but I never felt or had a scar look this good at 1 month. I would also suggest thinking about the Vitrase and ACell...I'm literally floored at how well my scar is healed..and it has to be the ACell. I also ate really really well during the 2-3 weeks and ate lots of healthy foods and proteins and avoids most fatty and bad foods. I think that helped but again that is just my personal opinion on the food (but some say protein helps scars heal faster).

Janna knows who I am. I've probably talked her ear off about how good my repair looks so far and she's probably sick of talking to me. And Janna and Matt are the best. Go to Shapiro...you won't regret it.

 

[Mr T]

Thanks Janna

Sparta - do you have any pictures you could show me?

Regards

 

[Ryth]

Yah, let me get my pics I took of the sides before hand that I sent to Janna for a consult and then I'll take a new set of pics of the sides now at 1 month. It's like night and day. I prob wont get to it till Wed or Thurs.

My only regret is not going a tad lower (like a few mm) and getting out some more of the diffuse area but we we're playing it safe and just removing the scar only. We're going to go back and put grafts in those areas later after the 2nd repair.

 

[janna]

Using this as an example (line being scar)

Ear <------------------------------------------------------------> Ear

First surgery I just did was taking out the scar from the sides (like below)...leaving just the back middle for the second repair.

Ear < Remove Remove ----------------------- Remove Remove > Ear

When I saw this part, I knew who you were. You should put that in your signature....lol.

Since you're posting, it might be a good idea to start your own thread "Scar Repair"so all others can find it easier after you post pics for Mr. T. I know there are many scar repair cases out there.

We're all thrilled your scar is healing up so well. I think ACell and Vitrase has a lot to do with it too for repair sessions especially, however, these applications are not used on majority of our strip cases. The scars are coming out very nicely so the technique our docs are using plays a huge factor in the outcome as well. I spoke about Vitrase recently on this site (Aaron1234 thread). You are correct, it makes the closure less tight.

Thanks for posting and speaking about your experience.

As for Mr T, you really have multiple surgeries ahead of you whether you go the revision/strip and/or FUE route and you live really far away from SMG and also have a busy work schedule. There are great docs near by so hopefully you can achieve your goals without adding on the time and expense of going so far for repair work. I know you wanted to stay closer to home when you began posting here. Having said that, we'll always address your questions or concerns if you have any for SMG.

 

[Mr T]

Janna



To get the best possible outcome, i'd consider coming to the US



Could you kindly pm me details of possible dates, costs, etc?



After seeing photos of Sparta, I will give Shapiro some consideration also...



You mentioned other doc's nearby who do just as good repair work, who would they be?

Do they also use ACell and Vitrase?



Regards

 

[Mr T]

As you all know, i'm in talks about my situation with a lot of top doc's, including Dr Feller and Spex



Here is what they had to say, and in all honesty, I can agree with their comments 100%






mrt,




This is the first I've heard of your concerns about your scar or results. Spence did mention you were seeing Dr Rogers for PRP and considering a scar revision but this

was a few months ago.As you may recall, I told you that flexible skin such as yours is both a blessing and a curse. A blessing in that you can grab more hair out of the

donor area in a sitting, but a curse in that the skin will always stretch far more than the norm as the scar forms. We discussed that in detail prior to your last two

procedures and I remember it well as patients like yourself come to us from time to time.



Unfortunately, as predicted, your scar stretched. We had already discussed the benefit to risk ratio and you felt it was worth risking a wider scar for more hair on the

top and hairline. Many patients with very loose skin choose this option. I gave you the option not to have the procedure and return your deposit since you didn't have

the benefit of an in person evaluation prior to surgery day, but you wanted to go for it.



I would strongly recommend that you allow your hair to grow out to enjoy the maximum benefit of the transplants. In the photos the hairs look rather short in both

donor and recipient areas. Hair transplants are about illusion and proper hair length is critical to maximum coverage.



I do not have photos of your last procedure here as my computer network was hit with a computer virus which necessitated the replacement of several machines

and hard drives. I believe the photos of your last procedure were lost at that time. Any pictures you may have taken on your own after that procedure would be

appreciated.



As always, my door is open to you.



All the best,

Dr. Feller


MrT,


I am sorry to hear and see you are unhappy. I would have hoped you could have discussed more specifically your concerns with me directly over the phone rather than reading it online, but non the less.
I did try to make contact with you last week and offer to meet you in person when i was in London. Last correspondence we had via email you were going for PRP and considering Rogers for revision due
to the Cheap deal he could offer you. I believe Dr Feller has replied to you asap via email last night and explained about your pre ops pictures which you know i would have sent to you if i could have a long time ago.
( looking at your old topic however clearly shows your crown situation pre op 3rd session)

I have always tried my very best to communicate and reply to you at all hours of the day /night over the last 5 years and help and have always replied to you in a timely manner.
You have my mobile and i would have hoped you could have always picked up the phone and called me.
I appreciate the scaring has got you down but as i believe was mentioned in your pre op consult with Doc Feller the day of your 3rd session there is always the risk of
scaring the more surgeries you have especially considering your stretchy skin as noted and discussed prior to the session.

I remember much correspondence btw us also over the last year about your continued shedding / loss of native hair which also was getting you down and creating much anxiety which
i honestly feel could be playing a heavy part in this result you are displaying. ( Further native hair loss)
Your hair now is very shor[/b]t too - If you were to grow it out longer then i think your illusion would be much much better as your pics show with longer hair and you would see truer benefit of the last HT even
though you have lost further native hair. Also looking at your pics after your second session and now there is definite growth in the crown. See pics.

Often these topics can go off topic to serve certain agendas.My phone is on all day everyday feel free to call me. Happy to meet you in London next week also if you wish as I previously offered.
I hope you can spare the time to allow me to meet you and discuss and even take some clear pics for the doc who as always will only want to help.

Regards
Spex

 

[Mr T]

All i'm wanting is advise on the best thing to do regarding my situation

I'm not on here to have a slanging match, just want advise and help, if you can do that, please comment, if not, please save it for another post

Kind Regards

Mr T

)

 

[baldasabadger10]

Hi Mr T,

The pictures you posted from the email above are very misleading to me sorry.

To clarify please have look at how your head is tilted backwards slightly to make the crown non visible in the post op email pictures.

Then take a look at your own thread on here

http://www.hairlossexperiences.com/view_topic.php?id=358&forum_id=3&jump_to=3499#p3499

It clearly shows that on picture eight in your own thread above, that the crown is still very thin indeed post op, which wasn't shown at all in the email.

There needs to be some clarification as to what is Post Op and what is Pre Op.

In the email you posted, the pictures of the bald crown say Pre Op, but on your own thread in the link it clearly says Post Op.

I don't want to get into a big dispute about your situation, but if it isn't 100% clear it's very hard to offer advice.

Best

 

[topccat29]

Mr. T it looks like the clinic was bending over backwards in both advising you and trying to correct your current situation. You probably should have been much more careful in the wording of your initial post. If they in fact told you about the laxity and the possible consequences than what more could you ask for. At this point you need to bear the responsibility which you might already know. It €™s also a good reason why a scar revision would probably be another gamble and not a good idea.

At some point you need to look more towards what is possible and realize it very well may not be perfect.

 

[janna]

Baldasabadger,

That post op pic of the crown in the link is from 2009. Mr T has since gone to address his crown 11 months ago so now that same crown pic is considered pre-op to this last procedure. Mr. T has had 3 procedures so 12 months after a procedure, you can post a pic as post op but that same pic would be considered pre-op right before the next procedure. Hope that makes sense.