Bertie

Bald class: 3V

Procedure 2

Second HT with Ron Shapiro I have just had my second HT with Ron Shapiro. I had my first HT with Ron Shapiro in July 2013, which consisted of 3632 grafts. This greatly improved my hair’s overall look, but frustratingly I still had thin areas at the temples and crown. Ron had implanted most of the grafts in the frontal core of the head, explaining that this would enable me to brush my hair down to cover my temples, which would work with my fringe hair style. I had hoped, perhaps naively, that a single transplant would attend to all areas, but I understood why he gave priority to the frontal core area; the result looked very natural. However, I now wanted more and fortunately had enough donor hair for a second op. I arranged my HT at the very beginning of my long school summer break; I’m lucky in being a school teacher as I have 7-8 weeks time for the HT and recovery. I flew out (from Heathrow-London to Minneapolis) for my HT scheduled for Mon. July 13, staying in the same hotel as for my previous op., ‘Country Inn and Suites’, which was very comfortable and situated only a 10 min walk away from Shapiro’s. However, on the day of the op., I awoke with an awful migraine. As a frequent migraine sufferer, I knew it would stick with me for the whole day, and the thought of having my head operated on during a migraine was daunting, to say the least! Nevertheless, having flown half way across the world, I couldn’t allow myself to be put off by mere illness and decided I’d just have to tough it out. Fortunately, Ron and his staff were very understanding and when it became clear how ill I was, my HT was shifted to Wednesday, the day before I returned to the UK; luckily, I’d arranged a four-day trip and was very grateful that Ron adjusted his timetable to fit me in. As expected, my migraine lasted only a day, and on the next day (Tuesday) I visited Shapiro’s to discuss my HT requirements. The discussion, which continued during a photo session, lasted over an hour. In addition to work on my crown, we discussed my wish to have more hair at the temples to give me less of a receded look. Ron explained how he would bring the temporal hairline forward while also building up the hairline, but emphasized that I didn’t need to have it brought forward very much; to illustrate this he showed me pictures of male models (including David Beckham), to show that there is typically a straight line from the front edge of the side-burn to the ‘temporal point’ (top edge of the temporal hairline). I also pointed out that I’d like to have the option of parting my hair on the left side, and remarked that I had some thin areas at the side where I would part my hair. Ron said it was common for men to have thinness in the side ‘allies’ stretching up to the crown and said he would insert grafts in these areas if he saw any gaps (especially on the left side where I parted my hair). We also discussed ACELL, which he recommended, and I agreed to have. He then drew in his proposed hairline which I was happy with. I had the HT operation on Wednesday 15 July, and everything went smoothly, with little pain or discomfort. I was quite concerned about my back as I’d had recent problems with a herniated disc and thought that lying in one position for so long could aggravate the problem. For this reason the nurses gave a me a few Valium pills, which made me sleep through most of the operation. After the op. I was pleased to see that much of my frontal hair remained (vital to help disguise the op) and that the hairline and crown looked good. I made sure that I applied ice to my forehead as I’d swollen up a lot in my previous HT. One of the nurse also placed a plaster band across my forehead, which was supposed to help against swelling; fortunately, I didn’t have any swelling on this occasion. I also slept quite well considering, although the staples were quite uncomfortable until I had them removed 12 days later. I visited the clinic on the following day for a hair wash. Later in the day, I caught the 10pm flight back to London-Heathrow. I had no problems whatsoever, and was able to apply the ATP solution in the plane’s toilet and also ice my forehead with a bag of ice provided by the plane staff.

Bertie

Bald class: 3V

Procedure 1

2 years hence: Planning a second transplant op with Ron Shapiro I chose to wait for my hair transplant to mature completely before updating this blog. Two years on from my op with Ron Shapiro, I am now planning a second procedure with him, having booked an op. for July 13, 2015. I am posting up photos of my hair taken at monthly intervals from after 6 weeks. The pictures tell their own story, but I do judge the transplant a success and am grateful to Ron Shapiro for improving my hair. I am pleased that the general thickness in the central area is much better than before my op. However, I am disappointed not to see much improvement at the sides and only a little difference at the crown. I had hoped to have only one transplant. It's quite a thing to have to go through another transplant, but I understand that it's common for patients to have a few transplants before they are happy. In the pre-op discussion, Ron advised me not to bring the hairline down at the sides, saying that the increased thickness of hair would address my concerns. Had my hair grown thicker at the sides, I may not be considering a second op., but unfortunately the area is still thin. The overall look is much better as I can comb my now thicker hair in a fringe over my thin areas, but this means that I need to keep my hair quite long at the front; a shorter haircut reveals the temple recession which is not flattering to my rather long face. I also had a consultation with Victor Hasson last November, who offered very helpful advice and suggested a treatment that would involve adding another 2500 to 3000 grafts (including 500 in the crown). I seriously considered Hasson as an alternative to Ron, but eventually decided to stay with Ron for the second op. Ron says his main concern in the first op was to address the central area and core, and he thought that bringing down the hair at the temples would risk sacrificing density in the central area, leading to a more see-through, unnatural look. He now proposes to bring the temporal hairline forward, to have a slightly less acute angle going back to it and to start the bend a little further out. This will also involve building up the hair a little more in the area right behind this. I’m having the op at the beginning of my summer break, and as a teacher am lucky to have about 7 weeks before needing to go back to work. But I want to keep this HT a secret, so wonder how I’ll look after the op. I don’t think I’ll need to shave down this time so can comb my fringe down  to hide the work done, but I’m not sure how effective this will be. As my crown will need to be cut short (or shaved?) to have about 500 grafts inserted, it may mean the whole hair will need to be shaved, so I may end up looking like Friar Tuck! Last time I suffered a lot of shock loss, and it took 6 months before I felt OK to go out without a hat. That was tough, and I hope I have a much easier experience this time round. I’d be interested in anyone’s thoughts, especially those who have had a second transplant with work done mostly at the temples and crown, as I’m about to have.

Bertie

Bald class: 3V

Procedure 1

9 weeks and 2 days This is the week I have to return to school, where I can't wear a hat and my hair is on view to everyone. I have grown back about an inch of my own untransplanted hair since the HT, which is what I'd anticipated. Unfortunately, at least half of my untransplanted hair seems to have gone missing, leaving me looking substantially bald at the front (compare today's pics to my pre-op pics). I knew I had a 20% chance of getting some shock loss and unfortunately the dice have not rolled as I'd hoped. Unlucky, eh – shock loss is quite shocking! I've used Toppik to cover as much scalp show-through as possible and it's quite an amazing product, but the contrast between pre and post op is still profound, like I've been thrust forward by at least 5 years to see how bald I'd have become had I not gone for a transplant, the very thing I wanted to avoid and a bit of a nightmare scenario. I've been getting quite a few comments and double-take glances. One teacher asked if I'd had some kind of accident, and I must admit it does feel a bit like that. But I do realise that shock loss is quite normal, so I just have to get through this period as well as I can. If cornered I'll say I'm suffering from temporary hair loss – or telogen effluvium, which sounds impressively medical as well as being actually true – and hope that my hair will soon start to grow. It's supposed to be about 3 months before the new hair starts to grow so hopefully not too much longer to wait. But it also takes about 3 months before hair lost to shock loss starts to reappear, so when I do start getting new hair it may be difficult to know if it's tranplanted hair or simply my own untransplanted hair growing back. I just want to see any hair growing back. I feel like I'm waiting for the cavalry to arrive!

Bertie

Bald class: 3V

Procedure 1

Pre op Pre-op stage: I had a 'brush down' rather than a 'comb over' style to disguise my thinning hair, which worked quite well. I still had a reasonable amount of hair – arguably too much to consider a hair transplant just yet  – but with continued thinning and temple recession the brush down style was becoming less credible. I also reasoned that having a hair transplant before baldness became really noticeable would make for a smoother transition, whilst saving me the embarrassment of having to own up to a hair transplant at a later stage. After much research, I decided to make the trip from the UK to USA to have a hair transplant with Ron Shapiro. Being a school teacher, I thought that my 8 week holiday would probably be long enough to grow back enough hair to ensure that no one noticed my hair transplant on returning to school in September. I was told about the 20% possibility of some shock loss which could make me appear 'slightly bald' for a short period, but I was also told that this would probably be temporary and be more than compensated for once the new transplanted hair grew. The shock loss prospect was worrying but the chances were 80% of not getting any, so I decided the risk was worth it.

Bertie

Bald class: 3V

Procedure 1

Day 1: Surgery With Dr Shapiro I turned up at Shapiro Medical Group on 8th July and was greeted at the desk by a friendly chap. I think he was called Del. Ron Shapiro soon arrived, and we discussed my hair-loss situation and the plan of action. I was thinning at the front and receding at the temples and crown. However, I was still able to create the illusion of a reasonable head of hair by combing my hair downwards, although this illusion was becoming untenable - hence my decision to have a transplant. Ron advised me to retain my hairline similar to how it was already but to fill in the areas at the temple which were beginning to cut back into my scalp. I looked as though it wouldn't be long before I had a 'widow's peak', which I wanted to avoid. As I had a lot of donor hair and good laxity, I thought that I may be able to bring the temples down more, although Ron said it would look fine as it was when the transplanted hair grew. He drew his suggested hair line on my scalp and I decided to trust his judgement. He also told me about ACell powder and it's 'possible' effectiveness in improving the scar and recovery time, so I decided I'd have this as well, although it was an extra 500 dollars. I went into the operation room - a nice bright room with a beautiful views overlooking lakes and woodland - and was greeted by lots of friendly techs. Without delay, Ron set about trimming and shaving my hair ready for the op. The only discomfort I felt was from the injections and also from resting my head on a cylindrical cushion, which I felt could have been softer. One cool thing was that they ran a vibrating device up and down my back to distract me from the injections, which was actually very effective. Once I'd been anaesthetised I felt very little, although I felt a slight 'crunch' with each follicle insertion that Ron made. Once he'd made the insertions I had about three techs working on my head at the same time planting the follicles - 3632 of them. I'd only expected 3,000 so was glad of the extra ones. During the op. I snoozed quite a lot. I started to watch a film and then dozed off. The op. went on to about 6.00 pm and Ron popped in a few times to oversee things and then towards the end did some extra work himself. I was given post op. advice - apply ice paks, graftcyte spray, take the prescribed pills and take care when placing my cap - and then got a taxi back to my hotel - Country Inn and Suites. This was good and only about 5 mins walk away. I stayed in Minneapolis for a few extra days and visited SMG each day for a morning hair wash. They also cut my hair. On the second day post op. I got quite severe swelling around the eyes, which looked a lot worse than it felt. Paul Shapiro took a look at it and told me it was quite normal and that it would go down in a few days, which it did. During my extra two days in Minneapolis I visited a huge shopping mall - 'Mall of America' and went for a few great walks to explore the lakes that I saw from Shapiro's windows, in Normandale Park. I highly recommend that other patients try this walk. The lake and woodland are really beautiful and I enjoyed a bit of bird spotting, contrasting the American birds I saw - Robin, blackbird, Great Egret, some kind of hawk, waxwing, heron - with those of the UK. Overall, I enjoyed the trip and found SMG very professional.

Bertie

Bald class: 3V

Procedure 1

11 Days: Staple removal Following a request from SMG, Zeiring Medical in Hammersmith London kindly agreed to remove my staples on day 11. This was a relief as they were a bit annoying and weren't helping me sleep, especially as we were experiencing a heatwave and it was hard enough to sleep anyway. The staples came out quite easily with little pain and I was told that the scar was looking good.

Bertie

Bald class: 3V

Procedure 1

6 weeks update My hair is growing very slowly. At pre-op I had a reasonable amount of hair which looked OKish when I brushed it down over my temples, I'd hoped that this would grow back to a greater extent than it has. I'd figured 1/2 inch per month so 3/4 inch at 6 weeks to give me a nice covering to blend in with my other hair and make a smooth transition for returning to work in 2 weeks (I am a school teacher). I think I've probably had a fair amount of shock loss. Unfortunately, my students are going to see a huge contrast to when  they last saw me as I now look substantially bald at the front. I can't think of any plausible excuse for why I would lose so much hair over the summer break and I'm afraid of whispered comments in the playground and staffroom about hair transplants and all the stigma that goes with this. I'll try using Toppik and hope that might help, but I'm becoming increasingly anxious. I really want to keep my HT transplant a secret, but I can't wear a hat at school. Could I possibly refer to some condition that's given me temporary alopecia? Are there any scalp conditions or infections that produce an effect similar to a HT in the 8 week stage. I'm OK now but things could get really awkward for me in a few weeks.  The other problem I have is folliculitis; sore bumps on my scalp and spots appearing. I visited a Harley Street dermatologist (£200 for a 10 min. consultation!) and he put me on antibiotics. This cured me for a week but now I've finished the course and the folliculitis has returned. Curiously, at least half the spots I've been getting have been in parts of my scalp that hasn't been transplanted. Just a little anxious that folliculitis may have a negative result on my HT and compromise the final result.