3 years later with dr Lam, planning on doing a second ht

[Arcticblonde]

Hello,


TLDR is I had surgery with Dr lam, and im still not really sure how i feel about the results.  The incision and donor site were handled well, and you cant really tell i had the operation, but there is some really patchy spots still. I went back and he didnt offer a discount or any recourse besides just doing a round 2, So i consulted with several other doctors. I now have a date with Dr Yaker in a few months, but before i actually do the op i want your input.  every normie i talk to says i look great and im crazy for wanting to do a round 2, but i cant wear fringe still and at times i can see the thin spots, which makes me uncomfortable.

I guess my biggest questions are:
1. When it comes to a touch up, is 2000 grafts reasonable for me you think?
2. Is a touch up easier, or is there more risk in terms of damaging the exisitng sucessfully transplanted hair? I've heard the success rate for touch up is higher.
3. my scars havent seemed to affect the density, how do you feel about my scarring?
4. in regards to Dr. Yaker, ive seen few reviews but the few ive seen with photos has been very positive.
5. Some of my hair was wire-y and curly at first which is not my typical texture. this seemed to decrease with time. is this normal? will they continue to straighten?

So heres my story, please dont judge me too hard, i ultimately just want to look ok.

background and prior operation

I had a somewhat stressful early adulthood had some level of anorexia, and as a result I think this malnourishment triggered alopecia a little earlier than i should have, around 19 or so (my brothers didnt begin balding until 30 or so, but perhaps i was just unlucky) i always liked to be more cute, so ive always had long hair, so even though i was quite self conscious of my hairline, but was able to cover it because of the length of my fringe for a while.  I tried a few snake oil solutions such as regenix and taking biotin and the like, but none of this really did anything. Eventually a doctor put me on some drugs to help it including spironolactone, (in this time, he really didnt want to put me on it because of my young age back then.)  This seemed to stabilize my hair loss and what i had grew thick again. my hair loss completely stabilized which i was happy about, but i had already some bad permanent recession which i was very humiliated by. again i already had long hair so it was ok to hide for a bit but i still worried about it a lot and found it very disgusting.

A few years later my doctors recommended i get major surgery on my head for an unrelated sinus issue.  this involved cutting into my skull.  This left a few deep scars inside my hair, but my surgeon was skillful and was able to sew it up in a way that reduced the appearance pretty well, and because some of the cutting went through my recession spot some of the bald skin was simply removed, which i thought looked good.  However, i think that the follicles in my hair near the incision site didnt fully come back, which partly was along my hairline.  so i finally decided to seek a hair transplant. my surgeon who had done my operation recommended Dr Wasserbauer of California Hair Surgeon.  But i did my research on her and was very uncomfortable with the results of some of her patients. this was in like 2020ish as well, so i was also a little hesitant to travel to San Fransisco which as you know was one of the most worst places for sick people.   On top of the poor reviews and covid, she also had very high prices, so i ended up rejecting the idea of going to her.

I'll spare the more gory photos on this one, but the most noticable thing was my part.
before any head surgery:

a while after surgery you can see its healed up and some grew back, it looks a little better than before due to the removal of skin.

but still not great

Dr Lam and my hair transplant

After some research i decided on Dr Lam. He wrote a lot of forward thinking things on transplant and was on a few lists of good surgeons, and also was not nearly as far, and while expensive i saw a few decent results.  He also said he had experience with hairline reshaping for female patients, which many surgeons mostly do male hairlines, so i figured my case would not be a novelty in that way, not a big deal but it did factor in.  The consult went well, he seemed very positive and confident.  he tried to sell me on a few other adjacent things but i mostly declined, but this did make me a little nervous. for one he has his own shampoo, and he also does PRP (which ive heard is good but i knew i just needed a transplant)

I decided to not be nervous and commit.  so i did. i was super happy at first, i saw lots of grafts do in. I didnt drink for a year after, and waited a week to cover it with a hat, and when i had to be in the sun i wore a hat.  But over time it seems not all of the grafts grew in properly.

Before transplant, if i really pushed my hair away, recession and scarring:

Directly after:


my part at 6 months (sorry for low resolution, best i could dig up):

at 1 year it got slightly better but the hair was still very wiry, i had to condition it a lot to hide this, and on humid southern days it was unruly, only in this spot:

at 3 years (current photo i used for consult
worst spot on the side thats mostly hidden:

hairline, im generally happy with this, but you can see the difference on the sides:
the wiry hair has finally subsided. its still slightly wavier, but nowhere like above and is to softened like my other hair.

if i pull my hair back you can faintly see the original scar and that the density is a little lower than elsewhere but the hairs i do have are healthy, even the ones growing from the scar. 
Its almost like there was a huge skill difference in the technicians that did the different side.  overall i think its good, but not what i expected.


donor area  looks and feels like nothing happened:


In general its easier than ever to hide, so im not really unhappy, and both my spouse and pretty much everyone ive complained to says i dont really need a round two and already look fine, but i really wish it was a little more normal looking so i could do more styles of fringe or part my hair on the other side. 

I went back to Dr lam to get his opinion on a touch up, and even checked my records and they acknowledge something went wrong with a section of it, but no one can tell me what happened, i dont recall any specific trauma or bleeding after. i was involved in an accident maybe 6 months after i had to get 2 blood packs for, but im totally fine now, i thought maybe that affected my results, or perhaps i had a period of being dehydrated in summer, but every doc ive asked says that should not have been an issue.

I asked directly about it and dr lam says the total was 2400 grafts (i had to check my records to get this number, it was never told to me and i didnt realize this was abnormal)
He says i probably had 80% survival in most areas except that really sparse left side, where it was only about 60%.  So, im obviously not super happy about that, but i mean, it is still an improvement from before, and none of my donor site is damaged really. so it could have gone much worse, i think a touch up would be good, but dr lam is not offering me any sort of discount or special plan beyond just sort of starting the process over, and with such low survival rate im not sure i trust him to go again, if this is an acceptable result to him. its not like hes a cheap surgeon by any means, he costs top dollar and has released many writings and is well known, so i know hes good, and he was quite confident a roudn 2 would produce a better outcome. I even paid and signed up, but my gut told me to not just do a repeat, so i cancelled.  but i still know i want to do a round 2, i think about it often, so i started researchign others.  One big caviat a lot of people dont seem to mention with DR lam is he focuses on hair but he does everything from filler to nose jobs so you need to read individual reviews with a grain of salt and look for photos, because he treats many people for other things.

dr lam is an excellent and knowledgeable surgeon himself, as the portion he is responsible for is good, but after much research i think the blame the lost grafts on the technicians.  i would only go to him again if i could be assured he has a new experienced team and i was doing something aggressive like this, i wouldnt do repair work with him.  his strength is the protection of the donor site, every surgeon has complimented that they cant even see where the FUT was taken from.  So i dont think he is bad, i just dont think his technicians cutting and placing the grafts are good. The nurses were also not sure accomodating of questions about post op care.  basically you are on your own with their info packet .

I will add one more little detail, on i believe my one year post op, dr lams team pretty much sits me in a room and asks me to write a good review on their computer for them. this was a little bit uncomfortable as i hadnt felt i had fully healed yet, and i never want to offend their team after all the good they have done, but i felt i never got a chance to be totally honest with my experience, so this post is a little bit of a confession, for not refusing to write a review at the time when i was not ready.  I wanted to give them a chance to examine the results before writing anything remotely negative, but now that theyve seen it and i have my records i think im comfortable opening up, since i dont think i would go back now, and everything here is honest.

Consulting and research for round 2

I'm still trying to figure out what to do next but just full disclosure, i went on to have consult with Dr Yaker, Dr Arocha, North texas plastic surgury, and bosley.

I pretty much ruled out bosley and NTPS immediately, bosley for reputation and NTPS for once again not being focuses on only hair.

I read tons of good things and got far into the process with arocha, but some thigns really didnt sit right with me. his office is just a house in kind of a bad area of houston, and he has a few stories online of him damaging the donor site and doing the incisions poorly.  many people tout him as being amazing or maybe even best in the country, but i realized that he has consultants posting for him on many forums.  Finally, the biggest red flag is he didnt ask for blood work, didnt ask for my previous transplant record, and scheduled the surgury date on the phone. the video consult was over some app called whatsapp which i had to download. further, he had immediate availability, which i think is not typical for a good surgeon, and was willing to schedule the operation on the same day as the physical pre-op, it all felt very rushed and high pressure. I have no idea how he has such a good reputation online, his work must be really good or the reviews are fake, because but his practice felt incredibly unprofessional, it was hard to believe this was the place everyone spoke so highly of online, so i decided to follow my gut and not to go with him.  He also kept my deposit despite cancelling over a month in advance, not a big deal but its all a little sketch, as i never signed even one document before they wanted payment.

Of course i looked into Wasserbauer again but the independent reviews speak for themselves, despite all her accolades she just seems to have a lot of unhappy patients and i cant justify the price for that kind of risk.

I had a consult with dr Yaker who is also in the same city as dr lam.   he seemed pretty understanding and professional, and even seemed hesitant to take my case at first, but after explaining in detail and looking at my records he changed his mind.  IT was very low pressure and the fact they wanted to see all my documents from dr lam and bloodwork before made me feel they actually took my case seriously.  But, I have found few reviews with photos from him.  What i have seen has been ok, and he seems a lot more meticulous and realistic, so right now im planning to go with him in august.  he thinks only around 1800 more would be all i need, which i think would be ok.

if anyone has a recommendation for someone else i can look into I dont mind travelling but i dont want to leave USA.

conclusion

 im most nervous about damaging the hairs that were OK or simply losing another percentage of donor hair, i think i probably lost around 400-500 hairs. having someone with experience with female hairlines would be good too, and not having wiry hair appearance again (which i believe simply means having technicians as long experienced as the doctor himself, which dr yaker seems to have)

In your opinion, what do you think of my result? am i right to seek a second operation? am i being unrealistic and my results were ok?  I just need a sanity check, i feel a little bit alone in all this, as much as i place in the hands of my doctors, i always feel i cant fully trust them and often feel pressured into doing more.  I'm a little afraid of moving forwards, but i really want to do all i can to look good, so people go easier on me.  hopefully you can at least understand my motivations.

I'm a little nervous to post publicly as i might get recognized, but i suppose anyone who knows me already knows i did this.  If anyone related to my care sees this and is offended, know im not upset and i think the work of dr lam was mostly good especially the incision, i just wanted more done, and i just want to make the most informed decision, because a second op is already one more than i want to do, i want it to go perfectly, so i dont have to feel so compelled to go back to the OR table.

also sorry for the long length of my post.

FTR, these are all worst case photos. the way i wear my hair normally i can hide it, which is why everyone thinks im crazy when i say im doing another hair transplant. but you see i have to have fringe and i would like to be able to do things like pin my fringe up with the rest of my hair in hot summer or when i am working without the patchy spot.   
Down:

tied up:


thank you for any future help and i appreciate any input you may have for me,
if you are reading this in the future on your own research, i hope for your good results.

 

 

 

 

[Arcticblonde]

the 6 photos at the end i didnt mean to include,but cant remove it. sorry about that.

[1978matt]

Hi, maybe get an opinion from Dr Sahar Nadimi at the Chicago Hair Institute.

I had my own HT's with her mentor, so I'm sure she is good.

[Arcticblonde]

Thanks matt, it cant hurt for me to do one more consultation while i wait.  her work looks pretty good, and doesnt look to be much more costly than what i am planning on paying for yaker, but shes got more reviews.  Ill ask for a consult and see if she would be hesitant to take me and what the wait is like.

[Al - Moderator]

9 hours ago, Arcticblonde said:

the 6 photos at the end i didnt mean to include,but cant remove it. sorry about that.

 

I updated it, but I may have deleted a few good pictures. It's hard to do from a phone.

 

[Al - Moderator]

I'm trying to follow this. Is the non growth in the same area where the scar from the previous surgery was? Or is it in a different place?

 

[Arcticblonde]

1 hour ago, Al - Moderator said:

I'm trying to follow this. Is the non growth in the same area where the scar from the previous surgery was? Or is it in a different place?

 

no, see the scar is that white line. the hair seemed to be fine on the scar. the area where it didnt grow wasnt scarred at all, it seems like a few spots were the density is just not as high, below the scar on the left and a smaller spot just above the scar on the right.

 

stangely it seemed to grow fine right in the scar, where i was told it wouldnt be able to grow. so that was good  as i said, not all bad. just need a touch up i think, and dont want to hurt what i have.

 

 

[Steeeve]

I’ve had 2 transplants with Dr. Arocha which I’ve documented/currently documenting here and I’m extremely happy with my results so far. His clinic is a 2 story office building surrounded by restaurants and shops. It is most certainly not a house. 🙂 I’m from Houston and that part of town isn’t unsafe at all. I mean, there’s a Trader Joe’s literally across the street.

I’m not saying any of this to talk you into working with Dr. Arocha, however, I do think you should take lots and lots of consultations with as many docs as you can.

What little I’ve seen of Dr. Yaker, while positive, just wouldn’t be enough to make me pull the trigger. I wanna see A Lot of results by whatever doctor I choose. I have also seen a few negative reviews. 

Dr. Nader in Reynosa, Mexico is an excellent option. His costs are low and his many patient reviews on this site are, like, 98% positive. He can be difficult to get ahold of, though.

Dr. Nadimi as stated above is another really excellent option.

Dr. Gabel out of Portland, Oregon.

My assumption is that you’re not looking to travel over seas.

I will say about Dr. Arocha that he is extremely meticulous and very hands on during the procedure. He does pretty much everything except graft placement, however, he is constantly in the room overseeing the procedure while graft placement is happening-I realize you feel like that’s an issue, though. The team really takes care of you. It’s almost like a spa day. 😂 Seriously, though. 

Whomever you chose I hope they get it sorted out for you. Good luck!

Edited Friday at 06:53 AM by Steeeve
Grammar’s always terrible

[Arcticblonde]

yes i do not feel comfortable leaving the usa. Nadimi might be a good option, ill talk to her but i do feel pretty comfortable with dr yaker and his staff so far, of everyone ive talked to.

do you know if nadimi does FUT ?

[Steeeve]

3 hours ago, Arcticblonde said:

yes i do not feel comfortable leaving the usa. Nadimi might be a good option, ill talk to her but i do feel pretty comfortable with dr yaker and his staff so far, of everyone ive talked to.

do you know if nadimi does FUT ?

You know, I don’t know that she does. That’s something you could ask during the consultation. She was trained by Dr. Konior, who’s truly a hair transplant wizard, so I’m sure she’s more than capable, however, I believe their practice is specializing in FUE now. There have been a few FUT cases coming from Dr. Konior on here somewhat recently so maybe she does, too? I haven’t seen any, though.