Balding again ??? [16th month post-op, transplant @ H/W]

Hi All

Over the last 1+ year I hardly had any time to write some updates. But, now that 16 months have gone by after the transplant (4658 grafts by Dr. Wong @ H/W), I thought I should post something.

I wish I had all positive stories and a happy face. But, these days I am starting to have doubts.

During the 12-14 month period post-op, I was very happy to see my youth coming back. But, as time progressed, during the last couple of months I started to notice visible thinning. Recently I had a consultation with Dr. Wong and he indicated 15-17% of the transplanted hair would go dormant. He indicated over the last 20 year or so, he encounter about 5-7 transplant failures. He wanted to monitor my progress.

Compared to the recorded 7th month result, the present condition (see 16th month pics) does not seem to be significantly better. Given that I had a surge during the 12-14 month period, I was certainly expecting more than what I have today. Also, I am wondering, if 4658 grafts are supposed to yield this result.

Please share your opinion/experience and comment about the results as you view them. H/W reps may not comment, only because I'd like to hear neutral comments (no offence!!).

My question basically is, "is it possible that I am balding again and I am heading for an unsuccessful transplant story" ? :confused::confused:

Thanks.

K_2009.

P.S:

:rolleyes:Currently I am taking 1/4th of a proscar 3 times a week. On Dr. Wong's suggestion, I am using Polytar shampoo twice a week and only soft soap on regular days. I had 1 session; 4658 grafts by Dr. Wong @ Hasson and Wong [H/W] on March 19, 2009.

:rolleyes:In future, I will share my detailed observations & experiences with H/W. For now, these are the only photos that seem to be shareable.

Hi K_2009

Thank for sharing your results with the forum. You have the right to feel disheartened after visiting one of the best HT surgeons on this planet and spending that kind of money. Your result at 7 mos and 16 mos looks similiar to me. Do you have any pictures at the 12 month mark as you seem to suggest that you had good growth during the time...

I dont think the number of grafts is an issue here as i have seen some amazing results from H&W with that kind of number on your level of hairloss....do you have any pictures of your scar? I have seen in the past that this clinic tends to take donor hair via higher scars which in my opinion are prone to get lost as a person looses more hair in the crown area...i have noticed many times that this clinic does not post any scar results as well in their patient results even though people have requested for the same..It is possible that proscar did not work for you and you lost some donor hair coz of the above reason..it is also possible that you lost some native hair as well....having said that, you definitely deserve a better head of hair after so many grafts..you are def better off than before but i dont think that solves the purpose and i dont agree with house of cards when he asks you to be satisfied with using concealers..that is not a solution in my opinion..i think this is a failed transplant and i would be interested in seeing if this clinic stands by its work and offers you a free transplant or some kind of refund..i would also consult some other physicians and see if they can throw some light on this transplant...Please be patient and know that all of us are here for you!!

I don't think this is a failed transplant. It might not be as dense as you like but you had a huge area to cover. I know over 4000 grafts sounds a lot but you were verging on NW 7 territory. You basically had Bill's level off baldness but he took almost 10,000 grafts over 4 sessions to get where he is today. Use some toppik and/or dermmatch and that will improve your situation until you go in for second procedure. It is possible that your new transplanted hair is going through the normal shedding and regrowth cycle.

I don't think this is a failed transplant. It might not be as dense as you like but you had a huge area to cover. I know over 4000 grafts sounds a lot but you were verging on NW 7 territory. You basically had Bill's level off baldness but he took almost 10,000 grafts over 4 sessions to get where he is today. Use some toppik and/or dermmatch and that will improve your situation until you go in for second procedure. It is possible that your new transplanted hair is going through the normal shedding and regrowth cycle.

Agreed, he had a huge area to cover but my understanding is that Ht surgeons start from the front and work backwards..but in this case please look at the hairline...you can easily look at the skin on the hairline...IMO, i would not call it a failed procedure if atleast the hairline was good but unfortunately it is not..it is easy for people to say to use concealers and all that but was this patient informed about this before the procedure..was he told that the best he would achieve is a diffused thinner look with a ear to ear scar in the back of the head!!

This is the reality of a hair transplant i am afraid.

With your level of baldness, 4600 grafts was only going to give you limited density(i have had about the same amount spread over same area).

I think we all fall into the same trap of seeing all this new hair where there once was none and get used to it,then we start to scrutinize on regular basis and before we know it "theres not enough!"

Rarely is a ht a "one and done " on a norwood 4+,no matter how good the surgeon is.

I will be embarking on no3 in the near future and am hoping that will be me finished,but i am no way expecting full density.

Look at your befores and realize how far you have come.

I wouldn't necessarily say this is a failed hair transplant, a disappointing result? Yes. Dr. Wong is one of the best surgeons in the world and I firmly believe he'll stand behind his work and he will offer you a free surgery or partial reimbursement. In my own opinion, I would stay as far way from concealers as possible (Dermmatch more that Toppik). Dr. Hasson believes they adhere to the scalp and intertwine with the existing hair, thus causing hair loss when you go to wash it out. That's what happened to me but everyone is different. Good luck!

You're not a NW 7, but you are a legitimate NW 6. For the number of grafts transplanted, I'd say your result is about average.

Does it look better, worse, or the same in person as it does in the photos you posted?

this is a tough one to judge IMO. I agree that there has been a cosmetic improvement. however, to say that this result is average is stretching it a bit. the top of his head looks very see-through. I understand to expect natural looking density with that # of grafts over a NW6 is unrealistic. but, I still think he should have gotten a little better of result than he did.

:rolleyes:Megatron

Thanks for your comments. I have added few more pics below. Some are taken by myself, not professional though (with flash on). Any more comments?

:rolleyes:Bill

I was really hoping to get your feedback. Many thanks for taking the time.

The 'feeling' of recent hair loss is hard for me to quantify. During the 12-15 month mark, a number of life changing events took place (mostly positive). Also, I assumed I have reached the pinnacle of hair growth :-(. For all these reasons I didnot really manage to take pictures and record my new found vigor. But, now that I am giving a closer look, hair-anxiety has become a pain in the butt.

I am in touch with Dr. Wong, and I am confident I am in good hands. My only anxiety is, am I heading south? How long will it take to know? On top of the loss of $$, how my appearance is going to be if I am actully loosing hair? etc. etc.

Are you aware of any examples of failed transplants for patients under similar conditions (transplant method, age, number of grafts, etc.)? I should have searched it myself, but trying to save some time ;-)

One important quesiton I have. I use hair dye once a month (L'Oreal, Clairol stuff). What is your opinion about link between dye and hair-loss??

Few more pics added, feel free to comment. TY.

:rolleyes:TC17

I think it looks definitely better in person, particularly because the frontal density is higher. Please see some more pics below (some are not very professional though, used flash).

On a relevant note, I found out hair is a wonderful thing, especially when women are around (hope wify is not reading this ). Proscar is the other side of the coin....wish someone comes up with some better drugs.

Thanks for you comment. Feel free to post more.

:rolleyes:Fingers Crossed

Thanks FC. Not only Dr. Wong is one of most reputed doctors, he is one of friendliest doctors I have ever met. So, I dont have any doubt H/W will be with me through this. Having said this, I will take the liberty to share some of my relevant observations/realities in future.

I dont plan to take any concealers for now. Everyone is indeed different. Each story is different too. TY.

:rolleyes:balody

You are right. HT is a ongoing thingy, I realized that a bit too late.

I think all transplant clinics should educate their patients more on this area, as well as on expected results. Just as a doctor would advise a patient on a matter of illness (say, for heart problem), HT clinics should lay out a long-term treatment plan that is not biased by $$ figures. Also, they should educate their patients proactively more on the associated realities (scar, numbness, medication, recovery challenges, etc.).

:rolleyes:Danielkiwi

Thanks for your comments. I am a little worried, that's all. As long as I mange to hang on to whatever I have got today, I will be happy. But, I will definitely need help from H/W, if situation arises.

Unfortunately, I dont have 12 month pics. Simply didnot manage to do that. Added some pics, including one for scar. My wife says, the scar is not visible and Dr. Wong says it healed well. Too bad, I cant see it myself :-(. Also not sure how it is going to be when I grow older.

Some new pics are added. Please feel free to comment.

I personally dont think a complet failure just took place. Rather I am worried about the future. Fingers crossed. Thanks for being with me & others.

:rolleyes:HouseOfCards

Some more pics added. Dont have 12 month pics. I dont feel like using concealers, simply because its one more artifical thing on my head. Thanks for your post.

Thanks all. Look forward to hearing fom you.

Peace !

K_2009

K_2009,

What is your age ?

How long have you been on Proscar ?

IMO 4600 grafts for a NW6+ spread over the entire balding area looks about correct for what you have acheived. It's probably a bit less than 100% growth, but definitely not a failed transplant by any stretch. I wonder why did Wong try and cover all that area with 4600 grafts ? Did you request this ?

Bobman had a pre-HT condition similar to yours, but he opted to have 4700 grafts placed only in the front third. Then he went back for a 2nd pass to address the crown. I think his approach was the most wise.

You essentially went from a NW6+ to a diffuse thinning NW2 with "see thru" hair. That's pretty much all you can expect from 4600 grafts placed over such a large area. HT surgeons are not magicians, unfortunately.

I must be looking at something different, because I see this and it looks as though if he didn't get 100% growth, then it was darn close.

The biggest issue you have is that your hair is really dark. If you were older, and your hair was white, the thin appearance wouldn't even be an issue. I'm not sure I'd do anything if I were in your shoes. Your scar isn't bad, you have a natural look, and as you age it will look better.

Why risk it?

Hair Transplant Videos hair transplant Video Page 1 - Hasson & Wong

Hair Transplant Videos hair transplant Video Page 1 - Hasson & Wong

Guys, please check out these two results from the same clinic...IMO, they have a similiar level of hair loss and no. of grafts....so what was the difference? Irrespective of that, even if the patient request for the entire head to be covered as ES seems to ask, i think it is the docs responsibility to give proper guidance and not heed in to the patients request!!!

The least this patient should have gotten was a full looking hairline and he did not get that..the doctor could have then gone back with whatever grafts were remaining!! I think that is the basis of any HT operation!!

D,

Those 2 cases are homeruns where the ball was knocked out of the park and to the moon! After 5 years of research on these boards I don't believe every patient can expect results on that level, ESPECIALLY in the 2nd link you posted!

IMO that patient 1) must have coarse shaft diameter, 2) MUST have been in the top 2% responders to finasteride, and hence alot of hair in the mid scalp and crown is regenerated native hair growing back and getting thicker, 3) must have had a higher # of 3-4 hair grafts than the average patient, so the total volume of hair may have been 10,000+ even though only 4200 grafts were listed. There's just no way IMO that all the hair coverage that patient has came strictly from 4200 grafts, and I would definitely not consider that anywhere near an "average" result for 100% growth of 4200 grafts. I could be wrong, but I think it is way, way, way above average !!

Something has to give somewhere! I think the OP could very well be experiencing the regeneration of the onset of aggressive MPB, though proscar held it in check for a little while. Look at the back of his head -- he has extremely aggressive & wide crown loss dipping way down. If proscar was working for him then by now that all would have filled in nicely. This is why I tell prospective HT patients to take proscar for at least 5 years before seeking a HT -- 10 to even be more safe!

Hair Transplant Videos hair transplant Video Page 1 - Hasson & Wong

 

 

Hair Transplant Videos hair transplant Video Page 1 - Hasson & Wong

 

 

Guys, please check out these two results from the same clinic...IMO, they have a similiar level of hair loss and no. of grafts....so what was the difference? Irrespective of that, even if the patient request for the entire head to be covered as ES seems to ask, i think it is the docs responsibility to give proper guidance and not heed in to the patients request!!!

 

The least this patient should have gotten was a full looking hairline and he did not get that..the doctor could have then gone back with whatever grafts were remaining!! I think that is the basis of any HT operation!!

K_2009

...... I feel your in good hands and they will help you gain the results you expected because you are not being unreasonable.

Thanks HouseOfCards. I do hope to receive help. But not sure what help would ease my situation. Would be glad to share my experience. Added you as a friend.

K_2009,

What is your age ?

How long have you been on Proscar ?

..I wonder why did Wong try and cover all that area with 4600 grafts ? Did you request this ?

...HT surgeons are not magicians, unfortunately.

I think the OP could very well be experiencing the regeneration of the onset of aggressive MPB

Hi EpliepticSeptic,

Thanks. I am 33. I went on proscar about a month before the procedure. I didnot make any particular request on how to use the grafts. Nor did anybody ask me. Therefore, I was under the impression that some 'default' method would apply for me.

HOwever, just before the surgery, the doctor drew a hairline and briefly discussed his plan to restore that line. The higher density of transplant at the front is reflective of that.

"regeneration of the onset of aggressive MPB".....scary scary stuff !!

Till now, I think the result is 'ok'. And I have no problem giving all the credit to Dr. Wong and his team. I am mostly concerned about what future holds for me, and if there any way of enhancing the results I have got today !!

I think that this is an interesting one.....

 

Whilst not a failure as such, I would see these results as dissapointing ....

 

I believe that if you were under the impression (due to your Dr), that this would be a one pass session, then more responsibility would be necessary from your Dr. It really depends on what was outlined and discussed pre HT. I wish you all the luck.

Yep, I could be an interesting study case, which I dont wanna be ;-) Yes, I am having a lot of mixed feelings and you guys have provided great inputs.

To be frank, I was assuming one procedure would be good for me. Why I assumed that... partly I was convinced that the 4600 grafts would take me a long distance. But mostly, I did not get any indication that more fun was inevitably on my way and it was just the beginning !

Rest of the folks,

I have responded to your comments in my earlier post. If not, I just want to say thank you, for being with me during this psychologically tormenting time. Keep posting.

After gathering a bit more info, I think I should comment on the following:

Hi K_2009

 

...... i have noticed many times that this clinic does not post any scar results as well in their patient results even though people have requested for the same.....Please be patient and know that all of us are here for you!!

I think this clinic's website has got lots of videos where the scar area is shown as part of demonstration. Also, there are lots of pictures in the web. Joetronic can definitely help you.

Thanks for your comments.

K

Personally, I think this is far from a failed TP. He has come very far and the cosmetic change has been dramatic. I do agree that a bit more density could have been expected but again, considering the area covered, I think its an average result. If the 500-1000 grafts, that I assume were used on the crown, were used on the top/front instead, I think we would not be reading this post. I would do one more procedure of say 3000 grafts putting about 1000 on top for more density and the remaining 2000 to give the crown some coverage. After that, I would move on. Again, I think the result is decent and you look good.

Congrats and Good Luck

D,

 

Those 2 cases are homeruns where the ball was knocked out of the park and to the moon! After 5 years of research on these boards I don't believe every patient can expect results on that level, ESPECIALLY in the 2nd link you posted!

 

IMO that patient 1) must have coarse shaft diameter, 2) MUST have been in the top 2% responders to finasteride, and hence alot of hair in the mid scalp and crown is regenerated native hair growing back and getting thicker, 3) must have had a higher # of 3-4 hair grafts than the average patient, so the total volume of hair may have been 10,000+ even though only 4200 grafts were listed. There's just no way IMO that all the hair coverage that patient has came strictly from 4200 grafts, and I would definitely not consider that anywhere near an "average" result for 100% growth of 4200 grafts. I could be wrong, but I think it is way, way, way above average !!

 

Something has to give somewhere! I think the OP could very well be experiencing the regeneration of the onset of aggressive MPB, though proscar held it in check for a little while. Look at the back of his head -- he has extremely aggressive & wide crown loss dipping way down. If proscar was working for him then by now that all would have filled in nicely. This is why I tell prospective HT patients to take proscar for at least 5 years before seeking a HT -- 10 to even be more safe!

Your point is well taken ES...However, i need to address another point in this case...We all talk about deceptive advertising from hairmills and other companies..To me those two results posted above are no less than deceptive advertising!! To make it more clear, let me explain

Why do clinics only post above average results that draws people into HT's...I am sure that this patient would have sent his photographs to H&W prior to posting on the forum. If the clinic in question is a truly ethical and realistic clinic, why didnt they post these pictures on the forum before the patient did? Now, i totally understand that this is a business and clinics will not post sub-par results..IMO, this is deceptive advertising as well..Here is another example to put things into perspective

A clinic like Hasson and Wong or Shapiro Medical group with two doctors operating would be performing atleast 4 surgeries in a week...that makes is approx. 240 surgeries a year..(this would be bare minimum) take an average of 5 years and it gives 1200 surgeries...Now, if we run a search on any of the forums, would you even see 10% of those surgeries..i know clinics have the excuse that patient do not send regular updates etc, but you guys tell me...what patient will not send their final pictures to the clinic to get an asessment even more when the procedure does not give the optimum result? I find it hard to buy into these clinics excuse...

Hence, to me posting these home run results that may be aided by meds, patient characteristics etc is no less than deceptive advertising!!!

If anybody else has any comment, please feel free to add

D,

I think it's absurd to expect any business to not advertise the most positive outcomes of their service. I also think you are unfairly accusing one of the best and most ethical clinics of "deceptive advertising." You obviously have not visited H & W for an in person consultation. If you did then you wouldn't be making these accusations! They would tell you honestly and straight-up what you could expect based on your characterisitics, and they would not decieve you!

I think you need to ask why is it that H & W is one of the very few clinics that even has outstanding looking results posted (in CLEAR detail) on formerly advanced NW patients ? Why is it that they are the only clinic that has a HD video section accompanying every result they post, with combs parting the hair section by section, as well as running thru the scar in the rear ? Could it be because they are so far ahead of all the other clinics when it comes to outstanding results ?

Rest assured that if ANY of the other clinics had as many outstanding results as H & W that you would see them plastered (in HUGE detail) all over the forums and on their websites. But the truth is that they just don't have the same quantity and quality of consistently great results -- period! The question you should be asking yourself as a prospective HT patient is WHY do so many of the other clinics not have very many great results to show ? And also WHY do they not have HD video in clear non-deceptive light showing the comb parting the hair all over the scalp, as well as the scar in the rear ?

As far as patients with sub-par or average results, why should any clinic be obligated to post those when you have the forum patient blogs for that ? Any really serious prospective HT patient should spend alot of time looking at these blogs. If a doctor only has a few cases from patients who do their own personal blogs, then WHY is that ?

Your point is well taken ES...However, i need to address another point in this case...We all talk about deceptive advertising from hairmills and other companies..To me those two results posted above are no less than deceptive advertising!! To make it more clear, let me explain

 

Why do clinics only post above average results that draws people into HT's...I am sure that this patient would have sent his photographs to H&W prior to posting on the forum. If the clinic in question is a truly ethical and realistic clinic, why didnt they post these pictures on the forum before the patient did? Now, i totally understand that this is a business and clinics will not post sub-par results..IMO, this is deceptive advertising as well..Here is another example to put things into perspective

 

A clinic like Hasson and Wong or Shapiro Medical group with two doctors operating would be performing atleast 4 surgeries in a week...that makes is approx. 240 surgeries a year..(this would be bare minimum) take an average of 5 years and it gives 1200 surgeries...Now, if we run a search on any of the forums, would you even see 10% of those surgeries..i know clinics have the excuse that patient do not send regular updates etc, but you guys tell me...what patient will not send their final pictures to the clinic to get an asessment even more when the procedure does not give the optimum result? I find it hard to buy into these clinics excuse...

 

Hence, to me posting these home run results that may be aided by meds, patient characteristics etc is no less than deceptive advertising!!!

 

If anybody else has any comment, please feel free to add

I was not pointing fingers at any clinic directly..and just wanted to illustrate an example. IHence, i request no one to take it personally..

I agree with you when you say that H&W is top notch and especially after you selected them after doing 5 years of research..and yes they still have the most patient results on these forums..but that still is not proportiante to the number of surgeries they do..To better illustrate

When you call these clinics for appointments, they give you an average of 2-3 months waiitng period..Which means that they are pretty much busy all around the year..My question is why dont we see a proportionate amount of results from these so called top notch clinics...

Is it because majority of the results are not worth posting on the forums? you are right when you say that clinics are not obligated to post sub-par results and why should do? but we as patient need to understand and read between the lines..