Hairline correction/extractions - 199 grafts @ Hattingen Hair, Switzerland - (1st Session)

[Berba11]

Hi all,

Last week on the 4th September I had an initial round of hairline extractions with Dr Laura Muresanu at Hattingen Hair in Stetten, just outside the lovely town of Schaffhausen (home of the Rhine Falls!) in Switzerland. I will be having a second surgery on the 4th December to remove the remaining grafts from the hairline that could not be taken on the first pass, as well as additional grafts extracted from the donor and placed into weaker areas of the frontal third and midscalp to bolster those areas. A third session may be required to add finishing touches and refinement to the hairline, but we will make an assessment on that in December. If you want to skip the details and head straight to some photos, scroll past this post and head to the second post!

The goal of these sessions is take the hairline position up to a slightly more mature and conservative position, more in line with where my hairline was in several years before my first surgery three years ago, which lowered the hairline too much for my taste. I won't be posting about my first surgery here, but I have a thread that people are welcome to seek out should they wish.

The issues I had with my hairline and key goals to address were:

• too low (hairline butted up right against the frontalis muscle, and some grafts moved a bit when raising my eyebrows)
• too broad (a very wide U-shape that never looked quite right from day one in my view) 
• too linear (not enough irregularities)
• grafts stuck up a bit too much across the hairline (grafts further back seem fine, however).

Once I have received the photos that Dr Sever took pre-op, I will add them to this thread to try and demonstrate those issues as best as possible. I do want to stress that my original HT did not look 'bad'. As HT's go, it was ok and served me reasonably well. However, those who followed my original thread (or seek it out subsequently) will know that I had some reservations about the shape and height more or less right away and I'd never really made my peace with it.

Consultations:

1. Last year I had an excellent consultation with Dr Ed Ball at the Maitland Clinic. He was more reluctant to do anything with my hairline as he felt that my situation was significantly better than most people who seek a repair with him. Often a patient's initial HT will be bad enough that the risk of removing hairline grafts are worth it - they would look better even if they had some scarring of blemishing compared to the bad HT. My case was less clear cut in his mind. He didn't reject me as a patient, but cautioned me along those lines which was appreciated. He also diagnosed me as having some seborrheic dermatitis resultant from my first HT and wanted me to make some progress in clearing that up before removing grafts and recommended a shampoo (Tony Maleedy Juniper Scalp Therapy) as well as a steroidal solution to use occasionally (Betacap Solution). I got great value from that consultation and appreciated his cautious approach. That said, I was a little surprised that he didn't really perceive too much of an issue with my HT.
2. Next I consulted with Dr Sever - initially via video call and then in person in London. Even on the video call, Dr Sever could see the linearity of the hairline and some of the issues with angles. I was good to know that I wasn't going mad! His initial proposal was to do only around 200 grafts to "break things up a little", rather than raise the hairline. He recognised that taking the hairline up would require multiple trips to Switzerland and dominate my life for a while and he was keen to advise against this if possible. After further discussion via email and video call (and having considered his ideas), I asked if he would take me on as a patient if I wanted to proceed with taking the hairline up. He agreed and also offered some additional ideas which included excising the hairline via strip, though advised this was more invasive and would require a second pass to add grafts to cover the scar. Naturally I wasn't too keen on that and we discussed further the multi-step plan for extracting normally via FUE over two session (with a possible third if necessary).
3. After having visited Dr Ted Miln on behalf of the HRN's onboarding process, I was very impressed by both his skill as well as his strategic mind for hair restoration and despite being keen on Hattingen, wanted to have a consultation with Dr Ted. I believed he'd have done a fantastic job and was also attracted to doing this in the UK for logistical reasons. Dr Ted offered me a consultation date at short notice and was generous with his time. We talked through my circumstances and he inspected my hairline. He noted several issues (hairline height, some multigraft hairs in the left side of the hairline as well as some scalp issues to be mindful of). We also discussed his approach to taking the hairline up and he proposed a three-step process. Dr Ted recognised I knew a fair bit about hair restoration generally and felt an approach in which we work on extracting as far as possible and liaise and communicate about how far we go in each session could work nicely. I liked this collaborative approach to the corrective work a lot and appreciated that he was willing to meet a patient at their level: some patients will know little about the process and others more, and I think it's good when a surgeon can adapt to the patient's knowledge base and formulate a plan of action around this. I very likely would have proceeded with Dr Ted but the quote came in decently higher than the others and I was priced out on this occasion.

I had also scheduled in person consults with Dr Feriduni in Belgium and some guy you may have heard of called Dr Zarev. Those consultations however are not until June and October next year respectively (and getting a surgery date would be at least another year on top for Feriduni and probably three years for Zarev), and I decided I wanted to proceed with Hattingen after much consideration after my consultation with Dr Ted. I will need to cancel the Feriduni consultation but will still take the Zarev one because getting his eyes on my donor area and seeing what he could extract will be valuable information going forward.

Surgery Day

The first session was designed to be a smaller session to remove the "biggest offenders", and to start to make inroads into the process of getting the hairline further up. After some conversation and photo taking, Dr Sever started to create a new hairline and invited me to take a look. The shape was great but not quite high enough. We made two small adjustments and again I was allowed plenty of time to analyse and think it over. I already knew going in pretty much where I felt things should be so that streamlined the process. Once we were happy, Dr Laura came to the OT and we had a brief discussion again. She asked me what it was I didn't like about the hairline, made sure we were happy and then got to work. Initially it was just Dr Laura and myself. She used a 0.8 & 0.85mm manual punch. The grafts were coming out quite easily and we were joined by a technician who collected and sorted the punched grafts. Dr Laura noted my grafts were "too perpendicular" with the scalp, but that everything was fairly straightforward. We then had a discussion about where to place the extracted grafts in light of the second session in December. We needed to ensure they were placed somewhere that we wouldn't be going into in December as she likely wouldn't be able to see those grafts only three months into their shedding/growth cycle. We discussed a couple of options and Dr Sever was called in to join the discussion. Once settled, Dr Laura made the incisions and then two technicians started placing the grafts. The whole surgery can't have lasted much more than an hour and a half.

I returned to the clinic the following two days for headwashing before flying home. Overall I'm really happy with how everything went. My hairline is narrower, more mature, a better height offering improved proportionality and things are healing nicely. Hattingen Hair is a very slick outfit, very professional and very personalised. Hopefully those positives transpire into a great result and I will update this thread occasionally to show the healing process, and then again after the second session in December.

Lastly, some quick thanks to posters who have kindly posted similar journey's that have proved a valuable resource for me in making my decision: @Tommy1991, @Paul_, @RTC, @Davy, @FormerFutureKrillin, @FortunatePatient

Edited September 12 by Berba11

[Berba11]

Post-op photos:

 

[Berba11]

Day 7 progress:

 

[Melvin- Admin]

Healing up nicely @Berba11 are you planning on getting any more procedures?

[Berba11]

12 minutes ago, Melvin- Admin said:

Healing up nicely @Berba11 are you planning on getting any more procedures?

Second session is booked for 4th December. 

[davidn]

Looks good Sorry if this has been answered already, but were the grafts re-implanted?

[RTC]

Glad to hear it! Great stuff bro, they truly are very slick and professional. I'm quite jealous that the whole thing only took 1.5 hours - mine took from 9 to 3.30pm, but mine seems to more complicated due to the way they stuck the grafts in. I'm sure you will be very happy with your new hairline 

[Berba11]

19 minutes ago, davidn said:

Looks good Sorry if this has been answered already, but were the grafts re-implanted?

They were - all 199 were reusable. 

[Berba11]

2 minutes ago, RTC said:

Glad to hear it! Great stuff bro, they truly are very slick and professional. I'm quite jealous that the whole thing only took 1.5 hours - mine took from 9 to 3.30pm, but mine seems to more complicated due to the way they stuck the grafts in. I'm sure you will be very happy with your new hairline 

Cheers mate. 1.5 hours is a bit of a guess on my part. It could have been a bit longer but not by much. I was surprised everything went so quickly/smoothly as well to be honest!

[Tommy1991]

Best of luck man, you are one of the most honest guys on the forum and I hope that transpires to results beyond your expectation as you deserve it. 
 

Healing up very quickly too, looks neat. 

[Berba11]

1 hour ago, Tommy1991 said:

Best of luck man, you are one of the most honest guys on the forum and I hope that transpires to results beyond your expectation as you deserve it. 
 

Healing up very quickly too, looks neat. 

Thanks mate, appreciate it. 

[SuperHans]

Looking forward to seeing how this goes. You're a beacon on this site to me mate. Really hope it turns out well 🙌 as you said, by no means and was your previous result bad but this should be the cherry on top! 

I am based in the UK also, your positive words about Dr Ted is encouraging. I'm reading that if prices aligned you'd have had confidence in Dr Ted for this work? 

[Rawkerboi]

I'm hoping for the best for you, @Berba11

Edited September 13 by Rawkerboi

[BaldReaper]

Good luck and thank you very much for documenting your journey

[Berba11]

33 minutes ago, Rawkerboi said:

I'm hoping for the best for you, @Berba11

 

13 minutes ago, BaldReaper said:

Good luck and thank you very much for documenting your journey

Thanks fellas!

[Berba11]

2 hours ago, SuperHans said:

Looking forward to seeing how this goes. You're a beacon on this site to me mate. Really hope it turns out well 🙌 as you said, by no means and was your previous result bad but this should be the cherry on top! 

I am based in the UK also, your positive words about Dr Ted is encouraging. I'm reading that if prices aligned you'd have had confidence in Dr Ted for this work? 

Thanks mate. 
 

Dr Ted is excellent and I’d have had no problem with him doing this work. The key to these corrections/repairs is that the extraction sites are distinct from one another, that not too many are taken in one go, that the surgeon takes their time (especially if grafts are misangled in a non-uniform way) and that the smallest punch possible is used. Dr Ted himself talked me through these things and explained how he’d approach it, including keeping a couple of different punches handy to see how small he could go and using appropriate tools for the job. 
 

If you’re thinking of going to Dr Ted then you’ll be in very safe hands, but that’s just my opinion of course!

[Paul_]

Love the new hairline shape, very smart what you did to go back through timeline photos and design it just right

You look like you'll be fully healed in no time as well!

Welcome to #punchoutclub 🙂 

Edited September 13 by Paul_

[Gramatik]

happy growing...how many grafts are you planning to implant in total? and how much did you pay in total?

[JasonElva1990]

happy growing bro ! Im on the other side,i need some additional touch up procedure fr my hairline and temples tp fill some minor gaps in beetween- can't find any of Hattingens work here. Are they good with doing hairlines or touch ups? When you did yur research,where did you look to find patient reviews of them? Anyway,good luck bro !

[Berba11]

7 hours ago, Gramatik said:

happy growing...how many grafts are you planning to implant in total? and how much did you pay in total?

Over the first two sessions it will be around 1500 grafts moved in total (donor & hairline combined) and that’s at 5CHF per graft (as stated on their website). But there may be a need for third session as well and at this stage that’s a bit of an unknown entity. 
 

My understanding is that Hattingen charge differently for punchouts since I started consulting with them a few months ago but I don’t know the details of that change. 

[Berba11]

2 hours ago, JasonElva1990 said:

happy growing bro ! Im on the other side,i need some additional touch up procedure fr my hairline and temples tp fill some minor gaps in beetween- can't find any of Hattingens work here. Are they good with doing hairlines or touch ups? When you did yur research,where did you look to find patient reviews of them? Anyway,good luck bro !

Thanks!

Hattingen are one of the most reputable & established clinics in operation. There are results on this forum and several other forums, particularly the German forums, spanning a decade. I didn’t have any problem finding results to be honest. 
 

As for their hairline… I think Dr Sever’s designs are some of the best around - lots of irregularities! - though I appreciate everyone has different taste in this respect. 

[Gatsby]

Your patience @Berba11 is going to yield a great result. 👌

[Berba11]

2 hours ago, Gatsby said:

Your patience @Berba11 is going to yield a great result. 👌

Thanks mate

[JHH]

Hey Berba,

best of luck for the repair!

I‘m new to the forum and have some personal questions. Could you maybe send me a PM (can’t do so) so that I can get in touch with you?

Thanks 😊

[Berba11]

1 month update

Nothing much to report really. Redness has come down a bit, but not totally. There's still a red hue across the old hairline which hopefully will continue to retrace over time. There's no real scarring visible - I can't really make out the extraction site at all - and as of a few days ago I've graduated to very lightly razor shaving the non-extracted hairs having previously cut them with scissors initially and then buzzed them with a trimmer. The razor certainly does a better job of hiding the stubble hairs left behind which we'll get out in December.