7 months post op - looking for advice

[kajl]

7 months ago I did a live consult to check if i'm eligible for a hair transplant. I proceeded with it in Malta which probably should not have been done. After the transplant I have been verbally told around 2800 grafts were used for the hairline and around 400 for the crown. Don't have anything written anywhere.

Around 2 weeks later started having alot of concerns.

1) Unsure how the hairline connects to the temple points even unsure of angles. (Never raised with doctor) even when swelling went down i'm seeing it a little bit too low.
2) Double grafts in the hairline (when i raised this with the doctor he said he could do another procedure with 100 single grafts)
3) donor area patchy when cutting hair a little shorter. (raised with doctor but said looks ok)
4) Too many grafts taken for the hairline considering my family history. (also I think i was/am already diffusely thinning) - Doctor said I'm taking medication and is fine.

5) Bumpy skin (check below comment )

Since my family history hairloss wise is very bad (every male member i know is bald apart from my grandfather who at my age had more hair than me) I don't think its wise to even try to repair this with single grafts and improve temple points (at the time I had no idea we had around 6- 8k disposition in our donors) so i had in mind
removing the curved odd connection of the hairline to the temples for now and when the time comes and I continue balding remove the rest. Today I decided to shave that area to see how it looks and like it better. To my horror though the skin is very bumpy. I had already mentioned this to the doctor around late december - 
he said it is not cobblestoning but healing skin. first he prescribed a cream called protopic which did absolutely nothing then suggested for another appointment and was going to suggest microneedling and PRP. Before doing anything else (invasive or not) I want to do further consults.

Would appreciate some honest feedback from the below pictures. This has taken a huge mental toll on my well being and these last 7 months I have been struggling professionally in what should be a high performing job.

Preop

 

 

 

 

 

Post Op - Immediate - I was told 2.8k grafts hairline - 400 - crown.

 

 

 

2 weeks  - post OP

3 weeks Post Op




Donor - 3 weeks post op

Donor - 5months Post OP

 

 

 

Present

 

Present skin (Note this area was shaved with clipper 0 guard today as sides were starting to bother me. 




Present -  diffused thining ?

 

 

 

 

 

 

 

 

 

 

 

 

Edited March 4 by kajl
removing duplicate pics

[Berba11]

Hi mate, sorry you're going through this. A few thoughts:

• Doesn't remotely look like 2,800 grafts for the hairline work
• Lots of grafts that are far too thick in the hairline and it all lacks the kind of soft, natural-looking refinements we'd hope to see. Luckily most lay people won't really know the difference
• Skin has definitely been irritated by those grafts one way or the other - possibly cobblestoning as you suspect
• Overall it's not great work, but its far from the worst case to ever pass through this forum

 

The good news is that this would be fixable. Those implanted grafts can be punched back out and even put back into the areas of your donor that you feel are most compromised. Usually punching the grafts out will also help improve or even eliminate the cobblestoning.

The bad news is that these kind of repairs are quite a bit more expensive than normal surgery - expect to pay more for the fix than the initial surgery - and can often require two or three sessions to get everything out and then get everything looking soft and natural again. The number of outstanding surgeons for this kind of repair work is a little limited. I'd recommend reaching out to Dr Feriduni in Belgium, Dr Bisanga (also Belgium) and Dr Laura & Sever at Hattingen for consultation/evaluation. If you're in the UK I'd also suggest a visit to Dr Ball at the Maitland clinic in Portsmouth.

EDIT:

Also, rather than shave off the offending corner grafts, you might find a better solution that doesn't expose the cobblestoning is to pluck out the most offensive grafts in an irregular pattern to create a bit of break-up. Definitely do not go back to this clinic for any more work though!

Edited March 4 by Berba11

[kajl]

Thanks for your reply. Just wanted to make sure this was not all in my head. 

My only problem with trying to fix this is my family history. I can maybe do 2 -3 sessions to fix everything but seeing all these grafts were wasted plus family history and to make matters worse - weak beard and chest hair.

I don't think it makes sense to continue pursuing this. If 1.5k grafts were taken from behind I think would make sense but I already feel my donor was shattered (god knows how many they transected) so fixing it would just be a temp fix 3-5 years then i'm screwed again and will be ineligible for future hair transplants because of the donor.

[Berba11]

12 minutes ago, kajl said:

Thanks for your reply. Just wanted to make sure this was not all in my head. 

My only problem with trying to fix this is my family history. I can maybe do 2 -3 sessions to fix everything but seeing all these grafts were wasted plus family history and to make matters worse - weak beard and chest hair.

I don't think it makes sense to continue pursuing this. If 1.5k grafts were taken from behind I think would make sense but I already feel my donor was shattered (god knows how many they transected) so fixing it would just be a temp fix 3-5 years then i'm screwed again and will be ineligible for future hair transplants because of the donor.

I'm not sure you've understood what I was suggesting you seek consultation about:

I'm saying you could have all of those grafts from the front punched back out again and placed elsewhere on your head (including back into your donor area), essentially resetting you to where you started (albeit with an emptier wallet). If you then wanted to just move on and allow your hair loss to progress however it will, then so be it. Here's a case in which a HT was totally reversed and the grafts put back into the donor to mask an FUT scar:

 

And here's another ongoing case of something very similar:

 

As for future hair loss... Have you considered taking finasteride?

[kajl]

Ah ok I thought you were saying to fix by removing grafts and redo the hairline with softer hairs gotcha now. 

I am currently on finasteride 1mg per day been on since feb of last year.  After the hair transplant my mental well being suffered and still is bad to this day and ended up eating junk everyday with no exercise.. and not sure if certain side effects I have now are due to finasteride or just mental + diet. I have been on fin with no side effects from feb till july which is when I did the transplant.

I am based in Malta but where I work we have in office in belgium so going there will be a no brainer. Was think of looking at Feriduni, Bisanga and Mwamba. and see what they suggest.

 

Again thanks for your help

[kajl]

And to think - I know 6 people who got hair transplants done at hair mills - cinik and serkan - all of them maybe had decent results just some thick grafts at the hairline but hairline and even their donor was spread correctly. Then theres me who tried to avoid the gamble of going to mills - got on here found a doctor (not forum recommended) but there were a few reviews and thought I was doing a wiser decision......... 

[Berba11]

21 hours ago, kajl said:

And to think - I know 6 people who got hair transplants done at hair mills - cinik and serkan - all of them maybe had decent results just some thick grafts at the hairline but hairline and even their donor was spread correctly. Then theres me who tried to avoid the gamble of going to mills - got on here found a doctor (not forum recommended) but there were a few reviews and thought I was doing a wiser decision......... 

 

Edited March 6 by Berba11
Surgeon's name removed at request of patient

[Berba11]

How are you doing @kajl? What's the plan moving forward?

[kajl]

consults with Dr Mwamba and Dr Bisanga scheduled this september. I will need to assess my options after their opinions - it looks like there was more harvesting done in two certain parts, I cannot be definitive its eiether too many extractions or hair was already miniturizing and less density in certain areas and harvesting also done there. Cutting my hair short at the back is no longer an option for me, with a guard 2 its still obvious something was done , the pattern of extraction is very evident it looks like a window in the back of my head, I was lead to believe that with fue you can still cut your hair short without things showing so this was a false expectation I had before surgery, that and also scarring. 

Bumps in the recipient area never improved, I know it sounds crazy but I am considering punching out (to remove the bumps) and putting back in my donor and lasering/electrolysis off the remaining. Downside to the punchouts is I scar very badly, they are always too hypopigmented, so I know punchouts will leave obvous scarring even though many people on here report not seeing anything I highly doubt that will be the case for me so need to see about this.

I started getting a side effect on fin and stopped taking it, currently shedding alot of hairs, wasting too much time on trying to battle the inevitable and just want to be done with it. Since my hair is really thin topicals make my hair look really flat and odd - I tried topical fin/min for a while.

[Berba11]

2 minutes ago, kajl said:

consults with Dr Mwamba and Dr Bisanga scheduled this september. I will need to assess my options after their opinions - it looks like there was more harvesting done in two certain parts, I cannot be definitive its eiether too many extractions or hair was already miniturizing and less density in certain areas and harvesting also done there. Cutting my hair short at the back is no longer an option for me, with a guard 2 its still obvious something was done , the pattern of extraction is very evident it looks like a window in the back of my head, I was lead to believe that with fue you can still cut your hair short without things showing so this was a false expectation I had before surgery, that and also scarring. 

Bumps in the recipient area never improved, I know it sounds crazy but I am considering punching out (to remove the bumps) and putting back in my donor and lasering/electrolysis off the remaining. Downside to the punchouts is I scar very badly, they are always too hypopigmented, so I know punchouts will leave obvous scarring even though many people on here report not seeing anything I highly doubt that will be the case for me so need to see about this.

I started getting a side effect on fin and stopped taking it, currently shedding alot of hairs, wasting too much time on trying to battle the inevitable and just want to be done with it. Since my hair is really thin topicals make my hair look really flat and odd - I tried topical fin/min for a while.

Remember that you can also start with a small number of test punch outs to see how things heal. You might be surprise at how nicely your forehead area heals compared to other areas. 

If you haven’t seen it already, @Paul_’s repair thread might be a big benefit for you as it seems you’re looking to do exactly what he did with Dr Ball. 

[baddecisions]

20 minutes ago, kajl said:

consults with Dr Mwamba and Dr Bisanga scheduled this september. I will need to assess my options after their opinions - it looks like there was more harvesting done in two certain parts, I cannot be definitive its eiether too many extractions or hair was already miniturizing and less density in certain areas and harvesting also done there. Cutting my hair short at the back is no longer an option for me, with a guard 2 its still obvious something was done , the pattern of extraction is very evident it looks like a window in the back of my head, I was lead to believe that with fue you can still cut your hair short without things showing so this was a false expectation I had before surgery, that and also scarring. 

Bumps in the recipient area never improved, I know it sounds crazy but I am considering punching out (to remove the bumps) and putting back in my donor and lasering/electrolysis off the remaining. Downside to the punchouts is I scar very badly, they are always too hypopigmented, so I know punchouts will leave obvous scarring even though many people on here report not seeing anything I highly doubt that will be the case for me so need to see about this.

I started getting a side effect on fin and stopped taking it, currently shedding alot of hairs, wasting too much time on trying to battle the inevitable and just want to be done with it. Since my hair is really thin topicals make my hair look really flat and odd - I tried topical fin/min for a while.

It doesn't sound crazy at all, it is actually the best choice: punching out hundreds of grafts and moving them back to donor. There are many doctors doing that on a regular basis. I wouldn't do electrolysis, because grafts are finite and by no means I would destroy them. Regarding scarring, well, each body is different but, as Berba mentioned, this area heals better than others, even more with the correct care.

[Paul_]

28 minutes ago, Berba11 said:

Remember that you can also start with a small number of test punch outs to see how things heal. You might be surprise at how nicely your forehead area heals compared to other areas. 

If you haven’t seen it already, @Paul_’s repair thread might be a big benefit for you as it seems you’re looking to do exactly what he did with Dr Ball. 

We've been in touch, rooting for you mate that everything goes well with your repair!

[Jasfor]

now what ur plan?

[Berba11]

43 minutes ago, Jasfor said:

now what ur plan?

Literally four posts up from yours... 

[kajl]

just got back from dr mwamba and bisanga - situation is not good

- Grafts taken from the back are to close together - sometimes in lines and also they went too high up in the  crown area. Dr Bisanga immediately pointed out demarcation line as soon I sat down in his office. My hair was not short during consult around guard 3-4. Dr Bisanga also pointed out I may have had permanent shock loss on grafts in donor due to blood vessel disruption and excessive trauma when examinging further. 
- Hairline hair where implanted in rows with obvious gaps between hairs contributing to a see through effect|
- Hypertrophic scarring and ridging in the recipient area due to incorrect depths the grafts where implanted.

- multis in the hairline, soemtimes even triples can be seen.

- Recipient hair in conflict with existing natural hair direction. My natural hair goes to the front and implanted hair where instantly put to the side with no transition in the corners.
- Unnatural corners left and right - both surgeons advised removal - Bisanga commented on bad directions aswell

Also during donor examination with dr bisanga - it looks like I am diffusely thinning even in the donor area. He advised oral minoxidil which should help my situation.

Repair wise 

Dr Mwamba would like to use 1k grafts bht to fix donor plus extract outside already extracted donor relocate in the donor to homogenise it better. Also would like to remove corners and put them further back and

Dr Bisanga - I am still awaiting for an official email however would like to extract a further 2k grafts from the scalp to homogenise donor and fix hairline gaps as it was done in rows. Also remove corner grafts and relocate further back. He advised that donor will never look good with my hair cut short and advised SMP.

I cannot begin to stress the mental impact this  has had on my well being and am still unsure on how to proceed. To anyone reading this please make sure you know what you're getting yourselves into. Before the transplant I used to watch videos about donor and hairline botches and thought this was not going to happen to me as I went to an actual local doctor and this stuff happened in turkey with teenage kids doing transplants. This surgery is so nuanced that you need someone with decades of experience who has seen it all. I have tried to shave it off to put this behind me but the hairline ridge/bumps and donor look ridiculous.

[Big Rome]

16 minutes ago, kajl said:

just got back from dr mwamba and bisanga - situation is not good

- Grafts taken from the back are to close together - sometimes in lines and also they went too high up in the  crown area. Dr Bisanga immediately pointed out demarcation line as soon I sat down in his office. My hair was not short during consult around guard 3-4. Dr Bisanga also pointed out I may have had permanent shock loss on grafts in donor due to blood vessel disruption and excessive trauma when examinging further. 
- Hairline hair where implanted in rows with obvious gaps between hairs contributing to a see through effect|
- Hypertrophic scarring and ridging in the recipient area due to incorrect depths the grafts where implanted.

- multis in the hairline, soemtimes even triples can be seen.

- Recipient hair in conflict with existing natural hair direction. My natural hair goes to the front and implanted hair where instantly put to the side with no transition in the corners.
- Unnatural corners left and right - both surgeons advised removal - Bisanga commented on bad directions aswell

Also during donor examination with dr bisanga - it looks like I am diffusely thinning even in the donor area. He advised oral minoxidil which should help my situation.

Repair wise 

Dr Mwamba would like to use 1k grafts bht to fix donor plus extract outside already extracted donor relocate in the donor to homogenise it better. Also would like to remove corners and put them further back and

Dr Bisanga - I am still awaiting for an official email however would like to extract a further 2k grafts from the scalp to homogenise donor and fix hairline gaps as it was done in rows. Also remove corner grafts and relocate further back. He advised that donor will never look good with my hair cut short and advised SMP.

I cannot begin to stress the mental impact this  has had on my well being and am still unsure on how to proceed. To anyone reading this please make sure you know what you're getting yourselves into. Before the transplant I used to watch videos about donor and hairline botches and thought this was not going to happen to me as I went to an actual local doctor and this stuff happened in turkey with teenage kids doing transplants. This surgery is so nuanced that you need someone with decades of experience who has seen it all. I have tried to shave it off to put this behind me but the hairline ridge/bumps and donor look ridiculous.

this is so sad, I hate that clinics get away with such work. I hope you find peace & happiness brother 

[Al - Moderator]

True repairs are hard to go through and even harder if you don't go through with it because you still have to deal with it every day. It sounds like both Drs are giving somewhat similar advice which is to remove the front corners and place those grafts elsewhere and fix the donor at least somewhat. Good luck with whichever you choose.